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Home My WebLink About445 17TH ST - Building Permits. - . -' ->i . _..,.. BUILDING SAFETY i_tARTMENT �T i �q � P, O. Boa No. 317 l�l V 162l. �' Costa Mesa, Caliioruia �} �../��,,� / Date + �� ✓7/YYY%'�/�i `i �1 � CITY OF COSTA MESA CERTIFICATE OF OCCUPANCY Buildin Permil No//��' ��r�jElec al Permit No Plumbiu Permit No Use of Building j�LlA',ii�/ • i<:"1�'"j" '�' /.�-�� g ;-r Tlie buildiug lceated I.egal DescriPNo � ! ._ /� � – � ' ' / Z � 7 (See mverse side for Metes and Boun � has been inspected and found to comply w'th the provisions of all City of Costa Mesa Ordin- ances applicable thereto for a Group v� Occupancy. ISSUFyDT� ,,,y_ � ,�/v' (/yf . �' _ � � • City Building Of icial w�a c� �rv�� . ��'�°'�`�✓ ( wner of Building) , 87.� CC: ❑ O' inal—Owner ❑ lst copy—Gas Co. ❑ 2nd copy—EdiBou�Co. ❑ 3rd`C py—File Form 208 SB P IM 1-fi0 _ city ot Costa n�esa D U P L I C A T E C 0 P Y aoua��e satety oePe.tmeot C E R T I F I C A T E O F O C C U P A N C Y 28� 5 P.O. Box 1200 � �� `:�{ Costa Mesa, California The Building located at 380 Eae[ 17th Str�et has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group F9 Occupancy. Use of Building Ci�nnrmnThnf LegalDescription n. v, fi17_9R1—"." iF.i7 (See reverse side tor Me2es end Bounds) Building Permit No '+�QRi. Electrical Permit No. '+'+��07 Plumbing Permit No. ��o Number of apartments and/or guest rooms �SSUEo TO: BuildingOfficial S��T.li...-� by /L� �- FtALPH'S GROCERY COMPANY Date .lulv 13. 1972 This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Offieial of the City of Costa Mesa under Sec. 306 (e) U.B.C. Form Bu 34 Rev. 11/70 `� . • :.'- ": � �' '7856 ' ' ,_ , COSTA MESA BUILDING DEPARTMENT P.O.@O% 317 � COSTA MESA, GALIFORNIA FOR APPLICANT TO FILL IN eui�oiNc !Jlill�' ,I' 1 aS7 . L'—/- COSTA MESA. ER ARCN OR LEGAL LQ� DESCRIPTION NQ, A.P.NO. // SIZE OF LOT ��5� RNIA LIC. NO. LIC. � TEL. -/O.OF BLDGS. I SETBACN LINE GflOM � ' ICENTER OF STREET REAR YPRD �� 1 SIDE YARO RIGHT LEFT DESCRIPTION OF WORK N ALTERATION ApDITION REPAIR MOVING OEMOLISH BUILDING NO.OF SIZE ROOMS STORIES EXTERIOR WALL ROOF � COVERING COVERING � .. .._... A . �� . ,:, �s�sl�t�6�i�� . 1c�'olc-�� ^�nM� /�';{�. �..•�.: CffLr1 G� �� ...�..� � APPLICATION FOR PERMIT BUILDING FOR OFFICE USE ONLY RECEIPT NO. PERMIT NO ILDING DRE55 COSTA MESA. CALIFORNIA APPROVED BV DATE �� IONS CITY C057A M , +T�pEp1 SUBJECT/ einr nro� I MEREBV ACNNOWLEDGE T 1 MtVE PEA� THI$ APPIICr�TION RNO $TLTE TMAT iME .�BOVE IS CONHECT AND �GREE TO COMPIY WITH 4LL CITY ORDINRNCES /.ND ST E L.�W$ REGUL/�TING BVILOING CONSTHUC� iioH. " (A_� VALUATION SIGNATURE OF Z, �' PERMiT FEE $ �O ` PERMITTEE � , �j /� 1%T PLANCHECK $ S � g O AUTHORIZED AGENT ' TOTAL FEE 8 /S^— `�� '� - �� 6y COSTA MESA BUILDING DEPARTMENT P. O. BO% 31'! COSTA MESA. CALIFORNIA 3UILDING 4�DRE55 FOR APPLICANT TO FILL IN �� S L� . /� . �7 _ COSTA MESA. CALIFORNIA NAIL 40DRE55 �ITY I qprHITECT D IGINEER ADDRE55 TEL. / �p S Q' NO./ I i �� N�p L. LEGaL ILOT h � OESCPIPTION 1N0. L � A.P. NO. I I �� I i SIZE OF LOT USE OF E%ISTING BLOG. 3ET84CN LINE FROM (.� :ENTER OF STREET /� REAR YARD BLOCK _ / U''�C� G3(��Q��D „�i �-/,s� �N�, FlC�;��f �PT. �]Tn Q3 6'�ta t7�Sp APPLICATION FOR PERMIT BUILDING FOR OFFICE USE ONLY �jv �� ZONE CITY LIC, tONE r�n l' �— TEL. NO. iRACT rvo.or a�ocs. NOW ON LOT ' �_7� ,. SI�E YARD RICjAj�� LEFT 6�— DESCRIPTION OF WORK N! ALTERATION I qDDITION I �MOVING..�.... .—�— REPAIR DEMOLISH BUILDING //� NO.OF SIZE / ` ROOMS / STORIES E%TERIOR WALL ROOF COVERING COVERING USE OF NEW � � Dn ST�TE TH/�t THE �BOVE IS CITY ONOINarvCES wNp ST TION. SIGNATURE OF � nGENT NS � � � C� � / / COSTA MESA. CAL�FORNIA �/.ND AGREE TOtOMPLY WITH aLL / REGUL TING BUILOING CONSTIiVC� VHLUATION 00 $��0� NS nrt r. PERMiT FEE S � PLAN CHECK S �Q�J[J TOTAL FEE $ d6 9'"` . . . .1 i�/4� �- a' • COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 31] GOSTA MESA. CALIFORNIA FOR APPUCANT TO f/ll /N COMPLETEIY TYPE OR PRINT BUILDING ADDRESS �� fqOSTA MESA. CALIFORNIA ■.- LOT � BETBRCK LINE FROM �J / LEFT /D DESCRIPTI� BUILDING �� v SRE n E%TERIOR W COVERING USE OF 9UILDING i Hewee� ncRnew�ec �ND BTATE TM�T TH8 PLY WITM ALL CITY O BUILOINQ CONBTRUCT SIGNATURE OF PERMITTEE AUTHORIZED AGENT 3 OR f IGHT WORK NO. OF ROOMS ROOF GOVERIN iK TO BE � EE REC�iVED ��° �`-30 --si 9v ftNANCE DEPT. CITY OF COSTA MESA APPLICATION FOR PERMIT BUILDING fOR Off/CE USE ON[Y I nece�rr rvo. ��r(�� Al IVHp BY DATE qECfiIVEO T 9 4 .._ � . _ .a I� �: GOSTA MESA, CALIFORNIA FIRE Z E TYP GR P � � �/ BY V AT I �^ ZONING " ' A 20N NO. OP ^I U6E OF N W� � �yl PLAN6 �y BUILDIN� � A . /i I /�� i✓v BYPROVED I. � ' � �ATE i — l YARDS E S REQUIRED ALLOWED ICENTER LINE 6T.1 FftONT � FT. F ' I HAVB READ THIS APPLICATION IS COPPECT wND /�GPEE TO COM- E8 ANO BTATE L�WB HEnGULhTINO � � �/f� -N�.v,-.✓ . O( �� -_ TH8 AMOUNT BMOWN UNOER VALUATION IB FOP THE PUflPOBE OP E6TABLIBMING A PERMIT FEE ONLY. VALUATION � PERMIT FEE $ �- ��,� `-- g PLAN CHECK S TOTAL FEE S � �� .`. _, ' r r.. . 'JL�•Yi�Ji .. � ., . ��... • •'a ^� �COSTA MESA BUILDING-SAFETY DEPARTMENT FEE RECEiV P.O. BOX 31] � COSTA MESA. CALIFORNIA f�r \ b\ �`fbR �PPPUCANT TO f%L[ /N COMP[ETECY APPLICATIO�� TYPE OR PRINT BU I I G BUILDING ADDRESS t _COSTA MESA, CALIFORNIA I'Vq OFFICG USE ONC! I MAII y �� LEGAL I6ETBAGK LINE FftOM CENTER OF 6TFEET TEL: Ho. or e�oas. NOW ON LOT DESCRIPTION OF WORK REPAIR I IIMOVING I 5 Z'E OIN�i �� NO. OF �. ROOMS EXTERIOR WALL IROOF COVERING COVERING I HEREOY ACKNOWLEOGE THAT 1 HAVE RENO THIB APPLILATION AND STATE THAT THE ABOVE IS COHFECT �ND AGREE TO COM� PLY WITH ALL CITY O ANCES ANO STATE L1W9 FEGULATINO BUILDING CONSTHUCTI SIGNATURE OF �� PERMITTEE �� aeceirr rvo. I / �s 7 ��ci � %'-T.�J"fi��c� � � :i BUIIDING .i�/ r l /�J�f COSTA MESA. CALIFORNIA FIRE ZONING 20NE ^/�IP AN8 �I B��IL �� / / BYPRO�D / ` / J � .D, �l M1. VARDS �v EVES REQUIRED ALLO1 (CENTEH LINE 8T.1 -,�S-( O u.e THE RMOUNT BHOWN UNOEfl V/�LUATION IB FOR TME PfIHPOBE OF E9TABL18HING A PERMIT FEE ONLY. VALUATION PERMIT FEE $ � , �- $ �/// O � PLAN CHECK S �� / �� TOTAL FEE $ �, �. �� ° e`1��-'�. '.`fj �:�,4-� �� 1>, ��'' . :....;.., _r� —r �i "�..��.:. ' . , COSTk�;1v�E5A BUILDING-SAFE �, DEPARTMENT AJOt'BO7( �f�� '`COr9TA fEEAlA:�IPORNIA For .�p 1 ean4 �o Fill�ln Comple4ely TYPE OR PRINT I BUILDING '� �� ADDRH6S COSTA MESA. CALIFORNIA I I MAIL GI wF 'Eci use or 4 EXISTING BLD 8[TOACN LJN6 IRON EXTERIOR GOVHRING U6¢ OP � TEL. _[ _ TEL. NO. TEL., NO'C S'�6' � xo. ov e�oea. NOW ON LOT GIGG DESC�IPglO�l OF !R/O�a ROOF ..._: ��:; �n-�p�nj-`��=i SEP 261961 ��fINANCE DEPT. OU/'' ,1� t�'CfTY OF COSZA MESA �.4'�qPPLICATION FOR PERMIT �' Bui��i�G For 04iice Use Only RECEIPT NO. PHR4lT NO. 'f'/S�_J7=.� COSTA MESA. CALIFORNIA � 80R11R1G ' ZON� �.NO.OF n I U86 OF NEW �LANB �� BU�LOINO uaw� po� %Ie� %7 /`i/`.T Mf Ti('. oeacxirnoH li—�_ � I �_ �11 (CENT6R LINB BTJ �Z FRONT y� Z_ R. SIDE y L. 61DE � / � Z 6 o�.e y z.�y IN, � IN. IN. IN. ATE � / I/�20 N� / • �� - �il �J�G �ita.( Lc..Gti7 ��JNn r1�/' itir�J �d r /� I HHReSY ACKNOWL8D06 THAT 1 MAV6 RBAO T5119 .VPYGTION }Hg �MOUNT BXOWN UNDER VALUATON IB POH TH! ANO 8T�T6 TNAT TH6 ABOVe 18 CORRHGT AND AOR88 TO COM- yUW08H OR CBTABLIBN�NO A PEHMIT FHE ONLY. PLY WITN ALL CITT OIiDINANC89 AND OTATg I,AWg p8 OULATIJ!O eu1tDlNo CONGTRUCTON. ��/il➢sY-.._��T VALUATION ,.,�. �..� 816NATURH OP - � PERMIT FEE $ CC PHRMITTH � $ ��. �93,� PLAN CHEGK S ��• �S AUTHORIZED AGE � � _ .�G ` TOTAL FEE I y / � � � /,�� i�oio COSTA MESA BUILDING-SAFETY DEPARTMENT I P. O. BOX 917 COBTA M68A. CALIFORNIA "" For Applieanf fo Fill In Complefely � ' TYPE OR PRINT COSTA MESA. CALIFORNIA TEL. / � ■ 0' ucTNo. Z � r+o. /� y6% 81ZE � NO. OP BLp08. OF LOTf�� /S � /_�^ NOW or+LOT U6E OP �� w0 � � �� vriarwr m nr T' i � B8T0ACK LINB PROM DESCRIPTION OF WORK �� WALL V .� 1 H¢PHBY ACKNOWLeD08 1'HAT 1 XAV2 HBAO TH19 APPLIGTION ANO 8TAT6 TXAT TH8 ABOV¢ IS CORPECT AND AOREE TO CON- PLY WITH ALL C1TY OROINANGE9 AND BTATe LAW6 R80ULATNO BUILD�NO CONB 6H N. � 81GNATURE OF � PERMITTE AUTHORIZED GENT APPpOVED � FEE RECEIVED �`' r�a�� s� � FINANCE DEPT. � , CITY OF COSTA MESA APPLICATION FOR PERMIT BUILDING For Office Use Only HECEIPT NO. I / P6HYI%N G/ !� � ' I �,b^EIVEO I DATE 188� ^ L y S`—✓O— a COSTA MESA. CALIFORNIA � ZONE NO. OF USE OF NEW 1�/ L Q�7'� PLAN6 � BWLDING R(��.�� a�� r"a. !a� � 7 Nf1; /f r7. T/�. oeecx�rnoH A.P.NO. II? - 3iZ - 3y YARD& EVES APPROVED ALLOWED fLENTER LINt 8T.) $ 6ti txe AMOUM BXOWN UND¢R VALUATION IB POR THE PUFP088 OP EHTABLIBHING A PERMIT FEE ONLY. ATION ' // C„r� � PERMIT FEE $ J ///�� S V '"_ � � PLAN CHECK $ TOTAL FEE � � . j- .s� � �� - � : :OSTA MESA BUILDING-SAFETY DEPARTMENT 1P.�0. BOX 917 C08TA MEBA. GLIFORNIA Fo� Applicanf fo Fill In Complefely � TYPE OR PRIN7 COSTA MESA CALIFORNIA � MAIL ■ AP' ■ STATE USE OF EXISTING BLDG BETBACK LINE PPOM .�, a ; ��,��'aRECEIiED I h/ �� APPLICATION�I'IANC�t�EPT. _ BUI�YN� COSTA MESR For Office Use Only RECEIPT NO. PQRM{T�jG� 1 �4, �m— �h� FIRE ZONE r� A T �S APPROVED ° u. /'o �pT R O• � C �/ O�� No. .� U "sl� O � �c�t DESCRIP � /� I NO. OP BLD69. � fe Now ON LOT A. P. N( /( �S U- d FF/��CS YAR�S I LEFT �� I RIGHT `` DESCRIPTION OF WORK I II ei rroer�nu I L- II enn�rinu $�ZE L ROOMS " STORIES 1-- E%TERIOR WALI. ROOP L COVERING COVERING USH OF BUILDING AND WORK TO BE PERFORMED � T�Rid2 � DeVv 9� iN� cv,�l�4s_ U ; TS—/S=/6—ao �I_as I X¢REBY ACKNOWLED6H THAT 1 XAV6 R6AD TH18 MPLIGTION ANU BTAiE THAT THB ABOVH 19 COPPBR AN� AORE¢ TO COM• PLY WITH ALL CITY ��MAl1C88 AN� BTI1T6 LAWB REOULATINO BUIlDIN6 CONBiAUGndN. BIGNATURE aP , AUTHORIZED AGENT � !Y `T7J C� � / % %cJ�h, COSTA MESA. CALIFORNIA ZONING NO. OF 86 OP N PLANB BUILD�NG Ll.op- �7 IJi � / .l� 'J�J �. (CENTER LINE BT.1 o � a� ic.ev — E RMOUM 9HOWN UI EN V/ PURP09E OP EBTABLIBNING A S j S�'� IB FOR TNE FEH ONLV. � f � .;. f CbSTA MESA BUILDING-SAFEfY DEPARTMENT P.O. BO; Dl] C08TA MBBA, CALIFORNIA For Appllcant to Fill In Complately MESA. CALIFORNIA a n,Aa STATE TEL LIC. NO. Z N . SIZE I NO.ORBLDOB. OF LOT NOW oN LaT USE OF EXISTIN6 BLOG. `:�' � , 6ETBACK LINB FRON CEniea OP crneGi RHAR YARO 91D6YARDI LfiFT RIQHT '- DESCRIPTION OF WORK BUILDINO NO.OP ' SIZB ROOMB BTpR HH EXTERIOR WALL ROOP COVERINO COVERIN6 USfi OP BUIL 111 ND WOR TO B ERFORM � � ifii. � "i�n 9 1 HEREBY ACKIIOWLBDOt TXAT 1 HAVB RBAD THIB �PPLIGTION /.NO BT�TB THAT TH6 �BOV6 IB COHRHCT ANO AORB[ TO COM. PLY WITH ALL C�TY OROINANCBY ANO /TAT[ LAWB P[OIILATINO BUILDINa CONBTHUGTION. 31ONATUREOF � PERMITTH -- ��H � ` AUTHORIZED A6ENT � `{�. FEE RECEIVED JUL 3 1 1963 � fINANCE OEPT. F`�� R BUILDING For OHica Use Only ii I R6C[I'T NO. I IPfBM1'LI�Q. " ` ZONING z no.o� uaeornew �una O I euu��r+o LHOAL O � �D • � GHGCPIrt10N A. P.�,�/ ��— J 7" VOTE: NO EAVE OVERHAN6 SHALL BE LE88 THAN 90' TO 61DE 6 REAR P. L. ' "cAVEB ALLOWBD fU.B. Q REQUIR6MENT: YARDSAPPROVED YARDSAPPROVHD MAIN BUILDIN6 AGCESSORY BUILDINO ( FROM GL 6TREET) VAR.Si I DATE TX8 AMOUNT eHOWN UNDBR V�LUATION IB POH TH8 PURP096 0I BBTABL�BHIN4 A PERMIT R88 ONLY. VALUATION � __ PERMIT FEE $ �� T TALFEE � � I .� COSTA MESA BUILDING-SAFETY DEPARTMEN� V.O. BOX 1200 � COSTA ME8A, GAIIFORNIA 0261E For Applicant fo FIU In Complero�y TYPE OR PRINT ADDRE'BG �1� COSTA MESA, CALIFORNIA � T6L �S^�� I we�i�vnu�roo�• Y Y6TlACK L�X[ 1110Y DESCRIPTION OF WORK BUILDIH6 &IZE EXTHRIOR WALL �1 HlRKbY �CKNOWL6D0[ TX/1T 1 HAV[ ANO 6TAT8 TNAT TX6 AlOV6 1� CORqI r�r w�n� •�� Cip'.pRDINAXCO 11ND 1 BUILOINOCONB}kYChON.o 1_ u �j :J � :� SEP-4-68P"-1D00 721� ****22.50 CHSA APPLICATION FOR PERMR BUILDIN(i fOf �ff�t9 Uf0 OII� SON[ I Ho.o� ` n � '� �LAXi 1/ L�O�L A _ ��I� '. � � J/°� % � OV [RHANO SMALL G6 LH88 THAN YARDDMPROVHD I YARDBAPPROVHD MAIN BUILOINO ACCED60RY BIIILDINO -f- v�a, tt I owre �� -cr a m � eo. Rr. � 0 TH[ AYOUNT ONOWN UNO6R VALVATON 1! POR TX6 j rUPPOGB OP i�TA8L10MIN0 A PHPMIi P88 ONLY. Zi VALUATIO � /"1. � � PERMIT FEE F 0 s � �• �./S/%� s 6 OTAL FE! i1/� � •• 42219 • COSTA MESA BUILDING-SAFETY DEPARTMENT P,O. BO7( 1200 COSTA MESA, CALIFOflN�A 92626 For Applicant to Fill in Completely — Use Ink Only BUILDING � � I � �v'�• A D D R ESS ��' OWNER ��Gc� CI�4'/�1CL1�WD MAIL � ADDRESS � r TEL. CITY G � A/� " NO. '� CpN$TRVCT70N � ( LENDEFl ��E BRANCH ADDiiESS AFCH�TECT /n�� q ��O _ TEL. CONTF/>CTOR GG�N �� (J �({� � / ADDRESS TEL. CITV NO. F STATE CITY i U0. NO. LIC. NO. Q: {y� SIZE NO.OF BLDGS. 0. OF LOT NOW ON LOT a USE OF �p � l � EXISTING BLDG. � "''—'�"� N FSeparate permits are required for � electric, plumbing and heating work, � USE OF BUILDING AND WORK TO BE PEFFORMED ar-„v.�, _.'tJ,,a�-C-�c�.tS � H.'fT�IC , UMI��f� � • � � a I haroUY ecknowletlpe thet I heva reatl thla eppllcetion entl stete � ihet tbe above Intormallon Is mrrect and eprea to comply wiffi � all laws repulatinB bulltlinp eonnrucNon, antl I shell not employ �any peraon in vlolatian ot the workmen's eompensetion law� 01 x iha St92e of Californla. 3 I herebV cartify that 1 em ptoparl Ilcansatl aa e contrector untler ihe Stmta of Californie Businesa a Professions Cotle, Dlvislon 3, Chapter 9, entl hei eueh licenaes era n fu f ce a�tl afie or I am ax¢mpt tro the provlsione of � a te o/ elHor uzine�� end PrOfassions C • slo 3, C p r $iB�OTUte 01 PermlKee �/ V v AUShoY��etl ABeni A.P. NO. BUILOING ADDRESS OWNE FIRE 20NE APPROVED Na�, . : ?9-75�,., .00'�542.f ,:::* �5'.3C i FORSTRUCTURALPERMlT _S I .1.. T � �. Zf�1E NO.OF � i PLANS � VAF�S APPROVED MAIN BUILOING (FROM GL STREET) BET VAR. qY+ C.U.P.v ba // l VALUE 5 GpOUP DATE '(� �7 USE OF � BUILDI � YARDS APPROVEO ACO�SSORY BUILDING BEf. MAIN & THE AMOUNT SHOWN UNDER VALUATION 7HE PURPp6E OF ESTABLISHING A PERMIT FEE VALUASION PERMIT FEE 5 ( p.</ PLAN CMECK $ � $ �� TAX S TOTALPAID $ i C m i V m N R m e � a N O LL f V d l (714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT ,lob Address: 445 E 17TH ST Suite: Viciniry: FIRESTONE BLDG (COMMERCIAL) Status: ISSUED Applied: 05I20I2003 Issued: 05I20/2003 Parcel Number: 42514334 Zoning: Applicant: ALEXSON, TROY ISSUED BY: Address: 1853SUPERIORAVE - �, i-��-�� _ " Phone: (949)642-7222 � . COSTA MESA; CA �� - � Zip: 92627 � ; r � �� - �� / o : i, �. � Owner: KATHY INVESTMENT CO INC '' , Address iSUITEC � �� ' � � " , ' � �.- � �� `� �, �COSTA MESA, CA , �;�- � - Phone: - - - , ti � �. � ;- �� ,�. � , / . i 445 E 17TH STj' �� Zip: 92627 3234 V,:. .. �: : �._ �`.�,�",>'� � �,\' \c � Coniractor: �LEE RQOFINGOF COSTA MESA � � �`� %Addiess, 1863 SUPERIOR AVE � . �,��-,' ` � � � ; ' / Phone:'�(949) 642d222 - � ; , . , - , .,.,, � �. COSTA'MESA, CA � � � ' , , � Zip: . 92627' � License: 349686 �� ' � � - � . , Arch : , , -, � _ . . �� . Eng: ' , � . , Address: , , � � , . � , - - � . , Address:= ' , , � . - . , , � Phone: _ . .. i � Phone: -- �. � ' .� � Zip: � , ' -' License: � License: � , � _. � , - �- . � , . SCOPE OF FERMIT-- ,- � REROOF "FIRESTONE BLDG (COMMERCIAL)_ REMOVE EXISTING QAP SHEET ROOf,�INSTALL �1 LAYER OF 25# BASE, 2 LAYERS OF-11# ' PLY; 1 LAYER 72# CAP SHEET. 85 SQUARES . . ' . NOTE: NO TEAR-OFF OVER UPPER ROOF (OPEN BEAM). '' . � . � FEE SUMMARY�� - ' � � � � Plan Check: $0.00 � ` . ; . � Calc Valuation: Saa,000.00 ;� � Permit: � �$293.25 ,� Claim Valuation:� � S�e,000.00 SMIP Res: $0.00 , : SMIP Com: � ,$3.78 ' � �� Othec ��,$0:00 . - � � � � , Inspection: �$0.00 ..�r . � �,-_ � � � ,. . � - �� . � �Total: " �5297 03 �� `. _- / , � � � � , i ., � - . � , �. � , � PLANNING & ZONING � SETBACKS \�� ; _� — . , � "- MAIN STRUCTURE FronC �0- 0�" i�/ � Reac _ 0- 0' Left 0- 0 � � Right -' 0- 0' �� \ , � � ' , , . . . ACCESSORY Front � �-0- 0 � � �� , � Rear � 0, 0 , Left 0- 0 � - �� ' Right . � ��0- 0 �- � �� i PARKING Existinq: 0 ��,,Required: 0 � ' ' ' Proposed: .0 �' ; � - . - ��'' NOTICE: The work authorized by this permit shall comply with all applicabla handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 7, 7247-92) EXPIRATION: This permit shall automatically expire and become vold if work is not commenced wi�hin 180 days, or it work Is suspended or abandoned tor a period of 180 days. ' INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspeetlone and final approval must be obtained. Failure to obtain Inspections and final approval will result in the expira�ion of this pertnit. FOR INSPECTIONS CALL: (714) 7545628 t44e�ae Idoo) WORKERS'COMPENSAnON DECLARAnON: , � I hereby eflirm untler penalry of perjury one of tha tdlowirig tledarations: ❑ I have end wlll meintein a ceNficate at consent b seltdnsure fw workers' campenseHon, es provldetl for by section 3700 of the Labor COAe, tor the pertortnanca of Ne —/ work far whlch this permit I5155ueC. !d � I have entl wlll mainWn workers' oompensetion inwrence, as required by sectbn 3700 0l the Lebor Catle, for the peAortnence ot e vrork fw wh�h Utis permit Is Iswed. M work co%� ensation I re carder end II number are: / (/ / Cartler.y �KP � � ry POIicyNumbar. �b� � XS (Thls secf/on need not be completed I! the permlNs veNed ef one hundred dd/ers (Sf 00) or /ess.) ❑ I cerlity thet in Ihe peAortnance o1 the work tor which this pertnit is issued, I shell not employ any parson in any mannor so es to bewme sub�ect to Iha warkers' compensation Ifomie, pntl epree Ihet il I shoulA become suh�ect to �ha workers' compensatlon proWsions ol Sectlon 3700 0l Ihe Lebor Code, I shall forlhwith comply with Ihe slons. ��/� �� Applicenl Sipnature: �(�� Date: � Zo WARNINO: FAILURE TO SEW RE WORKERS' COMPENSQION COVEMGE IS UMAWFUL rWD SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CML FlNES UP TO ONE HUNORED THOUSlWD DOl1ARE (5100,000). IN �Wf�ON TO TME COST OF COMPENS4TION, DAM40E5 il5 PROVIOED WR IN SECTIIXJ 3'N80F THE UBOR CODE, INTERESi, AND ATTORNEVS FEES. LICENSED CONTRACTORS DECLARATION: I �ereGy eHlrm that I am lorce end ettecL Lic. p� ContractoYs Slgnature: . of Chapter 9(commendng with Section 7000) ol �ivislon 3 oi the Buslne�5y and Protesslons CoEe, end my Iicense is In tull Class M �- • � � Date: � �-�6`�� CONSTRUCTION �ENOING AGENCY: ❑ I hereby eflirtn that there Is a construction lending egency tor the peAortnance ol ihe work lor wNch Ihls Oermil is Issued. (Sec. 3097, CiWI Cotle). Lenders Name: Lendefs Adtlress: Signeture: Date: OWNER-BUILDER DECLAHATIONS: 1 hareby eHitm t�at unAer penaly of pehury that I em y(EMP7 FROM THE CONTRACTORS LICENSE LAW tor the fWlowing reason (Sec. 7037.5, Business anC Prolessions Cade: Any ciry or counry which requires e pertnit to construq, elter, improve, tlemolis�, or repair any sWCNre, pnor to its issuance, elso raquires Ihe epplicant tor such pertnit to fle e signed stetement that he or she La Ikensetl pursuant to Ihe provisians at Ne Contrectors LJcense Lew (Cheptar 9(cammendng with SecUon 7000) of DMsion 3 of ihe Business entl Protessions Cade) ar that he or she is exempt therefran antl the besls br t�e elle8etl e:emptlon. Any violetlon of Sectlon �031.5 by any epplicant for e pertnit 5ub�eCl9 �he eppliCen� to a chril penaliy of not more Ihan frve huntlred tlWlflrs (5500)J: ❑ 1, as owner of Ihe property, or my employees with wepes as iheir sole compensetlon, WILL DO THE WORK, end the sirucwre is not intendetl or oHered for sale (Sec. 7044, Business antl Professions CotlerThe Conirectors LJcense Law Coes not epply lo en owner of property who builds or Improves thereon, and who does such work himselt or herselt or ihrough his or her own employees, provided that such improvemenls ere nat intended or oHered lor sele. If, however, the building or improvement is sold within one year of completion, the owneo-builtler will have{he burtlen ot provinq �het he or she did not build or imp�ove lor purpose ot sale.). � ❑ I, es owner of the property, am EXCLUSIVELY COMRACTINC WITH LICENSED CONTRACTORS lo conSlruct Ihe prqect (Sec. 7044, Business and Prafesslons Cotle: The contrectors License Lew does not eppty to en owner oi property who Uulltls or Improves ihereon, end who contracts for such projea with a contrector(s) license pursuant to lhe GonlreMors License Lews.). ❑ t em e:empt under sec. Business end Protessians Cade lar this reeson: Signature: Date: Owner ID veniietl by drivers Gcensa. ❑ Ves ❑ No Drivefs License No. Fxpires: Verllication oi Ownership by (rype of document, i.e. - properry tac bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: ❑ 1 �ereDy ceNiy t�at no evcavetlon five (5) or more feet in depih Inro which e person is required t0 descend, wlll be made In wnnecilon wlth work authodzed by thls pertnit, and Ihat no building structure, scaHolding, falsework, or demolition or dismantling thereof, will be more then t�irry-sl: (38) feet hiph. (C�ap. 32, Grp 2, Art 2, Sec. 341, Tltle 8, Califomia AtlminlstratNe Cotle). ❑ As owner-builder, I wlll not employ anyone to Go work which woultl require e permit Irom the Divislon of Industrial Sefety, es noted ebove, unless such pereon hes e permlt to do such work from the divlsion. Signeture: Dato: Divlsion ot Industrlel Safery Permi� Number: CERTIFlCATE OF COMPLIANCE AND AUTHOHVJITION OF ENTAY: I cenity untler penalry ot perjury thet I heve reaC ihiv applicetion end state Nat the inlormation given Is conect. I egree to comply with ell slate laws arW dry or0lnances releling ro DuilCing conslruIXion, end euthodze representaWes o1 the Clry ot Costa Mese to enter upon Ne ebove-descdbed property tor inspecllon purposes. I egree not to occupy or allow occupency of eny building euthonzed by Ihis pertnil until fnal inspectian. SI alOwner(s) A/A. AnNOr AUlhoriietl Appllcant COUE 1. INSPECTIONTYPE PAIE 1t�LS 7818 Fi:od System Final Fire PrevenNon 12 Pool Spe Finfll � Finel Re-Roo1 � � � 1 Finel Block/Fletelning Well 202 Final Fadary Fire Place 203 Final Sign 20C Finel Demolition � !� D�� Oate COOE� INSVECTIONTYPE 206 Finel Mechenicel 208 Final Plumbing 210 Finel Elecldcal 212 Final Flre Prevenllon 220 Final Plenning Apprwel 222 Final Site 250 FlnalBuiltling/Oaupenry PAg 11�L9 .. • �k�,N �'� ^ Apo��ant to flIi in ail soaees axCaot those within heavy Doraer lines antl slgn all appropriate CiTv oF-CosrA nnE A CONSTRUCTION.PERMIT �yg � . �?� s�-. c,u yuz�r Project Address _ .Applicant'sMailingAddress �5�� p'��'/Li^C'✓iA. �� Owner'sName /�Ii2'GII',� (��LSS��• Phone �y Addreu �S_�� 1 � S�ri �. -�� • �. �L'1 - Arch/Eng. N �.4 � License No. Address "� ' - �r�,.7�� ' Contracror'sName n'�P$u E�t�`�y�s`��•Phone4�L.&-_ ' Address'Imailing) �S�i�,�4irMu-ot/1[\ #' 1�1 N�'b• CI Z6�3 Ciry License No. ,�iz 3 � �i � LICEfJSED CONTRACTOR DECIARATION I be�eby affirm that I aT Iicensetl untl¢r provi51on5 of Chdrte� 9(commencing wi[h section ]000) of ,Division 3 ot tha Buslness antl Professions Code, antl � my Iicense is in f WI forcy,anlefject � `�/. �/'1'' License ss e��'�� —�icense N�. l. l 1 Date ' � � Si9nature ° � WORKERS'COMPENSATION DECLARATION , -' hereby affirm that 1 have a certificate of consent lo selt-inzure or a certiflcate Workers' Compensation �Insurance, or a certifietl copy thereof (Section .00. Lab. CJ /+- ,� �PolicY No. " V ComPdnY � ' t' �Certifletl copy is ne �umished. / - � Certif' tl ' ed witb tne city Builtljr(y I' Dat EXEMPTION FROM WORKERS' GOMPENSATION DECL:ARATION (Thiimction neetl ha[ be comple[etl if tne pe�mlt i5 tar One huntlretl ($100) or less). I certlty that in the pertormancebf tho work for which this perm�t is issuetl, I Shall not employ any par5on in any manner So as to become su j¢Ct to the Workers' Compensation Laws of Cali(orn . ` Date <'�� 2--1(�' Siqnature ' �� 'NOTIC�ai er ma in9 tnis tleclaratlon, you shoultl ecome subjett to the Workers' Compensatlon provisions of the Labor Cotle,-you must torthwitn cOmply with sucn provi5ion5 or thi5 p¢rmlt shall be tleemGtl revoketl. CONSTRUCTION LENDING AGENCV t' . 1 nereby alfirm that there Is a constructlon leneing agency for Iha performance of tho work for which tnis permif Is issuetl" (Sectlon � 3097 Civ. �C.) Lentler's Name � Lentler's AtlOress � OWNER BUILOEH �ECLARATION I her¢by at(i�m that I dm ¢xGTPt i�om the Contrdcto�'S LlcenSe Law tor the followin9 rea5on (Sec[ion 7031.5 BuSiness antl Protessional Cotle: Any city or county which requires a permit to construct, alter, Improvo, tlemolisn or repair any slructure, prbr to its issuance, also requires the applicant for suth permit I to fiie a si9netl statement that he/she is Ilcensetl pursuant to the provislons oi I' the Contractor's License law (Chapter 9(commencin9 wlth Section 7000) of '�ivision 3 of the Business antl ProfesSions Cotle)�or tha[ ne/shC is ezempt 9/¢bom antl th¢ ba5i5 fo� lhe allegetl ex¢mption. Any violation ot Section 31.5 by any applicant for a permit subjetts tM1e appliCant to�a civil enalty o[mt more than tive huntlretl tlollars (E500). b I, as owner of the properly or my employees with wages as tM1eir sole �compensation, will tlo the work, antl the structure is not Intentletl or offeretl for Shc¢ (Sec[ion 7044, Business antl Profl55ional Cotle: The COntracto�'S License Law tloe5 not appty [o an own¢r Ot a property who builtls or improves tryereon, antl who aoes such work himseli/herself or through his or her own employees, provitletl that such improvements are not intentletl or offeretl for sale. If, however, the bullaln9 or improvement Is soltl within ona year oi mm- pletion, the owner will nave tne burtlen of proving he/she tlltl not builtl or im- prOve tor Ihe purpose ot Sale). . • ❑ 1, as owne� ot lhe property, am exclusively contracting witn Iicensetl con- . t�aCtOrsto wnSVuct the prolect (SecNon ]044, Busine55 antl Protessions Cotle: Tho Contractor'S LicenSo Law tloez nol apply to an owne� ot prOparty who builtls o� improves [hereon, antl wM10 contraC[5 to� such projects wi[h a hon- [ractm�sl license pursuant lo the Contrac[or's License Lavu). I am aware that prOOf of their Work¢r's Compensation insuranG¢ 5hou10 be provie¢tl [o me. ❑ I am ezempt un0er Sectlon B. 3 P. C. for [his reason Date - Owner I hereby certify tnat I have rea� intormation is cortecL I a9ree to antl state laws rela[ing to builtlm sentativ of fhi5 �ity to ente/ Ins e an purpose5: i ,� r Signature T_� �r� Drive�cense or 55 qF CMF 0865�46, rev. 10/84 White - B TVPE OF CONSTRUCTION LJ NEW 1./7 ADO LJ ALTERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTIONOFWORK/U9�DG,.A1)OrnTL_ � A1�- _ TVPE OF PERMIT L� GRADING� LJ FOUNDATION �LI STRUCTURAL • ❑ TENANT Q ELECTRICAL ❑ PLUMBING � MECHANICAI ❑ �OTHER' I � PROJECT DESCRIPTION 50. FT. OCCVPANCY�_ CONSTRUCTIONTXPE � VALUATION$ ZONE � GRADING CV. VOS. ' ACRES_ Re Backflow Preventer Batkflaw Irrigetion Bathtubs Clarifiers_. . Dishwasher �� Drinking Fountains Floor Drains Floor Sinks � Gas Service Outlets Showers Service Sink Sewer Cap Sewer Connection � Solar Col lectors Solar Pipin9 Solar Swimm ool w/Spa Urinal Water Closet Interceptors ,Water Heater Kitchen Sink - Water Service Lavatories � Auto-Wash P-Trap � Laundry Tra� Roof Drains � ' ' �'P c� G,4 C�,� r ��2 A.P. ilE S Main Building: E T Front' A Rear ' � Right g Left Ping. Ref. # Planning Notes: �•1 �+• AuromaticWasher r. i, ConstructionPoleSub. �� '� Cooking Unit � Dishwasher �� , m Dryers ❑Gas� ❑Elec � � • FdO F.A.U. Fixtures . Device Boxes OUtI¢t5 Switches Gar6age Disposal Generator �0�5 KW C Reinspection Fee $15 , Issue Fee ' � 3 Boiler • Duct-UnderGround Duct - Structural Duct - Ventilating- 1 Exhaust System ❑ Multiple ❑ Firepl/Fact Blt. IC80 ak Heating System & Ducting ��o-i oa;000 sru O � oa,000 er Reinspection Fee � � $15 � - _ Canary - Applicdnt; Plnk � A<counting; GOItlGnrOtl - A55¢Ssor Hood or Typel ❑ Canopy Type II ❑ Refrigeration Sys[em , �p-100,OOOBTU ❑100,000 Sysrem Repair/Alteration Fire Dampers Registers Issue Fee ,.� A.a� : ; ;.: _ , �; z �-��1., , 2oa8 " �Atcessory Building: _ Z . 0 N _ ' � N G . R Parking ReqJProvided' - E , . Q M T S ELECTRICAL FEES Transformer ❑ 15-50 KW ❑ 50+KW 5-15 K W Hainspectian Fee � S15 Meter L'Sup ro 100amps Meter ❑over 100 amps � , Sub Panel ' Motors 0-7 HP l Y, - 8 Inc. Solar �9-15 HP 016-75+ Microwave . Pole Light Range Sign Standing Sections Trash Compactor Issue Fee DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approvad By Building Approved By � Appliption Issued By 4! � SUMMARV OF FEES - -{ BUILDING�PERMIT $ SMIP � PLAN CHECK ' $ PERMIT PLUMBING $ � ��UANCE PLAN CHECK �25% $ � ENERGV�P.C. ELECTRICAL $ GRADING PLAN CHECK '50% $ MICFiOFILM � MECHANICAL S �.�.� l'OTALFEE § 3 PLAN CHECK 25% $ e $ 3 $ ' CONSTRUCTION ANDPLANNING P�Q� PA APPROVALS Pe�mit # Date Inspector AppROVALS Permit # Date Inspector � 1. Temporary Electrical Service or Poie 52. Pool & Equipment Location - 2. Soil Pipe�Undrgrnd. 53. Steel Reinforcement � 3. Electrical"Conduit Utility-Undrgrnd.' 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electriral 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., Tesi 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. i • 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 �i 13. Roof Drains � 64. Plumbing System - Final 14. Rough Plumbing � 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final - 16. Rough Electric Wiring 67. Fencing & Access Approval � 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL � 19. Rough Heating & Air Conditioning �_3_y` L� FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace � � APPROVALS Permit # • • 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping � Gas ❑ Oil 23. Gas Pipe-Rough & 7est 72. Underground Flush �, 24. Roof Fiaming 73. Undergrnd.StorageTank OGas ❑Oil � 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat �' � 75. Dry Chemical 27�. Frame and Flashing 7.�Dc,y Standpipe 28. Lathing & Siding 77. FIXE�`SYSTEM FINAL 29. Insulation ., 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 37. Plaster Brown�Coat 79. FINAL INSPECTION 32. lectrical Power Meter-Final - 80. FOOD CERTIFICATE ISSUED � 33 inal Electric �� Notes: . 4. inal Heating & Air Conditioning �� q�12_Y(� t,�j 35. Final Gas Pipe-Test 36. Hood or Canopy ' 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar pomestic-Fin21 42. Backflow Preventer ' ' � . � 43. Backflow Irrigation . 44. La�dscape Irrigation System 45. Sound Attenuation ' .' " 46. Handicap Regulations , 47. FINAL STRUCTURE & BUILDING , 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATEOFOCCUPANCY No. Date . n 11 ApP��canl lo /III in all spaces eneept lhose wit�in heavy bortle� Ilnas anC Sign all apProO/�ale tlecla�ations. CiTv Or cosTa CONSTRUCTION PERMIT PER T N � TRACT NO. LOT NO. U�.' ; Project Address �Y-yS E. �/}7'H �lt�. ` Applicant's Mailing Address � / Q�S g �- � ,Owner'sName ��/�N ��fi`JV ._Phone G�+2'� Addreis. -�l9/A /}/OZ/�f%%Z� LODi' fi✓d2JV� � ArchlEng. License No. � Address Coniracror'snlam��LQR �LF..��Q�L Phone Gi/'D$$i ; Address Imaiiingl 4�n ��BL/.S BKFR CrL. �1i>1 J � CitV License No. ,�?J'$rJ � D2 O'U Sf t � LICENSED CONTRACTpR DECLARATION . � I hereby at(i�m tha� I:am Iicensetl unCer provi5ions of Charter 9(commencing � with uction 7000) of bivision 3 of tne BuSiness antl Protessions Cotle, and my Iicense is in i W I force antl eHect. ' , r� r Liconsa C.l�as's � ce o.�� Date S� -� � � Signature WORKERS' COMPENSATION DECLA ATION - I hereDy atiirm tnat I haye a certifiwle of mnsent to u1f-insure or a certiticale �of Workers' Compensation Insurance, or a certifietl copy thereof (Section 3600, Lab. C.) p -� - ��-/� - - -' ' ^ ' Poiicy No. 2� '/ � 2 Company `� —(((�� e Certif etl caPY 1$ �eetlbwithrthe dtlY Build�pg�evi�o /� Date ��_��- APPlicant �rIA 71L EXEMGTION FROM WQRKERS' COMPE ATION DECIARATION '(Thi55ectlon neetl not be complat¢0 ii the.pGrmlt is tor one huntlretl (§100) or . less). ' . . ' 1 cerlify lnal in tite Oe�tormant¢ ot Ihe work fot wlticn this perm�t is Issuetl, I ' shall not employ any perzon in any manner so as to become subject to the � WOrkers' Compen5ation �ws of CdlifOmia. , . Dale Si9na[ure � ' `NOTICE: If, aiter makiny tnis tleUaratlon, you shoultl become subject to the Wo�k¢rs' Comp¢n5alion Orovisions o� Ine Labo� Cotle, you must lortbwl[h comply�with�.suclt proyi5ion5 or [hi5 pC�mll shall ba tleemetl revokBtl. CONSTRUCTION LENDING AGENCV � . 1 hereby a(flrm tnat ther@ is a construction Iantling agency for the oerformance of lne work tOr whiCh this p¢rmit is ISSUCC (Seclion 3097 Civ. C.) 1_enaer's . Name � LCOtlC('S A�CItTS ' OWNER BVILDEN dECLFRATION I hareby aHlrm that I am ¢xempt irom lh0 ConVaGtor'S Licenie �aw for Ihe rollowing rcason (Sectiqn 7031.5 Businass antl Pro/essfonal Cotle: Any c(tY.or� county which requlres a permit to construtt, alter, Improve, tlemolish or repair any StruClure, prlor lo Rs IsSuanCa, also reqWros fh¢ dpplicant for zuch permit � � t0 /lle a Sl9netl slatem¢M1I that he/Sne IS IICanSBtl pul5uant to the ploviSiOns of �he Con��actor'S LI<¢ns0.�y�y (Cnap[er 9(commOncing with Sectlon J000) o( Olvlsion .3 of Ihe Busiryess antl�Prote55ions COtlC) o� lhdl he/she I5 uxempl �hCroirom dnA th¢ ba5i6 tor t�e aIIC9etl examptlan. Any violation ot $oCtiOn . 7031.5 by any aOPlicAn[ tor a P¢rmlt subjeCtS the apDliCant lo� d clvil . �¢nalty oi nol more lhan five huntlretl t1011ars (5500�. � 1, as ownar o� th¢ p�op¢rry or.my amployee5 wi�h wage5 as Ihel� Solo compensalion; will Oo lhe work, antl the strutlum is not in[enUetl or oHeretl for salo (Section 7044, Buslnezs antl Prolessional Cotle: The Contractor's � litense Law tloes not apply to an owmr ol a proporty who bul�tls or improves ' thcroon, antl who tloes suCh-wOrk hlm5<It/her5¢II o� Urough tfis or hOr Own , ' employous, provitle0 thA[ such imOrovement5 a�e noI intentled or ottetetl for sale. It, however, the builtlin9 or improvement is soltl wi[hin one year ot com- platlon, thn owner ;will have lne burtlCn ai PrOving he/Sh¢ tli0 not builtl or Im- prove for.tne pur0ose of sale). ' ❑ I, as owner of tne property, am exclusivery contractin9 with Iicensotl con- • VaCtols lo cOnstN<t th@ project ($ectiOn 7044, Busine55 antl Prote55ions Cotle: , T�o Contractor's License Law does not apply to an owner ot property who • bulltls or, Improves'tnereon, ana who mnVacts tor such projects with a con- bactor(s1 Iicense pursudnt�to the ConVattor's Liconse Ldw). 1 am awara Ihat proof o�� lheir Worker'S Compensation InsuranCe shoultl be provltle0 to me. ,� I am exempl unaer S¢ction B. 6 P, C. for this reason Date' Owner I hereby certity that I'have reaa tnis appliwtion antl state that Ihe above �(�dZ 0 � � ,� -. - . TVPE OF CONSTRUCTION NEW ADD LTERATION REPAIR. � ' ; ❑ CONVERSION ❑ DEMOLISH O�OTHER p�,p. �jb- � DESCRIPTION OF WORK/USE OF�BLDG. - - S Main:Building: , - E � TVPEOFPERMI� ORADING FOUNDATION STRUCTVRAL - T Front '- ❑ TENANT �ELECTROIC.A-L, ❑M P�LY �M�B�ING I❑_ ME5 HANICAL � ., , A Rear� ' ❑��OTHER nC[.J-� 11M1-�T�A `1U LiIG1_ - ;VROJECTDESCRIPTION so.FT. o vnrvcv C� Right K Left CONSTRUCTIONTYPE VALUATION$ ' $ ZONE � GRA�ING CU. VDS.. ACRES Ping. Ref.9IE Remarks: . '� i � ' . Planning Notes: Bar Sink Backtlow Preventer Backflow Irri9ation Bathtubs � Drinking Fountains Floor Drains , ' Floor Sinks Gas Service. Kitchen Sink Lavatories P-Trap Roof Drains ' Rai�speetion Fee Showers � Service Sink Sewer Cap Sewer Conne2tion Solar Collectors Solar Piping Solar Tank \ Swimming Pool w OuUets - Water Closet ' Water Heater � Water Service . � Auto-Wash Lxundry Trays � $15 laue Fee Duct - Under Ground Duct Structural . Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. ICBO # Heating System & Ducting ❑ai ao,000 sru O i oo,000 sT� intormation is correct. � agree to comply wil� all Uty anU countY ortlinan<es antl Slat¢ laws /elalin9 uilAing�consl�uction, antl h¢�eby autho�IEa repre- ; sentalives of this c' o entq� yP on lhe. above-mentionetl property for Inspectlonvur0oses� /// • � y-3 Bs � �Signature� /A�`� � Date . . Driveri' License or 5� � Reinspeetion Fee CMF 0865�46, rlv. 30/84 White - Bulltling: Candry = Applicant Pink = Accountin9: Gdltlenrod - A5se55or $15 Hood or Typel '❑ �Canopy � Typell ❑ Refrigeration System ❑aioo,000sTu ❑ioo,000 System Repair/Alt¢ration • Fire Dampers Registeri _ . ! Issue Fee v . $ 3 $ 3 Construction Pole Cooking Uni[ Dishwa5her Fan F.A.U. • Fixwres .- _ Device Boxes � Outlets $witCh¢5 � Garbnge Dispoul Generamr'�0-5 KW _'' ' . ""' ' ^ , n5FF 4/03/85 �� 18sac ri. Zone Accessory Building: . Z ' O _ N I � N , G R. Parking Req./Provided ; ' " E ' ' Q M � � . S • ELECTRICAL � • -- - - - Trensformer- �-15-50 KW � �b � ❑ 50+KW. Meter p to 100amps!L� � Meter �overt00amps • ectric Sub Banel - � Momrs�0.7 HPO1S�8 • Inc.Solar �9-15 HP �16-15+ ' -Microwave. ' " " " ' Pole Light � Range � I; Standing Sections ! 5 KW � I Trash Compactor � I Rainspaction Fee � I$15 I' I Issue Feo DEVELOPMENTSERVICESREQUIREMENTS: Zoning APProvetl By � Building Approved By FE S 3 SUMMARV OF FEES ' BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT � � � PLUMBING $ ISSUANCE $ � PIAN CHECK 25% $ ENERGV P.C. $ � ELECTRICAL § � PJ �eO GRADING- �$ � � PLANCHECK 50% $ MICROFILM 5 � , MECHANICAL $ TOTAL FEE �$ t 3•['X� PLAN CHECK 25% $ � - i \_ % . • ' -CONSTRUCTION ANO PLANNING , POOL & SYA ' APPROVALS Permit # � Date . Inspector p�ppROVALS' Permit # Date Inspector � �� 1. Temporary Electricgl Service or Pole � . � 52. Pool & Equipment Location � . � 2. Soil P�pe-Undrgrnd. , �� ' 53. Steel Reinforcement - , 3.� le2trical Conduit utility-Undrgrnd_--1 'Rl�� • 54. Forms � . Electrical Conduit-U�cligrnd. 55. Electrical Bonding '�`� , i• " 5'. Steel Reinforcemertt � - 56. Rough Plumbing & Pressure Test ' j` i 6.. Electrical UFER Gmd. . 57. APPROVAL TO COVER-GUNITE �!` �-7- Footings ' ,f' - ��` ' 58. Electrical Conduit-Undrgrnd. � ,� 8. Foundation .�. � ,• ��1 � 59. Gas Pipe, O Undrgmd., Test '9. Water Pipe-Undrgrrid: . 60. Backwash Lines, P�Trap, O Undrgrnd. - 10.• Structvral Floor System �1 '-� 61. APPROVAL TO DECK . ,71. Property Sewer Line & House COnnection � 62._ Backwash & ReceptorFinal - 12. Sewer,G.�p .� •• ' � 63. Heater & Vent-Final � 13. Roo�,Drains �'� ' 64. Plumbing System - Final ' . 14. Rough Plumbin�q• 65. Electrical=Final ` 15. Rou9h Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval _ 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING � �18. Rough Electrical-T Bar Ceiling _ 69. POOL/SPA SYSTEMS FINAL � ' 19. Rough Heating & Air CAnditioning FIRE DEPT. REQUIREMENT . 20. Rough Factory Fireplate APPROVALS Permit # � 21. Ducts, in Structure , 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23: Gas Pipe-Rough & Test 72. Underground Flush . 24. Roof Framing 73. Undergrnd.StoregeTank OGas ❑Oil 25. Roof Sheathing " 74. Overhead Hydro 26. T-8ar Ceiling (Structurel) & Monocoat 75. Dry Chemical ' 27.� F'rame and Flashi�g .'�, 76. Dry Standpipe 28., Lathing & Siding , � 7.7. FIXED SYSTEM FINAL 29. Insulation � 78. FIRE PREV. FINAL 30. Drywall Nailing " ," � HEALTH DEPT. REQUIREMENT � 31. Plaster Brown Coat � � y SPECTION 2: lectrical Power MeterF�nal �.._� /j 8 CE TIFICATE ISSUED � 33.� inal Electric �..._� . s: . Final Heating & Air Coa,ditioning - 35. Final Gas Pipe-Test , ' � " . 36. Hood'or Canopy , , - 37. Final Pactory Fireplace - - 38. Final Plumbing � � 39. Water Service-Fina� - , � ' . 40. Gas Service-Final ' � 41. Solar pomesticFinal � � 42. Backflow Preventer , ' � � . � . � . 43. Backflow Irrigation ' , � . � ' 44. ,Landscape Irrigation System , ' • i � 45. Sound Attenuation � , , ' ' ' ' ' 46. HandicapRegulations ' �' ' 47. FINAL STRUCTURE & BUILDING , 48. Special Requirements Completed �,� . � � " 49. Electrie Release to Edison � � � ,' � � 50..Gas Release �to Southem CaliSornia Gas Co � � 51. CERTIFICATE OF OCCUPANCY ' - � , ' • . No. - �- Date� ' - - - . . . - ' • . ACo��ant lo fill In all spaces except tnose within heavy eortler Itnes antl sign ail aoVrooriate Eeclarations. � . CITY OF COSTA MESA CONS �FiNCTION PE3MIT � PE MIj,JVO�. � O� TRACT NO. LOT NO. UNIT NO, ' SO93 9� ( I�B% , � SI o6O T ProjectAddress S t' g� �1 �i'�Cc7 � -' -� • , /L�SJ Vv �'R/O� � ✓O. TYPE OF CONSTRUCTION NEW ADD qy TERATION Re,p� R� Applicant'sMailingAddress � K-72dACji✓C/f� � - Zone _/2 � T �� ❑ CONVERSION ❑ DEMOLISH OTHER d � Owner's Name �� v`�"� �Le`GG= phone ��r �, 7�'c S`� DESCRIPTION OF WORK/USE OF B DG. S Main Building: /lccessory Buildin � Addreu 9 ArchlErig. � Licpnse No. TVPE OF PERMIT GRa.DiNG FOun��AT�oN STRUCTVRAL T Front� ' Z � O Address ' - � � ❑� TENANT ❑ Ei� CTRICAL ❑ PWM/B.,I G •❑ MECHANICAL � �B Real � . - � " N Convactor's Nam �� F' ^ Phone � J�'7�� , y't'�rHER KG7J/-/i✓ lG/� S �Ua �Y� p' , � . � F PaOJE�T DESCRIPTION 5(2. FT. • oCCUPANCv e��' C Right N AddresilmailingllB 3 �� /�/o/l 9✓c ,oST�t.�e'h1 . ,.��1� �f —^.�� K , - . . c O,( S%S/ � CONSTRUCTlnry.rvag_ VALUATION$ DL4 �4s S Left Cily Li�2n5eNo. ZONE � GRA�ING CU.YDS. ACRES ' . �' R LICENSED CONTRACTOR DECLARATION � ' � � - Ping. Ref. �W Palking REq./PfOvidCd E Q I h¢r¢by altirm Ihat-I am licensetl untler provi5lon of Charter 9(commencing Remarkf: � PldnOing NOt¢5: � � with SCGtlon ]000) of �ivision 3 ot the Busln antl Protessions Cotle, antl . . M mY li<enze Is in iull force a tl efiect. a ' - � T License C ss � s License No. `� 6 S Date Signature — . PLUMBING FEES � WOR RS' OMPENSATIONOECLA TIO • BerSink $howCrs ELECTRICAL � 1 hereby alNrm tha[ t nave a certiticate <onsent to sel!-insur a certlficate } FEES ' �of Workers' Compensation Insuranc or a cerUt{ea copy thereot (Sncilon'� 83ckflowPreventer � ServiceSink � ' _ � 3800, �ab. C.) i�p Aummatic Washer Transformer ❑ 15-50 KW 4 Policy No. '✓� '�� % company �S. F s b• Backflow Irri ation Sewer Ca ❑ 50� KW ,—��. 9 P ConstructionPoleSub. � !�/� �n} Certiiietl�copy is hereby fumisnetl. /j � . ,. , J� Certi i co Is fiieC with the city o�ws�on. GF6/�OYY�iw� Bathtubs Sewer Connection Cooking Unit Meter �up to 100 amps �'py�¢ APPlicant v� �A - EXEMP �10 FR M�WORKERS' COMP NS RATiorv- ^ � . Clarifiers , Solar Collector � _ Dishwasher .- . • - .�Meter �over 7002mp5� . . � (This section neetl not be comple[etl if e permi[ is tor e huntlretl (5300) or ; , , iess). � Dishuvd'sher . Solar Pipi Dryers ❑Gas ❑Electric Su6 Panel =� � I C¢r[ily lha[ In tne performance ot e work t0/ Whicb tbls pe�m�t is i55u¢tl I� sha11 not employ any person in any manner so as to become subject to'tf�e Drinking Fountains . Solar ank , Fan Motor 61 HP 01 Y. - 8 -`� Worker5' Compensation Laws of CaIltOrnia. Date Signalure Floor Drains � imming pa F.A.U. i , Solar 09�75 HP �16-15+ ' 'NOTICE: II, after making this tlecla�ation. You shpultl become subject to the _ Workers' Compensacion provisions of tbe Labor Cotle, you' must fortnwitn' Floor Sinks � Urinal f ixtures � Microwave comO�Y `�'�th such ptov�sions or thiz pe�mi[ Shall b¢ tleemetl �evoketl. ' _ CONSTRUCTION LENDIN AGENCV ' - ' -' GasSefvice' Outlets WaLefClout D¢vic280z¢5 1 nereby alllrm that there is mnstructlon Ientlin9 egency for the per(ormance Pol¢ Light of [hu work for whic lhi�pe�mil i5� Issuetl .�Section'. 3097 Civ. C.) �� Inteiceptors Water Hester - OuHets ' , Range Lentler's Name -0� - LenAer's Atltlress - - � Kitchen Sink � � ' Water Service Switches � Sign � OWNE0. BUILDEH DECLARATION � . . ' I hereby afBrm that I am exempt from the Conlractor's L'icen5e'Law for the Lavatorie5� , Auto�Wash •� � following reason (Section ]031.5 Business antl Prp(essional Cotle: Any city or -- Garbage Disposal ; Standing Sections county whlcn requires a permit to construct, alter, improve, tlemolish or repair P-Trap �' � ' . Laundry Trays, ' Generator 00�5 KW �5�15 KW � Trash Compactor . ' j � any structure, prlor lo�its'issu3nce, alzo requlres the aDP�icant for such permit to (ilc a signetl statement tM1at ne/she is Ilcensetl purzuant to the provisions of Roof Drains ` . ' .� � ' ' - . . [he Convactor'S License Law (Chapter,9 (commentln9 �+itn Section 7000) of ' ' � � Division 3 of the Business antl Professions Cotle) or t�a[ he/she is exempt , - . .. . . , the�efrom and [M1e ba5i5 for the allegetl Oxemptlon. Any violation of Sectlon ' � 7031.5'by any applicant for a pe�mlt subjec[5 [he applicant to a civll enatty oi not more tban five huntlretl tlollars (E50�). � ' ' � 1', as owner oi the property or my employees with wa9es as thcir soie ReinspeMion Fee $15 � Issua Pee � $ 3 • �compen5d�ion, will Co the work, antl Ihe 5[�u<tu�e i5 no[ intentleA orotteretl ReinspectiOn F@B $15 ' ISSY¢ Fee �$ 3 lor sale (Section 7044, eusiness anC Protessional CoCe: The GOMractor's - '� �MECHANICAL � FEES License �12w tloes not appty [o an owne� ot a p/op¢r[y who bulitls or improve5 thereon, antl who tloes such work-nimseli/herselr or mrough his or her own goiler � Hood or Type I ❑ DEVELOPMENT SERVICES REQUIREMENTSi , ; employ¢es, proviaed [ha[ such imp�ovem¢nls ar0 not intentletl o� offeretl /o� ' - Zoning App�OVetl By �1ata sale. If, noweveq the Euiltling or improvement Is tola within one year oi com- Gnopy Type II ❑ pletion, the owner will have the burtlen ot proving he/she tlitl not builtl or Im- Dutt � Under Ground Buildin8 %�PProved By /Ov0 iorthe purpose otsale). DdtB � � I, as awner of tne woperiy, am exclusively cbntractin9 wilh Iicensetl con- � Duct -Structural ' Refrigeration System Application Issuad By -,�.� ��; = Date�-�d'�7 t�actORto const�uct the prolec[ (Section ]044, B451nass antl PrOfezsion5 Cotle: ' ' ' Tne Coniractor's.License Law does not aoPly to an owner.otproperty who Duct- Ventilating - � - ❑0-700 OBTU ❑100,OOOBTU � �SUMMARY OF FEES builtls o� improves [hereon,-antl wtto contraG[s /or Such projects with a cOn- ' ' � , tractor�sl Iirense pursuant to me Contractor's Litenze Law). I am aware tnat Ezhaust System ❑ MWtiple ❑ S em RepaidAlteration BUILDING PERMIT $ ��`0� SMIP � $ / � proo/ o( their Worker's Compensation insurance snoultl be provitletl ro me.� _ PLAN CHECK $ r_ PERMIT ❑ I am exempt untler Section B. & P. C. for this reason FirepVFact BIt. ICBO # Fire Dampers i PLUMBING $ � ' �SSUANCE $' Date Own ' - Heating System & Ducting Registers p�qN CHECK 25% $ ENERGV P.C. $ i heretiy certity that I have ead uiis application antl state Itiat Ihe above -❑0-100,0008TU �100,0006T ' ELECTRICAL GRAOING ' S� information is correcL I a9r to comply with all city antl county ortlinances �$ antl state �aws relating t uimin9 constructlon, antl hereDy authorize repre- , PLAN CHECK 50% $ MICROFILM $� sen[atives ot this city enter upon lhe ab ve-mentione0 pr per for � / inspectlon pur . 9/ r � MECHANICAL $ TOTAL FEE �$ L�' Si9nature _ �ate � � . Drivers' license or 5� - Reinspec[ian Fee $15 Iswe Fee $ 3 PLAN CHECK 25% $ � GMF 0865-46, rev. 1/84 White - Builtling: Canary - Applicant; Pink - Accountin9: Goltlenrotl - Assessor � � `� CONSTRUCTION AND PLANNING " POOL & SPA APPROVALS Pe�mit# Date� Inspector AppROVALS Permit# " Date Inspector 7. Temporary Electrical Service or Pole / 52. Pool & Equipment Location 2. Soil Pi e°Undr rnd. � P g :j . 53. Steel Reinforcement � 3..Electrical�Conduit,Utility-Undrgrnd; �� 54. Forms � ` '' 4:'ElectricaPConduit,Undrgmd. �; • • 55. Electrical Bonding ' ' 5. Steel Reinforcement- �: ;, 56. Rough Plumbing & Pressure Test �,, 6. Electrical UFER Grrid. ' 57. APPROVAL TO COVER-GUNITE • i 7: Footing's' � � � ,,� . � 58. Electrical Conduit-Undrgrnd. , � ; � 8.� Foundation ; '� � . 59. Gas Pipe, O Undrgrnd., Test ., � �^ 9.�.Water Pipe-Undrgrnd:. , � ' 60. Backwash Lines, P-Trap, � Undrgrnd. �. 10:;Stluctural Floor System ,� � � 61. APPROVAL TO DECK � ,_� 11i'�Property Sewer;�ine,.& House Connection � 62. Backwash & Receptor-Final 12. Sewer Cap �` �.. � ' ' 63. Heater & Vent-Final � 13. Roof Drains r�. ' , 64. Plumbing System - Final .�� : 74. RoughPlumbing:� ' �� 65. Electrical-Final 15. Rough Electrical-Cqnduit �� 66. Solar System-Final - - 76. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign �- - 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling � - 69. POOUSPA SYSTEMS FINAL 79.� Rough Heating & Air Conditioning � FIRE DEPT. REQUIREMENT 20. Rough Factory Ffreplace APPROVALS Permit # �� 21. DuCts,in Structure 70. Underground Hydro 22. Ducts, Ventilating 77. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough &,7est 72. Underground Flush ��, 24. Roo4'Framing - ' � 73. Undergmd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing � 74. Overhead Hydro 26. T-Bar Ceiling (Structurall• & Monocoat ,. 75. Dry Chemical 27. Frame and Flashing t 76. Dry Standpipe 28. Lathi�ng & Siding �' � �� 77. IXED SYSTEM FINAL 29. Insulation � ' 78� FIRE PREV-.�INAL 30. Drywall Nailing - � j� . HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat & � �79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED . 33. Final�Electric � Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test . 36. Hood or Canopy - 37. Final Factory Fireplace _ . 38. Final Plumbing . 39. Water Service-Final . ' 40. Gas Service-Final ; . 41. Solar pomestic-Final � 42. Backflow Preventer . 43. Backflow Irrigation � 44. Landscape Irrigation System � 45. Sound Attenuation � � . andicap Regulations ' , 47. INALSTRUCTURE&BUILDIN �� D . Special Requirements Completed ' ' 49. Electric Release to Edison � 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY , No. ' Date �i �i �� I �oonasaveaim�o: q45 E 17TH ST OIMERBN41EIFqAWN: J�ES MIZZELL �op� 445 E 17TH ST COSTA MESA CA 92627 �vr�. ��na,o �oo�se: 1NCXIfECf OX FN�IEEP: YKII ON FlIG.'B MDPE49: uc. xo, uwr: UM: c��Toaew�LEE ROOFING CO (714)642-7222 cwrn�crars�uiwo 1653 SUPERIOR AV �oo�as COSTA MESA CA ��+o: 349686 92627 uwr: LICEN9ED COMRACfOH4 DECI�P�TION: I Mreby Nim ivNr panW y d prWry IM I em Ikw�W uM�r pmbbm d Cheqx D (wnmandn0 xMh Seciqn ]a00) d Diwion J M tM &itl�w� W Fmlarom Cod�. ud my Ibnw b In IW bm rM aMw. cmuc.No.:028751 ue.cuss:C 39 uc.r+o.: 349 EXP: 03/96 o.i.: caw.na: _ /Gl OWNEP B ILDEN ECLARATON: I Iweby efirm aMer perWy d perjry u 1 un axamq Imm tM Com�vfm lioena law lor tM IMowiq �won (Sedlm 10J1.5 &niiwa eM Pmlettion� Goda: Mry munry MhiN nQuim a pwmil m mnhucl. Mx. impow. lemd'eh. a rpei eery �weYvs. p'v b n'swio, tlm epium iM ' Ip weh pxnW tolJs e pprod �WWammq tlW M a�M s 4cwaE W�wW io NeV�+d iM Comredon Lbw� I��Wr H(oommwq�q weh Srfion lOW) d Drv'sion J M iM Buuma W Prdaaan Codel a ihel M a�M u sssmq Ihaehan uH iM Esm la tM elbped uunqion. My vuW un d 6atlun �oai.e W anr.up� �« e w�me wM� �ne a�r�um m e aw o�M d m mon �ne� n.. nwdrod eooan I�11. � I.nowrord�MpcOMYvmV�wl�wN++nNs�olemmV�.wLdoNswrk.vdlM�WCWr�emlWanded a ollanE tar veM ISactian 1au. emronmd Praf«wn Cotl�: TM CaNream t'vua Lew tlom nd WWYto en ownara p�apany wla Wids or inqwx IAeiem. md wM Ao» �uch waM1 NmWI rc MnN a Wa� h"v a M own ampbyss�, prwided tAet �uch impiw�erneme va nol iNmdM a dheeA ta uM. tl. Mwewr, �M W�dinp a inpwpn�nt b wtl wehin ons yw d oomple�bn. iM mm«�wae.r.a� �u.s ins was, a Aan'ro na a q�s ed m dad a unoiw. �ar u. wmaw a.d.l. � I. m ox+rr d tM prapery. em aztlitinly mnlratliq wiN fawaE eam�eebr� m miww tM peojea (�� . �Inre erd Prde�soru coEe: TAs Caq�epon Licww lew Eoa na eCMY b en oww d pWMY wM Moltl� n hnDA'�m �Iraon W wln mntreeU la vxh pajxb xiN a aavrrfor(e) IiwuM puniwa b tM CaVetlas Lbsnse lew�. � I em aRamq �Mw Sec�ion: B. d P.C.. la VJw iaesm: oete: �: I do hersby eaniy Uxt I em ewua d end �vdM�urd tM nyuinm�nn d Gelioem� HaeAh uq bdary Goda Bw1bm 25505, RSS�J. enE 255JI. end Ihtl I a arry Mun Wiltlirp osupaM r.iT / wil nd (c'vc4 ans) �+ed lo canply M� uid pet� aode� uM iM nywmnmb M epermillaaomtnic�bnamodifimiontram�MAi�iei�y uui{NnwYD'otntl.RsdAwaWmmruabn�pplreibmweiemqlnmiM� pwidau. Dma: �d: WONKER'8 COMVOI9�TON UKL�P�TION: I Iw�py dM1m u'dar p�nMy d pw�uy w d IM blbwinp AWucbm: � I Mr� uM MI meiNen e ceniliuts d mur� to �ep�mun br wMwi campemeibn. n pwN�E la b� Br}pn ]AO d tM lebor cod.. �n in. o.namenc. a m..oix r«.RiG, uJ. w�+:6.�ea. � I hev� erd wil meiMen r.wke�i oomp�rmiion imuruws. n npu4M by 9wbn ala0 N ths labor GOE�, br iM prlormviu d �M work la whM mb V*m� b e�uM. My worbn' odnWNdbn bueenu mnMr and D�Y mimEv v�: c.m.,: STATE FUND EXPIRES PdicyNumbr, i a� aaa—a4 06/30/95 /m�, s.nrm ns.e mr n canW.'ea r u. a�M u�a. w nwanE ed�en Rrool a w...) � I canN �� DM�^u d IM wak la r.hkh Ih6 pMmq b'm�wtl. I Mtll ury prcn In ury menMr �o n to pacoma wbjetl lo iM xorlura' wmp�nWbn lew al CNilanu prw tl I Emn�'uaW to iM worken' cnm°� iion/q� ian d SaUian J]00 M tM lebar hxii povb . on.: �. /// /Y � _ _ Ma iv iisuri �f � CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 072839 PERMIT NO: H 072839 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: OTH JOB DESCRIPTION : T/O LOWER 1STORY ROOF/INSTALL BUR W/ROCK SQ FT: 2,100 CLAIM VALUE: 2,100,00 CALC—VALUE; 2,100.00 GROUP OCC: B-2 / COMMENTS: THE "MIZZELL REALTY" COMPANY / LOWER ROOF OF A TWO STORY BLDG. ��rx�+r�r�r***x ***�r��*��*�r***��**�r*�r�r�r�r�r+�*****�*�r*�r�r�+�**�x��rx�x *�*x *�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 ------------ MA�N HUILDING ---------- --------- ACCESSORY HUILDING --------- FRNT: FT ;IN REAR: FT IN FRNT: FT IN REAR; FT IN LEFT: FT . IN RGHT; FT IN LEFT: FT IN RGHT: FT IN PARKING REQ:' � PROV: PARCEL: 00000000 ZNE: REF NO: PLANNING NOTES> �, . 1f 1f 1F iF iE if� * iE IE 1E iE 1t iE 1E 1E 1E 1E k iE iF iE IEiF if iE 1E IE iE 1E 1E 1E iF if 1f �E 1E iE'N' iE IE iE if �f �f iF iE iE 1E iF IE 1E 1E if iE fE'If 1E 1F iF 1E if iE iE'lE 1E iF if� 1E iE 3E if �E *'lElF iE iF if 1f 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: BUILDING APPROVED BY : DATE: APPLICATION ISSUED HY: DATE:�� *,��,�*��*��*�*��****� � �,�,�*��,�,�*,� � y.�-*� LEGALIZATION:N F E E S U M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBI G E RIC MECHANIC FIRE SMIP/RES GRADING PERMIT 54.00 SMIP/NON—RES PLAN .50 ISSUE FEE HUILDING—DIV—> PERMIT ISSU PLAN—CHECK TOTAL PAID DUE TOTALS----> 54.50 0.0 0.00 54.50 54,50 ,00 REVENUE DIVISION TOTALS--> LLECTED: 54,50 OVER/SHORT: 00 BLDG PMT PLUMHING ELECTRI MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECR 54.00 .50 ik 1! 1F 1E 1E 1k 1FlE k k i41k 1k 1E 1E 1E iE 1f 11� 1f 1E 1F iE if iE iE k iF 7! 1! if 1E iF iE it 1k 1E IE 1f Ik IF 1k 1k 1k fE 1E 1E iE iE iE 1E 1! �k 1! �E iF 1k iE fE k 1E 1l' iE ik iE iE 1! 1! Ik 1E iF iF iE 1E fE iF 1E 7F iE I N D I V I D U A L F E E H R E A K D O W N m.«��.on�..:ro�ro«u.eo��.,.a•i.��.�.na .rri.��.�.mvmr«ro�nmwc.r,.re.,.�e TYPE m� �'nML fhouuMlo/Yn (JIOQ0001, h MCIlbn N� cwt ol ro�vmutbrt d�q� u proHdM br In b LMoi CoOr. Infwu4 uW �ttumry'� I�u. SFC CONSTRUCTION LENDINO ROENCY: I MraEy eMvm imbr � d pr''vy IM iM h� mrutvfion Iwqiiq apaM.y lur U� peAwmaMa d tM v.ak fa xfild� IFe pxmi h's+ued (8sqion ]. Civ. CI. LENDEP'S NAYE: LENOEP'S �OOHESS: I caniN IMI I hm�a roeE tl�ia epd�e�ian W qe�s ihet iM e0we Inlpmqion o consp. I epiee io wmply Milh ell dry uM counry oMinencae entl eWa levn nk�vp b buJdvq cma�ueion eM MraEy einlw¢a nqaaenietivae d IM tnyto emar upon iM abon�meMioned pmpMy la iropadion WN�+� MIJS.&� B,URKE ��f'�7 i� P Neme i . W hn�ik�q 8 Selwy: Oieen-Fb: CvurY-�GP�: Pink-Rermw: CldEenmE-Nenaor QTY 21�� D E S C A I P T I 0 N ALTER HY VALUE COMMERCIAL NOZONE END OF FEES UNIT COST TOTAL COST 1.00 2,100.00 ✓ c_ on.�;�_.6-u�ir�:�c; s�.:T oazE: os ,s�o� rr��. �.s..., _ .::� _ CQNSTRUCTlON AND PLANNING �O. SPA APPROVALS Permit # Date inspectot AppROVALS � Permit # Date inspector 1. Temporary Electrical Service or'�ie 52. Pool & Epuipment Location ; ✓� � i 2. Soil Pipe-Undrgrnd. . 53. Steel Reinforcement �. !"' 3. Electrical Conduit Ufility�Undrg�nd. 54. Forms ' -' � 4. Elecirical Conduit�Undrgrnd. 55. Electrical Bonding �� 5. Steel Reinforcement. � 56. Rough Plumbing & Pressure Test '�'J .., 6. Electrical UFER'Grnd. 57. APPROVA� TO COVEfl�GUNITE � �� 7..Footings � 58. Electrical Conduii-Undrgmd. $, Foundation -- � 59. Gas Pipe, O Undrgrnd., Test � 9. Water Pipe-Undrgrrd. � �� i� 60. Backwash Lines�, P�Trap, D Undrgrnd. 10. Structural Floor Svstem �; ' 67. APPROVAL TO��DECK ' � ,i 11. Property Sewer Line & House"Conheciion 62. Backwash & Receptor-Firial `� 12. Sewer Cap _�'� 63. Hea[er & Vent•Finai '� ' { _ :-.. 13. Roof Orains - ! 64. Plumbing SYstem - Pinat ` :j � 74. flough Plumbing -�� 65. Electrical-Final /� 75. Rough Electrical�Coriduic '� 66. Solar SYstem-Pinal 1 � � 76. Rough Electric Wirir�,q , '� 67. Fencing & Access-Approval � '�� l7. Rough Wiring Sign _ 68. APPROVED FOR�PLqSTERING : J 19. Rough Electrical-T Bar Ceiiing 69. POOL/SPA SYSTEMS FINAL r 79. Rou9h Heating & Air Conditioning rn . FIRE OEPT..REQUIREMENT 20. Rough Factor,y'Fiieplace ._ ' ' ; '•' � APPROVALS_r Peimit,i`- � ' 21. :Ducts•, in� Structure'"4 - * ' � 70. 'Undergroynii Hydro 22. Ducts; Ventilating ' �.- ; .- � 71. Product PipingfO�Gas ❑Oil 23. Gas Pipe•Rough & Test _' � - �' 72, Underground Flush'.' _ 2�. 400f Framing . "� � u' ., ' .,`� �. 73. Undergmd. Storsge T.ank � Gas ❑ Oil L �j� 25. Roof�6heathin9 e Si Jt_,�2yf �� (/9 �.Ix/ 74: Overhead Hydro _ .. �=1,�f/ _ .. '. T-Bar Ceilinq �Structuralf & Monocoat - , 75. �Dry Chemical , . 27. Frame and Flashing , t. � � ' 76. Dry StandpiPe' = `_ 28. Lathing & Siding `- "T� ° c• " 77. FIXED,SYSTEM FINAL 29. Intulation " • • 78: FIRE PREV. FINAL 30. Drywall Nailing _� . � , � HEALTF'1 DEPT. REQUIREMENT 37. Plaster Brown Coat . � . � . ' • 79. INSPECTION +� � � 32..Electrical�Power Meter-Final `' �� 80T� FOODiCERTI'F16WTE ISSUED_ , 33. Final Electric - . .. .. Nptes: '% ' .. ' � � 34. Final Heating & Ai� Conditioning _ - �- �' �� . - . �` � �- 35. Final�Gas-Pipe-`fest�.- - •. � :, - � � -_ : � • 36. Hoocl�or �Canopy ' . - � T' ' - • ' ' . � ' .- �� 37. Final Factory Fireplace . � . � - ' � 38. Final,Plumbing . � ' - " - _ �� "' � � 39. Water Service�Final'' - � _ ' � ' •� � 40. Gas Serv"rce-Pinal � •' . � .. _ . 47. Solar pomestic-Final � � " , . � � 42. Backflow Preventer � ' -� �" � ' - �" - i c. 43, Backflow Irrigation � _" - .. , � � '44. Landscape Irrigation'SYstem ��`'•� ' ' � - ' ;' � . � � � 45. Sound A[tenuation ..'.. a ' . ` - , . 4 Handicap Fegulations . � + � • . ' FINP,L STRUCTURE & BUILDifi6-� �� W� . FINAL PLANNING ' ' � .. . �49. Elec[�ic Release to Edison " • , � . �50. Gas Release to Southem Califomia Gas Co - - ' . � �. 51. CERSIFICATE OF OCCUPANCY � � - ' ` No Date X �' �. Applicant to flll in all spaces except those within neavy bortler lines ana si9n ali apD�opriate Oeclarations. `' P IT P�RMIT NO. ._ TRACT NO. LOT NO. UNIT NO_.... , �Fi.TVwCOSTAMESA CONSTRUCTIQN ERM Prolect Address ��5 �/ 7T ✓T t�✓ir,� '��%•� �O./.SJ,� .��u73 4 Applicant's Mailing Address �y1 � �j ^� Owner'sName�/�4�a�✓ vf✓�n�v� Phone7q2y�� Address �' �Q1•-� O1 2 �i7 � `f �/Ai✓� �.�.0 /Z7S� Arch/Eng. �v`d✓6�� LicenseNo. — Address 7 7 � - �'�- � � Contractor's Nama �n"J^�F"-.4 Phone Address (mailing) City LiCenSe No. — LIrEN$ED CONTRACTOR DECLARATION 1 hereby ailirm ihal I am licensetl untler provisions of Chdrter 9(cOmT¢ncing with SeCtion 7000J of DIVISion 3 ot tne Bu5ine55 antl Profe55ion5 Cotle, antl my liceqse is in (ull forte antl ettect. ' License Class � license No. � Date � Signature — WORKpqS'COMVENSATION DECLARATION I hmeby aHirm that I nave a certificate of consent to self-insure or a certificate oi Wo�kers' Compen5alion Insurance, o� a certitietl copy thOreOf (SeCUon 3H00, L.�b. C.) ' ' PolicY No. Company 8 Ce�tifi¢tl copy i5 h¢�eby furnis�etl, Certifietl copy is tiletl with the city Builtling Division. Date Applicant EXEMPTION FROM WpRKERS' GOMPENSATION DECLARATION (Thi55e[tion neetl not be <Ompletetl if the permit is fOr One huntlr¢tl (b100) or less). I certify tha[ in th¢ Oe�to�mdnce of the wo 1(f � whic �s pe�/m( i5 Iisued, I shall n4t emplOy dny per50n In any Ta o as to D oma� SuNject to t11�� Work Cop�pepy� tlon Layts�E rn . , _ // Date�,'%Y 1d`1 619llature �jL� �' NOTICE: 11, atter maWng thls tletlaration, you shoul become subject to the I WorkerS' Compensation provisionz ot the Labor Cotle, you must forthwltn comO�Y wil❑ such provisions or tnis permit snall be tleemetl revokeU. CONSTRUCTION LENDING AGENCV ' 1 hereby aftirm thal Ihere Is a consV uction lentlin9 a9ency for tne performanca of tne work for whicn lhis permit is Issuetl (5ection 3097 Civ. C.) Lentler`s Name — Lentler's Atltlress � OWNEq BUILDER DECLARATION I hereby aHirm lhat I am ezempt Trom lhe Contractor's License Law for tho tollowing reason (Section ]031.5 Business antl Professional Cotle: Any city or munty �yhiGh require5 a p¢rmit to cDnstruct, alter, improve, tlemolish or repair any struclure, prbr to its issuan<e, also requires the applicant tor such permit to /ile a Siqnetl StateTen[ [hat he/she is IicenSetl Ou�sudnt to the p�ovl51on5 Of the ContractoYs License law (Chapter 9(commencin9 with Section 7000) ot Division 3 of lhe Business antl Professions Cotle) or that he/she is exempt therefrom antl the basis tor the allegetl ezemption, Any violaUon of Sectinn 7031.S.by any applicant for a permlt subjects the aOP��cant [o a civll �Q.e,�alty o/ not more tnan five huntlretl tlollars (5500). �1 �, ds Owner of the Property or my employee5 with wage5 d5 their sole compensatlon, wlll tlo the work, antl the structure is not intentletl or otferetl for wle (Section ]044, Business an❑ Protessional Cotle: The Conlractor's LiGense �, w tloez not apply [o an own2r of a p�o0etty who builtls o� ITp�ove5 thereon, antl who tloes such work himself/herself or through hiz or her own emploVeeS, provitl¢tl that such Improvament5 dr¢ nOt intentletl o� offeretl f0/ saie. 1� however, tbe bulltlin9 or improvemen[ is soltl wi[hin one year of tom- pletioq, ine owner will have [he burtlen of proving he/sne tlitl not bWltl or Im- prova }or the purpose o/ sale). ❑ I, az owner o! the pro0erty, am exclusivery contractlng with Ilcenzetl con- trattors to consV uct the project ISettion �044, Business antl Professions Cotle: The ConVactor's License L.aw does mt apply to dn owner of prOperty wh0 builtls or Imoroves t�ereon. antl who contracts ror such oroiects with a con- trac[or(51 license pursuani [o me Contractor•s License Ldw). I am aware [hat proot of lneir Wo�klr'S Comp¢OSatio 5 �ance Shnultl b0 OrovitleU to Te. ❑ I am exempt untler 5ectlon � ��. C. f�r this reasor� x I � Date /.,��'!��_P�� ownv�-��rtici/ �.11l /µ/b�'�Kca. I hereby cercity tn I have reatl this application antl state that the : intormation is cor c. I agree to comply ith all city antl county ortlin antl state laws re C g to bui onstr ctlon, antl hereby authorize i sentativ¢s ot Ih' ut)'/ to e ter u n e above-mep tioneG propert� Inspe<tion pu�p ¢S. /� // n 'e �� l.,/ c r_.nr� ✓ e i. D, /[ I A le.[!! Y i TYPE OF CONSTRUCTION LJ NEW LJ ADD }C�I ALTERATION LJ� REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WOR.K/USE OF BIDG. �N7rs_in o_ N6a/- TVP�E} OF PERMIT� U GRA�ING LJ FOVNDATION LJ STRUCTURAL IdJ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL LJ OTHER PROJECT �ESCRIPTION S�.FT, oCCUcarvCY� CONSTRVCTIONTYPE �� VALUATION$� ZONE GRADINGCU.VDS. ACRES_ Remarks: Bar Sink Backilow Preventer Backflow Irrigation Clarifiers Oishwasher Drinking Fountains Floor Drains Floor Sinks GasServiCe Outlets Interceptors Kitchen Sink . . Lava[ories Roof Drains Reinspection Fee $15 Duct - Under Ground Duct - Structural Duct - Vyntilating Exhaust System ❑ Multiple PirepVFact. Blt. �CBO # Heating Sysiem & Ducting ❑ a i oo,000 aTu � i ao,000 Reinspection Fee � $15 0865-46, rev. 5/88 Wnite - Builtling: Canary - qpp�lcanh Pink - Accountln9; Goltlenrotl - Assessor Showers Servite Sink Sewer Cap Sewer Connection Solac Collectors , Swimm Pool Urinal Water Clo Water Hea[e Water Service Auta-Wesh Leundry Tra'ys laue Fee Hoad or Typel ❑ Canopy Type II � Refrigeration System ❑0.100,OOOBTU ❑100,000 System Repair/Alteration Fire Dampers Registers Issue Fee �� A.P. #E . S Main Bu E r Front B Rear A C Right K Left S Ping. Ret. # Planning No' FEES Automatic Washer ConStruction Pole Sub. Cooking Unit Dishwasher Oryers ❑Gas ❑Eleccric Fan F.q,U. FixWres Device Boxes 3 Outlets Swltches Garbage Dispoul Generator 00.5 KW �5-15 Zone ELECTRICAL � Transformer ❑ 15-50 KW ❑ 50+KW Meter ❑up to 100 amps Meter ❑over100amps Suh Panel Motors �41 HP �1 Int.Solar �9�15 HP � Microwave � Pole Light Fiange ` Sign Standing Sections Trash Compactor Reinspection Fee $15 Issue Fee $ 3 DEVELOPMENTSEflVICESREQUIREMENTS: C Zoning Approved By fEES Building Approved By $ 3 'I,-e 5+ FEES N I N G R E Q M T S. SUMMARV OF FEES v BUILDING PERMIT $ -ZI..00 SMIP $ . SO PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK 25% $ ENERGY P.C. $ ELECTRICAL $ I, 7_1-�� GRADING $ PLANCHECK 50% $ MICROFILM $ MECHANICAL $ TOTAL FEE $ �8.75- PLAN CHECK 25% $ AGCOU�r'7 '>: 92.'y'?�U';�' �i CDS? GO' �,,r.3'+.'"-'.'' D7.'?a/f.9 ht 't iF, '• ._,. �`� �� CONSTRUCTION,AND P�,ANNING POOL & SPA APPROVALS Permit# Date Inspector p�ppROVALS Permit# Date Inspector Y� 1. Tempo �ary Electrical Service or Pole � 52. Pool & Equipment Location 2. Soil Pipe`Undrgrnd. � 53. Steel Reinforcement � r 3� Electrical�ConiJuit Utility-Undrgrnd. 54. Forms - � 4� Electrical Condurt-Undrgrnd. 55. Electrical Bonding 5:� Steel Reinforcement , � 56. Rough Plumbing & Pressure Test '' 6y �Electrical UF�ER�Gmd. 57.� APPROVAL TO COVER-GUNITE . �• 7.� Footings °� -- 58. Electrical Conduit-Undrgmd. ,' 8� Foundation . ' 59. Gas Pipe, � Undrgrnd., Test "`- � �. 9. Water•Pipe�Undrgrnd. � 60. Backwash Lines, P-Trap, � Undrgrnd. „ _ • 10.� Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection , 62. Backwash & Receptor-Final • 12.` Sewer�,Cap � � 63. Heater & VenbFinal � � � 13. �Roof D�ains � 64. Plumbing System - Final �� 14. 'Rough''Plumbing � 65. Electrical-Final ' . 15. Rough Electrical-Conduit � 66. Solar System-Final r �1'6. Rough Electric Wiring �5 ! �/ 67. Fencing & Access Approval n �1�7�. Rough Wiring Sign 68. APPROVED FOR PLASTERING 1�8. Rough Electrical-T Bar Ceil�g 69. POOL/SPA SYSTEMS FINAL �19r Rough Fleating & Air Conditioning . FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace � APPROVALS Permit # -27. Ducts, in Structure I�J 70. Underground Hydro 22. Ducts, Ventilatin `� 9�, � 71. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test ,•.� 72. Underground Flush 24. Roof F�ming .� ��) 73. Undergrnd.S[orageTank OGas ❑Oil 25. Roof Sheathing ,� �� 74. Overhead Hydro 26. T-BarCeiling (Structural) &'Mon6coat � ,. 75. Dry Chemical � 27?Frame and Flashing � �'' � �% � 76�bry Standpipe '28� Lathing & Siding �d 77. FIXED SYSTEM FINAL w 29. Insulation �L' �. � 78. FIRE PREV. FINAL 30. Drywall Nailing �� `� i� . HEALTH DEPT. REQUIREMENT 31. Plaster Brown Co�� .' �� 79. FINAL INSPECTION }3 Electrical Power�Meter-Final 80. FOOD CERTIFICATE ISSUED - 3. inal Electric �� Notes: 34. Final Heating & Air Conditioning J 35. Final Gas Pipe-Test �36. Hood or Canopy ,^37. Final Factory Fireplace " ��38. Final Plumbing !�� ' 39. Water Service-Final: � ;�� 40. Gas Service-Final , . 2 = 41. Solar pomestic-Final f^�i� 42. Backflow Preventer �//f `''• " , /: 43. Backflow Irrigation i�� -' 44. Landscape Irrigation System . � 1 ' 45. •Sound'Attenuation' " `�� : .� . ndicap Regulations � !+f " 47. INALSTRUCTURE & BUILDING '�i! ., 1•- . ' . Special Requirements Completed . r,49. Electric Release to Edison V�v' ' , b0.' Gas Release to Southern California Gas Co � j• ✓� • iti; 57. CERTIFICATEOFOCCUPANCY 4 �`'� ,� ��1{ O � 1 ! �/, No. Date - , b �7 ri e n • ' '