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Home My WebLink About480 17TH ST - Building PermitsOWNER LELAND D. KENDALL JOB AODRESS 480 E. l7th G,��ERAL CONTRACTOR �:�;�. 117-373-27 LOT INSPECTIONS - SOIL c•s w aT EF ROUGM PLUMBING PROP, SWA. LINE � NOUSE CON. SPRINKL�NG SYSTEM MISCELL�NCOUS ROUGH MEATING �NO �IR CpN01T10NING TEMPOR.RY SERVICE OR POLE UN�ERGROUNO [-j POWER � ROUGN wiRING iFEHCHES FOpr.+S STEEL NEI FLOOR SYSTEM 80N0 BEAM �j STEEL REINFORCE [- SHE�TMING fR�ME 4N0 FLRSHING L�iM1NG — IN n OUT [� f TER BROWN COnT � TUR�L, FIN�L ME�TING, VENT., REFPIG. �ND �.C., FIN PLUMB�HG. FIN�� NO WS TEST (� ELEttR�L. ciN�l a�u� mur. Fiuel DATE �p-Zg- BUILDING PERMI 31PTION of WORK Lega I i za t i o ZONE VALUEf 100 PE GROUP SUBCONTRACTOR n OWNER V DATE Z—ZII J08ADDRES8 L�80 East 17th Street BUILDING PERMIT NO. 9%1 'ERALCONTRACTOR Osmer-Builder VALUE $ �lJr�.�� oT AP#117-371-Ias�ocK TRACT Pottery Hobby Room GROUP F—Z TVPE V ZONE C—L FIRE DISTRICT 919 INSPECTIONB DATE $UBCONTRACTOR I DATE PIRMITSINu�E ER Footing Trench Foundation Forms and Gr de to G Rough Framing Plumbing, Rough to Slab Plumbing, Rough Complete Temporary Pole Wiring, Rough Heating, Rough Heating, Final F'^'0t', HOuse Sewer, St. icTank or Cesspool Lathing, In Out Plastering Plumbing, Final, Fistures Complel Plumbing, Final Gas Test Wirinu.Final �. _ JOB P� �. Sign Tag��903, � q�� COSTA MESA ANIMAL HOSPITAL TATF PERMIT ZONE 3 DESCRIPTION OF WORKElec. lOUP J TYPE IV ZONE ( PERMITS IS SUBCONTHACTOR ,.,,m� i ,,. OWNER SAWYEit� HO�JARD E DATE 7_2L_56 JOBADDRES$ LSO E,�%'th-St_ BUILDINGPERMITNO. (%'j3'jJy ��EHALCONTRACTOR Barr Remodel Service VAWE � 1�rjQ�.QQ AP 116-373-5 �oT qg s�oCK TRACT Partition & �anel per U. B. C, GROUP F� TYPE V ZONE (:'J FIRE DISTRICT ZIi'I(1 INSPECTIONS Foundation Forms and Grade to Rough Framing Plumbing, Rough to Slab Plumbing, Rough Complete Temoorarv Pole Heati Heating. Flnal Sewer, House ic Tank or Lathing.ln Plumbing, Final, Fix Plumbing, Final Gas Wiring. Final Occupancy FOflM 210 3M 10-'J� Out 0 DATE I SUBCONTRACTOR 0 PERMITS ISSUED I NUMBI (714) 754-5273 • Fex (714) 754-4856 Job Address: 480 E 17TH ST Suite: Viciniry: Parcel Number: 11737327 CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT Applicant: HOFMANN , CHARLES Address: 350 ROCHESTER ST BUILDING PERMIT Zoning: .Phone: (949)515.8822 COSTA MESA, CA . _ Zip: 92627 Owner: OON ELLY,TH I MOTHY Address 480 E 17TH ST � , - . ' ' , - . � Phone: 949-54&3794 , � C.M., CA � � Zip: 92626 ContraMor: HOFMANN FINN DEV COMPANY INC Address: 350 ROCHESTER ST Arch : Address: COSTA MESA. CA Zip: 92627 ' Phone: Phone:� (949)515.8822 License: 731034 - Eng: ' Address: PERMIT NUMBER B00-00321 77 FAIR DRIVE, COSTA MESA, CA 92626 Slatus: ISSUED Applied: 03I752000 Issued: 03I15I2000 � ISSUED BY: �Al�- Phone: �' Zip: ' � License: License: � SCOPE OF PERMIT DEMOLISH EXIST. WOODEN SHED AND REMOVE EXIST. CONC. SLAB. Plan Check: $0.00 Permit: $83.25 SMIP Res: $0.00 SMIP Com: $0.00 . Other: $0.00 Inspection: $0.00 Total: $83.25 SETBACKS MAIN STRUCTURE Front 0. D ACCESSORY Front 40 PARKING existinq: o NOTES: Rear 0. 0 Rear 0. 0 Reauired: 0 FEE SUMMARY PLANNING & ZONING Left 0- 0 Left 0. 0 Pro osed: 0 Calc Valuation: Claim Valuation: Right 0-0 Right 0. 0 Sz,soo.00 S2,soo.00 NOTICE: The work authorized by ihis permit shall compty with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period ot 180 deys. INSPECTIONS: In order for the work aulhorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inapeetlona and finel approval must be obtained. Failure to obtain inspections and final approval will result in the ezpiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPENSATION DECLARA710N: I here6y attirm under penalry oi per�ury one ol the lollowing tledarations: ' ❑ I heve entl will maintain e certificate of cronsent to setl-Insure for workars' compensatlon, as provided lor by section 3700 oi tha Lebor Cotle, for tha pertormance of the work for which Ihis pertnit is issued. � �I have and will maintain workers' compensatlon insurance, as reqWred by secUm 3700 0l �he Labor Code, tor ihe pertortnance of Ihe work for w�ich NIs pertnit Is IsweC. My workers' compensetion Insurence cerrier end poliq number ere: Cartier: Policy Number: (Th/s section need not be canpleted il fhe pemtitls velued ef ine huntlretl dWfeis (5700) or /ess.J ❑ I certily ihat in the pedortnance ot tha v oB tor which this pertnit is issuetl, I s�all not employ any parson in eny manner so as ta become su6�ec1 to the workers' wmpensation laws C lifomla, flnd egr a that I� oi become sub�ect ro t�e workers' com n tion proNsions ai Section 3700 oi t�e Labor Code, I shall lorihwith thes m i ns. � licenl Signat : Date: 3 I I S I �� WARNINQ: FAILURE TO SECURE WORNERS' COMPENSATIIXJ COVE IS UNIAWFUL AND SHFLL SU6IECT AN EMPLOYER TO CRIMINT ES ANO CIVI� FlNES UP TOONE HUNDRED TFIOUSAND DOl1ARE (5100,000), IN ADDRION TO TNE COST OF COMPEN TIqJ, DAMAGES AS PROVIDED FOR IN SECTION 3]OB OF THE UBOR CODE, INTEREST, AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I herebv eAirtn IhaLY'drrSTieereed undar orovisli �orce end eflect. Lic. A'. Coniractors Signeture: Chapier 9(commendng wl�h Sectlon 7000) ol DlNsion Ihe Business �nd�rofessions Cotle, end my license is In full Clau a / Date: � 3 [T yduU CONSTZi0CT1IIF LENDING AGENCV: ❑ I hereDy eflirm I�et ihere is a construction Iending egency tor the peAortnance of the work tor wNch Ihis permii Is issuetl. (Sec. 3097, Civll Cotle). Lentle(s Name: Lendefs Atltlreu: Signature: Date: OWNER•BUILDER OECL'ARATIONS j�� I hereb ettirm that under enal ol e u lthet:fam EXEMPT FROM TME CONTRACTORS LICENSE LAW tor the followin reason Sec. 7031.5, Business end Pmfessions Y P b' P�I !Y.. 9 ( Code: Any ciry or county which requires'e�permit to wnsWci, alter, improve, demolish, or repair any structure, pnor �o iIs issuance, elso requires the apP�icant for such pertnit to file a signed statement that he or she is licensed pursuant to the provisions of the Contrectors IJcense Law (Chepter 9(commencing with Seciion 7000) ot DMsion 3 ot the Business entl Professions Code) or Ihet he or she is ezempt therefrom an0 the basls for the alleged exempUon. Any Noletion of Saction 7037.5 by any applkant tor e permit sub�ects the eppliwnt to a civil penelry of not�more Ihen frva huntlred tlollars ($500).): � I, as owner of the Oroperty, or my employees with wages as t�eir sole wmpensation, WILL DO THE WORK, and the structure is nai intantled or offered tor sele (Sec. 7044, Business and Protessions Coda: The Cantractors License Law tloes not appty �o an owner ot properry who builtls or improves Nereon, and who does such work himselt or hersetl or through his or her own employees, pmvided ihai such impmvements are not intended or oflered lar sale. If, however, the building or improvement is sold within one year oi canpletion, the owner-builder vnll have Ihe burden of proving that he or she tlitl not builtl or impmve for purpose of sale.). ❑ I, as owner of the property, am E%CLUSIVELY CONTRACTING WITH LICENSED CON7RACTORS ta construct Ihe project (Sec. 7044, euslness flntl Prolessions Code: Tlie contrectors License Law tloes not aDPN �o an owner of property who builtls or improves thereon, and who comracts for such project with a coniracior(s) license pursuant to the Contractors License LawsJ. ❑ I em exempt under sec. Signatura: Owner ID venfied by dnvefs licanse. ❑ Ves ❑ No Business and Professions Cotle for �his reeson: Venfication ot Ownership by (type of dOCumen�, i.e. - properry tau bill or deed): Driver'S LitenSe No. Date: Expires: DIVISION OF INDUSTRIAL SAFETV VERMR CERTIFICATION: ❑ I hereby certity thet no excavetlon tNe (5) or mora feet in depih imo which e person is requiretl to tlescenq will be metle In conneaion wlih work euthorizeC by ihis pertnit, entl t�at no building structure, sCeHOlding, lalsework, or demolition or tlismantlinp �hereof, will be more ihen t�irty-si: (38) teet high. (Chap. 3.2, Carp 2, An 2, Sec. 341, Tltle B, Califarnia Adminlstrative Code). ❑ As owner-builder, I will not employ anyone to do work which woula requira a pertnit irom tha Division of Inaustnel Selery, as notetl ebova, unless such person has a permit to do such work irom ihe tlivislon. Slgneture: Date: Dlvision of Industnal Safery Permii Number: CERTiFICATE OF COMPLIANCE AND AIJTHORIZA710N OF ENTRV: I certily under penelry of per�ury �hat I have reed Ihis epplication and state �hat the information given is carrect I egree Io comply with ell state laws antl ciry oMinances relating to building construmion, and authonze representetives ot tha Ciry ol Casta Mese to enter upon the ebove-tlescnbetl property for inspection purposes. I agree not to occupy or ellow occupency oi eny building authoAzed by Ihis permit untll final inspection. CO�E M. INSPECTIONTYPE 1618 Flaotl System Finel Fire Prevention 1268 Pool Spe Final 200 Flnal Re-Roof 201 Final BIacWReteining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demditian 2atbae Q9IE It�L@ COOE I INSPECTION TYPE 206 Finel Mechenical 208 Finel Plumbing 210 Final Electrical 212 Final Fire Preventlon 220 Finel Plenning Approvel 222 Finel Site 250 Finel Builtling�Occupency r.17��Ciiii714' a CITY OF COSTA MESA __ BIIILpiNG DIVISION 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (774) 754-4856 • www.ci.costa-mesa.p.us FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER. S607-00053 i �I PERMIT TYPE B SIGN STATUS: ISSUED � OATE ISSUED: 06/07/2007 - � - "• ' ,ISSUED BY: SOK - - � �- - -�� , , . . .. , ,. • r '. �•,, JOB ADDRESS: 480 E 17TH ST CM � ;,�� Suite/Unit -,� vicinity: _ . . , � '+' ��_ ` `�• � •- SQ. FT: 0 ' - Valuahon ' . $4,450.00 , _ . .�:p�,, - t. SCOPE OF WORK: REFURBISH EXISTING5 FT. X 7 FT. SIGN FACE WITH 4 FT.'X7`FT.�SIGN FACE/NEW DESIGN AND ELECTRICAL WITH NO CHANGE TO S'fRUCTURE AND POLE LOCATION. NO CHANGE IN OVERALL HEIGHT. -, ��` ' � , . . OWNER: CA ' PHONE: APPLICANT: PHONE: DONNELLY, TIMOTHY -' _ ROBERT SMITH 949-689-8944 CONTRACTOR: ROBERT S SMITH � - � Address: 26871.CALLE ALCALAUnik � Ciry/State: MISSION VIEJO, CA ZipCode: 92691 • ARCHITECT: , , , ' ENGINEER: �. SIGN PERMIT FEE SUMMARY ,� PLAN CHECK FEE: � $72.31 ' HOURLY PC FEE: ' , ; � $0,00'�; � PERMIT FEE: ,'$1,1125 E�ECTRICAL FEE: $48:10' SMIP FEE: $0:93 =-- OTHER: $0.00 INSPECTION: $0.00 _ -`�Address: �. %DONNELLY ENTERPRISES INC UniI:COSTA MESA, City/State/Zip: �480 E 17TH ST Address: , Unit: � - CitylState/zZip: � ' . „ i . - � - � -��License No. 59Z275 � � ' � �PHONE: 949-689-8944 � � �-� - , � CELL: ' License No. , PHONE: License No. - '. - �• PHONE: . - . � � ' - - �-+-- .- ''�' -. ' �`.�� .. ... .. .Ji . . ,�: -�,y, . ;. '- � ��,. ,: - �. � ., , -;,,:.. ? _ �. � �, _ _. r . , . NOTICE: The work authorized by this permlt shall comply with all applicable handicap access requiremants under California stalutes and related regulations. (Ord. No. 92•2B, § 1, 12•21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order tor the work authorized under this pertnit to be wnsidered legal, such work must comply with all applipble codes, and all requfred inspecNons and flnal approval musl be obtained. Failure to obtain inspecdons and final approval will resull in the expiratlon of Nis De�it. GOOEt, �NsvernoxTrre 1818 Fixetl System Final Fire Prevention 1268 Pool Spa Final � 200 Final Ro-Root 201 Final BIocWRetaining Wall 202 Final Factory Fire Place 203 FinalSign 204 Final DertaliGon p� q �� GODEI �xsrEcnoNrvre 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Final Fire Prevention �, 220 Final Planning Approval � � �' � ` -- ` 222 Fina15ite 250 FinalOuiltling�OccuDanty PaIE IN7IfUL5 WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty o� perjury one of the tu��..wing declarations: � ❑ I have and will mainlain a certificate of consent to self•Insure for viorkers' compensation, as provided tor by section 3700 of the Labor Code, for the performance of Ihe workior which t�is permit is issued. � �OLhave a � v.o ers' om ensatiqq((�� insu2nc , re wr lion 3700 of Labor e for P ��he rk f Q i li this permit is issu d. My worke pensation I�s r e rrier nd policy number are: � . ��I cetlily that in t�e pEAortnance ot lhe wark tor which this permit is s d, I shall not employ any person in any manner sa as to become subjecl to lhe workers' wmpensat' laws of Califomia, and agree that if I should become subjecl to t orkers' campensation provisions of Section 37 0 of the Labor Cod II f h lh comply with lhese pmvisions. 7 b� pliwnl's Signa I _ e , � — WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLAF2S ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF 7HE LABOR CODE, IMEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS UECLARATION: I hereby affirm that I am licensed under provisions of ChaDter 9(commencing with Section 7000) ot Division 3 of the Business and Protessions Code, anC my license is in full force anC effect. � �� Lic. tt - - ��Class # � � �' r i tur ._ • CONSTRUCTION LENDING AGENCY: ❑ I hereby affirtn that there is a consiruction lending agency for the peAormance o( the work fa which this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lentler s Adtlress: Signature Daie OW NER-BUILDER DECLARATIONS: I hereby a(frm t�at untler penalty of perjury that I am EXEMPT FROM 7HE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5. Business and Pro(ession5 Code: Any ciry or county which requires a permit to construcL alter, improve, demolis�, or repair any sWcture, pnor to its issuance, also requires Ihe apPlicant for such permit to file a signed statemenl that he or s�e is licensetl pursuaN to the provisions of the Contracrors License Law (Chapter 9(commencing with Section 7000) of Division 3 of the Business and Pro(essions Code) or that he or she is exempt therefrom antl Ihe basis for l�e alleged exemption. Any violalion of Section 7031.5 by any applicant (or a pertnit suDjects the applicant to a civil penalty of not more than fve hunCred Collars ($500).): ❑ I, as owner of the proDerty. or my employees with wages as Iheir sole compensation, WILL DO THE WORK, and the structure is not intendetl or ofleretl lor sale (Sec. 7044, Business and Prolessions Code: 7he Contractors License Law tloes not apply to an ovmer o1 property who builds or improvas theraon, and who tloes such work himsetl or her5elf or through his or her own employees, provided that such improvements are not intendetl or offered for sale. If, however, the building or impmvement is soltl within one year of completion, the ovmer-builder vnll �ave the burden of proving lhat he or she did nol build or improve for purpose of sale.). ❑ I, as owner of the property, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to conswct the project (Sec. 7644, Business�and Professbns Code: The contractors License Law dces not apply to an ovmer of property wt�o builds or impmves thereon, anC vfio contracls for such project with a cont2cta�s) license pursuaN to the Contractors License Laws.). � ❑ � am exempt under sec. Business and Professions Code (or this reason: ]057A6 (10]) Owner ID verified by dnv ise. ❑ Yes ❑ No + � Driver's License No. Expires: � Verification of Ownership by (lype of document, i.e. - property tax bill or Oeed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: . ❑ I hereby certify that no exwvation frve (5) a more feet in depth into wfiich a person is requiretl to descend, will be made in connection with v.ork authorized by this pertnit, antl that no building structure, scaffdding, false�wrk, v demolition or dismantlinq thereof, will be more than thirly-six (36) feet high. (Chap. 3.2, Grp 2. M 2, Sec. 341, Trtle 8, Cali(omia Atlministralive CoCa). ❑ As owner-builtler, I will not employ anyone lo Co v.ork which would require a permit from Ihe Division of Induslrial Safety, as noted above, unless such person has a permit to tlo such work Irom lhe division. AOp�i�nl'S SipnaWre Division of Intluslrial Sa(ety Permil Number: _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or fulure building occupant neetl to file and cenify a Businass Plan for emergency response lo release or threatened release ol a hazardous malenal7 ❑ Yes ❑ No (Section 25505 of the Califomia Health and Safety Code requires, with some exceptions, that a Business Plan be fled with the Cosla Mesa Fire Depanment by every business which has at any one lime tluring a reportetl year a quantiry of hazardous materials equal Io or greater ihan a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic teet of compressed gas at standard temperaNre and pressure). 2. Does or will the appliwnt or present or future building occupant neetl lo file a registration lorm tor acutely hazardous materials4 ❑ Yes ❑ No (Section 25533 of the Calitomia Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department Dy each business which at any one lime has on hand a quantiry of acu[ely hazartlous materials equal to or greater than a weig�t of 500 pountls, or a volume ot 55 gallons, or 200 cubic feet of compressed gas at sWndarC temperature antl pressure). 3. Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Seclion 25534 0! the Cali(omia Heallh and Safery Code provides that the Costa Mesa Fire Department may require the preparetion, certification and filing vrith the Fire Department of an RMPP by Gusinesses which are required to register aately hazardous materials with the Fire Department. 4. If an RMPP is presently requireC, has Section 25534 of the Califomia Health and Safety Cotla been tully complied with? ❑ Yes ❑ No 5. Does or will the applican� or present or fulure building occupant require (or Ihe work which is the subject ol this a071iwtion a permit lor such wnsWction or motlifcation from Ihe South Coast Air Quality Management District or trom any other air pollution control AisMcl or agency7 ❑ Ves ❑ No (Seclion fi58502 of Ihe Calilomia Govemment Cotle requires that the requested information be Nmishe0 on applications for rarnresidenlial building pertnits�. 6. Will any part of the facility lo be constructetl untler this permit be wilhin 1000 feet from Ihe outer boundaries of a school7 ❑ Yes ❑ No (If yes", the laciliry must meet the requirement of Sections 2553d and 42303 of the Califomia Heallh and Safely Code). 7. If a pertnit from the South Coast Air Oualily Management DiSMct or other air polWtion control district or agency is requiretl lor lhe work which is the subject of lhis application, have all of the disclosures prescnbed by Califomia Heallh and Salety Code Section 42303 been made? ❑ Yes ❑ No 8. (If "yes", attach certificate of compliance from the appropriate air pollution control officer�. CERTIFICATE OF COMPLIANCE: I cenify that under penalty of perjury,lhe information given above is conecl. I agree lo wmply with all sWte laws and city ordinances regarding Hazardous Matenals and Emissions. • Signalure Oate CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have rea0 this application and state that the intormalion given is correcL I agree to comply with all state laws and city ordinances relating to huilding wnstmction, and authonze representatives o( the Ciry ol Costa Mesa to enter upon the above-tlescribed pmperty for inspection purposes. I aqree not to occupy or allow occupancy of any huilding authorized by this permit until final inspection. . reo1L wner�s) Da I . -A, orRWbonzetlAppican� L _.6a�e _ � : - .-_. 6'-9" 6'r0" ' CO�STA M�SA ��b �OoO�p�� °� APPROVED CITY OF COSTA MESA PLANNING DIVISION SUBIECT TO BLDG. DEPT. R NOTE: ADDITIONS, DELETT� OR CORRECTIONS SHALL PPRqUED BY THE PLANNIN � DIV � z•-o� 0 v S� �GIP ,�,e� ti�E� �� `G�P . �� `Oti Q� F C•` l� � .. o a. "� � � � .,-;: `'=` �'. nt " Zfa'S' � . ... e'J� "� i� • c�:,' ��"C� � . .n ,�. .� , . ,.;.,�c-;.�o�� cr''�N�sp jc..' r'�eM+'` \Ucad.f``' ; pl �` aed1 '` �"��2. �..�"2� d a�V� n�10��0� �� V .>L�.' �' S�pOs `j�hx �OQe' � ;a. ��,.a.. ��o�` x�a¢�ad. '=�'_ �� °�\ _A sra�\ Z a;s�a . � � Refurbish e�cisring double sided pole sign and ad pole covers. One 6'-9" x 6'-1" custom double sided pole sign with colors to match existing building colocs. Sign cabinet is 6'-0" x 4'-0" fabricated from .040 aluminum with Pleauglas faces. Faces aze to be lettered with opaque and transiucent lettering and illuminated with CWHO Fluorescent lamps. Decorative cap is to be fabncated from .040 aluminum and have a stucco texmred finish. Base is to be fabricated from .040 aluminum and will cover existing pole to improve aesthetics only. Address numbets will be routered from base and backed with red Pleaciglas and illuminated with red LED lig6ts. Pole cover is 10' from base of sign to grade and is 24" at grade and 50" at base of sign. Job Site Address: 480 E 17th St. I ��R� 159R� ' Costa Mesa, CA MZ��p � y1�� 949689�944 (714)754-5273 • Fa�c(714)754-4856 ,lob Address: 480 E 17TH ST Suite: Vicinity: REAR OF PROPERTY CITY OF COSTA MESA BIIILDING p1VISION DEVELOPMENT SERVICES DEPARTMENT, PERMIT BUILDING PERMIT Parcel Number: 11737327 , Zoning: Applicant: CHARLES HOFMANN Address: 350 ROCHESTER ST . � � � , . . ,Phone: (949)515.8822 COSTA MESA, CA _ . Zip: 92627 Owner: DONNELLY, TIMOTHY � � Address 480 E 17TH ST �- . � • , . . -� . , ,, � Phane: � . . �COSTA MESA; CA . . Zip: 92626 Contractor: HOFMANN FINN DEV COMPANY INC Address: 350 ROCHESTER ST �, COSTA MESA, CA Zip: - 92627 Phane: (949)515.8822 License:` . 731034 �, PERMIT NUMBER B00-00446 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 04/O6/2000 Issued: 04/O6/2000 ISSUED BY: �%� � , � � u11 r �' I � � 1 �' Arch : . � F r= ` . Eng: .. . Address: - �. � � `� , , -' . � Address: . , J . S ` , -z,,,_��Phone: . Phone: ' ��, Zip: � � " � � - License: , . License: SCOPE OF PERMIT . � � .� 82 LF OF CONCRETE BLOCK RET WALL (MAX.�2',RETAINING) AT REAR OF PROPERTY LINE MAX 8' HIGH. ' REF:898-01617 . - , - _ ` FEE SUMMARY Plan Check: $0.00 - _ .— % ,' ' Calc Valuation: $z,aso.00 Permit: $83.25 r Claim Valuation: So:oo SMIP Res: $0.00 � SMIP Com: $0.00 .. . . Other: $0.00 • Inspection:" $0.00 _ Total: $83.25 SETBACKS MAIN STRUCTURE .Front 0- 0 ACCESSORY Front 0- 0 PARKING Existinq: o NOTES: , Rear 0- 0 Rear 0-0 Required: 0 PLANNING & ZONING , Left 0-0 Right � Left 0- 0 Right Pr000sed: 0 - 0- 0 . NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatica�ly expire and become void if work is not�commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. � INSPECTIONS: In order for the work authonzed under this permit to be considered legal, such work must comply with all applicable codes, and all Irequired inapectlona and finel approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this parmit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPENSATION DECLARAYION: I hereby aHirm untler penel�y ot perjury one of Ihe following decleretions: ' �� ❑ I have and will maintain a certificate oi consent to self-Insure for workers' wmpensation, as provitled for by section 3700 of the Labor Coda, for Ihe peAormance of ihe �[ work for which Ihis permit is iuued. ' IO�I have and wlll maintain workero' compensation insurance, as required by section 3700 of ihe Labor Code, for the pertortnance ot the work for which this pertnit is issuetl. � My workers' compansation Insurence carner entl policy number ara: . Cerrier: Palicy Number: � (This section need not be comp/eted i/ the permlt is velued at one hundred tlollars ($f 00) or less.) � � I certify ihat in the pertormance of t e work fo which ihis permit is issueq I shall not employ any person in any mennar so as to become subject to Ihe workers' compensation la f Califomla, and ree � I sho Id become subject to the workere' compensation provisions of Sectippp�� 3700 of the Lebor Cotle, I shall torthwi�h comply with t se pi i ions. �� /��o Applicant SignaWre • Date: �� WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVE IS UNLAWFUL ANO SMALL SUBJECT AN EMPLOYER TO CFIMINAL PE@�1LTI 5 AND CIVIL FINES UP TOONE HUNDRED THOUSAND DOLLARE ($100,000), IN ADDITIQY TO THE COST OF COMPENSATIIXJ, DAlMGES AS PROVIDED FOR IN SECTIIXJ 3]OG OF TME LABOq CODE, IPIrEREST, AND ATiOBNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirtn that I am licensad und provisions Chapter 9(commencing with Section 7000) ot Division 3 of the Business force and ettect Lic. q %� � � 3 • Class # Conlractofs Signature:� /: (1 Date: Code, and my license is in full CONSTRUCTION LENDING AGENCY: ❑ I hereby attirm that Ihere is a consWclion lending agency tor the pertormance of the work tor which this permit is issued. (Sec. 3097, Civil Code). Lentlers Name: Lentler's Adtlress: ' Signature: Date: OWNER•BUILDER DECLARATIONS: � I hereby affirm thet under penalry of perjury ihet I am EXEMP7 FHOM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business and Professions Code: Any citypr counry which requires e p@�mit to consWct, alter, improve, demolish, or repair any sirucNre, prior to its issuance, elso requires the epplicant for such permit to file a signed�stetemen� ihat he or she is liCensetl pursuant to Ihe provisions ot ihe Conirectors License Law (Ghepter 9(commencing with Section 7000) of Division 3 of the Business and Protesslons,Code) or ihet he or she is exempt therefrom and the Dasis for iha alleged axemption. Any violation of Section 7031.5 by any epplicant for a permit sub�ects the a'pplicariCto a civil panalry of no� more than five huntlretl dollars ($500).): ❑ I, as ovmer of Me property, or my.employees w0h wages as their sole compensetion, WILL DO THE WORK, and Ihe sWcture is not intended or oHaretl for sale (Sec. 7044„Business andProfessions Cada: The Conirectors License Law tloes not apply to an owner oi property who builds ar improves Ihereon,'and who tloes such work himself or.herself or through hisoi tier own employees, provided that such improvemems are not intended or oHered for sele. If, however, the tiuilding or improvement is sold within one yeer oi completion, ihe owner-builder will have ihe burden of provinq ihet he or she did not builtl or improve for purpose of sale.). ❑ I. as owner of the property em E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTOqS ro constmct the project (Sec. 7044, Business and Professions Code: The contrectors License�Lew does not apply to en owner of property who builds or improves ihereon, and who contrects for such project with a contractor(s) license pursuant to the Coniractors License Laws.). ❑ I am exempt untler sec. Business and Professions Code for this reason: Signature: Date: � � Owne� ID veritied by tlnver's license. ❑ Yes ❑ No Driver's License No. Expiras: Veritication of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERM�T CERTIFICATION: ❑ I hereby certlty Ihat no e:cavation five (5) or more feet In depth into which a person is required to descenq will be matle in connection with work authorized by this pertnit, and ihat no building slmcNra, scaXolding, talsework, or tlemolition or dismantling thereof, will be more than ihirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, Caliiornia Administrative Code). ❑ As owner-Duilder, I will not employ enyone to tlo work which would require e permit from the Division of Indusirial Safety, es noted above, unless such person has a permit to do such work from the division. Signature: Date: ' Division of Industrial Safery Pertnit Number: , HAZARDOUS MA7EFilALS AND EMISSIONS CERTIFICATION: � 1 Will ihe apPlicant or presant or fuwre building occupant need to tile and certify e Business Plan for emergency response to release or ihreatened release of a hazartlous material? ❑ Yes ❑ No �. (Section 25505 of ihe California Heelth antl Safery Code requires, with some e:ceptions, that a Business Plan be tilea with the Costa Mesa Fire Depariment by every business which has at any one time tluring a reported yaar a quantity ot hazardous materials equal to or greater ihan e weight of 500 pounds, dr a volume of 55 gallons, or 200 cubic feet of compressed 9as et standard temperetura and pressure). 2 Does or will ihe applicant or present or f�ture builtling acupant need to file a regisiration form for acutely hazartlous matenals? ❑ Yes ❑ No (Section 25533 oi ihe Calitornia Healih and Safery Cotle, with some exceptlons, requires regisiration with ihe Cosla Mesa Fire Depatlment by aach business which ai any one time has on hand a quantity oi eCutely hazartlous ma�enals equal to or greater Ihan a weight of 500 pountls, or a volume of 55 gallons, or 200 cublc feet of comprassed ges et stendard temperelura end pressure). ._._.. .......— . .__...... ._ . . ..........._ ........_._ ... ........._ .. _ ,,...._.._.. ............ 3 Does or witl the epplicant or present or future bwldmg ocwpant need to prepare en RMPP (Risk Manegement and Prevention Program for aw�ely hazartlous materials)? (Section 25534 of tha Califomia Health and Safery Code provides that ihe Costa Mesa Fira Depanment may require ihe preparation, certitication antl filing with the Fire Department of an RMPP by businesses which are requiretl �o register acutely hazartlous materials with Ihe Fire Depanment. 4 It an RMPP is presently required, has S9ction 25534 ot Ihe Celifornia Health end Safery Code been fully complietl with? ❑ Yes ❑ No 5 Does or will ihe epplicent or present or future building occupant require tor Ihe work which is ihe subject of this e plication e permit far such consiructian or moditication irom the South Coast Air Quality Manegement DisVict or trom eny other air pollution control tlistrict or agency7 � Ves ❑ No (Section 658502 ot the Califomia Government Code requires ihat the reQuested information be furnished on applications tor non-residential building permits). — """._—___""_—_"___ _— _.__'_'.. __.'_......___..--_—. _ —_.—__._..—...—........_.. 6 Will any part of the feciliry ro be constmc�etl under this permit be within 1000 feet from Ihe outer bountlatles of a school4 ❑ Yes ❑ No i (It'�es", the tacility must meet ihe raquirement ot Sections 25534 antl 42303 ot Ihe California Heal[h antl Safery Code). 7 If a pertnil irom �he South Coasl Air Qualiry Management DiSMct or other air pollution control tlisinct or agency is required for the work which is lha subject of this aoolication. have ell of ihe disclosures ofescnbed by Calitomia Heal�h and Safery Code Section 42303 been made? ❑ Yes ❑ No , Qf'yes", attach cetlificate ot compliance irom the aOPropriate eir polWtion control officer). � CERTIFICATE OF COMPLIANCE: I cedity ihat undei penelty ot perjury Ihe inbrmation given above is correct I agree to comply with all state lews entl ciry ortlinances regarding Hazerdous Materials end Emissions. i Signature: Date: CERTIFlCATE OF COMPLIANCE AND AIJfliORVA710N OF ENiRY: I certity under penalry of perjury that I have reatl ihis application antl state that ihe infortnation given is correct. I agree to comply with all state laws and ciry ordinances relating to building consiruction, antl authorize representetives ot the Ciry of Costa Mesa to enter upon Ihe ebove-described property tor inspection purposes. I agree not to occupy or allow occupancy of any building authorized by �his permit until final inspeclion. tooe �. iNsveenoxTrve 1616 Fized System Finel Fire Prevention 1266 Pool Spa Finel 200 Final Re-Roof 201 Final BIacWRetaining Wall 202 Finel Fectory Fire Place 203 Finel Sign 204 Final Demolition 2466-4fi P9IE 0 IN ' Cy��! INSPECTIONTYPE 206 Final Mechanical 200 210 212 220 222 250 Final Plumbing Final Eleclrical Final Fire Preventian Final Planning Approval Final Site Final Building/Occupancy PAIE 1I�9LS (714) 754-5273 • Fau (774) 754-0856 � . ,. Job Address: 480 E 17TH ST Suite: Vicinity: CITY OF COSTA MESA _ � BIIILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT, PERMIT Parcel Number: 11737327 ` . Applicant: CHARLES HOFMANN Address: 350 ROCHESTER ST BUILDING PERMIT PERMIT NUMBER I B00-00447 T7 FAIR DRIVE. COSTA MESA. CA 92626 _ � � Status: � ISSUED Applied: 04I06/2000 Issued: 04/O6/2000 Zoning: � . • '. . • ' � A� ISSUED BY: Phone: (949)515.8822 COSTA MESA, CA .. � Zip: 92627 Owner: DONNELLY,-TIMOTHY Address 480 E 17'fH ST � � �. � • � . . " � Phone: ' COSTA MESA, CA Zip: 92626 Contracror. HOFMANN FINN DEV COMPANY INC Address: 350 ROCHESTER ST � - Phone; (949)515.8822 COSTA' MESA, CA Zip: " 92627� License:. 731034 Arch : Address: � � � - , � ' Eng: , ' � , � . � Address: Phone: Or,. Phone: - Zip: � � � . � License: License: SCOPE OF PERMIT ' 29 LF OF CONCRETE BLOCK WALL FOR TRASH�ENCLOSURE AT REAR OF PROPERTY LINE MAX 6' HIGH. � REF:B9&01617 � _ FEE SUMMARY Plan Check: $0.00 � � Calc Valuation: 8580.00 Permit: $26.55 Claim Valuation: So.00 SMIP Res: $0.00 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: . $26.55 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Frant 0-0. PARKING Existinq: o NOTES: PLANNING & ZONING Rear 0- 0 Left 0- 0 Rear 0- 0 � � Left 0- 0 Reouired: 0 - Proposed: 0 Right 0- 0 Ri9ht 0- 0 � NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regula�ions. (Ord. No. 9248, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is noPcommenced within 180 days, or if work is suspended or abandoned for a penod of 180 days. INSPECTIONS: In order for the work authorized under this pertnit to be considered legal, such work must comply with all applicable codes, and all required Inapeetlona end flnal approval must be obtained. Failure to obtain inspections and final approval will resull in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 WORKERS'COMPENSAnON DECLARAnON: ' I hereby eHirtn untler penalry of perJury one of the following declarations: i ❑ I heve entl will mflintain a certificate oi consent lo sell-Insure lor workers' compensation, as provided for by sectlon 3700 ot Ihe Lebor Code, lor the pertortnance of iha �work tor which ihis pertnit is issued. � I have antl will maintain workers' cwnpensation insurance, as raqulred by section 3700 of �he Lebor Cotle, for the pertortnance of the work for which Nis pertnit is issuetl. My workere' compensatlon Insurance carrier end policy numbar ere: . � Certier: Policy Number: (This section neetl not be comp/eted il fhe permit Is valued ef one hundred dollers ($f 00) or less.) � I cenity that In the peAormance of ihe work f r which this permit is issuetl, I shell nol amploy any person in any menner so es to become subject to ihe workers' compensation law t elifornia, en req th ' I sh Id become suDject to ihe workers' compensetion provisions of S�tl� 37� of Ihe LaDor Code, I shall torthwith comply with ih e p i ions. � � Applicent Signature � � Date: �— WAfiNINO:FAILURET UREWORKERS'COMPENSATIONCOVE UNLAWFULANDSHALLSUBJEGTANEMPLOYERTOCRIMINALPENFLTIESANDCIVILFINESUPTOONEHUNDRED TMOUSAND DOLIARE (5100,000). W FDDITION TO THE WSi OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SEGTIIXJ 31O60F THE LABOR CODE.IMEREST, AND ATfORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirm that I am force antl eNect Lic. N_ Con�rectofs SignaNre:r CONSTRUCTION LENDING AGENCV: Chap�er 9(commencing with Section 7000) of Division 3 of the I Class # �Q Date: _ Code, antl my license is in tull ❑ I hereby aHirtn that there is e consiructlon lending agency tor the pertormance ot Ihe work for which this permit is issuad. (Sec. 3097, Givil Cade). Lenders Name: Lendets Atldress: SlgnaNre: OWNER-BUILDER DECLARATIONS: Date: I hereby ettirm ihat untler penelry of perJury ihat I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7037.5, Business antl Professions Code: Any city or counry-which requires e permit to construct, elter, improve, demolish, or repair eny stmcture, prior to its issuance, elso requires the epplicant for such permit to file a signetl slatemeN Ifiat he or sha Is licensed pursuam to Ihe provislons of ihe Contractors License Lew (Chaptar 9(commencing wlth Section 7000) of Division 3 ot Ihe Business entl Professions Cotle) or, thet he or she Is exempt t�eretrom and the basis for Ihe ellegetl exemption. Any violation ot Sectlon 7031.5 by eny epplicant tor a permit sub�ects iha applicem to e ci'vll penelry ot not more than five hundretl tlollars ($500).): �� ❑ I, es ownerpf the properry, or my employees with wages as their sole compensation, WILL DO TME WORK, antl Ihe siructure is not iNentletl or oNered for sale (Sec. 7044, Business antl Professions Code::The Contrectors License Lew does not apply to en owner at property who builtls or improves Ihereon, and who does such work himself or herseN or through his or her�own employees, proNded that such improvements ere not Intended or oHered for sale. If, however, the building or improvement is sold within one year ol completion, ihe owner-builtler will have the burden of proving Ihal he or she dld not build or improve for Ourpase of sale.). ❑ I, es awner of t�e property, am E%CLUSIVELV CONTRACTING WITF1 LICENSED CONTRACTORS to construct the pro�ect (Sec. 7044, Business antl Professions Code: The conirectors License Lew does not apply to en owner ol properry who builds or improves thereon, and who crontrecro for such project with a contractor(s) license pursuant to the Contractors License Lews.). ❑ I em e:empt under sec. Signature: Owner ID venfied hy drivels license., ❑ Yes ❑ No Business antl Professions Code for this raeson: Venfiwtlon ot Ownership by (type of document, i.a. � praperty tax blll or deed): Drivers Licensa No. Date: Expires: DIVISION OF INDUSTRIAL SAFETY PERMIT CERTFICATION: ❑ I hereby certify Ihei no excavetion five (5) or more teet In depth Into which a person is required to descend, will be made in conneciion wiih work authorized by this pertnit, and Ihat no builtling structure, swttoltling, lalsework, or demolition or dismantlinq Ihereof, will be more Ihan thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, Califomia Administretive Coda). ❑ As owner-builder, I wlll not employ anyone lo tlo work which would require a permi� imm �he �Ivislon ot Indusirial Safery, es notetl e6ova, unless such person hes a pertnit to do such work Irom the tlivision. Slgnatura: Date: Division of Industnal Safery Pertnit Number: CERT1fICATE OP COMPLIANCE AND AUTHORVJUION OF EMAV: I cerlity under penalry of per�ury ihat I have read this appliwtlon entl slete ihat t�e intortnation given is correct. I agrea to comply wllh all state lews and city ordinances relating to building consiructlon, end authorize representatives oi ihe Ciry oi Costa Mesa to enter upon the above-tlescriDed property for Inspectio purposes. I agrea not to occuOY a� allow occupancy oi any builtling au�horizetl �y this permlt until Ilnel Inspection. i Slgna e Le r Da ' D �/-�-�� And/Or Authorized Applica Date � COUE I. INSPECTIONTYiE 7616 1266 Fixetl System Final Fire Prevention Pool Spa Final 200 Finel Re-Roof 201 Finel BIocWRatalning Well 202 Final Factory Fira Plece 203 Final Sign 204 Final Demolition 2ad6d8 � O J�Q 4QQ�( INSPECiIONttPE 206 Finel Mec�anical 20B Finel Plumbing 210 Finel Electrical 212 Finel Fire Prevention 220 Final Planning Approval 222 Final Site 250 Finel Building/Occupancy D� V�9Lff (714) 754-5273 • Fax (714) 754-4856 CITY OF COSTA MESA � BUILDING DIVISION � � DEVELOPMENT SERVICES DEPARTMENT PERMIT Job Address: 480 E 17TH ST Suite: Vicinity: WHOLE BUILDING Parcel Number: 11737327 npp�icant: DUFFY, BRIAN Address: 23881 VIA FABRICANTE MISSION VIEJO, CA owner: DONNELLY, TIMOTHY Address 480 E 17TH ST COSTA MESA, CA Contraaor. TRI COUNTY FIRE Address: 23881 VIA FABRICANTE MISSION VIEJO, CA FIRE SUPRESSION PERMIT Zoning: Phone: (949) 4723186 Zip: 92692 Phone: Zip: 92626 Phone: (949)472-3186 . . Zip: 92692 --Cicense: 659326 NUMBER F00-00182 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 07/OS/2000 Issued: 07I20/2000 ISSUED BY: ' SCOPE OF PERMIT FIRE SPRINKLER PERMIT FOR CONSTRUCTION OF NEW BUILDING FOR "COSTA MESA ANIMAL HOSPITAL". INSTALL 98 FIRE SPRINKLER HEADS. REF: 898-07617 Plan Check: $254.31 Permit: $391.25 Other: $0.00 Total: $645.56 FEE SUMMARY Calc Valuation: $zs,000.00 Claimed Valuation: SzS,000.00 NOTICE: The work authonzed by this permit shall comply with all applicabla handicap access requirements under Califomia statutes and related regulations. (Ord. No. 9248, § 1, 12-21-92) EXPIRATION:� This permit shall automatically expire and become void if work is not commenced within 1B0 days, or if work is suspended or abandoned for a period of 180 days. . INSPEC710NS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspeetlona and final approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. POR INSPECTIONS CALL: (714) 7545626 / WORKERS' COMVENSATION DECUIRATION: � ' I �ereby eflirtn under penalty oi perlury one of t�e following tleclaretions: � ❑ I have antl will maintain a �ertificate of consent to self-Insure for workers' compensatioq as providetl for by sectlon 3700 ot Ihe Labor Cotle, for Ihe peAortnance ot ihe work for which [his pertnit �5 i5sued. ' � �_I�hava�antl will maintain wDi7cers' compensa�ion insurance, as raquired by seIXion 3700 of �he Labor Code, tor the peAortnance of Ihe work br whlch this pertnit �s issuetl. My wor�kg!rs.' compensation ��suranca carner end poliry number e/re�: Carrier. LlJ�llOs�l4�i.� N(�"il-O.�A� �Ns. l��- f-diqNumber. �2'!c2'Qi/�//� / �eclion�need not be complefed i! Ihe permit is ve/uetl af one hundretl Uollars ($f 00) o� less.) � ❑ I certify ihat in the peAorrt�ance ot the work for which this permit is issueQ I shall not employ eny person in any manner so es to become subJect lo the workers' compensation laws ot Califomia, end agree ihat if I should 6ecome subject to Ihe workers' compensa�ion provislons of Section 3700 of ihe Lebor Code, I shall forthwith comply with ihese prov�'�'o/ps. � Applican(Sig`nature,� /'1 �� .�/� �Date: f%-2D —� . WMNING: FAILURE TO SECURE WORKERS' CAMPENSATI COVERAGE IS UNLAWFIIL AND SHALL SUBJECT AN EMPCOV O CHIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED iHOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATIIXJ, DAMAGES AS PROVIDED FOR IN SECTION 3]OB OF THE LABOR CAOE. IMEREST, ANO ATTORNEV'S FEES. LICENSED CONTRACTORS D�CLARATION: I hereby aHirtn �ha1�I�am�lic9nsejl� rptrLo� �ons of Ghapter 9(commencing with Section 7000) ot �ivision 3 of the Business and Professions Cotle, antl my license is In full force entl eHeci. Llc..xJ l0 3 cia� C /b _ 72a _cx� CONSTRUCTION LENDING AGENCY: ❑ I hereby aHirtn that t�ere is a consiruction lending agency for Ihe peAormance ot the work tor which this permit is issued. (Sec. 3097, Civil Code). Lentler's Name: Lentler's Address: SignaNre: _ __ _ Date: OWNER-BUILDEB DECLARAT�ONS: � I hereby aHirm that untler penalry ol perjury that I am EXEMPT FROM T}iE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business antl Professions Code: Any ciry or county which requires a permit to construct, al�er, imp�ove, Oemolish, or repair any structure, pnor to i�s �ssuance, also requires the epplicent for such permit lo file e slgned statement that he or sha is licensetl pursuant to the provisions of tha Contraciors License Lew (Chapier 9(commencing wlth Sedlon 7000) of Division 3 of tha Business antl Professions Code) or that �e or she is exempt therelrom entl tha basis for the alleged exempilon. Any violation of Sectlon 7031.5 Dy eny applicam for a pertnit sub�ects the applicant to a civil penalry of not more than five hundretl dollars ($500).): ❑ I, es owner of ihe propehy. or my employaes with wages as their sole compensetion, WILL DO 7HE WORK, antl the structure Is not intended or oMeretl for sale (Sec. 704a, Business and ProFe95ions Cotle: The Coniractors License Lew tloes not epply to en owner of proparty who Ouiltls or improves thareon, antl who does such work himseN or herself or Ihrough his or her own employees, provided l�at such improvements are not Intended or otteretl for sale. If, however, ihe building or impmvement is sold within ane year oi completion, the owner-builder will heve iha burden of proving that he or she did not builtl or improve for purpase oi sela.). � ❑ I, es owner oi the pm0erry, em EXCLUSIVELY CONTRACTING WI7H LICENSED CONTRACTORS to construGt Ihe project (Sac. 7044, Business and Pmfesslons Code: Tha contractors License Law does not appy to en owner ol properry who builds or improves ihereon, end who contracis for suc� project with a contractor(s) license pursuant to Ihe Contractors License Lews.). , ❑ I am eaempt under sec. Business and Professions Code lor ihis reeson: Signature: Date: Owner ID venfied by drivefs license. ❑ Yes ❑ No Drivefs License No. Expires: � Verification of Ownarship by (typd of document, i.e. - pmperty tax bill or tleetl): DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICATION: ❑ I hereby certity that no exCevation five (5) or more feet in depth Into which a person is required ro descenG, will be made in connection with work authorizetl by this permii, antl that no building swcWre, swfloltling, falsework, or tlemolitlon or dismantling t�ereof, wlll be more than Ihirry-six (36) teet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Title 8, Calitomie AtlmiNstretive Code). ❑ As owner-6uiltler, 1 will not employ enyone to tlo work which would require e permit from Ihe Division of Intlusinal Safery, as notetl above, unless such person has a permit to do such work from the division. Signature: Division of Indusinal Safery Permit Number: Date: ARDOUS MATERIALS ANU EMISSIONS CERTIFICATION: WIII tha applicant or present or future Duilding occupant need to file anG certlty e Business Plan lor emergency responsa to release or ihreatened release ot a hazartlous meteriel7 ❑ Yes ❑ No (Section 25505 of ihe Califo�nia Healih and Safety Code requires, with some exceptions, ihat a Business Plan be tiled with the Costa Mesa Fire Department by every business which has at eny one time during e reported year a quentiry ol hazardous materials equel to or greater ihen a weight of 500 pountls, or e volume of 55 gallons, or 200 cubic feet of compressed gas at stantlartl temperature end pressure). Does or will the applicant or present or tuture building occupant need to fila a registration form br ecutely hezartlous matenals7 ❑ Yes ❑ No (Section 25533 of the Calitomia Haalih and Setety Code, with some exceptlons, requires regisiretion wiih the Coste Mesa Fire Department by each business which a� any ona time has on �antl a QUanllry ol ecutety hazerdous matedels equal to or greeter then a weight oi 500 pounds, or a volume of 55 gallons, or 200 cubic feet oi compressed gas at standard �empereWre flnd pressure). or Presem or prepare an (Section 25534 ot the Calitomie Health and Safery Code provides Ihat ihe Casta Mesa Fire Depertment may require tha preparation, cenlflcetion and filing with ihe Fire Department of an RMPP by pusinesses which are requiretl to reglster acutety ha�rdous materials with Ne Fire Depanment. � 4 If an RMPP is presently required, hes Section 25534 ot the California Healih end Safery Code been lully complied with? ❑ Yes ❑ No 5 Does or will ihe epplicent or Prasent or future builtling acupant require for the work which is the sub�ect of this a plication a ertnit tor such constructionlor moditication from ihe South Coast Alr Ouality Maneqament Disind or tmm eny other aIr polluiion contml disldct or egenc� � Ves � No (Section 658502 ot the Califomle Govemmant Code requires ihet the requested informatlon be furnishetl on applications for non-residentiel builtling pertnits). 8 Will any part of Ihe facility to be constructed under this permit be wit�in 1000 teet from Ihe outer bountlaries ol e school7 ❑ Ves ❑ No I Qf `yes", ihe facility must meet t�e requirement of Sectlons 25534 antl 42303 ot t�e Calitomia Health end Safery CoOe). 7 If e pertnit from the South Goest Air Oualiry Management Disirict or olher air pollution wntrol district or agency is reQuired for ihe work which is Ihe sublect of �his epplication, have all ot the disclasures prescnhed by Califomia Heelth antl Satery Code Section 42303 been made7 ❑ Yes ❑ No 8 (II yes", attach cenificate of wmpliance from the appropriate air pollution control oHicer). � CERTIFICATE OF COMPLIANCE: I certity that under penalry of perjury the intortnation given above is correct I egree to comply wlih all state laws and��ciry ordinances reperding Hazerdous Materiels end Emissians. , SignaNre: Dete: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRV: I certify under penalty ol perjury ihat I have read this application antl state t�at the information givan is correct. I egree to comply with all steta laws end city ardinances relating to building construction, end euthodze representatives of the City af Costa Mese to enter upon Ihe ebove-descnbad properry for inspectlon puryases. I agree not to occupy or allow occupancy oi any builtling au�hodzetl by t�1s permit until llnal lnspectioa I COOE �. INSPECTIONTYPE 1� �p 1[�ELS 1818 Fixed System Finel Fire Prevemion � U—�CYJ � 7266 Pool Spa Final 200 Final Re-Roof 201 Final Block/Retaining Wa�� 202 Finel Factory Fire Place 203 Final Sign 204 Final Demolition 26a&46 � �� COOE � INSVECTION TYVE 206 Flnel Mechenical 20B Final Plumbing 210 Final Electdcal 272 Finel Fire Prevention 220 Finel Planning Approval 222 250 Final Site Final Building/Oaupancy � � � I i �� i' CY� i�,l _ � � " ° ,n . - .. �^JI . ��::�.r-..,•t.�.:�.-y�.:••.. �..rvs..�...,... _ , � �it�p o f c�o�ta 7Y� e5a � Developmenr Services, Division of Building and Safety CERTIFICATE OF OCCUPANCY � This cerriFicate is issued pursuant adopted by the City of Costa Mesa c below described was inspected� d1 i � Building Address 480 S; � �, Use qet Office/Ani�mal H i�y �-� ;-;r Group B Owner of Building !lm Address 480 E. 17 BUII.DING OFFICIAL� Street � al f��` � � zi,,,— " — -�_-�,-� Sn �-M Fire ��'� a:= v;.� �G�C�iO:Z !��ti�� '- " Ten .��.� �•--�-�'�%,a-� sta Mesa; CA ,92fi2� �� i . - -- �r��'� �ns�� .4 - ��f0.�ti♦. i t�v ��ntiY' w, v� rl. �LI �G��'��C�� F' =_ � �- � �. �::�.�.; J )� , � . � i -"- �,r' �%;.;��,1Si- REQUIRED TO BE By �cec . _a9',/� Y- Building Code, Section 308 the building structure herein Permit No. 898-01617 -��' '�� Use Zone �ata,Meea Animal Hospital" PLACE . . . . . ......... . ._ ,,,.,��.,,.. . ., r.,_,., , . . ..x, „� �.. :,. Y.+ p - t �, J �� (714)754-5273 • Fex(714)754-4856 ;� dob Address: 480 E 17TH ST Suite: Vicinity: NEW BUILDING CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT Parcel Number: 11737327 Applicant: CHARLES HOFMANN Address: Owner: KENDALL, LELAND D TR Address 18056 HUMMINGBIRD DR PENN VALLEY,CA ContraCoc Address: Zip: Arch : RICHARD DAYTON Address: 2900 SILVER LN BUILDING PERMIT Zoning: Phone: (949)515-8822 Zip: Phone: Zip: 95946 Phone: License: Eng: Address: Phone: 949-645-1717 NEWPORT BEACH,CA Zip: 92660 License: C74287 � NUMBER v I 698-01617 77 FAIR DRIVE, COSTA MESA, CA 92626 Slatus: ISSUED Applied: 091iO11998 Issued: 09/30I1999 ISSUED BY: �l I I7T SCOPE OF PERMIT CONSTRUCT 4,651 SF (3,644 SF 7ST FL, 1,007 SF 2ND FL.) VET OFFtCE/ANIMAL HOSPITAL. SEE DEVELOPMENT REVIEW DR•97-15 FOR DETAILS. OK TO EXTEND PERMIT APPLICATION A ONE TIME TILL 9I30199. PER WILLA DR EXPIRES IN 12199. Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total $363.55 $2,23725 $0.00 $77.70 $0.00 $0.00 $2,678.50 SETBACKS MAIN STRUCTURE Front 0- 0 � ACCESSORY Front 0- 0 Rear 0. 0 Rear 0- 0 FEE SUMMARY PLANNING & ZONING Left 0. 0 LeR 0- 0 Caic Valuation: Claim Valuation: Right 0. 0 Right 0-0 Phone: License: $370,000.00 $370,000.00 : � NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 72-21-92) EXPIRATION: This permit shall automaticelly expire and beeome void if work is not commenced within 1B0 days, or it work is suspended or abandoned for a penod of 180 days. INSPECTIONS: In ortler for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inepeetlone and final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 � WORKERS' COMPENSATION DECLARATION: I hereby eMirm untler penalry ol perjury one oi ihe tollowing aecleratlons: ❑ I have entl will melntain a certtticata ol consent to self-Insure for warkers' compensatlon, as providetl for by section 3700 of ihe Lebor Code, for Ihe pertortnance ot ihe work for which this permit Is issuetl. �I have anC will maintein workers' compensatlon insurance, as required by section 3700 of t�e Lebor Coae, tor Ihe peAortnance of Ne work for which Ihis pertnit is issued. My workers' compensation Insurance carner and poliry number ere: Carder. Policy Number. (This sectlon need no! be oomple(etl !! fhe perml(!s valued ef one hwMred dol/ers (5100) or /e55J ❑ I cartity that in tha mance of the wo c tor whic� ihis pertnll is IssueQ I shall not employ any person in eny mannar so es to bemma su��ect to the workers' compensetion laws I C mla, end egr hat if ultl 6ewme subject to ihe workers' compensation provisions oi Sectioppp 3700yyy ihe Lebor Cotle, I shall lort�wit� comply with these rovisi n. ry/�U /^ � v �� ADOIIcanl Signeture: ' Date: �� WARNINO:FAILURETOSECUREWORKERS'COMPENSATIONCOVERA�E U WFULANDSH4LLSU&IECTANEMP�OVERTOCRIMINAL ENALTIE ANDGVILFINESUPTOONEHUNDRED THWSANDDIXL4RE�5100,000),INADIXiIONTOTHEWSTOFCOAIPEN$A , GE50.5PROVIDEDFORINSECTION3]O60FTHElABOFCODE,IMEREST,ANDATTORNE`fSFEES. LICENSED CONTRACTORS �ECLARATION: I hereby eMirm that I am licensetl lorce end eHect. Lic. q CaNractoYs SignaWre:� 9(commenUng with Section 7000) ol Divislan 3 ot Ihe Busines�i.�nd Professions Coda, antl my Ilcense is in full 1 CI255 M �� _ CONSTRUCTION LENDING AGENCV: ❑ I hereby atlirm �het there Is e consiruclian lending egency lor ihe peAormanca of the work for whlch this permit is Issued. (Sec. 3097, Civll Code). LenCer's Name: SlgnaNre: _ OWNER•BUILDER DECLARATIONS: Lendefs Adtlress: Date: I hereby affirtn Ihet under penalfy ol perjury thai l em EXEMPT FROM TME CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business antl Professions Code: Any city or counry which reQulres e pertnit to construcl, alter, improve, tlemolish, or repair any slrucNre, pnor to Its issuance, also requires the applicant for such permit to file e signetl statement thet he or she Is licensed pursuant to t�e Drovlslons of tha Contrectors License Lew (Chapter 9(wmmencing wlih Section 7000) of Division 3 ot the Business antl Profeuions Code) or Ihet he or she is exempt thereirom end the basis for the elleged exemption. Any violatlon of Section 7031.5 by any applicant tor e pertnit sub�ects the epplicant to e clvll penelty ol not mora then fiva huntlretl tlollers ($500).): ❑ I, as owner of the property, or my employees with wages as Iheir sole wmpensetion, WILL DO TME WORK, and the stmcture Is not intended or oNered for sale (Sec. 7044, Business and Professions Cada: Tha Contrectors License Lew dces not epply to en owner of properry who builtls or Improves thereon, antl who daes such work himsett or hersell or thmugh his or her own employees, pmWdetl Ihat such improvements are not intentled or ottered for sale. If, however, ihe builtling or improvement is sold within one year of completion, the owner-builder will have �he burtlen oi proving that he or she ditl not build or improve for purpose of sale.). ❑ I, as owner of the pmperty, am E%CLUSIVELY CONTRAC7ING WI7H LICENSED CONTRAC70R5 to consirun Iha project (Sec. 70aa, Business antl Pwiessions Cotle: The cnntracrors License Law does not apPh ro an owner ot property who builds or improves thereon, and who contrects tor such pro�ect with e wntraaor(s) license pursuant to the Contractors License Laws.). ❑ I am ezempt under sec. Signature: Owner ID venfied by dnver's license. ❑ Yes ❑ No Business end Professions Cotle for t�is reason: Vedfication of Ownership by (rype of tlocument, i.e. - propetly tes bill or deed): Drivefs License No. Date: Expires: DIVISION OF INDUS7RIAL SAFE7Y VERMR CERTFICATION: ❑ I �ereby certity that no excavation Trve (5) or more teet In depth Into which a person is repuiretl to tlescend, will be matle in connectlon with work aut�orized by this pertnit, end that no huilding struCture, sCattolding, lalsework, or tlemdition or tlismantling thereol, wlll be more t�en thlrry-slx (38) teet high. (C�ap. 32, Grp 2, An 2, Sec. 341, Ttle B, Califomia Adminislretive Code). ❑ As owner�builtler, I will not employ anyone to tlo work which woultl require e permlt irom the DiNsion of Indusinal Safery, as noted above, unless such person has e permit ro tlo such work from the tlivision. SlpneNre: Dete: Dlvision oi Inaustrial Satery Permit Number: CERTIFICATE OF COMPLIANCE AND AUTHORRATON OF EMAY: I cenify under penelty of perjury ihat I have read this eppliptlon and state ihat the information given is correct. I agree to comply wllh all stete laws end ciry ordinences releting to building construction, entl authorize representetives of the Ciry ol Costa Mesa to emer upon ihe ebove-tlescn6ed properry tor inspectlorrpuryoses. I agree not to acupy or allow occupency ot any bulltling authodzed Gy this partnit until Ilnal inspection. COUE I, INSPFCTIONTYPE 1616 Fi:ad System Final Fira Prevention 1266 Pool Spa Finel 200 Final Re-Roof 201 final BIocWRetaining Wall 202 Final Factory Fira Plece 203 Final Sign 204 � Finel DemoliUon 26a&a8 Q9g 1t�AL5 ��. : i �' ' COOE� INSPELTONTYVE 208 Final Mechanical 20B Final Plumbing 210 Finel Electrical 212 Finel Fire Prevention 220 Finel Planning Approval 222 FInalSite 250 FInalBuilding/OCcupancy PAIE INitfIpLS :,.. CITY OF COSTA MESA BUILDING DIYISION �-� DEVELOPMENT SERVICES DEPARTMENT PERMIT pia� �sa-sz�s • Fex (�ia� �sa-aess Job Address: Suite No Vicinity: Parcel Nunmber: Applicant: Address: Owner: Address Contractor: Address: ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) Pool / Spa Lightin9 Fixts Recept Oullets Switches Non Res Appl Res Appl Service to 200a Service to 7000a Service over 1000a Motors to 1hp Motors to 10hp Motors l0 50hp Motors l0 100hp Motors over t00hp Communication dropg Sub panel to 200a Pale Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole 480 E 17TH ST NEW BUILDING 11737327 CHARLES HOFMANN KENDALL, LELAND D TR 18056 HUMMINGBIRD DR PENN VALLEY. CA ELECTRICAL PERMIT Phone: (949)515-8822 Zip: Phone: Zip: 95946 HOFMANN FINN DEV COMPANY INC 350 ROCHESTER ST COSTA MESA, CA Phone: (949)515.8822 Zip: 92627 License: 731034 NUMBER E99-00897 77 FAIR DRIVE, COSTA MESA, CA 92626 status: ISSUED Applied: 0912311999 Issued: 09/3011999 ISSUED BY: Sl 1 !� SCOPE OF PERMIT 95 LIGHTS, 80 OUTLETS, 41 SWITCHES, 7 1000 AMP SERVICE, 6 MOTORS TO 1 HP, 3 MOTORS TO 10 HP & 3UPT0 200 AMP SUBPANELS FOR NEW ANIMAL HOSPITAL. REF:898-01617 823.50 50.00 $0.00 $0.00 $0.00 $0.00 $74.75 $63.80 $35.33 $0.00 50.00 $0.00 $62.15 $0.00 $28.50 $36.90 50.00 50.00 $0.00 50.00 $91.50 $0.00 $0.00 $0.00 50.00 Quantity 0 0 0 95 80 41 0 0 0 1 0 6 3 0 0 0 0 3 0 0 0 0 FEE SUMMARY Temp Dist System / Lighting Busway I700 fl Standing Sedion Misc Eledrical Equipment Transformers up to 1 kva/kw ................up to 10 kva/kw .................uP l0 50 kvalkw .................up to 100 kvalkw ..................over 100 kva/kw Low Voltage Equipment Low Volt Wiring System / Ckt Misa Conduit Misa Conductor Cirws ( gen or rida) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand Other Eledrical Fee Investigation Fee Plan Check Fee Reinspection Fee Quantity $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 so.ao 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 80.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES 5416.43 COMMENTS / SPECIAL CONDITIONS NOTICE: The work euthorized by this permit shall comply with all applicable handicap eccess requirements under Califomia slatutes and relatetl regulations. (Ord. No. B2•28, § 1, 12-21-92) EXPIRA710N: 7his pormif shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned (or a period of 180 days. INSPECTIONS: In order for the work aulhorized under this permit to be consitlered legal, such work must compiy with all applicable codes, and all requirad inepectlons entl (Inel epprovel must be obtained. Failure to obtain inspections end tinal approvel will result in the expira�ion of �his pertnit. FOR INSPECTIONS CALL: (714) 7545626 � WORKERS'COMPENSATION DECLARATION: I hereby aHirtn under penalry ot perjury one oi Ihe tdlowing dedarations: ❑ I heve antl will main[ain a certlficete ot conseni to selt-Insure for workere' compensation, es provitletl for by sectlon 3700 of ihe Labor Cotle, for the peAortnence ol Ihe work tor which Ihis pertnit is issued. I have and will maintain workars compenselim inturance, as required by sectlon 3700 oi Ne Lebor Code, for the peAortnanca of iha work tw whid� this pamut is issued. My workers' compensation Insurence cartier and policy number flre: Cerder. Pollcy Number. (This sectfon need not be complefed i/ Ne perm/t Is veluetl ef one hundred dollers (3100J or /esSJ ❑ I certily that in lhe peAormence oi the work lor which this permit is issueQ I shall not employ any person in eny menner so es to become subjact to the workere' compensetion laws of Celifomia, and e ree t t If I should become subject to the workors' compensation provisions ol Section 3700 of the Lebor Code, I shell lorihwith comD�Y with t rows . � //� AppllCenlSlgnaWre'� Dete: ` �� WARNING: FNILURE TO SECUR WORKEFS' COMPENSATION COVERAGE IS UMAWFUL AND SHALL SUBIECT AN EMPLOVER TO CRIMINAL iENALTIES AND CIVIL FlNES UP TOONE HUNDRED TIpUSAND OOLLARE (5100,000�, IN ADDRION TO THE W5T OF COMPENSATION, �AMACaES AS PPOVIDED WR IN SEGTION 370fi OF THE LABOR CODE, IMEREST, AND ATTORNEVS FEES. LICENSED CON7RAC70RS DECLARATION: I hereby eHirm that I em licen ed under royi k lorce and eflect. Llc:tl - % O�G Conirectafs Signatu ol Chapter 9(commendng wilh Section 7000) ol Division 3 of Ihe Busing�fi antl Professions Cotle, and my license is In full class a � ' oate: q CONSTRUCTION LENDING AGENCV: ❑ I hereby aHirtn thet Ihera is e construction Iending egency for t�e peAormance of lhe work tor w�ich Ihis permit Is Issuetl. (Sec. 3097, Civll Code). Lentler's Neme: Lentlefs Atldress: Signeture: OWNER•BUILDER DECLARATIONS: Dete: I hereby aflirtn thet under penalry of perjury that I em EXEMPT FROM TME CONTRACTORS LICENSE LAW for t�e following reason (Sec. 7037.5, Business antl Professions Code: Any city or counry which raquires a permi� to consiruct, alter, impmve, damolish, or repair eny sWCNre, prior lo Its Issuance, elso requires the applicam tor such permit to file a signed stalement that ha or she Is Iicensed pursuent to the provisions of Ihe Con�rectors License Lew (Chapter 9(commencing with Section 7000) of Division 3 0l Ihe Business end Pmfessions Code) or Ihat he or she is exempt therefrom antl the Dasis tor the alleged exemption. Any Nolation of Sectlon 7031.5 by any appliwnt br a permit suC�ects the eppliwnt ro a civil penalry o1 not mora Ihan frve hundrad dollars (5500).): ❑ I, es owner oi the property, or my employees wit� wages as their sole compensetion, WILL DO THE WORK, end the structure is not intended or oHaretl lor sale (Sec. 7044, Business and Professions Code: The Contrectors License Lew tloes not appty to en owner ol property who builtls or imprwes thereon, antl who does such work himself or herself or through his or �er own employees, provided that such improvements are not intended or oHered for sale. It, however, Ihe building or imprcvement is soltl within one year of complation, the owner-builtler will have ihe Durden ot proving Ihat he or she ditl not build or improve lor purpose of sale.). ❑ I, as owner of Ihe properry, am E%CLUSIVELY CONTRACTING WI7H LICENSED CONTFACTORS to construct the Droject (Sec. 7044, eusiness and Professions Cotle: The contractore License Lew tloes no� aDPly �o en owner of property who builds or improves thereon, and w�o contrects lor such projeci with a coniractor(s) license pursuant to �he Conlraclors License Laws.). ❑ I am exempt untler sec. Business and Professions Code tor t�is reason: Signeture: Date: Owner ID verified by drivers license. ❑ Ves ❑ No Drivers License No. Expires: Veritication ol Ownership by (type oi tlocument, i.e. � property tan bill or tleed): UIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby cently ihat no excevation IWe (5) or more feet in depth Into whlch a person Is required to descend will he matle in connectlon with work authorizetl by ihfs pertnit, end that no Duilding structure, sceMolding, talsework, or demolition or tlismantling t�ereol, will be more t�an ihirry-six (36) leet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Tille 8, Celifomia Atlminisiretive Cotlej. ❑ As owner�bullder, I will not employ anyone to Co work which would require a pertnll trom Ihe Divislon oi Intlusiriel Sefety, es noted ebove, unless such person has a permit to do such work tram the diWsion. Sipnature: Dete: Divlslon of Indusirial Safery Pertnil Number: CERTIFlCATE OF COMPLIANCE AND AUTHORQATION OF EMFiY: I cenity under penalty af perjury that I hava reed this epplication and state that the infortnatlon given Is correct. I agree Io comDN w��h all state laws enC clry ordinances relating to 6uilding construc�ion, and euthorize representatives at the Ciry of CasW Mesa to enter upon the above�descrlbetl properry lor inspaction purposes. I agree not to occupy or allow occupancy ol eny building authonzetl hy thls pertnit until tinal InspeIXion. COOE �. INSPECTIONTYPE 1618 1266 200 201 202 ,s�g � a� �,�a�,g, 9 � y�� And/Or Authonzed Applicent ate Fixatl System Final Fire Prevention Pool Spa Final Finel Re-Roof Finel Block/Retaining Wall Finel Fectory Fire Place 203 Final Sign 204 Finel Demoliilon zaawn QdIE 1tQIIlAlS CODE I INSVECTION TVFE 206 Final Mechanical 20B Final Plumbing 210 Final Electrical 212 Final Fire Preventlon 220 Final Planning Approval 222 Flnal Site 250 Flnal Building/Oaupancy 2AIE Ixrma�S (714) 754-5273 • Fex (714) 754-4856 m Job Address: 480 E 17TH ST Suite No Vicinity: NEW BUILDING Parcel Number: 1 � 737327 Applicant: Address: Owner: Address: CITY OF COSTA MESA BUILDING DIVISION " DEVELOPMENT SERVICES DEPARTMENT PERMIT CHARLES HOFMANN KENDALL, LELAND D TR 78056 HUMMINGBIRD DR PENN VALLEY, CA MECHANICAL PERMIT Phone: (949)515-8822 Zip: Phone: Zip: 95946 contractor: HOFMANN FINN DEV COMPANY INC Address: 350 ROCHESTER ST ArchlEng: Address: COSTA MESA,CA Phone: (949)515.8822 Zip: 92627 License: 731034 Phone: Zip: License: SCOPE OF PERMIT 6 VENT FANS & 3 AIR HANDLERS LESS THAN 10,OOOCFM FOR NEW ANIMAL HOSPITAL. REF:B98-01617 ISSUE FEE Inst FAU <100 k BTU Inst FAU >100 k 8TU Repair I Alt CoolingMeat Inst I Rep. Recess Wall Htr Refrig Sys <700 k BTU Refrig Sys >700 k BTU Gas Piping Facrory Fireplace Hood w/Mech Exhaust VAV BOx Vent Fan / Single Duct Appliance Fire Dampers Smoke Dampers Inst or Relocate Appl Vent Air Handlers < t0000dm Air Handlers > t0000dm Floor Furnace Floor or Suspend Heater 523.50 $0.00 $0.00 50.00 $0.00 50.00 30.00 $0.00 50.00 50.00 $0.00 $43.50 50.00 $0.00 $0.00 30.00 531.95 50.00 $0.00 $0.00 Quantity FEE SUMMARY �RMIT NUMBER M99-00453 77 FAIR ORIVE, COSTA MESA, CA 92626 Status: ISSUED Applled: 0912 3/1 9 9 9 Issued: 09I3011999 ISSUED BY: S1 f�T Repair I Alt Absorbtion Unit Repair I Alt Refrigeration Unil Ventillation System Evaporative Cooler Commercial I ncinerator Domestic Incinerelor Compressors I Absomtion Svstems Upto3hp/100kBTU 3 To 75 hp / 500 k BTU. 15 To 30 hp / 1,000 k BTU 30 To 50 hp / 1,750 k BTU Over 50 hp I Over 1,750 BTU Boilers Up to 3 hp 3To15hp 15 to 30 hp 30 to 50 hp Over 50 hp Other Mechanical Fee Investigation Fee Plan Check Fee Reinspection Fee TOTAL CALCULATED FEES COMMENTS / SPECIAL CONDITIONS Quantity 80.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 598.95 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Celifomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for ihe work authorized under this permit to ba considered legel, such work must comply with ell applicable eodes, and all �equlred inepectlone and finel approval must be obteined. Failure to obtain inspections and final approval will result in the expiration of �his permil. FOR INSPECTIONS CALL: (714) 7545626 WORKERS'COMPENSAnON DECLARAnON: I hereby aHirm untler penalry ot perjury one oi the tollowing tleclaratlons: ❑ I �ave and will meintain e ceNficate ot conseni to self-Insure tor workers' compensation, es provided br by section 3700 of the Lsbor Code, for the pertormance of the work for which this pertnil is issued. �I have antl wiil maintain workers' compensetion insurance, es reQuiretl by secGon 3700 ot lhe laDor Code, for Ihe peAortnance of Ne work for which ihis permit Is issuetl. My workers' wmpensation Insurence carner and policy number ere: Cerder: Policy NumCer. (This secNon need nat be complefed 7! fhe perml( is veluetl ef one hundred tlWlers ($100) or less.) ❑ I cetlify ihat in ihe peAormence ol the wo br whic i this permlt is Issueq I shell not employ eny person in any menner so as to become subject to the workers' compensation law lif mia, end egree et If I s uld become subject to Ihe workers' compensetion provisions of Seqqqtion 3700 of the Lebor Cotle, I shall Iorthwith comply wiih these rovi 1. �/ '/ � Applicant SignaWre: ' Dere: �1�0 � � �L— WARNINGFAILURETOSECUREWORKERS'COMPENSATIONWVERAGEI WFULANDSMQLSl1BlECTANEMP�OVERTOCRIMINALPENALTIESANDCIVILFINESUPTOONEHUNDRED THOUSANDOOLLARE(5100,000),INADDfiIONTOTNEWSTOFODMPENSATi , AMAGESASPROVIDE�FORINSEGTIIXJ370fiOFTHELABORCODE,IMEREST,ANDATTORNEY'SFEES. LICENSED CONTRACTORS DECLARATION: I hereby ellirm ihat I em Ilcense • r rovi ons 1 Chapter 9(commencing wllh Sectlon 7000) ol Division 3 of Ihe Business �od�Professions Cotle, and my license is in full toroe ena ettea. uo. « G c�ess a /`S c �c_ � `�-r—,-S 9 Comraaors Signature: Date: � � O CONSTRUCTION LENDING AGENCY: ❑ I hereby ettirtn thet there is a conslruction lending egency for the pertormance of t�e work for which Ihis permit Is issuetl. (Sec. 3097, Civil Cotle). Lentler's Neme: Signature: _ OWNER•BUILDER DECLARATIONS: Lendefs Address: Date: I hereby eflirm that untler penalry of per�ury that I am EXEMPT FROM THE COMRACTORS LICENSE LAW lor the following reason (Sec. 7031.5, Business and Professions Cotle: Any city or counry which requires a permii to consiruct, alter, improve, demolish, or repair any structure, prior to its issuance, elso requires the appliwnt tor such permil to tile a signed statement thet he or she is Iicensed pursuem ro the provisions of Ihe Contrectors License Law (Chaptar 9(commencing wit� Section 7000j of Division 3 of Ihe Business and Professions Code) or Ihat ha or she is exempt therefrom antl �he Oasis for the alleged exemption. Any violation oi Section 7031.5 by any epplicant tor e permit sub�ects the applicant to e chnl penalry of not mora than Me huntlretl Aollare ($500)J: 0 I, es owner oi ihe properry, or my employees with wages es iheir sole compensetion, WILL DO THE WORK, entl t�e siructure is not intended ar oHered for sale (Sec. 7044, Business and Prolessions Cotle: The Contrectors Llcense Law does not apply to an owner of property who builtls or improves thereon, anC who dces such work himseN or herself or ihrough his ar her own employees, provitled t�at such improvements are not intendetl or oNeretl for sale. If, however, ihe building or imprevement is sold within one year ot completion, the owner-builder will have Ihe 6urtlen ot proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner af the properry, em EXCLUSIVELY CONTRACTING WRH LICENSED CON7RACTORS to consWct the project (Sec. 7044, Business entl Professlons Code: The wntractors Licensa Law does not appy m an owner of pmperry who 6uiltls or improves ihereon, and who contracLs tor such project wi�h a contracror(s) license pursuant to the Comractors License Lews.). ❑ I am exempt under sec. Business and Professions CaOe tor this reason: Signature: � Date: Owner ID venlied by dAvers licanse. ❑ Ves ❑ No Drivers License No. Expires: Verification ol Ownership by (rype ol doCument, I.e. • property �ax blll or tleed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby certtty Ihet no eacavetion INe (5) or more teet In depih Inm which a person is required m descend, will be matle in connection wlih work authorizetl by t�is pertniC end that no building struaure, scattWding, telsework, ar tlemdition or tlismentling thareol, will Oe more ihan Ihirry-six (36) feet high. (Chap. 32, Grp 2, An 2, Sec. 341, Title 8, Celifomia Atlministretive Cotle). ❑ As owner�bullder, I wlll not employ enyone to Oo work which would reQuire e pertnil trom the Division ot Indusiriel Safery, as notetl above, unless such person �as a permit to tlo such work trom tne dlvision. Signature: � Date: Dlvisian of Intlustrial Sefety Pertnit Number: CER7IFlCATE OF COMPLIANCE ANO AUTHOR¢ATON OF EMAV: 1 cenity untler penalry ot perjury that I have read this application antl siate that the intortnation given is correct. I agree to compty wlih all state laws end ciry ordinances relating to builtling construction, flnd euthonze representatives oi the Ciry ot Costa Mesa to enter upon the ebove-descrlDetl properry lor Inspection p+rposes. I egr�e not to occupy or allow occupancy ol eny building authonzed by ihis permi� unlil final inspeciion. 4opE �. INSiECTIONTYYE QS¢, INTITIpLS 1616 Fixotl System Finel Fire Prevenlion 7266 200 201 202 203 Pool Spa Final Finel Re-Roof Finel BIocWReteining Well Finel Fectory Fire Place Finel Slgn 2C4 Finel Demolitlon zaae as I � = � CODEt INSGECTIONTYPE 206 Final Mechanical 0 i� 20B Final PlumDing 210 Final Electncal 212 Final Fire Prevention 220 Final Planning Approvel 222 Final Site 250 Final Builtling/Occupancy :.� . ��ia� �sa-sz�3 • FaX (�ia� �sa-aess • www.ci.rnsta-mesa.r��LDING PERMIT Job Address: 480 E 17.TH ST Suite: Vicinity: Parcel Number: 11737327 '. Zoning: npp�icant CHUCK HOFMANN Address: 350 ROCHESTER ST ' Phone: (949)515.8822 COSTA MESA, CA Zip: 92627 Owner: DONN�LLY, TIMOTHY Address 480 E 177H ST � PfiOne: COSTA MESA, CA Zip: 92626 Contractor. HOFMANN FINN DEV COMPANY INC Address: 350 ROCHESTER ST Phone: (949)515.8822 COSTA MESA, CA Zip: 92627 License:. 731034 Arch : Address: // hHltt UHIVC, I:VJIH MCJX, l.A ye0�0 . ... � . • + ISSUED BY: Eng: Address: Status: ISSUED Applied: OB/OB/2000 Issued: 08I08/2000 � Phone: - Phone: Zip: License: License: � � SCOPE OF PERMIT DEMOCISH EXISTING 2,748 SF WOOD FRAME ANIMAL HOSPITAL TO PREPARE AREA FOR PARKING LOT FOR NEW � ANIMAL HOSPITAL BUILDING. ' " � ' � - REF:898-01617 . Plan Check: Permit: SMIP.Res: SMIP Com: Other: Inspection: Total: $0.00 $139.25 $0.00 $0.00 $0.00 $0.00 $139.25 SETBACKS . MAIN STRUCTURE Front 0- 0 ACCESSORY Fmnt �0.0 PARKING Ewstinq: p NOTES: Rear 0- 0 Rear 0- 0 Required: 0 FEESUMMARY Calc Valuation: Claim Valuation: PLANNING 8 ZONING . : Left 0- 0, Right 0-,0 Left 0- 0 Right 0- 0 Proposed: 0� ' 0 P $6,500.00 ss,soo.00 NOTICE: The work authorized by this permit shall compty with all applicable handicap access requiremenis under California statutes and related regulations. (Ord. No. 92•28, § 1, 12-21-92) EXPIRA710N: This permlt shall gutomatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECT�ONS: In order for the work aulMrized under this permit to be consitlered legal, such work must comply with all applicable codes, and all required I�epections and finel approvel must be obtained. Failure to obtain inspections and tinal approval will result in tha expiration of this permit. FOR INSPECTIONS CALL: (71q) 75q-5626 . / 2ane-ae le�ool // (/ �. WORKERS'COMPENSAnON UECLARATON: - I hereby aHirtn under penalry oF perjury one oi ihe foliowing tledarations: ❑ I have entl wlll malntaln e cenilicata of conseni to sell-Insure tor workers' compensation, es provided lor by section 3700 of the Lebar Code, tor the paAartnance ot Ihe �work for which 1�I5 permit Is issuetl. I have an0 wlll maintain workers' compensation insu2nce, as requireG by section 3700 oi ihe Labor Cotle, for the performance ol Ihe xrork for whlch this pertnit is issued. My workers' compensatlon Insurance carrier entl poliq nu ber are: , ca��a.: ST�¢.�t—��n..ra �ti� �. �� w-n Pou� N�mc�,: rs 6 S 3 z-/ 6- o0 (ihis section need no( be canpl�mu( is valued et one hundied dd/ars (Sf 00) or less.) � I ceNiy ihet in the iance ol Ne work r which t pertnit is issueq I shell not emplay eny person in any menner so es to become suDject to Ne workers' compensetion I s of a fomia, entl egree at if I Itl b9ppme subjed to the workers' compensatlon provisions of Sectlory 370p of the LeDor Cotla, I shell foMwith comply with th se pr is4 ns. v p_ q�/�� Applitent Signature: Date: /J � O � WARNIN(3: FAILURE TO SECURE WOHKERS COMPENSATION COVEM IS LAWFUL ANO SHALL SUBJECf AN EMPLOVER TO CRIMINAL NAL IES AND GVII FlNES UP TO ONE HUNDRE� TlIOUSPND DOLLARE (5100,W0), IN FDDRICN TO TNE COST OF , OAMAGES AS PRWIOED FOR IN SECfION 3lOB OF TNE LABOR CODE, IMEREST, AND ATTORNEVS FEE3. LICENSED CONTRACTORS DECLARATION: I hereby eflirm ihat I em force and etfect. Llc. a_ Conirenofs Signeture: (commencing with Section 7000) ol Dlvlsion 3 ot t�e Business@ qA Professions CoOe, end my license Ig in lull � Glass q li i i Date: �-Ja_ 0 CONSTRUCTON LENDING AGENCY: ❑ I hereby aHirtn Ihat t�ere is a wnsiruction lending egency br ihe peAortnance of Ihe work tor which Ihis partnit is Issued. (Sec. 3097, Civil Code). Londefs Neme: Lentle/5 AGdress: SlgneWre: _ OWNER-BUILDER OECLARATIONS: Date: I hereby ettirtn Ihet untler penalry oi perjury thet I am El(EMPT FROM TME CONTRACTOHS LICENSE LAW far the tollowing reeson (Sec. 7031.5, Business entl Professions Code: Any ciry or counry which requires e permit to canstruct, elter, improve, demolish, or repair eny siructure, prior to its issuance, elso requires the epplicant for such pertnit to flle e signed statement Ihat he or s�e Is Ilcensed pursuam ro the pmvisions oi �he Conirectors IJcense Lew (Ghapter 9(wmmencing with Sectian 7000) of DiWsion 3 of the Business and Professlons Cade) or ihet he or she is e:empt therelrom antl the besis Por ihe ellegad exemption. Any violation of Section 7031.5 by any epplicant for a pertnil subjecis the epplicant Io a civil penalty of not more ihan fiva huntlred dollars (5500)J: ❑ I, as owner of the properry, or my employees vrith wages es their sWe compensstion, WILL DO THE WORK, anE the structure is not intenaed or otferetl for ule (Sec. 7044, Business and Professions Code: Tha Coniractors License Law dces not eppty Io an owner ot property who builds or Improves ihereon, anU who tloes such work himsetf or herself w Ihrough his or her own employees, D�ded [hat such improvements are not Imended or ofteretl br sele. It, however, t�e Duiltling or improvement is sold within one year of completion, the owner-builder will �ave the burden ol proving ihat he or she did not builtl or improva for purpose ot sale.). ❑ I, as owner ot t�e property, am EXCLUSIVELV CONTRACTNG WfTH LICENSED CONTHACTORS to construct t�e projecl (Sec. 7044, Busineu and Professions Code: The comrectors License Lew tloes not epply to an owner ot propeny who builtls or Improves Ihereon, end who contrects for such project wlth e wNrector(s) license pursuant to the Contractors License Lews.). ❑ I am exempt untler sec. SignaNre: Owner �D verified by drivers license. ❑ Ves ❑ No Business and Prolessions Cotle tor t�is reason: Venfcation ai Ownership by (rype ot tlocumenL i.e. - property tex 6ill ar tleetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: Drivefs License No. Date: Expires: ❑ I hereby certify thet no excavation fNe (5) or more leet in depth into which a person Is required to descend, will be mede In wnnection wlth work euthoAzetl Dy thls permit, entl t�al no builCing sWcture, swflWtling, lalsework, or demolition or tlismantling thereof, will be more than Ihirty-siz (36) fee� high. (Chap. 3.2, Grp 2, M 2, Sec. 3dt, Ttle 8, Calitomia AdministratNe Code). 0 As ownao-builtlar, I will nat employ enyane to tlo work wMch would require e pertnit tmm the Division at Intlusirial Sefery, es noted above, unless such person hes e pertnit to do such work from the di�nsion. SignaWre: Da�e: DlWsion of Intlusirial Sefery Permit Number: GOOE /. MSPEC110MTYPE Q�g f({��j 1616 Fixed System Flnal Fire Preventlon� � 1286 200 Pool Spe Flnal Final Re�Roo� 201 Finel BIocWReteining Wall 202 Final Fectory Fire Place 203 Final Sipn � 204 Finnl Domoliiion COOE� INSiECTIONTYPE 208 Finel Mechanical 208 Finel Plumbing 210 Finel Elecirical 272 Finel Fire Prevention 220 Final Planning Approval 222 Flnel Site 250 Final Building�Occupancy PdIE P�E45 CITY OF COSTA MESA ' BI/ILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT (714)754-5273 • Fax(714j754•4856 Job Address: Suite: Vicinity: 480 E 17TH ST GRADING FOR NEW BUILDING Parcel Nunmber: 11737327 Applicant: Address: owner: KENDALL, LELAND D TR Address 18056 HUMM�NGBIRD DR PENN VALLEY,CA GRADING PERMIT Zoning: Phone: Zip: Phone: Zip: 95946 Contractor: HOFMANN FINN DEV COMPANY INC Address: 350 ROCHESTER ST COSTA MESA, CA 2ip: 92627 Eng: R.V. PEARSALL, INC Address: 2595 LIME AV Phone: (949)515.8822 License: �31034 Phone: 562-5957391 LONG BEACH,CA Zip: 90806 License: SCOPE OF PERMIT CUBIC YARDS GRADING FOR NEW ANIMAL HOSPITAL. 333 Plan Check: $33.00 $0.00 Permik $89.50 Other: $0.00 $0.00 Inspection: $0.00 $0.00 Total: NOTES: $122.50 FEE SUMMARY PLANNING 8 ZONING NUMBER 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED ApPlied: 11/25/1998 Issued: 09/3011999 ISSUED BY: " � 1� Calc Valuation: so.00 NOTICE: The work authorized by ihis permit shali comply with all applicable hendicap access requiremenis under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall eutomatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a penod of 180 days. INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work must Comply with all appliCable Codes, and all requlred inapeetlone and finel eppraval must be obtained. Failure to obtain inspections and final epproval will result in the expiretion of this permit. FOR INSPECTIONS CALL: (714) 7545626 � WORKERS'COMPENSAnON DECLAFiArON: I hereby ettirm under penalry ol perjury one of the Idiowing tledaretions: ❑ I �eve antl will maintain e certificate of consent to seltdnsure tor workers' compensation, es pmvidetl tor by section 3700 of the Labor Cotle, tor Ihe peAarmance of tha �/ work For which this pertni� is Issuetl. 171. I have and will maintain workers campensation insurance, as requiretl by section 3700 of the tahor Code, for the paAortnance oF ihe vrork tor whidi this pertnit is issuetl. T� My workers' compensation Insurance carrier antl polity num6er are: Cerrler: Policy NumDer. (TM1is secNon need nat be canpleted ll fhe permit /s va/ued et one hundred dollars (5100) or /ess.J ❑ I certi}y t�et in the ertormence af t a wotl tor which this pertnit is issued, I shall noI employ any person in any menner so es to become subject to the workero' compensatio � 1 Califomla, en< gree at If I ould become subject to Ihe warkero' compensation provislons of Section 3700 of the Lebor Cotla. I s�all forthwith comply with hese r visions. c^.�, `��/� � Applicant Signet e: Date: / � WARNINQ: FAILURE SECURE WORI�RS' OMPENSATION E E IS UNLAWFUL AND SFULL SUBIECT lW EMPLOVER TO CRIMINAL ENALTI S AND GVIL FlNES UP TOONE HUNDRED THWSANO DIXIAFE (5100,000), IN ADORIIXJ TO TNE C0.ST OF TIIXJ, UAMNGES A$ PROVIDED FOR IN SECTION 31O60F THE LABOR CODE, IMEREST, AND ATTORNEI"5 FEES. LICENSED CONTRACTORS DECLARA710N: I hereby eHirm Iha! I am licensetl under�rovisions of Chepter 9(wmmencing wlth Sectlon 7000) of Divlslon 3 0l Ihe Business�d Prafessions Cotle, entl my Iicense is in tull larce antl eHect. Lic. q Class q ContrectofssignaWra: � .w� \ Data: ��Q q9 CONSTRUCTION LENDING AGENCY: ❑ I hereby aHirtn thet Ihere is e construction Iendirg egen�y Por the peAortnence ol the work lor whic� this parmit is issued. (Sec. 3097, Givil Cade). Lenders Neme: Lenders Address: Signeiure: Date: OWNER-BUILDER DECLARATIONS: . � I �ereby aNirm Ihet unCer penelry of perjury thal I am EXEMP7 FROM THE COMRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business entl Professions Code: Any ciry or counry which requires a permit to consWct, alter, improva, demWish, or repair any siructure, pnor to its Issuance, also requires the applkaN tor such pertnil lo file a signetl statement thet he or she Is Ilcensed pursuam to the provisions ot the Conirectors Licensa Lew (Chapter 9(wmmencing with Sectlon 7000) ot Division 3 of Ihe Business antl Professions Code) or Net he or she is exempt therefran antl the bazis tor Ihe alleged ezemption. Any Nolation of Section 7031.5 by eny applicani for a pertnit subjects Ihe applicant to e civil penalry ol nm more than iive hundretl tlollars ($500).): ❑ I, es owner ot the property, or my employees wli� wages as iheir wle compensation, WILL DO 7HE WORK, and tha structure is not intentletl or ottered for sale (Sec. 7044, Business and Protessions Code: The Comractors License Law tloes not apply to an owner of property who builds or improves thereon, and who aoes suc� work himself or herself or through his or her own employees, provitletl that such improvemenis are not intentletl or oHered for sale. If, however, the building or imprcvement is soltl within one year of comple�ion, Ihe owner-builtler will have Ihe burden of proving that he or she did not builA or improve for purpose of sale.). ❑ I, es owner of the properry, em EXCWSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construq t�e project (Sec. 7044, Business and Protessions Cotla: The cromractore License Law does not appty to en owner of propeny who builds or improves ihereon, end who coNracis for such projeci with a commcbr(s) license pursuant to tha Conireciors License Laws.). ❑ I em exempt under sec. Business and Professions Cade lar t�is reason: SignaWre: Data: Owner ID venfetl by tlrivers license. ❑ Yes ❑ No Dnvers Licanse No. Expires: Vedfication oi Ownership by (rype of tlocument, i.e. - pmperry tax bill or deed): DIVISION OF IN�USTRIAL SAFETY PERMIT CER7IFICATION: ❑ I �ere�y certity thal no excevatlon five (5) or more feat in tlep�h into which a person is requlred to descenq will be mede in connection wlth work authonzed by this permit, entl that no bulltling sirucNre, scattoltling, lalsework, or demolition or dismentling theraot, will he more ihan Ihlrry-siz (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, 7�1e B, Calilomia Adminlstrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require e permit irom ihe Division of Intlustrlel Salety, es noted above, unless such persan has a permii �o tlo such work Irom the tlivision. Signe�ure: Date: Dldslon of Industdal Sefety Permit Number. CER7IFICATE OF COMPIJANCE AND AIJTHORIZATION OF ENTTiY: I certity under penalty of perjury ihat I have read Ihis epplica�ion flnd state �hat the information given is correct. I agrae to comply with ell state laws and ciry ordlnences relating to building consimction, end au�horize reprosentetives of ihe City ol Coste Mesa to enter upon Ihe ebove-described Dropeny tor inspectlon purposes. I egrea not to acupy or allow occupancy ol eny Duilding auNorized by this permit until final inspection. Signa Of Le Ow r � 7U/pp�gq� `-� AnNOr Authorizetl Applica �� ,Date COpE I, INSPECTIONTYPE Q�jf, �,$ 1816 Fixed System Finel Fire Prevention 1268 200 201 202 203 Pool Spa Final Final Ra-Roof Final BIocWReteining Wall Final Fedory Fire Place Final Slgn 204 � , Final Demditlon 2da&a8 GOOE� INSPECTIONTYVE 208 Final Mechanical 20B Finel Plumbing 210 Finel Elecirical 212 Finel Fire Prevention 220 FinelPlanning Approvel 222 Final Site 250 Final BuilGing/OauOency PdIE Ui�lEii ��ia��sa-sz�a • Fex��ia��sa-aess Job Address: 480 E 17TH ST Suite No Vicinity: NEW BUILDING Parcel Nunmber: 11737327 Applicant: Address: owner: CITY OF COSTA MESA BUILDING DIYISION DEVELOPMENT SERVICES DEPARTMENT PERMIT CHARLES HOFMANN KENDALL, LELAND D TR PLUMBING PERMIT Phone: (949)515-8822 Zip: Address 18056 HUMMINGBIRD DR Phone: PENN VALLEY, CA 2ip: 95946 Contractor: HOFMANN FINN DEV COMPANY INC Address: 350 ROCHESTER ST ArchlEng: Address: Phone: (949)515.8822 COSTA MESA, CA Zip: 92627 License: 731034 Phone: Zip: License: NUMBER P99-00552 77 FAIR DRNE, COSTA MESA, CA 92626 Status: ISSUED Applied: 0912 3/1 9 9 9 Issued: 09I30/1999 ISSUED BY: S� SCOPE OF PERMIT 1 BACKFLOW IRRIGATION, 1 BACKFLOW PREVENTER, 1 BATHTUB, 2 DISHWASHERS, 9 FLOOR DRAINS, 2 ROOF DRAINS, 1 EXPANSION TANK, 1 GAS EARTH�UAKE VALVE, 5 GAS OUTLETS, 1 GAS SERVICE, 1 LAUNDRY TUB, 1 LANDSCAPE IRRIGATION, 1 SEWER CONNECTION, 1 SHOWER, 9 BAR SINKS, 1 FLOOR SINK, 1 KITHCEN SINK, 1 MOP SINK, 2 WASH BASIN SETS, 1 WASTE & VENT SYSTEM, 2 WATER CLOSETS, 1 WATER HTR & WATER SERVICE FOR NEW ANIMAL HOSPITAL. REF:898-01617 ISSUE FEE BackFlow irrigation Backflow Preventer Bathtub Clarifier System Connect (Ice,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earthquaka Valve Gas (1-4 ouUets) Gas (Over 4 outlets) Gas Repipe Gas Service Interceptors (Grease, Oil) Interceptors (Sand Auto ) AMT $23.50 $9.80 $9.80 $9.80 $0.00 $0.00 $0.00 $19.60 $8820 $0.00 $19.60 $0.00 $9.80 $11.00 $6.15 $1.10 $0.00 $9.80 $0.00 $0.00 QTY FEE SUMMARY AMT Laundry Tub / Washer $9.80 Landscape Irrigation $14.80 P-Trap $0.00 Pressure Regulator $0.00 Process Piping (per 10 ft) $0.00 Receptors $0.00 Septic Tank $0.00 Sewer Cap for Demo $0.00 Sewer Connect $24.65 Sewer Private Line $0.00� Shower $9.80 Sink, bar $88.20 Sink, commercial $0.00 Sink, Floor $9.80 Sink, kitchen $9.80 Sink, service/mop $9.80 Spa (private) $0.00 Spa (public) $0.00 on 1 1 0 0 0 0 0 0 1 0 1 9 0 1 1 1 0 0 SumpPump Swimming Pool Trap Primer Urinal Vacuum Brkr Bkflow(7-4) Vacuum Brkr Bkflow(5+) Wash Basin Wash Basin Sel Waste and Vent System Water Closet (Toilet) Water Heater / vent Water Piping Qnst or Rep.) Water Re-pipe Water Service Water Softener OTHER VIOLATION PLAN CHECK REINSPECTION AMT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $19.60 $9.80 $19.60 $12.30 $0.00 $0.00 $9.80 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES: $465.90 aTY 0 0 0 0 0 0 0 2 1 2 1 0 0 1 0 NOTICE: The work authorized by this permit sh�(g�t�pl�l��_h�tji��sequiremenis under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requl�ed Inepeetiona and final approvel must ba obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 � WORKERS' COMPENSA710N DECLARATION: � I hereby aflirm under penalry oi perjury one ol the tollowing declarations: ❑ I heve antl will malntain a cenNicate of consent to salf-Insure for workers' compensation, es provitletl for by section 3700 oi Ihe Lebor Code, for Ihe peAormance of Ihe �work tor whiCh this permit is issued. I hava antl will maintain workers' compensation insurance, as required by section 3700 ot Ihe Lebor Code, for ihe pertormance of the work for which Ihis permit is issued. My workers' compensation Insurance carrier and policy number ere: Carrier. Policy Number: (This section need not be camp/eted /l !be permi( is velued et one huntlred tlollers ($f00) or less.) ❑ I certify ihat in ihe OeAormance of ihe work tor which this permit is issuetl, I shall not employ eny person in any manner so es to become subjact to �ha workers' compensation laws of Califomia, antl agree ihat if I shoultl become subject to Ihe workero' compensation provisions ot Section 3700 of ihe Lebor Code, I shall forthwith comPtywi ihes .. s �� _ �/�/�� Applicant Signature: Dete: �,�_�^� WARNING: FAILURE TO SEC WORKERS' COMPENSATION CAVERAGE IS UNLAWFUL AND SMALL SUBJEGf AN EMPLOYER TO CRIMINAL PENALTIES PND CIVIL FlNES UP TOOfJE MUNORED THOUSAND DOLLARE ($100,000), IN ADOITION TO THE COST OF COMPENSATIIXJ, DAMAGES AS PROVIDED FOR IN SEGTIIXJ 3]Ofi OF THE LABOR CODE, IMEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirm tha! I am farce antl eHacL Lic. # Contractors Sionaturre-.- oi Chapter 9(commencing with Section 7000) oi Division 3 of the Bus u and Prolessions Code, and my license is in full Da�e�a �/�T� ' 9 CONSTRUCTION LENDING AGENCY: ❑ I hereby aHirtn that there is a consWction lending agency tor �he pertormance of the work tor which ihis permit is issuetl. (Sec. 3097, Civil Code). Lender's Name: Lentler's Address: Signature: OWNER•BUILDER DECLARATIONS: Date: I hereby aXirtn ihat under penalty ol per�ury ihat I am EXEMPT FHOM THE CONTRACTOHS LICENSE LAW for iha following reason (Sec. 7031.5, Business and Professions Code: Any ciry or counry which requires e pertnit to consiruct, alter, improve, demolish, or repair any siructura, pnor to iis issuance, elso requires Ihe epplicant for such permit to file a signad statemeN that he or sha is licensed pursuant to the pmvlsions ot ihe Conirectors Licensa Lew (Chapter 9(commencing with Sactlon 7000) oi Division 3 of tha Business antl Professions Code) or thet he or she is exempt Iheretmm entl the basis for ihe alleged exemption. Any violation of Section 7031.5 by any appliwnt lor a permit sublecis the applicant to e civil penalty o1 not more than five hundred dollars (5500).): ❑ I, es owner of ihe property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the siructure is nat intentled or oHeretl for ule (Sac. 7044, eusineu and Pmtessions Code: The Contractors License Lew tloes not apply to an owner of property who builds or impmves Ihereon, antl who does such work himsetl or herself or ihrough his or har own employees, provided that such improvemenis are not intended or oRered for sale. If, �owever, tha builtling or improvement is soltl within one year oF completion, Ihe owner-builder will have the burden of proving that he or she tlitl not build or improve for purpose ot sale.). ❑ I, as owner of ihe property, am EXCLUSIVELV CONTRACTING WITM LICENSED CONTRAC70RS to constmct ihe project (Sec. 7044, Business and Professions Cotle: The contrectors License Lew does not apply to en owner of property who builds or improves thereon, end who contrects for such project with a coniractor(s) license pursuant to the Contractors License Lews.). . ❑ I am exempt untler sec. Business antl Professions Code for ihis reason: Signeture: Date: Owner ID verified by tlnvefs licensa. �❑ Yes ❑ No Orivers License No. Venfication of Ownership by (type of daumem, i.e. - properry tax bill or deed): OIVISION OF INDUSTRIAL SAFETY PERMIT CERTGICATION: Expires: ❑ I hereby certi(y that no excavation tive (5) or more feet in depth Into which a person is repulretl to descend, will ba made in connection with work authorized by ihis permil, and that no building structure, scaHoltling, falsework, or tlemolition or dismamling thereof, will be more ihan Ihirty-six (36) teet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title 0, California Administretive Cotle). ❑ As owner-builder, I will not employ anyone to tlo work which woultl require a permit from the Division of Intlustrial Safery, as noted above, unless such person has a permit to do such work from tha tlivision. Signature: Date: Division of Industrial Safery Pertnit Number: CERTIFICATE OF COMPLIANCE AND AUTHORIZA710N OF ENTRY: I ceM1ify untler penalty of perjury that I have raad ihis epplicalion end state that ihe infortnation given is correct. I agree to comply with all state laws and city ordinances relating to building constmction, and au�honze representatives oi �he Gry ol Costa Mesa �o enter upon the above-descnbed property lor inspection purposes. 1 egree not to occupy or ellow occupancy of any building authonzed 6y this permlt until tinal inspection. tSig egal„Owner(s) q/�� AnNOr Authonzed Applicant Date CQDE �. �NsvecnoNrrve 1616 Fixed System Final Fira Prevention 126fi Pool Spa Fina� 200 Finel Re-Roof 201 Finel BIaWRetaining Well 202 203 204 2a4&a8 Finel Factory Fire Place Final Sign . Final Demolition � I[�JALS cooe� iNsvecnoNTrve 206 Final Mechanical 208 Finel Plumbing 210 finel Electrical 212 Finel Fire Prevention 220 Final Planning Approval 222 Final Site 250 Finel Building/Occupancy � � �. ��s� � � Cost� Mesa Building Department , "� - �-�111 EAST 20th S"I'-ET � GOSTA MESA, CALi tNi FOR APPLICANT TO �T Building /�'h Addrese �/1 n/ / � Costa Mesa, California • • Nn��n.1 _ . _ " . • . Mai Arohitect or Engineer' Address_ � Contrecto Addrew • • . Legal I�Lot Deseription No. (Attach Metes and 7 � ' Tel. . No. � Ltc. , „ , No. . ' , �- � ', , City LIC.• . � �' No. �k .- I Tract - I I A�teretlon Ii� � Addition II Moving I I Demolish No. oT Rooms StoAea Wall , � I Root Coverin :w 7 d �� -� I hereby acknowledge that I have read this and state that the above is correct end agre with all City Ordinances and StBte Latd: building rnnst ion. Signature of � Permittee Authorfzed Agt. Valuation O Permlt pee $ � $ �/ Plan Check $ -� .� r! � Total Fee pM 204 G-H 2M 5-Sa ��`F� APPLICATION FOR PERMIT !/ BUt" �.�NG ' FOR OFI+'ICE USE ONLY Address � Nearest �- /s/v'_1 I . _a _ _� �t-C�— /7 "_'/� Mesa, California � Date - � . CORRECTIONS '�. ?a.Q � t� GI � , n m K� . . ,� -� � .. Forma. M: Under-Pin Frame: Fire Lath. Ext. Plaster,lnt Plaster, Ex£ � Masonry Reinforced 00 Bnwd Beam � � � r _ .. . . .. � .. . �._... .. � _" "' ` ' _ ` . � _ . . . .. _ -�- 'F ' .. ..,.- - . .+ .. ' ' � , . _ r •1 � . '� � \ . . __ - - �_ i ,� � ' , . c �: -. . �; c . .� � , , . ' J . . . . _ . . . . a::' - ` a` , "; `I , . ,. � " . �_..` . .l . _ - _ • -- -� ,� • - - . •. � '. , _., �- _ �:\ --� , - - � . _ ' _ , _ _ _ ; - . � �r�� - -- - ' - 4 " ' 1 � . ��... ,_ ..'�` ♦tJ�� _ '. ` ` • . \ . � . \ - ' '�.� �. - . z�o�� ,_ ".�.� :..�_,� - . � ' I . .. - ` -- � . � . ` - 1`-,4 -� . _ ' � • , .i�t I _. . , . '. - - . - ' � � , � • , .. c r;�-� �. �/ . � . . - , - \. +.. � , -• ..�` ' _ _ . .� • . -.U� '1J � . , . . ' -Stre6t � - .•ir� ..'''-. ' _ �.�J ;I �I.+�.. ... � � :n� ' ��r� � \ ' �._ � � "" P+�v1�I.AN� ° . . . � . �'.; .. . .�. .- .._ Show lacatlon and distances irom � . . . �' �•: .. .•hY: -. ; ' . property�lineand Cetween buildings. � .. , _� . � :.�' t . __ _ . _ . . Rl�;i ^ � �. . ..��." ,- _ _ , ^ .'i„ , � ..... � .. " ` . . ' . _ � . . ..�w_ _1 ' �:i�" . . . , � ' . �J' \� �' • , `` • `. y � , . . . � ., � � � � '` " . .. . ' _ . ' . � '1 ( . - � � '� � _ •. ', ' , " .i--.''. . .. 1 . .. .�_ . ..y r . . , ^ _ . . � .. '1 I.: / _� _ . . � ' .. . - . ,��..� � , , . i� . .' _' " " -�' 1" .. � � - �. . ,� .. ..' '_ _ _" ' _ _ ' ' '_ _'_"' ' " ' " ' ' _.. ' �-._ . . : . , ' • ' .� ' . ._. . . t . __Oi '" Co�ta Mesa Building Department _ :1PPLICATION FOR PERMIT . � ,;Y P.O.Box3� .,�410 BU�DING � � ' CUSTA MESA, CA RNIA. FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY Receipt No. Permit No. Building GO � r� (�y— -j 37 t/ Address 0 / A { � T Costa Mesa, California Received by I Date Rec'di 'jDate Issued Nearest (�� .�. —.� _J G ( —d- �� S:o CrossSt. o�L1/'ti+t.Q � � Gf/J� Building Address Owner �, Costa Mesa, California Mail �r'O � � .A `^c�.. Nearest Address 6 ��l"V 7 /� .I�`,,-� Tel. Crou St. City l� OyY+I /�Wtlh.. No..l Zone C1v I plans I Type Group� Architect or Lic. �� Cfty Lic. A � �ontrector �/�p� ,yo. �y 4ddress !1� rr' E��cJ� S t/"r Legal I Lat I I Description No. Block � Tract o. (Att ch M eg��a so�oagj /i� 3 73 _ J�' No. of Bldgs Size of Lot �� Y X�� 6 I Now on Lot I 4seof q No.of I No.o} Existing Bldg. Families Room Setback Line from Rear Vard Center of Street Side Vard DESCR ON OF WORH New I I Alteretion I Jl I Additfon Repair I I Moving I I Demolish Building / y / No. oi Rizn /� A lv Ranme Stnrien rti�«, I hereby ackn and state that with all Clty building const Signature of Permittee �/ {� /��Q/ Foundation Lotation Forms, Materials, Under-Pinning �� Frame: Fire Stops, Bra�ing, Bolts at I have read this Applicutlon is correct and agree to rnmply Lath. Int. s and State Laws regulating � n Lath. Ext. Valuatlon PermitFee $ or -- / /"Y Plan Check $ �� $ Jj1JQ � Total � � Fee $ NAL Eut � 0 Inspector � � Date O a � 2 D r PLOT PLAN Bhow locallon and distancea from property Iine and 6atween buildinga �. :• r ,: -.. , � �:i cosrr, � �.�trt:,:• (1 � �JI:L 24 `�6PDaE5A` ' 19n¢. $.. 0 ,.��, . � , ,� �; . � �,. _ �. • L , . .• �,' `• , ';1•. �;1� � i � I. 1�• Ja �,' ' i : . '. ._ 1'�'. ; ��; ,. .,�1` < < ��', 1- .� � � `,\' � t : �, i A � � 1 ? y�• �• ` • •, � . , , I7?..?_5 . - COSTA MESA BUILDING•SAFETY DEPARTMENT P. O. BOX 917 C08TA MEBh GLIPORNIA � Fo� Applieani to Fill In Complefely TYPE OR PRINT COSTA MESA. CALIFORNIA Dr. Hoxard E. 5awyer 1�80 E. 17 St. coata rusa, ca�.ir. NoL3.83794 re�- �/ ¢ v Ho. ✓ I.� ADDRE6S �' �� CITY STATE � TEL LIC. NO. NO. a�ze 621: x 2q0� OF LOT � U8H OP ' $}�prQ TOQiR EXI@TING BLOG BHTBACK LIN6 PPOM _ _ _ FEE RECE�� ED JUM7 '1962 FIIVANCE' DEPT. � GAPPLfCAT(dN� FOR�APERMIT BUILDING For Office Use Only NCC8IPT NO. YCRMIT 1 � y.�D �L� . /'�% C� COSTA MESA. CALIFORNIA FIRE ZONE MPROVED ZONH NO. OI )q S_Y PS(.N8 � 8" J � f � L66A1 DHeCRIVf10N NO�.OP-BLDO�.z I � � . DESCRIPTION OF WORK•• I II 11 . . 1 Y 1')t PBRRORMED ( f�M[P L1M6 BT.1 _ PRONT 1 H8R8BY ACNNOWL8D08 TXAT 1 NAVH RGD i1119 APPLIWTION AND 8TAT8 TXAT TX8 ABOVH IB CAPRC� AMD AOH86 M COM• PLY WITN ALL CITY OflDIN�NCEB AN� 6�///AT6 LA 1180UU1TN0 9UILOINO CONBTRUCTIOy/' �� „ ' SIGNATURE OF �/u wA !1/NLi/ , AUTHORIZED A6ENT � 1168 OP N¢W�' 'BUILDINO � 3 — �- EVES ALLOWED � FT. . - F � � FT. %.F7. � � � v. . TX6 AMOUNT BHOWN UNDBR VALUATION IB POR THe PYRPOBe OP EBTAOLIBHINO A PeRMIT P88 ONLY. c�0 s /9 � � � 3. � LL _. - � . � 2� I ?6 � COSTA MESA BUILDING-SAFEfY DEPARTMEM P.O. BOX 9/7 C08TA M69A. CALIPORNIA For Appllean� to Fill In Completely 7YPE OR PRINT au��oinc �� ,' � �"' -+ ADORE59 COSTq MESA, CALIFORNIA ■ MAIL ■ BETBACK LINH OF BUILDItIC TEL. 1 X2HEBY �CKNOWL8008 TNAT I N�VB RCAD TXIB APPLICATION AND BTFT@ THAT THQ A60V8 �8 CORRlR AND AOqH6 TO COM. PLY WITH ALL CITY OqO1NANG68 AND BTATB uW9 RHOYLATING BUILDINa CON8TRU ON. � SIGNATUREOF � PERMI7TE AUTHORIZ&DA NT 1G� ��,� R E C E%' E U�`.�-�'.`' �� ' JU L 8 1963 �(�J�' FINANCE DEPI. � p9�PP��6P�TRoD9Ek'�n�ir BUIiDING i For Offite Use Only � n¢cnrt no. I �x� /� C /J/J � , O� ZONING � zon� rvo. oF uea or n�w (,_ �� vuns ^� euaoixo � ksa�a m a R L u f 9`� lTfON NOTE: NO EAVE OVER 90• TO BIDE @ REAR F EAVES ALLOWED YARD9 APPRO V ED MAIN BUILOINQ VAR. }i I� ] ' ��`,f O BHALL BE LE88 THAN (U.B.C.REQ4IREMENTI YARD9APPROVED ACCESSORY BUILDIN6 - v.� �. � .,,;, . /o O � 6 f � Fr. lo n 6C.FT. � TN8 AMOUNT BXOWN UNOBR VALUATION �9 POR TM8 = PURPOBB OF HBTABLIBHIN� A PBRM�T FQ8 ONLY. p VALUATION f m PERMIT FEE �% �_ � � Q m $ VORI tm� E� p 4 TOTAL FEE �- �� ' i�"" - �� ' ' ' COSTA MESA B t C�r-SAFEfY uEPARTMENT F F Fi 2R� E I V E D P.O. BOX ]1] C08TA MCBA. CALIRORNIA !r� Por Applicanf fo Fill In Completely APPLIC^A�TION FOR PERMfT �PE OR PR�� S CIIi�Vr {�UJIX ry�tJ�- BUILDINO � ADDRESB / I � COSTA Iv1E5.4, CALIFORNIA P«a�rtno.-. ' re rt . . . � o�id.�` `R[C [ Y Tt C[IV D DA e D OWNER %�i P� ZI('� /�� / y�`� MAIL !/e Q L /� �I S T BUILDINO T _ J � � `� � ADDRE68 [/ ADDRH88 � � . TEL � �ZONH �'� ' TYPE ORO cirr C O .c %%fS41 �C �t� No.� Xj� �(/ . ARCHITECT �-- TEL. L_^ ' B,,PROVED � ', DATE V v � OR ENGINEBR NO. - . . . � ' ONINCi' . wooRess zona no.a. U9[OPN[W � �^J� _'Y nune ` — I em�nino CONTRACTOR Ci� [/�y L[OAL L'� ADDRHIID OX �� /��O/%'� f o[seR�R1oN VI` LQ CITY ��J" L{6 Q C Q�/ A. P. NO. r ��-� 7�J �O N NOTH: NO HAVE OVeRHANG SHALL BE LE98 THAN 6TATB . THL. %�� Q 90' TO SIDH Q R6AR P. L. LIC. NO. EAVEB OF LOT 6 z X 3/o NowoN LOT� � ALLOW6D (U. B. C. REOUIREMENT) USEOF • YARD9APPROVED YARDSAPPROVED E%ISTIN68LD0. Sr%I�C / / QS � MAINBUILDINO ACCESSORYBUILDING fFROM C/L9TRfiHT1 BETEACK LII16 P110M c FRONT FT, c¢niea Op orneR V� RHAR YARU �� BIDH YARD LHPT ��/�E RIOMT //' R' $��H �' 'I �' DESCRIPTION OF WORK �. s�oe rr Fr. � NHW ALTiRAT10 ADOITION X RHAR PT. Ff. DISTANCH BET. BHT. MAIN Q REPAIR MOVIN DEMOLISFI MAIN BLD 8. ACCESS. BLDGB. BUILDIN6 � NO.�M VAR.TC � DATE �^� , SIZE ROOM8 HTORIEH C. U. P. APPROVED HJRERIOR WALL ROOP MPROV[D � COVERING COVERINO B�' DAT! U86 OP BU ILDIfiG AND WORK T� BE PHRPORM6O REMEN'1'� t10LU FOR SPECIA REQ Q so. vr. � " 0 1 NHqHBY �CRNOWL8O08 TH�T 1 HAVB HGO THIB ApPLIGTION TN[ AMOUNT OHOWN UNOBH VAIIIATION IB pOq TN8 = AND 8TAT8 TNAT TN8 ABOVB �B COHRBCT AND AOft86 TO COM. YUflP09[ OI [BTABLIBXINO • PBRMIT FE8 ONLY. p � PLY WITN �LL CITY OqO1N�NC80 AMO YT�T6 LAWY qtOULATIXO ypLUATION BIIIlO�NO CONBTRU 1 , �� q��) N SIGNATURE OP � e' PERMIT FEE S� U v � PfiRMITTE //� [�/ .• m ( f 1 y'� G a AUTHORIZeD ACHNT �`� U � 4 � TOTALF6H $ � ' ,,:,.,, � � _ . �,_ ., . ;`,i1, ; -.� .� ; , ` '. ' SpeCial� �ec�uir men s:�t _. . .� . .. _ . 1. Ii';�ar,k�n� ,�.s,.�.n fr.ont, a low planter area be installed to1 matcki• aci�aining property. ' `' '• ' A'iit� Ai�'J�� lU r(i;l " , . • .2: Fire extinguishers' as per,pamphTet_No;�lO.N:F:P.A.' and.� , subject to local fire_code. _ ' � � - � ` • ' . .—�.: . . ' , . . : '� 3•' Strinaerst sound-proofing regulations. ---- — .•,_.'=;4. :Installation of commercial sideualks-across;the entire, ,;-1 fPontage of the property, including concrete drive�ray approaches k�x�camakac by applicant and�or owner �� at his expense, under the direction-of the City Engirieer. .r' " ` 1 . ' - . . ti ��.•;1 " � , , _ ..'. ,\:'. .. _, .,�.... , , �' . . . . ._.. _ � -- • - � �.. , ��' � � i- 1. .. �� . . - � , . ..- . . , � ti-- ' ' . � �.. .. .. . .. �. _. ' 1 ' " � '- - - - � -i - � - � � . i::�� i � . . , . .. _ . ._ ... . . .' . . f ' . .�. . . . _ , .:: . L .,r - . ; .. .. .. . .. ._ .... .. . ... .... . . . _ . . . _ _ 1'��'� -'_ ' . . .l •. ... . ...,. ._ . . . . . - • ' • . , � . _ _ ' + . l 1 . . 1 .. ` . ' � .. .. . .- .. . _' . �.'"' -, , , ' . . .. _ "' . L.._._ _ . .. _ . .. , r � � � . 2431 COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BO1[ it] COOTA M@9A, CALIFORl11A For Applicant fo Fill In Complataly TYPE OR PRINT a��o�Ne ,,r,�o .r'. �i r� .sr- ADDRE88 COSTA MESA. CALIFORNIA 20 2 c�Tr C ni�h a JF //" h- _ �G. NO. NO. �• �.r al 1 � � s�ze �»2 � �y�./5 I no.ore�oac. oF Lo7 � now ox w1T USEOF ��jU J DS f�/•/C�C/ EXISTING BLD6. Y � BGTlACK LIN[ IROM /� �J CENTBP OP YTq[lT v� /✓J REAR YARD /� � /� 81DHYARD LBIR ��%�V R16NT �„ DESCRIPTION OF WORK � 'I HEPHBY ACRNOWLHOOB THAT 1 N/1VH RFv�D TXIB APpLIWT10N M1ND BT�TB TNAT TX8 ABOVB IB CORRECT ANO AORHB TO COM. PLY WITX �LL CITY OR�INANC88 AND eTAT6 LAW6 N60YLATINO BUILOINO CON9TPOC1'I�N: � /i /J r AUTHORIZHD AOHNT L80AL C(TY OF CGS . NiESA JUN 18 1965 _• NO. OR �/ 8[ OI PLANB � em�ou ��3 — z� . HANO BHALL BE LE89 THAN YARD6APPROVED I YARDSAPPROVED MAIN BUILDING ACCE680RY BUILOINO tOMC/�R�>I / .y ` � RHAR �'V PT. Pf'. S�1 F DI6TANCH BHT. BfiT. MAIN R Z MAIN BLD08. ACCE88. BLDpB. � VAR.ii DATE [/ C. .P. 7 APPR V6D .0 l�_� Q' AYPROVV �,1 DATE � �cJ G � W � � � Q V a �y] so. Fr. 4 a T116 AMOYM BXOWN YNDHR VALUATION IB ROR TN8 S N PURPOBH O! 88TABLIBXINO A PBHMIT PH8 ONLY. Q a VALUATION �0 � O PERMIT FEE � /^� � m Q ��/ �� Q Q� LL � TOTAL FEE $ I V . �. , . :. . y � ,;�. . COUNTY'�Ot�ORANGE � • q BUILDING DEPT. � 3 � � / � " 636 No. Broadway ' Petmi[ ivo."-'_"'-""-' -" ---'-. ,. Santa Ana� California Application for Building Permit .�� ~ Phone: KI 2.6271 AND FOR A � Certificate of Use and Occupancy � �/ —!�r j - ' Date.._�v ✓_.__z �i.. /9SQ-------" 1. OVi�NER'S NAME-- C:__.MFeck�°---- New�c!�------"-'-------------'---'-'---'-----'-'-`--`---- PHO[VE: NArb�r-_/SfQ--- n4nILitvG nDDRESS--439...-.A_�_a_c,.i-a---.-----------------------------------------------CITY_Coro.ng-.---2c.�----A!Ia./"-- Name �•._.%%?.f.EM.A_.�%--'--------'---------'--'- --'-----'---'------ ' (;.erRi�ecc-oo-.6nsi�xer) D.CAF7THAM Address �rc _.N_Mo.lTc-,PFLLo-_-�L_vo._-----__--- City _./.�/%ONTk.9.EL�o__�.._' CAL�F_'--"--"-'--_--"-"'_-"--- State Lic. No.._�ONE--------------`- Phone./i�NLoN.C_�3P/3-`- PROPOSEp USE: ___C-E_2� 0 Namc.-- G� `-/�!1.h.c. K( G------N ew..'f°.�------------------------------- (Contrnctor) Address ---......_.---.�. R_.�. � ---`-'-•------------------------------------ City----'--'-------'-- ---'--'----------------'--'--'----`-----------'---------' Statc Lic. No..'--..F�O.!!N6------- -'.._.... Phone_SyM-�"-------'-- r ,�"-----��/----' '- � 2. JOB LOCATION---=----- _ --------------------�7--�--S.PRF..eT---- ---------•--------._Coar.�.----f'1�s.n.------------------------ (House No.) (Nam¢ of Scre¢t) (Town or School District) 3. LEGAL DESCRIPTION: Lot.--------.i8-------------------------Block -------.-..--'---,--------------'-'---.----Tract.il(G..W_PS±<.T---//CiGH'TS (Meres and Bounds Dexripcion—Use r¢urse side oE form) . 4. CORIVER [,OT ( ) INTERIOR LOT ( x j 7'HROUGH LOT-( Y ) SLOPE OF LOT ( L E�r L . , � -. • � 5. SIZEOFBLDG.:_6-i_X42-------.AREA:_Z�A�'�--NET__.SIZEOFLOT:._�.�_x3i�....._..AREA:._/9,_zzo------ 6. HEIGHT OF BLDG.:__�4.�_4��_____..______.CEILIIVG HEIGHT:.SL�oc-i�!o'rorr�d NO. OP STORIES.___.__�.___.____._ 7. NO. FAMTLIES Size oi Smallest Bedroom: .__.LL_K �?r....._..._. Size of Kitchen: 8. EXTERIOk WALL CONSTRUCTION:_.F«�^.�'___________________..I[VTERIOR WALL COVERING ...D..2ysv.A�L.___._..__._.___ ' (Frame, Stucco, Etc.) (Plaeacr-Drywall, Ecc.) _�"" n 9. SETRACKS: Front Yard from Center Li�e of Strcet.""'_-'_�o.-S' 0'--_---""-'-'---"'-_"_"'----_---___"--""'-__-"_-..---'_"'_'-"_"---_-- Ncarest Side Yard._._.L4.=� ��_._.Rear Yard.____.__.LZ�.._,_.Distance in Fcet Between Bldgs. on Same Lot.....f✓e�N�._ .. IU. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH. /A� a__ ............. V%idch of Wall -.----¢%_".. I L For (a) Foocing: Widch -------_.-_-_'.' ------------------- Dcp�h in Ground..-_--_/--�� Atccssory � ' . • . Bldgs.' and . b � Siu of Studs: .__.___.9.K4_��..______ S acin ¢� ��._.._...__."CC ' Matcrial oE Floor ._C oNC.__ ._., • ( ) . - � P 8-__._-_"-' Sim�lar Structures: ' � . ' • • ' (c) Size vf Floor Joists: --_'--N°M'E"....._... .Spacmg /✓on(c�_'----_:_"CC . �d Sizc o£ Rafters: -'---�/��R_-�' ��- ---"'_ �L ��---"'--;---'_"CC ) --".Spacing _....'--- 12. VALUATION OF PROPOSED WORK: Intluding all faboq plumbing, electrical wizing, heating, fire sprinklers, paint- ing arid sewage disposal �__'-%Opo__O.Q_.__________.'__"___-______ ' . . 13. I HEREBY �ERTIFY THAT TO THE BEST OF MY KLVOWLEDG6 AND BELIEF THE INFORMATION IN THIS APPLICATION IS CORRECT AND THAT.THE CONSTRUCTION WORK WIL[, CONFORM TO ALL LAWS OF THE COUNTY OF ORANGE AND THE STATE OF CALIFOR[VIA APPLICABLE THERETO. Plans Filed:.__'._'_____//�//__.J__._v.___________ / FEESn Bldg. Permie . �_. Plan Check • $.. To[al - - • �_. Receipt No. - - _. Paid to - - .. Daee --- ---._...------ . . FOR DEPARTMENTAL USE ONLY � �� GROUP--..-_-_-_� -.--CJ'D TYPE.------... � -------- ----------------�- '_._c!_D DIST. _ �MAP---------�-- --� . SHEET NO.----------�------ , .' �� DATE.---'-- f ��-��`�--0 -------- !M-L�O C�H�jECK�NC BY APPLICATION.._(/.C'.`. � /HEALTH.._._,_____,___._.__._... // FIRE ZONING.---�--------l� MARSHAL.-------------------- PLA[VS AND SPEC'S ------------------------- - STATE --- ----------- ----------- CORRECT10N5 ENGINEER �M7Y BUII.0 INSPECTOR � COUN'I7 OF ORANGE , BUII.DING DEPT.�I — 636No.Broadway � APPlication for Building Permit Santa Ana� Califomia� �� Phoae:KI2-6211 - AND FOR A Certificate of Use and .Occupancy ; J 1. OWNER'S MAILING f Name ._.<r---�" �--�" �---"'---- ' .................-- (Architect or Engineer) Addre=_=_ .._...... City State Lic. i YROPOSED U 2. ]OB �� ON Permit N�(.!...!...�..�...... llate��%�� ..�.�...�� _^��,... � ...--- . � - - � .............. PHON ----�.�.�L_�_.� / �---- - - - ... CI .. -�- --�i:Y[ j� _Gl� Name .. � . ... .. .. .. _.. . _ -------' ............ ...-----'--' -- (Contrac[or) Address................._.......... - - ............. - ------ - .......-' ........ City .... State Lic. No. ..............- - � .. Phone..-- -- ........ -- - - i r ...............I....... ...- --- -,._... --...- -- " eSSrI/% 8 P.��7//�r (Hous'e No.) .. �(N/a�me o Street) (Town or Sthool District) j/� 3. LEGAL DESCRIPTION: Lot.----�'!'_��....�7..-�� ........Block ..........................................r.%...... yTract�QFi%��'�-.N.Q�� (Metes and Bounds Dewription—Use reverse side o( f6rm) GC e��f•��%•NG e� � Y / 0/ �� 4. CORNER LOT (. ) ]NTERIOR LOT ( ) V THROUGH LOT ( ) SLOPE OF LOT (�Q ve L. i. SIZE OF BLDG.:I��- %�..� �'-AREA:---(�..��-./........SIZE OF LOT:.�j.�.�....'�.'-D....AREA: -c--- ................. G. HE]GHT OF BLDG.:._�..�-�-----------------------CEILING HEIGHT:.�.'`...�...Z.....NO. OF STORIES......._...._I................ 7. NO. FAMILIES.._.-.(.�.:il�-......_...Size of Smallest Bedroom :................._-_-.---..---._.---- Size of Kitchen�-.........-.----.-- S. EXTERIOR WALL WNSTRUC?ION:.�'YJFT�t:��.---INTERIOR WALL COVERING ...............�� (Frame, Smcco, Etc.) (PlasterDrywall, Etc.) 9. SETBACKS: Front Yard From Center Line of Street....... �.. [ � 7"�h�✓��-�. .. ..�� ................-----��- ��-- --� �� -..... - - -- ...... _. __ , , Nearest Side Yard..�a../._.__.Rear Yard..�Q�..,.......Distancc in Feet Between Bld'gs. on Same Lot......`�.�. �........... 10. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH. 12. 13. ..� / For (a) Footing: Width.....-----�..+ ._1. `-_............Depth in Ground.......�_�1{�.:�^.......Width of Wall-----� �/ .... ....... Accessory • ' � ? fn � Bldgs. and �b) Size of Stude:..y�..... ......._Spacing....� ..................:'CC Material of Floor.��✓.!��!��...�' Similaz .. . . ... . Structures: (c Size of Floor oists:...._...........�-.....5 acin �`" ) J P €.....: - - . .................... � CC (d) Size of.Rafters:---�}'...X-�_-----------.....Spacing....---�..../.---------------:'CC . � . VALUATION Q�R PO E Including all labor, plumbing, electrical wiring, heating, fire sprinklers, painting and sewage disposaL$'��.. , t� _ � I HEREBY CERTIFY THAT TU THE BEST OF MY KNOWLEDGE AND BELI$F THE INFORMATION ]N THIS APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OF THE COUI�'TY OF ORANGE AND THE STATE OF CALIF RNIA APPLICABLE THERE O. � M � Signed:._.. ......_./iR./ ........... .. - - .... ...� .................._...- - -- - -- Plans Filed:...��..".----�-------"7-'.�"--`-.._.---------'--- FEES: 00 Bldg. Permit ' $-- --y-"'a'G -`-....... Plan Check - $.- -1- � ---- �- - -� - � ro- Total . . , pe$---� -- - _ ............. Receipt No. • .�-_.a�.�'j - --- --.. Paid to - - .......:...-� -�---- � ---- Date H.-aa__-50. ........ -- - �--- --- -- - -� (Authorized Agent) FOR DEPARTMENTAL USE ONLY CHECKING BY GROUP..G, .......................... APPLICATION.� HEALTH---.----.....----_...._-_ TYPE---._��..�../.....-----• - - Ci FIRE ZONING.. ....................... DIST. MARSHAL ......................... �P .�._ � (.� PLANS AND � -----...... ' SPEC'5 ............................. --��---- .........-- ......... SHEET NO.......,� .............. CORRECTIONS ENGINEER DATE., � �� ......................//''�� s nt—e-sf V / � ✓� (/ /7 � V/ Applicant to_fi11 in all spaees except those within heavy eoraer lines anC sign all aDo�opriate aeclarations. CITY OF COSTA MESA C NST^�R4 •CTIOyN PERMIT PERMIT NO. ' - � TRACT NO. LOT NO. � UNIT N6. , � ProjectAddress '�9� �� /��1 S1� � �� ''� � ' TVPEOFCONSTRUCTION NEW ' ADD ALTERATION REPAIR A licant'sMailin Address �M� � • � PP 9 ��y�Z�q ❑ GONVERSION ❑_DEMOLISH ❑ OTHER � � � Owner's Nam`e ON e� Phonai7_v__✓__�L� DESCRIPTION OF WORK/USE OF BLDG. Address JA�e o Arch/Eng. _ License No. y53I90 TVPE OF PERMIT Gab.Dirvc FOUNoarloN ❑ 57RUCTURA� Address� ❑ TENANT � ELECTRICAL ❑ P�UMBING ❑ MECHANICAL Contrac�Or'S Name (/i Nc'eh7' �/e� al c p pne � � ❑'OTHER - - ' -- . Address (mailing)' �19 L�%+ �[�fh UNt t� PROJECT DESCRIPTION SQ. FT. OCCUPANCY— �� , � � CONSTRUCTION TVPE � -VALUATION $ City License No. ZONE ' GRA�ING CU. V�S. � ACRES_ LICENSED CONT�RACTOR�DECLARATION ' ' ` ' I hereby atfirm Ihat I am Iicensetl untler provisions ot Charter 9'(commencing . Remarks: '. � : ' wlth section 7000) of Division 3 of the Business antl Professions Cotle, antl : my license is in fu/ll �forf e antl effect. � License Cla�s'�/ � / � l.l�ense N��r Date ��zJ-� $'g t �� WORKERS' COMPENSATION DECLARATION --� lereby atfirm that I nave a certificate ot consent to selbinsure or a certificate ' , Workers' Compensation ,Insurance, or a certifietl copy thereof (Section � ,d00, lab. C.) : , ' Policy No. � � Coritpany � ' 8 Certifietl copy Is hereby furnishetl. � . . ' . Certifietl copy IS iI12G WILII IIIE CIIy BUIICIl19 DIVISIOO. � � Date APPlicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION � (Thissection neetl not be complet¢tl if [he permit.i5 (or One'huntlretl ($300) or � Iess). I certify tnat in the pe[tormance of the work for wh'Ich this permp�t is i55uetl, I shall not employ any person in any man�so �s Fogecome s bject to the Workers' C p� ion Laws ot Calitorni // 1 f'7r Date '� Si9nature � b(1V�lM.<firy'c! �'NOTI : If, after making this tleclara[ion, ou shoultl become subject to the ' Workers' Compensation provi5ion5 of the Labor Cotle, you must torthwith � comply 'with su�h provisions or tnis permit shall be; tleemetl revoketl. ' CONSTRUCTION,LENDING AGENCV I hereby a(firm that there is a construction lentling agency for the performance � of the work for which this permit is � issuetl (Section 3097 Civ. �CJ Lenaer's Name _ - Lentler's AtlOress ' - - � OWNER BUILDER OECLARATIOIV ' I hereby af(i�m that I am exempt from [he Conttac[o�'S Llcense Law for the . following reason (Section 7031.5 Business antl Protessional Cotle: Any city or ' county which repuires a permit to construct, alter, improve, tlemolish or repatr any stru[ture, ptior to its issuance, also requires the applicant tor such permit �. to �il¢ a si9ned statement that he/sh¢ is Iiten5e0 pu�suant to th¢ provisions of , �ndr��r.a�tr.rc i icenae I aw tCnaoter 9 fmmmencine wi[h Section 70001 of 'rom antl the basi5 (or the allegetl exemption. Any vlolation of Section 5 by any applican[ (or a permit subjects tM1e applicant to a civil ty ot not more than (ive huntlretl tlollars ($500).� � . �ds owner of the� property o� my employee5 with waqes as thei� Sole ensation, will tlo the work, antl the structure is'not intendetl or offeretl , gle. (Section ]044, Business antl Protessional Cotle: The Contractor's se Law tloes not apply [o an owner ot a property who builds or improves m, antl who tloes such work M1imselt/herself or lhrou9h his or her own � ryees, provitletl that such improvements are not int¢ntletl or oiferetl ior If, however, the-builtlinq or improvement Is soltl witnin one yeai ot com- n, the owner will have [he bu�tlen ot proving he/She tlitl nOt builtl o� Im- for lne purpose of sale). 1 I' tl Sink " tflow Preventer _ PLUMBING ' Showers � . � . ServiceSink � � � Sewer Cap� , - . : n � _ .._..__..'____'.'_ ' Clarifiers ' • . Dishwasher " Drinking Pountains � Floor Drairis � � Floor Sinks ; Gas Service Outlets` Interoeptors� ' � Kitchen Sink , , LavamrieY ' i P-Trep., Roof-0rains' ' � Reinspection fee $15, � � � Boiler � - ' ' � Duct-UnderGround u i, ds owner of the property, am exUusvery cont�acHng w�th icense mn- Duct-SttuCTu�31 tractors to'Const�uct the O�olecl ISection 7044, Busine55 antl Pro(essions Cotle: ' The ContractoYs .License �aw doe5 noLapply to an owner of �property wh0 ' DuCt - VEOtilating I bulltls or improves Ihereon, antl who contracts tor SUGh projecis witb a con- tractor(5) license pursuant�to the,Contractor'S License Law).,I am aware that ExhauStSystem ❑ Multiple proof of their Worker's Compensation insurance shoultl be provitled to me.' _ ❑ I am exempt untler'Section� B. & P. C. for this.reason ' Firepl/Fact BIt. ICBO # �' Date' Owner � � ' ' Heating System & Ducting � .- I hereby certify that I have reatl this application antl state that�the_abave � b0.100,000BTU �100,0001 information is correct. I agree to compty,wrth-all city antl county ortlinances antl state Iaws relatin to bu Itl'n9 mnstruction, antl hereby authorize repre- sentatives oi this ci t0 �r upon !he ove-men[ionetl P�ope�ty �fo� ' ' . � inspection purposes. , /� O / Signature " Dat¢ d ' ' . Drivers' License'or 55 � ' - Reinspeition Fee CMF 0865-66, rev. 10/84 White - Builtling; Canary - Applicanh Pink - Accountinq; Goltlenrotl - Assessor $15 � � Solar Pipin9 . SolarTank : . Swimming Pool w�/Spa Urinal Water Closet Wacer Heater ' A.P. # S Main Buildi E T Front B Rear a C Right K Left S Ping. Ref. # ' Planning Notes: w � AutomaticWasher; . � CanstructionPoleSub. � Cooking Unit' ' ' . Dishwasherr � . � ' Auto-Wash � j Laundry Trays � � � j ; . ' � la�ue Fee � $ 3 IANICAL � . 'FEE Hood or' Type I � ❑ . • ' Canopy Type I I' ❑ � iefrigeration Sys[em � . �0-100,000 BTU 0100,000 BTU - System Repair/Alteration � I � " F.ire Dampers ' • ' " ' Registers '� . ' �— . 1 e Fee � $ 3 Fan F.A.U. Fixtures ' Device Boxes . ' $WI[C�1Q5 Garbage Disposal � Generato� �0.5 KW uµoi li��/tl6 - - .- Zane Accessory Building: � i• Parking Req./ProJided . � ELECTRICAL'� � - ' Transformer ❑� 15-50 KW. � 50+KW � Meter _�up to 100.amps � Meter oven100amps_ i �Sub Panel ' ' ' MomrsO0.7 HP:O7�-6 Inc.Solar �9-15 HP �i6-15+ Microwave ' Pole Ligtit � � � Range ' , Si9n . � � " f ; Standing Sections �5-15 KW . Trash Compactor � Reinspection Pee � DEVELOPMENT SERVICE Zoning APProved 8Y_ Building Approved By n....r..�.:..., w....i o.. ' �- $15 � � � Issue Fee � HEQUIREMENTS: �l1oJw ��, Z O N i N G R E Q M T S PEES ' � - � ' ' � `- SUMMARV OF FEES ' � ' � � � � � �.B�UILDWG PERMIT � $ � -� SMIP .. _ � $ � - ; PLAN CHECK ; $ � .� ' � PERMIT � , , , - �PLUMBING '� $ ' ' �ISSUANCE $ _ �� PLAN CHECK 25% 3 � j '- ENERGV P.C. $' : �ELECTFICAL' , , $ ' ��: GRADING � ! $ ' -PLANCHECK�_ 50% $ MICROFILM $ �=C - MECHANICAL $ TOTAL FEE �$ O r J� . PLAN CHECK 25% $ , � � CONSTRUCTION AND PLANNING POOL & SPA . APPROVALS Permii# Date Inspector ppPROVALS Permit# Date Inspector�l 9. Temporery Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms - 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding � 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Gmd. 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 Facto�Y 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 & Sicling 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 MeterFinal ' 80. FOOD CERTIFICATE ISSUED 33. Final Electric G Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test _.. . 36. Hood or CanoPy , � . 37. Final Fac[ory Fireplace • � , 38. Final Plumbing , . 39. Water Service-Final , 40. Gas Service-Final - 41. Solar pomesticFinal ' �� 42. Backflow Preventer . ' ' - � 43. Backflow Irrigation �.. ; � • 44. Landscape Irrigation SYstem � . " 45. Sound Attenuation � � 46. Handicap Regulations . "_ , � 47. FINAL STRUCTUf?E & BUILDING � , . � . �48. Special Requirements Completed � ' � 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co � � 51. CERTIFICATE OF OCCUPANCY - � No. Date - . �- �. Avo��ant to /i11 in all spaces except tnose within neavy eortler Iines ana sign all aoD�opriate aeclarations. CITY (�F y'�STA M/E,SA /C7ONST�RUCTION P—ER/ynA�'' T P�MIT NO. �� RAC7 NA.� �OT�NO.�� UNIT NO. Pr�je �;.�1eis �� -+-�//y/� •�� .. j�iFu� App�icsm'sMail7in-g-Address t�22/-L./%� � Ownw rName / �� %��=-=�Y //ghone�.�1 '� � nddress �^ S/L-�%E� �Ny. /(�Ce�i"L� Arch/Eng. � • �� Licen No. /Ul �3 Address 2Z U6 � Contractor's Nam _ /�7� Addresslmailingl..3��'� �� C y CityLicenseNo. ��tS�� LICENSED CONTRACTOR DECLARATION I hereby affl�m lha[ I am Ilcensetl untlar provisions of Chdrl¢r 9(commencing witn sectlon '1000) of Division 3 ot t Buslness antl Pro(e5sions Cotle, antl my Ii<ense is in tWl torc na eHect. � � LicenseClass Lice 5� Date �" Si9naWre WORKERS' COMPENSATION OECLARATI 1 her¢Dy afflrm that I have a c¢rtiflwte ol Consent t0 selLinzure Or a Certificate Sf Workers' Gompensatlon Insurance, o� a certifiGtl cOpy thereof (SeCtion 3800, Lab. C.) Policy No. Company 8 Certifietl cooY �s hereby tumisnetl. � Certifiea copy is tiletl with the city Builtling Division. Da[¢ APplicant EXEMPTION FROM W00.KER5' COMPENSATION DECLARATION (Tnis section n!¢tl not b0 completetl 11 Ihe permit is for one huntlretl ($300) or less). I certify that in the pertormance of tn k for which thi rm�t is issuetl, I shall not employ any pe�son in an man r So d5 to e Sub� ct to �he Workers' Cp[ppepytipL�8tiv5 u/ C If0 I Date �� ) �f ��I9natu e NOTICE: H, aile� mdkinq lhis tloc , you ultl become subject [o Ihe Workers' Compensatlon Provisions oi tne Lab Cotle, you must (orthwi[h comply with such� O�ovisions or thi5 pormit Shall be tleemetl -revoketl. CONSTRUCTION LENDING AGENCV I nereby af(irm thal t�ere is a tonstruttion lentling a9ency tor thc performan<e of Ih0 work for� which tfii5 pmmlt iz ISsuetl (Section 3097 Civ. G.) Lender's Name Lentler's Atltlress OWNER BUILDER UECIARATION � I hereby atfirm that 1 am axempt trom tho Gontractor'i License Law tor the following raason (Sectlon 7031.5 Business antl Professional Cotle:�Any city or counry whlCh require5 a pa�ml� to ConstruCt, altOr, ImD�ove, tlemoli5h or �epal� any structure, prior to.lts Issuance, also requires tha applicant for such oermit to ti10 a slgnetl Slat¢rtlenl thdl h¢/ShC Is IlcenSetl DurSudnt tOlhe plavi5ioni Of the ConVactor's License law (Cnapter 9.(tommoncing wlth Section 7000) of Division 3 of the Business antl Prolessions COEe) or tnat ne/she is ezempt herolrom dntl tne baiii fOr I�e allagetl exOmption. Any violalion O( Section 031.5 by any applicant lor a purmit subJects tha aDO��<ant to a civil �+enalty Ot noI mor0 lhan five huntlred tlollars (E500). LJ I, as owner of tne properry or my amployeas witn wages as lheir sole componsation, will Co tho work, antl the structura Is not Intantletl or ottered tor wle (Section 7044, Busine55 anU Prolessional Cotle: Tne Contractor'S LlcenSe l.aw tl005 not appty to an owner Ot a prOperty wbo bulltl5 Or improves thereon, antl wno tlaes sucn work hlmsMt/herself or through hiz or her own em0loy¢Cs, O�ovitlCtl [hat SUCh Impfovament5 ar¢ nOt Int¢nCetl or oftaretl IOr sdle. If, nowever, the bullding or Imvrovoment is soltl witnin one year of com- pletlon, lho owner will nave tho burtlen ot provinq hn/she tliC not buila or im- p�ove tor IM1u Purposo of sale). ❑ 1, as owne� oi lh¢ property, am exUUSiv¢ly Wntra<ting witb lic¢n5¢tl cOn- f�actor5 t0 conStruCt t�e projoct (SGctiOn 7044, BuSiness antl Prof¢Ssions Cotle: The Contractor's License Law tloes not avPly to an owner ot property who builtls or Imvrovez theraon, antl who contracts for suc� orojects with a con- . tractor(s ❑censa pursuant to the ConVactor's Llcanse l.aw). I am aware that proof o� their WO/kor's CompenSatiOn Insurante zhoultl be provitletl to me. ❑ I am axempt untler Sectlon B. 6 P. C. �or lhis reason Date Owner _ I nereby certify that I havn r¢aa this information Is c recl. I aqree lo comp antl ztale Id�rel ting lo bulltli�n9..� sentatives bf this citv to ent� ui>or Drivers' Licenze or 55 � � *� <.; ., _, • �fVPE OF CONSTRUCTION U NEW' IJ ADD L.1 ALTERATION lJ REPAIR ❑ CONVERSION ❑ DEMOl15H ❑ OTHE�I, A p �y � DESCRIPTION OF W RK USE OF BLDG. -�`++�+�� ' 4� u�� ,E S Main Building: T^VPE OF PERMIT�� GRADING�/ FOUNDATION STRUCTURAL T Front �.� TENANT IH ELECTRICAL L�IPLUMBING ❑ MECHANICAL B Rea1 ❑ OTHER A PROJECT OESCRIPTION 50. F7. oCCUaAr��Cv- C Right CONSTRUCTIONTVP�� VALUATION5�.2�4L6� $ Left ZONE GRADING CU.YDS. ACRES Ping. Rei. � Remarks: Planning Notes: �_y�� Bar Sink Backflow Preventer Backflow Irrigation Clarifiers Dishwasher Drinking Fountains Floor Drains . Floor Sinks Gas Service Outlets Interceptors Kitchen Sink Lavatories P-Trap Roof Dreins Reinspection Fee Showers Service Sink Sewer Cap Sewer Connectian Solar Collectors Solar Piping $olar Tank Swimming Pool w/Spa Water Closet . Water Heater � Wacer Service AUIo-Wash Leundry Trays $15 laua Fee Boiler Duct - Under Ground Duct - Svuctural Duct - Ventilating Exhaust System ❑ MWtiple ❑ FirepUFac[. Blt. ICBO # Heating System & Ducting ❑6100,000 BTU �10 BT Fee � $15 CMF OB65-46, rev. 10/84 WhitG - Builtling: Canary - qpp��cant: Pink - AccOunting; GoltlenrOtl - ASSe55o� FEES 5 3 7EGMNNIGAL FEES Hood or Typel ❑ Canopy Type 11 ❑ - Refrigeration System ❑aioo,000sr ioo,000eru Syste pair/Alteration ire Dampers ' Regiseers Issue Fee 5 3 Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Eleci Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Dispoul Generator �0� C I Reinspection Fea — DEVEIOPMENTSER 2oning APProvad BY _ Buildin8 APProved By Aoolication Issued Bv_ 7880 5/13/07 2—I zo�e Accessory Building: Parking Req./Provided EIECTRICAL Transformer ❑ 15-SO KW ❑ SO+KW Metere�up to 100 amps Meter �over 100 amps SKW 515 BUILDING PERMIT S PLAN CHECK , $ PLUMBING $ PLAN CHECK 25% $ ELECTRICAL $ PLAN CHECK 50% $ MECHANICAL $ PLAN CHECK 25% $ Su6 Panel Morors DO-1 1 h- 8 Inc.Solar 9�15 HP �16-15+ Mi ave ole Light Range Sign Standing Sections Trash Compacror luua Fee REMENTS: 103,08 'f� FEES $ 3 Z O N I N G R E Q M T S Y FEE�/ � SMIP $ ..'SZ� PERMIT ,QO ISSUANCE S ��ENERGY P.C. $ � _ GRADING S MICROFILM $ — TOTAL FEE $ Lo3 �48 CONSTRUCTION AND PLANNING POOL & SPA APPROVALS Permit #`- Date Inspector qppROVALS Permit # Date Inspector 1. Temporary Electrical Service or PoIC 52. Pool & Equipment Location •� 2. Soil Pipe-Undrgrnd. ' 53. Steel Reinforcement .. � 3. Electrical Conduit Utility-Undrgrnd. 54. Forms � � 4. Electrical Conduit-Undrgrnd. 55. Electrical Bondirig � 5. Steel Reinforcemen[ 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVALTO COVER-GUNITE a 7. Footingi 58. Electrical Conduit-Undrgrnd. 8. Foundation , 59. Gas Pipe, O Undrgrnd., Test�� 9. Water Pipe�Undrgrnd. - 60. Backwash Lines, P-Trap, O Undrgmd. � 10. Structural Floor System 61. APPROVAL TO DECK ��. i t. Property Sewer Line &-House Connection 62. Backwash & Receptor-Final .� ' 12. Sewer Cap ' 63. Heater & Vent-Final • � �� ' 13. Roof Drains ' 64. Plumbing System - Final �� i� 14. Rough Plumbing � y�� L 65. Electrical-Final �, 15. Rough Electrical-Conduit � 66. Solar SYstem-Final � � 16. Rough Electric Wiring � 67.�Fencing & Access Approval 17. Rough Wiring Sign 68. A��PROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling .69. P OL/SPA SYSTEM$ 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 •�/� L 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 S[andpipe � 28. Wthing & 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: . �� ' �" -�� i /7D 'a• i 34. Final Heating & Air Condi[ioning � ` � P �•J � f 35. Final Gas Pipe-Test - ' � ' i r7 � ". . 36. Hood or Canopy . !� L 37. Final Factory Fireplace . � � � . , '. 38. Final Plumbing �..'x7��Y . , , ' 39. Water Service�Final ' ' ' " ' ' . � 40. Gas Service-Final ' � . ' ' ' � 47. Solar pomesticFinal '^ � � , 42. Backflow Preventer • - � , , 43. Backflow Irrigation , . ' , � • 44. Landscape Irrigation System . -, � ;'� � � "45. Sound Attenuation • �- 46. Handicap Regulations . � . . i�� 47. FINALSTRUCTURE&BUILDIN� � ' � � � • . „ 48. Special Requirements Completed 49. Elec[ric Release to Edison � ' � f �., 50. Gas Release to Southern California Gas Co rJ '�r. '� . 51. CERTIFICATE OF OCCUPANCY ✓ Np, Date