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Home My WebLink About660 17TH ST - Building PermitsOwNER SGNINNLING SYSTEM ra15CELL�NE0U5 AOUGM ME�TING �NO �IR COND TEMPOR�ar SERVICE OA POIE UNOEAGROUNO � POWER � ROUGH WIRING TPEHCHES � FOR 5 iL00R SYSTEM BONO BE�M �1 STEEL REU SHE�iNING FR�mE �ND FL�SNING ��TMING — IN � I OUT � PL�SiEN.BROwN COAT 5' TUR�L. FIN�L M\ IG, VENT.. REFRIG. �N� PLUMBING. FINeL ANO WS TE DATE SUBCONTRACTOR VW1V1'iK OlGYL'IVD� Jllu LH1G 11 GG-00 JOB ADDRESS 66o west i7th street Hid�.�2 BUILDING PERMIT NO. 2E�93 GENERAL CONTRACTOR Owner-Bldr. DFSCRLPTION OF WOAK IriteTlOr Partitions 3�_ or Da[e I GROUP F-2 TYPF SUBCONTRACTOR OWNER SGI�ROFF Leo DATE 3-23-76 JOB ADDRE55 fi60 weat 17rh Srraar _ 425 BUILDING PERMIT N0. 47452 LOT TRACT soi� SI'l9:LCCl,Y�A R�I �U:�'l�l� SMEATMING FRAME RN� FLRSHING LPTHING - IN n i PLRSTER, BROWN COAT 5T�"`TURAL,FINAL Hl G. VENT., REFR PLUMBING, FINAL AN� ELECTRIC, FINAL BUIL�INL, FINR� COSTA MESA BUILDING DEPARTMENT �TQ ' �pr� p 111 East 2pth Street l� C7 �� Costa Mesa, CalfTornia /n — "� . . t Pate........f...Y.....�._..... ..._�.._'---� � CITY OF COSTA'�M�E3A S CERTI CATE O�\�.yOCCUPANCY _ Building Permit No�/��Electrfwl permit No4'..n��P�umbip9 Permit No4...�� . . Use of Building .... ... ....:..........� .._�'..:.......4......j.......' c . . ...... ^ _.... ....... .... The 6uildin8, located at.,.._/-..._C....._�'.._.d:.�!.."'Tt.!� ......... ............... ....�.�i"Z2—E_.r.1.�.....�1..r.Q.:.:f...a—::..._�..`.cL�`� �! .._'..._........__c........... -..y......._ ,.._......... � h Lot ...............'._'.._.".."..'_........ Bloek.................'._....................... r v�-` 'Ei.��-�V �y ,- �.". ."_...��..._....""""".......�C . (See reverse side tor Metes and Bounda) has 6cen inspected and found to comply with the provisions of all City of Costa Mesa Or- dinances applicable thereto for a Group_..��...�_.:.0cx\v pancy. I SUED Tp; � A. J. VOLY �ty Bui O ai �..�.��1�lT.��.1...�� ✓ (owner� Buildin9) By.....�.._--- . .. �f�.�... ......----.....-- ---'•-'-- CC: ❑ Origlnal—Owner ❑ lst copy—Gas Co. ❑ 2nd copy—Edison Co ❑ 3rd copy—File I'orm 'toti G-H 1M 12-53 OWNER BARNARD� AL St� TIF`FANY , DATE 6-8-56 JOBADDRESS (�(� W.�th St. BUILDINGPERMITNO. "jlO ' GFNERAL CONTRACTOR Ormer-builder VALUE a(>Q�Q��O� �oT pp 116-200-4 e�ocK TRACT ' MZ-StOPHgQ & Light Mfg. � GROUP F2 TYPE � ZONE MI_ ' FIREDIRTRICT i9Qri � PERMITSISSUED INSPECTIONS p C� /DATE SUBCONTRACTOR Y�/(�G (�-2%�s _ _„ /� DATE I NUMBER r Foundation Forms and Grade to Rou M -�P..c'LI .S-tf'O-/ ✓ Sewer, House rfi.(;[� Sewer, St. -'% �l,e'�,�'jJ.� /0% �,� l� ✓�Pw.u.('2 �/�.z5 �S 6 -5 �=-� / � S :TankorCesspool L_ .ma. In Out. Plumbing,Fin�al,FixturesComplete /0•/ 'S� Plumbing,FirualGasTest nh�P .C�� O-/ Wiring, Final 0/f% Oecupancy [] FORM210 3M 10�^v3 ' ��Vl OWNER TIFN�s`�a AL � DATE 11�-61 JOB ADDRESS__660 id05t 17th..StrB2L BUILDING PERD4IT NO.- F TVo.116-200-09 LOT Ii,.,PECTIONS dr 7'RACT FIRG 7.ON� � Signaturc � DAT� GROUP VALUE S ZZS.00 DE5CRIPTION OR \i'Oi{IQjOn TYPE 7.ONE SUBCONTRACTOR .S JOB ADDRESS AP No. llb—� I ECTIONS OCCUPANCY .GEQRGE LOT TRACT FIRE ZONE � DATE I GROUP IV SUBCONTRACTOR DATE 11-9—%O VALUE PERMITS ISSUED Farm 210—SM-1 L59 5-B P , 1326Z' OWNER STFVFNS� .TTM DATE (�_1 J�_(�� JOB ADDRFSS 660 West 17th Street, Bld�. �i2 BUILDING PERMIT NO. 1(�6$1 . GENERAL CONTRACTOR p�er VALUE $ 200 00 � Ap No.��/,_��n_n9 LOT TFtACT FIRE ZONE DESCRIPTIONOFWORKint.alt_t.o �nd_t 1, ECTIONS � DATE I GROUP F_9 1`YPF, TT 7.ONF. M_l OCCUPANCY Form 41�SM-11-59 S-B P SUBCONTRACTOR I PERMI75155UED 1lt681 owxEx A. E. Tiffin,p & D., Bornard OCT 2 8 1958 DATE �-1-5� JOB ADDRESS h60 W. 17th' P3�e :`� � BUILDING PERMIT NO. %2(y% 1 GENERAL CONTRACTOR _ VALUE $- SOO.00 � . o. LOT TRACT ' PIRE ZONE DESCRIPTION OF WORK -Spra,y Booth l.._.�UP E _ TYPE ZONE Ml � PLAN NO. 721i7 INSPECTIONS I DATE I gUBCONTRACTOR I ___ PERMITSISSUED coat House Con. St. Swr. °✓ . % 2117 ...... NER BARNARD & TIFFARtY r�r � �33 UNTT A JOBADDRES$ (7�j0 :'T. 1%th BUILDINGPERMITNO. ZZfl GENERALCONTRACTOR ��ard & Tiffany VAWE $ 2(}.��.00 � AP 115-200-9 BLOCK TRACT� I StoraPe & li�ht manu£acturin� INSPECTIONS Footing Trench � Foundation Forms gnd Grade to G Rough Framing Plumbing, Rough to Sla Plumbing, Rough Complete Temporary Pole Wiring, Rough � Heating, Rough Heating, Final �Sewer, House Sewer, St. L ig, In Out Plastering ' Plumbing, Fin�al, Fixtures Co� Plumbing, Fin,al Gas Test �% i Wiring, Final Occupancy .:.,.__ �inn vitnni Gc DATE I SU �icr �u(u PERMITS ISSUED I NUMBER OWNER BARNAP�D & TIFFANY DATE 12-20-5� �� TT B JOB ADDRE$$ (7(j� 4I, 1%th BUILDING PERMIT NO. 2191 GENERALCONTRACTOR L,. BLOCK TRACT GROUP TVPE INSPECTIONS DATE Footing Trench /—�/ " Foundation Forms and Grade to Garage RoughFraming ��/ � �_�� Plumbing, Rough to Slab Plumbing, Rough Complete Temporary Pole Wiring, Rough �i{% , 0 ,{ Heating, Rough � Heating, Ffnal Sewer, House Sewer, St. Se�?ic 7ank or Cess000l L P Plumbing, Fii Wiring, Final Occupancy O ut � � :I SUBCONTRACTOR VALUE FIRE DISTRICT PERMITSISSUED NUMBER OWNER DATE I1NIT JOBADDRESS bbo w. 17th BUILDINGPERMITNO. ZZ%�. GENERALCONTRACTOR VALUE $ L BLOCK TRACT GROUP INSPECTIONS � Footing Trench Foundation Forms and Grade to Rough Framing T. - / Plumbing, Rough to Slab Plumbing, Rough Complete Temporary Pole Wirinq. Rouph Sewer, Hause Sewer, St. SP�tic Tank or Cesspool ing, In Out Plastering Plumbing, Final, Fixtures Complel Plumbina. Final Gas Test !� Occupancy DATE ,7L� SUBCONTRACTOR I IRE DISTRICT PERMITS ISSUED DATE I NUMBER /� JOBADDRE33 6E�n W [eT��r�l:►_\��b: L INSPECTION$ Footing Trench Foundation Formsand Gradeto Plu Heating, Final Sewer, House � SeoticTankor - ng,in Plastering Plumbing, Fin. Plumhing, Final Gas Test Wiring, Final Occupancy O ut BLOCK �73�� cd TRACT SUBCONTRACTOR DATE RPII7�7G[H-l�:lulYi VALUE UNIT D�3 D -N./�n PERMITSISSUED DATE � NUMBER uNZT E � z9 � OWNER gARNARD & TIFFANY DATE i.�_��_5K JOBADDRESS 66o w, 1%tlt BUILDINGPERMITNO. ��9� GENERALCONTRACTOR VALUE $ L BLOCK TRACT GROUP TVPE INSPECTIONS Footing Trench Foundation Forms and Grade to Garage Rough Framing � � p ..,, , � i Plumbing, Rough to Slab Plumbing, Rough Complete Temporary Pole Wiring, Rough (,(/ Heating, Rough � Heating, Final Sewer, House Sewer, St. Seotic Tank or Cesspool I ng, In Out Plastering Plumbing, Final, FixturesComplet i� Plumbing, Fin.al Gas Test � Wiring, Final Occupancy CGG !� c....... •�i n r u i Gnn i ss DATE p I � SUBCONTRACTOR J I� PERMITS ISSUED I NUMBER � ER � JOBADDRESS bbn w. l�th BUILDING PERMIT NO. 219� ' GENERALCONTRACTOR Barnard & Ti£fany VALUE $ 26�QQ� �� AP 116-200-9 �B�ocK TRACT Stora-�e & l�ht Mf�. L GROUP �2 ti TYPE IV ZONE I`TL FIREDISTRICT 2O7S � �' PERMITS ISSUED INSPECTIONS DATE SUBCONTRACTOR DATE NUMBER FootingTrench 1'%� � Forms and Grade to iing ;ough to Slab �6 touah Comolete ao-S,f��77�f-', '^ ,.,..,...., . ,. _ . Wirina. Rounh .7-I� /%/ii/1( /'J ./-5T - /�i / L /.�/ 2�0_. C'( ' n��zz G ir �i �.. g, Rougt g, Final Flouse Tank or L ng,ln F ering Plumbing, Plumbing, Wiring, Fi Occupancy 2wer, St. Out Final GasTest nal 6� ��L �— ._... , . ,. . . ... ,. � ., � UNIT G OWNER BARNARD Rr TT�?�'AFIY DATE i2-2o-55 �S� , JOBADDRESS BUILDINGPERMITNO. �'IOZ GENERALCONTRACTOR VALUE$ Q(��QCO Qp I BLOCK TRACT � INSPECTIONS Formsand Gradeto P Wirir Heati L 'ng, In Out F .ering Plumbing, Fin�al, Fixtures Co�, Plumbing, ��n.al GasTest Wiring, Finel Occupancy �o v-,._.... �. n r� u i Gnn i G� 9 i DATE Z '2 _� ZONE FIRE SUBCONTRACTOR I PERMITSISSUED I NUMBI . _. .. . �- OWNER BARNARD & TIFPANY UNIT H _ DATE j2-2n—rjrj ,� C JOBADDRESS BUILDING PERMIT NO. �p� GENERALCONTRACTOR VALUE $ 2(�OQO OO BLOCK GRQUP _ _ TYPE ZONE FIREDISTRICT PERMITS ISSUED INSPECTIONS DATE SUBCONTRACTOR DATE I NUMBER Forms and Grade to iin9 3es= uuph iu Slah� Heattng, Rough Heating, Final Sewer. House Sewe Septic Tank or Cesspool L `ng, In Out F ering Plumbing, Final, Fixtures Coi Piumbing, Fin,al Gas Test Wirin9, Final OWNER �g�jARD & TIrFANY DATE ZZ—ZO—SS �I�'7 JOBADDRESS BUILDINGPERMITNO. ��(�� GENERALCON7RACTOR VALUE$ 2(�innn.On TRACT GROUP PERMITS ISSUED INSPECTIONS DATE SUBCONTRACTOR DATE I NUMB� Foundation Form3 and Grade to G Rough Framing �� Plumbing, Rough to Slab' Plumbing, Rough Complete 7emporary Pole Wiring, Rough Heating, Rough Heating, Final Sewer, House Sewer, St. Septic Tank or Cesspool L 'ng, In Out P._ ..ering Plumbing, Final, Fixtures Complel Plumbing, Final6asTest Wirina.Final � r'� � UNIT J. p4VNER BARNARD R;.TIFFANY DATE � _20-55 .�f� JOBADDRESS (�(�n W. 17th BUILDINGPERMITNO. Q19 GENERALCONTRACTOR Barnard & Tiffanv VALUE $ 2�7,��.�0 � aP 116-200-9 s�ocK rRncr tnraaP & Li�ht P4ynu£acturin� GROUP �.Z TVPE Iv ZONE M'I FIRE �ISTRICT in%� INSPECTIONS Footing Trench Foundation Forrt�s and Grade to Rough Framing ,� Plumbing, Rough to SI Plumbing, Rough Complete Temporarv Pole Heating, Final Sewer, House Sewer, St. Septic Tank or Cesspool L '�g, In Out F. .ering Plumbing, Final, Fixtures Complel Plumbing. Fin.al GasTest Wirino.Final n DATE � SUBCONTRACTOR PERMITSISSUED DATE I NUMBE � (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesaEc��TRICAL PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: Suile No Vicinity: Parcel Nunmber: Applicant: Address: 660 W 17TH ST 39 42428123 WILLIAM BEES Phone: B00-608-4683 Z�P- <� , � . � � .. ��. . Owner. PACIFIC MESA P,,ROPERTIES � �� " Address 670 W 17TH ST SUITE C-,4� _- - � -- ' � - ' Phone � . ` ,. . Stams: ISSUED Applied: 08/18/2005 Issued: OB/18/2005 ISSUED BY: �n� a; i COSTA��.MESA, CA � �. � ��'� - "-rZip: ;'�92627-E �'�'-' `° � - ' Contractor:"'y ACCESS CONTROL INC `� " Address:'' 272 VIL[ANOVA RD � ` -" """ . � � ' - - ' f . _ � Phone: 714-655-7192 . . � �, � ; .-,COSTA MESA, CA Zip: _�92626 , . � � " License:833018 , � . . � �� =� . . .,� . .. . _ `_ - - t. � � .. f �, � � ; ` - � ,. ;� SCOPE_OP PERMIT �,. � � � � � INSTALL 1 QONDUIT�AND 1 OUTLET FOR "URBANISM", NO OTHER WORK�IS AUTHORIZED BY THIS� • .. .PERMIT. ,:,>: � . ` .. . . � 3; � � � FEE SUMMARY � `"s� �� fi � � �'-' � ,. .�. � ., � ;, � T , . Quantiry.� , r Duanhty ( e, ISSUE FEE ;$23 50 ,: Temp`Dist System / Lighhng z`�, $0.00 !• 0 id, , �-�P;; Tem'p service test ' ' $0 00 � :;_ � . _., -8usway 1100 ft ,�,�, " $0 00 ' � 0 , � Res. a/c'package a� $0 00"�� 8landing Section :,x. $0.00=��'�+ 0= �� - New Res (1-2'unAs)` � ' � ' �$0 00 F 0 ^ Misc Electriral Equipment _ , $0.00� 0 „ , , New Res�(3+units) _ ��$0.00 �" 0� �,,:, ,,� �� •"'�Trensformers up to 1 kva/kw - �80.00 � 0 . � � � , . � Li htin F „:. `��:$0.00 .� � 0;: �.-� � . . ;� ' � � . = p to-10;kvalkw . Pool/SPa�; ;_ ,-, u .��Ov .-� .. .." "` $0.00, g �. � 9 9 �s _ ,. ,�- -� -$0.00 . .0` ..�' --� ........:.:..up to 50 kva/kw � - � �� $0.00 0,:� � � .. Recept Outlets -- " . `;.� - $1.10 ��.:.� � 1 ................:up to�100 kva/kw . -. $0:00 . ... 0`. . . � : Switches „,, - � � � $0.00 0 ...........:.....ove� 100 kva/kw �--... g0.00 ,0- � -� , Non Res Appl . -. j�� $0.00 - �, 0 Low Voltage-Equipment � $0.00 " 0�� ' Res Appl . ' ,'�.' � �. ; ; $0.00 .. . t . 0 Low Volt Wiring System / Ckt �$0.00 �. 0 Service to 200a :, $0.00 t 0 . . Misa Conduit 51820, ;�' 1� . _ Service to t000a� '-^- � �'$0.00 � ' 0 -; e. �'x � i,',' Misc: Conductor ' 50.00 "�-�-° 0 . - Service over 1000a � $O.00r _, ; 0 Circus ( gen'o4ride) 50.00 ` 0 � Motorstothp '�`�'�. $0.00'?� �..0.;� � �- '��'�Cimus(mech�rideorlights)_,, v �50:00` '0�_ ' Motors to lOhp �;,_�� ,$0.00,. �, -'0 , j, , . � ' ',,;.., ChriStmaS Tree Sland ,,;`�:;-; $0.00 0 •� „ Motors to 50hp , � 50.00 � 0 � � - � Firewoiks-Staod. �� 80.00 , 0 Motorsto700hp `� � � �-50.00� -�=,0� ' �� _ -0therElectricaiFee f�.��'r=: - $0.00� �* - Motors over 100hp "50.00 . , ' �0„ �," � ' � . , - . � . , Communication drops `� = �- $0.00� :- 0 �•= �`` �'�� ' Jnvestigatwn Fee-�� $OAO� � ` � ' Sub panel to 200a '- � .:;,50.00.,� , r� 0 �-.� ' � �.PIan.Check Fee � - ;$0.00 , Pole Light Pkg � ; b0.00 � �'. �0 . �� . �� Reinspecfion Fee �� . � $0.00 � � Sign Circuits `�$0:00� . ` i0 , � � �- .'�� `; ��'` � - Y-�. � Temp Pwr Pole 50.00. ��.- 0-�%, ,' " �. TOTAL CALCULATED'FEEB ,.542:80 �- IntermedPole $0.00�� :.��0 ��'. �� - ,��:-� ,y ,.. -� �:: � ,wP s S� .� � .. l �� '�� .. . 1 �� NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (OrU. No. 92-28, § 1, 7241-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspen0ed or abandoneA for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legai, sueh work must comply with all applicable codes, and alt requlred inspections and final approval must be obtained. Failure to obtain inspections anA final approval will result in the expiration ol this permlt. FOR INSPECTIONS CALL: (7/4) 7545626 ris� -,:�i .rm WOHKERS'COMPENSAnONDECLARAnON: ' I hereby eHirm under penalty oi perjury one of Ihe I011owing declaretlans: ❑ I have and wlll malntein e cenificete of consant to self-Insure for workers' compensellon, es provided for by section 3700 of the Lebor Code, lor t�e paAormence of the work tor which IhiS pertnit is luuetl. � ❑ I have and will malntein workere' compens9tlon insurance, as requiretl by secGon 3700 oi Ne Le6or Cotle, tor Ne peAortnance of the work iw which Nis permlt i� issued. My workers' compe n Insurence cartl en I number are: Certier: �'e (�r � Policy Number. � (This secNon need nof complered il the p f s veluetl at one hundred dollars ($1 J oi less.) I ceniry Ihat in the Deriormance of a worK �or w�lch this permit is issued, I shall not employ any person in any manner sa es to become subJecl lo Ihe workere' � compensatlon laws of Celifoml entl egree Ihet tl I shoultl become aubJect to tha workers' compensation provislons of Sectlon 3700 of the Lebor Cade, I shell torthwllh comply wilh these provi5ions ///��/ /// D 7_ �AppllcantSignatura: �/� J/// — � Date: � �p v/�� WMNING: FNLUfiE TO SECURE6YORKEFIS' C ENSATION COVEMOE IS UNIAWFUL AND 5 SUBJECf AN EMPLOVER TO CRIMIN .W�TIES M1D GVIL FlNES UP TOON NUNDRED TIIOU,WJD OOLIARE (5f 00,000�, IN ADDRION TO THE �T OF COMFENSATION, DAMAGES AS PRWIDED FOR IN SECiION 31080F TME �P ODDE, INfEAEST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby a�rtn thet I em Iicensetl u er provlsit torce antl eNecL Lic. # ContrectafsSigneture: �/l.i,. of Chapter 9(commencing with Section 0) of Division 3 oi �he Business and �P.Jofessions Code, end my Iicense Is In full / Class x � / iJ Dale: � P J _ _ T CONSTAUCTION LENDING AGENCY: ❑ I hereby effirm ihat there is e construction lending agency tor the peAormance of the work tor which Ihis permit is issueC. (Sec. 3097, Civil Cotle). Lendefs Neme: Signeture: _ OWNER•BUILDER DECLARATIONS: Lende/s Adtlress: �ete: I hereby aHirtn thei under penelry of perJury that � em EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ihe tollowing reasan (Sec. 7031.5, Business anA Proles5ions Code: Any ciry or counry w�ich raquires e pertnit lo wnstrucL alter, improve, demolish, or repair any siructure, pnor to Its issuance, also requires the appliwnt tor such pertnit lo flle e signed stetement that he or she Is IlcenseA pursuant to Ihe prodsions of the Conirectars LJcense Law (Chepter 8(commenGng with Sectlon 7000) of Dlvislon 3 01 the Busineu and Professions CoCe) or thet he or she is exempt therefrom and the basis for Iha elleped exemption. Any Noletlon ai Section 7031.5 6y eny epplicent tor a pertnit su6jects Ihe applicant to e civll penelry oi not mo�e Ihen five hundretl dollers ($500).): ❑ I, as owner of Ihe proparry, or my employeas with wages es �helr sole compense�ion, WILL DO TTIE WORK, antl ihe structura is not intentletl or oHered for sale (Sec. 7044, Business end Protessions Code: Tha Contractors License Law does not apply to an owner oi property who bulltls or improves ihereon, antl who does such work hlmself or herself or Ihrough his or her own employees, provitled thet such improvements ere not intended or oHered br sale. If, howeve�, the builtling or improvement is soltl within one year of completioq Ihe owner-builder will heve t�e burtlen ot pmving that he or she did not �ulld or Improve for purpose of sele.J. • ❑ I, as owner of Ihe pmperty, em E%CLUSIVELV CONTRALTING WI7H LICENSED CONTRACTORS to consWct the pmject (Sec. 7044, Business antl Professiona Code: The wntractors Licensa Lew tlaes not eppty to an owner of pmperty who Oullds or Improves thereon, antl who comracts tor such pro�eq with a comractor(s) license pursuant to the Contractors License L.ews.). ❑ I am exempt undar sec. Business entl Professions Code tor this reason: SignaNre: Date: Owner ID verified by dnvefs Ilcense. ❑ Yae ❑ No Driver's License No. Vedticetian of Ownership �y (type ot daument, i.e. - property tex bill or deatl): Expires: DIVISION OF INDUSTRIAL SAFEN PERMIT CER7IFICA710N: ❑ I hereby certity ihet no excavelion Ilve (5) o� more fee� in depih Into which a person is requlred to descend, wlll be made in wnnectian with work eutharizetl by this pertnit, antl thet no Duiltling strucNre, scaXolding, talsework, or tlemolition or dismaniling thereot, will be more t�an thirry-sl: (36) teet high. (Chep. 32, Gry 2, Ar12, Sec. 341, Ttle 8, Cell�ornla Atlministrative Cotle). ❑ As owner-builtler, I will not employ enyon� �a do work which woultl require a permlt from t�e Division ot Indusirial Safety, es notetl above, unless such person hes e pertnit to tlo such work trom ihe division. Signature: Date: Division of Intlustrial Satery Permit Number: CERTFlCATE OF COMPUANCE AND AIfiHORW710N OF ENfRY: I certify untler penelry ot perjury that I have read this epplication end state that ihe intormalion given is conect I egree to comply with all state laws and Gry ordinances relating to bullding constructlon, and authodze representetives of the Ciry oi Coste Mesa to enter upon the ebove-descnbetl property for inspection purposeS. � egree not to occupy or ellow occupanq ot eny building authorized by Ihis pertnil until Tinal inspaction. CODEI, INSPECTIONiYPE 1676 Fixetl System Final Fire Prevention 1266 Pool Spa Finel 200 Final Re-Rooi I201 Final BIocNJRetsfning W all 202 Final Fectory Fire Placa 203 Final Sign 204 Final Demolition �g �$ �QQFa INSPECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Finel Electncal 212 Pinel Flre Preventlon 220 Finel Planning Approval 222 Final Site 250 Final Builtlinp/Occupency PdT3 It�A4fl :Q� �/� I- �,nnnEssaew�oca: 660 W 17TH $T WRIENSN.WEIFpIQYN: pACIFIC MESA PROPERTIES �op� 670 W TH ST #C-4 C.M. 92626 �vc�. Yu� woaEss: AfICNRECT OX BRiNFEN: caxm/,crars ru�: cam�croAs �uimc AUDNE54 uM: A-20 11G NO.: UNi: uc. xo: uNr: LICENSEO COMPACTOHS OKLAflATION: I IweEy elhm uMx penely d prjuiy thm I em Ice�mA uMer pa�'via�e d CMqm 9 (mmmemiiq wnh SecUon ]00% d Drvieion 9 d Ne Busmu eM Prdmebns Coda, eM my lioema u in hA taca ard eflea. cm uc. no.: uc. cuss: uc. No.: EXP : o�a: �o��ad�: OWNEH BUILUER DECLAHATION: I hreEy etf�m uMer pmely d perjiry thel I em ewemq hom tM Comrmon lioeeue lew In Me id�:ro � �seuo� �m,s a,.:b.. �a v.a� coaa: tin on a�ur.nKn naW.. e w�e �o �wn..d�. mwo.+. ��oloh, ar repei eny vi�ucture, prbr lo ns'vauence, eho reQuiree iha epplkant lor wc� paimN to Rb e epr�eE stmemant ihm he a eM ensaA WnuW ta iM porivians d iM Coniredm Limnse faw IChepa 9lmmmeneM wnh Satlion ]W0) M Divebn � d Ihe nwsa eM Prdeseone Gada� rn tlw M or eM ie eiemq IM1xahan aM �he Dmia lor IM dleqed exempibn. My volelian d Seabn ,w�.s M d+rr eoW�� u e o«ma wbi�+ �na y,d�u m e aw ae�n d m m«s men ri.e m,ne�ee mum. �.wop. � I. m owror d iM popenYa my emWop� x'th wepe� m thai eds mmq�umion. v.ill Ao Na wk. eM Ne aweiure e ew� intanded a oneiad br We lSeclion)ow.8w'viev end Pmlmdom Code: The CaNreeaa Liwme Lewtlov nd MNY lo en ownard poperly who WiE� a inpw» tMimn, uq xM doee suM wark Nmwtl n MnN a thraph he or Mr own empbyw, provNaA ihet auch improwmmb ere mi iniendeE a dlxed la ede. tl, howaver. �M WiMirq a inprrnanm� u eotl r.iihin one yeer d mmpinion, the o..�«-wad.� w�n n,� mo n�,a.o d o�mu na o, .ne ab �a wne o, �mo� �« ine wm�e a we�. � I. d owner d the poOeM. em udua�+h oontreaYq v.nh IicanaeE canvenon io eannrua Ne pMb (&eaion'lOL1. &nine» enE Pmlesscm Code: The Caqratlan Leeve law Em ml eppy w en owner d popeny Ma dtitls a'vnpwm tMnm ud who convern M atl� pqwe vAth e mrpredor(a) fcemad punuvu to ths Ca4rapae Liwnae Lewl. � ��e,.ma�e«s«��,:BP7044 B.BP.G..farNisn o:OWNER BUI D v, a�,: � eo �eM uner uw � em e.u. w ena wdentena m. na��«v, d c.uomi. Ne.nn n a�r coe. s.eiae ssm. nsv..m . ud thm I a ury Muro buiM'uq omiper� will / wil ml (aeeb me) � lo eampty w k siete eade md �he mpu'uemend M aromtill«wuwetion«modAratianhantheA'r�ty enpemeni0ivrie.RuidaaialmeutvaionePO�broenazemNlmniM�e oele: AVWicem: WONKER'S COMVENSATON DECLAPATION: I Mraby effirm vMer penalty d psjay ans d Ihe Idbwi�p Eetlaietnns: � I hew aM wil meieuen e cenTctle d rdean� �o �Nlirmurt br r.vrken' oompe�uetion. m povkaE ta by Swim 3]OG d �M lebor coea. �w m. vMamerce d m. xvM �w whcn ml. v�n u u.uee. � I have eM WII meintein waAert mmpenee�ion ineurenu, u reQuirad by Seaim 9]00 d the lebor Cade, br the peilo�menw d �ha work la whiM Nb pe�mii u hsueE. MY ��' �^Ve^�� inwrance fertis and pdiry number me: c�,: Pdry Numbr sseiai naw �m es cano+aroa r tn. v�• e ror a» wnena dwan /stool a we.) � I mnN �hel in IM pedomunu d tM work lor v.h'rh ihia permil i� inueC, I ehNl nd empby vry pemn in eny menner eo m lo beeome w4w �o �he woekere' mnwmeiion lewe d telilanie. end eurea tlw tl I Mwk baconr abNd io tM wYen• compenution pwiauro d Setlbn 3)00 d ihe lebor COEe. I ehell lonhwil� mnpy xilh Ihom prwidaro. Dele: �Dd�� Weminp: Fellun b s1eun woMr�ri eamplruetlon rownps l� unhrvful, �neaNll w!/�ef �n employ�r ro erliNnel pMuMu �ne clvll Ilna ,p ro m� M.ndiM fhouund JN/an (Sf00,0a0f, M etlJltlon ro tlN cwl ol nmpHuetbn d�mep+ u prvvlWd br In 9�c0on J106 0l M� G�4orCOM, Inf�q mC �ttomry i Na. CONSTHUI.TON LdDINO ROENCY: I M�eby dfirm uMx penelry d perjury �htl �Mn o a m�ut�uabn bMinp pency fu Ne peAormuxa M tM xak M xfiitli Ihe psrmi u ceuaE (�� . Civ. CI. LENDER'S N4ME: LENUEN'S AOUNESS: I cMily ihm I havs reed Uu appficUbn uM tlele IM1tl Ns ebae iNamNbn b cmW.l pras b canp�y wilh M tiry eM cwMy pE'vwior aM �We lewe reWi�q b buJCiq eonmWion erd Iwsby aWiores nprseen�eYva d Ihie tily lo enler upon iM ebo.e�mamuned peopsrly �«��'�'�"� SUSSAN GABRIE� Dme: � �� / v (St51J0.WP) Whito-BuilEip 6 3e1ery; Oreeo-Fla; Cenery-AppliceM; Pink-Ravenue; OdEenrod-Nuewr ._... �_,,,:,� CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO: E 075932 PLAN CHECK NO: N CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE JOB DESCRIPTION : ELECTRIC METER CLAIM VALUE: CALC—VALUE: PERM NO: E 07593 GOVT: N SUPP; N PURPOSE: OTH SQ FT: GROUP OCC: B / COMMENTS: X �rieieie*ieatatitat*at��ititit*ititet�titit��*it*it�itatatatit****ir�rie***�tatx�itit***iF�**ir**�E+titx�*+e*ieif�tat�*it*ieirif 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 --------- 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> � "� I iF iFlE i! M 1k if fE 1F iE if iE 1E ff M it iE 1E 1E iE 1E M 1k iE iF iE 1F 1E it iE,iE iE ff iE 1E fE iE iE ik 1E M k fE 1E 1E 1E 1k iE iE iE iE 1E 1F 1E 1E 1E rt iflf iE iE iE 1f 1f if if 1E IE 1E 1E it 1E iE ib 1F 1E iE 1E iE 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: HUILDING APPROVED BY c "�i DATE: f � APPLICATION ISSUED BY: � /.. ' ********��r*x�*x�x�x��x�x�x� LEGALIZATION:N F fi E S U M M A R Y BLDG PMT PLUMBING ELECTRIC MECHANIC PERMIT 18.50 � 50$ PLAN ISSUE FEE 15.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTALS----> 18.50 15.00 0.00 REVENUE DIVISION TOTALS--> COLLECTED: BLDG PMT PLUMBING ELECTRIC MECHANIC 33.50 FIRE STRUCTURAL SEGMENT:N SMIP/RES GRADING SMIP/NON—AES TOTAL PAID DUE 33.50 33.50 .00 33.50 OVER/SHORT: ,00 FIRE SMIP/TOT GRADING PLAN—CHECK 1E IE 1E 1f k 1E 1E 1E iE iF iE iE iE 1f if IE if Ik if iE if 1f k if 1E iF ik 1f iF iE IF iE 1E Ik i(� 1E 1E iE iE k 1E 1f 1k fE 1f 1f iE M 1f� 1E iE iE 1E 1! 1E 1F 1E 1E IE 1E 1E IE IE 1f IE iE'IE if 1E iE ik 1E IE iE 1E 1E 1F 1f 1E I N D I V I D U A L F E E H 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 SERVICES BELOW 600 V 6 BELOW 201 AMP 18.50 18.50 END OF FEES ti1 OV: ".�' � j�"�n:19R! ��% IT.� 7 �y 'f� OP:E' �7 .i - -Z1'' i•,,..:;u CQNSTRUCTION AND PLANNING :: � POOi �VA APPROVALS Permit# Date Inspector ' AppROVRLS Permit# Date Inspector 1. Temporary Electrical Service or Pole � 52. Pool &' Equipment Location 2. $oilPipe�Undrgmd. �, 53. SteeiReinforcement � c3.�E}ectrical Conduit Utility-Undrgmd. 54. Forms � : �'4_,Efectrical ConduibUndrgrnd. � 55. Electrical Bonding �%�� ..�5;-,Steel Reinforcement o 56. Rough Plumbing & Pressure Test � �;L;�lectrical UFER Gmd. ��' S7. APPROVAL TO COVER�GUNITE ��7'. Footings 58. Electrical Co�duit�Undrgrnd. `- �_,8� Foundation 59. Gas Pipe, � Undrgrnd., Test - � �� ..5.' Water Pipe�Undrgmd. 60. Backwash Lines, P-Trap, O Undrgrnd. �T'0. Structural Floor SYstem ,.., 61. APPROVAL TO DECK � �1. Property Sewer Line & House Connection S �62. Backwash & Receptor-Final 12. Sewer Cap a 63. Heater & Vent-Final 13. Roof Orains a � 64. Plumbing System - Fina� � 74. Rough Plumbing -7 "? 65. Electrical-Final H 15. Rough Electricai-Conduit '3' � 66. Solar SYstem-Final 16. Rough Electric Wiring 67. Fencing & Access Approval � 77. Rough Wiring Sign 66. APPROVED FOR PIASTERING , J 18. Raugh Electrical-T Bar Ceiling 69. POOLlSPA SYSTEMS FINAI ' 19. Rough Heatin & Air Conditionin F ^ � n� r�� , n v.� �n �x � �. LR��PT.�3EQUIF�EMENT am �t� • � a,: > »� o , x i �, 20. �ough F�tor�Fir'�J"�ace , S.m �,� r r � r� APPR,AV��,.,.. Pe�mit # -,-. 21. Duc[3^inStruEtur¢'1'r •• •• �-+F M = � H:� t� 70. bnder§"��nd HJdro 22. Ducts; V�dtila��ingvx i �� C � n F�� •� �� Produ L PjPing � 6as Cyl Oil 23. (a�as P�pe-Rouq6 & Test n �s .�l c' �� '- � 7z, Undergrourid F�a9h ' E" � �-� m c 24. Roof-Fra`inM . `" � �:; " �''t'' ` � 9� F � E F � r � r,> :7�.y UndergrrY"d.Stor�ge7ankKOGas ❑Oil �25. Roo�;She Shing n d e v�.} � C7 p Na 7�r Overhead Hydrp-, � � m ^� Y t 26. �-Ba"r�eiling (Struct�Urap & td'o��d-�r.oat � ` .�C, � '�-'�'�� 7� Dry Chemical ;..,� t � - 27. �ameand,Fiashin9 t _'�a:c *[' ?+ c_* 76. Dry StanBbfpe v� �' u = a n �. -�28. Lsttiing &$iding '. �'-' y""� � � � ' 7� FIXEO 51'`6TE{�P �NAIe � t :k ,.�. G I •�`* 7 � H iTJ >: �' r-1 .... w �•f - � "_ 29. Insulatioir. x S • � I �k 7;. FIRE PREV. Flf�f�L �` � T30. OtY'Nall IV2ilin9 'x H � �; r, I � .r�.� ��HE�ALTH.''DEP�.`NEo-P.11R�EMENT ;31. PlasterBr,own�at a�.' i r�t� �'� i rx.'79�FINALII3SPECTiD(V � v 3 - �-.n r ';32. Electriwl�ow,z`Y, Mef�h'r��i�al i ' N �` ` 8(�''.� FOOD CERTIFl�FiTE I�S�lE�; p ' .,. > , �t�Q� ,•. _.:. � 33. Fjnal:Electric-� * ;,7 i e; t � N6tez -,�� ^:r-; �r �f O , � '-34. Final'�-leating'8i Air �ondrtioninFj:>' !� * ^ ' �X �.' ' ' i1^� '� =' �., 4;n *> *c rn�r� oi F-C z 'o� '*' - ar �< � .. >, ��,� -,� .• •35. Ftna�'ias Pipe�Test � � : r, .� I ,^C Gti * .' .�36. Hood or CanoPY ' '� � ' �'"y o "�'^• � .� � :^c a ^':: � I i"�iT /l T i�i �O 'S T �l 1 =37. F:fna�Factory Fireplace x � ;;F o � � '1 � x � "t� .,. �-+38. Final'flumbin " ��% � o x ' �' S �-+ �� =� � �� 9 .. ,T p .�. i �c t; r+ cC '" ' 39. Wate� Service-Final # r ,,. � � �;; , ` � �� , f �. � .;r�40. G�s Service-Final �;�i r:tT�t' Y tT1 � O'.� ^�Ci .+. � o' < � F�. ,� F• o E x�t s �41. Solar �omesticFi�a� =' '�.�,� ' �. � � � i,. y� a �; ;Y � T� � �42. Backflow Preventer � �i � =�' �f^ � � � -. t ^. u ]. .,-f � LTI ir; l� h' L. 43. Backflow Irrig�Cion � ;,,SS y; � W; it' .. "-i 44. LandscapellrrigatiomSysiem Aa1CJ �: :r G� O C O-i' N N '•'�� Y� � �� ^� m r' d i: ; �; W O w � S x HQF C' �E F H n��.� r. r� � � .n 45. Spund AVen4dtion ; �.. .. � n tr". T C Q• Fc "� � 46. Hdndicap�Regulationc r, O r• � x t^ 5 7e S t+ �- v c hk ^ -: i fi C". 4�. �INI� STRIfC'TUR.F� & BUIL'DING �; E., I- rr � N � C s F 48. FIN,AL PLANNING � � E-�E, x n% �� n n; s * t. � --_ 49. Electne Release to E�ison �� _ �i�; � ^ � .r. x ' �, � T � , .., ^ 50. Gas Release to Southem California Gas Co � � r, -• n,r, c � • r v :J v 51. CERi1FICATE OF OCCUPANCY' � � •' � � ^ R - `� No. Date . A�P��wnt to fill in a11 spaees exca0t t�ose wHhin haavy borCer iines anE sign all approD��ate Oaclantions. � PERMIT NO. TRACT N0. LOT NO. UN NO. CITY�!�F f TA MESA CO.NSTRUCTION PERMIT A.P.3W zo�a P t�FS� %�,O � /7t:j � /f�� S Main Building: Accezsory Building: � !L � 6 ,AppliCa�('S Mailin/g �AGdtl�r¢55� TVPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR Owner'S Nem¢ �`"'� y� � �hone��'�� CONVERSION ❑ DEMOLISH ❑ OTHER B Front N �t DESCRIPTION OF WORK/USE OF BLDG. A Rear Address TYPE OF PERMIT GRA�ING FOUNDATION STRUCTURAL C Righ[ N Arch/Eng, License No. K� G Addfe55 �",�� /f //� ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHFNICAL g� Left \/,.lc:i � lJIU Q� —I��T ❑�OTHER 9 9 Q R Contractor's Nem Phone P�^ Ref� �' Perkin Re /Provided E �� Z� ��i�,��,y p� PROJECT DESCRIPTION So. FT. oCCVPANCv Plannin Notes: � Address Imailingl � 9 M 3Z4�q CONSTRUCTION TVPE VAWATION S Ciry Licpnse No. T ZONE GRADING CU. VOS. ACRES S LICENSED CONTRAC70P DECIARATION I �ereby atfirm that I am licensatl untler provislons of Charler 9(colnmencing Remarks: with sec��on 7000) of Divi57on 3 ot the Buslness anC Pro/essiops Cotlo, and Ty IIC¢nSC IS IO fpll }OfC¢ d =ffGt /I��rk� oG ELECTRICAL fEES LJcensc �I s Li No. Y� �Gcp IQ � PIUMBING FEES P�utomatic Washer Transfarmer � 15-50 KW Dale 99�ature �� WORKERS' COMP NSATION OECLARATION ConStfUttion PoleSub. ❑ 50+ KW '•eby aftirm tnat I have a certlficate oi wnsent to selt-insure or a certificate Bar Sink ShOwC�s �orkers' Compensation Insurante, or a certi(ietl copy thereot (Sectlon gackflow Preventer ServiceSink CoOking Unit Meter ❑up toill0amps '$' J. Leb. CJ (�� /� . Polic No. WP�'�9��-P'� Compan �'^"-'u� �N` Qz�a��.F"IJ°" �ishwa5her Meter ❑over 100am s v Y � Backflow Irrigation Sewer (:ap . P 8 Certiy�eA copy Is hereby turnishetl. 1C. 1� I�— • Oryers �Gas ❑Elect�ic Sub Panel � � Cer i¢tl co 5 filetl w"th the city Builtling D' io . Bathtubs Sewer Connection Date Appiicant � Fan Motors �41 HP 1'h - 8 Q EXEMP7�ON FR M WORKERS' COMPENSATION OECLARATION Clarifiers $plaf CoileCtofs less)5 ��"on neetl not be comDletetl i( the permit is for one nuntlratl (5300) ar Dishwasher Saiar Piping F•'4•�� Inc. Solar O&15 HP �1615+ I certitY that in the performance of t0e work for which this permR I5 i55ued I shall not amploy any person in any manner so az lo become subject to tf�e Drinking Fountains Solar Tank F�xture5 Miuowave WO�ke�S' COmpenSdtiOn �aws of Calltornia. Device Boxes Data Signature Floor Drains Swimming Pool w/Spa Pale Light NOTIC�; 11, after making this Oeclaratlon, you 5hou10 �ecome sub�ect to tna Outl2ts Workers• Gompensation provisions ot the Labor Cotle, you muit fortnwlth Flpo� Sinks U�inal Rtng¢ comply with sucll plOviSiOns o! this petmit Shdll be GGGTetl fevokBtl. SWItCh¢5 CONSTkVCTION LENDING AGENCV Gas$elVice OuNetS WeterCloiet Sign I hereby aliirm that [nera is a conitruttion lentlin9 a9ency for the pertorman<e of tha work for wnicn tnis permit is issuea (5ection 3097 Civ. CJ Interceptors Water Heater Garbage Disposal Standing Sections Lenaer•s Name Generator �0.5 KW �5-15 KW Trash Com cmr Lontler'y Atltlress Kitch¢n Sink Wet¢t Service � � OWNER BUILOER DECIARATION I hereby afflrm inat I am exampt irom Ihe Contractor's License �aw for lhe l.avatO�ies AutO-Weih tollowi�g reason (Settion 7031.5 BuSiness anC Prafesslonal Coae: Any city or countY which requires a permit to canstrucl, alter, improve, tlemolisn or repalr P-Trap Laundry Tre'ys any sV��ura, prior to its iszuance, alzo raQWres the applicant for sucb permit lo tilo d slgnetl statament that he/iha ii Iicensatl pursuant lo the pravl5ions o( ROOf D�ainS the Coqtractor's L¢ense Law (Chaptar 9(commencing witn SecUon 7000) 01 �•ISIo� 3 OI lhe Busine55 antl Pro�eiSiOns COtlO) o� Ihat he/Slte I5 ax0mpt ReihSpeCtion FBB $1$ ISSUB FB9 s 4 etrOm and the basis for the alle9o0 exemp[lon. Any violation of Section 1.5 by any applitant for a Oermlt SUD�ectS tna appllcant to a civll alty of not more than tive hunaretl tlouars (E500). - DEVELOPMENT SERVICES REQUIREMENTS: b 1, as owner o� ihe property or my omv�oYoas with wa9e5 at thelr sole ReinspeMion Fae $15 Isue Fee $ 3 ZoninB Approved By cnmpoqsation, will Co the work, an0 tha sVuctura is nol Inlentle0 0� ofte/ntl DetB tor sale (Section 7044, eusinoss antl Professional Cotle: Tho Contractor's • MECHANICAL � FEES Building Approved By License �aw tloes nol apply lo an ownor of a property wno builtls Or Improves Date �.A ther¢or1, antl who DoeS such work himsel//nersalt or Ihrough his or her own APpliration Issued By � y7 employ ecs, Provitletl that su<h improvements are not in[entletl or olleretl /or BoilE� HOod or Type I ❑ Uatu sale, I1, howaver, lhe DuilCin9 or improvement is soltl within one year ot com- Canopy Type II ❑ SUMMARV OF FEES pletlon the Owner will hava lhe burtlan OI provin9 ha/S�e tlIC not 4UIItl Or im- Duct - Under Ground nrove �or the ourpose of uio). BUILDING PEFMIT $ SMIP $ � I, aE owner ot tne Drooarty, am extlusively contractln9 wfth Itcensotl con- Duc[-Str�ctural Re(rigeretion SysTem P�p.N CHECK $ PERMIT iractorS to tonstruct the Droject (Section 7044, Business and Rofeszlans Cotla: The Contractor's License Law does not aDO�Y to an owner of property who Duct - Ventileting �6100,000 BTU ❑100,000 BTU PLUMBING $ ISSUANCE $ builOs or improves thereon. ana who contracts �or such oroletts with a con- ENERGY P.C. $ tractor�s� Iicen50 purSUani to ene Contractor•s Llcenu I�w). i am awaro thac Exheust System ❑ Multiple ❑ Syztem RepairlAlteration PLAN CHECK 25% $ proot p thair Worker•s Compenvtlon insurance shoultl be provltle0 to me. ELECTRICAL $� GRADING $ ❑ 1 am ezempt untler 5ectlon B. & P. C. for tnls reason Fir2pl/Fett. Blt. �CBO # Fir¢ 08Tp¢rs PLANCHECK 50% $ MICROFILM $ � Date owner Heating System & Ducting Registers MECHANICAL �__� I heraty certify that I have reatl Nis aoP�ication antl state that the above ❑0-100,000 BTU 0100,OOOBT $ TOTAL FEE $ �� informatlon is correct. I agree to comply with all city antl county orUlnances ' PLAN CHECK 25% $ antl 51a(e laws ralatin9 to builtlin9 constructlon, antl hereby authorize re0re- santatives ot lhls city }d2nier upon the above-mentionatl property tor • Inspett{on purposes. /�J � 2-3-�I Sl9nat4re ( f%T� _ _ oate Drtvars• License o 55 Reinspection Fee $15 Iswe Fee $ 3 O3 GQ025705-Qt1025705 7n'a- ao r.n oaes-ab, re�. s/as Whit2 - BWltling; Candry - AppllcanG PInK - ACGOunting; GoltlenrOtl - A55¢Sio� uHlt� :1"L/O.i/$9 TIPIE: 14:08 v'�'\ . J �.' - � � ♦ . .. • , .. . i' . ♦ � \ 1 •. � CONSTRUCTION AND pLANNING POO ;PA � �PROVALS Permit� Date Inspector qppROVALS Pe��nit# Date Inspector ! � 1" Temporary Electrical Service or Pole , 52. Pool & Equipment Location . Soil Pipe-Undrgrnd. �;. 53. Steel Reinforcement 3. iElectrical Conduit Utility-Undrgrnd: 54. Forms 4. Electrical Conduit-Undrgrnd. �_ � � 55. Electrical Bonding . ' 5. Steel Reinforcemerit " . 56. Rough Plumbing & Pressure Test '. � 6. Electrical UFER Grnd. '� 57. APPROVAL TO COVER-GUNITE '7. Footings 58. Electrical Conduit-Undrgmd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test �� 9. Water Pi e-Undr rnd. . �� P 9 �; �� 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 Orains - 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 �7. Rough Wiring Sign 68. APPROVED FOR PLASTERING �1,8`. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19 Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplacp APPROVALS Permit # '21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush � 24. Roof Framing 73. Undergrnd.StorageTank OGas OOiI 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT -31. Plaster Brown Coat 79. FINAL INSPECTION 32.' Electriral Power Meter-Final .6 8 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 47. Solar pomestic-Final 42. Backflow Preventer � � 43. Backflow Irrigation .' 44. ,Landscape Irrigation System � 45. Sound Attenua[ion � � 46. Handicap Regulations .,� � 47. FINALSTRUCTURE & BUILDING f / 48. Special Requirements Cbmpleted ! ' i 49. Electric Release to Edison 50.�Gas Release to Southern California Gas Co ..• '� � 51. CERTIFICATE OF OCCUPANCY . . -. " ' '� 1 No Date :_ � i . � ^i � Applicant [o flll In all spaces except thosa within heavy EorCer linas an0 sign all ap0�opriate aeclarations. CITY OF COSTA /MESA ,CIO,N�RUCTJ�I PER�I� PER�NO� TRACT NO. LOT..NC` - UN�,NO�T q.p, # Projecl Addrnss rT��i� W/� - (� � � ��aCJ TVPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR' S Main Buildi Applicant's Mailir.y Address E Front ❑ CONVERSION ❑ DEMOLISH ❑ OTHER T Owner's NamL�� '�q Phone f�� DESCRIPTION OF WORK/USE OF BLDG. I A Rear Address _�t_g- Arch/Eng. LlCense NO. TVPE OF PERMIT GRADING FOUNDATION STRUCTV RAL � K Right Addre55 ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL g Left Contractor's Nam � 5�� Phone E'y �� OTHER P�ng. ReL # Address (mailing) �'� �'�v� N' PROJECT DESCRIPTION 5�. FT. OCCUVArvcv Planning Notes: �l qOy CONSTRUCTION TYPE VALVATION $ CityLicenseNo. v� � ZONE GRADINGCU.VDS. ACRES LICENSED CONTRACTOR DECLARATION 1 nereby affi�m tbat I am licensetl under provi5iOn5 ot Charte� 9(commentlng with section 7000� of DiviSion 3 Of the 8usi est antl PrOf¢SsiOnz Cotle, antl my lirense is in /uu Orc� ntl etfett. s/ Licen �CIqd5� � 5e No. �� Dale��Y� $i9nature ' WORKERS' COMPENSATION DECLAR TIO S,_ �reDy aftirm [hat I havc a certificate � consent ro self-insure or a certificate jE„�i'?;,Norkers' Compensa�ion InSurancp, � a wrtifietl copy the�eof (Settion .��i.� b, Lab. C.) Policy No. Company Certifietl copy is hereby fumishea. Certifietl copY is tiletl with Ihe'city Bulltling Division. �a[e Appli<ant E%EMPTION FROM WORKERS' GOMPENSATION DECIARATION (Thi55e[lion neetl not be complel¢tl ii Ihe OG�mit I5 fo� One huntlretl ($300) or less). I certify that in the per(ormance oi the work to w ich t Is perm�t is issuetl, I shall not mploy a person in any man er 5 as come subject to the Worke ' r�0 � Laws ol Cali(ornia Date Si9nature NOTICE: If, a er m kln9 this tleclaration, ou shoultl become subject to the Workers' Compensation provisions o( [he Labor Cotle, you must forthwith mmpty with such provisions or inis rmit shall be tleemetl revoketl. CON57RUCTION LENOING AGEryCY I nereby affirm Ihat there is a cons[ruCtion lentling a9ency for the performance ot the work for whiCh this perrriit i5 ISSuetl (SeCtiOn 3097 Civ. C.) Lentler's Name Lentler's Atltlress OWNER BUILDER DECLARATION I hereby affirm that I am exempt trom the Contractor's License Law for the following reason (Settion 7031.5 Business antl Protessional Cotle: Any clty or counly wnich requires a permit to construct, alter, Improve, Oemolish or repair any slructure, prior to Its i55uanca, dlso requirez [he applicant tor such permit to tile a signed stal¢ment that he/She Is lit¢nsetl purSuant to th¢ P�ovi5ion5 of the Contrac[or's License Law (Chapter 9(commentin9 with SecHon']000) of ^�vision 3 of the Business antl Protessions Coae) or that he/she is exempt re(rom an0 the basis for tne allegetl exemption. AnY violation of Section I3.5 by any applicant for a pprmil subj¢Cls Ihe applicant [o a civil ��alty of not mare than five huntlretl tlollars (E500). ❑ I, a5 owner of the property or my employee5 wi[n wages as their sole tompenzation, will tlo the wOrk, anq the St�ucture is not int¢ntletl or otfe�etl for ule (Section 7044, Business antl Protessional Cotle: The Contrattor's License taw tlo¢s nol apply to an oWper of a property who builtls or improves [hereon, antl who doe5 such wO�k hlmself/hersalf or fnrough his o� h¢r Own emO�oYeeS, prOvitletl [ha[ such ImOrry�Cmenis a�e �Ot Intentletl o� otfe�eC to� sale. It, however, Ihe bWltling or iTbrovement IS soltl wlthin one year of com- o�etion, tne owner will have the burden of orovin9 he/she tlitl not builtl or Im- p�ovG 10� lhe purpose Ot sale). ❑ I, as owner of the property, am exclusively tontractin9 with Ilcensetl <on- tractors to construct the Project �Sec(ion 7044, Business antl Professions Cotle: Tne Contraccor's License l.aw oes not apply to an owner oi property who builtls or improves thereon. antl wno contra<Is for such oroie<ts with a con- 'I tractor(s1 license pursuane eo �ne Conttacror•s Ucense Law). i am aware that proof o{ their Worker's Companzaqon inzutanc¢ zhoultl be provitletl to me. ❑ I am exempt untler Section 8. 6 P. C. tor this reason - Date Owner I hereby certity that 1 have reatl lhis application ana state lhat the above information is correct. ree to comply with all tity antl county ortlinances antl state laws rela mg to IEing Constructlon, anC hereby au[borize repre- senta[ives of his ily On tb¢ aoove-mentionetl pr p rt to� inspection pur ose�( � 8 � Signa[ure �� Date �P Drivers' Li o 55 # �- Rema�ks: Backflow Prevenrer Backflow Irrigation Bathtubs Clarifiers Dishwdsher Drinking Fountains Floor Drains Floor Sinks Gas Service Outtets Interceptors Kitchen Sink Roof Drains Reinspection fee � $75 Boiler Duct - Under Ground Duct - Strucaral Duct - Ventilating Exhaust System ❑ Multiple FirepVFacL Blt. iCBO # Heating System & Ducting ❑ 6100,000 BTU O 7 00,000 Reinspection Fee � $15 0865-46, rev. 5/88 White - Buildinq; Canary - ApP�lcan[; Pink - Accountin9: Goltlenrotl - Assessor $ItOWClS Service Sink Sewer Cap Sewer Connection � Solar Collectors Solar Pipin9 Solar Tank Swimming Pool w/Spa Urinal Warer Cioset Water Heater Water Service Auto-Wash Laundry Tra'ys Issue Fee Hood or Typel � Canopy Type II ❑ Fefrigeration Sys[em �6700,OOOBTU ❑100,000 System Repair/Alteration F ire Dampers Regisrers Issue Fee FEES Automa[ic Washer Construction Pole Sub. Cooking Unit • Dishwasher - Dryers ❑Gas ❑Eleo - Fan F.A.U. Fixtures Device Boxes ✓ f Outlets Switches Garbage Disposal - Generetor OPS KW C Zone Accessory Building: Par ELECTFICAL Transformer ❑ 75-50 KW ❑ 50+KW Meter Llup ro 100 amps Meter ❑over100amps Sub Panel � Motors�0-7 HP�iX-B Inc. Solar �9-15 HP �16-15+ Microwave Pole Light Standing Sec[ions 15 KW Trash Compacmr Reinspection Fee $15 luue Fae $ 3 DEVELOPMENTSERVICESREaUIREMENTS: 2onin8 APGroved By FEES 8uildine APProved By - Aooliption Issued Bv � $ 3 N I N G R E Q M T S. FEES SUMMARY OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK 25% $ ENERGV P.C. $ — ELECTRICAL $ �� GRADING $ PLANCHECK 50% $ MICROFILM $ MECHANICAL $ TOTAL FEE $ �� PLAN CHECK 25% $ __ _ 02 4U0'+i`'L7-U�031507 TCtg k4,�� OA'iE: Q4�2c/89 TIftS: 14:4: CONSTRUCTION ANDPLANNING POO 'PA APPROVALS Permit# . Date Inspector AppROVALS Permit# Date Inspector .c 7. Temporary Electrical Service or Pole ' r„ 52. Pool & Equipment Location : �.. 2. S9il PipA-Undrgrnd. ��. 53. Steel Reinforcement " �-' 3:,�Electrical Conduit Utility-Undrgrrid. �• ' 54. Forms � �' .. 4. Electrical Conduit-Undrgmd. ° 55. Electrical Bonding �', 5., Steel Reinforcement 56. Rough Plumbing & Pressure Test - i, 6. Electrical UFER Grnd 57. APPROVAL TO COVER-GUNITE � ' J. Footings l{ '�- .58. Electrical Conduit-Undrgrnd. �, �8. ,Foundation v , .� i � � 59. Gas Pipe, � Undrgrnd., Test j" r .9. Water Pipe�Undrgrnd. ',%� ��,, �` 60. Backwash Lines, P-Trap, � Undrgmd. 10. Structural Floor System , �.t� � 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection �-� 62. Backwash & ReceptorFinal � P2. Sewer Cap ' 63. Heater & Vent-Final , •' 73. 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 � �{7. Rough Wiring Sign 68. APPROVED FOR PLASTERING 1S. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL �n 19�. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20: Rough Factory Fireplace APPROVALS Permit # 2�L'. Ducts, in Structure 70. Underground Hydra 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test 72, Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank � Gas ❑ Oil . 25. Roof Sheathing 74. Overhead Hydro �26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical :27. Frame and Flashing 76. Dry Standpipe 128. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT -, f31. Plaster Brown Coat 79. FINAL INSPECTION ;�2. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes:�_�,fi p �� y ?,'15 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 IPrigation f� - SJ ," � � 44. Landscape Irrigation SYstem 45. Sound Attenuation 46. Handicap Regulations � � . 47. FINALSTRUCTURE&BUILDING • l� 48. Special Requirements Completed �� . i 49. Electric Release to Edison �y . _ � 50. Gas Release to Southern California Gas Co �`{ 1.. �' 51. CERTIFICATE OF OCCUPANCY J` ' �- �".� No. Date •� v � �, :./ i� AOP�icant to fi11'in alt spaces within heavy bortler lines ana sign ali aooropriate aeclaratlons.'r TRACT NO. LOT NO. � BLDG: Nd. "- 1 " ' " "- - - - ' " " CI7Y oF COSTA MESA i PERMIT NO �j.�jOO„ ,5/p5/BP .' I3.00 TLi 1COP'STRUCTION PERMIT �� ' — � ', �' . . . . - _ . , . � ' ProjBtt Address � ' TVPE OF CONSTRUCTION � � • - � " _ • . ' � � ' . Ownef - -' PhOn - - � ❑ NEW ❑ ADD ❑ ALTERATION ' ' Li1n y) .. ' • . . . E'Addfe�' - � O REPAIR �O.CONVERSION ❑DEMOLISH ./� Q zONING REGULATIONS �� ' .'qrch/Eng. � � - - License No. -- - - � OTHER ' . _ . . . OESCRIPTION OF WORK A'P' � Address � _ ' " . _ _ _ ' _ . ._ _ _. _ _ . . . . . _ - " _ . ' _ - '__ . .. " ZONE PLNG. REF. � j�Conuactor ' .. L. � '-.Phone• � � TYPEOFPERM ' , •- . . - -- -` . . ._ . _ TpgU Lp .• � � �SETBAC PROPE�ftTVNLINE : Add(ess . � � . � "' � . � ",� GRADING O 'FOUNDATION ^�`STRUCTVRAL -' ;L O VqRD a � . - . I ��LICENSED•CONTRNCTO DEClA0.AT10N- ' []TENANT IELECTRICAL OPLUMBING OMECH{iNIC E - - --- . � - E �I [�E v �1 hGreby dffirT thLt 1 am Iicansetl unAer provi5ion5 of Charte� 9(Com- ' ,_ C 1 HT mancing with sectlon--7000) oflDlviSion�3�of Ihe Buslne55 antl -�•OTHER- - -� --�-- - � - Rofe351on5 Cotla, an � my cense is �� full torte��nn�� fect - ' REAR VARD (TO P/l) - �, . i . . � � PROJEC7_DESCR�PTION, _� __ - __ _ Licen6e Clas �r � � �n�e No. , , � - ,- �• � G. SPACE RE�. PROVIDEO' �Oate_ . 5�9 � "' i - /�� . SQ. FTr � .' _ _... .'_ _ � _ ' . _ _ �.PK WORKERS C MVENSATION DEC� �1 N�-- --- - � OCCVPFNCY_COPISTRUCTION,TVPE. ' STREET WIDTH y �ARK FEE E �� ' I herBby affi�m Inat I have a Certl(iWte O�conSent t0 self-Insu�O Or a� VALUATION � ZONE ZONING APPROVED�BY„ ,, �' DATE- - certifiwte of Workers'' CompmSation InSurance, or-a certl�letl copy � -- - - --- - --. - --. _ - -_. . ' ' �thereof (Secti 800; Lab. ) � . GRADING CU.rVDS. ACRES � i5PEC1AL CONDITIONS: ,.;� - p. i � �',3�•s�s-�,� �Tsr�-Fu�U �' • - " - - `9cY No. - omPanY '" ' � � ' ' ' ' ' ' ' " � :ertifieticopyl5nerebyfurnishetl..- - .- . _ �-REMARKS!'" .� _ _.. _ . - . '� tertNietl <opy Is filetl with the Uty Bulldin9 Divislon. _ . . _ , �E%EMPTION�FROM WORKERS' COMPENSATION'DECLARATION ' " "'- - ' ' ' ' ' (This settton neetl not,oe.comPletetl if the permitJs;fo� one hundretl __ . �� __ ,_� . _ _ _ � _ _ __ _ ___ ' _� __ _ �, : - �_ - _ . ; (E100) or less). t I .I,c¢rtliy,that in the.Per(ormanCe Of_th¢ wOrk tor whith this perml[ I5 issuetl. I 5hall not employ any perion in any manner So as to,be<ome PLUMBING - PLAN CHECK � � �.ELECTRICAL �� PLAN CHECK.� �sub�eG� to [he WOrk¢rSLCompensation Ldwi ot Califomid.[ _- ' -" - _ _ f BATHTUBS SFIOWERS � '� .. �i I Date Signature � . ` '- - i NOTICE: It af[er makin9 this tlecl5ra0on, you shoultl becomatsub)ect, 'TOILETS yURINACS" '-' `- "GENERATOR ' �0-11(VJ_ 1d0;KW� � to [ha bVorkers' Compensation Provisions of the Labor Cotle, you must � . � ___ . �TRHNSFORMER . _�� forthw��h comply with such provisions or this permit shall be tleemetl LAVATORIES �OUBLE'L"AVS '�APPL`IANCE � -30�50'KVJ_- 50'+ KW` _ revok6tl. " _ �.... ._.._' ' .'.._ �. . . " _ ' '._ ... . _ , . _ . ' ,: CONSTRUCTION LENDING AGENCV � KIT:S�NKS 'DISFiWA5HER5" - �- --- MOTORS " ' '0-1 HP_1-10 HP `�- ' ' - �I hereby aftbm thaf t0ere I5 a<OnStructlo0 lentling agency to� [he pGr- SERV�CE SINK$ r SUMPS� y� "� ��" "- ��NQ SOLAR v �'�-'�� {'t - forma�ce of the work !or whlch this permit is issuetl (Section 3097 %'-10-50 HP-_ 50 * HP �Civ. C.Y• " "" "" - " `-"" ' ' "" "" � �' � � FLOOR 81NK5,. . FLOOR ORAINS � iFIXTURES � � OUTLETS� -SWITCHES ' �' � � � Gentle�'S Name � - ' ' °' ' Lentla�'s Atldress - ' 'DRINKWG FOUNTAINS r "-- - � � -- ' GAS TUBE SIGNS ' "" ' - ' ' ^ . OWNER'BUILDER'OECL'ARATION ' ` " �`�� ' �INTERCEPTORS CLARIFIERS � 'POLELIGHTS' - --- - "-.' " - " -" - I hereUY affirm that I am exempt trom [h¢ Contractor's license Lnw for . tne'fo��owinq reaso�'(Section ]031.5 Business'�antl-AotesSionsCotle: -SWIMMINGPOOL�-' P'TRAP-' '- '"" ' " " - " ' --- " - Any tlty or county wnicn•requirez a permii to construc[, alter, 'POLES METERED .SUB � imp�o�o,'tlemollsp o� �epai� any structure; priorto'Its'Issuan<e,-also're�' yyqTER SERV ICE- ALTERATION - � - PANELS' � ' MAIN `� � ' S08 " '- -- -- qWres the ap.liwnt (or such pC/mi[ to file a signetl statement tba[ h¢ ''� � 1 IS IIce05etl pur5udn[ ro th¢ provi510n5'01 the'Contrattor'S'LicenSe f�w GASSERVICE OUTLETS -' i 'SERVICE' � ' -" AMP - (Chapter 9(COmmenting with SecNon 7000) of Divlslon 3 of the - " � Busin855 antl PrdMsions Cotle) or thabhe is exempt theretromantl�the WATER HEATERS -- BTU OUTPUT' - '' '- ' -" -' ' ' -' ' - �b•�6 for tne alle9etl exempHon. Any viola[ion of Section ]031.5 by �� apPllcant fo�'a permit su0)ects the-applicant to'a civil pend�tY-' -$EWER�CONNECTION$ "---" " -- '"" ' ' - - -' . -' _ ' ' � ,( mOre [han live huntlretl tlollars (E500). � : , 'ps �owner af ltie praperty, or my emPloyees with wz9es zs tneir' SOLAR TANK " � COILECTORS - - -` -- " " � -+- - ' � - �- - ' sole �cOmpensation, will tlo the work, antl the structure.is.not intentled _ _ or o/tCretl tor sale. (Section 7044, Business antl Rotessions Cotle: 7he SOLAR PIPING SVS. � -� - ISSUE FEE '-' ' ' -' - - - '- CoMtOttor's. LiC¢n5e Law tl0¢5 Pot apply to dn ownef Of a prOpe�ty_ . - ---• - — -- qppLICATION'APPROVED BV ' who builtls or improves thereon, antl who does such work himself or ISSUE FEE - � -"'�"DF�TE throuqh hls own eTployees„provl0¢tl_Ihal zuch improvements,are nOt �' ' �" intentletl or offered �or sale. If, howeveq [M1e builtlin9 or improvement MECHANICAL PLAN CHECK y is.soltl '�+'��hin one year o( completion, the owner will have tne burtlen . SUMMARV OF FEES � � ;� of 0�0��9 he tlitl not builtl or improve for -[he pUrpose ol Sale). -,BUIL�ING'-- ' ' - ' ' ��1, az �owner-o�- lhe�prop¢rty, -am-e%clusively-cOntracling-with HEATING SVSTEM 0-100,000 BTU � _ _ PERMIT E _ _ _ -_ _' SMIP P ' '._S " _ __ AND OUCTING "I: -" ' � � licensed contracto�s (o construct the praje<t (Section 7U44, Business 100,000�� 8TU , P1J1N CHECK y PERMIT � ' antlPvofessionsCotle:-TneConlractor•sLiGense�LawdOesnotapply�ro - --�--- --ISSUANCE E ' an ow�er of pro0erty who builds or improv¢5 thereon, antl wh0 Con- REFRIGERATION 0-300,000 BTU 1 �PLUMBING E! �� i��}. tracts��rom such-projects witb a contrac[or(s)-licesnetl-pursuan[ [o SVSTEM - --- � - - - - - �� - - -� - - ----• - .GR{1DING�'-$ � ' �� tM1e ContraCtOr'S LiGense Law). _ ' 100,000;+ gTU PLAN CHECK §" ��' �' ' l i � ) � � � ��1. ��.)t ' I�. .\�Q" � �, - �ELECTRICAL E__tc.�_ ' . . , ❑ I arn exempt untler SecBon B. 3 P. C: for tM1is' BOILERS BTV � a. .-� � reawa. . .,"_'-. ' ' _" . _ '_" " . . _ �: M PCAN CHECK-� E '- �CROFILM_S •' � y` - SVSTEM REPAIR,ALTERiiT,ION�� 1 ' 1J �� U? ^ ,v Dato Owner - � - ''� ^',-` � __. _ . _._ .T,OTALFEE�S. � ' MECHHNICAL' E I heretlY �ertify that.l have reatl lhis application antl state tnat the above EXHAUST SVSTEM MVLTIP�E � . s' -+•' �v�'�c .� ^ i LE55 F1D-� �' �� •' �'_ J Iriformation is correct.-I a9ree lo comply� with all dty and county � . '�PLHN CHEGK - E- -"- � VANCE PC - 5- - 1 ortlina��es antl state laws re ating lo construc[ion, antl hereby au no ze ' � -, . - repre56ntative5" N' y'(o enter' upon tfie aGove ti etl � �'� �� ' �� / pr�P¢rtY r ' rposez. _ �• i . /�3'� � Si9n3tWe �� - ._ •' _. FINALFEES Drivorb' Licen "5 $ - - ISSUE FEE ^-" - ' - - " -' - -' - -- ' - ' ' - ' ' - " ' CMF 0865-A6 hite-Builtling; Canary-Applican[; Pink-Accowling: Goltlenrotl-Assessor � - CONSTRUCTION AND PLANNING . � POOL & SPA �,J' { - �� . , APPROVALS Permit #�� Date Inspeitor ' qppROVALS Permit # � �' Date '' InspCcior��' 1. Temporary Electrical Service or Pole � 43. Pool & Equipment Location - - -� -- • - - - -- � 2. Soil ipe _Undrgrn �- � � 4 . Steel Reinforcement • - � -• - - - ti • - -- -- - - . 3. Electrical Conduit Utility-Undrgrn _ - 45. Forms � � - 4. Electrirat Conduit-Undrgrn _ 46. Electrical Bonding y. --- - -- - • - �- - - ` tee ein orce � '� 47. Rou h 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 m, Test �- �• � 9. Water Pipe-Undrgm 51. Backwash Lines P-Tre " ❑ � ndr m � ` - - - -' - - -- � 10. Structural Floor System � 52. APPROVALTO DECK '' '"-"'" - -"-" � 11. Property Sewer Line & House Conneaion. ' 53. Backwash & Rece torFinal � � ' • . 12. . Street Sewer Connection - � ' ' - -._ ,�. _ 54. Heater & Vent-Final � � � 13. Rough Plumbing _ - - - ' - - - . .-- - � - -- �-- 14. Rough ElectricConduit - - - � •56. Electrical-Final- - �� ' � • 15. Rough Electric-Wiring - -" -' -- -- - - - - 57: Solar SYstem-Final- � ' ' - � - ' 16:- �Rough �Heating & Air Conditioning � - - - - encing_& Access Approval 17. Oucts,.in Structure ' . _ `"' ' ` �._ _ .. -._. . _ • APPROVED FOR PLASTERING . , . ' _ • " . - 18. _Ducts, Ventilating ' _ � ' _. _ _ _ __ _ . . 19. Gas Pipe•Rough�&Test �� ' 60. POOUSPA SYSTEMS FINAL^ _ � ,� ; 20._ Roof Framing. - - - " ' ' � ' � � � � � - - - .. _ _.... - -� --•- - - -- - 21, Roof�Sheathin ' ' � -' . . . "� � �.... . � . � '--'-- -- -- -- -- --- - - " NOTES: . ' . , � . , ;. . . � ; � . . . .,,-. ,. ' ' 22. Frame and Flashin . _- �. . . � ,�. �' ` . _ .-- - - -- - - _ _ . I 23. - Insulation " ' � ' ' ' � ' j� ' - - ' t 24. Lathing & Siding - ' � / - - . . . 25. Drywall Nailing � - ' ' ' ' � � " � 26. Plaster Brown Coat . � � - . �27. Electrical Power MeterFinal . � ' � -' ' � � � 28. Final-Electric � " � �� ' � � 29. Final Heating & Air Conditioning. - � ' � � ' � - 30. Final Gas Pipe-Test ' � - " � - � ' ' . 31: Fina��Plumbing - ' ' � � �--32. Water Service-Final ' ' � � � ' 33. Gas Service-Final � - , 34. Solar pomesticFinal � � � � ' � - ' � 35. Landsca e S rinklin S stem � ' - ' ' � 36. Sound Attenuation - " • � • 37. Handicap Regulations � � � � • � 38. FINALSTRUCTURE&BUILDING -- �� - • � . 39. Special Requirements Completed- ' � ' � -�• � " ' �' - ' " "' ' � � - i 40. Electric Release to Edison ' ' d �-� -� � 41. Gas Release�to Southem California Gas Co.' ' � 42. CERTIFICATE OF OCCUPANCY . _ _ � � No Date ApOlicant t0 /ill In all SD9Ces exceot t�ose within heavv CorEer Iines antl xlon all aooreoriale tleelaralions CITV OF COSTA MESA, � • ' � . � � PERMIT NO. � � TRACT NO. , � LOT NO.� , , BLD . , � � • � � • - � CONSTRUCTION PERMIT ' • � ` ' • , - � . " , � Z S ; `� - 8661 • 4/I6/84 H.�II . P�qect AddrMs ` � � � � - TYPE OF CONSTRUCTION NEW ADD ALTERATION •, REPAIR � � Applicant's Mailing Addreu. �9� M%• I%��' � �/S,faAAC'Stl ❑ CONVERSION ❑ DEMOLISH ❑ OTHER 'q.p. # ' - � ' 2one . ` � 1� � hone ��L DESCRIPT�ON OF WORK � �� Owner's Name ��u �" i ' � � ' S� Main,Building: _ � A�ceuory Building: ' Z Aildress �% ��i�' MG`YJ Gli� �`�?� l�i��• ' � � � . E . . .. . . O ,,�/ IVPEOFPERMIT GRADING FOVNDATION �STRUCTURAL T Front . - (� Arch/Eng. �!W��d1,' —Lic2ni2 No.' � � TENANT ❑ ELECTRICAL� O PLVMBING ❑ MECHANICAL � B - � . , ' � � I . � . . � I . Rear � - � � ' N Addiess' �,I ❑ �OTHER ' - ' � Ri9h1 . . . . ' " � � � G Contractor's Nam rYn�� hone •' PROJECT DESCRIPTION SQ. FT. � � � ' OCCUPANCY ' � - R Addfe55 (meiling� , CONSTRUCTION TVPE VALUATION $ ' g Left ' ' � . � E ZONE ' GRAOING CU. V�S. ACRES P�p Ref. # Park.FeCs $' � City License No. � ' 9� V LICENSED CONTRACTOR DECLARATION Rema�ks: � ' Pdikiny R2q./P�Ovid¢d ' - - ' � b.hereby�affi�m [hat ,I am Iicensetl untlG/ p/Ov�510n5 O/ Charte� 9(comm¢ncing � R with section ]000) of Dlvlsion 3 of the Bus��ess antl Professlons Cotla, antl ' , � ' Use of Building: � ' . � E my IiC¢n5¢ f5 in fUll IOrG! dntl <HBCL . Lltense Class Licensa No. ' PLUMBING FEES Planning Notes: � • ' ' M E Date Signature . ' • ' WORKERS' COMPENSATION DECLARATION Baf Sink Showefs N �-'�h¢reby aHi�m�that 1 �ave a certlflcata o7 con4enLto Self-insu�e o� a ce�tlficate Backflow Preventer Service Sink ' � ' � -- - -� - T =-workers' Compensation Insurance, or a certlfletl copy tnereof (Sectlon �� S k�;"oo, Lat. CJ � ' � . Backflow Irrigation Sewer Cap � � • � • ELECTHICAL FEES Policy No. ' Company ' ' ' BCertlfietl copy is hereby fumishetl. � Bathtubs $ewer Connettion� - � qutomatic Washer Transformer � 15-50 KW - Certlfietl copy is filetl with Ihe tity Builtlin9 Dlvlsion. Date Appncant Clarifiers Solar Collectors � Construction Pole Sub. ❑ 50+KW E%EMPTION F0.0M WORKERS' COMPENSATiON DECLARATION Dishwd5her SOler Pi In � (Thissection neee no[ be comple[etl If the permit is for one huntlretl (E300) or P 9 Cooking Unil Meter �up [O 700 amps less). I certify that in the performance oi the work for whi<h thit perm�t is issuetl, I Drinking Fountain5 Solar Tank Dishwa5her . � Meter �over 100 amps sitall not employ any person in an nner s as to become su �ect to the . worke om ensatlon Laws ot ifo i �f Floor Drains Swimming Pool w/Spa Dryers �Gas ❑Electric � Sub Panel Date �Slgna[u�^ .<(./��`/ � NOTIC : Ii,� t er making this tleUaratlon, you shou ecome su ect to tha FloorSinks � �� Urinal � Fan Motors �0.1 HP �1'h-8 Warker5' COmp¢nsa[ion provi5ion5 of the I�Dot Cotle, y0u mu fort�with . comply wltn such provlsions or thi5 pennit snall be tleemetl ravoketl. Gas Service Outlets Watef Closet � CONSTRVCTION LENDING AGENCV � F.A.U. Int.5010r �&15 HP �16-15+ I bereby affirm that there is a construction lentling aqency tor the performance Intercept0�5 ' ' Wate� He2t¢r FixturEs ' MicrowavC ot the work for whlch t�is permit Is Issuetl (Sectlon 3097 Clv. C.) l.entler's Name Kitchen Sink Water Service Device Boxes Pole Light l.entler's Atltlress ' OWNER BUILDER DECLARATION . LevetO�i¢5 � OuL12t5 � I hereby aftirm that I am exampt from the Contractor'S License Law for the Range following reason (SecHon 7031.5 Buslness antl Pwtessionaf�Cotle: qny city or P—Trap Switche5 Sign county whl<h roquiras a permlt to construct, alter, improve; Cemolish or repair � any structure, prbr to Its issuance, also requVes the aDPlitant for su<h permit FoOt Drains - . Garbage Di5po5al Standing Sections to file a signetl statement that he/she is Ilcenzetl pursuant to the provisions o/ , Iha Contractor's Llcense Law (C�apter 9(commencin9 with 5e<tlon 7000) of G2n¢rator 0Q5 KW 05-15 KW S��IviSiOn 3 of the Business antl P�o/¢SsiOns Co40) or that he/she IS exempt � Trash Compactor _arefrom anC t�e basis for the allegeC exerpP��on. Any vlolatlon of Section . �`� tldit Of nOt TO/Bp1han flve�nuntlletl tlolla�sa15500 tha applicant lo a civil Reinspeetion Fee $25 Isue Fee � $ 3 � +R�� Y 1• 1, as owner of the property or my employeas with wa9es as their sole MECHANICAL Rainspection Fee $25 Issue Fee $ 3 mpensation, will ao the work, antl Ma sVu�turo is not intentletl or o/teretl ' FEES for ule (Se<tlon 704a, Business anA Protessionai Cotle: The Contractor's PUBLICSEflVICESREOUIREMENTS: Llcense Law tloet not aDP�Y to an owner of a Property who builtlz or Improvas gOiler HOod or Typ21 ❑ thereon, antl who tloes suc� work hlmself/h9r5elf or tnrou9M1 his or her own 2oning Approved By �ate 'employ ees, provitletl that such Improvemen[s are nol Intentlatl or oftered for � CenOpy Type II ❑ � sale. If, however, tne Duiltling or imorovamant Is soltl wltnln one year ot com- Duct - Und¢� Ground pletion, t�e owner wlll have the Gurtlen of proving he/she tlitl not builtl or im- Building Appravad 8y D0t0 ova tor tha purpose of sale). Duct - Struciural Re(rigeration System ApP��mtion laued By �%� ne� ((Q , as.owner of tne proparty, am excluslvelY contractlng wltn Iicensetl con- ❑p.100,000 BTU ❑100,000 BTU ' t actorst6 mnstruct Ihe project (Sectlon 7046, Buslness antl Profassions Cotle: Duct - Ven[ilating , , , , . SUMMARV OF FEES � , Tna Contractor's Llcense Law tloez not applY �o an owner of oroperty who BUILDWG PERMIT builtls or Improves tnereon,'anC who contratts for such Drojetts with a con- Exheust System ❑ Multiple ❑ System Repair/Alteration $ SMIP $ tractor(s) Iicanse pursuant to rne ContractorY License Law1. . PLAN CHECK $ PERMIT � ❑ I am exempt untler Sactlon B. & P. C. for this reason Firepl/Fa[T. Blt. ICBO �h PLUMBING $ ISSUANCE $ �� p� , i Heating System & Ducting � PLAN CHECK 25% $ ENERGV P.C. $ I hereb certl/y that I have reatl this applicatio � stata-lhat Ihe above -- �O100,000.BTU �100,0008 - GRADING $ In/ormation Is correct. I agree to comply wlth al l ty and county ortllnances ELECTRICAL $ R.� an0 51ate laws relaling to builtling contbu ion, antl hareby authorize repra- . � MICROFILM $ santative ! thk City' to antar upon above-mentloned property /or ' � ' , PLAN CHECK 5096 $ � Inspec on p rp 5. / ' ' ' � � �/'� Date L� � MECHANICAL . $ TOTAL FEE $_S.L`"-- Slgnat Rainspection Fee �$25 • �� = �swe Fee . $ 3 � � PLAN CHECK 25% $ 1 Drivers' Licanse or 55 � � - CMF 0865-46 rav.�12/B Whlte • Builtling; Cd�ary - Appilcanh Pink - Accountin9; Goltlenrotl � Assessor . ' ` '" - � �iCONSTRUCTION.AND_PLANNING '. ' . POOL, 4 <.- j � _ •: .; ' Date Inspector '-'Date � � Inspec4or�_ - • APPROVALS Permii# � - APPROVALS Permit # _ � . - a :, '" 1: Temporary Electrical Service' or Pole � ' 52. Pool & Equipment Location . ' -. � 2: Soil Pipe-Undrgrnd. _ � � � 53. Steel Reinforcement , � � 3? Electrica� �Conduit Utility-Undrgrnd. 54. Forms - - . � _ � ; 4. Electrical Conduit-Undrgrnd�. `� � � - . 55. Electrical Bonding , . � _ _ ! 5. Steel Reinforcemenf ' ' ' - � � 56. Rough Plumbing & Pressure Test - . = . ' ' � _. 6. Electrical UFER Grnd. .� .- 57. APPROVAL TO COVER-GUNITE � 7. Footings ' � ' - , 58. Electrical Conduit-Undrgrnd. - � . i. 8. Foundation ��' . . 59. Gas Pipe, O Undrgrnd., Test . �� ,. 9. Water Pipe-Undrgmd. . - 60. Backwash Lines, P-Trap, � Undrgmd. -� . 10. Structurab Floor System , � � � 61. APPROVAL TO�DECK _-� .� 11 . Property Se'wer Line & House Connection - 62. Backwash &.Receptor-Final � . ^' i 12. Sewer Cap � ,' 63. Heater & Vent-Final 13. Roof Drains ' ' 64. Plumbing System - Final . ' -' 14. Rough Plumbing � � 65. Electrical-Final � � �- _ ""15. Rough"Electrical-Conduit "' .. ' , 66. Solar System-Final � � �- - - - - . .16. �Rough�Elec[r,ic Wiring . ' 67. Fencing & Access Approval �� - -� - ' c � 17.-Rough Wiring Sign -•� • . 68. APPROVED FOR PLASTERING . 1 _ 18...Rough Electrical-T;Bar Ceiling ' � � � �69. POOLlSPA SYSTEMS F{NAL � � - � 19�. Rough Heating &�Air Conditioning FIRE DEPT. REQUIREMENT _�' 20. Rough Factory Fireplace , APPROVALS Permit # ; � I r! 21. Ducts, in Struc[ure ,� � . i ' ' � 70. Underground Hydro _. � . � � ,� 22. Ducts, Ventilating . � ' �� 71. Product Piping � Gas ❑ Oil . � ;;, ' ' 23. Gas Fipe-Rough & Test � .� . 72. Underground Flush � � I-j -' 24. Roof Framing .' 73. Undergrnd. Storage Tank O Gas _ O Oil '� ' � 25. Roof Sheathing � �_ I � � • �� 74. Overhead Hydro - � �` 26. T-Ba� Ceiling (Structural) & Monocoat - 75. Dry Chemical , � �27. FrameandFlashing , 76. DryStandpipe � � ; ' '� � ` � 28. �Lathing & Siding �- � � ' ' � 77. FIXED SYSTEM FINAL � � •' 29. Insulation � � � ' 78: FIRE PREV. FINAL � � ` �-30. Drywall Nailing � . HEALTH DEPT. REQUIREMENT � � ' � 31� Plasier Brown Coat ' � � i 79. FINAL INSPECTION ; 32. Electriral Power Meter-Final . 80. FOOD CERTIFICATE ISSUED - i " 33. Final Electric �7 Notes:. ; � � ' 34. Final-Heating'& Air Conditioning -, , _ t 35. FinafGas Pipe-Test' � � • , � � . _ . ,. � . 36. Hood or Canopy� ' - � ' - . . • ' � , - : + i i 37. Final Fact,ory Fireplace � ' � � � � � - � 38. Final Plumbing 1 � � , , . � � � 39. Water Service� Final � � , ' � �. � , • ' - � � �� i 40. GasService-Final � � ' ' � - � ' ' 41. Solar pomesticFina,l � � , � � � � ' ' � - - - ' ' ' � ' 42. Backflow Preventer; � � . �� _ ' ' t � ' 43. Backflow Irrigation � � � � � . � - - • ' ' , 44. .Landscape Ir�igation System � � , . . 45. Sourid�' Attenuatiom , � � . � � � -. � � - 46. Handicep�Regulatiois , , � � � ' . . ' � . . ' , � - . 47. FINAL STRUCTURE & BUICDING� - ' � � - � , � . , � 48. Special Requirements Completed, � ; � � � , ' � � � ' � � � �� 49. Elearic Release to Edison � � � . � � ' � - � �� a I � . ..� 50. Gas Release to Southern California Gas Co ' � � � . � � ' '. j ! � + � ,. v I i i ' 51. CERTIFI6ATEOF OCCUPANCY � - - - -, - - ' • � i � No. _ • _ - � � � Dafe . . -. ° - - - - � • � - . AVDlicant to fill in all spaces excev< those wil�in heavy Doraer Iines ana sign all appropriate eeetarations. CrrY oF coS7A(��jQE(S/�r) ClONSTRU�CrT�ION PERMIT Projec[ Address `"" v 11 � ��^ . 1 � � � � �'"� �• Applicant'sMailingA dress ��lv�-�. � -,� /'�cr- Owner's Name � Phone,�iti�1 I Address ��t'�n^'s '% �1%�l(�ll'-�L � . Arch/Eng. � Licenu No. Address I ^� Contractor'sNa e1 - �- Phone /� 2�Z�, Address Imailingl ��`,�A-�7U 1 N'\ �� V�i..D City License No. - ��{ � LICENSEO CONTRACTOR bECLARATION ' � ' � i I hereby affirm Ihat I am lic¢nsetl untler provisions of Cnarter 9(commencin9 wlth section 7000) of Division 3 0( the Busines5 antl Protessions Cotle, antl my Iicenze is in full force an ffec . � L'Jcenif( C��l�ass Licens o Datej��. Signature WORKER�� COMPEN ATION DECLA ION � � I heretiy aftirm tnat I have a certiticate of consent to Seli-iniure r a certlflcate rt Workers' Compensation Insurance,�or a certitietl copy thereo( (Secilon - :800, Lab. CJ , , ' , Policy No. Company BCerti(ietl copy Is hereby f�mishetl. ' Ccrtitietl coOY �5 fileE witA the <ity Bulltling Division. Date Abplicdnt EXEMPTION�FROM WORKpRS' COMPENSATION DECLARATION � (This sectlon neeC not be tompletetl if the permit is for ne huntlretl ($10�) or less). • I certify [ha[ in [he pe�form8nce o Ih wo tor w ich t s pe�mk is i55uetl I shall n t employ any pa soq in a y ann � to c me s�bject to [�te . ..__ ._.Q, _ _ ._. . ��.....' _ _ .._ _� �_ . , NOTICE:Y(, after making this tleclaration, you shoTNtl'become sNbfect to lhe WOrkers'_Comp¢n5ation proyi5ion5 oi the.Labor Cotl¢, you m8tl torthwith comD�Y �+�th sucn prOviSiops o� thi5 Oermi[ shal� be tleem¢tl revoketl. CONSTRUCTION LENDING'AGENCV ` 1 nereby atfirm that there is a wnstruction lentlin9 agency for Ihe performance of Ihe work tor which this permit IS ISSueC (Seclion 3097, Civ. C.) Lentler's Name ' Lentler's AtltlreSs �' � � OWNER BUILDER DECLApp,T10N�� ` � � � I hereby, af(irm that I am"eaempt from the Contracfor's License Law for the followina reason (Section 7031.5 Buslness antl Protessional Cotle: Any ciry or the Contractor'S LicenS¢ LaW (Chapter 9(cOmmencing with Sectlon 7000) ot DlviTion 3 of the Busine55 antl Prof¢551on5 Cotle) of thal h¢ Slle is exempt ;,the�ef�om antl [he basi5 f0/ the dllegetl ex¢mption. Any viola ion of Se[tion �:a031.5 by any appliwnt }or a pe�mi[ subjects the applicant t0 a clvil '�,'penalty of not more than fivp huntlretl Oollars (550�). ❑ I, as owner o� the p/oberty o� my am0�oyee5 with wages a5 thei� so10 compensation, will tlo lne work, antl the sVu<ture is not inlentletl or otieretl for sale (Section 7044, Business antl Profeszional Cotle: The Contractor'S License Law Does nol apply to an own¢� of a property who builtls O� imprOves [he�eon, antl who tloes Such wo�k hlmselt/he�self or throu9h his o� her Own ¢rOployees, provl�eE lhat sucn improvements are no[ intendetl or pf(eretl for ule. If, howeveq the bulltliqg �� imprOvement is zoltl wlthin onG yea� ot COm- pletion, tne owner will bave [he burtlen oi proving he/she tlitl not builtl or Im- �1rove forthe�purpose of sa1e�, u I, a5 owne� of �the prope�ty, am ezclusively cont�aGting with Iicensetl COn- tractors to construct the project (Sectlon �044, Business antl Pro7essionz Cotle: The Contractor's License Law doe5 nOt apply to an own¢r of property who builas or improves thermn, antl who mntra<ts tor such projects with a con- tractor(s1 license pursuant'to-the�ConVactoi's License Law). I am aware that �pr of of tneir Worker'S ComOensatiOn insuranc< shOultl be provitletl to m<. I dm exempt untler 5¢ctiGn B. & P. C. tor this rea5on Date Orivers' Owner �1�0� � �. _ _ � I . ..�. TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAI R ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLDG. TVPE OF PERMIT LJ GRAOING LJ FOUNOATION LJ STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MEGHANICAI_ O OTHER PROJECT DESCRIPTION 5�: FT. oCCUaArvCv_ CONSTRUCTION TVPE ' ' VALUATION $ � 20NE � GRADINGCU.V�S. ' ACRES � Remarks: Sink i � PLUMBING - �, Showers ' Preventer - . ._Service Sink Irrigation SeWer Cep Sewer Cannection Solar Collectors Drinking Fount. Floor Drains Floor Sinks � Gas Service Interceptars Kitchen Sink • Lavatories P-Trap Roof Drains� Reinspection -Fee �Utl2t5 Solar Tank Swimming Pool w/Spa Urinal Water Closet � Water. Heater .Water Service .� $15 Issue Fee ' Duct - Under Ground Duct - Structural Duct-Ventilating � . Exhaust System ❑ MWtiple ❑ Firepl/FacL BIL ICBO # Heating System & Ducting ❑6100,000 BTU 0100,OOOBTi Reinspection fee , � �$15 CMF 0865-46, rev. 4/1:4 White - Builtling; - Accounting; GoltlenrOtl - AsSessor Hood or Type I ❑ Canopy Type I I ❑ Refrigeration System ❑0-100,OOOBTU ❑t00,0008TU System Repair/Alteration Issue Fee A.P. �k S Main Building: - E T Front A Rear ' C Right SLeft Ping. Ref. # ' Plannin9 Note's: � � Automatic Washer � - Cons[ruction Pole Sub. Cooking Unit � � Dishwasher 6��s ei2iie4 iion� Ti , Accessory Building Zane . 2 O N ' I r � N G R ied E. Q M . T S. ELECTRICAL �Transformer - � -15-50.KV � 50+KW Merer LJup to 100 amps Meter ❑over 100 amps' Dryers ❑Gas �Electric Sub Panel ' Fan ' � Motors OO-1 HP O1 Y. - 8 F.q.U. Inc.Solar.�9-15 HP 016�15+ Fixwres . 'Miuowave . _ ' � Device Boxes Pole Light ' • Outlets Range . � Switches Sign Gar6age Disposal �. 'Standing Sections . - Generator �45 KW 05-15 KW Trash Compactor $ 3 $ 3 FEES , 0 � Reinspection Fee �$15 � � luue Fee � � $ 3 � DEVELOPMENT SERVICES REUUIREMENTS: 2onin9 APProved BY Date Building Approved By -y�� v, Date Appliotion luued By �/� � � � Date_� SUMMARV OF FEES BUILDING PERMIT 3 SMIP $ PLAN CHECK 3 PERMIT PLUMBING $ ISSUANCE $ � PLAN CHECK 25% $ ENERGV P.C. $ ELECTRICAL $ �Q(� C7 GRADING $ � PLAN CHECK 50% $ �''-'v MICROFI LM $ MECHANICAL $ TOTAL FEE $ ' � �" � PLAN CHECK 25% $ CONSTRUCTION ANDPLqNNING � � � P��'-'PA '- APPROVALS Permit # � Date ,- Inspector APPROVALS Permit # Date Inspecmr 1. Temporary Electrical Serviqe or Pole . � 52. Pool &�Equipment Location 2. Soil Pipe-Undrgrnd. � 53. Steel Reinforcement ' -� �3. Electrical Conduit Utility-Undrgrnd. �� 54. Forms . , 4. Electrical Conduit-Undrgmcl. , ' S5. Electrical Bonding ' � 5. Steel Reinforcement � � ." . . 56. Rough Plumbing & Pressure Test � 6. Electrical UFER Gmd. - � � -'. 57. APPROVAL TO COVER-GUNITE � � �,F7. Footings' � . ` ' ;, - � 58. Electrical Conduit-Undrgmd. - � 8. Foundation ' �.' � . , 59. Gas Pipe, O Undrgrnd., Test �I � 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 � .-a`� 1�3. Roof Drains � 64. Plumbing System - Final � � 14. Rough Plumbing . � 65. Electrical-Final ' � 15. Rough Electrical-Conduit ' � 66.'SolarSystem-Final �, � 16. Rough Electric Wiring - �g L9 67: Fencing & Access Approval � � � 17. Rough Wiring-Sign, 68. APPROVED FOR PLASTERING - 18. Rough Electrical-T.Bar Ceiling 69. POOL/SPA SYSTEMS FINAL � � 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT� 20.'Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure_ ' 70. Underground Hydro • 22. Ducts, Ventilating . � 71. Product Piping�O Gas ❑ Oil ' 23. Gas Pipe-Rough & Test' ' . 72, Underground Flush , ' 24. Roof Framing . �.. � 73. Undergrnd.Storage�Tank �Gas ❑Oil � ' 25. � Roof Sheathing � � � , 74. Overhead Hydro � - - 26. T-Bar Ceiling (Structural) & Monocoat . 75. Dry Chemical� 27. Frame and Flashing � 76. Dry Standpipe . ' �28. Lathing & Siding ' , 77. FIXED SYSTEM FINAL 29. Insulation . , 78. FIRE PREV. FINAL 30. Drywall Nailing �. � HEALTH DEPT. REQUIREMENT � 31. Plaster Brown Coat • � � 79. FINAL INSPECTION � � � - 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED . 33. Final Electric - � ' -3 ��° � Notes: ' 34. Final Heating & Air Conditipning . 35. Final Gas Pipe-Test ' 36. Hood or Canopy � : 37. Final Factory Fireplace i �' � " 38. Final Plumbing , . 39. Water Se'rvice-Final ' � - � � • � 40. Gas Service-Final , � . � 41. Solar pomestic-Final � i - _ • - _ , 42. Backflow Preventer , � . 43. Backflow Irrigation + � � ' . 44. Landscape Irrigation System , 45. Sound Attenuation � . ' 46. Handicap Regulations � 47. FINALSTRUCTURE'&BUILDING � . 48. Special Requirements Com{�leted � ' � � , , � 49. Electric Release to Edison � , , ., 50. Gas Release�to Southem California Gas Co � � 51. CERTIFICATE OF OCCUPANCY ' _ No. � Date � ' AOp�icant to fill in all spaces witnin heavy Gortler Ilnes antl sign aii approvriate ee ratians. CITY OF COSTA MESA ' P RMIT N,O// � ` TRACT NO. -' - LOT NO. BLD ': NO. ' ,- ' " � ' ' " - ' "' ^ "- ' . ' � . 'l9silSTRUCTION PERMIT � 3Y� 7 ' ' ,� 5499, �5/05/.82 �., • : 13.00 TL, Project Address ' ' TVPE OF CONSTRUCTION ' � .. ___._'� � , . , " , , OWnef � � � PhOne , ❑ NEW ❑ ADD ❑.ALTERATIOIV f ' ` - � '- � � - , f `Address .j , � ', ' '7 ." ❑ REPAIR ❑�CONVERSION; ��DEMOUSH , � -- - ~ 20NING�REGULATIONS ' ' - . ArcAlEn9. - ' - f - ' ' License ' ` . -0 oTHER . �• ' ' . _ ' _ __ ' _ ' DESCRIPTION OF�WORK A'P' � � "' • " Addr¢55� ,� . � . �' - � �ZONE�- �- PCNGfREF.$ ' �+ Contractor - ( C �' Phone - � . TVPE OF PERMIT � . �„ ', -' � ' -- ' , - ' -- "' - ��OPU � LpI NG ; 'I�� SETBACKC LST. _ ERTV LINE � � : Add(E55 � � � - _ ❑ GRADING FOUNDATION - � STRUCTURAL `SIOE VARD _ - � - � -- LICENSED C NT ACTOR' CLARATIO � 4 LEF _ � "� TENANT V ELECTRICAL �PLUMBING�OMECHANICA 5I�E VA I herebypfilrm th�C I am licensetl �untler provisions ot Charter 9(wm- .^ , . ' RIGHT , � mendn9 w�th sectlon-7000) of Division-'3-of-tne'Buslness�antl ��'OTHER -- - --�-- - - � . ._ _ . _ _ O Professions Cotle, iantl �r license is� in full force antl etfect��, � � � ^^ ^� ` � REAR VARD (TO P/L)'- � :.PROJECT DESCRIP_TION' __,...-.. . Y _I. �Litense Clas � e N . �� . � � � �. PKG. SPA'CE REQ. � PROV IDED - , �Date 9nature . . ' _ 54: FT. •��..'` � .:�. .'._ ' ' " "' _ .. . � _. . . � . . '�i �� '� ;�STREETWIDTH PARK"FEES ; `W00.KER5" O PENSATION'DECLARATI N ---- - - � �- � � � OCCUPANCV_CO�NSTRUCT.IONTVPE, _ _ �, 'I hereby affirm that I have a<ertiFlcate of tonsent to self-msure•or a VAL'UATION °��{a TZONE - �ZONING APPROVED BV ` DATE - ,certificat¢ Of Work¢rs' CompenSatlOn InSurance;'or a certi(ietl' C� Q- Y - - - ^- • - ----- - _ _ . ,thereof(Sect�i/y3�00,�,d� ) ' (� �/�� (/ GRADING'CU.iVDS. � ACRES +' �'SPEGIALCONDITIONS� �PolicY NO. Yd�/ i-�/j��omPanY_" .\��A�' `f'cli�-CK. ' ' " _ _ __ __ __ _ ' � _ -•--+ ._. _ _ . _,. . _ . . . ' " . 7ertifietl copy ii hereby furnisheC. �- -�- - -- � - � • � REMARKS: ' - .�3.-'.' . . ___. . _ . ... _. _ ,..� -__ � .. . � ]ertifietl copy Is�filetl with the city Builtling Division. - �� ;�! �; ,' � .��:, t cREMPTION FROM WORKERS' COMPENSATION DECLARATION - ' - � ' �' �- - "" ' - - - , - -' � � . . .. . . ` . . - , . . , _ . (ThiS Settiom�neetl not b0 compl¢tetl if the-permiLis to� one huntl�etl _ ._ . _ . f. _ -' ; '� ' - ! ` (EIQ�) Of IE55%. i � : .' • ... n . 3 . .,` .. _ _ _.._ �- .._ _ . _ . ' � J . 4� C¢�tity-thaPin the perto�mance�oLthe�work.for.which.thrs.pe�mit I5. � � - + , i55u¢tl, I shall nOt employ any pe�5on In any manne� So a5 to: become - PLUMBING -Gc { 4-PLAN CHECK `' 4 " 'ELECTRICAL-- - -" PLAN-CHECK�, - - . ... _ .'�� subjectttr[he�Workers'Compensation-Lawsof-Glifomia. .__ ' " "' " ' � � � Date Signature ^ BATHTUBS SHOWERS ��- � - 7 --� '- "-' ' - - .. _ �_ � NOTICE: If after makin9 �his tleclaration, you shoultl become subjec[ '�=TOILETS , �[y ' t VRINALS�'"' ' - - -'" ' - �GENERATOR-- '0-1 KW"_1-30 KW - -" '-'' to the Workers' Compensation provisions of tne Labor Cotle, you must . .TRANSFORMER LAVATORIES DOUBLE'LAVS""' """ � � torthwith comply wi[h such provislon5 or this petmit snall be tle¢mGtl , i 1'APPLIANCE""'10-50 KW_50�* KW- - -- -- � revoketl. -- . ."""" "'- --'------'- - -KIT.SINKS ' . �-"- DISHWASFIERS" -' '-iMOTORS"'--" - -' - -'- �CONSTRUCTION LENDING AGENCV 0-1•HP"_1-10 HP -' ,I hereby affirm Ihat there is a construction lentlin9 agency for the perv SERVICESINKS "^ j'�;j�5UMP5� �- �` �- ''""- IUNC. SOLARj�._ 30-50 HP_50 +.HP.�� -.��` -� � formance of [he work tor which this permit is issuetl'(Section 3097 "- ' ''� ' '__" ..._"'__ ;Civ. C.). � \ '. ��. FLOOR SINKS�.�.'„ FLOOR DRAINS -� � f'--� � -� �FIXTURES �^-OVTLETS"^SWITCHES - - - � ,Lentler's,Name - � - � ` '� - ^ � �� • DRINKING FOUNTAINSy�' �- `--" - -- - ` ' �GASTUBE'SIGNS- --�- --- -- - - - - ' �Lentler'S Atltlress � � -__ - - . . - -- - • OWNER BUILDER DECL"A0.ATION" "' ', "' �"-, _.` -'�" - "-' '-- ""'�"` - "" --- '"-- - - ' ' "___' _. .. "' � _. . . . � � � INTERCEPTORS CLARIFIERS _ ' " �POIE L•IGHTS'-' - I hereby affirm tha[ I am exempt from.the Contractor's License;L,aw for � � ' '-�� ^ � the following reason (Section 7031:5'Business'antl'Professions�Cotler' SWIMMINGPOOL � "'P'TRAP'-" -'"'-" ' ' - - -` � -_ � _....V._ : ...-.. . _ . Any,.city or, county,_which requires a permit to mnstruct;?alteq t, ' 1 .POLES METERED ��.SUB-� � � '�� improve, tlemolisM1 br repair any structuie, prior Eo'its'issuance, al5o�re= yyqTER SERVICE '-- �ALTERATION" � "", ""' "-'(PANELS' �' ' ,'-MAIN'-'�:.' 'SUB �� - / - quires the ap'�IlcantJor�such permit to file a sgnetl statement that fie, � ' ,`� ...... is licensetl pursuant to tM1e�provisions"oi"the Contractor'S License Law�' �GAS SERVICE' � � � OUTl.ETS� � LL - ""�SERVICE - - ^ - -•AMP- �-- -- ... �.. . . ' . (Chap[er -9 (tommencing with Sectlon- ]000) of Division., 3 of the• � '- ' ' ' ' - ' Buslne55 antl P�o1e55ion5 Cotle)'or that he-is'¢xert�pt ther2irom,anG'�th¢ -" --�- - " - �j WFITER�HEATERS .-BTU'OUTPUT 'T "' : "' '- -' -- --' - " - -- •- �� i basis for'Jhe allegetl ezemption. Any violation of Section ]031.5 by - '' - " "' _ = -' �applicant for'a'permiY'subjects the"applicant'to a'civil penalty" ' "SEWER CONNECTIONS"�1""'-" - "- ' �"'-" �-' - "" "' -� �-'- ' - _--- - - • � - rt more_than (ive huntlred Gollars ($500). � �.;7.' , � �• � ' � , as owner of the property, or my employees v+ith w5qei as their, SOLAR TANK" -" --"COLLECTORS '""- " " "" j- ` - '-' - ---- - � -- •- -- - - �sma tompensation, will-do-lhe-work, antl the structure_is not intentled! ' ''0' ' � ' � ` ' " or offeretl for sale. (Settion 7044, Businezs antl Professions Cotle: The ., SOLAR PIPING SYS.. � � � ^ ` } 'i55VE FEE-- - �'--- - -- .- - - � ;Contractor'S-Lit¢nse �law tloes-not apply. to-an owner of_a property. , �. ...,, _ . _. _ j who builtl5 0� imOroves thereon, antl who tloes such work hims¢It O/ ISSUE FEEy � � ' �APPLICATION�APPROVED BV---- --- - DA� -- dh�ough his own employ¢es, provitletl that5uch.improvement5 are_nOt„ c ' � � 'inlentletl or offeretl tor sale. It, howeveq the builtling or improvement MECHANICAL`� ' PLAN CHECK � �-�-' r- �-�.�.�T.SUMMARV,OF;FEES �is-soltl wilhin.one year of completion,.the owneLwill.have the,burtlen_ � � � _ _-_ __ _ _ .�.5� ` __ T. bt provinq he �itl m[ build or improve for the purpose of sale). HEATING SVSTEM 0-100,000 BTU- � BUIL-DING - - �{�'I,-as"owner' of'the-property; am-ezclusively wntractin9 with ..__ _ _ _- . _ _ _ 'PERMIT _ _g' _ _SMIP.`-_�i E' _ 'AND DUCTING" - - - �licensetl contractors to mns[ruct the project (Section 7044, Business 300,000'+ BTV ' PLAN CHECK E� rPERMIT -.: i., �c antl'Pr0(¢ssions'Cotle:'The ConVatto�'s Licenze Law�tloe5 nobapply to- 1 � - - . _._ _ _. __, _. _ .ISSUANCE� E ' ' 'an owner ot proDerty who builtls or improves thereon, antl who con- REFRIGERATION 0-300,000 BTU , PLUMBING g tiacfs from'sucn'pro7ectz �with-a-contractor(s)-licesnetl pursuant-to � -SYSTEM- - r- � -- - }---^ -- - j---- - - - . __ . `_ ".GRADING__E �� '�' � �the Contractor's License Law). 100,000 + g7U - � �PLAN CHECK S � - - �;� � ; ,�f• . � , , ❑ 1 am exemp[ un0er Se'ction � - 8. & P. C. for this ' - - - - - "" - - ELECTRICAC '$'�� ' - ' $ G_ '_"""" � � BOILERS BTV � F .: �reason � ____ __ �.: � -MICRO ILM:S_ �,� _ _ � � �Date - ' ' Owner -- -- - -- - SVSTEM REPAIR, ALTERATION � � �PCAN CHECK� S' -- ' '•MECHANICAL-.E - '��= �} `.TOTAL`FEE S' "�� _�' �I.hereby cer[ify that.l have reatl,this apP��cation antl state that the above EXHAUST SVSTEM MULTIPLE � �� ' ''; L'. ��i�.LE55 AD-� •� �+ ri--� information is mrrect. I agree lo comply with all city zo county �� _ jPLAN�CHECK��$- �=`-�= --- -�VANCEPC- S"�- -' -� ortlinances antl state laws relati q to construction, an0 hereby ut orize J�� y_ �.� y�� ' �� _- . ;, i-y �•� � 'representatives of thi it q enter upon tKe aboJe e pqtl � I -property .for_'�p ' ses._ __ . � �� " NAL E E� � ' "�_" 519natu�¢ __ . i ' � � - � - �,. . , _ . . - ._. . . -- � -ISSUEFEE- ___.._-_ � _ _' _'__ i____'.___ .._......___.. _,_ . . � Drivers' License $ � ' � � � � �- CMF 0865-J6 White-Builtli0g; CaOary-Applicant; Pink-Accounting; Goltlenrotl-HSsessor ' ' ,A_ , . , � CONSTRUCTION AND PLANNING �� '� POOL,& SPA ' ' . �.. ' � �� q�� Date Inspector "� - - � - � - . . Date� . -�Inspe�lor APPROVALS Permit # � '"td' APPROVALS - , . � Permit #� � 1. Temporary Electrical Service or Pole •. � � - ' 43. Pool & Equipment Locatiort- - - - � - - �� ' .. 2. Soil .ipe-Undrgrn ~- ;� - �'_ . --_ - - . .� •. - . . 44. Steel Reinforcement � - •- � = ; - - ' �- - -•-• --' - ` - 3. Electricaf Conduit Utility-Undrgm � 45. Forms � � 4. Electrical Conduit-Undrgrn,. - 46. Electrical Bonding - . tee em orce - . , 47. Rough�Plumbin & Pressure•Test - . ' . _ .__ . .-. ' `'- � -- -- = - - -` `- - '. .6.. .Elect[ical UFE Grn _ _. y - . '� �-�� ' ' ' "'48. APPROVALTO COVER-GUNITE- � � �-- � . . _. . _ . _. � _ 7,. .Footings . _ - �-� - 49. " Elect�ical Conduit-Undr rn � � � ' -6.-.Foundation . ' "' � � � 50.�,,-GasPipe,.DUndrm;Test�� ' ' _ 9. Water_Pipe.Undrg�n�.__ ._ - 51.- Backwash tines P-Tra -�' ndr rn�' "� t' -- - - - - -- .. ._ . ,.._ 10.._Structural F.loor System .. . „ 52. . APPROVALTO DECK ' `---� -- " - - . ._. .�. . . . ,. . _ . � ` ..11.. .. Property Sewer.Line..&.House Connection- -. �' � _ , . . ._ __.,.. _. _ , � _. 53. . Backwash.& Rece torFinal'� � � � `�-< :- ' � - � . 12.. Stceet.Sewer Cqnnection__.��' ' ' � � ' ' � �� .. . 54. Heater�&•Vent-Final' � � � � � � �� ' ...13. Rough Plumbing. _ - -- - � . -�-.. -_ �_ . . . . _ - - - -- - --- ' •' - -. . 14. Rough ElectriaConduit - - �- -- - � � �56.- - Electrical-Final � - � � 15. Rough ElectricWiring � � � ` - - - -- --57.-- SotarSystem-Final � '� ' ' �- - � ' � " 16. - Rough'Heating�& Air Conditioning-- � -- -- �' ' -� Y � - � - • - encing & Access Approval - - . 17.- Ducts-in�St�ucture"-'- - "� " '� 9. APPROVEDFORPLASTERING��.. � � 18. Ducts,-Ventilating� - ---- - � _ ___ _ _ .. - _ 19. Gas Pipe-Rough &Test � - .�� ' . _ 60,__ POOL/SPASYSTEM&FINAL� � � . . , � -20:- ��Roof Framing - - -- - - � . � , - - -- - - - . . , ' . � . . .. . . . ' .. . �, - 21. Roof.Stieathin ' - - - - - - -- - ,- . T . .. � . � .,.. . a^ NOTES: r." .•. . • ' .. � . ' 22, --�Frame and Flashin9 -- - -- - - - - - -- - - - - - - � - . ' . . . � , - .. .. , � . . � . .. . . . _ . ,. � 23. Insulation� - - . . _ . . ' . . � _ ._'. . - - -- --. : .' C�J �/O-SZ:. , . . _ _ .. . '' .. 24�.- Lathinq &�Sidin9 - -- - � _ --- -- - - . ... - - - ,...'//- ,.. ' -251 �Drywall Nailing - - �. �_._ �--. - - . . � - -#-- � , � , . . . . � . � �. . .r . 26. . Plaster �Brown Coat -�'a=' ' - - - � - � � ' ' � � ' � � "' � �- 27. Elect�ical Power Meter-Final " � ' :- ' ' ' " ' � " � � " � " � � " � 28. Final� Electric - -- - - � - "`-i � � � �. . , � :, * � � � . . ' ". ' , -- - - -_ _- _ ,� . � 29', FinalHeating&AirConditioning� � - . '- i. � �- ' � ' � �"- � �' " "�" ; 36. Final Gas Pipe-Test - - - - - - � "' � � ' � ' ' 31': Final;Plumbing �� ' � � ' ' "'" "' � ' . -' - . :_ .. . .. ,__.. :, . r � 32. - Water Service-Final - - � � a � ' ' � - " ' � ' ' " � ' -' •-' - - --- - �- 33. Gas Service-FinaF- _--- - - - _. �- � � � ' � - � 34. Solar pomestic-Final�". . . - �; � . . , .^''.. "•. - . . ' . ' . '35. Landsca eS rinklin 5 stem � �� '" �'' ' ' ' ` 36. Sound Attenuation ' ' �' ' ' � ' - ' � - - - � 37. Handicap Regulations � � • � - - ' ' � ' � ' ' ' �� 38. FINAL STRUCTURE & BUILDING � - - -- � �' � � � � • � ' 39. Special Requirements Completed � � � � ' � �� ' ' �� - � " " � 40. Electric Release to Edison � " � ' - � � - � " ` - ' - - � ' ' 41 . Gas Release to Southern'California Gas Co. ' � � � - � - - � � 42. CERTIFICATE OF OCCUPANCY � �� . , _ ; � _ ' � � No. Date - "; - - - - �. . _ s Applicant to fill in all sDaces except t�ose within neavr bortler lines ane sign all aoaro0riate aeclara<ions. CiTY o�COSTA MESa CONSTRUCTION PERN�IT ,Project Address � � 7 T� ��Q �i�� ApplicanYs Mailing Address 'SRNn4 - � r� � ��q--� Owner's Name G� Phon/g.7/...]_9�xL� 1 Address n�� 7 � � U"�^�S � Arch/Engr License Nc—� Address �1 Contractor's Nam� � r1 4�� L - Phonet 73 262� Address (mailing) 6 � City Licensc No. i — �p LICENSED CONTRACTOR DECLARATION ' 1 hereby aftirm Ihat I am pcensetl untl<r provisiont o( Charte� 9(commencin9 with section 7000) of Division 3 of the Business antl Profesilons Coee, antl ' my Ilcense is in jylli �ce a��(�c . Licen � Class �•• Licens � o � Ddte Si9qature � WORKER ' COMPENSATION DECLARATION ' � I nereby aftirm [hat I M1ave e certi(ICate ot con5ent lo self-insure or a certiflcate M Workers' Compen52tion Insurance, or a certitietl�copy theieof (Sectlon J800. lab. C.) � ! '—, ' Policy No. Company Certifietl copY �s hereby (umisite'd'�. �� ^ � CerA�fiqp coqXizjRDtl with the c�ry g�niping,Divi�pr�/�� l� M (This section neetl not be cpmpletatl if the permtt is for one hundretl (S}t10) or- less). � � � - 1 certify that in the periormance oi the work for which thiyp mk is'issuatl, I shall'not employ any perso� in an r so a� to b fo bjetf [o the worker o e satlon La�ys ot C ifor ia. �ate � Si9natu NOTICE: If, ft r mdking lhis tletlaratien, ou zhoultl om! zubj lo tha Workers' Compensation Otovisions of Ne Labor Cotle, you mus fortnwith compty wiln such O�oviRions o� thi5 permit sh511 b¢ tleemetl revOkeO. CONSTRUCTION LEN�ING AGENCV ' I hereby afflrm that there ig a constructlon lentling agency for tne pertormance of the .work for which this permit is issuetl (Section 309] Civ. C.) Lentler•s Name Lentler's Adtlress � OWNER BUILDER DECLqRAT10N I hereGy affirm lhat I am exempl trom the Contractor's Licens Law for the following reason (Seclion 7031.5 Business antl Professional Cotle: Any city or county wbich requires a permil fo cons(ruct, al[er, improve, tlemolisb or repalr any Structure, pflor to I[5 i55uance, a150 Iequile5 the apO��Cdnt for such pefmlt to tile a signetl statement that he/she is IicenS¢a oursuant to tne provisions ot [he Contractor•5 License Law (ChaO�er.9,(mmmencinq with Sectlon 7000) of Division. 3 of Ihe� Busine:s antl Professions Gotle) or Ibat he/she is exemp[ "tlerefrom antl the basis for the allegetl ezemplion. Any viola[ion of SecNon 03L5 by, any applicant for a permit subjects the applicant -to a civll �I �enalty of not more tnan tive hunGretl tlollars ($500). I, as owner of the property or my employees witb wages as thelr sole comoensation, will tlo the �york, antl lhe structure is not tnlenGetl or offeretl (or wle (Seclion 7044, Business 5ntl Professional Cotle: The Contractor's License Law tloes not apply to an owner of a properry who builas or improves Uereon, antl wno aoes sUch w0/k himself/h¢r5elf o��tbrou9h his or h¢� own ¢mployee5, Provitletl that Such imp�ov¢ments are not intentle0 or offeretl for sale. Ii, however, tne builtlin9 cr improvement is soltl within one year of com- pletion,'the owner will ha�e the burtlen oi provin9 ne/she ditl not build or.im- �iOve tor the purpose of Shce). U I, az'owner oi tne property, am ¢zclusively contracting wltn licensetl con- [ractorsto construct the prqect (Section 7044, Business antl Protessions Cotle: The Con[ractor'S License �yw doe5 ml appty to an owner Of property w�o builtls or improves tnereGn, antl who contracls for such prqactz with a con- tractor(sl license pursuant to tne Con[ractor's License Law). I am aware that proo( o( thei� Worker's Compensatlon insurance Shoultl be proNtleC t0 me. �,l am exempl untler 5¢ction �_ B. ., fo is reason Date � Owner I hereby rtity that I have rea� in(n.matinn iz mrrect. I ao.ne m � _� � 3� __...._. TYPE OFCONSTRUCTION NEW ADD ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER p p # ' . , DESCRIPTION OF WORK/USE OF BLDG. - . � � S Main Building: TVPE OF PERMIT GRADING FOUNDATION ❑ STRUCTURAL T Front - ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL � A Rear ❑ �OTHER � ' � . ' PROJECTOESCRIPTION Sp.FT. OCCUPANCV C Right � K' . CONSTRUCTIONTVPE VAWATION$ ' g Left' ZONE GRADING CU.YDS. ACRES Ping. Ref, # Remarks: --/,� � _/j _� � .��.�( .L,/ „9, (> C . Planning Nores: Bar Sink 0 Pr¢venter Irrigation Jrinking Fountains � Floor Orains Floar Sinks GasService �Outlets - Intereeptor5 � Kitchen Sink ' . Lavatories • ' - _ . —irap � - Roof Drains � � Reinspection Fee'� $15 Bofler Duct � Under Ground Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact. Blt. ICBO # Heating System & Ducting ❑ ai oo,000 eru O i oo,aoo Drivers• Licenu or 55 # �� I I Aeinspection Pee . I 315 � CMF 0865-46, rev. 4/84 White - Builtling: Canary - Applicant; Pink - Accounting; Goltlenrotl - Assesmr $howers ' ServiceSink .. Sewer Cap Sewer Connection Solar Collecrors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet . Water Heater Water Service ` ' Issue Fee Automatic Washer Consiruction Pole Cooking Uni[ � Dishwasher Fan F.A.U. Fixtures Device Boxes - 6553 8/17/E4 Zone - Accessory Building: � � Parking Req./Provided �.� ' Switches � Garbage Disposal Generator �0.5 KW 05-15 $ 3 ELECTRICAL � ' Transtormer ❑-75-50KW ❑ 50+KW Meter IQup ro 100 amps Meter ❑overi00amps . Sub Panel Motors�0-7 HP01X-8 Inc. Solar �9-15 HP �76-15+ Microwave Pole Light � Range ' Standing�Sections • Trash Compactor . IANICAL FEES Reinspection Fee �$15 laue Fee DEVELOVMENTSERVICESREQUIREMENTS: Hood or Typel O , Canopy Type I I ❑ Zoning Approved By . Buildin9 Approved By Refrigeration System ❑0.100,OOOBTU ❑100,000 System Repair/Alteration laue Fea ' � $ 3 Bo0�1 Tl Z - ' O N I N G R , E � M T $. � FEES 53 SUMMARV OF FEES BUILDING�PERMIT $ SMIP $ PLAN CHECK $ ' PERMIT ' PLUMBING $ ISSUANCE $ PLAN CHECK 25% $ ENERGV P.C.� $ ELECTFICAL ' $ �.OL� GRADING � $ PLANCHECK 50% $ � ,MICROFILM $ MECHANICAL $ TOTALFEE $ � �•� PLAN CHECK 25% $ CONSTRUCTION ANDPLANNING , P00� oPA Date � Inspector - Date Inspector , APPROVALS Permit # r. APPROVALS Permit #� . e' � 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-Unilrgrnd. 55. Electrical Bonding - , � 5..Stee1-Reinforcement ' - 56. Rough Plumbing & Pressure Test � . 6.`ElectricalUFER.Grnd. 57. APPROVALTOCOVER-GUNITE � , 7.�Footings - ' � � . , , 58. ElectricalConduit-Undrgrnd. � 8:nFoundation ' � 59. Gas Pipe, O Undrgrnd., Test ' '� 9. Water Fipe-Undrgrndti.� . 60. Backwash Lines, P-Trap, O Undrgrnd. -10. Strucwral Floor System , � 61. APPROVAL TO DECK � 11` Property Sewer Lin �& Nouse 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 Electriral-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 ' 72. Underground Flush 24. Roof Framing � 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing ' � 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. �Dry Chemical 27. Frame and Flashing . 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL � 29. Insulation � 78. FIRE PREV. FINAL 30. Drywall Nailing . HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat � 79. FINAL INSPECTION 32., Electrical Power Meter-Final f 80. FOOD CERTIFICATE ISSUED 33. Final Electric � Notes: � � 'i 34. Final Heating & Air Conditioning � , �, 35. Final Gas Pipe•Test . � ' . . I 36. Hood or Canopy � � • . � 37. Final Factory Fireplace _ ' 38. Final Plumbing 39. Water Service-Final ' � 40. Gas Service-Final � 41. Solar�Domestic-Final � � 42. Backflow Preventer � 43. Backflow Irrigation . . � � � 44. .Landscape Irrigation System : 45. Sound Attenuation � � . 46. Handicap Regulations � ,' ' 47. 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 AGREEMENT WHEREAS, the undersigned has applied to the CITY OF COSTA MESA for permission to install temporary electrical power pole facilities as set forth in electrical permit application No. 32017 , and WHEREAS, the City has granted such permission on the condition that said temporary power pole facilities shall be removed one (1) year from the date of the granting of such permission, or whenever the five boat hulls ar.e built and completed, whichever first occurs, and � provided further that in the event said temporary power pole facilities are not removed as above set forth, City shall have the right to remove said temporary po�•ier pole facilities at the cost of the undersigned; NOW, THEREFORE, in consideration of the granting of the aforesaid permission to install temporary electrical power pole facilities, the undersigned does hereby agree 4iith the.City of Costa t4esa that said City 5ha11 have the right in the event the undersigned fails to abide by the aforesaid set forth conditions, to.enter upon the premises and. remove said temporary electrical power pole facilities, and the undersigned hereby agrees to compensate said City for all expenses incurred by said City in such removal. WITNESS our hands this day of � P�, ��, . C. � ��C � �� . � �� S� ��-�o� a�/7� / �% p , Ytt EAST 20th STHEET + ,"> COSTA MESA, CA(.IFORNIA � `� IM�6�+ � FOR APPLICANT TO k'lLT, xN Building / AdEress ��i�✓. i%��r• Costa 11Tesa,, California Owner,ry •� j j /=��5/ Adtlress �� .%/�'� lic. &izt Ot Lot ��3� �'% Q , Now onBLot �� ' Usepf Na.p1 No,ot Existi�tigBldgn��OyN � F.amilles � Flooms � Setbaok Line from ti �� Rtar vard �:.d a G7m �� 7 4" �r Wall�� ,q Gvir..t Ntw _ � � � Storiea � ng 4C�i^. ,LrON , .� I herehq acknowledge that I have read this ApF and state that the above is correct and agree to with alt CCty 6rdtnanecs and State I.aws rei building cnnstruction, Signature af PetmitteC __�___� ✓ . !% � Authorized A Valuatiqn d C, Permit Fee 5..� 3. p U p Plan Chnck ;�� rotal �r,�7 FCe $ u .Gr � ?ar�(:, tM 12.b. . _ -_; : � .B U.1 L.D`I� N G . .... _.'� FOR 4Fb`ICE US� ONLY 1 j � Recelpt No. I %e� it.No ' ! f v. �� 1 t:eiv by Date tc'd Oate. s4ued i �� q I �'�% �..7 l7 �rL�'�� re� �� 7 .z-�� ; ' Casta Mesa, C�liforn9a , ; rest �? ,s�' � , cs St. /�'D ,G%'a rL��41" _LT !.� `G G : %� �� Plane/O O I Type� j Gro� �, roved � + n,•. . S u -- - .._.__ _ . . . __ p _ _ ��.��.�.-..�-. y ' � ..�� In `z , •t � _ ______ r Materia�s, ne: r�re acopg�.: _ - .. •. .. ^aeing, Boks---' � "� . .. '� .. . r. `� �i ' . ' . i. lnt. . . �.,Ext.. . � i � . . ter.l�t. . -";•� .�.. • . . .. ._ Bond Be FINAL� Ext / � _ 7 , , x 3 `�,'k- � . , � . " . -� ``"t�• . - ' - - • r. o .. . ..�. . , � _ a . J c _ ' ' aJ . � � . _. .. . a" o ` ' , .,. . . _�, . ,.., . . a .-.r,,{: . . . . - � � - -- . ... . . . . i • . � � - ��. , - � \ ' , - �- - - . - -- -. � ..� .:;1� ,.. . � . . ' .' � - t � � .. , .. , . _ .:.. ' � i � � '. � -- '- .- , � . . . � - � . _ _' r' 1 .. _ • .� _ . � . . �. . - _ � _ _ " _ _ -i . . . -' _ , . .. � , — � �- , -, : . . Street � � - " ' . � � .,-.- .,. . . . : .�� . � - . � . . . . - ' . . : , ...,. 7 ' PLOTPLAN ..- - - ---- ' Show Ioeation and distances irom , property line and betwee� buildings. � . .i _... , . � . - . ' . , . -� , Do you carry Workman�'e Compeneation Insarance4 Yea � - No � : ` I am aRare pf Provision 3700 oP the State � iabor Code vhich requires everyemployer � ; to be insured against liabzlity for . workman's compens bion. - 3igned: �G(i• / � 1C1� - . _..- � , r - . � _ --- - -- - _ t � . - . . .. . ..�.. �.w..... � OWNER A.E. Tiffany -� � DATE Q_ � 23—J4 JOBADORESS 660 W. 17tI1-SY.. BUILDINGPERMITNO. 1� GENERALCONTRqCTOR �e�Builder VALUE S 36,000.00 LOT �8 & 507 BLOCK TRACTNeW�1t. MCSB. 5 11R�t8 OY BtOI'&g8 !_G[111D F< ��1 TVPF 1Y )flNF r11 FIWC IIICTQI(`T �� , IN nva / ✓ �i��,,�� ne /-'(i � _ j — . Formsand Gradeto Plumb�ng, Rougn io 51ah /'i�/� l Plumbing, Rough Complete � Temporary Pole .i%D � Wiring, Rough . ll� Heating, Rough N O �tf,�- Heating,Final ,�/o /�i�- Sewer �L�J Septic Tank or Cesspool .UO (�/� Lathing Ii�C /1�l� Plastering O /V -2 Plumbing, Fir�al, Fixturos Complete! Plumbing, Fi�l GasTest /(%O Wiring, Final � Occupancy r��, xin ax I�i 1469 DATE SUBCONTRACTOR DATE PERMITS ISSUED R -a `Costa Mesa $uilding Department � �LI(:irrI R PEIt1V7IT�-� "' 177 EqST 20th STREET 9_8i� �� ____.g.U_I_�.D_,�.N_G.__ :�_ 9: •�' ,-' � 1 COSTA MESA, CALIFOfiNIA t—'" �OR APPLICANT TO FILL IN � FOR OFFICE USE ONLY� : p� Rec(e;ip�/t No. Permft No. � nddress U ` ; � ' 7� b � �%3 � �- Costa Mesa, California R�ceived.b� Date Rec'd. Date Issued, �i/ Nearest � , T� � � i Cross St . , Building � µ �w� '`/ � -� �p ^ � Address � 1�� • � Owner ,s ��r� • . (iOStB, �058�� Ci&IIfOT1113� �� Mail ' Address Nearest ( � ' 7 Cross St, - � CitY �Ct, ��%%��'�. Nol �,rY�-/�G� � 2oR�/i I Plana I TYP� I JL�f- Ku�_ � e....�.:�.�� . _.�,: i .� � :., _ _ City (Attach Metes and Bo4nds) h At ,/ No. of Bldgs. Size oi Lota ��/� 4i�� Now on Lot �� Use oi No. of No. of Existing Bldg. ",rQ�Q I F,amiliea I Rooma Setback Line irom ,( / Rear Vard 3�� Center of Street ✓ � Side Vard 3 � DESCRIPTION O� WORH New % I Alteretion I ( Addition I Repair I I Moving I I Demolish I � Building ' No. oi Size � �0'6 Rooms Stories 'erior Wall Rooi ering yi ,,,�.-�I Coverin 'J� i,�r.� U iN i � , � ; L. _ ' ! , , , , � . __' .. ._�. __ "__' _ _'... . o I _ ' < A �.. _ -...._ _ "'_"'_ _"_. _ ... _ _ _ "'.� 2 .�. d.. r� -'j ir�i r s� o ew Foundation Location BuilAing ; ^YiC A _ Forms, Materials � ' ` — Under-Pinni i /Jy� �f�t/rt! .� Frame: Fire St , r �' _ Brecing, Bolts Lath.lnt: I hereby acknowledge that I have read this Application and state that the �bOve is correct and agree to comply Lath. Ext. with all City Oidinances and S1at�yC�reBulating building construc �on. Signatureot � � 1 Plaster,int. Permittee � _ / Plaster, Ext. Authorized Agt�/ „-_�q - - Masonry Reinforeed Valuatio�j J J- � Permit Fee $ �1 � b Plan Check $ i � Bond Beam $ -I J Total . Fee $ r.S��D FINA� n,...., •me r..Hnm 12-fi3 � �� t ' � �_. ,�r. - ' �� —� ' �� _ ' , + - ��6`� � f;l � � . , . . � 3how Iocatlon and distanees irom property Ifne and between buildings. � • r • �'.� .... . . + . . . , . __. . , , . . �: �. - ' 1 . _ . .. �,// '_ . ... . . ...,,.,.,..:, . . . . O NER TI' ANY� A.E. ' DATE �1-9—�ill JOBADDRESS 660 w. 17t]7 St,. BUILDINGPERMITNO. �73 �.GENERALCONTRACTOR VALUE $ L�O�OOO.00 Newpt. �i�LOT 5�7 & 508 gLOCK TRACT Mesa 2 Storage Bldgs. I�GROUP F-2 TVPE IV ZONE M—�. FIRE DISTRICT #ZE;O , /f �� I PERMITS ISSUED INSPECTIONS �� DATE SUBCONTRACTOR _ .i �TI .� � DATE I NUMeER Foundation Forms and Grade to Rough Framingl�u — —� Plumbing, Rough to Slab %/! Plumbing, Rough Complete � TemporaryPole �6 � Wiring, Rough �i� Heating, Rough i� D Heating, Final �(J �'. Sewer Septic Tank or Cesspool ',(f G Lathing �(J /; Plastering /t%i Plumbing, Final, Fixtures Comp Plumbing, Final GasTest �/ Wiring,Final �.� Occupancy Z�� F'm�m Ll0 (4H IM 12-69 �. Costa Mesa Building Department r�IPPLIGATI�i.�r OR PER1i�IIT ' . . • .�. ceer �mF s4nccr . p �� 1 f1 � \� /'� • '� . ' TIPi'�I�4 SIO� VI(JITA^I,IYYA 3asm3i�sqs(I. �nib[iu$ ,szsdll s3zoD ' '��u1 a, � U 9 r`, ;T T33AT2 d10S T8A3 �tf '; � �� AINAOi1JA� .A23M AT20J�� : _ . ` . '...' .. _ _ . .. .� . _ ' . _ . " ' . . ... ,_.. .� . _ � . o . J ' � d J � P . . . a _ . �.; �'�� . , . . . • 0 a 1� a • - ` . • - - , • � t.,. �> ,�•� � .. .. : . � '' - - -- , ,:� . � , -- . , ;.. . . — ,. . • .- � -. . _,I� street ( . � . '" . . . L . � . PLOTPLAN ` --."�.: �.:'':t' �i` r';' :�.. .. . . Show location and distances from , . . property line and between buildings. i� . . . . . . -,.. : . , . .,. . - r� __..._ - - . . � .. _ .,... ; - -. - �. . _. , � t.: ., . . ., _ - � �.�--, - �.� "� DATE JOBADDRE88 660 �`l. �.%'tIl St. BUILDINGPERMITNO. 2OO GENERALCONTRACTOR O�,mer-Buil3er VALUE $ 36,000.�� or AP'� 116-200-9 e�ocK TRACT 5 Units o£ Storage Bldgs. GROUP F''-2 / TVPE ,}•/_ ZONE M'1 FIRE DISTRICT ��7 �`� � PERMITSISSUED INSPECTION$ 7,� � � $�Ty7,� �y� � �ATE SUBCONTRACTOR ;:.t-�e-�.�t!._i-t4 � 7�d 11ti'1� I I DATE I NUM9ER i renon b -z.s "54 9on Forms and Grade to Gara to Final Tank or u/ T ✓ I C_ ��5� — Final Form 210 GA 1M 1Y-68 'osta Mesa Building Department �r'f APPg,ICATION FOR PERMIT =�,� ' � 111 EAST 2pth STREET n vy 6 � � `D �L �G ' � ' COSTA MESA, CALIFORNIA IGr�I � � k'OR OF�`ICE USE ONLY FOR APP�.ICA.Na TO F`I�L TN Receipt No. Permit No. aaa�es9 [�Q f�iZ � �i4 -B -� -h- f � I `� / `%'/ osta Mesa, California Recei by Date Rec'd. Date Issued Nearest ' � ��Or �a� ��S Cross Sk. Building / Address — er Owner,Lp ��' . i Costa Mesa California u_u , � - /1/// I Flans Approved 'Z(SO� 0� `� � I �,4� � .t.r �..• / Ir '�_ Size of Lot 3 6 6 3 I Nowo� �ot 7i l�� --� o Useof No.of No.of �y� 9 ExistingBldg. f% � I F�ami�les I Rooms -•��I � O 1v v • G� Setback Line from �1n / ...� Rear Vard . , — _— -��' A � Building ! ! No.oT Size `%n % X /l�L Rooms Stories I hereby aclmowledge that I have read this Applicetinn . and state that the above is correct and agree to comply with all City Ordinances and State Laws regulating building rnnstructi��jj Signatureo��/�� Permittee y —_�_ Authorized Agt. � Valuation Aermit Fee $ ''i�.�i � � � O $ � � p QQ Plan Check $ %,$� � Total �) Fee $ .� d" � � � AM 209 S-BP 2M 8-55 APPROVALS Foundation Location Inspecto Forms. Materials, Under-Pinning Frame: Fire Stops, I nt. rwx ri..yi� 8how location and disYances from property line and between buildinga :�'! 10-SSPD sEsaQ 377ti �•**�8 �0 .!c • �. , "'� �; :'� - � t.: - — .� ,,. . . J. �i.... ' .. � . " � � ' Costa Mesa Building Department � 111 EAST 20th STREET , • � • �COSTA MESA� CALIFORNIA FOR APPLYCANT TO FII.L IN Building '/ Address ��_� �� G{� -�v —r ,� Costa Mesa, Ca ornia Owner Mail Address .,�ntractor Use Metes and / w Tel. No. Lic. // / No. t0 y City Lic. No. I Biock � Trae� 'O ��/ — 2/J/1 — Alteration I � Addition � Maving I I Demolish I No. of Si/ Raoms Steries _ AP�'Y,ICATION Y�'OR PERMIT �� BUILD��NC� ' FOR O�'FIC� USE ONLY Receipt No. Permit No. �/ 93 R�ec�erv by Date Rec'd.� Date Issued %�?� �/�/O -SS I ��a�S,s Buildi�g � ��_ J /_ � Address f"� Costa Mesa, California Plans � erior Wall I Roof — eeriny / — Covering � A,PPROVAY�S Use of New r Buildin Foundation Loeation Inspector � Forms, Materials, ' Under-Pinning Frame: Fire Stops, Bracing, Bolts I hereby acknowledge that I have read this Application and state that the aboVe is correct and agree to comply Lath. I nt. with all City Ordinances and 5tate Iaws regulating building construction. Lath. Ext. Signatureof � Permittee �_� Plaster, Int. Authorized AgS. plaster, EM. Valuation O O. Permit Fee $ �,�i :'� G Mawnry Reinforced Plan Check $ � � � � ' Bond Beam $ `� Total o n Fee $ 6 0 � FINAL nM �ll16 C_RD 9M R_SS .. • . .� ' _ , • . ,'�U�1n �SPD�esn�3�C� ^50.00 �:,�._ . , . , . Bhow Iocation and distancea from property Iine and between buildinga _': . . -• ,. . � osta Mesa Bailding Department :�PPLICATION FOR PERMIT P.O.Box3�� 995 BUILDING.. '� /° -' �� COSTA MESA, CALIFORNIA � • FOR OFFICE USE ONLY '� FOR •r�PPLICANT TO FII.L IN Receipt No. Permlt No. Building I .�/ /, � Add�� 6 G o w. �-�� s� r� . �; Costa Mesa, California Received by Date Rec'd. Date Issued Nearest �� —� � �i � C �- �'�.S �i CrossSt. ��.{ � ' C, p Building � _` � Address Owner , t' q� p p Mail Costa Mesa, California Address Nearest \ Tel.'HAKh• CrassSt. \ City No. `,y, — 4 Zone /� - No. of Type Gr up � Archrtector Lic. f"/ � I P�ans I Engineer �' No. Approved � � b Date _Address � q� v �-k-c, � e�n .2 . C M � ORRECTIONS �:/ City Lic. atrector �i iil� OA� N�_ /f �n . A// � _!'d �. Size of 1 4se of Existing Setback Center c M _ 1 ,.o. o. F,amilies m � Rear Varc '� - Side Vard Building Size \C7o ) ' `erior Wall ering � use ot New I hereby i and state with all bullding < Signature �� D� $ ^ ��Y/�`.�i:>D. o �� qM 309 10�55 O. P. G S. No. of Rooms Stories Roof Covering M��r ._ � � 1 .......- that I have read this 2 ve Is correct and agree ic� and�Stat� Iaws $� S.' O O $� o0 s � r� , o A' � APPROVAi.0 in Location I Inspector I � Date Materials, Lath.int. Lath. Ext Plaster, In Z D r —� PLOT PLAN Show Iocation and distancee from property Iine and between buildinpa � , . �, . . . .., �, ; • - � � . , 7 ,. �IAY �2-55P��"es�n"3Za a:'r,:t:42.�0 . - � � ' r ' • � , � ' � r' �` ! . . .. . , ,, ' ..,.. �'S�` �, , v . • . : ,' ;�� -. � . . -y-� ; .- ; : ,- ,; . . , ; <. , � � � , r , , . ; ' ' `�^/� ' �! � - � : _ . , � � � , � �� ' ` (K"/; �;. �, � . .. ' � ).: l ..!;. :c� t,. .;; ,,_�,..�; ; , _ . �.,_ ... , I•. ,. , , _ _ ; , ,._, � _ ,. i: '• �� osta Mesa Buflding Department l?IPPI,ICA7`ION FOR PERMI�1' 111 @AST pOth STREET �� f � p,` N G ' COSTA MESq, CALIFORNIA .. � �'OR OFFICE YJSE ONLY � FOYt APPLICANT TO FII.L IN Receipt No.. Permft No. s��ia��9 Address Q � �' � S�; CiOS� nZCSBy California Rece d by I ' Date Rec'd.. Date Issued ��e__e� �- I//�/D - SS� 'Cross St. Owner i IArohitector Engineer y �-Idress / ■ Address Metes and from 'erior Wall No. City No. � � ��e � ,�SQ Block r �a�� f �,Cs//6.- :l o O '. _ . � t l•f�o: oi Bldgs � e I rlow�on Lot ,�� . N .of No.ot � -.; ,5amilies Roome Addition � Costa Mesa, California � � No. of � Type �� Grou Buflding -7Af�f �"�C �*p y ,y Foundation Loeati� : Forms, Material: �- � ^ -- Under-Pinning , �' - Frame: Ffre Stops, Bracing, Bolts I hereby acknowledge that I have read this Application and state that the above is correct and agree to comply Lath. In4 with-all City Ordinances and State Laws regulating . building construction. Lath. Ext. Signatureaf ,� Permittee _�� Plaster, Int. Authorized Agt. , , Plaster. Eut Valuation PermitFee$ . �r. ' - M � O ��"' Plan Check $',3 - s a g $ J Total — Fee �� . �� F � FOAM 204 S-BP 2M 8-55 � . 0 V�S ��ppector _ _ . ..�.�.�.. , �—.—. . __ _ ; _ ', � . . ..� - ,. . , � .. •. m -- - � d j - � . i _ _ � J d '� - � ' j coszn a . ' a ;',av1�`,�'Ouesa`; 37&� >y;:,s103.�Q r-. __. ; •_:.-,.: . . ;l. . . _ '' - --?J � '.. . . . �.' � . .,. . . r _ _ _ . __ '"' e � - ?ar- `"'" � _ k ,+ , t � _ _ ' . Y `� ' ' _ � . . �� ` -:� , � ir-_\.. _ . - . - "r � �' . . - ' . " _ _ _ ' ' V . ' ' -' ' � . J- - • - . ,- . .�'. - � •=� - � — >• , +_�.-. ' - _. -�' ' .. ----i4 �_' � � J . m �- � T . � . - - I StrceY ' I � . , ,- . - . . ,. � _ . � ' _ _.. �c:�' , , 7Pu�J.' PLAN . ' , r 4 _.. t '�� . - , - 6how loeatiori and distances from , • property Iine and between buildinga � � � .. -- - - - -.. 2`' • ' •' __ . _ ' � I , . .. " _ `_-.� .-_- . :..- ' _ } . . ' _. . _. ' —_ •--» .� __ . .7f'.. : �t7 . . � ., � � -' ' ' ' i . . ` � ' - - - - —; •f^�..�� L_ �-- - --- ;.�__._ . .�. --- � - =,,.-.... -- _ , - _ . . , i . _ . - °� � . ' , .. ,�._• _ ' ` . . . .. • - - -- ; � _ � .� �.-;� '724'� . I '� COSTA MESA BUILDING DEPARTMENT P.O. BOX 31] GOSTA MESA. CALIFORNIA FOR APPLICANT TO FILL IN BUILDING ' A�DRESS �' COSTA MESA. CALIFORNIA MAIL ADDRE55 ��6 w, / CITY {,� USTt� M�f3 ARCHITECT OR �NGINEER / AL. L55 b �/2 CONTRACTOR � r NO. LIC. NO. CITY LIC. NO. TEL. ADDRE55 NO. LEGFL LOT oescvirnov NO. BLOCN TRACT A.P. NO. //l -� /f-D// � � � SIZE L / No.ov e�ocs. OF LOT �/�� X[J ��/� NOW ON LOT USE OF EXISTING BLDG. �9.f n r f p �-7' a y� SETBPCK LINE FROM G � c[NreA oF srA[[T - REAR YARD � �ISIDEYARD � RIGHT 4,�/� LEFT � DESCRIPTION OF WORK � NEN� ALTERATION ADOITION REr. .R MOVING DEMOLISH �BUILOING NO.OF SIZE ROOMS STORIES EXTERIOR WALL ROOF ` COVERING T "GOVERING ' USE OF NEW BUILDING Q/JY>.i /3nn %T. /� cosra Q �*k��4.00� nuc -i -sePDd�s�, � i�+a APPLICATION FOR PERMIT BUILDING FOR OFFICE USE ONLY FECEIPT NO. PERMIT NO AODRE55 /�� (f {��/ / / � b COSTA MESA. CALIFORNIA FIRE � ZONE 20N^ MO.OF TY A 1 Pt,.�ji/.�M/ , BY CORRECTIONS G�[TY ��} t'U�"" �.naIECT TO ST�1TE THwT TME T90VE I$ CORRECT PND AGPEE TO COMPLV WITM 4LL CITY OPDINFNCES RNO $TRTE L4W$ REG LPTING BVILOING CONSTNUC� ilOt�. VALUATION SIGNATIIRE OF PERMITTEE s �j0o\ AUTHORIZ AGENT PERMIT FEE � �� - P�AN CHECK $ TOTAL FEE S � `�� . ' 993'7 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 917 COSTA MESA. CALIFORNIA fOR APPC/CANT TO f/ll /N COMP[ETELY TYPE OR PRINT ADD EISS V�7�1 W� l�th �t. ALC� • 7(27 , COSTA MESA. CALIFORNIA 660 W. 17th St. �� LEGAL SIZE I^NOW ON LOT OF LOT i p USE OF AA /7/) � � � EXISTING BLDG� (�� T 1�7 SETBACK LING FpOM p � �� DESCRIPTION OF WORK .'�I� 1�{=v�:a�f Lii .� JUL 2 v 1959 fINANCE UEPT. CITY OF COSTA MESA APPLICATION FOR PERMIT BUILDING FOR Off/CE USf OHtY IRECEIVf NO. I P � IVfiD B�y I D'TE RECHIVED� � (�Y ,/7—< GOSTA MESA. CALIFORNIA FIRE �_v ZONE � TYPE GROUP / APPROVED �% �/. `� BV l DATE ZONING ZONE ' I NO.OF UBE OF NEW / PLANB BUILOINO BVPROVED DATE � YARDS EVES , REOUIftED ALLOWED (CENTEH LIN6 BT.1 - FRONT ,FT. IN. �� R.SIDE FT. IN. L. SIOE � FT. IN. BUILDING %`/ � NO.OF SIZE k9 J�. ROOMS STORIES E%TERIOR WALL IROOF COVERING COVERING USE OF BUIL�ING AND WORK TO BE PERFORMED Painting {"�c oT/� I HEflEBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THS A80YE IS CORftECT /�ND AGREE TO GOM- PLY W�TN ALL C�TY OflDINANCEB AND STATEJfAWS NEGULAT�NG BYILOING CONSTRUCTION/� / // AUTHORIZED » u.e TH¢ AMOUNT BMOWN UNOER VALUATION 18 FOR THE PURP08E OF PSTABL�SHING A PEPMIT FEE ONLY. VALUATION � DO PERMIT FEE $ �� $ ��ao � PLAN CHECK S'-/ � ! TOTAL FEE S/y' � "� . � � 13�C2 COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 917 COBTA M68A. C�U-�RORNIA For Applieanf to Fill In Complefely TYPE OR PRINT ' - BUILDING � ADDRE68 COSTA MESA. CALIFORNIA . �. � B6TBACK LIN2 iROM TEL. NO: OP lLDG6. SIDE YAR� I LEFT I RIGHT DESCRIPTION OF WORK ' I�^ II ALTERATION I I ADDITION REPAIR I IIMOVING I IDEMOLISH BUILDING NO. OF BIZE ROOMS STORIEE 6XTERIOR WALL ROOF . ' ' COVERING COVERING USE OF BUILDING AND WORK TO.BE PERFORMED � A�✓ir�.�vs.S"fto/� &oti /O �� '�i�� V �� NOV 9„ �� . CiTY,OF t�TA �1E��A APPLICATION FOR PERMIT . BUILDING For Offiee Use Only aece�wr rvo. . p t} . �� , MESA, CALIFORNIA �r�ATE �� ZO I�11 NG �� Ho. ov /� use or xew PI.ANe / / BUIlAIN6 � Q � / LEOAL (C6NTHR LIN! BTJ APPROVED � � � � � EVES 1 HER¢BY ACKNOWLED6E TXAT 1 XAVE Ii6�� n��e APPLIWTION 7Hg AMOUM 9HOWN UNDER VALUATION IB FOR TX[ ANO BTATE TXAT TXE �BOVE IB CORRECi AND A6RHL.TO COM- � PURPO6E OP,.EBT�BLI9HING A.PERMIT FGE ONLY. PLY WITH ALL GIiY O NANCEB AN� 8TAT6 uW8 RCO TINO BUILpiNo CONBTRU VALUATION n BIGNATURE OF ! PERMIT FEE $�G' / PERMITTE � //J �� ' S/"/ S � PLAN CHECK $�-_ AUTHORIZED AGENT � � TOTAL FEE � . � � � �_ _� �� COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX i17 Cpg7A MEBA. CALIPORNIA For Applicant fo Fill In Complefely TYPE OR PRINT � BUILDING / � O /�� .� �� ADORESS « w/ COSTA MESA CALIFORNIA '�' FEE RECEIVED �' JUN 14 i ;�l ~ FINANCE DEPT. CITY OF COSTA MESA APPLICATION FOR PERMIT BUILDING For Ofiice Use Only aece�rr no. /n�je rv er I oAT6 xec �V6D� I o�Te Bai / t/ i 7E�. COSTA MESA. CALIFORNIA NO. FIRE � ZONE TYPE GROUP APPRO ��r/�I��.r�/ I�� e1ZE I no. op etnas. OF LOT NOW OH LOT USE OF EXIBT NG BLDG. 86iBACN LINH FROM /_'� ✓ . DESCRIPTION OF WORK NO. oF ROOMB WALL IROOF COVEF 'ILDING AND WORK TO fi r _� - iz x ao oy� ��F ✓ e-N s e v � I H8R8BV ACRHOWLCD06 TN�T 1 MAV6 NHAD TMIB ARlJGT10N AND 9T�T6 TMAT TNH ABWB 18 CORRBGT I�ND AORBB TO COY• PLY WITH ALL WT' OHDINANC86 AND 8TAT8 lAWB fi6OUlATHO BURDINO CONBTItU�G�T10N. , � I 81GNATURE OF �//O ._ . . AUTHORIZED AGENT ZONING ' Z(j�i8 _� I HO. OR U88 OP NeW ' ,.�f PLANB �/ 9UILDINO n�svnnu...�u '� U!( ./ /i (7 � � -a--OCJ'U VARDS APPROVED cceemn uHe ei.� TH6 AMOUNT BXOWN UNDeR V�LUATION 10 YOR THe PURPO88 OP, 88TASLI6HIN6 A PBHMIT P[B ONLY. VAWATION � � PERMIT FEE $ $ �/� � (�(/ � PLAN CHECK $ E K n , � : �., �3�?2 ' -f,OS'fA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 9f] COHTA M6BA, CALIFORNIA For Applicanf to Fill In Completely . TYPE OR PRINT BUILDINO ADDRESS � f COSTA MESA, CALIFORNIA FEE R�CEIVEU FI�^'NCE20EPT�� .. ��4.`}�I��rCR/Y1R BUILDING For Office Use Only � RHCeIPlNO. I PEF D '�✓ NO. S - - Z 6 NO.OF OBCOFNEW �4JN2.�� V i C( Q Y � �uNa 2� au�LGlrvO I LeOAL I -{/- /�) 1,(/, / S 1 DHBCRIrt10N 0 /�(1 1' V '�G � I�" p ?' rr� � � � A. P. NO. O�" � �. L � � ' NOTE: NO EAVE OVERHAN6 SHALL BE LESS TIiAN � TEL. ' � 80" TO 91DE @ REAR P. L. NO. I EAVES ! No, oc pLDOB. ALLOWED <U. B. C. REqU1REMENT: rvOW ON LOT YARDBAPPROVED YARDSAPPROVED _ .... .. _ _ .. ?.. i . MAIN BUILDINO ACCESSORY BUILDINO BETBACK LINE FROM � ^� ' CENTER OF 9TREhT REAR YARD SIDHYARDI LEtT •�' ' I R16HT ^ DESCRIPTION OF WORK REPA BUI1. NO. OF ROOMB• I BTORIEB � IROOF' O%"`�WnL(� COVERIN6 O 4KT0 B6 PfiRFORMH� ...... _ ' 0 l�-:.. n o r o �---�— 1 HEREBY ACKNOWLEDOE THAT 1 MAVB R6AO TMIB APPLICAT�ON AND BTATE THAT THE ABOVE IH CORRECT�AND AGR88 TO COM. PLY WITH ALL CITY ORDINANC88 AND'6TAT6 I.AWB RHOULATINO BUILDINO CONeTRUCiION. . SIGNATURE OF ^ � PERMITTEE ��'�-t-��i-�'+�� < �' : �uC6a}a U AUTHORIZEDAGfiNT . - DIBTANGE BET. MAIN BLD6S. VAR.?t BET. MAIN Q AGCESS. BLI DATE 5 a so. Fr. THE AMOIINT BHOWN UNCER VALUATION 19 FOH TH8 �', p�1RPO5E Op EbTABLIfiHINO A PERMIT FEE ONLY. � VALUAT ON ' �� N � PERMIT FEE $ J . j S m $ � / LA CHEQ —^ � 3 "-� ` TOTALFEE S ' �• < 26393 •;. COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESAr CALIFORNIA 99l28 For AppllcaM fo Flll In ComplsNly TYPE OR PRINT �uaoiNaCGO W• /7�ST• S�D(r#.Z ADDRfiYG GOSTA MESA, CALIFORNI� A�� o,�e� J�ir� �T� ✓�Ns M�� o �x � 9 �3 �nr�aeu �/G/!T DESCRIPTION OF WORK �00 pART/T/oACS' FoR OFf�G� R �¢ �•9 , — 1 XCR6lY ACRN�M�6�DCt THAT.1 XAV6 RYD TY1i� AP�LiGTON AND BTAT[ }HAT TM[ 11BOVi,IB CORR ANC AON6[ YO COY• PLY WITX ALL CITY O IW�NCf! A�ID TA uvw piouunHs Bu1LDIN6CON9TPY� N. � HIGNATURGtlr y�/rj�j' - � P6RM1TT8 AUTHORIZ[DA [N'[ NUV 22-66 00 971 �*****3.00 MPLICATION FOR PERMR BUILDING f0� �lt� Uf! �Itn/ p[c[IIT HO. �_ , �� r n�ta nccnvao W'Ii IBBYBD li �1:� -�6 �r- �a�-�� 6o w� /if/,, Sf � ,� �a TYP[ � GROVP �! /J % o�re �� `G� �o(� IONING UO[ OP MI y � BUILDINO L60AL A.P.NO. //CD'�c(U%%-�/�% NOTE: NOEAVlOVERHAN68HALLB8LE88THAN YARDSAPPPOVlD I YARDBAPPROVBD MAINBUILDIN6 AGCH880RYBUILDINO \ v,�rs. # DATB APrROV[D �% OATQ /�'- G `1'�� w m � so. rr. � TX[ AMOUM {XOWt� UND[R VALUATION IB �OR n�e � �URPoG[ OP fPTAGLI8XIN0 A P61iMIT P66 ONLY. VALUATION +7 � �0 PERMITFE6 J•�� E �' s Oj �O �_ W TOTAl.FEE '�•O� F � W a Q ' y F ..s _. � COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOx 1200 COSTA MESA. CALIFORNIA 92626 \ �Hfl �Z'71Jfp<`1oo� 170�`� �'1}'t{Y 10.5( e APPLICATION FOR STRUCTURAL PERMIT For Applican[ to Fill in Completely — Usc Ink Only RECEI OATE RECEIV DATE ISSVED BUILDINO D �� Z �� ADDRESS / �Z OO PERMIT NO. �� OWNER �, G � O � A.P. NO. ADDRESS G(� O wi I�f�� Y" ` S ADDRESS �_ �/ TEl.6�/ Z TRACT LOT BLOCK CITV O S N F'' � NO. CONSTRUCTION W A D A P M LENDER �— BRANCH � ` OWNER � Gf�tt�A ADDFE55 � VALUE �,��% ARCHITECT _ TEL 5 S S/(TP �/ OR ENGINEEF N �_ FIRE 1/ ADDRESS ZONE TV I✓ GROUP APPROVEO � �� CONTRACTOR p L (. BY DATE ADDRESS ��r _��I�Ph TEL. � E � NO.OFJu+r USE OF NEW CITV �-- NO. �� 7jAfJ�` UILOWG STATE �� CITV �'ARDS AP ED VARDS APPROVED LIC. NO. LIC. NO. MAIN B N ACCESSORV BUILDING SIZE NO.OFBLOGS. (FROMC/ EE OF LOT NOW ON LOT ROM ' F7. USE OF ' EXISTING BLDG. J SO � .� G t p( N T FT Separate permits are required for L. SID FT. PT. electric, plumbing and heating work. REAR FT. FT. USE OF BUILDING AND WC�RK TO BE PERFORMED DISTANCE BET. BET. MAIN & P MAIN BLDGS. ACCESS. BLDGS. S P P J� VA�1.9?'� �ATE / S �^ Cl p Q � C.U.P.qW APPPOVEO Q 1( 1 � V 1 d k S I' A I I P O I N APPRO D�% �� C—.� � l l J t ( I hereby ecknowled8e that I have reatl this application antl state thet the above Information Is correct antl ag�ee to comply with all lawc reBuletinB bulltllnB co�rtruc2lon, enC 1 shell not amploy any person In vlolation of the workman's compensaHon laws of Me Stata of Celifornle. I hereby cartify thet 1 em properly licansetl as a conttactor untler SQ. FT. the State of Calitornla Businaxi and Profeuions Code, Divlsion 3, THE AMOUNT SHOWN UNDEF VALUATION IS FOR Chepter 9, and t�et such Iicensas era In full force antl attact, or 1 THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: em axempt from the provlsion5 of the Steta of Californie Busine¢5 VALUATION PERMIT FEE S antl Professlons Co e, Dlvislon 3, C apter 9. � PLAN CHECK $ � Sipneture of Permittae � S `�OD TAX S Q Authorizad Agent TOTAL PAID $ ' S� . �` . � : •� ' 0��46 �5�� Z9o. COSTA MESA BUILDING-SAFETY DEPARTMENT 6533 I,0/09/7B 25•25 T�' P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 ' APPLICATION FOR STRUCT'URAL PERMIT �/ For Applicant to Fill in Completely — Use Ink Only qECEI V ED B V DATE RECEIVED BUILDING D!�TE ISSUED ADORESS , \�""�}h � � � OWNER ,�� ' � �� A.P. NO. -aa o P MA I L , ' \ BUILDING ADDRESS Cp� W.��kh S� �_ �+ODRESS 0" � TEL. TFACT LOT BLOCK CITV CQS�'� ��S NO. CONSTRUCf10N W ADD A R LENDER BRANCH OWNER y ADDRESS ` � E ARCHITECT TEL. US $� OR ENGINEEF FIRE �l ADDRESS 20NE TVPE GROU� �O� V� \UV � Q� R -'� APPROVE CONTRACTOR BY DATE 1 ADDRESS `rj�� 7, � �W _V 'ZO NO.OF USEOFNE CITY Q�(� \�� NOL �\ '� PLAN$ p� BUILDING .F-i STATE CITV YAR SAPPROVED VARDS PROVED LIC. NO. `�` ,'Z� 4C. NO. MAIN BUILDING ACCESSORV BUIIDING {� SIZE NO.OF BlDGS. (FROM C/LSTREET) �. OF LOT NOW ON LOT FT. FT. a USE OF � EXISfING BLOG. FT. FT y FSeparate permits are required for �. si FT. FT. 0 electric, plumbing and heating work. REAR FT. FT. �.W..i USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. ET. MAIN & qMAIN BLDGS. A . VAR.qW DATE aS'�� = C.U.P.q�`- APPROVED 7 ' APPROVED i' ..� a v� � I heteby ecknowledBe ihat I have reatl thiz epplication antl rtete � y� ihet t�a ebove InformeNon is correct and aprea to comply with m a ell lews repuleting builtling eonrtruction, end I shell not employ Z eny Oerwn in violatlon of tM1e workman's compenaatlon laws of : S ihe Stata of Celitornia. -� m 3 I heraby certify thai I am prope�ly Iicensatl as a contractor untlar SQ. FT. � J tha Smta Of Celifornia Business end Ptofaulons Cotle, Diviclon 3, THE AMOUNT SHOWN UNDER VALVATION IS FOR 0 Chaptar 9, antl thet such Ileensez ere in full foree ontl efiaci, or t THE PURPOSE OF ESTABLISHING A PERMR FEE ONIV: � am exempt from tha provlsions of tha Stete of Celifornle Businass — � U a Bnd PrOfecslon9 ode, DivialOn 3, �epter 9. VALUATION PERMIT FEE 5 � Sipnefura of y �al P�N CHECK E O1 _, �j o Permlttee $ `��\ • TAX 8 �b u Authorizatl AO^�t TOTAL PAID SZ –. Z� �� E' � W 0. a y � S F G F� C C ..1 a > r .� x w a O �. a Z W S 3 . 047028 ' COSTA MESA BUILDING-SAFETY DEPARTMENT P.D. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Comple[ely — Use Ink Only BUILDING -7 ADORE55 �LO W • � 1`�• S� • OWNEfi �Z��O�� YI�I�� MAIL � ADDRE55 GLCJ W• I �� • CITV G�7�A M�'�..� NOL �O% BRANCH ADDRESS ARCHITECT OR ENGINEEF A�DRESS TEL. CITV NO. STATE CITY LIC. NO. �IC. NO. S12E NO.OF BLDGS. OF LOT NOW ON LOT USE OF EXISTING BLDG. Separate permits are required for electric, plumbing and heating work. USE OF BUILDING AND WORK TO BE PERFORMED AP L C ION FOR STRUCI'URAL PERMIT REC I EA V DATE RECEIVED E�iy� // ^� i A.P.NO.II �p � �Ud'-`�/ I'.�..�...� ADDRE s GGO � . :7 � C r O ' TRACT /y��Lf LOT SD B ROVED ZONE NO.OF M %/ P� p,Ns ; VAROSAPPROVED MAIN BUILDING VAR. 9W C.U.P.gy+ � USE OF NEW /�NT• BUILD7NG A L.T • VARDSAPPROVED ACCESSORV BUILDING BET. MAIN 2 ACCFSS. BL[ DATE APPROVED .,�r� !/ I hereby acknowledBe t�et I have reatl this application end rtete Shet the above info�mation Is correct and egrae to comply with ail lews rapul6tlnB builtling conrtruction, anE I shall not employ any Darwn in ��olation of Ma workman's compansatian laws ot Me State of CalNornia. � � w� I hereby certifY that 1 am properly Iicensetl as a contractor untlar FT. %�D �f+�(. — ihe Stete of Callfornia 6usiness and Professions Cotle, Dlvislon 3, THE AMOUNT SHOWN ALUAT Chapter 9, end that such Ilcensea ere In full force and �effect, or 1 THE PURPOSE OF FSTAB S A PERMIT am axempi fr Ma provi5lons ot the State of California Bus(nass VALUATION p MI FEE S entl Profes na otle, Divisio ,� pter 9. /'� ` L � PLAN CHECK E� Signetu� � (� Parmlttee � $ �//�� 7AX $ V\ AuthOrized APent 70TAL PAI D $ IS N � m 7 m e u� m m 0 LL F U � 1 e • � ' � COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only ADIDRESS L�l�� iI /�%/1.. ST MAIL ADDRESS CITV CQS, CONSTRUCiION LENDER BRANCH ADDRESS ARCHITECT R W . L. TEL. �V � ��H� I/22/79 23e00 APPLICATION FOR STRUCTURAL PERMIT RECEIVEDBV DATERECEIVED na�rciccnFn A.P. NO. / / k BUIIDING ADORESS TRACT 0 PERMIT NO. BLOCK � ADDRESS U p �J�CUK-� - TEL. i ZON NO.OF USE OF NEW CITV % �(/�/�p� NO. Z �� P�� BUILDING � � STATE CITY YARDSAPPROVED VARDS f � LIC. NO. Q LIC. NO.Q�� 2, MAIN BUILDING ACGESSOR' (a� SIZE NO.OFBLDGS (FROMGLSTREET) lJ 0. OF LOT NOW ON LOT RONT FT a USE OF � EXISTING BLDG. F � FSepa�ate permiu ace requiced for L. SIDE o electric, plumbing and heating work. REAR F7 (.W.i USE OF BUILDING AND WORK TO BE PERFOFMED OISTANCE BET. � MAIN BLDGi. ' �LNSI�9(�1-Tl�nl O� G� C�G-�r.�2 �2oS C URP.� ort ` SR'�� P�iNT � ; � X�sT ��c�� ROVEDGW a �2r �- L,t,t�. a o- - PGc-nFaM w 0 1 �e�eby acknowletlpe thet 1 have reed this apPllcation antl rtete (Y, Mat the ebove Information Is correct and aprea to comply with a all laws regulatinp bulltline �onstruction, entl I shali not employ Wany perwn in vlolailon of the workmen'z compensallon taws af S Me Smte ot CalHornia. 3 I he�eby cenify that I em properly Iicensatl as a contractor untler SQ. F' the Stata ot Calitomfa Busineu and Profeulons Cotle, Dlvision 3, THE AMOVNT'. Chapter 9, and thot suc� licenses are in full farce antl affact, or I THE PURPO6E O em examOt from the provlsions ot the Steta of Calitornia Businecs VALUATION antl Profeulonf Co , Divtsion 3, Ctiep�9. S�etura Of ((( L /� P rmlttee _ t ` � $ BET. MAIN & ACCESS. BLDGS. oa� APPROVED �— ��T< < -L-t., n m . ' m m N IOWN UNDER VALUATION IS FOR m ESTABlISHING A PERMR FEE ONLY: e PERMIT FEE § p N m PLAN CHECK $ ^� 0 TAX S LL f TOTALPAID 5 � V