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Home My WebLink About440 17TH ST - Building Permits- • - . . $U[LDI�iG SAFETY DF :TMENT N� �1418 � P, O. Bos No. 317 CHsta Mesu, Cnllfornia Datest o� .Z�7 . / 9�n CCCY OF COSTA MESA CERTIFICATE OF OCCUPANCY Building Permit No��Electric/al�Permit No Plumbing PermiO No. Use of Build'wg ��SG � l � ft � Y,e � i S Y'n.Y. �C The 6ullding located at_�� 7 TK 57 Legal Desedptio� (See reverse side for Metes and Bounds) has been inspected and found to comply with the provisions of all City of Costa Mesa Ordin- ances applicable thereto for a Group ��Occupancy. ISSUED TO: �y�y gqd�g Otficial �� f% F,Q . (Owner of Build�g) By -/. � a-% �� CC: ❑ Original—Owner ❑ lst copy—Gas Co. ❑ 2na copy—Edison Co. ❑�c�copy—File �Form 2(IB S-B P 1M 1-80 v �J� . BUILDING SAFETY DE� TMENT NQ �� P.A. Boa No. 317 CosEa Mesa, California Da�P .�fG � '/�f�.-, CITY OF COSTA MESA CERTIFICATE OF OCCUPANCY Building Permit No� Eleclrical Permik No Plumbing Permit No Use of Building Si' k tii � c �'� �lia o �C ��-.r � Toa c�. The building located ar. � 4/n i,� /" [•7 T H ; T 1 Jni, y�� • z• e. c/ Legat Descriptlo� . (See reverse side tor Metes and Bouads) �has been inspected and found to comply with the provisious of all City of Costa Mesa Ordin- ctnces applicable thereto for a Group �'z Occupancy. {SSUED TO: �Sty Building Official �a/ � '� S liF� � (Owner of Building) By ""'�,��L�� CC: ❑ Original—Owner ❑ lst copy--Gas Co. ❑ 2nd copy—Edison Co. ❑ 3rd copy—File Form PAB $.B P 1M 1-W ,� � � Ciry of Costa Meu Developmen[ Services Departmen[ Building Safety Division P. O. Box 1200 Costa Mesa, California CERTIFICATE OF OC'CUPANCY No. The Building located at 440 Ea.St 17th Stree�. Unit 6 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group R9 OCcupanCy. Use ot Building Legal Description ISee reveru side for Metes and Bounds) Building Permit No f: 57�7R Electrical Permit'No. f: 51�7R Plumbing Permit No. (: 57�7R Mechanical Permit No. G 51278 Fire Prevention Permit No. F 52�80 ISSUED TO: Eleamor Fischer 47-390 Amir Drive Palm Desett. CA Number of apartments and/or guest rooms BuildingOfficial '�ny C'D� Baca by ..r� ... , � Date JulV 16, 1991 This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. � � � CMF 1o15-a6 rev. 1/83 White -Owner; Canary _Numerical File; Pink - Bldg. Permit File , .�,� � `. � � 12905 COSTA MESA BUI4DING-SAFETY DEPARTMENT P. O. 90x H17 COHTA MBHA. CALIPORNIA For Applieanf fo Fill In Completely , TYpE OR PRINT ry� � iir�• .� i � COSTA MESA CALIFORNIA N TEL. � BHTBACN LINB PPOM TEL. NO. O� BIdUO. DESCRIPTION OF WORK BUILDING e�ze � E%TERIOR WALL ROOF GOVERING K TO BE PERFORMED FIRE FEE RECEIVED � S� z. � ,sso FINANCE "DEP'C. APPLICATI�NYF�F ��TATMESA BUILDING For Office Use Only N6CB�PT NO. P6RMIT_NO. � COSTA NO. 0• `/ I U8H OP N8W PLAN9 BU�ID�N� (C[M[R LIN[ BT.) APPROVBD �1_/ /r II 1 HBft6BY ACI(NOWLmGB TMAT 1 XAV6 RBAD iHIB �'PLIGTION TH6 AMOVNT lXOWN UN�eR VALUATION IB FOR TM6 AND BTATE THAT THe ABOVH 18 COqH6GT AG TO COM- PLY WITH ALL CITY OftDINAM AND LA ItEOULATINO P��098 OP HBTABI.I6H�N0 A P6RMIT F66 ONLY. Bu1LOINa CONBTxUrnoN, p R�CE �AWATION �/ � f 61GNATURE OF/ ' Eo J G�� PERMIT FEE $ PERMITTE ��CJ - o S PLAN CHECK $ AUTHORI2ED AG TOTAL FEE �' 0 d � 2882I -� - ,�OSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA� CALIFORNIA 92620 110. —9-68v�'o00 726+ *�**2�.00 CNSA . � ! ^-/�.y/a�-�'w■ • . �_M�.VV1 � / COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 977 C08TA MEBA. CALIPORNIA For Applieanf fo Fill In Complefely _ /, a, 3 TYPE OR PRINT ,{,I/�`� aooRess 7 iO i � . /%T ~ �%. � �� COSTA MESA. CALIFORNIA ♦ _ i i _ , _ TEL.�l�O' BUI NO. A�I TEL., � FIRE � � TEL. �eaw� ' � � No. oe 3 0 �� o oescnu . I NO. OP BLD68. i 86TBACK LINB PPON / CBNTeR OP BTHa6T C� REAR YARI 81DE YARD I LEFT C�J I RIGHT ( DESCRIPTION OF WORK �ez�it+c22X /G 1 HEPBBY I.LKNOWLeOG¢ TMAT 1 AND BTATE TH AB PLY WITH I. ITY iiDl 6 OUILDIN6 CON9TRU ION. 81GNATURE OF PERMI7TE AUTHORIZE� AGENT TO CON- �I'lYar �i�t��:`.�, . t-.Ya� �(,��pq�� 211960 4P�C�i;"1�ICE D�pY. ATION�'�FOR PERMIT� �"�� BUILDING For Offiee Use Only RBCEIPT NO. v[RMIT NO. /�S 9/ er o4 aec rveo wre•�ssueo � l�•-.,� /-G i� % � - � , COSTA MESA. CALIFORNIA TVPE "� GROUP DATE ZONING �.+ . I PLAN9 � I BUILDIN� gW Pol� C.bf <� h. YARDS APPROVED ICBHTeR uN8 EVES CHECK $ ./ ' • � • • ��0-� ,CO�TA MESA BUILDINGSAFETY DEPARTMENT fP. O. BOX 9f7 ' C06fA M66A. CALIPORNIA For Applieanf fo Fill In Compleiely TYPE OR PRINT BUILDING _I G� ADDRE88 �`•/..' +.� � COSTA MESA CALIFORNIA e MAIL ■ ARCMITEGT ■ 87'ATE USE OF EX18T G BLOG BHTBAGK LIN6 IPOM �� BUILOING NO. 81Z8 ROC EXTBRIOR WALL RC COVERINO CC USE OP BUILDING AND WORK 1 TEL. NO. TEL. � �. OP BLDOi. OF WORK FEE RECEIVED DEG 211960 FINANCE DEPT. APPLICATION � P�RGITSTA MESA BUILDING For Ofiice Use Oniy RBCHIPT NO. iBqp�I�NO� l � CY I pAT8B8CH`IV �! DA�H IpBY¢D / 1 � i7��. COSTA MESA. FIRE zoNs/� NO. OI li �LAN9 (CHMtP LIN[ BTJ r �ATE �/I �/� IhG �Q.R� ue¢ oP Naw BIIILDINO �� % � � �i � � � �{� �D�AT � � � / 1 NBPBBY ACIWOWLdOOe TXAT 1 NAVB X[AD TMIB APPYWTION M1D BTATB THAT THH ABOV9 I6 G�RRBCT AND AOR86 TO cor• TX� AMOUM 6HOWN UNDBR VALUATION IB IOR THH PU1�08H OI 86T�GL16NINp A PHpMIT P86 ONLY. PLY WITX ALL CITY OPGINANGHB D 6TAT6 LAW6 R80Ul.ATINO Bu�tnlNo coNaTRUCnoN. VALUATION . �'J 81GNATURE OP � VO PERMIT FEE $ `"� PERMITTE - �� '� —_ n S PLAN CNECK $ AUTHORIZED AGENT �' � o 70TAL FEE p, ' � 129�'� .COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 917 C08TA MeBA. CAL�PORNIA For Applicant fo Fill In Complefely TYPE OR PRINT BUILDINO � D � AOURE66 COSTA MESA. CALIFORNIA ■ MAIL TEL. NO. TEL. 'BTATE � TEL. _—_ � LIC. NO. NO. 61ZE ' I NO. OP GIDQB. � B6i9AG1( DESCRIPTION OF WORK BUILDING NO. OF SIZE ROOM& / STORIES EXTERIOR WALL IROOF ' rtE RECEIVED �'SEP 2i 196g . FINANCE OEPT. eirr oF c��a �Esa APPLICATION FOR M BUILDING For Office Use Only REClVT NO. �P}RN$R4� OY CASTA PIRE ZONH APPROVEO ZONB�` A I HO. OI / I U8H �F N6W J� PLANB t� BUILDIN� L6OAL jl� I\ %ir% (CCNT[R UN[ eTJ APPROVED �� 1 H[RBBY ALKNOWLED6H THAT I NAVH RBAD THIB APPLIGTION }M6 AMOUM BHOWN UNDeP VALUATION IB POR TH[ AND BT�Te THAT n�e ABOV¢ IB CARAB� I�ND AORL6 TO COY• PUWO88 OP BBTAGLIBNIN6 A PEqMIT IHH. ONLV. PLY WITH ALL GTY ORD�NANC88 1V1� RAT6 LAWB R60UL�TNO BUILDINO CONBTRUCTION. - VALUATION ��q/ 81GNATURE O �� /p/ O�{E��/ PERMIT FEE S �"� �� PERMITTE . $ ��y /Y puN CHHCK $ �� / � S AOENT TOTAL FEE � � 4 . _ -T.� „��..�_�_-� ` . , � :.�;.... �,��_J� , �OSTA MESA BUILDING•SAFETY DEPARTMENT FE� RECEI � 4.10' P. O. BOX 917 C08TA MEBA. GLIPORNIA '� �� L - 3- �� For Applican+ to �ill In Complefely A�ICATIO��R�• TYPE OR PRINT .LA � B��g��Cp�A MESA� BUILDING ,{y� � ,�7_� - � � �� ADDRE68 COSTA MESA. CALIPORNIA For Office Use Only OWNER v. � �� , /�� aeceivi No. vennii No. S'�% � MAIL /^ ; .I//��/ O•/,.f��J rtee av �re aeeivo p• ise o ADDRESS `� �� G�I4 L � � / I ��— I v�j '' 1 TEL. L`�2.3C � Yc BUILDING C�Ty �L`eO�v/a �E� NEI-2_. NO. ADORESS arscH�recr � ;] � TE�. CpSTA MESA. CALIFORNIA OR" .INEER L `�/L� NO. ADDncS6 �� tL�/)O � / �C-� /7 FIRE ZONE TYPE . GROUP CONTRAGTOR (.'LUIJh`f�Z AP�'ROVED /3 /i BY DATE �� ADORESS � fl r� __ NING �� ZON � I NO.OF I U98 OR NEW (�'�j'Y PLANB BUILDINO LIC.rNO. {1�l S% �i No. C�L �[' !'t�D �'c"'- 0 LO c�J OH9CRIPTION 6IZE �C�C x�C/ G I NOW ON LOTB N/� 3 OF l0T A. P. NO. � USE OF YARDS � EVES EXISfING BLDG /�-�n��G APPROVED ALLOWED 86TBACR LINC PROM / ICCNTER LINB YT.) / CENT6R oP 8TRe8T � � � REAR YARf� � �` � ""._ �=_�% — � / ."" SI�E YARO I �EFT % U I RIGNT I� DESCRIPTION OF WORK NE`' I•-\ IIALTERATION I IIADDITIO REPAiR I IIMOVING I IIDEMOLI! BUILDING l��}O � NO. OF SIZE ROtlM8 STOF COVERING WALL� I RO�F CCO CpVERING ��y USE OF BUILDING AN� WORK TO BE PERFORMED I MEH¢BY ACKNOWLCOOe THAT 1 XAY6 AND 9T�T8 THAT TX8_ABOVH IS �RRE PLY WITH ALL G17Y O�DIF AND 6 BUILDINO CON9iRUR10N. � - � SIGNATURH OP �/ PERMITT!* ' AUTHORIZED AOENT •PPIJWTION THL AMOUM BXOWN UNOER VALl1ATION 18 FC�TXE IH8 TO COM• pURPOBE OF EBTABLI9NIN0 /� pERMIT FEE ONLY. fi80UL11TIN0 VALUATION � PERMIT FEE $ � N P $�� PLAN CHECK $ � p 70TAL FEE � u z - ' 3463.6 � COSTA MESA BUILDING-SAFETY OEPARTMENT ' P.O. BOX 1200 COSTA MESA,CALIFORNIA92626 For Applican! ta Fill rn Completely _/ BUILDING /^ //1 _— p,� ADORESS �= / 1 •\` -O'7�PAILQO OE3� �+,r�1Q.07 � APPLICATION FOR BUILDING PERMIT OWNER �[�4 A.P. NO. � / " � ,FT,� � MA I L BUILDING Z . J ADDRESS s' ADDRE55 ��, S� i d U CIT V � /�.{��e NOL S�Q �L ' A'4C � LOT B!-OCK Z Z Q CONSTFUCf70N A O N LENDEF � a ^i BRANCH � a W ADDRESS � OWNER m m ARCHITECT /� TEL. / S VALU$ /` I �:i9 J a OR ENGINEER�1 ��W� N �(YPT/ ZQ , FIRE / �� W� ADDRESS �j 20NE TYPE GROUyP �-w APPFOVED c� )_�� J O CONTRACTOR �� BV DATE �/ L m Z J � ADDRESS �� ' w W TEL. ZON NO.OF ^ USE OF NEW ZF CITY � �� NO. P�� o'� BUIIDING • wO STATE �� /�I CITV YARDSAPPROVED VARDSAPPROVED N� LIC. NO, r LIC. NO. MAIN BUILDING ACCESSORV BUILDWG 7 O IFROM C/L STREET) SIZE ND.OF BLOGS. n . OF LOT (}Q � b NOW ON LOT pi.� ONT FT. F USE OF EXISTING BLDG. GD M� � T FT I" 512E OF q NO. OF 2 Z LOG. IJ ROOMS -+ STORIES L.SIDE FT. a EMEFIOR WAL ROOF )� • ' COVEFING « COVERIMGIYE U REAR "PT. FT. J USE OF BUILDING D WORK TO BE PERFORMED DISTANCE BET, BET. MAIN & a u!c /�� MAIN BLDGS. ACCESS. BLDGS. a Q VAR.3W DA7E O `_('��/�' (,=� C.U.P. q� APPROVED N � ! /L lO/G G.� C-/G� 7/ O� APPftOVEL� .S _C�' /_L z � Uf heraby acknowtedBe [het I �ave reatl this application enC smte � iAat ihe above information is correct and agr¢a ro comply with � all laws reBulatln8 building cnnsiruction, antl I shall not employ F eny perzon in violatlon of tha workmen's compensatlon laws of y ihe Sta[e of Califomia. ? I hereby cartify that I am prooerly licensetl as a contractOr under SQ. FT. [ha Sta[e at Califomle Business antl Professions Coda, DiWsicn 4, THE AMOUNTSNOWN UNDEF V Chep[er 9, and that suc� licenses ere In full torta and effect, or I THE PURP06E OF ESTABIISHING A am exempt trom the provlsions ni the Stare of Celifornia Businass VALUATION antl Profess{ons Coda, Division 3, Chapmr 9. PERMIT FEE SIB�eture of I,, ',� /'� Parmlttae N/�-�"C) $ �OO✓ PLAN CHECK ` Authorizetl Apen TOTAL FEE � STATE i� � / m � O i ¢ m 7 m o` LL ' � . '� `' 34379 � COSTA MESA BUILDING-SAFETV DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 � For qpplicant to Fill in Completely BUILDING n ADDRESS r � / OWNER W. � . �� S WQY Z ADDRE55 Q� ShCKC�I � d U CITV �t.Gr�a� yC� MLYV NOL. Z2 Q CANSTR�UCTION � ' BRANCH ADDFES'. ADDRESS CONTRACTOfl C�('j� ADDRESS �'A p"IZ , CITY 'V'y�Kk STATE ` LIC. NO. �LGJ��p S S12E OF LOT VSE OF E%ISrING BLDG. SIZE OF wa�L JILDING AND TEL. NO NE �o�.97ry,�t. r � fl�q„�lH� rTvo.`��3 ' � CITV LIC. NO. NO. OF BLDGS. NOW ON LOT NO. OF ROOMS STORIEt ROOF COVERING IK TO BE PERFORMED 1 hereby acknowletlge that I have reatl this epplication antl state that the ebove info�mation is correct entl agree to comply with all laws raguletin8 builtling construction, entl I shall noi employ any person in r�olation of tha wOrkmen's cOmpensation laws ot the Stete ot California. I hereby c¢rtify that I am properly licensetl as a coniractor untler the Stete of Cel�tornia Businass antl Protessions Cotle, Divisicn 3, Chapter 9, and that such licenses are In iull force and ettect, or 1 am exemp[ trom the provlsions of the State ot Celitornia Business antl Professions Cotle, Division 3, Chapter 9/.//J /J/ $�QI18SUfB O} �/ /C�'^�J/ //` �� Permittee -"'LL' � K�� Authoriza0 e�i ". -^-7?«-�,�00 266# �*�*tr5.04 APPLICATION FOR BUILDING PERM�T BUI�DING ADDRESS FIRE ZONE APPROVED NE / NO. OF / �' PLANS p VARDSAPPROVED MAIN BUILDING DI5TANCE MAIN BLD� VAfi. 51�' LOT%/ gLOCK i� VALUE �� $ G/ .` DATE� �, USE OF NEW BUILDING VAROSAPPROVED BET. MAIN & ACCESS. BLDi DATE THE AMOUNT SHOWN UNDER V THE PURPOSE OF E5TABLISHING A VALUATION PERMIT FEE 3 �OO PIAN CHECK TOTALFEE $ m e 0 R � ¢ a N J m E `o _ LL � CITY OF COSTA MESA - . o p"'F BI/ILDING DIVISION 0 r 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us r �' ° . FOR INSPECTIONS CALL: (7�4) 754-5626� �"""°""'� PERMIT NUMBER: E10-00006 PERMIT TYPE ELEC STATUS: ISSUED APN: 11732126 DATE ISSUED: 01/20/2010 ISSUED BY: RMD JOB ADDRESS: 440 E 1>TH ST CM Vicinity: REAR OF BUILIDNG Suite/Unit: SCOPE OF WORK: ELECTRICAL PERMIT TO REPAIR AN EXISTING ELECTRICAL METER MAST AND HOUSING TOP FOR A COMMERCIAL BUILDING, LOCATED AT REAR OF BUILDING. OWNER: OIENICK, NANCY LINN PHONE: APPLICANT: HALL, DAVE PHONE: 562-404-7444 CONTRACTOR: CARE CONSTRUCTION SERVICES INC Address: 136101MPERIAL HIGHWAYUnit: STE 2 City/State: � SANTA FE SPRINGS, CA ZipCode: 90670 ELECTRICAL PERMIT FEES Electrical Plan Check Fee: $0.00 Electrical Permit Fee: $41.70 Reinspection Fee $0.00 TOTAL FEES $41.70 Address: 2575 MEADOWMIST LANE Unit: CitylSlate2ip: ENCINITAS, CA Address: 13610 IMPERIAL HIGHWAY Unit:STE 2 City/State/zZip: SANTA FE SPRINGS, CA License No. 899601 PHONE: 562-004-7444 CELL: 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, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this pertnit. 04 pE p. INSPEC➢ONTYPE 1616 Fixed System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 201 202 203 204 Final Block/Retaining Wall Final Factory Fire Place Final Sign Pinal Demolition �RTE INTITIALS CODE1 INSPEC110NTYPE 206 Final Mechanical DATE IN7171RL 208 Final Plumbing �_�'y]_ � 10 Final Electriral 2 I J I� r% 212 Flnal Fire Prevention 220 Final Planning Approval 222 Finai Site 250 Final Building/Occupancy WORKERS' COMPENSATION DECLARniION: I hereby affirm under penalty of perjury one of the tollowing declarations: ❑ I have and will maintain a certificate of consent to self-Insure for vrorkers' compensation, as provitled (or by gection 3700 of the Labor Cotle, for the performance of the work for which Ihis pertnit is issued. ❑ I have and will maintain v+orkerv,' compensation insurance, as required by sectbn 3700 of Ihe Labor Cotle, tor the peAortnance of the work for which this permit is issued. My vrorkers' cortlpensation Insurence carcier an0 policy number are: •�arrier: �fi%E i�u.c//6 Tnis seclon need rpt he mmpletetlllne � is rdluetl a� me nurrtlred Doe'ars (5100) wless ) P,olicyNumber. O� 2 1 �j Cm�I bO fj ❑ I certify thal in Ihe peRormance o! the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation lavrs of California, antl agree lhat if I should Decome subject to the vrorkers' compensation provisions of Section 3700 of Ihe a� de. I shall fprthwjyi comply with these provisions. //// 6c�Cf' l-�C�/� A pli n'SiWet rpua—i�— Dne� �,�:. � WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE IS UNLAWFUL AND SHALL SUQJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP Tp ONE HUNDRED TNOUSAND DOLLAF2S ($700,000�. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLqRATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing vrith Section 7000) of Division 3 of the Business and Professions Code, antl my license is in tull force antl effecl . �L,/icu�#--�. ,4�/ 0 .Ciass tt' C—/ a � G _�_w. Y�' �_'�b•!!) �Gaal�aG�a'sSrgnaWre � CONSTRUCTIO� NDING AGENCY: ❑ I hereby aKrm ttia[ tM;re a consWctbn lending agency (a Ihe peAortnance of the work for v.hich tfiis, rtnit is issued. (Sec. 3097, Civil Code). .•.'"+., Lender's Name: ' Lendeis Adtlress: Signawre i t' � Date OWNER-BUILDER DECLARATION$: ' . �� I hereby aKrm that under penalty of perjury th� I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the fo wing reason (Sec. 7031.5, Business and Professions Cotle: Any city or co�nty which requires a permit to constmct, alter, improve, demolish, or rey�ir any structure, prior to its issoance, also requires Ne applicant for sucKpermil to fle a signetl statement that he or she is licensed pursuanl to tl�e provisions of ihe Contractors License Law (Chapter 9(commencing withrSeclion 7000) ol Division 3 0( the Business antl Professions Code) or that;he or she is ezempt therefrom and the basis tor the alleged exemplion, qrJy violation of Seclion 7031.5 by any applicant for a permit subjects the applicant lo a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees vrith wages as their sole compensation, WILL DO THE WORK, and the struclure is not intentled or oHered for sale (Sec. 7044, Business and Professions Code: 7he Contractors License Law does not apply to an owner ot property who builtls or improves Ihereon, and who does such vrork himself or herself or through his or her ovm employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner-builtler will have the bwden ot prov'mg lhat he w she did not builtl or improve for purpose of sale.). ❑ I, as owner of the pmperty, am EXCLUSIVELY CONTRACTING WITH UCENSED CON7RACTORS to construct lhe project (Sec. 7044. Business and Protessions Code: 7he contractors License Law dces not apply to an owner of pmperty who builtls or improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.�. ❑ 1 am eaempt under sec. Business and Professions Code for this reason: Owner ID venfed by driver s license. ❑ Yes ❑ No Driver's License No. Expires: Verifiwtion of Ownership by (rype of document, i.e. - property lax bill or dee0): DIVISION OF INUUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certi(y that no excavation frve (5) w more feet in tlepth into �+Aiich a person is required ro descend, will be made in connectbn with v.ork aulhorizetl by Ihis pertnit, and iha[ no huilding slrucNre. scaffdding, false�+ork, a tlemolition or dismantling Ihereo(, will be more than thirty-six (36) feet high. (Chap. 32, Gry 2, Art 2, SeG. 341, T�le 8, Califomia Administ2tive Code). ❑ As owner-builder, I will not employ anyone to �o work which vrould require a permitlrom Ihe Division of IndusMal Safety, as noted above, unless such person has a permit to do such vrork from the division. Applicam's Signatore Division o( IndusUial Safety Permit Number: _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or fuWre building occupant neetl ro file and certify a Business Plan for emergency response lo release or threatened release ot a hazardous material? ❑ Yes ❑ No (Sec�ion 25505 0( the California Health and Safety Code requires. wilh some exceptions. Ihat a Business Plan be fled with the Costa Mesa Fire Deparimenl by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2. Does o� will the applicant or present or (uture building occupant need to file a regisUation form for acutely hazardous matenals? ❑ Yes ❑ No (Seciion 25533 of [he Calitomia Health and Safety Code, wi[h some exceptions, requires registration with lhe Costa Mesa Fire Department by each business which at any one time has on hand a quantiry of acutely hazardous materials equal to or greater lhan a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard [empera[ure and pressure). � 3. Does or will Ihe applicant or presen[ or W[Ure building occupant need to prepare an RMPP (Risk Managemen[ antl Prevention Program for acutety hazardous malenals)? ❑ Yes ❑ No (Section 25534 of the Califomia Health and Safery Code provides that the Costa Mesa Fire Department may require the preparation, certification and fling with the Fire Departmenl of an RMPP by businesses which are required to register acutely hazardous materials with Ihe Fire Department. 4. If an RMPP is presently required, has Section 25534 0( Ihe California Health antl Safety Code been fully complied with7 ❑ Yes ❑ No 5. Does or will Ihe applicant or present or future building occupanl require for the vrork which is the subject of Ihis application a pertnit for such construction or modi(cation from the South Coast Air Qualiry Management DiSMct or from any olher air polWlion control dislnct or agency7 ❑ Yes ❑ No (Sectbn 658502 of the Califomia GovemmeN Cotle requires thal the requested intortnation be fumishetl on applications fa non-residential building permits). 6. will any part of the facility to be constmctetl under Ihis pertnit be within 1000 (eet from the outer boundaries o( a school? ❑ Ves ❑ No Qf "yes", the facility must meet the requiremenl of Sections 25534 and 42303 of the California Heallh and Safery Code). 7. If a permit from the South Coasl Air �ualiry Management District or olher air pollution control districl or agency is requiretl (or the vrork which is the subjecl of this application, have all of the tlisclosures prescribed by Califomia Health and Safety Code Section 42303 Deen made? ❑ Yes ❑ No 8. Qf'yes", attach certifcate of compliance from the appropnate air pollu�ion control OKcer). CER7IFICATE OF COMPLIANCE: I certify that untler penalty of perjury ihe information given above is correct I agree to comply with all sWte laws and city ordinances regarding Hazardous Materials antl Emissions. SignaWre Date CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalry of perjury that I have read this appliwtion and state that the in(ormation given is correct I agree to comply vrith all sWte laws and City ordinances relating to Duilding conswciion, and authorize representatives of the City of Costa Mesa to enter upon Ihe abovetlescnbed property for inspection purposes. I agree not to occupy or allow occupancy of any builtling aWhorized by Ihis permit until fnal inspection. SignaWreolL ga Own Da�e SignaWre Date /^—y �_ �Or�%% �OS'/J613/O)) ! trp+'� �� V�An�biAul aizeEAppliWnl ^Dale (714) 754-5273 • Fan (714) 754-4856 • www.ci.costa-mesa.c��LiIING PERMIT n FAIF DRNE, GOSTA MESA, GA 92626 Job Address: 440 E 17TH ST Status: ISSUED Suite: Applied: 08/72/2003 Vicinity: Issued: OS/12/2003 Parcel Number: 11732126 Applicant: HANSEN, DUKE Address: 260 E ALTON AVE SANTA ANA, CA Owner: OLENICK, NANCY LINN Address 2575 MEADOWMIST LANE , �� .ENCINITAS,CA� � � Convactor: ROSS & BARROWS INC. Address: 260 E ALTON AVE SANTA ANA, CA Zip: � 927W ' Arch : Address: Zoning: Phone: (714)557-7440 Zip: 92707 Phone: Zip: 92024-6533 Phone: (714)557-7440 License: 327802 - Eng: Adtlress: ISSUED BY: Phone: � Phone: Zip: License: License: SCOPE OF PERMIT REMOVE EXISTING BUILT-UP ROOFING �AND INSTALL A NEW FOUR PLY BUILT-UP ROOF. FEESUMMARY Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total: $0.00 $223.25 $0.00 $2.61 $0.00 $0.00 $225.86 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front 0=0 PARKING Existinq: o NOTES: Rear 0• 0 Rear 0-0 Required: 0 n PLANNING & ZONING Left 0- 0 Left 0- 0 Pro osed: 0 Calc Valuation: Siz,aso.00 Ciaim Valuation: Siz,a5o.00 Right 0- 0 Ri9ht 0- 0 NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and related regula�ions. (Ord. No. 92-28, § 1, 1241-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned tor a period of 18fl days. INSPECTIONS: in order for the work authorized under this permit to be considered legal, such work must comply with all eppllcable codes, and all requlred Inspectiona and final approval must be obtained. Failure to obtain inspections and fnal approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5628 2ad&d8 (8/00) WORKERS'COMPENSAnON DECLARAnON: � ` � I hereby aflirm under penalry o� perjury one oi Ihe following tleclarations' ' � . ' ❑ I have and will maintain e certllicate ot consent to selbinsure for workers' campensatlon, as provided tor by section 3700 of ihe Labor Coda, tor Ihe pertortnance ot Ihe work tor which ihis permit Is issued. I hav and will maintain workers' compensation insuranca, as requiretl 6y section 3700 of the Labor Code, for Ihe pedortnance of the work br which I�is permit is issueA. � orker5' Compensatlon Insurence cartler entl Dolity number are: Carrier: Policy Number: (This section need not be completetl il the pertnit is valued et one huntlretl tldla�s ($100J or /essJ ❑ I ceriify that in lhe pertortnance ol the work for which this pertnit is is5ue0, I shall not emplay eny person in any mflnner so as �ecome subject to the warkers' compansetion laws o rnla, end agr�t ii I should become subject to:,0e workeh,' compensation proNsions ot Sectip 3700 ot t B LaDor Code, I shell fonhwith comply with these ovisi /r Ap icapl n1�SlgneWre:� ��--� i�� Date: (% WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNUWFUL AND SHFLL $Ufl1EGT AN EMPLOYER TO CRIMINAL PENALTIE$ AND CML FlNES UP TO ONE HUNDflED TTqU$AND DOLLARE (5100,ODOJ, IN ADDITION TO THE COST OF COMPENSATION, DMMGES AS PROVIDED FOR IN SECTION 31080F THE UBOR WDE, IMEREST, AND ATTOHNEY'S FEES. LICENSED CONTRACTORS OECLAHATION: I hereby eflirm that I am Iicensed under proNsions of Chapier 9(commencing wit� Sectlon 7000) ot Division 3 ot the Business antl Professions larce and effect. Lic. N Class a-�7 Co� nirectofs SigneWra: � �� i L _ Dete: _� CONSTRUCTION LENDING AGENCV: antl my license is in full 0 I �areby aNirm that there is a consWc�ion IenOing agency for Ihe peAormance of the work tor which this pertnit is issuetl. (Sec. 3097, Civil Code). Lenders Name: Lendefs Atltlress: Signature: OWNER-BUILDER DECLARATIONS: Date: I hereby afllrm that under penalry of perjury Ihel I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Busineu en0 Professions Code: Any ciry or counry which requires e permlt to construct, alter, improve, demolish, or repair any structure, prior lo its Issuance, elso requires the epplicant tor such permit to file a signed stetement that he or she is Ilcensed pursuent to the provisions of Ihe Contrectors License Law (Chepter e(commencing with Sectlon 7000) of Division 3 oi ihe Business end Protessions Cotle) or thet he or she Is exempt therefrom end the besis for ihe elleged exemption. Any vlaletlon oi Section 7037.5 by eny eDPlicant for a pertnit subjects Ihe epplicent to a civil penalry of nat mare than live hundred dollars ($500)J: ❑ I, es owner ot �he properry, or my employees with wages as thelr sole compensation, WILL DO TME WORK, entl Ihe struciure is not intended or otterad for sale (Sec. 7044, Business and Professions Code: The Contrectors License Law does not epply to an owner of properry who huilds or improves �hereon, and who does such work himself or herself or Ihrough his or her own employees, provided thet such Imprwements ere not iniended or oXered tor sale. If, however, ihe bullding or improvement is sold within one year of completion, Ihe or.neo-builder will heve the burden of proving that ha or she did not build or improve for purpose oi sale.). ' ❑ I, es owner of the properry, am EXCLUSIVELY CONTHACTING WI7H LICENSED CON7SiACTORS to canstruct the project (Sec. 70dd, Business antl Professions Code: The coniractors License Lew does nol apply to en owner oi propeny who bullds or Improves thereon, end who contracls for such pro�ect with e contrector(s) license pursuant to tha Cantrectors License laws.). ❑ I em e:empt untler sec. Business end Protessions Catle for this reason: Signature: Date: Owner ID venfietl by anveYs license. ❑ Ves ❑ No Dnvers License No. Evpires: Venficetion of Ownership by (type of tlocument, I.e. - propeny taz bill or deetl): DIVISION OF INDUSTRIAL SAPETV PERMIT CERTIFICATION: ❑ I hereby ceNty that no ezcevation live (5) or mora teet in depih Into whlch a person Is required to descend, wlll be made in connection with work euthonzetl 6y t�is pertnit, and that no building siructure, scattolding, falsework, or tlemolitlon or tlismanlling thereof, will Ue more than thirty-six (36) feet hiqh. (Chep. 32, Grp 2, Art 2, Sec. 341, Tille 8, Celifomia AOminisiretive Cotle). ❑ As owner�builder, I will not employ anyone to do work which would require e pertnil from ihe Division ol Indusiriel Selety, as noted above, unless such person �es a pertnit to do such work irom the tlivision. Siqneture: Dale: Division af Intlusirial Satery Permil Number. CERTIFlCA7E OF COMPLIANCE AND AUTNORVJITION OF EMRY: I certify untler penalry of perjury ihat I have read ihis epD�ication and state Ihet lhe infortnation given is cortect I agree to comply with all stete lews end ciry ordinences rela�ing to bullding construciion, end emhodze representatives ol Ihe Ciry of Coste Mese to enter upon the ebove-descnbed pmperty for insDection purposes. I agree not to occupy or allow occupancy of any building authorized by ihis permii until finel inspection. Signa legalOwner(s) An r Autho' ed Ap� t ' GOOE �' INSiECTIONTYPE ' � � 1816 Flxed System Final Fire Preventlon 202 203 PLE � � I[�ALS .. Pool Spa Final /.�4�/� Finel Re-Rooi ��7� (S(,� Final BIocWRetaining Well Final Fadory Fire Place , , Final Sign 20a Final �� .: I �� _ COOE1 'INSPECTIONTYPE � 206 � Final Mechenical 208 Final Plumbing 270 Finel Electdcal 212 Final Fire Preventlon 220 Final Plenning Approvel 222 Final Si�e ' 250 Final Bullding�Occupency �F � = PXOJECi AOUFESS: Q Q O E 1 7 TH S T owNensxnme: FREEMAN FISHER nooq�ss: ,Z 36 DRIFTWOOD , CORONA DEL MAR CA 92625 760-0730 pqtN/ENGINEEN: AODHESS: xEc.wo.: uxiT: 6 UNIT: PE"MiTTEE: FREEMAN FISHER ( 714 ) 760-0730 RDUflE55: 23( DRIFTWOOD RD COftONA DEL MAR CA 92625 UCENSED CONiflFCTOP OECIABATION: I nereby al�irm ��ai I am licensea untler pmvisions oi ChaO�er 9(commencing wi�h $ection 700fq ol Oivision 3 al I�e Business and Prolessians Cotle. ana my license is in lull f0¢e and elted. CITY llt.: STRTE LIC.: ClASS: Oate: Signawre: OHKEBS' COMPENSRTION DECIAPaTION: I nereby aifirm inat I have a cenilicate of consent m seif-insure or a certiticate of Workers' ,ompen5aiion Insurance. or a cetliliea copy tnereol (5ection 3800, Lao. C�. IPOLICY NO.: E%P. DRTE: � COMPFNY: ❑ Ce�itie0 copy is hereby fumi5he0. ❑ C¢rlilieA copy is liletl vnth Ihe cily Builtling Division. �ate: PpDlicant: E1(EMPTION FflOM WOBREBS'COMPENSFTION DECLANATION: (iAisseclion neea nol6ecomplele0ilihe permilislaronehundreA(5140�orless�. I Certiiy tha� in t�e peri0rmante oi Ihe work lor w�ich �his Oermii is issu¢tl, I 5hall noi employ any person in any mannef Sa a5 �o hetome su�letl �o ��e Workers' Compensalion Laws 0� Cafilomia. Daie: Sipnatwe: NOTICE: I1, alier making ihis declaraiion, you s�oultl become subject to ��e Workers' Compensa�ion D�ovisions of �he Lahor Cotle. you mu5i farlliwith complY wil� such pwvisions or Ihis permil s�all be deemeA revoketl. CONSTBUCTION LENDING AGENCY: I �ereby allirm Iha� Ihere is a canstmction lending agency �or Ihe pedormance of the work �or which Ihis permii is i5sue0 (Sec�ion 3W7, Civ. C�. LENUFH: nooeess: CITY OF COSTA MESA�— BUILDING PERMIT PERM NO; IB 05099 PERMIT NO: IB 050993 PLAN CHECK NO: � N GOVT: N SUPP: Y CONSTRUCTZON TYPE: PERMIT TYPE: OTH STR PURPOSE: OTH JOB DESCRIPTION : CLOSE FZLE ON EXPIRED PERMIT SQ rT: CLAIM VALUE: CALC—VALUE: GROUP OCC; H-2 / COMMENTS• LEGALIZATSON CLOSE FILE B20602 if iE if if iE it �E iF k iF if if iFiE iE iE if 3F iFiF 7f iE �E �f 1E iE if 1f 1E if iF �E �E iE 3E iE iP 3F iE if iE iE if 3E iE iE iE 3k iF iE 1Eif iE iE iE ik if if iE 3F 3f 1f if iE aFlE if 1E iE !P!f if !E if iE 3E iE 3f 3f Z O N I N G R E Q U I R E M E N T S S E T H A C K S ------------ N3AIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR: FT ZN FRNT: FT IN REAR; rT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT ZN PARKING REQ• PROV; PARCEL: 11732126 ZNE; REF NO:' ' PI.ANNING Nt5TE5> i *�**�*****x*�*x*�r��•*�r�x�**x**x**�r*��*******�r��r**�xx�*x��*x�*�r�x�**xx�r****x�*�*�***� D E V E L O P M E N T S E R V I C E 5 R E Q U I R E M,E N T S ZONING APPROVED BY DATE: ' BUILDING APPROVED BY ; APPLICATION ISSUED BY: lEiElE�IEi61E1fif1E1k1Eif3tiFlf�EifikifltitiEiF3F � �F3FiEir iE iflE iF iE iE iE 1E �f it 1E 1f iE iF 1F iE �E it �IE iP # iE 1F iE iE iE 1f iElE 1F iE 7f iE if if df 1k 1E LEGALIZATION:N F _ E $ 1��I D'ATE: x �i t � �FiEifikDlElEiflF� 0��1F�f 3E fF if 3E 3ElE iE 3E if 7f -If iE �f iF lE �ElE 3F IE if if iF if 1k iE iF i(� if !E 3FlE 7(� iE iE �f iF iE �E M M A R Y STRUCTURAL SEGMENT;Y owNexsu��o¢xoeCUFln7�oN: inerebvaairmihauamexempitrominecomracmrs'State�icense�awmrihemnowinpreason HLDG PMT PLUM ELECT C MECHANIC FIRE SMIP/RES GRADING �Section 7031.5 Business antl Pmkssional Cade: Any cny o� counry wMc� repwres a permii ro cons�mc�. alter, impmve, aemolish, or p ERM I T 3 �, � 0 - � repau any slmclure. prior io i1s issuance. also reQuires ��e applicanl �or Such permii �o file a signetl slatemeni thai he/she is licensetl . ' Dursuam m t�e pmvisions ot ��e Comracmrs' State License Law (C�apler 9(commencing wi�h Seclian 7000) ol0ivision 3 0l �he Business � ' $i"i 1 P�N�N—ii$$ antl Prolessions Catle) or ihat �e/she is exempt inerelmm antl Ihe basis lor ihe allepetl exemption. Any violation ol Section 703L5 Ey P LAN ��y apP�icant for a Oermit suCl��s the apDlicant io a ciNl penalry ai not mare I�an five hunareG dollars (5500�. ISSUE FEE � i, as owner oi me oroPeny or my empioyees with wages as meir soie comDansa�ion, wi0 Ao the wonc, and ine BUII,DING—DIV—> PERMIT ISS ' PLAN—CHECK TOTAL PAID DUE stmcmre is not intenaea or ollerea far sale Iseaion 7oaa, Business ana Pm�essionai Code: Tne Convacmrs' State �icense Law TOTAL S----> 3 0, � 0 � 0, Q � 3 �, � � j �. 0 � , Q Q does no� apDly Io an owner oi a pmpe�y who builtls or impmv¢S i�erean, antl w�o tloes Sut� work AimSeli/herself or ihroUgh �is or �e� own em0loyees. pmviaea iha� sucA impmvements are nat intentle0 or ottereE tor ule. 11, hawever t�e bdltling or impiovemem is solU vni�in one year ol com0letion. IAe owner mll have tAe hurtlen oi pmving �e/she did nat 6uilU or imprme REVENUE D I V I S I ON TOTAL S--> COLL ECTED : 3 �. � � OVER / SHORT ; � � m�men��Po:eoiuiel. BLDG PMT PLUMHING EL� TRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I, as owner of t�e pmpeny. am exclusively coniracting with licensea coniractars ta constmct ihe D�olect (5¢ction 7044, Business 3 �, 0 � ❑ ana Professwns CoGe: T�e Coniraclors' S�ate Lkense Law Gces nat apply �o an er ol O�oDerry wAo Um10s or imyoves thereon anOwhoconlrac�sforSuchO�oleciswil�aconlrac�or�s�licensepursuan�to eConVacmrs'S IeLicenseLaw�.lamaware *{�.*.K..��(.{p.K.�(.{(..��(.*�(.{(.j(..7(..�{(.{F{(.**�(.�(.�(.�(.�(.*. �(.{{*.k-*{(.7e*�(..7p*{(.*{�.jp.K.*.**.**.7E.*.**..7�..K.*.K,K,.��,{�.�.,�**K_{�.{�,�..�.�(..K,.7�.K,*.K,* ��a� pmo� 0� Iheit Work¢i 5 Com0en5aiion insuranCe 5�oultl C¢ DmviAeO �a e. W i am ezemo� �nde� seciiore BP709 4 B' 8 P' �' I N D I V I D� A L F E E B R E A K D O W N m�ims eaw`: CONTRACPORS HAVE C i TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST oaie: �"ef jN5 1 BUILDING AE—INSPECTION FEE 30.00 30.00 I do here y cenify that I am aware oi and unAemanO the repuiremems ol Califamia Health an0 Safety Catle Sections 25505, 25533, anU END OF F EE S. 25534 and I�atl orany�ulure OUlldinp occupanlwillhvillnoi�circle one) neeJ Ia comply vn�� said state todes anE��e requiremenisfora . Oermil for consirutlion or rtwAdica�ion imm Ihe Air Oualiiy Managemenl Oistricl. flevdential conslmc�ion aDDlications are exempi imm . . ihese provi5ions. � �a�e: Ap0licanl: ' , , I �ere0y tetlily I�al I have reatl IhiS applitalion an0 Slale I t a e inlorma' i correcl. I agree to comON �� all cily anU counry or4inancesan4s�alelaw5relatinglobuilOinBconslm[lion� ahei b uihorizer re e a�iv ' ti�yloen�efUponlheabove�meniioned ' ' � pmOanY �or `!pet�ion purpOses. � , w�e: 3 Signature: '^ �� O1 OiJL��0519—�DOE0519 Y4?�' 3p.�JD od�er's ucense or Sociai Secun�y x: � oAT�: 02/13/93 'i 1�� (:: 23 16a1 46 Wnne—BuilCmg; Gmen—Cotle Enb¢emenl; Canary—Appllcanl: Pink—Revenue: Goltlenrod—Assessor � 1 CONSTRUCTION ANO PLANNIi G $ SPA _ APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector 1, Temporary Electrical Service or Pole 52. Pool & Equipment Location . , 2. Soil Pipe�Undrgrnd. 53. Steel Reinforcemen[ . 3: Electrical Conduit Utility-Undrgrnd. 54. Forms . 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reintorcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE 7. Footings •. 58. Eiectrical 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. Etectrical-Finai � � 1 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 79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace � " � �• � APPROVALS Permit # 21. DuCts, in Structure . .�.. . � , • -. 70. Underground�Hydro � 22. Ducts, Ventilating , • - � 77, ProductPipirig OGas �Oil 23.� Gas',P,ipe•Rough & Test ' � , � � � ; , 7Z, Underground Flush �. : ' 24. Roof Framing• � •� � `' � 73. Undergrnd.StorageTank OGas ❑Oil' 25. Roof Sheathing � � � 74., Overhead Hydro � 26. T�Bar Ceiling �Structural) & Monocoat - " 75. Dry Chemical . • 27. Frame and Flashing . . 76. Dry Standpipe �. ' 28. Lathing & Siding � �•� ^� ••�� 77, �� ED SYSTEM FINAL � � ' 29. Insulation �� .. � � I � 78. F F2E PRE'b�F NAL 30. Drywall Nailing • � � ! I i�� ' �?' HEALTN,DEPT: REQUIREMENT ' 31. Plaster Brown Coat ' � � � �; ; J9. FINAL INSPECTION '� 32. Electrical Power Meter�Final � ��' I �i i, �. G80. FOOD CERTIFICATE ISSUED � .33. Final Electric � ' , � � � ' i;,f j Notes: � ' � , � � � 34. Final Heating & Air Conditioning , . I I � � . f. � - � • � 35. Pinal Gas Pipe-Test . . , � � (�'� I� / � � „ �, 36. Hood or Canopy . • ' . , � i r ; � � � � ' I 37. Final Factory Fireplace � � r,� �-' ' � 38. Final Plumbing , - � ��; �}� i 39. Water Service�Final ' " . � I�j � 40. Gas Service�Final � . , � � � . . 41. Solar pomestioFinal � �• � , � �� , 42. Backflow Preventer ' � � � I 1 . , 43. Backflow Irrigation , 44. Landscape Irrigation System - � . -45. Sound Attenuation ' 4 andicap Regulations � � 47. F NAL STRUCTURE & BUILDING tyl i�� . FINALPLANNING � , � I i.'I I i i:i 49. Electric Release to Edison � �� I • 50. Gas Release to Southem Cafifornia.Gas Co i i��' - 51. CERTIFICATE OF OCCUPANCY . No Date � x,OiecTaooness: qq0 E 17TFi ST OWNEX'SNAME: FRtEMAN FISHER auoeess:,z36 DRIFTWOOD �• CORONA DEL MAR CA 92625 760-0730 ABCM/ENCINEEfl: RDONE55: flEG.NO.: uxir: 6 UNIT: PEflMITTEE: FREf.MAN FISHER ( 714 ) 760-0730 nooaess, 236 DRIFTWOOD RD CORONA DEL MAR CA 92625 LILENSED CONTflALTOfl UELUIMT�ON: I �ere�y a��irm t�ai I am IicenseU unEer pmvision5 0� C�aD�er 9(tOmmenting vril� Settion 1000� ot Oivision 3 o�lhe Bu9ne55 an0 Prolessions CoEe. antl my license is in lull brce anU eflec�. CITY LIt.: STATE LIC.: CU�55: f`aie: Sipnaiure: ONREBS' COMPENSRTION DECIANATION: I hereby allirm �hal I have a tehilica�e oI ConSenl IO Seli-insure or a tetlifita�e o� Workers' .ompensalion Insurance. or a cer�died copY ��ereol (Seclion 3800, Lab. C�. 1 YOLICY NO.: EXP. OATE: COMPANY: , ❑ Cetlilied copy is �ereby Wmished. ❑ CerlifieU copy is filed with �he city Builtling �ivision. Date: pp0licanl: E%EMPTION F80M WOBKEPS' fAMPENSAiION OECLAflRTION: (!h¢ seclion neeG noi Ee compl¢�eG il ��e permit is lor one huMr¢0 (3100) or less�. I ce�ily Nat in Ihe petlormance ol ��e work �or w�ic� I�is Oermil i5 issuea, I shall noi emDloy any person in any manner So a510 D¢come SUEIatl �o I�e Vlorkers' CompCn5aii0n LaxS ol Calilomia. Date: SignaWre: NOTICE: II, a�ter making ihis Ceclara�ion, y0u shoulG Gecame SUClect �a t�e Workers' Comp¢nsafian provisions o� ihe LaGor COtle. you must foMwith compty wit0 suc0 O�ovisions or ihis permit s�all Ue AeemeA revakeA. CONSTBUCTION LENOING RGENCY: I here�y allirm Iha� there is a conslm[�ion I¢nEing ap¢nty lar Ihe perlormance ol ihe work �or whicA t�is permi� is issuetl (SEctian 3097, Civ. C), � LENOEB: FDOflESS: OWNEH BUILUEB OECNPR710N: I here0y allirm Ihat I am exempt imm t�e Conimctors' Slate License Law for the tollowinA reason �Seclion 7031.5 Business antl Professional Cotle: Fny ciry ol coun�y whic� reQuires a permi� lo conSlmci, al�er, improve, tlemolis�, or repaii any slmdure. priar to iff issuance, als0 reauires tne apP��ant Ior such oermii to tile a signe0 slatement thal tle/she is licensed pursuam to t�e pmvisions of roe Coniracmrs' State License �aw �Chapter 9 �commencinq wi�� Section 7000) of Division 3 ai t�e Business •� anC Pi0te55i0ns Cotle) or �ha� �e/SAe i5 eK¢mp� Iherelmm anC th¢ ba45 �of lhe alieqetl eMemO�ion. My violatiUn o� Sec�iOn 7031.5 by �y applicanl br a permit sub�ects t�e aD7lican� IO a Civil penalry ot not more I�an live hunOreE tlallars (E500�. I. as owner of ihe propeny or my employees with wages as iheir sole compensation, will tla �ne M'ork. an0 Ihe L� 5lmciure is no� in(endetl oro0¢rea far sale �5¢clion 70E4, Business antl Pmlessional CoOe: The ConVaciors' $Iate License Law Eoes no� apply to an owner a� a pmp¢ny w�o OvilUs ar improves �nereon, antl w�o Ooes such work Oimsei�/hersell or �AmuAh Ais or �er own employees. provitletl ��at sucA impwvements are nol inlentle0 or ofteretl lor sale. If. however tAe huilding or impmvemem is sold within one year oi completion, the owner will have the bur0en of DrovinA he/she did not builA or impmve lor I�e purpose of SaIB)� I, as owner of ihe pmOthY. am exclusively coniracting with licensetl conlraciors lo consimct the pmlec� (Section 7044, Business Q d00 PfO�¢5510�5 COd¢: TAC COOIf3C�Of5 Slate License Law tloes not apply lo an owner o� properiy w�o builtls ar improves thereon anG who contracls �or such pmlec�s wi�� a conlractoqs�license OUrsuam m �he Comractors' Sta�e License Law�. I am aware �hat Omo� of iheir Woiker'S Compensalion insurance should be O�o�itled la e. 9 � � am eKemPt under semion: B P 7O 4 4 8. 8 P. C. � j mr mis rea o3 � C�NTRACTORS HAV C Mf� � V_ Q � oa�e: ��/ 3 �( Uvner. "f" l,�f' ��1�--.�� I ao Oereby ceNly Iha� I am aWare ol anG untl¢r5iana Ihe re0uirements o� Califomia Healih anU Sa�¢ry Cotle S¢c�ions 2550.5. 25533, anU 25534 andihal lor anyluture builAinA occupanlwill/will not (circle ne�needto camply with SaiO slate codes anathe requiremenisfor a permil lor conslmc�ion ar motlification imm �he Pir Ouali ana menl DiS��ic1, fle5i0eniial conslmction applita�ions a�e exem0� ��om Inese o�ovisions. Oa�e�. �' ADOlicam: — I heieby ceitii Iha� I have reatl I�is ap0licalion antl s�ale I�a� Ih a�oveinlofmaiion is t rreCi. I aAree�o Compty wiih all Cily an0 Counly ortlmancesantls�atelawsrelatingtohuilGingconstmcliona byauthonlereDr 1 vesol ' cirytQ-enterupontheabove�menlionetl o�ooeny mr mj�ec�ion purpo5C5. Date' �(�%L� SignaWre: � o��ers �rcense or Sociai Security x: �16<t�<6 Wn�te—Butlaing; G�een—Coda Enlorcomenl: Canary—AppOcanl: Pink—Revenue; Golaenrotl—Assessor CZTY OF COSTA MESA - BGILDING PERMIT PERMIT NO: B 050992 PLAN CHECK NO: 00581-91 5 CONSTRUCTION TYPE; PERMIT TYPE; STR T [ �� , . _ PERM NO; B OS099 � GOVT: N SUPP: N PUFiPOSE'; ALT JOB DESCRIPTION ; T.I. TAYLORING SQ FT: 2,000 CLAIM tiALUE; 2,000.00 CALC-VALUE; 2,000,00 GROUP OCC: B-2 / COMMENTS: LEGALIZATION **��r**�r��r**��*****��r�*�x x**x�+�*�*�*****�***•x�**x-x**��*�+r*�r*��r*��**�***x�**�x�** Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCE:550RY HUILDING --------- FRNT: FT IN AEAR: FT IN FRN7': FT IN RE:AR: FT IN LEFT; FT IN RGHT: FT IN LEFT: FT ZN RGHT; FT IN PARRING REQ• PROV: PARCEL: 11732126 'LNE: C1 REF NO:, � PLANNING Nt7TES> LEGALIZE AN F.XI5TING NON-BEARING PAR'CITION WALi, AETWEEN " > UNITS 5 6 6 • � x�***�x�x**+��*�****�***��r**��***x�x�*�*�****�r*�r**x��x**�r�*�***�***��**�*x**�***** D E V E L O P M E PI T S E R V Z C E S R E Q U I R E M E N T S 20NING APPROVED BY DAT'E: BUILDING APPROVED BY ; DATE: APPLICATION ISSUED DATE: OZ- c3. � �r�r�r*�r*x�r�e�r*�e**�***�t , **��**�r�*� *� iEiEiE3F�fiFiFifkif�FifiE1ElF!liEiPifiFlfifiElFltlE3EiEiEiEiflEifltilifl� �iElEi4�EiEifikifiEMiEfEifiElEiFiE�E1EiEiElEiEiEififlEiflElEiFifiE3(�ifltihiEiEif�E . LEGALI'LATION.;Y F E E S I7 M M A R Y STAUCTURAL SEGMENT;Y BLDG PMT PLUM NG E.iCTRIC MECHANIC FIRE SMIP/RES GRADING PERMZT 90,00 ' SMIP/NON-RES PLAN 58.50 — .50 ISSUE FEE BUILDING-DIV-> PERMZ SSUE PLAN-CHECK TOTAL PAID DUE TOTALS----> 90.50 0.00 29.25 119.75 119.75 .00 REVENUE DIVISION TOTALS- COLLECTED: 119,75 OVER/SHORT: ,00 BLDG PMT PLUMBING E ECTRIC MECHANIC FIRE SMIP/TOT 'GRADING PLAN-CHECK 90.00 ,50 29,25 iE jE 3E iE iE±F 1F if 1k 1E if i! 1E iE iE if %K IE iF if iE if iE iE if if 3E it iE iE iF if 1f iP dE 3E iE if iF if iE if iE 1E if iF if i! if 3E if �E �E iE if df iE ik iFjE �E iE if 3FlE 3E if fE iF iF iE 3E iE 3( 3E 3E iE if Z N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAI, COST SFC 2000 ALTER BY VALUE COMMERCIAL NOZONE 1.00 2,000.00 END OF FEES . � o� anoso5�3—+]ODEQ525 r ��- ax�.�s� OATE: D2l13/9Y TIItE: ;Zes� i � CQNSTRUCTION AND PLANIV�i � a'PA . AP'PROVALS Permit # Date Inspeetor qpPROVALS Permit # Date Inspector �' 1. Temporary Electrical Service or Pole _ 52. Pool & Equipment Location 2. .�",oil Pipe•Undrgrnd. 53. Steel Reinforcement ' � 3. Electrical Conduit Utility-Undrgrnd. 54. Forms � 4. Electrical Conduit�Undrgrnd. 55. Electrical Bonding . � � � 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test ' 6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE 7..Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe•Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection ' 62. Backwash & Receptor-Final , ' 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Piumbing System � Final 14. Rough Plumbing 65. Electrical-Final � 15. Rough Electrical�Conduit 66. Solar SYstem-Final - 16. Rough Electric Wiring 67. Fencin9 & Access ApProval 77. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical�T Bar Ceiling 69. POOLlSPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace - � � � • APPROVALS � ' Permit # 21. Dutts, in Structure . �.. . 70. Underground Hydro 22. Ducts, Ventilating ' 71 . Product Piping O Gas ❑ Oil 23. Gas Pipe�Rough & Test � . � � � . 72. Underground Flush� � � 24. Roof Framing� � • 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro � 26. T�Bar Ceiling (Structural) & Monocoat �� 75. Dry Chemical � - 27. Frame and Flashing , , „� 76. Dry Standpipe � �28. Lathing&Siding - � � � ••' 77. FK� DSYSTEM�FINAL' .I . I ' ' 29. Insulation �. "� . � � I 78. RE PR FIN,�L 30. Drywall Nailing � � ,, ,��'. � EALTH EPT: REQUIREMENT '31. Plaster8rown;Coat' - � �� ;,�y � 79. FINALINSPECTION 32.�Electrical Power Meter,Final . I � f ;.. 80. FOOD CERTIFICATE ISSUED � 33. Final Electric' � �� ' ` Notes: , , . � 34. Final Heating & Air�Conditioning � j J I'�,'� •� - � 35. Final Gas Pipe-Test ' "; i,; f' ' a. 36. Hood or Canopy . �� " �' , '37. Final Factory Fireplace- � ' ' � � � � i 38. Final Plumbing � � ! � I 39. Water Service�Final • � � � �� , 40. GasService�Final ' �' � 1: 47. Solar pomesticFinal . • i � � . ' 42. Backflow Preventer ' � � � ' . . � i 43. Backflow Irrigation . � ' ' .44. Landscape Irripation System . � � , 45. Sound Attenuation � 46. Handicap Regulations . 47. INAL STRUCTURE & BUILDING ;S �l�l ,�� 6 . FINAL.PLANNING� � � ' � . i i . � 49. Electric Release to Edison ' %�"� 50. Gas Fielease to Southern California Gas Co , �'" . i 51. CERTIFICATE OF OCCUPANCY , , �� No. Date CITV OF COSTA MESA CONSTRUCTION PERMIT AOP�leanl lo ftll in a1l spaeas axcept thoso wilhin heavy border Iines an0 sign all approoriate aeclaratlons. � PERMIT�O�` � TRACTNO.. LOTNO. - "BLD . . Q PrOj2tt Addrei9 � ✓ / � TVPE OF CONSTRUCTION. NEW ADD _.ALTERATION REPAIR Applicant'SMailingAddre55{ Z 1 � " � - ❑ CONVERSION -❑ DEMOLISH ❑ OTHER ' Ap y�� ,F� i` f �G�J P %EL] A'Z�O DESCRIPTION OF WORK Owner s Name =$ � hone • Address �,o_��Si R.-\ 1F i' �i E � 1_�� • Arch/Eng. License No. Address � � � � h � � Contractor's Nam� e' � e� I�S 3 Address (meilingl ') S2H `nI <,..� � R_� R�i��, en , I Ciry LicP�se No. �Q -3 � \LICENSED CONTRACTOR DECLARATION _ I I hereby allirm that 1 am licensetl untler provislons of Cnarter 9(tommencing with saction 7000) of �iviston 3 0/ tho Buslne55 ana Professions Cotle, anC my Iicenso Is in tull forca antl eHect. � Llcanw Class � Icensa No 1 Datc �� ' Z r+� A7 Signatur � W00.KER5' COMPENSA710N RATION h¢rCby afti�m fhat I hav4 a C¢rtifiG [e of con5¢nt to sel(-InSU�¢ Or a C¢rtl �ate �f Workers' Compensation Insurance, or a cartlfletl copy tnereof (Sectlon ' 3800, Lab. C.) � Q PollcyNo. ny$�-LO � Company_p�-V�=� 8 Certitietl <opY is hereby furnisnetl. ' Certltietl copY �s filetl with the city Builtling Division. �atc Applicant EXEMPTION FROM WOqKERS' COMPENSATION �ECLARATION (This saCtiOn neetl not be ¢pmpletetl if Ihe permit Is for one huntlretl (f100) or lazs). I certHy that in the Oerformance of thb work for whlch this permR Is issuea I shal� not employ any person In any manner zo as to be<ome zub�ect to the � Workers' Compensation Laws of Callfornia. • Date • �Ignature ' NOTICE: If, atter making this tleclaration, you shoultl be<ome suD�ect to the Workers' Compenution provlslons of the Labor Cotle, you muil fort�wilh comO�Y w��h such provislons or -Nis ,parmit shall be tlaemetl revoketl. CONSTRUCTION LENDING AGENCV ' - I hareby a111rm that there is a tonstructlon lentlinq agency for the performance 01 lho work for whlth Ihis permil I5'.Issuetl (SecHon 3087 Civ. C.)' LenCer's Namn � _ I..¢ntler•i AdtlreSs OWNER BUILDER DECLqRAT10N 1 . ' 1 hereby af(irm that I artl'exempt trom the Contrattor'S License Law for the following reasori (Section.7031.5,Buslnass antl Professional Coae: Any city or county which requlres a �ermit"to construct, alter, Improve, tlemolish or reDalr any structurn, prior to itx issuance, also reqWres the applicant for such permit to filo a si9netl statement tnat ha/she is Ilcdnsetl pursuant to the orovisions ot , •he ContrdCtOPs Licen58 law (Chapter 9(commencing witM1 5ectiOn ]000) of �vision 3 ot tne Businass ane Professions Cotle) or tba[ he/she iz exempt erefrom antl tne basiz for t�e allegetl ezemption. Any.violation ot Section .031.5 by any aDP��cant for a permit subjects'the a0plicant to a civil �enalty o/ not more than {i�e huntlrea tlollars (E500). I, as owner of ihe proper[y or my employee5 with wa9e5 as t�eir sole compensalion, will tlo thp work, antl lhe structure is not Intenae0 or o(tere0 for salo. (Section ]044, Business anG Prolessional Cotle: The Contractor•s LicenSe Ldw tloes not apply to an owner of a proDerty who'bWlaz or improves theraon, antl who tloes such wo�k hlm5elf/he�581f o� thmpgh hiz o� hGr own Bmployea5, p�ovitl<tl that such imprOvlTantS d�e not intentletl or of/eretl !or sale. If, however, tne builtlin9 or Improvemant I5 soltl within pne year of com- D�ation, tne owner will hg�e tne burtlen ot provin9 he/she tlitl not bui1C or Im• �1fove tor lhe purpose of Sale). u I, as ownar O/ the D/qperty, dm e%clu5lvely cOOtrd<ting with II<ensetl COO- tractors to construct tha project 1Sectlon 7044, Buziness and Professlons Cotla: The Conlractor's Liconse �aw does not apply lo an owner o( property who builtls or improvas tbereon,.antl who contracts (or sucb projects wl[h a<on- tractor(s) Iicenia pursuant to tha Contractor's Llcense Law�, ❑.I am oxempt untlar Se��lon B. & P. C. tor tbis reason Dato Owner I hereby certity t�at 1 Mave reatl lhls application antl ztdta tM1at tne above Informatlon Is correct. I agrea to comply with all cily antl tounty ortlinances antl state laws relatinq to bWldina construction. ana hereDv auihorize reora- Signature `^�-"� Driver5' Lice or55 CMF 0865-46 tev. 7/83 TVPEOFPERMIT IJ GRADING LJ FOUNDATION LJSTRUCTURAL � ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ OTHER � PROJECT DESCRIPTION Sa.FT. oCCVPANCv_ CONS7RUCTION TVPE VALUATION $ Ramarks: . ' Bar Sink Backflow Preventer Backflow L-rigation Bathtubs qarifiers � Dishwasher" ' Drinking Fountains Floor Dreins'. Gas Service C Interceprors Kitchen Sink - lavatories ' P—Trap � � Roof Drains I Reinspection Fee -' GRADINGCU.VDS. ACRES_ Showers Service Sink Sewer Cap Sewer Connection Solar Collecrors Solar Piping Solar Tank Swimming Pool w/Spa ��.��—�: _■�� _.�� .__�- �S�_— ��_�- �■�� $25 Boiler Duct - Under Ground Duct-Structural ' Duct - Gentilating Exhaust System ❑ Multiple Firepl/Fact. Blt. ICBO dk Hea[ing System & Ducting ❑6100,000 BTU 0100,000 .XD�[� 7 �Co""7'�'V�Toate//-3�`2(S.' -� � � � � Reinspection Fee WM1ite - Buittling: Canary - Ap0licanQ Pink -�Accountin9: Galtlenrotl - Assessor laue Fee Hood or Typel: ❑ CanoPY TYPeII ❑ . Refrigera[ion System ❑aioo,000eru ❑ioo,000 System Repair/Alteration ' Issue Fee ES S 3 $ 3 S Mam ewldmg. E T Front B Rear A C Right � _ g Left i Ping. Ref. dh ' Perking Req.IProvid� Use of Building: Planning Notes: � , .--' 965 : t t J:; -i'' : �o . : ' 2one : �Acceuory Building: Z �� ' Park:Fees $ � � i 1 Automatic Washer ' +! Construction Pole Sub. � Cooking Unit ' � :� , Dishwasher Dry¢rs ❑Ga�. Fan F.A.U. Device Boxes Outlets Switches Gerbege Disp� ELECTRICAL � ❑ 15-50 KW ❑ 50+KW ro 100.amps �r 100 amps Electric .' 'Sub Panel � ' Motors �61 HP � 1 Yh - 8 . 'Inc.Solar �9�15 HP 016�15+ . � Microwave ' , _ Pole Ligh[ • � ❑0.5 KW,OS-7 . � Sign '� : Standing Sectionz i,KW ,Trash Compector :s� Reinspection Fea • � I S PUBLIC SERVICES RE�UIREMENTS: 2oning APProved By . APPlicatiori.Approved By —� Issue Fee FEES a C 5 3 • � � SUMMARV OF FEES � � BUILDING PERMIT $ SMIP � $ -PLAN CHECK $ PERMIT . i PLUMBING $ � 'ISSUANCE $ ' � PLAN CHECK � $ � ENERGV P.C. � $ � .ELECTRICAL - $ GRADING ' $ •� PLANCHECK � $ MICFiOFILM $ , MECHANICA� $ ' TOTALFEE $ �S��D 'PLAN CHECK $ __ O N I N G R E ' Q U 1 R E � M � E N T t .�CONSTRUCTION AND PLA I ' POG SPA . APPROVALS Permit# -� �� Date Inspector APPROVALS Permit# Date Inspector . � -1. Temporary Electrical Service or Pole 52. Pool & Equipment Location ' 2. Soil Pipe•Undrgrnd. � � 53. Steel Reinforcement � ' 3. Electrical Conduit Utility-Undrgrnd. � 54. Forms . 4. Electrical.Conduit-Undrgind. . ' 55. Electrical Bonding 5. Steel Reinforcement '� 56. Rough Plumbing & Pressure Test 6. Electrical�UFER Grnd. , 57. APPROVAL TO COVER-GUNITE ,. 7. Footing5 . � . " 58. Electrical Conduit-Undrgrnd. � 8. Foundation � 59. Gas Pipe, O Undrgrnd., Test ,� 9. �Water Pipe-Undrgmd. �: � 60. Backwash Lines, P-Trap, O Undrgrnd. � � 10�StructuralFloor'System � 61. APPROVALTODECK 11. Property Sewer Line & House Connection " 62. Backwash & Receptor-Final ' 12. Sewer Cap � . .� 63. Heater & Vent•Final � • 13. Fioof Drains �� - ,� 64. Plumbing System - Final ,� . 14. Rough Plumbing � - ' 65. Electrical-Final �' 15�: Rough Etectrical-Conduit � 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval � 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating `71. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test D2. Underground Flush � 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat �►5 �'Dry Chemiral . tY 27. Frame and Flashing �76. Dry St�ndpipe 28. Lathing & Siding � ��77. FIX�D SYSTEN�"FUVAL r 29. Insulation ,; 78. FIfAE PREV. FINAL 30. Drywall Nailing ' � HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat �` 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning �. o ' 35. Final Gas Pipe-Test 36. Hood or Canopy � 37. Final Factoiy Fireplace . 38. Final Plumbing ' � � Water Service-Final ' ' 40. as Service-Final -�'�� . Solar pomestic-Final 42. Backflow Preventer 43. Backflow Irrigation � 44. Landscape Irrigation System 45. Sound Attenuation � , 46. Handicap Regulations ' 47. FINALSTRUCTURE&BUILDING 48. Special Requirements Completed 49. Electric Release to Edison � � � 50. Gas Release to Southern California Gas Co - 51. CERTIFICATE OF OCCUPANCY . No. Date Pfl0.1ECTR00BE55: 44O E 17TH JCT OWNEN'S,NAME: FREEMAN FISHER aonness: Z36 DRIFTWOOD CORONA DEL MAR CA 92625 AXCN/ENGINEEN: 7 6�~ O 7 3 � FDOflE55: REG.NO.: uNiT: 6 UNIT: PE"mmEE:FREEMAN FISHER (714)760-0730 FDOflE55: z�s DRIFTWOOD RD - CORONA DEL MAR CA 92625 LICENSEO CONTPIICTOH OECUIPATION: I hereby allirm thal I am licensetl un0er provisions ol C�apler 9(commencing wiih Seclion 7000� of Div�sion 3 of Ine Business antl Prolessions Cotle. antl my license is in lullforce antl elfec�. CITY LIC.: STATE UC.: CLASS: Oa�e: Signature: WOHNEBS' LOMPENSA710N DECLNHI17i0N: I �ere0y alfirm rtia� I have a cenificare oi wnsent m self-insure or a certifiwte of WOAers' ( Compensation Insurance. or a ce��ilied coDY �hereot (Seciion 3800, Lab. C�. POLILV NO.: E%P. ORTE: ' COMPpNY: ❑ Cenilietl copY �s �ere0y fum�s�etl. ❑ CenilieE copY is filetl with t�e city BuilUing Division. �aie: ApOhcanL EXEMPTION FPOM WOPKENS' COMPEN511TION OECIABRTION: Qhisseclion neeU no� be complete0 ii the permil is �or one hun4reG (5100) or less�. 1 C¢�ity thal in the p¢dormanw ol lhe wwk tat w�ich L�iS Detmil is i55ued. 15ha11 nol employ any Derion in any manner io as t� hecame suDject to Ine workers Comoensalion Laws ol Catilornia. Date: SignaWre: NO7ICE: If. alter making inis eetlaration. yau snoul0 Oecome subject to the workeri ComDe��ion pmvisions ol ine LaDor CoGe. you musl fotl�wi�h ctlmply with suc� pmvisions or this Oermil s�all be 4eeme0 revaked. CONSTNUCTION LENUING RGENCY: I he�eby aflirm Iha� t�ere is a con5iruc�i0n lentlinp aAe�cy tor 1�¢ pedormance o� lhe vrork �or wAich Ihis permi� is issuea (Sectian 3097. Civ. C). lENOEfl: pODflESS: OWNEfl BWLOEB DECLABATION: I �ereby allirm t�ai I am eeempl Imm Ihe ConVac�ors' $Iaie license Law lor ��e followinp reason (Sectian 70.37.5 Business anC Pmkssional Cotle: Any city ol county w�ich Bquires a Derrttit lo constmct, alter, impmve, Gemoli5�, or repair any Slmtlure. prioi l0 iis i55uant¢, also reqUir¢S ihe aODliCanl lOr 5uth permil Io �ile a Sign¢E Siatement �ha� h¢/She i51icen5eA oursuant to ihe pmNsions of ihe Loniracmrs' State License Law (Chapter 9(commencing wilh Seclion 7000) of Divivon 3 al ihe Business anG Pwfessions CoGe) or Ihat �elshe is exemp� �herelmm and Ihe �asis fo� Ihe alleAetl ex¢mpli0n. Any Wolation nl Section 7031.5 Uy any applicant for a permit su�jeds t�e applicant Io a civil penal�y ot nol more Ihan ilve �unAreO tlollar5 �$500). I, as owner of Ihe proPeny or my employees with wages as ineir Sole comDensation, will tlo ine wark, anA ihe ❑ slmclure is not in�entletl 0� offered for sale (Sec�ion 7044, Business an0 Pmiessional Code: The Coniracbrs' State I.icense Law tloes nol apply lo an owner of a Dmpeny who huilOs orimD�oves ihereon. and who tloes such work �imself/hersell oi throu0h his or her own emDl0yee5, pmviAeO Ihai SutM1 impmv¢menl5 are no� inientled Or ollerea lor Sale. Ii, hOwever �he builtlinp Or improvemen� is soltl wilhin one year ol compleiion. Ihe owner will have Ihe bmaen o� pmuing he/she did no� builU or impmve lor Ine puroase ol sale�. I. as owner ol tAe propenV, am excWsively conlracting with licensetl coniracbrs lo consiruct the D�olect (Section 7094, Business ❑ anG Pmlessions CoGe: The Contractors' State License Law Ooes not appN �o an ovmer of Oroperty who �uAAs or impioves therean anG who Conlracis �or w�h pr01e[ls mt� a canVactor(s�license pursuanito tM Convaciors Sta�e License Law�.l am aware iha� pro01 0� ��eir Worker'S Compen5dli0n in5urante 5houlA De pmvided I me. � i am exempi unaer section: B P 7 Q 4 4 B. 8 P. C. m� tnis reason. CdNTRACTORS HAVE �JM Z " � � Ownec Dale'. ' I 0o here0y cerl ly Ibal I am awar¢ ol antl UntlerS�ana I�¢ r¢puir¢m¢n�s o� Calitomia Heall� anU Salely COCe Seciions 25505, 25533, antl 255Ja antl ihat I or any fulure 6uilding occupant will/will not (circle one) nee0 to comply witn saitl slate co0es antl ihe requirements tor a permil lor consimclion or rtwdiliGalian Irnm t�e Fir Oualily Managemem Distnc�, flesiaentul constmciion applicaiions are exempt �mm IheSe provisions. Dale: p001itant: _ I hereby tertity thal I have reatl Nis a001italion anA Siale lhal lhe hav¢ intoyyation is arreti. I agrte lo COmply with all ti�y anA tounry or4inanW5and51alelaw5relatingtobuilCingconstmclio ner yaW�or�relrtse aiiv I�iSdtytoen@ruponthea�OVC-meniion¢0 pmper�y �lar in�sp/eclian purpases. � Daie:—L�� Si9nalmc: '�'� � / �river's License or Social Secunrv a: Canary—AppliwnC Pink—Revenue; GdEenroa—Assessor 1� � , CITY OF COSTA MESA — BUILpING �ERMIT PERM NO: IP 05099 . PERMIT NO: IP 050997 PLAN CHECK.NO; ,. - N GOVT: N SUPP: Y CONSTRUCTION TYPE; PERMIT TYPE; OTH.PLU PURPOSE: OTH JOH DESCRIPTION : CLOSE FILE ON EXPIftED PERMIT SQ FT; , CLAZM VALUE: CALC—VALUE: GAOUP OCC; B-2 /• *�******�r�***�*�****�*{��**�**+r�*********��r+t�r*�,�� x �r�� r**,**�r ��****� **� x��r#***�t***+r ; Z O N I N GS ERTEBQAUCIK�'SE M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BDILDING --------- FRNT; FT IN REAR: FT IN FRNT:� FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ • PROV; PARCEL:�11732126 ZNE; REF NO; PLANNING N(7T'ES> > iFifif-N�iflfiflElFiEiEiEiEifiFiflEdEiElfififiFiEiFlE�EiFifififif3FiEiE9EiE1FiE1E�E1FiEdEifi(;ff�ffiE'1EiEiEiEiEi(�IfifiEiElEifiFiElE*�Eif�lEifiElf�EiF3FiFlflf�FiE ' D E V E L O P M E N T S E R V I C E S" R E Q U I R E,M �E N T S 20NING APPROVED BY � :� DATE; BUILDING APPROVED BY : ' � DATE; APPLICATION ISSUED BY: � ff �tlP �(� iF af iE if !f if 1E iE iflE iE iE iElE * lf !E �k iE ik ik if 1E iE if if if if if if iFlE iF if !f if if ft 1E iF if iE if if iE 1E 1F iF IP if if iFlE dE iE iE iE if LEGALIZATION:N F E S U/ ' HLDG PMT PL __ � ELECTRIC` PERMIT 0,0 PLAN z5 ISSUE FEE HUILDING—DIV—> PERMIT S TOTALS----> 30.00' REVENUE DIVISION 'I'O'PALS--> BLDG PMT PLU,NBING ELE 30.00 �l ' � DATE • G 7� !y t e� iE1f1EiE�lEifif�!(�7kiE r iEiE k iE i! it iF iE±F lE �f if if ik iE K� iE 1f if if �� iE if !F �E iF fE �f ik iF�E iE iE iE ik if iE �E iE M M A R Y STROCTURAL SEGMENT:N MECHANIC PIRE SMIP/RES GRADING SMIP/NON—RES r PLAN—CHECK TOTAL PAID DUE 0 0.00 30.00 30.00 ,00 COLLECTED: 30,00 OVER/SHORT: 00� IC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 0 if �f iEiE if iE 1E if if 1F iE iE iE ik 1F iE if iE iE if 1E if !E 1c !E 1f iE iE iE` iF iE 1E if !k iE �E df fE �k iE!! iF iE IE fFlt if !k!b iE 3F if iE iF if iE iflE iE iE iElE If 3E 1E iF k i6lk !E!f k �E 1ElE 1F if 1f I N D I V I D U A L F E E B R E A K D O W N • TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST PLU 1 PLUMBING RE—INSPECTION FEE 30,00 30.00 END OF FEES � 0 �1 C.Dav��J`27'�4��Pid`J:� !�[r� ..�i.l' DRTF: 02113J91 72t1Ec 12:23 CONSTRUCTION AND PLANNI� �& SPA APPROVALS Permit # Date Inspector qppROVAIS Permit # Date Inspector 9. Temporary Electrical Service or Pole 52. Pool & Equipment Location ' 2. Soil Pipe•Undrgrnd. 53. Sreel Reinforcement � 3. Electrical Conduit Utility�Undrgmd. 54. Forms � � 4. Electrical Conduit�Undrgrnd. 55. Electrical Bonding -- 5. Steel Reintorcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNiTE 7. Footings 58. Electrical Conduit-Undrgrnd. 8.� Foundation �� 59. Gas Pipe, � Undrgrnd., Test .. . 9. Water Pipe�Undrgrnd. 60. Backwash �ines, P-Trap, O Undrgrnd. �� 10. Structural Floor System 61. APPROVAL TO DECK � 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final - i 12. Sewer Cap 63. Heater & Vent-Final • 13. Roof Orains 64. Plumbing System - Final '' 74. Rough Plumbing ' 65. Electrical�Final � 15. Rough Electriwl�Conduit 66. Solar System-Final .- � i 6. Rough Electric Wiring 67. Fencing & Access ApProval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace ' " '•' APPROVALS Permit # ' 21. Dutts, in Structure , � .�.. . � ! �. ` 7p, Underground Hydro � 22. Ducts, Ventilating ' _ ' �' 71, Product Piping OGas OOiI 23. Gas.Pipe�Rough &�Test � ' � . ; � ; �� , 7y, Underground Flush � 24.�floof Framing• r �� - ' '' 73. Undergmd.StorageTank OGas ❑Oil 25. Roof Sheathing � � 74, Overhead Hydro- 26. T-Bar Ceiling (Structural) & Monocoat ' •' 75. Dry Chemical ' 27.'FrameandFlashing , , . 76.�DryStandpipe � 28.� Lathing & Siding � - . + �� ^� • 77, FIXED SYSTEM �FINAL ` 29. Insulation , ' ' , ' I �� . 7g,r�F'pR:E;,�REV. FINAL 30. Drywall Nailing � � � ' I I ; �i's ; �� • • H �L,iT,H DEPT: REQUIREMENT 31. Plaster Brown Coat ' ' � i � �� ,. 79�.+FINAL INS?ECTION � � 32. Electrical Power Meter�Final � • � � I� ��+ � 80� FOOD CE'RT� ATE ISSUED 33. Final Electric�, ' ` � � ' �� j ; -F�otes: ; ; • 34..Final Heatinq & Air Conditioning ,= � I �� ;� ,� • � 35. Final Gas Pipe-Test ' _ - ' ' � I ��,�'� ' . �,' . ' � 36. Hood or CanoPY . � I ..;•Ji li � • .. . . Final Factory Fireplace ' � I �� i 8�F nal Plumbing . ., , 'Z ��Cl(i /�p �. . ater Service�Final j ' �' 40. Gas Service-Final • � ' � ! � i 11�, 41. Solar pomesticFinal • � � f I � � � ; 42. Backflow Preventer �� ' I I ( - � i 43. Backflow Irrigation -. ' ' ; 44. Landscape Irrigation System , � . . . - � � 45. Sound Attenuation ' 46. Handicap Regulations - ' � � 47. FINAL STRUCTURE & BUILDING I ��- - I i .. 48. FINAL PLANNING • I I"'i ' 49. Electric Release to Edison � i ; �; � , �i 50. Gas Release to Southern California Gas Co � ��, • . 51. CERTIFICATE OF OCCUPANCY . ` , No. Date _'� PP0.IECT ROOHESS: q Q O E 17TH �T OWNEfl'SNRME: AZlZ A$LAMl nooeess: � � 1 g 5 BROOKLYN AV ' YOR�A I,INDA CA, 524-5519 AflCN/ENGINEEN: aooeess: PEG.NO.: ueir: 6 uxiT: PEflMITTEE: HLAKE SICN COMPANY INC, ( 714 ) 891-5682 aooaess: I566S PRODUCER ST N HUNTINGTON BEACH CA 92649 LILENSEO CONTflACTOB DECIpqATION: I �ereUy allirm tlwl I am licensed unEer O�ovisions ol ChaO�er 9(commentinp vnlA Seciion ]000� ot DiuivM 3 of tne Buspess anE Protessions CoOe, an0 my license is n lulllor e� tl2lfect. cirruc.: 04189I8 ST�TELIC.:SO642Z�� t. ` 'Oaie:��.3�/ Signalure:__ NOPKEBS' COMPENSRTION UECLAflPTION: I �ere0y allirm Inai I nave a Cer�ilitale o� conseni Io Sell�insUre or a cenilitate 01 Workers' Compensalion Insurance. or a �etlilietl coDY ihereol (Seclian 3800. La�. C). POLICYNO.: lO.3O1S%-89 _ E%P.UATE: 0%�Q1�9], comraxr: STATE FUND ❑ CeniliM mpy is �ere0y ipmishetl. � Ceni�ietl cap i �i� n��' a ti ' �/y,/�DiCision. Ddle:�-/�7^/-� AODlicant: Y�"�+'�+�� EMEMPfION FBOM WOflKEflS' CQMPENSRtION OECLANRTION: �iks 5e[Oon neW noi be cOm plettd il0e ce�M� �s �or One IUWrM (5100) or less �. I cenily IIWI in ine oetlormdnce o� ine work lor wnicn this oermit is issuea. I shall not emDloy any per5on in any manner Sp as la Oecome SUC�eC1 lo I�e Workers' CAmD@nsalion Laws ol Calilomia. Da�e: Signamre: NOTICE: II, aller making ipis Oetlamlion, y0u S�ouIG �eCome Su�lec� �o �AC Workers' Compensati0n prouisions ol Ihe La�ar fAOe. you must �otl�wi�� Comply vn�� suc� O�ovisions ar lhis Oermit S�all Ge 4eeme0 revoke0. CONSTflUCT10N LENUING AGENCY: I �er¢by ailitm tha� IAere is a Conslrutli0n 1¢ntlinp apenCy lor ��e performant¢ DI I�e work tor wnic� ��is permil is i5su¢tl (Section 3W7. Civ. C�. LENOEN: RDOflESS: OWNEB BUILOEB OECUNATION: I herehy affirm ihat I am exempt trom �he Convaclors' State license Law lor IAe IWbvnnq reason �Seclion 7031.5 Bu5ine5S antl Pm1e55ional CoGe: Fny ciiy 0� counly wOkh fequire5 a permii �o constmc�. alter. imprOve, Gemolish, ol reoair any simclure. D�ior lo ils issuance. also repuires Ihe applicant tor sucn permit to lile a signea statement ihat npJsne is licensetl pursuant lo t�e pmvisions al t�e Comratlors' Stale License Law (Chapter 9(commencinp wi�h Sec�ion 7000) ol Division 9 0� tAe Business �n� Pmlessi0n5 Coae) Or �hai �e/She is eKempl �Mretrom and the basis �Orlhe allegeU ¢xemption. My violali0n ot $¢Cfion 7031.5 by �y apolicanifor a Dermil sub�ects the aDDlican� Io a civil penalty ol not more ihan live huntlred dollaR (55001. I, as owner ol the D�openy or my employees vn[h wages as t�eir sole compensatian, will Oo l�e work; anG tAe ❑ swcmre is no� imende0 ar oflereA Inr ule (Section 70a4, Busness antl Pmlessmnal Cade: T�e Contractars' State License Law Gas noi apON ro an o�er of a O�oPeny wtp Ouiltls or imprwes tAereon, anA who tloes such xvrk hirtoelilAersell or tNouph tus or �er vxn emD��'ees. D«eG Out suc0 improvements are rot imenOeE or olfereC br sale. If, Mwever ttre bWJing or impmvemem is solC v��jn one year of completion, t�e ovmer will hav¢ �he GuNen of Dmving he/s�e diE rot EudO or improve bt t�e Durpose of 5aIP1. I, as owne� o� I�e pmp¢rty. am exclusively contracting witn licensetl conlractors m constmct �he Orole�� (Section 70aa, Business ❑ ana Rafessions Code: T�e Caniracmrs' Sta�e License Law Oces noi appN �o an mmer oi pmpertp who bmlas or improves tAeaon ane who contracis for suc� pmiecls wit� a comracmr(s�license Dursuam to �he Comractors' State License Law),I am aware Ilial D�� al ��eir Woryyr's Campensalion insuqnce shoulU be pmvitletl lo me. � I am exempl untler Se��ion: B. 8 P. C. lo� I�is reason: Da�e: Ovmer: I ao nereoy cenity Inai I am awar¢ oi and unaerstana t0e �eaviremems ol Calilomia Heal�h ana Salery CaAe Sections 25505, 25533, antl 25530 an0lAdt I or any luture buil0inp occupant wiMvill nol (drde one� need la compN wiih saiA state Lrotles anE itle apuiremenis for a permii lar consirunim or moAiliwtion irom t�e Air uably Manag¢m¢ni USlntl. ReSi�enlial LronSlNttian appliCalion5 are erem0� «Om I�ese proviSi0n5. Daie: qpplicanl: I here0y cetliiy ItWi I have reaq ��is aOPlitali0n an0 Slale Iha� � abnve imorma �op is correcL I agree io comoly wiln all ciry antl counry o�0inancesantlstalelawsrelalingla�uiltlinqconslmctionand�.rt .I'rt¢ere esLnllives 'y�oenlerupOnl�eapOve�menlipn¢0 D�opeily lorinspetlqionopurpo5e5. Da�e� _?j r � J_(� SipiuWre:. . _ _ • Driver's license or Sona� Securny x: 16CL<8 WNic-BwIOi�: G�p¢n-COOo ENOrcamonl: Canary-AOpI¢anl; Pmk-RovOnue; GolCanroE-NSaa950r CITY OF COSTA'MESA - SIGt3 PERMIT PERM NO:'S3E'•.05139 PERMIT NO; SBE 051349 PLAN CHECK NO: 00911-91 S GOVT: N.SDPP: N CONSTRUCTION TYPE: ' PERMIT TYPE: ELE STR SIG PURPOSE: OTH •1 JOB DESCRIPTION : EXTERIOR ILLUMINATED SIGN SQ FT: CLAIM VALUE; 562,`O.Q CALC-VALUE; 562.00 GROUP OCC; B-2 / COMMBNTS: E}iTERIOR ZLLUMINATED CAN SIGN **�x�**�+��*�*��*�e�**��*x-��*�e*x*x*�*+�*r**�+r+r�*«�*�*��*��*x x��•x*x��r�e+c�x z�c�w*�*� S I G N �I N F O R M A T I O N DISTRICT: 1. TYPE: WALL ILLGMINATION; INT CATEGORY: NEW . DIMENSIONS: 2F'P 06IN X 6FT OOIN AREA: 15.00S�FT LETTER HT; 10 TN STREET FRONTAGE 1: 100,00 STREET 1: 17TH ST STREET FRONTAGE 2: U,00 STREET 2: PARCEL: 117327.7.6 7.ONE: C1 LOCATIUN > FRONT; X R£HR: BUSINESS NAME: ARIANA > LEFT: RIGHT; O T H E R 'C O T A L S G R O U N D S I G N THIS ACTIVITY : 15.00SQFT OVERALL HEIGHT: OFT OIN � THIS SITE ' : 100.00SSaFT GROUND CLEARANCE: OFT OIN ITEMS OF INFO : 4 . PLANTER AREA: O.00SQFT IT'EMS FOR ACTIVITY: 4 HLDG,SET BACK: 7.OFT . COPY VEABZ A G E : A R I A N A C U I S I N E U F A F G H A N I S T A N PLANNING NOTES: PER PA-91-06 k 1F aF if IF 3f iF iE �F iE if k iF iE ie �F 1E if i� ik k iE 1E iE k �E aE k Y.� if iE K if if if !f R IE if �E k!E ib if iF jF iF iF ik if �)t M iE iE 1� iE 1e IF if i:- if If 1E k k iF 1E iE iE Y� i� i� V,� K aE iE #� IF iF D E V E L O P M E N T� S E R V I C E S R E Q U I R£ M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY : DATE: APPLZCATZON ISSUED BY: DATE: d.3'�� iEiti�if'+I"7eifielf#�IFiFiFYiEit'X'Y.'iFiEiEiE . . . . .,ciEificii�±I'it�if'IE�f'iFiiFi' riE LEGALIZATION:N F E E S M M A R Y STRUCTURAL SEGMENT;Y BLDG PMi PiUM 'LECT SC MECHANIC SIGN SMIP/RES GRADING PERMIi 17,00 1 00 1�,00 . 502 SMZP/NON-RES PiAN 11.05 .50 ISSliE FEE 15.00 BUILDING-DIV-> PERMIT SUE PLAN-CAECI( TOTAL PAID DUE TOTALS----> 47.50 15.OU 11,05 73.55 73.55 .00 REVENUF. DIVISION TOTALS--> COLLECTED: 73.55 OVER/SAORT: 00 BLDG FMT PLUMBING EL :TRIC MECHANIC: STGN SMIP/iOT GRADING PI,AN-CHF.CK 17.00 'O.OU 15.00 .SO i•1.05 iE iE �E �k M if k M iE i! %-1f iEdf iE+f 1f if �k iF IE iE iF1E iElf �lE 1E iE iE 1f �%�X 1f �lE if i( iE if �If 1flf if if �IE i! if i!� !f if if if #f 7F iE iF iE 3( k# iF 3E �I( �Y �f �1( JF�If i(1( ik iF •1f Y.-+f �)f dE �)f �lE I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E 5 C R I P T S O N UNST COST TOTAL COS'I' EI.E i SIGN/ OI3TLINL I.IGAT SYS ON 1 HR CIRC 15.00 END OF FEES I5.00 oa onaa2571-oa0A2S74 'E 4! Y QA?E: 03/I�/41 TIFit: i4:3R �� , CONSTRUCTION AND PLANNING POOL & SPA APPROVALS Permit # � Date Inspector qppROVALS Permit # Date Inspector 1. Temporary Electriwl Service iu Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. '� 53. Steel Reinforcement y. . 3. Electrical Conduit Utility�Undrgrnd. � 54. Forms 4. Electrical Conduit�Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Ro�gh Plumbing & Pressure Test 6. Elecuital UFER Grnd. 57. APPROVAL TO COVER�GUNI7E 7. Foot��gs � 58. Electrical Conduit-Undrgrnd. S. Foundation .� ;_/ 59. Gas Pipe, � U�drgrnd., Test �.� -- _ : �. 9. Water Pipe�Undrgmd. -= �:;� 60: Backwash Lines, P-Trap, O Undrgmd. ; j, 10. Structural Floor System --;�-" � 1, 61. APPROVAL TO DECK �� -: 11. Property Sewer Line & House�Connectidn, � 62. Backwash & Receptor-Final ��-- �j i 12. Sewer CaP " � �� • � • �"� 63. Heater & Vent-Final �, :. � 13. Roof Drains - '.i 64. Piumbing System - Final � 74. flough Plumbing � - � 65. Electrical-Final 15. F;ouqh Electrical-Conduit 66. Solar SYstem-Final 16. Rough Electric Wiring 67. Fencing & Access ApProval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 16. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace . . APPROVALS Permit # 21.'Duas, in Struaure . � - 70. Underground Hydro 22. Duc[5. Ventilating � • 71. Product Piping OGas ❑Oil ' 23. Gas Pipe�Rough & Test ' 72, �U�dergrou�d Flush � 24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil 25. Roof Sheathing ,, � 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing � � 76. Dry Standpipe 28. Lathing & Siding � 77. FIXED SYSTEM FINAL _ 29. Insulation 78. FIRE PR V�{N L 30. Drywall.Nailing � ' � � � EALT �DEP�''.`R UIREMENT 31. Plaster Brown Coat ' 79. FINALaNSPEC �ION � 3. Electriral Power Meter�Final 80. � OODjCERTI CATE ISSUED 3 Fina.l Electric `�"--� Note :• ' � . _ 4. Finai Heating & Air Conditioning * _ 4s�� 35. Final Gas Pipe-Test �� i �.� - � '- - 36. Hood or Canopy . ' ' , �,'. ;��. �. ' � 37. Final Factory Fireplate � � r 38. Final P�umhiag � � � 39. Water Service�Final - 40. Gas Service-Final , � � 41. Solar pomesticFinal . 42: Backflow Preventer � � 43. Backflow Irrigation 44. Landscape Irripation SYs[em . . � 45. Sound Attenuation andicap Regulations , � 47. F NAL STRUCTURE & BUILD c � 3 9 `' '48 FINAL PLANNING Q • . 9. �Electric Release to Edison - 50. Gas Release to Southern California Gas �" '�, 51. CERTIFICATE OF OCCUPANCY No. Date �I I VPOJELT AUOflESS: 9 Q O E 1 7 TH ST OWNEN'S NAME: FISHER 6 FISHER aooeess: 236 DRIFTWOOD RD CORONA DEL MAR CA 92525 UNIT: APCMIENGINEEfl: NEC.NO.: II�OflE55: UNIT: PEflM1TTEE: AZTZ ASLAMI ( 714 ) 644-3225 FDONESS: 1%SSS BROOKLYN AV YORHA.LINDA CA 92686 LICENSED CONiBALTOB OECIABATION: I nereby allirm �nat I am IicenseC unCer Dmvisions of CAaO�er 9(commencing witn Section 7000� of �iv,sion 3 0l ��e Business anA Professions Cotle. antl my Iicense is in full force antl ettect. CITY LIC.: STATE LIC.: CU15S: Da1e: Signamre: wOPREpS' COMPENSATION oECLABA710N: I hereUy allirm Inat I nave a cenilicate ol mnsent to selLinsure ar a cenificate of warkers' 'Compensation Insutance, ot a tetlilieU copy thereof (S¢clion 3800. Lab. C1. POLILY NO.: E%P. ORTE: COMPpNY: ❑ Ce�ilietl copy is hereby fumished. ❑ CetlilieE coDV is lilee with �he ciiy BuilAinA OiNsion. . � Applicanl: _.EMPTIONFIIOMWOBREHS'COMPENSATIONOECUBATION: (Thi55ectionneetlnolbecompleteailthepermi�i5larOnehwMreO(5100)orless�. I rerlity thai in tM1e petlorman�¢ ol ihe work lor which IhiS Oe�mit is issued. I s�all not employ any person in any manner sa as to hecome Su�le�� 10 Ihe WO�k¢R' Compensation laws ot Catilomia. Oa�e: SignaWre: NOTICE: II, alter makinp Ihis declara�ion, you ShoWd became Suhleci to Ihe WOBers' Compensa�ion pmvisions o� ihe La�or Coee. you musi Ionhwiih comply witn such pmvisions or ihis vermit shail be aeeme0 revokeC. CONSTpUC710N LENOING AGENCY: I nereby aflirm ihal ihere is a wnsimclion lentling agency lor tne peAormance of ihe work Ior wnicn Ipis permit is i=suea (Section 3097. Civ. C�. LENOEfl: aooxess: OWNEq BU11DEfl DECLAflPTION: I hereby at�irm I�at I am exempi imm ihe Coniramars' State License Law lor Ihe �ollowinp reason �Sec6on 7031.5 Business an0 Pwlessional CoOe: Any city of County which repuires a permil to conslmn, atier, impmve, aemolish, or rtpair any simclure. O�ior lo ils issuance. also re0vires t�e applicant for such permil ta lile a signe0 staiement Ihdl �e/she is IicenseA pursuahi to the pmvisions ol t�e Contracmrs' State License Law �C�apter 9(commencing wilh Sectan 7000) of Oivision 3 oi �Ae Business antl Prpiessions Cotle) or t�a� �e/she is exempt therelrom anA the basis tor ihe allegetl eremD�ion, Any violation ol Section 7031.5 hy any applicant for a permil sublects ihe applicanl to a civil penalty ot not more ihan live IlunOretl tlollars (E500). I, as owner ai i�e D�openy or my employees wth wages as tAeir sole camDensation, will Qo the work, antl tAe � stmcture a not intenae0 or ollere0lor sale (Secuon 7644, Business anG Pmlessional Code: The Cantracmrs' SWte License Law tloes nol apD�Y la an owner of a pmpeny who builAs or improves thereon, an0 who tloes sucA woM1 himself/hersell or ihrough his or �er own employees. proviOeE t�ai such impmvemen�s are nol int¢n4eA ar oflered lor sale. II, however ��e builtlinq or impfovemeni i5 5010 vn�hin ane year Of Com0leiion. I�e Ovmer will have 1�2 DufAEn a� pmWng �e/5he OiC n0i bui10 Or impmve lor Ihe outoose ol salel. I, as owne� olll�e propeny, am exclusively conlractin0 w��hlicense0 coniraclorsto calstNcithe project(SectiDn 7044, Bu5i0ess . antl Pmfessiore Code�. The Contractors' State License Law tloes not apDly to an owner ot D�operty who hwlds or imDraves thereon an0 w�o conVacls lor such pmlec�s with a canVacior(s�license pur5uani io I�e ConVactors' State License Law�. I am aware t�at D�ool ol tAeir Worker's Compen5alion insurance s�oultl he D�oviUe� lo me. � I am exempt untler Seciion: B. 8 P. C. /� lorthi��lr�son: / y � ( � \/ � I Oate: Rwnec I do hereby cenily Nat I am aware o ane untlersiantl ine repuirements af Caiilomia neallh ane Safery Code Sections 25505, 25533. ane . 25534 antl t�al l or any IUWte �uil0ing oaupant wilVwill nol (cilcle ane� neeA to cam0ly wiih saiA siate ca0es and tAe �epuitements for a permit loi constmction o� mo0ilicalion Imm �he qir Ovaliiy Managemen� Dislrici. ResiUen�ial con9mclion ap0litations are exempt �mm I�ese provisions Dale: Fpplicant: I �ere0y ceruty I�ai I have r¢a0 I�iS appli[atiw and Slat¢ I�al t0e a0ove inbrmaiion i5 tortet�. I agre¢ 10 tompty vnih all tiry ana tounry or0ina��¢s antl state laws rela�ing Ia buil0ing consimnion an0 �ereCy amhorite represen�ative�is ' y �o emer upon Ihe above�meniionee pro�eqy� I�prJi9SDec�ion purposes. �^ Oaie: // /�.(t%��r Signamre: � c� , "' • T'T � ori�urs �icense or sociai security a: i64t�ag Wpi�e—Builtling; Green—CoOe Enlorcemenl: Canary—Applica^t: Pink—Revenue; GolOenrotl—Aweswr CITY OF COSTA•MESA — SIGN PERMIT � PERMIT NO: SBE 055211 PLAN�CHECK NO: 04868-91 S , ; N CONSTr�UCTION TYPE; 5—N PERMIT TYPE; ELE STR SIG �URPOSE; OTH JOB DESCRIPTION ; INSTALL ONE (�1.1-�ILLUMSNATED WALL SIGN SQ FT: CLAIM VALUE; 500.00 CALC—VALUE: 500.00 GROUP OCC; B-2 / COMMENTS: THE "ARIANA" RESTAURANT �e*+t*�**�*�x*x**x��et*�**� ��rx* �**�*�ex�e ��e�r**�e**�t*�t*+t*x+�x�*+�*******+t�t*��**+�**��e****�r S I G N I N F O R M A T I O N DISTRZCT: 1 TYPE• WALL ! ILLUMINATION: INT CATEGORY; NEW I7IMENSIONS: 3F'i' lOSN X 3FT 101'�N AREA: 14,SOS�FT LETTER HT: lOIN STREET FRONTAGE 1: 100,00 STREET 7; 17TH ST STR£ET FRONTAGE 2: 0.00 � STREET 2: PARCEL: 11732126 ZONE: C1 LOCATION > FRONT; X REAR: BUSINE5S NAME; ARIANA OF AFGFIANISTAN > LEFT; RIGHT: O T H E R T O�T A L S G R O U N D S I G N� THIS ACTIVITY 14,SOS FT •: OVERALL HEIGHT: OFT.,,..pIN Q y . �: 1'HIS SZTE � 100;00SQFT , GRUUND CLEARANCE: OFT'.OIN ITEMS OF INFO :, 5 . ,. PLANTER AREA: " O.00SQFT ITEMS FOR ACTIVITY:. 5 � �• HLDG SET BACR: 20FT�„ y COPY VERBIAGE : ARIANA FINE CUISINE OF AFGHANISTAN � a � `� i PLANNING NOTES• '•: • • iF if �f iF IF jk if �F fE iF 1E iF jf if if lE 1F iF 3k if iE k k ik if If 1t if iE 3f fE jE if 1t 3f iF iElF'!F if if !F 1f iflf �f iF if iF iF If iF if iF iF 3F iF if if )f iE if if # iE # 3f 3F ##� iF#E k iE'�F�E �F iE �lE D E V E L O P M E N T S E`R V6I C E S R E Q U I R E'M E N:T S: ZONING APPROVED BY :�� ' , D�ATE: �, S 1p r � � 1 BUILDZNG APPROVED BY : ' DATE:%��_�p� APPLSCATION ISSUED BY: DATE: � if�lF3fiFIFit1f1E�E1f1E�k�fiFiEiFk3EiEi�lE* 3EiE�FiflFif'K3FafIF �fiE LEGALIZATION;N ' F'�E"'� S U hj/M A R Y STRUCTURAL SEGMENT:Y ti, r.. BLDG PMT PLUM$TNG ECTRTC MECHANIC $IGN SMIP/RES GRADING PERMIT 15',00 15.00 14,50 ' SOY SMIP/NON�—RES PLAN 9.75 , ISSUE FEE � 15.00 BUILDING—DIV—> PERMIT E PLAN—CHECK TOTAL PAID DUE TOTALS----> 95.00 .00 9.75 69.75 69.75 .00 REVENUE DIVISION TOTALS--> COLLECTED; 69,75 OVER/SHORT: 00 HLDG PMT PLUMBING EL TRIC MECHANIC SIGN SMIP/TOT GRADING PLAN—CHECK 15.00 .00 14,50 ,�0 9.75 �FiEif*iF3FiFifiF�Fi�jEiEiFikiElFifitifiFif3E�FifiEiEiF �EiE�FiEiF�F�EiEiFiFiE�tiElFiEfFlfififMiFiFikiFiPjEifiklEififlEiEiE�FiFifkiE#F3FaFiElEk3fififiE I N D I V I D U A L F E E B R E A K D O W N TYPE QTY �D E S C R I P T T O N UNZT COST TOTAL COST ELE 1 SIGN/ OUTLZNE LIGHT SYS ON 1 HR CIRC 15.00 15.00 END OF FEES �`�\Q� -�_ - _. - = .. � \ Lr.�. .�� i.. CONSTRUCTION AND PLANNING ' , POOL & APPROVALS Permit# � Uate Inspector qppROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole - � 52. Pool & Equipment Location -. ,� 2. Soil�Pipe-Undrgrnd__ 53. Steel� Reinforcemen[ ' 4 • • 3.'_�ectrical Conduit Utility�Undrgrnd. � 54. Forms ' �Y "'4.Electrical ConduibUndrgrnd. � 55. Electrical6onding � Y � 5.,SiBAI Reinforcement - 56. Rough Plum6ing & Pressure Test ��6^ Electrical UFER'_6cnd. 57. APPROVAL TO COVER�GUNITE � -- -7> Footings 58. Eiectrical Conduit�Undrgrnd. �,B..Foundation - 59. Gas Pipe, � Undrgmd., Test � 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, � Undrgrnd. (, ,. 10. Structural Ploor System 6L APPROVAL TO DECK .'�,,_ J i 11. Prope�ty Sewer Lin; & House Connection 62. Backwash & Receptor�Final '� -., :� 12. Sewer Cap ., � 63. Heater & Vent-Final •� ��? 13. Roof Drains '� 64. Plumbing Syttem � Final "� �� 14. Rough Plumbing � 65. Electrical-Finai �` � 15. Rough Electical�Conduit 66. Solar System-Final �• � 16. Rough Electric Wiring 67. Fencing & Access ApProval 17. Reugh Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electriwl�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMEN7 - �� - 20: Rough Factoty Fireplace '- ' � _ " 'APPROVALS�� P2 'rmit # ~ "- � r 2.' ' - � r.•. li�� .i J. ' �l i \•. �' 'S -.4 21. Duc[s, in Str.uctU�a � r�:.'. ,- ,� 70, Wnder9round Hyd[o . . 22. Ducts, Ventilating�, � "-�' �' '� 71. Product Piping O Cyas OOiI ' 23. Gas Pipe-Rough & 7est '.'' •' _ � � � �2._ Lnderground Flush ," , � � -, . . 24.' Roof Framing � • a. �,_�• :" ' - C• ' 73 � Undergmd. Storay'g'Tank O-G�s Q Oil " 25. Ro f Shea[hin ' . ''` . ' . ,,., `` '��, � , _' " Q 9 . r � , - � � . 74:j Overheqd�lydro 'J� , 26. �T�Bar Ceiiing (SV.ucturall & Monocbat � x � 75: Dry Chemical � � <- 27. Frame and Flashing - ' " • . , 76. bry StanB'pipe ' ' � " 28. LaIhing & Siding •� . ^ � � • � Y . •77,• •FIXED SYSTEM FiNAL;'� � 29. Insulation � , p; "�' �.:- . ,i_ _ � �u •�78:,FIRE PRE'�'IP�L � ! . . 30. Drywall�Naiting' - � ' � ",�' � � ;� - 'EALTH� EA`T:,REQUVREMENT - ` 31. Plaster Brown Coat " � - - � °INAC I�NSPECT �(�l ` ' ' :i • � � . , -7--' , . '', o�� -�cal Power Meter-Final , - � • � FL �D ERTIFICATE ISSUED _ _ .. ,.. -Y- - .33.'�Final Ei ctric ; ^'�7 �/ Note .' " � � � .: � - -. � , �/��_!ti :I��' . . . _ _ . : ot. �:.,.I Heating & Air Conditioning ' . t�-� -, . � _ ' '-35;, Final Gas Pipe-Testi � ` ' - .' c - .. `.. � • _ � 36' Hoyd or Canopy . � � � - : . ' ,� �137. Firral Factory Fireplace - r- � y� ; ��• s. � � 38: Final Plumbing . • - � , i,- . �-� � � . 39:- Water SErvice-Final ' � � • • • "� � r .�. �- - ;.40' Gas�Service:vf,inal : , � " " - .r � � . � i `,v . 41�� Solar pomeSticFinal� � . : t..- - • � T. - . ` , • � v'1 � . . . 42`Backflov� Preventei ,. - ' q,. ' , - ' _ , , . 43. Backflow Iriigation � �= < +.' �� r -_. _ � " n- - z � '�, 44. LandscaPe krigation SYst�m .,�,: �.. - �r .: ��. - - � _ ,� .�', � . .. �-45..Sound Attenuation - '• _ ' ... - � i = 46. HandicaP Regulations . ' ' i ` -- � � �, ,r � ��' . . � 47:,F.NAL STRUCTI}�RE & BUILDINC � .79 [1� � ' = �� - �' - LsJ'//i i i � 4v. i �'48:�FINALPLANNING ��S �� • �� ,.� �, ��, , . >49: Electric Release to Edison , /r� •�� u' � - . o - r� r� r - .�50., Gas,Release to $outhem California Gas Co ~� � ! �� r � - - r�-.� ��. � - 51. CE�iTIFICATE OF OCCUPANCY . ,- ,: ,' , No. Date PHOJECT AODPESS: Q Q O E 1 7 TH ST OWNEH'S NRME: ELEANOR FFSCHER . nooqtss: q�-390 AMIR DR ' PALM DESERT, CA 619-346-6366 AXCN/ENGINEEX: AO�flESS: HEG.NO.: uN�T:6 I ' CITY OF COSTA MESA — BUILDiNG PERMIT PERM NO; F 05218 PERMIT NO: F 052180 PLAN CHECK NO: 01645-91.5 GOVT: N SIIPP; N. UNIT: PEHMIT�EE: EXECUTIVE FZRE PROTECT'ION (213)433-3338 ROOflE55: %O GLENDORA AVE � S LONG BEACH CA 90803 LICENSEO CUNTHNCTaB OECLAPATION: I hereby alfirm Iha� I am licensed untler pmvisions of Chap�er 9(commencing with Sec�ion 7�00) oi Divismn 3 oi I�e Business and Pmlessions Code, and my license is in full lorce and efiecl. � ciTruc.:�0 z� sTnTeuc.: 963 cuss: (' 6� �5 � S�nature'. �" �� oa�e: — WOflNEflS' COMPENSATION UECLABRTION: I hereby afiirm �hat I have a cetli a�e oi consen� to selbinsure or a cehifica�e ol WOBers' Compensalion Insurance. or a certtlietl copy thereoi (Seclion 380o. lab. C). POUCY NO.: E%P. URTE: COMPANY: � Certilietl copy is hereby Wmishetl. ❑ Ceni6etl capy is liled wi�� he ciry Builtling Divisian. �ate: AVO�icant E%EMPTION FflOM WOBKEBS' COMPENSRTION UEC�N: (ihis section need na� be comDle�eU ii �he permi� is lo� one hundretl ($100) or less�. I cetlify �ha� m IAe pedormance oi the work lor w�i is permit is is ed. I shall no� employ any person in a manner so as �o become su�ien m t�e Worker ' ComDansa�ion �aws ai alilomia. . / Da�e�. Signature: NOTICE: IL a�ter making is declara�ion, you shoultl become subject 1 e Worker5' ComDensation provisions ol ��e labor Cade you must lotlhwilh comply with SucM1 pmvisions or Ihis permit II be Oeemed revoketl. . LONSTNUCTION LENOING pGENCY: I here6y aifirm �hat Ihere is a constmction lending agency to� Ihe DeAormance of lhe work tor whicn Ihis permil is issuetl (Semion 3097. Civ. C). LENOEN: aooness: OWNEfl BUILOEfl OECLAflPTION: i hereby a��irm Iha� I am exemp� �rOm ��e COnVattor5' State License Law �or I�e �oliowing reason �Seclion 7031.5 Business ana Pmfessional COAe: Any city of counly whic� requires a permit �o construc6 atler, impwve, Oemolish, ar repair any stmclure. prior lo iis issuance. also requires Ihe apD�icani for such permil to file a signed statemeni �ha� he/she is Iicense0 Dursuanlm�he provisions oflhe Conlracmrs'Slale License Law(Chapler 9�cOmmencing wi�h Section 7000) o�Division 3 oft�e Busine55 and Pmfessions COAe) or �ha� he/she is exempi therelrom an� �he basis for Ihe allegetl exemp�ion Pny viola�ion o� Sec�ion 7031.5 by any apPlicam for a Dermit suDlecis the applicant to a civil penalty of not more ihan live hunUred dollars (E500�. I, as owner ol ihe pmpeny or my employees wi�h wages as their sole comDensalion, will tlo Ihe work, antl ine ❑ simcWre is not intenaed or oiferetl for sale (Section 7044. Business and Proiessional Code: The Contractors' State License Law tloes noi apDly lo an owner ol a pmpeny who OuilAs or impmves thereon, antl w�o tloes such work nimsell/herself or IhmuA� his or her own employees, pwvitletl that such impmvemenis are not inten0etl or offeretl br sale. Ii, however the buildinA or impmvemen� is sold wit�in one year of campletion. Ihe owner will Aave ��e �urtlen ol pmving he/she ditl nal huild o� impmve � , far ine purvose af sale). ' � I, as owner o� the propeny, am exclusively conVac�ing with licensetl conVac�ors �o constmc� �he prolec� (Section 7044, Business ❑ an0 Prolessions CoOe: The Con�mcmrs' Slate License Law tloes not appty m an owner ol pmDenY who builtls ar impmves ihereon antl who conirac�s for suc� pmlects wiih a contrac�or�s)license pursuan� to Ihe ConVac�ors' Slaie License Law�. I am aware �hat pmoi of ��eir Worker's Compensa�ion insurance shaultl be provitletl �o me. � I am exemp� under Section: ' B. 8 P. C. for Inis reason: Da�e: Qu+ner: I tlo hereby cenify Ihat I am aware oi and understan0 the requirements ot Califomia Healih antl Safery CoOe Sections 25505, 25533, antl 2553< antl Ihal I or any �uNre builtlinA a��upant will/will nol (circle one) nee0 lo comply wilh saia stale cotles antl the requirements �or a permit for conslmc�ion or motllfica�ion tmm Ihe Alr Oualiry Menagemen� DisUicL Besiden�ial conslruction appllcations ara aKemp� irom Ihese pmvisions. �ate: Applicanl'. IhereDy cetl�ly�hai t have read this applicati antl Sla�e Iha� the a�ove in�orma�ion is wrreci. lagree lo comply wiih all ciry an0 county ordinznces antl stalelaws relaiingto bmltlin onsimc�ion and nereb �horizerepres atives o��his cityto enta�upon�he above�men ' ned pmperry br inspection pur ses. �� aie: � � � SignaWre. � onvei's I.icense or Socia� Securiry p: 164La6 Wlii�e-9uiltling: G�een—Cotle Enlorremenl; Canary—Applicanl: Pink—Revenue: Goltlenr —Assessor CONSTRUCTION TYPE; V—N PERMIT TYPE: FIR PURPOSE: ALT JOB DESCRIPTION : 13985F RESTAURANT T,I „ RE:G51278 SQ FT: CLAIM VALUE: 1,000.00 CALC—VALUE: GROUP OCC; H-2 / COMMEN'LS: INSTALL HOOD SYSTEM **�*�**�***+��***�*�***��r�***��****�**��*�**��r*******�**r**�*��*�c*�e*�x�**�* Z O N Z N G R E Q U I R E M E N T S � S E T B A C K S ------------ MAIN BUSLDING ---------- --------- ACCESSORY HUILDING --------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; FT IN LErT; FT IN RGHT; FT IN LEFT; FT IN RGHT:. FT It3 PARKING REQ • PROV; PARCEL; 11732126 ZNE: REF NO: PLANNING N(3TES> � �E �E if iE jf iE iF 1E 3f iE it iE af if iE if iE iF 3F 1F iF 1E f(� jF iE fE iE �klk fE iF ff aE iE iF 3f iE iF-lf * iE it 1E iE iE if !E lE iE If if if iE if iE if if !F iF if iE �E IE 3E 1E fE 1E If iF iE?t iE 3f if if jE iF if �F D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S / ZONING APPROVED BY . BUILDING APPROVED BY ; APPLICATION ISSDED BY; 1E jF if �lf �i 3E if iE if iF iF 3F iE �f iF 3f 3E iF iE K jE if iF 3E af if iF iF 3E 3f if 3F 3E if iE 3F 3F fF 3F iF iF 3E jF aE iE iF #f IE iE ib �lf �F �)k ib �1! ik jE iE LEGALIZATION:N � F E E BLDG.•PM'T ,�PLUMHIN � PERMTT . � PLAN _ ' ISSUE FHE ' HUILDING—DIV—> PERMIT ISSUE y:R TOTALS----> 25.00 0,00 REVENUE DIVISION TOTALS--> C LE HLDG PMT PLUMBING ELECTRIC C DATE: DATE; _ � C'F DATE; �� . .. �E�7f�1fiF�1EY#FiFiEiF t �1fiE IE aR iF 3k if if iE if iE 3f if 1E )E iE iF if IP if 3F-141EiF k iF if iP iE af {E 3E� fP iF ik iE iF iE jE iF ie 1E iF iE �U M M A R Y STRUCTURAL SEGNENT:N IC N,ECHANIC FIRE SMIP/RES GRADING 25.00 � 16625 SMZP/NON—RES —CHECK TOTAL PAID DUE 16.25 41.25 41,2� ,00 TED: 25,00 OVER/SHORT�: .00 ANIC FZRE SMIP/TOT GRADZNG PLAN—CHECK 25,�� 1E iE iF �E iE iE iFiFiE iF �%-1E if iE if 1E �Jf if-1f iE �f �E jF if if 9E 3f 3E �E 9E 9f !F �lE dF if �7(-if if �1E 3E iE # iE �)E if ff iE il-aE iE iFa(� 3f iE dE �3(�if if iE if �E3f jE if jf iE �%�%3f i(-if iE �f iF iFiE dF 1E iF I N D.T V I D U A L F H E B R E A K D O W N Y TYPE QTY D E S;C R I P T I O, N FSR 25 FIRE EQUIP FEE (FROM HLDG VAL TABLE) END OF FEES . i , _ ' ' UNIT COST TU'fAZ CUST 1.00 � 25.00 �� 3 o7/G1GY70 ot o�o�'r9�a-nul�,s��s�? ��'� z;.:7t QATE� 6�!??'4i 'iA:'�: :p:�5 ' Y CONSTRUCTION ANDPLANNING POC SPA APPROVALS Permit # Date Inspector AppROVALS Permit # Oate Inspector 1.�Temporary Electriral $ervice or Pole � 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. � 53. Steel Reinforcemen[ 3. Electrical Conduit Utifity�Undrgrnd. 54. Forms " 4. Electrical Conduit�Undrgmd. 55. Electrical Bonding �� 5. Steel Reinforcement_ 56. Rough Plumbing & Pressure Test � 6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation �� 59. Gas Pipe, O Undrgrnd., 7est . 9. Water Pipe-Undrgrod. 60. Backwasfi Lines, P-Trap, � Undrgmd. 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 i 6. Rough Electric W�ring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 78. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Condifioning � FIRE DEPT. REQUIREMENT 20.�Rough Factory Fireplace '` � APPROVALS. Permit# 21. Ducts,inStruaure. .� �• � - 70. Underground�Hydro 22. Ducts, Ventilating � i' �71. Product Piping O Gas O�OiI 23. Gas Pipe-Rough & Test . .,, . 72. Underground Flush 24. •Roof Framing , ' `73.' Undergrnd. Storage Tank � Gas ❑ Oil 25. Roof Sheathi�g . ' � 74.- Overhead Hydro 26. T�Bar Ceiling (S[ructural) & Monocoat ' � 5 ry Chemical �' Cv,� W�� 27. Frame and Flashing �� ,,h .�� 76. Dry Standpipe , � 28. Lathing & Siding . - ' � . F XED SYSTEM�FINAL '- .� �-�j; Jy�� 29. Insulation � � : � 78.. IRE PREV. FINAL � �j-�;.�� 1i'� •30. Drywall Nailfng ' � i� HEALTH DEPT: REQUIREMENT I 31. Plaster Brown Coat �; 79."FI.NAL INSPECTION , � 32. Electrical Power Meter�Final ' 80. FOOD�C -T.I�CATE ISSUED . 33. Final Electric � , - N �tes: � �^ . ` . Z.A JD 34. Final Heating & Air Conditioning , - � �� - . . /• 35.'Final Gas Pipe-Test' - ' � !'� � r � . ' �36. Hood or Canopy . 37. Final Factory Fireplace ' - ' � . . ' 38. Final Plumbing - . � � � � � •39. Water Service�Final ' � � ' �_ ' 'r40. Gas Service-Final , . . . 41. Solar pomesticFinal � - , 42.'Backflow Preventer� , i , ,- . � . . � 43. Backflow Irrigation � ' 44. Landscape Irrigation System . . . ' i- ' ' 45.-Sound Attenuation ' . . � � 46. Handicap Regulations � . , '_ . � � , 47. FINALSTRUC7URE&BUILDING � � � ;� �� 48. FINAL PLANNING � - � , � ; . 49. Electric Release to Edison I � � � ' � i r � 50. Gas Release to Southem California Gas Co � � � �� -� � P 51. CERTIFICATE OF OCCUPANCY , . • No Date � i i PPOJELT ADOflESS: � 4 � E 1 7 TH JC T OWNEfl'S NRME: ELEANOR FISCHER aboxess: 4 7-390 .+'.M1R DR . PALM DESERT, CA 614-346-6366 APCMIENGINEEfl: n[c.xo.: uNiT: 6 RODNESS: UNIT: ' PFPMIREE: AZJ Z ASLAMi ( 714 ) 644-3225 nooxEss: L%185 BROOKLYN AV YORBA LINDA CA 92686 LICENSEO CONTNACTOP OEClAMTION: I nereby allirm �nai 1 am licensetl unOer D�ovi4ons ol Chapter 9 �commencinA wiih Section 7000) o� Division 9 0� I�e Butiness anE Prole55ions Cade. an0 my license is in lull lorte anG e�fecl. CITY LIC.: $TRTE LIC.: CIASS: 'jate: Signa�ure: NORNENS' COMPENSATION OELNBATION: I �ereby altirm Ihat i have a tertili[ate o� COn5en1 to 5¢Ibinsure or a cerii�i[af¢ o� Workers ComDensaiion Insurance. or a cenilie0 coDv �hereof (Section 3800. Lab. C�. POLICY NO.: EXP. OATF: COMPFNY: ❑ Cenniea copy is hereoy lumisnea. ❑ Cenifietl copy is hlea wiih Ihe city BuilCinp �ivision. Dale: FppliWni: E%EMPTION FPOM WOBI(EBS' COMPENSPTION �EClAP�1710N: (Tha seclron nee0 wt be campleteE il IAe permit is Ip me ImMreG �5100� m less�. I cenity Ihat in Ine oedarmance of Ine work Ior which inis permit is issue4 I snail nol emvloy arry Pe�son in any manner 50 as to hecame suD�etl to I�e 4Vorker5' Compen5aiion laws 0� CalilorON. Oate: Sipnawre: NOTItE: II, atter maMinp Ris tleclaration, you 5�oulU �ecome suDject to t�e Workers' Compensation provisions ol t�e La�or CoOe, you musl bnMiitn fqmpty witn sucn pmvitions or itti5 permit stWll oe aeemeE revoketl. CONSTBOCTION LENUINC �CENLY: I �e�eUy allirm tlwt I�ere n a canstrUtlion IenGinq apenty for Ihe cehormdiKe ot I�e wOrk for � wNch ihR permii is isSuM �Seciim 3091. Gv. C�. �exoes: aooness: IOWNEB BUIL�Efl OEUAMTION: I nereoy allirm Ihat 1 am enempt from the CAniraclors' State License Law lor Ihe following reason �Setlion 7031.5 BuSineu and PmleSsional Code: Pny diy of couniy w�ich repuires a Oermil io conslrucl, alter. improve. Eemolish, or �Qoair any slructum. prioi lo ils issuance. also repuires ihe aodiWnt lor such permlt ta lile a signee statement ihat hOsne is licensed pursuant Io I�e O�ovision5 Ol lhe ConlraCiars' State License Law (Chapter 9(crommencinp vnlh Section 7000) ol DMsbn J ol tAe Business tnd Pmlessions Cotle� or thal he/she is exempl lherefmm antl ��¢ �asis lor ihe alteped eKemplion. Any violatian ol SEttion 7031.5 Ey my apPlicanl lor a oermit weiects tne applicant to a civil penalry of not more ihan live hunOretl dollars (55001. i. as owner ol ��e pmperly or my empIoyeeS vn�h wages as their sole comOenSaiion, wiil Oa Ihe wark, and �he ❑ SlmtiUr¢ i5 nol inlentlee oroilereA lOr 5ale (Secfion 70A4, Busme55 and Prolessional Cotle: The Coni2ttar5' Slale Litense Law Aoes nol appty Io an owner ol a pmpeny wlw GuilOs or improves ��ereon, ana who Oaes suc� work �im5el�/�erul� or IAmugh �is ar �er own em0loyees, pmvitletl i�ai such imD�o�emen�s are not intenaed or alleretl lor sale. II, �owever tAe �uilAing or imD�ovemenl is 50�4 wil�in one year ol camplelion, ihe owner will �aue t�e DuNen ol Omving he/s�e Ei0 not DuiIJ or imDmve lor �ne puroose ol satel. ,% I. as ownei ol I�e pmpeny, am e�clusively caniractinp wiih IirenseA coniractors to wnstmci t�e D�qect (Section 7074, Business LJ anG Prolessions CoOe: T�e fAnlrati0r5' Slaie LiCenSe Law OoeS noi aDWY la an owner al prOperip wAo CudUs or impmves Iher¢on ana w�o mnlracis lar such prOjec(5 vnl� a contractoqs� license OurSwni �o I�e CanVac�o�s' State Licensa Lawl. I am aware Iha� p�aol ol Itleif WorkeYs fAmpensalion insurance s�oula �e D�oviaed lo me. � I am evempi under $eclion: B. d P. C. �o� Ihis rea50n: q ////�� Date: 3 � ! ' �1=t) �Owner: �/ l � M �_ � I ao nere�y cenily Ihai I am awd2 of anA untlerstana tlle requiRmenis of Cabfomu Meatttl anA Salety CaUe SEClbns 25505. P5533. anU 2553< anE t�at I or any lulure �uildm9 acuDant wilVwill not (�rde one) nee� to compty wii� uiU slale cOCCS anA IM ttpuircmenis lar a permn loi consimt�ion ar mm0ilicatian Imm Ihe Nir valny Management Ustrict. ReSiGential canstmction appliutions are exempt Imm I�Me D�ovisions Date: App�icanC _ I �ereby cetltly @at I �ave rtad Ihis ap0licalion and slate t�at ordmances anA slate lavrs r¢latinq Io Euilding cry5tmctian antl f O�oPetly brinspection purposes. / oam: 3' �J—L�.�,.I—� � \ lo comON `M�� atl ciiy anA counly lo en'er U�pn Ilre abOve-menlioneG t6n1-n6 WOue—BwlOing�, Grean—Code Enlo¢emenL Canary—ApPhcanl: Pink—Revenue: GOltlenro0—Assessor CITY OF COSTA MESA – BUILDING PERMIT .,. , ., �, PERMIT NO: G 051278 PLAN CHECK NO: 00414-91 S .. , CONSTRUCTION TYPE: V–N PERMIT TYPE: ELE MEC PLU STR PURPOSE: ALT JOB DESCRIPTION ; 1398SF RESTAURANT T.I, SQ FT; 1,398 CLAIM VALUE; 19,000.00 CALC–VALUE: 16,968.44 GROUP OCC: B-2 / COMMENTS: X � 1! If if 1f i� i� if iE le +F � I{ if iF if I! iF if if if if ia if 1i IE iE iFif iF iF±F+f k 3E iFiR it ii if Ie i%if +i if iE if If ik 1R iF iF+i II' K'+E 1%M if +f+E if iF iF i4 Y IE i!� iF jf i( � if ts i� if r�( �c � Z O N Z N G R E Q U I R E M E N T 5 S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCf� SORYO�USPDCNAL REQUIREMENT$ FRNT; FT IN REAR: FT IN FRNT: FT IN REAR; FT� IN LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: N PARKING REQ• 46 PROV: 52 PARCEL: 11732126 ZNE: C1 REF NO;" –91-06–'–� PLANNING NiSTES> 1389 SF TI TO AN EXISTING COMMERCIAL SUITE TO BE IIS > AS A RESTAURANT, NEED TO PROVTDE LANDSCAPZNG IN FR NT, �r�r*****�r***+t��r�r�t+r�rrt*�c+rrt�r*��r**+r*x�*�t�t*r.x*x��t�tx�*+�x��x*��►:�r+r*v�+r�*��+t*�Eu�c��**�r*�r� D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T•S ZONING APPROL�ED BY � SCL' DATE; �(��j�_ BUILDING APPROVED BY : DATE: APPLICATION ISSUED BY• " �� y4' DAT£: •�� IFk1f1�1FkkiE1f1f1EiflPiEkiFM�7fififkf! . . . . . . Y,�iFi4iF±F#1E�fifif �u+c 1! 1E 14 iF 1F %� iE iF IF )t iE iE 1f fF if� !M1!(� 1! iE 1E 1f iF if i!� 1! #!�!f 1E if 1F )E iE if ff if i.if i(��1F iE ik 1E M iF %� IE IE if� iE IE iE if #'-±! if iE�l' ik k 3f 3(�!f iF if ie if iF IF if IF iE if If Y.-1h if 1!� if if LEGALIZATION:N . F E`_:S . M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING CTRIC MECHANIC FIRE SMIP/FtES GRF�DING PERMIT 180.00 14�SR �SOY 625t SMIP/NON–RES PLAN 117,00 • 1,q7 ZSSUE FEE 3.00 15,00 BUILDING–DIV–> PERMIT ISSUE AN–CHECK TOTAL � PAID " DUF. TOTALS----> 210.47 33.00 117,00 360.97 360,47' ,00 R'aVENUE DIVISION TOTALS--> COliL TED: �243,47 OVER/SHORT; ,00 BLDG PMT PLUMBING ELECTRIC MEC ANIC FIRE SMIP/TOT GRADING.PLAN–CHECK 180,00 17.00 22,50 1.50 ,. 2,47 if iE ff iE iF i(' iF if' � k i4 iP if if iF i6 M' iF M'+E M if 7f iC If if IE iF iE if if 1t if IE aE if if iF i! k)f K k'M� iElE� i! if iF if k i("If Iflf iE if �f i'f Y� 1F it if � Y.' 1(' l� iE%It �Y.1� i4 if i%{P?�a6 I N D I V I D U A L FrE E B R E A K D O W N TYFE QTY D E S C R I P T I O.N - UNIT COST TOTAL COST SFC 1398 RES–INT. ALTER TYPE V–N –AVER 11,78 16,468,49 ELE 2 FIXTURES LTGHTING 1 ST 20 � EA. .75 1.50 EiE 2 MOTOR/POWR APPARATUS 0;0 – 1.0 HP 3,00 , 6.00 MEC 1 INST HOOD W/DUCTS FED BY MEC EXHAUST 6.50 6,50 PLU 3 WASH BASIN ' 2 00 6,00 PLU 2 WATER CLOSET (TOILET) o ' 9,00 PLU 1 WATER HEATER AND/OR VENT `.v � '��0 2,00 PLU 1 SINKS, FLOOR ` Z��pA 2.00 / � END OF FEE��R 7 1991 �) D f CI7Y OF COSTA MESA _ � " CONSTRUCTION AND PLANtuiNG OG, . SPA APPROVALS Permit # Date Inspector qppROVAIS Permit # Date Inspector !41 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location • 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement ;� . � 3. ElectricalConduit�Utility-Undrgmd. 54. Forms ' --� --� 4. Electrical Conduit-Undrgrnd, 55. Electrical Bonding --� � 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test �� 6.�ElectricalUFERGrnd. 57. APPPOVALTOCOVER�GUNITE - 7. Fbotings . 58. Electrical Conduit�Undrgrnd. 8. Foundation 59. Gas Pipe, D Undrgrnd., Test � i 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd. � ti 70. Struaural Floor System 61. APPROVAL TO DECK �� V 11. Property Sewer Line & House Connection 62. Backwash & Receptor�Final � - � 12. Sewer Cap 63. Heater & Vent-Final ' � 1-� 13. Roof Drains 64. Plumbing System - Final � /- � 1 74. Rough Plumbing 65. Electrical�Final �,. ,( 15. flou h Elettr�ical-Conduit � t 9 66. Solar System-Final �'� 16. Rough Electric Wiring 67. Fencing & Access AnProval ' 1 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electricai-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT � 20. Rough Factory.Fireplace ' - * APPROVALS Permit # _ . - 21. Dut[s, in St�ucture � 70. Underground Hydro 22. Oucts, Ventilating 71. Product Piping O�Gas ❑ Oil 23. Gas Pipe�Rough & Test ', , 72. Underground Flush 24. Roof Framing ' 73. Undergrnd. Storage Tank O Gas O Oil • 25. Roof Sheathing � � -' 7q, Overhead Hydro 26. T�Bar Ceiling (Structuraq & Monocoat - • 75. Dry Chemical � � � � . 27. Frame and Flashing ' 76. Dry Standpipe . 28. Lathing & Siding . i� � • 77. FIXED SYSTEM FINAL � 29. Insulation� �- � ' '. ' 78. FIRE PREV. FINAL 30. Drywall Nailing � HEALTH DEPT. REQ 31. Plaster Brown Coat , � 79. FINAL INSPECTI , 32. Electrical Power Meter�Final � 0. D CERTIFICATE ISSUED 33. Final Electric , - , 7�2-4,1 F otes: H 34. Final Heating & Air Conditi0ning � q�( �� f! ` � Y 35. Finai Gas Pipe-Test �� /� � �9 , J 36. Hood o� Gnopy � -��{( �.61' :' � 37. Final Factory Firep�ace � 38. Final Plumbing ' . � � ,�`2 Q( � � � '-�� ' ',� 39. Water Service�Final � -r � . • i 40. Gas Service,-Final . . � , ' ' � � � '�: :' 41. Solar pomesticFinal � - � - . • ' ,� . 42. Backflow Preventer • ' �- _ ', . 43. Backflow Irrigation _ ' ' ' � 44. Landscape Irrigation Sysiem � , . � �``'' _ � 45. Sound Attenuation - . Handicap flegulations r � 47. INAL STRUCTURE & BU�LDIN - (� (�t 48. FINAL PLANNING s ` � ��' 49. Electric Release to di on � '- 50. Gas Release to Southern California Gas Cn , , 51. CERTIFICATE OF OCCUPANCY , No. ' Date � PNOJECT AUOflE55: q 4 O E 1 7 TH 5 T OWNEfl'SNFME: FREEMAN FISHER aoo8ess: z36 DRIFTWOOD ;�� CORONA DEL MAR CA 92625 760-0730 AflCN/ENGINEEH: AD�flE$$: HEC.NO.: uNiT: 6 UNIT: PE"M'nEE: FREEMAN FISHER ( 714 ) 760-0730 aooeess: 236 DRIFTWOOD RD CORONA DEL MAR CA 92625 LICENSEU CONiPpCTOP DEClA8l1TI0N: I �ereUy aHirm Itwt I am tic¢nSeE un0er O�wisions of Ctuo�er 9(commencing wit� Setllon 7000� of Oivision 7 0l lhe Business anE Pmles5i0n5 CoOe. anG my licen5¢ is in full lorce an0 efl¢ct. CITY LIC.: STRTE LIL.: LU55: I Dale: Signawre: — IOBRENS' COMPENSR710N �EClANa710N: I neteey atlirm tnal I have a tenificate of consenl to self-insure or a cenificate ol workers' ,omoensatian Insurance. or a certiliee covY ��e�� (SecGon 3800. LaU. CI. � POLICY NO.: EXP. ��TE: LOMPANY: ❑ Cetlitie0 t00Y �5 her¢Gy �u[niSAeJ. ❑ CeNiieE woy is IileG wit� [�e ciry Builtlinp Oidsion. Da1e: AOOlicanC E%EMPf10N FXOM WOPIlEflS' COMPENSATION OEClAfl11TI0N: (ihit 5e[OOn n¢e0 ipt Oe cOmpkt¢G if fAe perint ¢ lor ane �urMteO (5100) or 1¢55�. I rertity Iha� in ��e pedormance of I�e work for wNc� llus perrttii is i55ue0. I shall not ¢m0�%' airy Oe�n in any manner w as to b¢[Om¢ subieci lo t�e Workers' CamOensalion lavrs ot Calitomia. Oate: SignaWre: NOtICE: u, atte� making this Ceclaration. you shoNA hecome suGlect to t�e Workeri Campensatian provisions of t�e La�or Caa¢. yrou mUsl laM1�wit� Compty vni� 5ut� Omvitions ar Ilrs permii StuA Ee tleeme0 teuoke0. CONSTBUCTION LENDING RCENCY: I nere0y ailirm tlw� Inere is a wnstrucfion lenamq aAmcy for the ce�ormanw of tne work lor which Nis nermilis�issue0 �Section 3097. Gv. C). LENOEfl: RDOflE55: OWNEB BUILOEN OECUBRTION: I �ere0y allum that I am eKempi Imm t�e Contractors Sute License Law for ihe lollowinp reason (Sectwn 70.37.5 Business an0 Protessqnal COEe: My cliy al munty w�ich repuires a perrttit lo canstrucL altec improve. OemoliSA. or repair any simcWre. prior to ils issuance, also repuires l�e appliWnl for suc� De�mil to lile a 5ipneE slatemenl tllat he/s0e is IicenseA oursuant ta ine Dro�ons ol tne Contractor5' State Litenu Ldw (Ctupter 91��enting wlm Settion 70W) of Oivision 3 0l �ne Busine55 antl Pmiessions CoEe) or tnai �rlslie a evempl ��eretmm anC t�e Easis tor Ne alle0� exemption. My violation ol Section 7031.5 by 'y a001icant tor a Dermit subjecis t�e applicani lo a civil p¢nalry al not more t�an Irve huMrea Gollars (SSW�. 1—� I, as awner ol t�e D�ope�y or my emPIoyeeS wil� wages as theit Sole compensation, will do tAe wark, antl I�e LJ SIlpLIYfC 6fIpIlOfCOEld Ol O�ICtEE10! SdIE�$Mlqn 70C4, Bu5ii1lSS dfld Pf01l559WICOtl¢: T�¢ fAnf�2tI0R' SIdIC Lit¢II50 Liw aoes noi apD�Y to an ovmer ol a D�oOetty wtn EuilOs w improves tbereon, and wlp Coes suc� wark himselllnerull or InroupA �i5 Or �er awn ¢mploYe¢5. pmviQeO IOaI Sut� imD��emenl5 2r2 nol inlCn4e0 of o�lere0 lof sale. II, �owev¢r IhB Ouilding Or improvemenl is 5010 witNn one year oi tompletun, ihe owner will luve t�e EurGen ol 0«�B ��e Oi0 not Ga10 or improve lor ine Ourpose ol 5ale�. I, as owner ol tlre O�o7eny, am e.clusively contracW q mt� Iicense0 coninctors lo consimG tM• mleci (SectWn 70aE, Busineu ❑ ana Prolessions CoGe: The Contractors' Slate Liceree Law Eces noi aDPN �o n owner ol properl wM OUAEs or improves tAereon ana wha mn(ratls br Sut� prqettt wiltl a CdIItaGOt�S) IkP,nSe W�Sudni t Ihe COnUat�ars' aie Li[ense Law). I am awaR I�al D�oOt ot l�ei� WOrkei 5 COmpensation in5urance S�ou10 Oe proviEeG Io 8. � � am e�emp� un0e� Sepion: B P% O 4 q 8. d P. C. mr nis reasoo: COqN/TRACTORS HAV C M Oate: �� / r Owner. ' t I do �ereby�thai I am aware ol aM unUerstan0 t�e �epuirtments ol Calilomu Healt� anE Sal¢ry COEe Sections 25505, 25533, an0 2557a ana ihat I or any IUWre OuilUing aCupant vnlVwill nol �ci¢le one) nee0lo tamply wi(� Sdid siate fA0e5 antl I�e teQuiremenis br a p¢rmii lOr conSVu[lion or rtqUilicali0n Irom I�e Ait Ouahry Manapemenl U51riCi. HeSiQeniial tqn5lmciion aODliq�ion5 ar¢ exempl imm inese o�adsions. Daie: AppliCant: I �er¢by c¢mly ��ai I have reaa f0i5 a00hca�ion antl 51a�e t�e Ove in7afmaiio � car .tl. I aptee �a Wmpty vnih all Ciry anC Counry' ar6ndntes anJ slate WwSrPJatinq�o buiMinq Construtl' M t y aui riz¢r¢ 5¢nu � s o h' ' I�Y�;erupOnlhe a00v¢�men�ion¢0 O�opetly lorins ec�ion purpOses. Date: �� Sig�ture:� oriver�s ucense or Saia� Secuniy a: i6<t-a6 WM1ne—Bmldmg: Green—Cotle Enbr[¢menc Canary—AOO��cam: Pink—Rmenue: Goldenro0—Asseswr CITY OF COSTA MESA,— BUILDING PERMIT PERM NO: IE 050999 PERMIT NO: IE 050994 PLAN CHECR NO: N GOVT: N SUPP: Y CONSTRUCTION TYPE: . PERMIT TYPE: EI,E OTH PURPOSE: OTH JOB DESCRIPTION : CLOSE FILE ON EXPIRED PERMIT SQ FT: CLAIM VALUE; CALC—VALUE: GROUP OCC: B-2 / *�****�+St******�*�***�*��**�*�*****x��*****#rt�x�*��r+t*x**x*�e**x*x�*****�rx****+t**** Z O N I N GS ERTEH�AUCIKRSE M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR; FT . IN FRNT: FT , IN REAR: FT IN LEFT: FT FN RGHT; FT ' IN LEFT: FT ZN RGHT; FT IN PARKING REO• PROV; PARCEL: 11732126 ZNE; REF NO; PLANNING NZSTES> • ' 1E iF if iE iE if 1E 1f iF if if !k 1F iE if iE iE iE iF iE iE if !E 1f !t iE if ik iF 1ElE 1E if iflf 1Elf i! iF ff !f !F iF k ff iE iE iE k 1! kiE iF iElFiE if �E iE iE iE 1E if 1F if if iElE iElf iF if !E!E iE iflf iE jF D E V E L O P M E N T S E R V I. C E S R E Q U I R E M E N T S ZONING APPROVED BY • DATE: ' BOILDING APPROVED BY : APPLICATION ISSUED BY• *��*�r�r*****+r*�r**�r�*�r�r* if ik if it it 1t it fE k ik iE fE 1E it if k iE if iF ff if it iE iflF iF iE M tE iF if if if 1f iE 1F iE if LEGALZZATION;N F E E � HLDG PMT PLU BT' ELE TRIC PERMIT 0.00 50i PLAN � ISSUE FEfi BUILDING—DIV—> PERMIT "POTALS----> 30.00 REVENUE DIVISION TOTALS--> BLDG PMT PLUMHING EL DATE; DATE: bZI3� I . ifififiEiEiFiEiEkik�iF£ifif E iF il� 1f 1E 1! 9E 1ElI�iF ik iE If )f �!E it iE !f if !Elk±l� if if 1E iE i(� K iE 1f !F ff !f !ElE�%� if iE i! iE U M M A R Y STRUCTURAL SEGMENT;N MECHANIC FIRE SMIP/RES GRADING ' SMIP/NON—RES iJE PLAN—CHECK TOTAL PAID DUE 00 0.00 30.00 30.00 .00 �COLLECTED: 30.00 OVER/SHORT: 00 IC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK itlF 1E i!!f if iE 1E 1f %iF iF i! 1E iF iE i! iklE iE it if ik iF fFlE ff !E 1Elf 4 iblE!!!E iklElE it 1k ik 1! 7! iF 1t f4 i! if if iE 1E fb if fk ik iE 1E 1f it if jf k!F 141E if iElP fE 1tlElElf 1t 1E iE iE 1f ?f I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 1 ELECTRICAL RE—INSPECTION FEE 30.00 30.00 END OF FEES UI GG�Er_1�—;;"DE051£ 'Vt'y�- °;,�;,; DATE: �2l13/92 TI,ie: 12:11 % , t ` CORSTRUCTION AND PLANN�rvd OOL & SPA ARPROVALS Permit�# Date Inspector APPROVALS Permit# Date Inspector 1. ; emporory Etectrical Service or Pote 52. Pool & Equipment Location _ 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement � 3. Electrical Conduit UtilitY�Undrgrnd. 54. Forms 4. Electrical Conduit�Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test ' -6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE 7. Footings 58. Electrical Conduit�Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test � 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, � Undrgrnd. 10. Structural Floor SYstem 61. APPROVALTO DECK 17. Property Sewer Line & House Connection 62. Backwash & Receptor�Final 12. Sewer Cap 63. Heater & Vent-Final 13. Aoof 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 FOfl PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT � 20. fiough Factory Fireplace ' � • APPROVALS, Permit # 21. Ducts, in Structure .� „ , 70. Underground Hydro • 22. Ducts, Ventilating • 71. Product Piping OGas OOiI 23. Gas Pipe�Rough & Test ' . -�� 72, Underground Flush . 24. Roof. F�aming �• � : � 73. Undergrnd. Storage Tank � Gas � Oil - 25. Roof 5heathing �' � 74. Overhead Hydro � � 26. T�Bar Ceiling (Structural) & Monocoat . . 75. Dry Chemical 27. Frame and Flashing . , 76. Dry Standpipe , 28. Lathing&Siding � • •• �� •• � 77: FIXEDSYSTEM'FINAL� 29. Insulat�on �� -_ � � � 78:? RE PREV. FINAL . 30. Drywall Naiting � � �� 1� ~'�HEALTH DEPT: REQUIREMENT -� a ' 31. Plaster Brown Coat ' � � i ;i, , 9! NAL INSPECI'10 , � Electriwl Power MeterFinal � �� 8� FO �ERTIFICATE ISSUED 33. inal Electric . �,,,l;�/1q� �f;� ' �Notes: �' , , . Final Heating & Air Conditioning � � � � � - . . I i Il tt 35. Final•Gas Pipe-Test � ;�''1 �' '' ' ,_� ; '. 36. Hood or CanoPY � � � j-�"� � 37. Final Factory Fireplace � � �.�� 38. Final Plumbing � , � I � � i 39. Water 5ervice-final � � � � � 40. Gas Service-Final � � I� i � 41. Solar pomesticFinal ' � I 1. 42. Backflpw Preventer � �. , . 43. BackflOW Irrigation , 44. Landscape Irripation System . . 45. Sound Attenuation 46. Handicap Reguiations � 47. FINALSTRUCTURE&BUILDING � I„ . . , 48. FINALPLANNING � � ;i 49. Electric Release to Edison -- � , I 50. Gat Release to Southem California GatCo j � � 51. CERTIFICATE OF OCCUPANCY . No. Date PFOJECT /lUOflESS: 4 q O E 1'�'I'H Jr'i` OWNEX'SNAME: FREEMAN FISAER _ aoneess: z36 DRIFTWOOD CORONA DEL MAR CA 92625 760-0730 AXCHIENGINEEfl: ADDPESS: NEG.NO.: uNiT: 6 uxiT: PEHMITTEE: FREEMAN PISHER ( 714 ) 760-0730 aooeess: Z36 DRIFTWOOD RD CORONA DEL MAR CA 92625 LICENSEO CONTflACTON OECIAflATION: I hereby aflirm that I am Iicense0 untler pmvisions of ChaD�er 9(commencing wit� Seclion 7000� ol �ivision 3 oi Ihe eusiness ana Pmlessions CoOe, antl my license is in lull brce and e��ect. CITV LIC.: STATE LIC.: CLASS: �aie: ' � Signalure: NOflREBS' WMPENSRTION DECIABATION: I �ereby affirm Iha� I have a certi�icate ot consen� b sel4insure or a cehificate of Workers' :,ompensalion Insurance. or a cenilie0 copy thereo� (Section 3800, Lab. C). i POLICY NO.: E%P. OpTE: � "OMPpNY: Cetli�ietl capy is here0y �umiSheA. ❑ Cerli�ietl copy is filetl wilh the ciry Building Division. Date'. PpplicanC E%EMPTION FflOM WOXREflS' COM7ENSpT10N �ECLAflATION: .(This section need na� be camDleletl if Ihe permit is lar one hunUreU (5100) or less�. I cenify ihai in Ihe perbrmance oi I�e woB �or which ihis permit is issueq I shall no� employ any person in any manner so as b become 5u�leci �a Ihe Workers' ComOensation Laws of Califomia. ' Oaie: - Signamre: - ' NOTICE: II. atler making �his tleclara�ion, you shoultl become sublect �o �he Workers' Campensa�ion pwvisions of Ihe Lahor CoOe, you musi forihwith compty with such provisions or �his Dermi� shall �e tleemed revoked. CONSTPUCTION LENOMG AGENCY: I here�y aifirm Ihat there is a constmc�ion lending agency for the pedormance o� Ihe work �or which Ihis permi�'is issue0 �Setlion 3097. Civ. C�. ' LENOEN: IIDOXESS: ' ' OWNEH BUILDEB UECIAPATION: I here0y afiirm t�at.l am exempt imm ihe Contracmrs' State License Law for ihe followinA �eason (Section 703L5 Business antl Pmlessional Code: Any ciry of cowry which requires a permit �o constmci, alier, impmve, tlemolish, or �epalr any slmciure. piior to its issuance,.also requires �he aDPlican� lor such permit �o file a signetl statemeni t�a� he/she is Iicense0 pursuam lo �he pmvisions ol ihe Comra[mrs' Slaie License Law �Chap�er 9(commencing with Seclion 7000) ol Division 3 ai ��e Busine55 antl Pmfessions Cotle) or Inal helshe is eximpt therefmm anU ihe basis for the allegea exemplion. Fny violation ol Section 7037.5 by �y applican� for a Oarmil 5u01ec�5 Ihe appiican� Io a civil penai�y o� no� more �han five hundretl tlollars (55110�. I, as owner of �he O�oDeny or rtry employees with wages as theirsole compensation, will do the wark, antl �he �❑ stmcwre is nol intenGeJ or ofleretl for sa@ (Secuon 7044. Business and Professional Cotle: -T�e Coniracmrs' State License Law does not aDPty to an owner ol a pmDenY who builds or improves thereon, and who does sucA work himself/herseli or IhmugA his or ner own em0loyees, pmviDed that such impmvemenis are not intentled or oflered tor sale. II, nowever ine Euilding or impwvemen� is SoIU wilhin one year ol completion, �he owner will have ihe �urtlen o� pmving helshe ditl no� build or impmve ' lor Ihe purpose ol salel. I, as owner o� the pmperty, am,exclusivel9 coniraming with licensetl comracmrs �o constmc� �he pmlect (Sec�ion 7044. Business ❑ and Pmiessions Cotle: The Con�mctors' Siale License Law does no� apply m an owner oi pmpeny who bwlds or improves ��ereon antl wha con�racls br such pmlects witti a contrac�or(5)license pursuan� I �he Cont�actors' tale License Law�.l am awa�e ��at pmoi ol Iheir Worker's Compensation insurance should be pmvitletl t me. � I am exempi unaer Section'. H�j'� � 4 4 B. 8 P. C. , mi mis �e an: CON'PRACTORS HAVE C MP Daie: ��5�_�( Owner. I tla hereby cer�ify ihat I am aware ol antl untlerSlanU �he requiremems of Calitomia Heal�h and Sa�ery Code Sec�ions 25505, 25533, antl 25534 and ihal I or any lulure builtling occupanl will/will nai (circle one) neea �o comply with said 5[a[e cotles antl Ihe requiremenis lor a permi� lor cons�mclion or modihca�ian �mm Ihe Nir Quality Management DiSVict. Resitlen�ial constmc�ion apDlications are eaempt imm Ih¢5¢ pf0VI5i0f15. � � Dale: Applicant. ' I nereby cetlify Iha� I have read t�is aD�lication antl statethatihe a veinformationi rr t I agree to comply with all cily an0 county ordinance5antls�atelawsrelaiinglobuiltlingconsimclion erbY uthor¢erepr ntaCes Hhi5ly�oenieruponlheabove�mentioned pmperry for ia. eclion ourposes. �'- �aie- — � Signalure: Oriver's License or Social Securily a: ' t601�46 Whpe—Builtling: Green—COtle EnforcemenL Canary-Apolicanl: Pink—Revenue: GOICenrotl—Assessor CITY OF COSTA MESA - BUIL'DING PERMIT PERM NO: IM 05099 PER'MIT NO: IM_ 050996 PI,AN�CHECK NO: , N GOVT: N SUPP; Y CONSTRUCTION TYPE: PERMZT TYPE; MEC OTH ^---� PURPOSE: OTH JOB DESCRIPTION : CLOSE FILE ON EXPIRED PERMIT �� SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: B-2 / ,- COMMENTS; LEGALIZATION, CLOSE FILE M20137 � ***+�**�r��*** ��*��c�**�***x�****��+��*�x+�*+��***�******x****+�*•�*��*�rx�•**+�**�**�c�*�* Z O N I N G R E Q U I R E M E N T S S E T B A C K S ----------- MAIN HUILDING ---------- ------'-- ACCESSORY BUILDING'--------- F'RNT:. FT IN REAR; , FT IN FRNT: FT , IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEr^T: FT IN RGHT; F'T IN PAkKING REq • PROV; PARCEL: 11732126 ZNE; � REF'NO: PLANNZNG N(STES> • • �, . � . .. _ __ _. . . ... . 1F if iF iF �ElF iF1E iF �E iFiF iE iE 3E 3F �F �E iF i4 if iE 3F �F IF iF iE �F lE 1E iE iF iE iE if iF iE�if iElf iE 1E �F iF iF it !6 iFiF 3f�iF 1E dE �F iF if # �f IF �1F�1F aF iE If 3F iF iE If if if d(� iP iE iE iE iF iF iE �E � D E V E L O P M E N T 5 E RyV I C E S R E Q,U I R E M.E N'f S i � i. i ZONING APPROVED HY ' DATE: BUILDING APPROVED BY : 'DATE: APPLICATION ISSUED BY• DATE: 62� iFiEiElElEifiEiEiEi6iPiEiE-1EiEiFiE3EiE1E1flF�iti . iFiFiF�iFiF�iFiFlElEifiFlFiflEfEiE3f ifiE iEit�ffifiFitiEiEiF3F�EiEiEif3flF�FiFifiElfiFlEitiklklflF�)FiFififlFiE3flFiEiE �1fiE1EjF3E3EiE3fifiElF9EiEiEiEifiFlEifiFiEiFiEifiPiliPiFitiEiElEiEiFikjfiE�EiE LEGALIZATZON:N F E E ' U.M M A A Y STRUCTURAL SEGMENT;N ' BLDG PMT PLUMBING ELEC'.RIC MECHANIC FIRE SMIP/RES GRADING PERMIT ' 30.00 � 258 ', SMIP/NON—RES PLAN ISSUF.. FEE ' BUILDING—DIV—>, PERMIT ISS'• PLAN—CAECK TOTAL PAID DqE TOTALS----> 30.00 .00 0,00 30:00' 30.00 .00 REVENUE DIVISION TOTALS--> COLLECTED; 30,00 OVER/SHORT; 00 BLDG PMT PLUMHING ELEI"RIC MECHANIC FZRE SMIP/TOT GRADING PLAN—CHECK 30.00 1E �F�E iE iE 3E �E �E 3F 3E �E �ElE iF iP iF iF !E �1E iE iE 1E iE i(� if 1E it if iE �tlF if �f it i(� iE 1E �!E hE iE �IE !k �E iE iElF iblf iF lE �E �1E it 1E!( iElE iElE 1E ik if iFlF it iE iE 3f iE if �F 3f IF iE if IE if df if I N D I V I D U A L F E E �H R� A K'D O W N T'YPE QTY D E S C R I P T I O N UNIT CUST TOTAL COST MEC 1 MECHANICAL RE—INSPECTION'E'EE 30.00 30,00 END OF• FEES 0 az oaesa�?�-eeo�os?� Te]i' ao.ua DATE: 02/13/�S TIfiE: 1?�i4 C�NSTRUCTION AND.PLANNING � � � /O� . SPA APPROVALS Permit # Date Inspector pppROVALS Permit # Date Inspector 1.+Temporary Electrical Service or Pole _ . 52. Pool & Equipment Location . 2. Soil Pipe�Undrgrnd. � 53. Steel Reinforcement 3. Electrical Conduit Utility-Und�grnd. 54. Forms . 4. Electrical Conduit-Undrgrnd. � 55. Electrical Bonding � 5. Steel Reinforcement ' 56. Rough Plumbing & Pressure Test . 6. Electrical UFEfl Gmd. 57. APPROVAL'TO COVER�GUNITE 7. Footings � � 58. Electrica� Conduit-Undrgrnd. ' 8. Foundation �� 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undr9rnd. 60. Backwash Lines, P-Trap, � Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection . . 62. Backwash & Receptor-Final � � 12. Sewer Cap � 63. Heater & Vent-Final � � � 13. Roof Drains • 64. Plumbing SYstem - Final ' I 14. Rough Plumbing, 65. Electrical-Final � � I 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 BarCeiling 69. POOL/SPA SYSTEMS FINAL 19. Rou9h�Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace • ' � � ' APPROVALS� " Permit# 2L �Ducts, in Structure . �..�.. � + . 70. Underground� Hydro 22. Ducts, Ventilating t � , • � � : 77, Product Piping OGas OOiI 23. Gas,Pipe-Rough & Test . ' , � - �; � ,jy, Underground Flush. . 24. Roof Framing- � � • �• . ` -73. Undergrnd'Storage.Tank OGas ❑Oil - � 25. Roof Sheathing ' � . � 74, Overhead Hydro . 26. T-Bar Ceiling (Structural) & Monocoat � . . 75. Dry Chemical - � - 27: Frame and Flashing ; � 76. Dry Standpipe �� 28. Lzthing.& Siding � � ' . - • •� •• � 77, ��FIXED SYSTEM F.INAL' 29. Insulation , �� ' 78.,FIR rPRE,�. FINAL - 30. Drywall Nailing �� ' � � �� : HE�'TH DEPT. REQUIREMENT - 31. Plaster Brown Coat„ . � , I �; �y �. 79. FI'NAL INS ECTIOP , 32. Electrical'•Power Meter-Final �� ` , � � ,t i'�� . 80. .FOOD C �RTIFICATE ISSUED r;, ; 3 Final Electric' "j ' � ; � I �I �r� ;I � ' Notes: ' ' � . 4. inal Heating�& Air�Conditioning , � �� c)a I !� ; . /j�, � . � . � �. + r� � � i i ;,�. - . . . . Final'Gas Pipe-7est' ' " � ' � ;�' , % � ' �. , ' . 36. Hood or Canopy .• �� I�,,'� .. � 37. FinaVFactory Fireplace, � � ; I �� ' � , 38. Final Plumbing � � � . � , i,l � . . • , 39. Water Service�Final ' � � ',! , � ' � - i i ' 40. Gas Service-Final � . . I � . -41. Solar pomestio-Final •• • � ( l� �� ' � i. 42. Backflow Preventer; - ' �' I � �� ' .. 43. Backflow Irrigation - � ' ' ' ; 44. Landscape Irrigation Sysiem , , 45. Sound Attenuation • � 46. Handicap Regulations � . � � � � 47, FINAL STRUCYURE & BUILDING � �".i � � � r, � 48. FINALPLANNING I I ��•' . 49. Elearic Release to Edison � � � � i � �I; 50. Gas Release to 5outhern California Gas Co � �� . •. . �- . � '� � 51. CERTIFICATE OF OCCUPANCY i , ; . No. Date PNOJECT AOOflESS: q 4 O E 1 7 TH ST OWNEfl'S NAME: -j,+xEEMAN FISHER � nooxess: z36 DRIPTWOOD CORONA DEL MAR CA 9267.5 NflLM/ENGINEEB: 7 6 0' Q 7 3 � p00NESS: ' HEG.NO.: uNir: 6 UNIT: 'EqmmEE:'FREEMAN FISHER • (714)760-0730 aoosEss: z 36 DRIFTWOOD RD CORONA DEL MAR CA 92625 LICENSE� CONTNACTOB OECLANATION: I hereby altvm ��at I am licensetl untler pmvisions ol Chapler 9(commencing w11� Sec�ion 7000� o� �iv�sion 3 o��he Business antl Pmtessions Code. and my license is in fullforce and efiect. CITY LIC.: STRTE LIC.: CLASS: Date: Signaiure: �OPNEHS' COMPENSpTION OECLAFFTION: I hereby affirm that I have a certificate ol consent m seli-insure or a certificate oI Workers' Compensaiion Insurance. or a cenified copy Uereof (Seclion 3800. Lab. C). POLICY NO.: E%P. ORTE: COMPpNY: ' • ❑ Cenified copY is here6y fumished. ❑ Ce�ified copy is liled with ��e ciry Building �ivision. �ate: Applicanl.- E%EMVTION fflOM WOPKEBS' COMPENSPTION OECLANRTION: Qhis seqion nee0 not �e campleted i�ihe permi� is for one hun4reA ($100) or less�. I cetlity Iha� in I�e petlormance ot Ihe work br which �his permit is issuetl, I shall not employ any pe�son in any manner so a5 io hecome su�le�� 0 Ihe Workers' ComDensatmn laws ot Califomia. oale', Signa�ure: � NOTICE: II, atter making ��is tleclaraiion, you 5hoW4 become Subleci �o Ihe Workers' Compensa�ion pmvisions of Ihe Labor Cotle. you musl �ort�wilA compty with suc� pmvisions or Ihis permi� shall be deemetl revokeU. CONSTflUCTION LENUING AGENLY: 1 Oere6y allirm that Ihere is a cansimclion lentling agency lor 1he pedormance ol �he work for which Ihis Dermitis issued (Sec�ion 3097. Qv. C�. LENDEH: ROUPESS: OWNEN BOILOEfl DECLAFATION: I herebV aftirm Ihal I am exempt iwm Ihe ConVactoK S�ate License Law lor the following reason (Se[Iian 7031.5 Business antl Pmiessional CoOe: Any ciry o� couniy whic� �equires a Oermit �o conSlmcL alte�, improve, tlemolish, or repair any stmciure. prior Io ns issuance. also requires �he aDPlicant br such permi� lo lile a signeA statemem Ihai helshe is licensea . pursuant to ��e pmvisions ol the Contractors' Sta�e License Law (Chapler 9(commencinp with Section 7000) oi Division 3 0� the Business I x m ti n Fn violalion of Seciion 7031.5 b i m h r hom and Ihe �asis �or the a le ed e e o. P i i n CaOe or Ihai Ae/she s eze � I e e antl messos 9 P Y. Y ) � �y apDlicant for a permii suhlecis �he aDPlicanl Io a civil penalry o� noLmore �han five huntlre0 tlollars-�$500). ' 1, as Owner o� Ihe Omperiy or my employees wilh wages as lheir Sole tompen5aiion, wiil 4o the work. antl the s�mcW�e is nat in�entletl or oflered for sale (S¢ction 704A, Busne55 antl Pm�e55ional Code: The ConVatiors' Sia�e LiCense Law tloes noi apply lo an owner ot a pmpetly who builtls or impmves thereon, and wAo tloes such work �imself/hersel� or �hmugh �is or Aer own employees, pwvided that such improvements are not inten0e0 or offeretl for sale. Ii, however ihe huilding or impmvemenl is so10 within one year ot complelion, t�e owner vnll have Ihe bur0en o( proving �e/she tlie not builtl or impmue forihe purpose of sale). I, as owner ot the property. am exclusively conVaiting wilh licensetl conlractors to conslmci ihe D�olec� (Sec�ion 7044, Business ❑ and Pmfessions Cotle�. The Camracrors' State License Law tloes not apply ta an owner of pmperty who butlds or impmves therean antl who comraas lor such pmiec�s with a contraqoqs� license pursuan ihe Contract s' State License Law�. I am aware thai pmol o� their Worker'S Compensa�ian insurance 5�ou10 be pmvided t me. � I am exempt untler Section: B P 7 0 4 4 B. 8 P. C. m� mis �easo�: CONTRACTORS HAVE ON r' Da�e�. —/ ��— � � Ownec . � I tlo hereb�y �hai I am aware ol antl underslan0 the requirements n� Calitomia Heal�� antl Safe�y Code S¢clions 25505, 25533, antl 25534 antl ��al I or any fuiure DuilOing occupan� will/will noi (circle one) neea �o comply vn�h said state codes ana IAe requirements lor a permit for conslmclmn ar mo0ilicalion imm �he Air Oualiry Managemeni �isVici. Fesitlen�ial consimc�ion applications are eMemp� irom Ihcse pmvisions. , Dale: Applicanl: I hereDy wtlity lha� I have reatl Ihis applicaiion anU sla�e 1h e ab e inlarmatio �s corre L I agree �o comply with all city antl county ortlinancesantlsialelawsrelalinglobutltlmgcans�mclian tlherby N�orizerepre5en Iiv o -(4¢n�eru04nthea6ove�menlione4' propert tor in peciian purposes. L �ate: Sgnalure: Driver's License or Social Securiry a: 16<LGfi Whi�e—Building', Green—COtle En�orcemenL Canary—Applitdn�; Pink—Revenue: GOldenro0—Assessor CITY OF COSTA MESA — BUILDING P6RMIT PERM NO: IM 05099 PERMIT NO: IM 050995 PLAN CHECK NO; N GOVT: N SUPP; Y CONSTRUC.TION TYPE: PERMIT TYPE; MEC UTH PURPOSE: OTH JOB DESCRIPTION : CLOSE FILE ON EXPIRED PERMIT SQ FT: � CLAIM VALUE: CALC—VALUE: GROUP OCC: B-2 / *�****�**.*** ��*��***�*�*�*�***�******�**�*�ec**+��****��x�*�+�*x+r*x*�rx*+�*�rx x��c**�r+� •Z O N I N G R E Q U'I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCE550AY, BUILDING --------- FRNT: FT IN REAk: FT . IN FRN'f; FT IN!REAR: FT IN LEFT: FT IN RGHT: , FT TN LEFT; FT IN RGHT; FT IN PARKING REQ• PROV; PARCEL: 11732126 ZNE: REF NO: PLANNING Nf5TE5> � ' iE % iF iF �3E if if iE iE iElFlE iFlE 3E jE k iE if iF iE iF iE if iE if iE if iE if iE iE iE if 1ElE��1E iE 1f iE jE !E if iE iE 3E iE 7E 1F iE jF 3E ik iE iE iE iE iE iE iE iE iF lE If iE if !F iF iE �f iE 3F-)f 3f 1E �� iF iE iE D E V E L O P M E N T S E R`;. V I bC E S R E Q U I R, E M E N T S� ZONING APPROVED HY " 'v DATE: BUILDING APPROVED BY APPLICATION ISSUED BY•�,�F�� !E if aE ik it iF iE 1E if if iE iE �k if iE if iE if iE iE iF iE iE iE-1f iE iE iE if iF if ib if ik ik iF iE iE ik if iE !f �f iE if 1f iP if �f if if iE iE if iE iF LEGALIZATION:N. F E E BLDG PMT PLUMHING E� PERMIT 7 DATE; DATE: » � x x * *� *�t x ��i��f�* * � ifiFlf�EiflFlFlE3f)EifiFlFjEifiEififfEiPiE�EifiEifiE#ikK-3FiE3E�EiF3fjE M M A R Y STRUCTt7RAL SEGMENT;N �MEC30AN�I�C FIRE SMIP/RES GRADING 25t SMIP/NON—RES � PLAN _ ISSUE FEE — V—> P BUILDING DI ERMIT ISSUE PLA� CHECK TOTAL PAID �DUE TOTALS----> 30,00 0.00 0.00 30 00 30 00 . . 00 � , . REVENUE DIVISION TUTALS--> COLLECTED: 30,00 OVER/§HORT; 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIAE SMIP/TOT GAADING PLAN—CHECK 30.00 -1f if iE iE iE 1E iE iE iE iE �F iE iE iF iF iE i( iE iE iE 1E iE iE iE iF iE if fklt iE iE �f iE iE iF iE k iE iE iF i(-iE IE if iE ib af if i! iE !F if iE iE ik iF �E if lt 1E iE iE if ik it iF it if iF iE 3E iE it iE 1E rt iE i! iE I N D I V I'D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N � UNIT COST TOTAL COST MEC 1. MECHANICAL RE—INSPECTION FEE END OF FEES 30.00 30.00 o: 000los�a-000sas�zo �r��-r• ;�,,n�. Dp7E= U2lI3�o3 TIYiE: I�:1�. � 0 CONSTRUCTION AND'PLANNING wV` �A APPROVALS Permit #- Date Inspector p�ppROVALS Permit # Date Inspector 1. Temporary Electriwl Service or Pole 52. Pool & Equipment Location � , 2. Soil Pipe-Undrgrnd. � 53. Steel Reinforcement ' � 3. Electrical Conduit Utility-Undrgrnd. 54. Forms � � 4. Electrical Conduit-Undrgrnd. . . 55. Electrical Bonding . � 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test . �6. ElectritalUFER�Grnd. 57. APPROVALTOCOVER�GUNITE . 7. Footin9s � �. 58. Electrical Conduit-Undrgrnd. S. Foundation �� 59. Gas Pipe, O Undrgrnd., Test � 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, � Undrgrnd. 10. Structural Floor System 67. 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 ' 77. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling � 69. POOL/SP,A SYSTEMS FINAL 79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT i 20. Rough Factory Fireplace � �• APPROVALS Permit # � 21. ,DuCts, in Structure, � � �..� . ; ., - � � � 70. Underground Hydro � � 22. Ducts,Ventilating � � • • - �' '" 77, ProductPipingOGas ❑Oil 23. Gas PiperRough &�Test � � , . ,- � _ , 72. Underground�Flush � 24. Roof Framing• � �• � �• � � ' 73. Undergrnd.StorageTank �Gas OOiI' 25. Roof Sheathing '� 7q, pverhead Hydro _ 26. �T-Bar Ceiling (Structural) & Monocoat ' 75. Dry Chemical ! ' 27. Frame and Flashing'. � , �� 76. Dry Standpipe ' �28. Lathing & Siding y � . � • • ••� •• � ' 77. �FIXED SYSTEM�FINAL` � - 29. Insulation �� . , I � I. „ 78. FIRE PREV. FINAL � 30. Drywall Nailing ��' � �� I � �(�+ � HEALTH DEPT.�REQUIREMENT 31. Plaster Brown Coat �. ' . I �•� �;, ; 79. FINAL INSPECTION � 32. Electrical �Power Meter�Final � � ��;h ,� � 80� FOOD CERTIFICATE ISSUED - 33 inal Electric' " ' I rj' � Ik '' NO?es.. �, , ��. 34 inal Heating �& Air Conditioning , J�( ci� I �� Il � f ;- �'� `� .. . �� , /r � 35. Final Gas Pipe=Test;' �� .� � � � ��'� � a` � ' f , .', ' , ' , 36. Nood or Canopy .�� i I �r-! �� " 37.'Final Factory Fireplace' • '" � i ii�� - ' ' ,� .38. FinalPlumbing �� I � � � I� .� 39. Water Service�Final i. I � � �-� 40. Gas Service-Final , , . � � � i ! I� . , 4 41. Solar OomestioFinal � � � � �� I � ' '42. Backflow Preventer i ! I, , 43. 8ackflow Irrigation � � � : �44. Landscape Irriqation System � � • .� � _ , • . 45. Sound Attenuation ^ � , � 46.'Handicap Regulations � � � 47. FINAL STRUCTURE & BUILDING � I G�i � " . � !nl 46. FINALPLANNING I I � 49. Electric Release to Edison • � I/,.; � 50. Gas.Release to Southem California,Gas Co . �'�' i I• 51. CERTIPICATE OF OCCUPANCY � i, . No. Date ADG�icant to fill In all � -'41T.Y�OF COSTA MESA ceR,,G�+ IT NO. CONSTRUCTION PERMIT /" �I Addrea �./C1/) G, / %�'7') ` ` � ' License No. Address Contrector I hereby aftirm that I am Ilcensetl untler provision! mencing wlth section ]000) -o/ Divlslon 3 0(� Ro(esslons Cotle;/� ntl Iicense is in full License Ciass ' C'�0„� L' Date�'�'�� Si9nature� ��^� within heavy borOer lines a WORKERS' COMPENSATION [j�iCLARATION — 1 hereby af/irm [hat I have a certlflcate of consent to self-ins re or a �certiflcate ot Woikers' Compensatlon Insur n, or `certifl tl copy tnereof (Sec o_ 3 0 ). � Policy No. • � �Company ❑ CertlTietl opy is.hereby Turnishetl. ^ ' � ❑ Certifietl topy is Tiletl with the tity Builtling Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This settion neetl not be completeA�if [he permlt is for one huntlretl (g100) or less). I certify that in the performance oi Iha work for which this permit is issuetl, I zhall not employ any person in any manner so as to become sub�ect to the Workers' Compensatlon Laws of CallTornia. � Date 519nature ' NOTICE: If atter making Ihis tleclaration, you shoultl become subject to the Workers' Compensation provlsions of the Labor Cotle, you must forthwith comply with such provlslons or this permit shall be tleemetl revoketl. - ' - � � - — � � CONSTRUCTION LENDING AGENCV I hereby afflrm that there is a construction lentlin9 agency tor [he per- formance oi Ihe work tor.which Ihis permit.is issuetl.(Sectlon 3097 Civ. CJ. -LenOer's Name Lentler's AtlGress or coumy wnicn reawres a :mOlish Or r¢Pair any st�uctu�i (Chapter 9(commencing with Sec[ion ]000) of Division 3.ot the Bu5ine55 antl Professions CodeJ or that he Is exempt th¢re(roT and th¢ basis for the allegetl.exemption. Any violation of Sectlon 7031.5 by any appll�nt for a permit subjects the applicant to a civil penalty ot not morE than five huntlretl tlollars (E500). ❑ I, a5 own¢r of Ihe property, or my employees witM1 wages as thelr sole compensation, will tlo the work; antl the structure�is not intentletl o� otfetetl fo� Sale. (Section ]044, Business antl H'ofessions Cotle: The Cont�acto�'S Lice�Se'Law tlo¢s nOl apply to an owne� of a prope�ty who builtls or improves thereon, antl who tloes such work himself or throu9h'his own employees, provitletl that such improvements are not intentletl or ofteretl for sale. If, howeve�, [he bulltling or Improvement is soltl within one year ot complG[ion, the owne� will have tM1e burtlen of Oroving he tlitl not builtl or improve for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensetl contractors to mnstruct the O�oject (Seciion J044, Business antl Professions Cotle: The ContraCtor's LicenSe law tloes not apply t0 an owner ot property who builtls or improves [hereon, antl who con- t�atts trom SucM1 projecti with a mnt�actoi(s) Ilcesned pursuant to the.Contracto;'s Li<ense Law). , . ❑ I am exem0� untler Section 8. & P. C. tor this ieason Date - Owner I hereby certiry that I have reatl this appliwtion antl Stat¢ [hat the above into�mation is mr�ect. I agree to comply with all Ci[y antl county ortlinanC¢s antl state IawS r¢lating to construcHon, antl heYeby BUthOrize re0�esentative5 of this city t0 ¢nter pon Ihe abOve mention¢tl propnrty fOr 5 ecti� pur�s. � � �`,�; �� Signature Drivers`License or CfyF 0865-46 V all appropriate Eeclarations. LOT NO.� �BLOG.NO. � TVPE OF CONSTRUCTION ❑,�, /ryyry ❑ ADD ❑ ALTERATION ,CJ REPAIR.�❑ CONVERSION ❑DEMOLISH ❑ OTHER ' ' DESCRIPTION OF WORK TVPE OF PERMIT. � � ❑ GRADING ❑ FOVNDAT,I�O,�N ❑ STRVCTVRAL ❑ TENANT ❑ ELECTRICAL I�PLUMBING ❑MECRAN ❑ OTHER ' PROJECT DESCRIPTION - � SQ. FT. . ' ' ' OCCUPANCV_CONSTRUCTION TVPE VALUATION' ZONE GRADING CU. YDS. - ACRES PLUMBING PLAN CHECK BATHTUBS SHOWERS TOILETS. . ' URINALS LAVATORIES DOUBLELAVS KIT.SINKS DISHWASHERS SERVICESINKS -�� SUMPS FLOOR SINKS FLOOR DRAINS DRINKING FOUNTAINS INTERCEPTORS CLARIFIERS SWIMMINGPOOL PTRAP WATERSERVICE ALTERATION GASSERVICE OUTLETS WATER HEATERS BTV OUTPUT SEWERCONNECTIONS SOLARTANK COLLECTORS SOLAR PIPING SVS. ' ISSUE FEE � �� MECHANICAL Pt.n,N CHecK HEATING SVSTEM 0-300,000 BTIJ= AND DUCTING 300,000 + BTU _ REFRIGERATION 0-300,000 BTU_ SVSTEM 300,000 + BTU _ BOILERS BTU SYSTEM REPAIR,ALTERATION EXHAUSTSYSTEM MVLTIPLE ISSUE FEE Itling; Canary-APPI_iwnt: Pink-Accountin9: Goltlenrotl-Assessor �.� ;: , � • , . �t A.P. qj` 20NE 9873 12/23/81 REAR VARD (TO P/l) PKG.SPACE REQ. STREET WIDTH ZON I NG APPRO V ED B V SPECIAL CONDITIONS: PLNG. REF. � ' �. PROVIDED PARK FEE ELECTRICAL PLAN CHECK GENERHTOR 0-1KW_1-lOKW TRANSFORMER �APPLIANCE 10-5 _SO+KW � . MOTORS 0-1 HP_3-10 HP (INC.i I 10-SOHP SO+HP FIXTU 5 O TS SWITCHES GASTUB I POLE LIG � PANELS MAIN �, SERVICE � � , SUB AMP 6.00 71; APPLICATION APPROV,ED.BV � - - OATE-� y SUMMARV OF FEES ' � ' BUICDING ��PERMIT $ SMIP $ � PLAN CHECK $ PERMIT PLUMBING g� �SSUANCE $ ' t GRADING $ PLAN CHECK $ ELECTRICAL $ $ PLAN CHECK $ ' MIGROFILM $ MECHANICAL 5 TOTAL FEE $ PLAN CHECK $ LE55 AD- - - , � VANCEPC $ FINALFEE 5� CONSTRUCTION AND PLANNIN � ' POOI & SPA . ' ", � , ` � " � Date Inspector � Date Inspector APP,ROVALS � Permit # ` APPROVALS ., Permit # . . 1. Temporary Electrical Service or Pole . 43. Pool & Equipment Location Soil� ipe•Undrgrn ' � 44. Steel Reinforcement 3. Elec[rical Conduit Utility-Undrgrn " �45. Forms � 4. Electrical Conduit-Undrgrn 46. Electrical Bonding � . tee ein orce 47. Rough Plumbin & Pressure Test �' 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE ' 7. Footings � • ' ' 49. ' Electrical Conduit-Undr rn • " 8. � Foundation - 50. Gas Pipe, ❑ Undr rn, Test � � 9. Water Pipe-Undrgm 51.- Backwash �Lines P-Tre �� ndr m � � 10. Structural Floor System 52. APPROVALTO DECK -- • 11. Property Sewer Line & House Connection - �� ' � � 53. Backwash & Rece tor-Final - � � � - � ? Street Sewer Connection 54. Heater & Vent-Final ' � � " ' �3. Rough Plumbing ' � � ' - - ' � - � 14. Rough Electric-Conduit ' �56. Electrical-Final � � 15. Rough Electric-Wiring � - - �- -- 57. Solar SYstem-Final � � � � �� • • " - .16. Rough Heating & Air Conditioning • encing & Access Approval � 17. Ducts in Structure � ' - APPROVED FOR PLASTERING 18. Ducts, Ventilating ' ' . � - . 19. Gas Pipe•Rough &Test. 60. POOL/SPA SYSTEMS FItVAL� . �, . . 20. Roof Framing "°'�� ' � ' � � � �- � 21. Roof Sheathin � � � � . 22. Frame and Flashin "'!'� NOTES: �� ' � . 23. Insulation � - ' � � ' ' 24. Lathin & Siding ' 25. Drywall Nailing •% '- - ' 26. Plaster Brown Coat - 27. Electrical Power Meter-Final ' � � - - '8. Final Electric � ' � - �. Final Heating & Air Conditioning 30. Final Gas Pipe-Test � 31. Final Plumbing ' � Water Service-Final 33. Gas Service-Final ` / � - Solar pomestic-Final 35. Landsra e S rinklin S stem - 36. Sound Attenuation 37. Handicap Regulations � � � � 38. FINAL STRUCTURE & BUILDING ' 39. Special Requirements Completed � ' ' - � 40. Electric Release to Edison � � � '- • 41 . Gas Release to Southem California Gas Co. - -" � � 42. CERTIFICATEOFOCCUPANCY ' No Date ' � � � �