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Home My WebLink About3188 AIRWAY AVE - Building Permits� CITY OF COSTA MESA Development Services, Division of Building and Safet� CERTIFICATE_QE:QCCUPANCY -,�� C'r `? i � � r?'�� This certificate is issued pursuant to the requirements of,the Uniform'Buildmg Code, Section 308 adopted by the City i �� J _ -:. �!� �r�� .�?. of Costa Mesa certifies that at the Hme of its issuance ttie.building s�tru\ct.u're fiereui below described was inspected and approvedforoccupancyasfollows��' C��% \,\\�� /�!�� . �° �\. Building Address 3188 AIRWAY�AV,: , OA , p; , .,. -�Bldg(Permit Number B02-00550 _ /r/� /,al ,� r :: � ��, � � ,_�\�`\\� Use Co�ercial/Indus$rial� yf�,�, } %�,`��''- � -,_��j� �� r -i .i '�� t/� �.. - j .� i r � �,�, 1�,� � � �� r �; i Group B�S-1 TypeotConstructioma�c�rniccnrac Fire�Zone ��` � ��'� UseZone �1, �^ ° i ` `-•-- I ; i _, .� Charles'H:'�Hofmann,s�✓� Office/Warehouse Owner of Building �:1, �,� _ _ _ �n� _ - �Te'nant ; ., Address 1048 Irvine Ave;'1Suite�624 Newport Beach;';CAi;92660�� -�,�� -�� .-;� T'• �/ -✓ � \ � ' y % � � B BUILDING OFFICIAL-R1CiC�l�� BI�'OWII; C.B � ��°" �� /� �- --s_ - - �� 8/�30/02 \�/� � — _ Datej?i / / \�`�Jif ��i.�<� �'J : S`J '�%° - i> '�� REQUIRED TO BE POSTED IN A CONSPICOUS PLACE � • (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 3188 AIRWAY AV Suite: A Vicinity: BLDG A(HOFMANN FINN CORPORATE OFFICE) Parcel Number: 42719333 Applicant: Address: Owner: Address j � Contractor Zoning: Status: ISSUED Applied: 04/25/2002 Issued: 04/25/2002 HOFMANN, CHARLES H _. .---- .� iSSUED BY: i�-��_ 10481RVINE AV j j�j'j!'=Phone:/ 949-515-8822�� /�`�\� STE 624 � � � ,. � -_ ,_ � , NEWPORjBFACH CA -^� � ' Zip: 92660 ; . � �� \ � �/, �� . , � i � � �� HOFMANN;�CHARLES H t � ' �' ! � �� /A� ,�� 7048�IRVINE AV � � � - - � - � '�' �� STE 624, A � / - ' _ Phone: � ' � ,'•. �.� � �` �� . , � � _. : NEWPORT,BEACH CA � `- Zip_ 82660 � � -- `�� j� �� \ ; i'�!',"/� �� \ � � �� , ��\ OWNER BUIL-DER �'�� %� � � � ;\ ; "Address:; � �/,/; - �' ��.�� ✓ � \ % �'% ,�i�"�Y� Phone:!� ��.�. � �;, � . l � , % / /.,/ � . �'�� \�� Zip -! /L��' ' License:"-0 ' - � _ � �� A . .� � .. _ A '�,,. ' � ,:' , , -' - _ � ��, , . � . -� . � Arch, : � � % - Eng: • �� , .� � Address:� " / �L,� y �� Address:; - � �� , �� ;�: � �� Phone: -' - _ _. _'. _ . , _ ✓," �� - � , � j � Phone: ' , • � � , � . -� . i / . �� /'' �t� .- ' ��Zip: '- .��' � \ ''License: � � � 'Licen4e: . � ' � i J. �. j _ �� ... - , � � �' �''v,,-P,:';Y /�� SCOBEAFPERMIT-,:;-:�-• ��.� � ; � �� , ' �/ INTERIOR DEMOLITION OF�AN EXISTINGJNDUSTRIAL BUILDING,FOR FUTURE 71 WORK�(OFFICENVAREHOUSE). . � - - -- �- . ._ _ . , ,, , % ', ' ' - � FEE SUMMARY ^ - � Plan Check:, � � $0.00 = " �� °^ - � �: _ � �` � � � y; �� Calc Valuation: �� Sa,000.00 � PermiL $97.25 ; " ' � ! ` � Claim Valuation ` ' $a,000.00 ' �SMIP Res:�� $0.00 � � . . ��- �� - % � �,, ; SMIP Com: ' $0.84 �' - �' � - _ Other. $0.00 -` �. � �Inspection: ` ',�$0;00 ��_.;:_ � i��:,�� '� , ,` � '.� i ...,i.. , � ��Total: � , $98-09 � - ,',�� . ��/ \ �> _ \\� . �,�:-, - - - ' �� = �,%% > % ,�.; � �//� �`: � 1 PLANNING 8 ZONING - �' / � / � • ,, . SETBACKS �A �� j; ._�� ,, � � , % � �; % , � � MAIN STRUCTURE Front- 0 .0�% � �Rear `0 0 � Left ' 0-,0 . Right 0-0.0 � . � � \ ,. � ' . _ ,,. _ . -:� . , i , ACCESSORY �Front� � 0- 0� /�% \Rear- - 0- 0 � Left 0- 0 - Riglil �' . 0 0�' �/� � i(, � . _ . . ;�, � i!i",/ \. � �. r . ' ' / 1 �' � • 1 \ i /.' l \ ' � . ' 7' - . / PARKING Exlstinq:� 0�_� Re'uired: 0 Pr000sed: 0� _., �� ' -- �i , . �� . . . __. - ' �� ii�_ � NOTES: ' � - � , `'� NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremants under California statutes and related regulations. (Ord. No. 92-28, § 1, 12•21•92) EXPIRATION: This perm0 shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and ell required inapeetions and final approval must be obtained. Failure to obtain inspections and final approvel will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 zsac+e lawl WORKERS' COMPENSAnON DEC�RAnON: I hereby aHirtn under penelty of perjury one of the following declaratlons: � . ' ❑ I heve and will maintaln e certUicate at consant ta self-Insure for workers' compensation, ea pmvided for by section 3700 ot the Lehar Cotle, for the petlormence of the tiwark tor which this permll Is IsSuetl. 0 I lieve arW will main(ain workers' compensaUon �nsurance, as repuired by sectlon 3700 0l ihe le0or Code, for the peAamarice ot Ne work tor which this permit is LaweC. My workers' compensatlon Insurance caMer end pollcy number ere: Cartier: Poliry Number: (This section neetl not be complete0 �� the perm/t !s veluetl at one hundred dollars ($)00) oi less.) ❑ I certify Ihat in the pedormance o� the work for which Ihis permit is Issued, I shall not employ eny person in any menner so es to bacome subleci to ihe workers' wmpensetlon laws of Calitom�a, and agree Ihat it I shoultl becoma subfect to the workers' compensation provlsions of Section 3700 oi Ihe Labar Code, I shalllorthwlth comply with these pravislons. Applicent Signetura: Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UMAWFl1L AND SHAl1 SUBJEGT AN EMPLOYER TO CRIMINAL PENALTIES ANO CML FlNES UP TO ONE HUNDRED TMOUSAND DOLLARE ($100,000), IN AODRIqJ TO THE COST OF COIAPENSNTION, OAMAGES AS PROVIDED FOF IN SECTION 31060F THE LABOR CODE, IMEREST, M'D ATTORNEVS FEES. UCENSED CONTRACTORS DECLARATION: I hereby aflirm ihat I am licensetl untler provisions of Chapter 9(commencing with Section 7000) af Division 3 of the eusiness end Professions Coda, end my Ilcense Is in tull force and eHecL Lic. N CIasS M Gontrecto/s Signeture: Dete: CONSTRUC710N LENDING AGENCV: ❑ I hereby aftirtn ihat there is a construction lentlinq agency for Ihe peAortnance of iha work for which ihis pertnit is issued. (Sec. 3097, Civil Code). Lentlefs Name: _ Lenders Address: SignaWre: � Date: � OWNER-BllILDER OECLARATIONS: I hereby aHirtn thet under penelry of Oerjury thet I em EXEMPT FROM TME CONTAACTORS LICENSE LAW tor Ihe tollowing reason (Sec. 7031.5, Buslness end Protesslons Cotle: Any dry or wunry which requires a permit to consiruc6 elter, improve, demolish, or rapair eny strucWre, prior to Its issuance, also requires the applicant for such permit to file a signetl stetemem thel he or she is Iicensetl pursuam m t�e prodslans at t�e Contrectors Licensa Lew (Chapter 8(commencing with Sectlon 7000) of DlNsian 3 of Ihe Busineu enO Prolesslons Code) or ihet he or she Is exempt Iheretrom end the basls for the alleped exemption. Any violation of Section 7031.5 by any applicant lor e pertnit ��ects the applicam to e civil penalry ot not more t�en Tive hundred dollers ($500).): I, es owner of the property, or Riy employees with weges as thel� sole compensation, WILL DO THE WORK, and ihe stmcWre �s not Imentlea or ottered tor sele (Sec. �7044, Business and Professions Code: The Comraciore License Lew does not apply to an owner ot property who Duilds or improves Ihereon, end who does such work hlmself or herself or �hrough his or her own employees, provided ihet such improvemenis ere not intentled or ottered for sele. If, however, the building or Impravement Is �sold within one year of complelion, the owner-builtler will have ihe burden of proving that ho or she did not build or improve Por puryose of sela.). I, as owner of the properry, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct t�e proJect (Sec. 70d4, Busineu and Professions Code: The comractors License �-ew tloes not apply ro an ownar oi properry who �uiltls or Improves Ihereon, and who contracts br such project with a contractor(s) license pursuant lo the Contr dors Li anse ws.). ❑ I em exga�tpptler sec. � Business entl Pmfessions Code br Ihis reason: Ignature:s�_ � ti� �� _ EDete:> � � " Owner ID verifietl by ddvers license. ❑ Ves No Drivers'License No. 6cpf�res�.�— fL / 6]i Venficatlon of Ownership 6y (type of daument, i.e. - properry tez bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICA710N: � I hereby certify Ihat na excaveHon tive (5) or more faet In depth Inta which a person is requlred to descend, will be mede In connectlon wlth work euNodzed by Ihis permit, and that no building stNcture, scaHolding, falsawork, or demolition or dismantling thereof, will be more then thirry-six (38) feet high. (Chap. 32, Gry 2, An 2, Sec. 341, Ttle 8, California Adminisiretive Code). ❑ As owner-builaer, I will not emDloy enyone to do work which would require e partnit trom Ihe Division of Industnel Safety, as noted ebove, unless such person hes e permit to tlo such work Irom the division. Signature: Data: Division of Industdal Sefery Pertnit Number: CER7IFlCATE OF COMPIJANCE ANP AIfT}IORIZATION OF ENTBY: I cetlity under penelty of perjury ihat I have reatl this flpplication and state that the information given is correct. I agree b comply wlth all si 6�e laws nd city ortlinences relating to building constructlon, anO euthonze representatives of ihe Ciry of Costa Mesa to enter upon Ihe ebova-dgetTlt��rry for insp i �� es. I ree not to xcupy or ellow occupancy of any builtling aut�orized by this�J rmit until tinel inspecUon. o `l/ �— S� �O 1� I neture Of Legai O erT`s ' Date._� ..,s,.c. - >-� , .. � � . qnd/pr puthorized Applicent Date GOUE I, INSPECTIONTYVE 1616 Fixed System Final Fire Pre�ention 7266 Pool Spe Finel 200 Final Fe-Roo1 201 Final BIxWReteining Wall 202 Final Fedory Fire Place 203 final Sign 204 Final DemWition � 1�� COOE� INSPECTIONTYPE 206 Final Mec�anical 20B Finel Plumbing 210 Finel EIBc�Acal 212 Final Fire Preventlon 220 Final Planning ADP�oval 222 Final Site 250 Final Builtling/OccuDency � �-13-oZ_ � (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 3188 AIRWAY AV Suite: A • Viciniry: Parcel Number: 42719333 Applicant: MILLER, MARK Address: i, � Owner. HOFMANN, CMARLES H Address -10481RVINE AV , �. . � ' STE�624 � - " , -'NEWPORTBEACH;CA"- - Contractor: �SKYLINE ROOF CO INC Address: P.O. BOX 91538 - � -. LONG BEACH, CA � Zip: 90809- � Arch : Address: „ � Phone: Zoning: Phone: 2ip: Phone: Zip: 92660 Phone: (562) 4260848 Status: ISSUED Applied: O6I18I2002 Issued: O6/18/2002 ISSUED BY: License:� 606954 . _ - Eng: Address: Phone: Zip: � � , License: � License:. „ � , - SCOPE OF PERMIT RE-ROOF WITH 4-PLY BUILT-UP..ROOFING. .� . � . , , _ . „ . . � � � Plan Check: $0.00 Permit: $15325 SMIP Res: $0.00 SMIP Com: $1.64 Other: $0.00 Inspection: $0.00 TotaL ' $154.89 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0- 0 PARKING Exislinp: o NOTES: � _ ; -. .,.' " Rear 0-0 Rear 0- 0 Reouired: 0 FEESUMMARY PLANNING & ZONING Left 0- 0 Left 0- 0 Proposed: 0. Calc Valuation: Claim Valuation: Right 0- 0 Right 0- 0 $7,800.00 $7.800.00 NOTICE: Tha work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and related regulatlons. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned tor a period of 180 days. INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requl�ed inapectlona and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 , 2aa6b8 (fl�00) WORKERS'COMPENSAnON DECLARAnON: � I hereby aHirtn under penalty o1 perjury one of tha following declarations: . � p I hav end wlll rt�inteln e ceRificate of consent to self-Insure tor workers' compensatlon, es proNtled tor by section 3700 0l the Lebor Code, for ihe peAartnence of ihe ` w tor which this pertnil Is issuetl. � have and will maintajn workers' compensetion Insurance, as requlred by section 3700 of the Labor Cotle, for Ihe pertortnar�ce oi the work for which Ihis pertnit Is Issued. My warkers' compery5etlon Insurence cerrler entl pollcy number ere: Carner. Policy Number: (This secHon need nat be rnmplefed 1/ Me permif Is ve/ued ef one hundred dollars ($100) or less.) ❑ I certity that in the peAortnance of�tha wark for which this pertnit Is Issued, I shell not employ eny person in eny menner so es to become subject to the workers' campensetion laws of Califomie, end egree thet H I should become su �ecl �o ihe workers' compensetion provisions af Section 3700 of the Labor Cotle, I shell forihwith camply with Ihese provislons./J�J� / � (`��/7 ApplicantSigneture: i�'U�Y�-�,� Deta: V��' � �v ` WARNIN�: FWLURE TO SECURE WOHKERS' COMPENSATION COVEFiAGE IS UNIAWFUL AND SHFLL SUBIECT AN EMPLOYER TO CRIMINAL PENALTIES AND GVIL FlNES UP TOONE HUNDRED TliOUSMlD DOLLARE (5100,000), IN ADDITiON TO THE WST OF COMPENSATIIXJ, DAMAGES AS PROVIDED FOR IN SEGTION 31O80F THE LABOH COOE, IMEREST, PND ATTORNEYS FEES. LICENSED CONTRACTORS DECLAHATION: I hereby eHirtn that I am licensed under proNslons of Chepter 9(commencing with Sectlon 7000) of Division 3 of the Business antl Professions Cotle, entl my license Is in tull force anA ettect Lic. q Class p Gonirecrols Signatura: �L Dete: � CONSTAUCTION LENDING AGENCY: � ❑ I hereby aHirm ihat t�ere is a construction lending agency tor Ihe perfortnanca of ihe work for which this pertnit is issued. (Sec. 3097, Civil Code). Lenders Neme: lenders Adtlress: Signature: Date: OWNER-BUILDEfi DECLARAT10N5: I hereby eflirtn Ihe� untler penalry oi perjury Ihet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW tor ihe follawing reason (Sec. 7031.5, Business entl Professions Code: Any clry or counry which requires e pertnit lo construct, elter, Impmve, demolish, or repair any strudure, prior to its issuance, elso requires the eppliwnt tor such pertnit to file e slgned statement thet he or she Is Iicensed pursuent to the proNslans ot the Contrectors Llcense Lew (Chaptar 9(commencing with Sectlon 7000) of DlNsion 3 of t�e Business entl Protessians Code) or thet he or she is ezempt thereirom entl ihe besls for ihe alleged ezemptlon. Any vidation oi Section 7031.5 Dy any applicent for e pertnit subjeds the epPlicant to e Uvll penalry ol not mare than Me hundred dollars ($500).J: ❑ 1, as ownar of the property, or my employees wilh wages as their sde compensetion, WILL DO THE WOfiK, and the structure is not intended or oHeretl tor sale (Sec. 7044, Business and Professions COAe: The Contrectors License Lew does not epply to an ownar of property who builds or improves therean, and who daes such work himsell or herself or through his or her own employees, provided Ihet such impravements ere not Intended or ottered for sale. If, however, the building or Improvement is sold within ona year of comDletion, the ov+neo-builder will heve tha burden ol proving that he or she did nat build ar improve tor purpose of sale.). ❑ I, 85 owner ot lhe property, flm El(CLUSIVELY CONTRAC7ING WITH LICENSED CONTRACTORS Io wnslruct lhe project (Sec. 7044, Business and Pmfe55ions Cotle: The contrectors Llcense Lew tloes not eppty ro en owner of properry who bullds or impmves thereon, enA who contracis tor such project with a contractor(s) licen5e pursuant to Iha Contrectars License LewS.j. ❑ I am exempt untler sec. Signature: Owner ID verifed by drivers Iicense. ❑ Vas ❑ No Business entl Protessions Code for this reason: Venfication o1 Ownership by (rype of document, I.e. - properry tax blll or tleetl): DIVISION OF INDUSTRIAL SAFETY PEHMIT CERTIFICATION: Drivefs License No. Data: Ezpires: ❑ I hereby certify that no excavation live (5) or more feet In depih Into which e person is required to tlescend, wlll 6e made in connedion with work euthonzed by this pertnit, end that no building struclure, scaHolding, talsework, or demolition or dismaniling Ihereol, will be more �han thirty-six (36) feet high. (Chap. 32, Gry 2, Atl 2, Sec. 341, 71t1e e, Cellfomia Administretive Cotle). ❑ As owner-builder, I will not employ enyone to do work which would require a pertnic from the Division of Industnal Satery, as notetl ahove, unless such person hes e permit to da such work from the divislon. Signatura: Date: Division of Industrial Safery Permit Number: CEHTIFlCATE OF COMPIJANCE AND AUfHORQATON OF EMRY: I cenify untler penalry of perjury that I have rea0 �his apDlication and sfate that the inlortnation given is cortect. 1 egree to wmply with ell stete laws entl city ordinances rela�ing to building construction, entl euthorize represantatives of ihe Ciry of Costa Mesa to enter upon Ihe ebove-described property lor inspection purposes. I agree not to occupy or ellow occupancy oi any building authonzed by this permit un�il fnal inspection. s%'�' '�Lf/�-iure (.�ega ne s)� ' / ' / �� O � �0 Antl/Or Aulhorized Applicant Date COpE 1, RISPECl10NTYiE 1616 Fixed System Final Fire Prevention 126fi 200 201 202 203 Pool Spa Final Finel Ra-Roof Final BIocWReteininp Wall Final Faclory Fire Pleca Flnal Sign 204 Final Demolition Pdg I�LS j�� i�Ol..� �'%✓ LOOE� QISPECfIONTYPE 206 Final Mechanical 20B Final Plumbing 210 Final Electncal 212 Final Fire Prevention 220 Final Planning Approval 222 Final Sita 250 Final Building�Occupancy QSTu I[�1R (714) 754-5273 • Fa�c (714) 754-4856 . www,ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 3188 AIRWAY AV Suite No A Vicinity: Parcel Number: 42719333 Applicant: Address: Owner: Address: HOFFMAN,CHARLES 10481RVINE qV NEWPORTBEACH;CA , � HOFMANN, CHARLES H , 10481RVINE qV - � - STE 624 NEWPORTB�ACH,CA MECHANICAL PERMIT Phone: 714-5452263 � Zip: 92660 Phone: Zip: 92660 Contractor. HOFMANN FINN DEV COMPANY INC, Address: 350 ROCHES7ER ST � ,COSTA MESA, CA .Phone: (949)515.8822 Zip: 92627 License:731034 Status: Applied: Issued: ISSUED BY: SCOPE OF PERMIT 6000 SF INTERIOR TI FOR AN EXISTING INDUSTRIAL BLDG: 4040 SF OFFICE AREA AND 1960 SF WAREHOUSE�. � ' � � � PORTION OF FRONT WALL TO BE PUSHED OUT RESULTING IN 80 SQ.FI'. ADDITIONAL AREA. REF: B02-00549. MECHANICA� TO INCLUDE: REPAIR/ALT EXISTING SYSTEM (5 ZONES), 3 VENT FANS TO A SINGLE DUCT. ISSUE FEE Insl FAU <100 k BTU Inst FAU >100 k BTU Repair/Alt Cooling/Heat Inst / Rep. Recess Wall Htr Refrig Sys <100 k BTU Refrig Sys >100 k BTU Gas Piping Factory Fireplace Hood w/Mech Exhaust VAV Box Vent Fan / Single Duct � Appliance � Fire Dampers Smoke Dampers Inst or Relowte Appl Vent Air Handlers < 10000cfm Air Handlers > 10000cfin Floor Fumace Floor or Suspend Heater $23.50 $0.00 $0.00 $68.50 50.00 $0.00 $0.00 E0.00 $0.00 $0.00 $0.00 $21.75 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 so.00 $0.00 Quantity FEE SUMMARY Repair / Alt Absorbtion Unit Repair / Alt Refrigeration Unit Ventillafion System Evaporative Cooler Commercial Incinerator Domestic Incinerator Compressors I Absorption Svstems Upto3hp/t00kBTU 3 To 15 hp I 500 k BTU 15 To 30 hp / 1,000 k BTU 30 To 50 hp / 1,750 k BTU Over 50 hp / Over 1,750 BTU Boilers Upto3hp 3To15hp i5to30hp 30 to 50 hp Over 50 hp Other Mechanical Fee Investigation Fee Plan Check Fee Reinspectlon Fee ISSUED O6/04I2002 O6/04/2002 Quanlity $0.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 so.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES $113.75 COMMENTS / SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under Calitornia statutes and related regulatlons. (Ord. No. 92-28, § 7, 12-27-92) EXPIRA710N: This pertnll shall automatically expire and become vaid if work is not commenced wlthin 180 days, or ii work is suspended or abandoned for a pedod of 180 days. INSPEC710NS: In order for the work aNhorized under this permit to be considered legal, such work must comply with all appliwble codes, and all required Inspeetlons and final epproval must be obtained. Failure to obtain inspections and final approval will resul� in the expiratlon of this permit. FOR INSPECTIONS CALL: (714) 750.5626 . saasre �aoo� WORKERS'COMPENSAnON DECLARAnON: I hereby eKrtn under penalry ot per�ury one of ihe fdiowing dedaretlons: ❑ I heve entl will meintein e cenilicata of consent to self-Insu lor workers' compensetion, as proNAad lor by sedion 3700 of the Lebor Cotle, for Ne peAortnance of �he wo for w�ich t�is pertnit is IssueC. ve end will malnfain workers' cmn�tlon insurenca. requiretl by section 3700 of Ne Lebor Code. lor the pertortnance of Ne work for which tlds pertnil ls issuea. My workers' C 5 ion Iryt ra te cem r end poliq n ber ere: Ilr1L� ��/I Cerrler. � .�/1'� G Policy Number. �`� J�� I�C �� (This secNon need nof be camp/efed 1! fhe permi Is re/ueC ef onB huntlred tld/eB (5100) or IBuJ ❑ I cenity thet in the peAormence of the work lor which this pe it is Issued, I shell not employ eny poraon in eny manner so es to 6ecome subject to Ihe workers' compensatlon laws of Califo , entl egree thet If I oultl � i i uClect to the workers' compensatlon provisions of S ctlon 33700 of Ihe Lebar Catle, I shell forihwlth comply wlth these proNsi s. � 1�//, � Applicent Slpnature: Date: I � lJ WARNINO: FAILURE TO SECURE WO CERS' COMPENS�TION COVEfUOE IS UI M1D SHMl SUBIECi NI EMPLOVER TO CRIMINAL PENr1LTIE5 �HD CML FlNES UP TO ONE HUNORED THIX15MlD DOLURE (5100.000), IN ADqTION TO THE WSi � WMPFNSATION. ES AS PilOVIDED FOH IN $ECf10N 3�O60F THE LABdi COOE, IMEREST, AND ATfORNEYu FEES. LICENSED CONTRAC70HS DECLARATION: I hereby eHirm Ihat I am Ilcensatl under s� forca entl eHect. Lic. a � contrecrors signeture: Seclion 7000) ol Dlvision 3 oi Ihe Business and Prolesslons Code, end my Ilcense is In full _ Class k Date: D i� �% CONSTRUCTION LENDING AGENCY: � � ❑ I hereby eifirtn that Ihere is e Consiruction IerWing agenty lor the peAortnance of tha work lor which Ihis permit is issuatl. (Sec. 3097, Civil Code). Lenders Neme: lentlers Atltlress: Sipneture: Date: OWNER•BUILDER DECLARATIONS: I hereby eHirtn that untler penalry oi per�ury Ihei I am EXEMPT FROM TME CONTRACTORS LICENSE LAW tor tha tollowing reason (Sec. 7031.5, Buslness end Professions Cotle: Any ciry or wunty which roqWres e permit to consWct, fllter, improve, tlemolish, or repalr any sirucWre, prior to its Issuance, elso requires the applicant br auch permil to flle a signetl statemen� that �e or she u Iicensed pursuant lo ihe provLsbns ot the Contrecmrs License lew (Chepter 9(commendng with Seclion 7000) oi OMsfon 3 of ihe Business end Professions Code) or Ihat he or she is exempt therefrom and Ihe basis for the alleged eaemption. Any Nolation of Sectlon 7031.5 by any epplicant for e pertnit sub�ec7s the epplicant to a dvil penalry of not more ihan Me huntlreO Oollars (5500).): ❑ I, as owner of lhe property, or my employees wii� wages es t�eir sda wmpensation, WILL DO 7HE WORK, and the SWCNre I5 not intendeC or oflerad br sela (Sec. 7044, Business entl Protessions CoOe: 71ie Contractors License Lew does not appty lo en owner of properry who builds or improves thereon, and who does such work himselt or hersett or ihrough Ns w her own employees, providea Net such improvements are not intentletl or oNereC for sale. tl, however, lhe building or imprwement is sdd within one year ot wmpleUon, the owner-0uiltler will heve t�e burden at proving that he or she did not builtl or improve tor purposa of sale J. ❑ I, as owner of ihe properry, em EXCLUSIVELV CONTRALTING WITH LICENSED CONTRACTORS to construct the pro�ect (Sec. 7044, Business antl Professions Code: The contractors License Law tloes rwt apPN �o an owner o1 pmperty w�o huilds or impmves t�ereon, end who coNracts lor such prqect with e wntracror(s) licensa pursuant to the Contradors ticense Laws.). ❑ I em ezempt under sec. Business end Protessions Code for Ihis reason: Signature: Date: Owner ID verified by tlrivers license. � Yes ❑ No Drivels License No. Veriticatlon of Ownership by (rype of dacument, i.e. - properry taa biil or OeeC): DIVISION OF INDUSTAIAL SAFETV VERMR CERTIFlCATION: Fxpires: ❑ I �ereby caNfy Ihat no excavation five (5) or more teet in depth Into which e person is requlred to descend, will be matle in connection with work eu�honzeA by Ihls pertnit, end ihat no building structure, scaXdding, talsework, or Aemdi�on or tlismentling thereoi, will be more than t�irty-slx (38) leet high. (Chep. 32, Grp 2. Art 2, Sec. 341, Title B, Caliiomla Adminislrative Cotle). ❑ As owner-builder, I wlll not employ anyone m do woB which would require e permit imm I�e Dlvision of Industrial Sefey, es notetl ehove, unlass such person hes a permit ro tlo such work tmm the tlivision. Signeture: Date: Dlvision ol Indusirial Safery Permil Number. CERTIFICA7E OF COMPLIANCE AND AUTNORIZA710N OF ENTRV: I ceniry under penalry ol perjury Ihat I have read ihis epplication entl state ihat the information gNen is correct. I egree ta compy with all stete lews en0 dry ordinences releting to builtling construction, end euthonze representetives oi t�e Ciry oi Coste Mesa to enler upon the ebove-described D�operry tor inspecqon Durpo�ses. I egree not to acupy or ellow accupanq ol any building authorized by Ihis permil until finel inspection. COOE I. INSPEGTIONTIPE 1876 Fixed System Final Flre Prevention 1268 Pool Spa Finel 200 Final Re-Rool 201 Finel BIocWRelalning Well 202 Final Factory Fire Place 203 Finel Sign 204 Finel Demolition PAgi � CO � 0�_ Date �$ �( INSVECTIONTYPE 208 Final Mechenical 208 Finel Plumbing 210 Final Electricel 212 Final Flre Prevention 220 Final Planning Approvel 222 Finel Site 250 Finel Building/Occupenty �.1 JIII... � • .. � 1 (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: Suile No Vicinity: Parcel Nunmber: � �' � . 3188 AIRWAY AV A 42719333 � ` Applicant: HOFFMAN, CHARLES Address: 10481RVINEAV -., � " NEWPORTBEACH,CA i / � �� Owner.' �HOFMANN, CHARLES H Address �� 10481RVINE AV' � � � - STE 624�� NEWPORT BEACH, CA Phone: 714-545-2263 . Zip: 92660 , " Phon�: Zip: 92660 Contractor: HOFMANN FINN DEV COMPANY INC Address: 350 ROCHESTER ST - ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) Pool / Spa Lighting Fixts Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to 1000a Service over 1000a Motors to 1 hp Motors to 10hp Motors to 50hp Motors l0 100hp Motors over 100hp Communicalion drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole COSTA�MESA, CA . �-'Phone: (949)515.8822 Zip: 92627 License: 731034 Status: ISSUED Applied: 06/04/2002 Issued: O6/04/2002 ISSUED BY: i, , . � , SCOPE OF PERMIT 6000 SF WTERIOR TI FOR AN EXISTING INDUSTRIAL BLDG:�4040 SF OFFICE AREA AND 1960 SF WAREHOUSE. . - � � - � � PORTION OF FRONT WALL TO BE PUSHED OUT RESULTING IN 80 SQ.FT. ADDITIONAL AREA. REF: 602-00549. ' � ELECTRICAL TO INCLUDE: 88 LIGHT FIXTURES, 84 OUTLETS, 25 SWITCHES, 1 SERVICE TO 200 AMP, t LOW VOLTAGE EQUIPMENT, 1�ELECTRIC WATER HEATER. $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $71.64 $68.72 $25.65 $4.75 $0.00 $30.50 $0.00 $0.00 $0.00 so.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity 0 0 0 88 84 25 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY ,_ ,�, , Temp Dist System / Lighting Busway/100 k Standing Section _ Misc Electrical Equipment �� _ Transformers up to 1 kva/kw ................up to 10 kva/kw .................up to 50 kva/kw .................up to 100 kva/kw ..................over 100 kva/kw Low Voltage Equipment Low Volt Winng System / Ckt Misc. Conduil Misa Conductor Circus ( gen or ride) Circus (mech nde or lights) , Christmas Tree Stand Fireworks Stand Other Electrical Fee Investigation Fee Plan Check Fee Reinspection Fee Quantity $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0:00 0 $0.00 0 $0.00 0 $18.20 1 $0.00 0 $0.00 0 So.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES $242.96 COMMENTS / SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) . E%PIRATION: This permit shall automatically expire end become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. � INSPECTIONS: In order for the work authorized under this pe�mit to be considered legal, such work must comply vrith all applicable codes, and all required Inspectiona and flnal epproval must be obtainad. Fallure to obtain inspections and final approval will result in the expiration of this permit. POR INSPECTIONS CALL: (714) 7545626 . 2406d8(N00) WORKERS'COMVENSAnONOECLARATON: � � I hereby aHirtn under panelry of perjury ane of Ihe following dacleretions: ❑ 1 heve entl will malntein a cenitiwte of consent to selbinsure tor workers' compensation, es proNtletl tor by sectlon 3700 of Ihe Lebor Code, tor the pertortnance of the wark tor whic� Ihis pertnil Is Issuetl. . ❑ I have antl will mflinlain workers' compensatlon Insurance, es requiretl by sectlon 3700 oi the La6or Cotle, for tha peRortnence of the work for whiU this permit is issuea. My workere' compensation Insuranca cerder entl policy number are: Carrier: Policy Number: (Thls section neetl not be completed i/ the permit is velued af one hundred dollers ($ f00) w/ess.) � ❑ I certity that in �he pert n e of the work for ich this p rtnit is issued, I shell not employ eny person In eny manner so es to 6ecome sub�ect to Ihe workere' compensatlon laws Cal' a, end egree Ih sh I� eco subject to Ihe workers' compensetlon proWsions ot Sedlor 3700 of the Labor Code, I shell ianhwlth camptywiththese ovisio r � /�/ `-� / Applicant SlgnaNra: Date: � U �� WARNING: FAIWRE TO SECURE WORKERS' WMPENSATION COVERAGE IS NLA L AND SMALL SUBJEGT AN EMPLOVER TO CRIMINAL PENPLTIES AND GN� FlNES UP TO ONE MUNDRED TlIOUSAND DOLLARE (5100,000), IN FDDfiIIXJ TO TME WST OF COMPENSATI D GE5/5 PROVIDED FOfi IN SEC(ION 3]OB OF THE IABOR CODE, IMEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby eMirm Ihat I em licens der provisions ot Chep 9(co endng '�h Section 7000) of Divislon 3 of the Busineu antl Professions Cade, antl my license is In full force and eflect. Lic. N n qass a ConiractoYSSignaWre: �� Date: �.�T, 7 CONSTRUCTION LENDING AGENCY: �� ❑ I hereby aMirtn Ihel lhere is a consiruction lentling egency for the performance ot the work for which ihis permit is issued. (Sec. 3097, Givil Cotle). Lenders Neme: Lenders Address: Signature: OWNER•BUILOEN DECLARATIONS: Date: I hereby affirm that under penalry of perjury Ihat I am EXEMPT FROM TME CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business and Protesslons Cotle: My dty ar counry which requires e permit to consWc�, elter, improve, tlemolish, or repair any structure, prior to iis luuance, elso requlres Ue epplicaN tor such permit to Ole e signed stelement that he or she is Ilcensetl pursuant ta tha proWsions of ihe Coniradors Licensa Lew (Chepter 9(commendng with Sectlon 7000) of Divislon 3 oi the Business end Professions Cotle) or that he ar she is exempt tharetrom end ihe basis for ihe alleqed exemption. Any violation of Section 7031.5 by eny epplicent for a pertnit subleds ihe epplicant to e civil panelry of not more �han iive hundred dollars ($500).): ❑ I, as ov.•ner of the praperry, or my employees wlih weges es thelr sole wmpensation, WILL DO THE WORK, end the structure is not intentled or oHered tor sale (Sec. 7044, Business and Protessions Code: The Coniradors LJcense Lew dces not apply to an owner of properry who builds or improves ihereon, antl who does such work himseli or herselt or through his or her own employees, provitled that such improvements are not Intended or oHered for sale. If, however, the building or improvement is sold wlthin one yeer of completion, ihe owner-6uilder will have ihe burden of Droving ihat he or she tlitl not build or improve for purpose ot sale.). ❑ I, as owner of the property, em EXCLUSIVELY CONTRACTNG WITH LICENSED CONTRACTORS to construct ihe project (Sec. �044, Businass end Professions COCe: The contractors license Lew does not eppry to an owner ot pmperty who buiids or improves Ihereon, and who contracts tor such project wlih e contreqor(s) license pursuant to ihe Coniracmrs License Lews.�. ❑ I em exempt untler sec. Business end Professlons Cotle for this reeson: Signature: Date: Owner ID veritied by tlnvels license. ❑ Ves ❑ No DriveYs License No. Expires: Veritication of Owners�ip by (type at document, i.e. - property lex bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: ❑ I hereby certiry ihet no excavation five (5) or more teet in depih into which e person is requireC to tlescenq will be made in connection wi�h work authorized by this pertnit, antl that no Duiltling strucNra, scaHolding, talsework, or Cemolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Gry 2, Art 2, Sec. 341, 77t1e 8, Calibmia Administrative Code). ❑ As owner-builder, I will not employ enyone lo do work which would require e Oermit irom Ihe Division oi Industrial Safery, as no�etl above, unleu such person hes a permit to tlo such work irom the division. SignaNre: Date: Division of Indusirial Sefety Pertnit Number: CERTIFlCATE OF COMPLIANCE AND AI7THORRATION OF EMRY: I certify under penalry of perjury that I have reatl this application and state Ihat t�e intormation given is correct. I egree to wmply with all state laws and ciry ortlinences relating lo building construction, end authorize representatrves of Ihe Ciry at Costa Mesa to enter upon the ebova-descnbed property for inspaction puryoses. I pgree not lo occupy or ellow acupancy ot any building euthonzed by ihis permit until final inspection. COOE 1. INSYECTION TYPE 1616 Fixed System Final Fire Prevention 1266 Pool Spe Finel 200 Finel Re-Root 201 Final BIocWRa�aining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition ' � ¢eie � ��e� ��r Date f�QQf,j INSPECTIONTYPE 206 Flnal Mechenical 20B Flnal Plumbing 210 Flnal Electncel 212 Finel Fire Preventlon 220 Final Planning Approval 222 Final Siie 250 ' Final Building/Occupancy PLg ViIIDELS -4-02 (71a) 754-5273 • Fax (714) 754-4856 • www.ci.cosia-mesa.ca.us P FAIR ORIVE, COSTA MESA, CA 92626 _ PLUMBING PERMIT ' lob Address: 3188 AIRWAY AV Status: ISSUED Suite No A Applied: 06/04/2002 Issued: O6/04/2002 Vicinity: ISSUED BY: Parcel Nunmbec 42719333 - „ � �', , _ -- , . - , , . _ , . Applicant: HOFFMAN, CHARCES - Add�Ess: 1048 IRVINE AV- � � � . � - ,� � �,� � �. ` . � ' . Phone: 714-545-2263 - � - ` �` NEWFORT B�ACH; CA � � Zip: 92660 . ' � : . � " �� _ . . _ � , . . Owner:� �HOFMANN, CHARLES H „ � " � , � Address �10481RVINEAV"' :��,`,� '. ' � ` , STE 624-,== `�� Phone: , � , ' _ � NEWPORT BEACH, CA Zip: 92660 .' � �. � Contractoc HOFMANN FINN DEV COMPAN.Y-INC Address: � 350 ROCHES7ER ST-" \ � - . . - . , . � ' � � .. ., � '_ � � Phone: (949)515.8822 � , � � ' .. . . ' . . � .. COSTA MESA, CA. Zip: 92627 � . ' _ License: 731034 � ' . . , ,__�. � _ , .' /• _ __ _ . . � . 'Arch/Eng:� .- .- - ._ �_� _, - --�� `-- �,-,_ . Address: ; - ' � �, , � . � Phone: � , � , _ _ _ . ' _ _" Z�P' . _ . . � ' � License: - . -- � . . � � SCOPE OF PERMIT . 6000 SF INTERIOR TI FOR AN EXISTING INDUSTRIAL BLDG: 4040 SF OFFICE AREA AND 1960 SF � WAREHOUSE. , PORTION OF FRONT WALL TO BE PUSHED�OUT RESULTING IN 80 SQ.FT. ADDITIONAL ' � AREA. REF: 802-00549. � - � PLUMBING TO INCLUDE: 1 DISHWASHER, 3 FLOOR DRAINS, 1 KITCHEN SINK, 1 SERVICE SINK, 3 TRAP PRIMEI2S, 3 WASH BASWS, 3 TOILETS. - �� -- � FEE SUMMARY AMT QTY . AMT �TY AMT QTY ISSUE FEE $23.50 Laundry Tub / Washer $0.00 0 Sump Pump , $0.00 0 BackFlow irrigation � $0.00 0 � Landscape Irrigatlon $0.00 0 Swimming Pool " $0.00 0 BackFlow Preventer $0.00 � 0 - P-Trap $0.00 � 0 Trap Primer.- $29.40 3 Bathtub $0:00 0 - Pressure Regulator � $0.00 0 � Urinal ' $0.00 0 Clarifer System $0.00 - 0 � Process Piping (per 10 ft) $0.00 0 � Vacuum Brkr Bkflow(1�1) $0.00 0 Connect (Ice,Soda,etc) $0.00 0 .. � . �Receptors , $0.00 0 . � � Vacuum Brkr BkFlow(5+) $0.00 0 Dental Unils $0.00 0 . Septic Tank $0.00 0 Wash Basin $29.40 3 Dishwasher $9.80 1 Sewer Cap for Demo � $0:00 0 Wash Basin Set $0.00 0 Drain, Floor $29.40 3 Sewer Connect $0.00 0 Waste and Vent System -$0.00 0 Drain, Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet (Toilet) $29.40 3 Drain,Roof $0.00 0 Shower $0.00 0 WaterHeater/vent $0.00 0 Drinking Founiain $0.00 0 Sink, bar $0.00 0 Water Piping (Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink, commercial $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 Water Service $0.00 0 Gas (1-4 outlets) $0.00 0 Sink, kitchen $9.80 7 Water Sokener $0.00 0 Gas (Over 4 outlets) $0.00 0 Sink, service/mop $9.80 1 OTHER $0.00 Gas Repipe $0.00 0 Spa (private) $0.00 0 VIOLATION $0.00 Gas Service $0.00 0 Spa (public) $0.00 0 PLAN CHECK $0.00 IntercepWrs (Grease, �il) $0.00 � �� REINSPECTION $0.00 0 Interceotors (Sand Auto ) $0.00 4 NOTICE: The work authorized by this permit shall comply with all applicable handicap access req��r�iAr�s�Gn��i4�a�or�i� s'tatUi�s'ar�d related �9 ilafnnc (4rA No Q7-0P § 1 1&21-92) EXPIRATION: This permit shall autom2tically ex ' in 180 days, or if work is suspended or abandoned for a period of 1 BO days. INSPEC710NS: In order for the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspeetlona and flnal approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of lhis permit. FOR INSPECTIONS CALI: (774) 7545626 , zansae (s'ooI . WORKERS'COMPENSAnON DECLAflAnON: . I hareby ettirm under penalry ot peryury one oi the fallowing dedaratians: ❑ I heve end wlll melntei� e certificate ot consent to self-Insure for workers' compensation, as providetl for Dy section 3700 oi ihe Lebor Code, tor ihe pedormance of ihe wo for which this permit Is issued. I �ave flnd wlll main in work mmpensatlon insuren as requlred by section 3700 of i�a Lebor Cotle, for the peAortnance of Ihe work Por whfch this pertnil is issued. My workers' en fltion I suren� ca e�rJ e�nC p�oll numDer ere: %�I� ��// � T Cartier r�""��i�.� T WY\ ' Policy NumOer \JIUS �/J I�(J ' V� (This secflon need not be mplefed 1! the pertnit is va/ued e( one �undred dollers ($f 00) or less.) . ❑ 1 ceniry that in Ihe pertormance of the work for wY �ch t�is pertnil Is issued, I shall not employ any person in any menner so as lo become subject to Ihe workers' compensatlon lews oi C 1Mymie, end egree that' sho scom ub�ect to tha warkers' campensetion provislans ol Sectlon 3700 oi Ihe Lebor Cotle, I shall torthwith complywiththesapro sioRs � /r / �� ApplicantSigneWre: Dete: �� ' WARNING: FAIWRE TO SECU � WpqKERS' COMPE SATIIXJ COVERAOE 1 LAWFUL AND SMALL SUBJECT AN EMttOVER TO CRIMIIUL PENALTIES AND GN� FlNES UP TOONE NUNDRED THOUSFNDDOLLARE�E100.Opp),INAODITIONTOTHECOSTOFCOMPENSATI ,DAMAGESASPROVIOEOFORINSECTION3'lOBOFTHEIABOHCADE,IMERE$T,qNDATTORNEV'SFEES. LICENSED CONTRACTORS DECLARATION: I hereby eMirtn ihet 1 am force entl eHect. Lic. N_ Contrectofs Signature: wilh Section 7000) of Division 3 of the Business end Profe551yns Cotle, and my license is in lull Cless N �—% Date: _ __ _ �n �% Il% CONSTAUCTION LENDING AGENCY: " ' ❑ I hereby aMirtn �hat Ihere is a construction lentling egency for the pertortnence of t�e work for which this permit is issuad. (Sec. 3097, Civil Code). Lender's Neme: Lentlers Address: Signature: Date: OWNER-BUILDERDECLAppTONS: � I hereby eHirm thet under pbnelty of per�ury thet I em EXEMPT FROM THE CONTRACTOHS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business ana Professions Cotle: Any clry or counry which requires a pertnit to construct, eller, improve, demolish, or repair any structure, prior to Its issuance, elso requiras iha epplicant for such pertnit to file e signed stetement Ihat he or she is IicenseO Dursuant ro the proNsions of the Contrectors lJcense Lew (Chapier 9(cammencing with Section 7000) ot DiWsion 3 of the Business entl Protesslons Code) or Net he or she is eaempt thereirom entl t�e basls for tha alleged e:emplion. Any vloletion of Sectlon 7031.5 by any applicant for e pertnit subjects the applicent to e civil penalry of not more ihan five hundred dollars ($500).): ❑ 1, es owner ot Ihe propeny, or my employees wlt� wages es thelr sole compensetion, WILL DO 7HE WORK, end the sducWre Is not intendetl or oHeretl for sale (Sec. 7044, Business antl Professions Coda: The Contraccore License Law does not epply to an owner of property who builds or improves Ihereon, and who does such work himselt or herselt or Ihrough his or her own employees, prnNded iha� such improvements are not imended or ot/ered lor sele. I/, however, iha building or imp�ovement is sold within one year oi completion, the ownar-builder will heve ihe burden ot proving that ha or she did not builtl or improve for purpose of sele.). ❑ I, as owner of Ihe pmperty, am EXCLUSIVELV CONTRACTING WI7H LICENSED COMAACTORS to construct the project (Sec. 7044, eusiness and Profeuions Cotle: The coniractors Llcense Lew tloes not epply to en owner af property who builds or impmves thareon, antl who comracts tor such pro�ect wlih a coniractor(s) license pursuent to Ihe Contractors license Laws.). ❑ I em ezempt under sec. Business and Professions Cotle tor this reason: Signature: Date: Owner ID veritied by dnvefs license. ❑ Yes ❑ No Onver's License No. Expires: Verilication of Ownership by (rype of document, i.e. - praperty taz bill or deetl): DIVISION OF INDUSTRIAL SAFEfY VERMR CERTIFICATION: ❑ 1 hereby certify Ihat no excavation five (5) or mora feet In tlep�h Imo which a person Is requiretl Io tlescenq will be made In connaction with work euthodzed by Ihis permit, and �hat no building structure, scafloltling, falsework, or demolition or tlismantling thereoi, will be more Ihen thirry-six (36) teet hig�. (Chap. 32, Grp 2, Ar12, Sec. 341, 71tla e, Celifornia Administrative Code). ❑ As ownervhulltler, I will not employ anyone to do work which would requlre a pertnit irom the Division of IntlusMel Setery, es noted above, unless such person hes e permit to do such work fram ihe division. Signeture: Date: Division of Industrial Safery Parmit Number: CERTIFlCATE OF COMPLI4NCE AND AUTHORIZATON OF EMRY: I cenity untler penalry ot perjury that I have read Ihls epplication antl siate Ihat the information given is correct. I agree to comply With eli state laws end ciry ordlnances relaling to Cuilding construction, and authonze representetives of Ihe Ciry ot Costa Mesa lo enter upon Ihe ebove-tlescribetl pmperry tor inspection purposes. I egree not to occupy or ellow occupancy of any building authorized by t�is permit until final inspection. COpEI. INSVECTIONTYPE Qejf, IMRI�LS 1618 Fixed System Final Fire Preventian 1266 200 201 202 203 Pool Spe Final Final Re-Roof Finel BIocWRetaining Wall Final Feclory Fire place Final Sign 204 Final Demolition ��Ci�� Date cooe� n+sv¢rnoNnae 206 Final Mec�anicel 208 Final Plumbing 210 Final Electrical 212 Final Fire Preventian 220 Flnal Plenning Approval 222 Final Site 250 " FinalBuilding/Occupency Q� IC+IIIIELB : - Y ._ CT� (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us � 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 3188 AIRWAY AV Status: ISSUED Suite: A Applied: 04/25/2002 Vicinity: BLDG A Issued: 06/04/2002 Parcel Number: 42719333 Zoning: App�icane HOFMANN, CHARLES H - Address: 10481RVINEAV , � ' � � - � � � STE 624 '� ,�; � _ ;Phone: 949-515-8822 NEWPORT.BEACH, CA Zip: 92660 � � , Owner: HOFMANN, CHARLES H � Adtlress �10481RVINEAV - , � STE 624, � � - Phone: � � NEWPORT BEACH; CA" Zip: 92660 \ Contractor HOFMANN FINN DEV COMPANY INC Address:- 350 ROCHESTER ST , � - , Phone: (949j515.8822 COSTA MESA, CA Zip: 92627 � License: � 731034 Arch : Address: Zip: RUDYJUREACK 2062 BUSINESS CTR DR STE 240 IRVINE, CA � 92612 Phone: 949-833-9330 License: C24021 ISSUED BY: � Eng: TAGGART, PHILIP W Address: 3151 AIRWAY AV STE G1 COSTA MESA, CA � 92626 Phone: 714-96G0825 License: 25739 -, - SCOPE-OF PERMIT - , , 6000 SF INTERIOR TI FOR AN EXISTING INDUSTRIAI.'BLDG: 4040 SF OFFICE AREA AND 1960 SF WAREHOUSE. ' PORTION OF FRONT WALL TO BE PUSHED OUT RESULTING IN 80 SQ.Ff. ADDITIONAL AREA. HOWEVER, OVERALL KOLL DEVELOPMENT SITE IS AT A.29 FAR --.30 PERMITTED. SO FAR OK. Plan Check: $412.20 Permit: $634.15 SMIP Res: $0.00 SMIP Com: $10.18 Other: $0.00 Inspection: $0.00 Total: $1,056.53 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front 0-0 - FEE SUMMARY Rear 0. 0 Rear 0. 0 PLANNING & ZONING Lek 0- 0 Left 0- 0 Calc Valuation: Claim Valuation: Right 0- 0 Righl 0. 0 PARKING existin : 0 Reauired: 0 � Pr000sed: 0 � NOTES: ACHAM CN 06/04/2002 APPLICANT IS CONTESTING CORRECTION FROM SFA REGARDING VALUATION INCREASE. PER APPLICANT VALUATION IS CORRECT AND SFA MAY BE CALCULATING ATTIC SPACE AS MEZZANINE. ADVISED APPLICANT ISSUE WILL BE RESOLVED BETWEEN SFA AND SALEM IF SFA DOES NOT AGREE WITH APPLICANT.( PASTED AS COMMENT FOR FUTURE REFERENCE ON 6/4/02.). ACHAM CN 06/04/2002 80 SQ FT OF ADDITIONAL AREA REQUIRES SJC FEES TO BE PAID PER DENNIS JOHNSON. ACHAM_CN O6/04/2002 OCCUPANT LOAD NOT PROVIDED ON PLANS. $48,480.00 sas,aao.00 NOTICE: The work authorized by this permit shall comply with all applicable hantlicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 days, or if work is suspended or abandoned for a penod of 180 days. INSPEC7IONS: In order for the work au[horized under this permit to be considered Iegal, such work must comply with all applicable codas, and all requlred Inapeetions and final epprovel must be obtained. Failure to obtain inspections and final approval will resutl in the ezpiration of this pertnit. FOR INSPECTIONS CALL: (714) 7545626 . � WORKERS'COMPENSATONDECLARATION: ' - , I hereby eHirm under penelry of perJury one of t�e lollowing declaratlons: ❑ I heve and wlll meintein e certificate ol consent to self-Insure lor workers' compensetion, es proWded for by seclion 3700 Of lhe LaDor Gotle, tor Ihe pertormence ot Ihe w rk for which ihis pertnit is IssueC. heve flntl wlJl ,ma t�in w rkers'r� ensation insuranca, as requiretl by secllon 3700 of the Labor Code, lor Ihe peMortnance of Ihe work for whlch this pertni� is issued. My workery�o� tio Insurence caMer entl policy numher ere: ��^��' '` � Cartier. i i C� Poliry Number. 0 d � U (Th/s secfion need not be canp/eted M the permit is velued et one huntlred dollers ($100) or less.) � - ❑ I certify that In the peAo ance of the work tor hich t�is ermit is issued, I shall not employ any pereon In eny manner so es to become sub�ect to the workers' com� Y setlon law P��end egree th if I sho becom sub�ecl lo the workers' compensetion provislons ot Section�3 700 f Ihe Lebor Cotle, I'shall forthwilh com I with these ms �/�� Appliwn� Slgnature: j Date: � WARNINQ: FAIWRE TO SECIIRE WORKERS' CIXAPENSATION COVERAGE IS �LA f�UL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FMES UP TOONE HUNDRE� iHOUSAND DOLLARE (5100,OW), IN AODITION TO TME COST OF COMPENSATION�nr,�ICES AS PROVIDED FOR IN SECTION 3](IB OF THE LABOR CODE, IMEREST, AND FTTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereDy eNirm t�at I am li s tl upCer o'o ol Chapj9� 9{commendng with Section 7000) of Division 3 of iha Business and Professiore Code, e force entl ettect Lic. p CJ Cless a ' Contrectors Signature: Date: CONSTRUCTON LENDMG AGENCV: � ❑ I hereby aXirm ihat there is e consiruction lentling agency tor the peAormance of the work for which this permit is issued. (Sec. 3097, Civil CoCe). Lenders Neme: Signature: _ OWNER-BUILDER DECLAHATIONS: Lender's Address: Date: is in tull I hereby aHirtn that under penalry ol perjury that I em EXEMPT FROM THE CONTRACTORS LICENSE LAW lor the following reason (Sec. 7031.5, Business and Professions Code: Any city or counry which requires a permit to construc�, alter, Improve, demolish, or repair eny siructure, pnor to its Issuanca, also requires the apD��cant tor such permit to tile e signed stetement Uet he or she is Iicensed pursuant ta the pravisions oi the Contractors License Lew (Ghapter 9(commencing wlth Sectlon 7000) of Divlsion 3 of the Business end Profeuions Cotla) or that �e or she is exempl Iherefrom end tha hasis tar the alleged exempiion. Any Nolation of SeMion 7031.5 by eny eppliwnt for e pertnil sub�ects the epplicant to a civil panelry of not more than five hundred dollars ($500).): ❑ I, es owner oi tha properry, ar my employees with wages es their sole compensatlon, WILL DO TFfE WORK, end the structure is not IntendeC or otteratl tor sale (Sec. 7044, Business and Professions Coda: The Contractors License Lew does not apply to an owner of properry who builCs or improves Ihereon, end who does such work himself or herself ar through his ar her own employees, provided Ihet such Improvements ere not intanded or oflered for sele. If, however, Ihe bullding or improvement is sold within one year oi completian, the ownerbuilder will have �he burden of proving ihat he or sha did not build or improve tor purpose of sele.). ' ❑ I, as owner of the praperty, em EXCLUSIVELY CONTRACTiNG WITH LICENSED CONTRACTORS to construct Ihe project (Sec. 7044, Business ana Pratessions Cade: The conirectors License Lew tloes not eppy to an owner ol property who bulltls or Improves thereon, and w�o conirects tor such pro�ect with a contredor(s) license pursuant m the Comracrore License Lews.). ' ❑ I em eaempt under sec. Signaiure: Owner ID verified by drivefs license. ❑ Yes ❑ Na Busineu and Professions Cade lor this reeson: Venficetion of Ownership by (rype ol document, i.e. - properry taz bill or Aeetl): Drivefs License No. Date: Eapires: DIVISION OF INDUS7RIAL SAFETV PERMR CERTIFICATION: ❑ I here6y certify ihat no excevetlon five (5) or more faet in tlep�h into which e person is requiratl to dascentl, will 6e made in connectlon with work authodzed by this pertnit, and that no builtling strucWre, scaHolding, talsework, or demolition or dismantling thereol, will 6e more than thirty-six (36) feet high. (C�ep. 3.2, Grp 2, Art 2, Sec. 341, Title 8, Califomia Administrative Code). � As owner-bullder, I will not employ enyona to do work which would reQuire a Dermit from ihe Division of Indusirial Safery, as noted ebove, unless such person has e permit to do such work from the divislon. Signature: Date: Division ol Industrial Safery Pertnit Number: CERT1FlCAlE OF COMPLIANCE AND AIlTMORIZA710N OF ENfAY: I certily under penalry of perjury ihat I �ave read Mis application and state ihat Ihe Informatlon given is correcl. I agree to comply with all stale lews and ciry ordinances releting to bullding construction, end euthorize representatives uf ihe Ciry of Cosia Mesa Io enter upon ihe eDove-described Oroperty for inspection purpose� I agree not to occupy or ellow occu0ancy af eny building authonzed by Ihis permit until finel inspection. [d•7 T�1�I:F1i{��b];�N�i 1616 1266 Fi:etl System Final Fire Prevention Pool Spa Final 200 Finel Re-Raof 201 Final BIocWRetaining Well 202 Final Factory Fire Plece 203 Final5lgn pp4 Final Damolitian p�TE f�$ �� INSPECTIONTYPE 206 Final Mechenical 208 Final Plumbing 210 Finel Electrical 212 220 Final Fire Preventlon Final Plenning Approval 222 Final Site 250 Final Building/Occupancy � �- IZ-ot_ .�w_ . ,�'. �: RECORDING REQUESTED BY: Fidelity National Title Company - Major Accounts Escrow No. 620436-PB 7itle Order No. 9733344-11-�). When Recorded Mail Document and Tax Statement To: Mr. Charles H. Hofmann 1048 Irvine Ave., Suite 624 Newport Beach, CA 92660 This Document was electronically.recorded by Fidelity ional Major Accounts Recorded in Official Records,County of Orange Darlene Bloom,lnterim Clerk Recorder �� 14.00 20020254084 01:27pm 03/27/02 10359G025 453.75 453.75 0.00 0.00 8.00 0.00 0.00 0.00 GRANT DEED SPACE ABOVE THIS The undersigned grentorls) declarels) Documentary transfer tax is S907.50 [ X ] computed on full value of property conveyed, or [ ] computed on full value less value of liens w encumbrances remaining at time of sale, [. 1 Unincorporated Area City of Costa Mesa FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, MP Properties, a General Partnership hereby GRANT�S) to Hofmann Finn Investments, LLC, a California limited liability company the following described real property in the City of Costa Mesa County of Orange, State of California: SEE EXHIBIT ONE ATTACHED HERETO AND MADE A PART HEREOF DATED: March 14, 2002 STATE OF CALIFO , f COUNTY OF ON � �. before me, ersonally appeared X � �-- iL personally known to me (or proved to me on the basis of satisfactory evidence) to be the person�s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized.capacity(iesl, and that by his/her/their signaturels) on the instrument the person�sl, or the entity upon behalf of which the personlsl acted, executed the instrument. Witness m hand and official seal. Signatur MP By: BY: general partnership . '`ic•`_ . • :: �. � ''� '' • : . . �z..�% . , .�.. MAIL TAX STATEMENTS AS DIRECTED ABOVE FD-213 IRav 7/96) GRANT DEED November 3, 2003 The Cornerstone Group PSALMS I 18:22-24 L„ � :: Hofmann Finn 3188 A Airway Avenue Costa Mesa, CA 92626 Subject: Rough Grade Pad Certification Reference: Commercial Retail Center, Costa Mesa Gentlemen: Per a field survey conducted under my supervision and in accordance with the requirements of the building code, we have found that the rough grading for the building pad at the above referenced project has been completed in substantial conformance with the approved Grading Plan. ` ; Engineering Planning � Suneying This Certification constitutes an expression of our professional opinion �regarding the facts mntained herein and does not constitute a warranty or guarantee, either expressed or implied. _ o0.0FESS/n.. . � � 1485 Sprvca Sireet, Suifa H Sincerely, Group Ru�sell E. Sharp Professional Engineer R.C.E. No. 28248 RES/cmf Ma C2B2qg �. ��-os c:CertlficafSons.4512-Hoffnann Fnn.PadCert.RES.da Riverside, CA 92507 909.342.0036 Tel 909.342.0268 Fax www.lcgroopr.com .- COSTA MESA BUILDING-SAFETV DEPARTMENT ' P.O. BOX 7200 COSTA MESA, CALIFORNIA 92626 % For AppGcant to Fill in Completely — Use In� Only ADIDRESS ✓�06 /�' ��W�+ � T�E ANT�R�,��K�TG' .a�,Cf�� MAILING � S f � ADDRES 2- �y� TEL. CITY GO$'T'i(J /h�',�iy NO�/jS.{�,jPj BRANCH ADORE55 ARCHITECT �q T � OR ENGINEE N I/ A�/=� NO. ADORESS rO � CONTRACTOR.��Q � � � ADDRE55 �/ �Z� � CITV �ZJ GLq/( /Q� \� NOL � F STATE CITY � IIC. NO. �� LIC. NO. {y SIZE NO.OF BLDCS. 0. OF lOT NOW ON LOT a USE OF „�. EXIST7NG BLOG. h FSeparate permits are required for 0 electric, plumbing and heating work. �.W. USE OF BUILDING AND WORK TO BE PERFORMED a • c • Q � 7 � . } � .a a w � I heraby acknowlatlge that I have reatl this eppllcation antl rtate a ffiat ffie above informaiian is correct and agree to comply wiffi d all laws regulating builtling construction, antl I shell not employ Z eny perwn in violation of the workman's compensation laws of Tthe Staie of California. 3 I hereby certify that i em properly licensetl as a eonttacto� under the State of Californie Business and Professions Cotla, Division 3, Chaptar 9, antl that such licenses are in full force entl effect, or I am exempt from t�e provisions of the Stete of Calltornia 8 iness antl Professions Cotla, Divis'Qn 3, Chapte� 9. Signatura of � `��j.y � / Permittee �� or �/ / �j Authorized Agent Date APPLICA'fION A. P. NO. � Z BUILDING �7/< ADDRE55 \1 UNIT OR SPACE NO. NEW I %�DD OWNER' //� USE �%��' • APPROVED PLANNING ACTION i-�STR�I�e��[.PERMI'F�61.B5 TL MIT N� " 51254 �� ) 1 BLK. ( EPAIR MOVING DEMOLISH 1 L , VALV br/w�� r�� r' � � PE � GROVP DATE �/I/n/�I DATE APPROVED m a' m SQ. FT. � J THE AMOUNTSHOWN UNDER VALUATION IS FOR rtl THE PURPOSE OF ESTABLISHING A PEflMiT FEE ONLV: � VALUATION PERMIT FEE 5 /s N (�� / PLAN CMECK § �J O o $ ! V/ � O TAX S Z• V U TOTALPAID S/(A� �� ti . 4.19I.3 � 'COSTA MESA BUILDING-SAFETY DEPARTMEN P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completety — Use Ink Only BUILDING �a, iKr. � 1 . n . . (Y �._ OWNER�/U� MAIL p AD�R/ElSS dI cirv (_c7Sy-� CONSTRUCTION LENDEP BRANCN CONTHACTOR � �,y��,,, ADDRE55 3�v0 A � CITV S A ��.TL� TEL. � SSD C.. APPLICA PA16 „AY-4-7Er.nai�� 17�'f �'��*73.16 FORSTRUCTURALPERMIT ivw _ 7 ,, A.P. NO. a .� � , P NO. ! AD' RfE S �I�C �.�IQW C TNA�.7 !� LOT BIOCK � �• OWNER -�-NV�.1'lT�� . VAWE S FIRE ZONE TY E GROUV APPROVED _ � 7� ZONE NO.OF USE OF NEW PLAN$ BUILDING r.f+ STATE CITV 1'AflDS APPROVED VAFDS APPROVEO LIC. NO. ��- LIC. NO. MAIN BUILDING ACCESSORY BUIIDI � SIZE NO.OF BLOCS. (FHOM C/L STREET) a. OF LOT NOW ON LOT F ONT FT. FT. a USE OF .N. E%ISTING B�OG. �/N E Pi�CM. T FT y FSeparate permits are required for L SIDE FT. fT. electric, plumbing and heating work. Ci REAR FT. FT. �.W. USE OF BUI�DING AND WOFK TO BE PERFORMED D4STANCE BEf. BET, MAIN & C� MAIN BLDGS. ACCESS, BLOGS'. "'� �i%STIWCT !CI• � VAR.�W DATE a �Of(,'( (� A!L(..L' C.U.P.�{+' APPFiOVEO � �'(1NL 0�1�� „y1'.i�[� IN Sfl(� �ROVED a L'CC . w Q1 heraby eeknowledpe thef 1 heve reatl this apP��cation and Ymte y' that the ebove Into�matlon Ia conoct antl agrae To comply with a ell laws repuletinp buildinB �onRrucNon, entl I shell not employ r� eny peraon in vlolatl0n of the workman's compensatiOn lews of � Ma Smta ot Catliornla. �S t hereby cartify that I am prOperly Iicanwtl es e contrecior untler SQ, FT. Mo S2ata of Celifornia Businesa entl Protessions Cotle, Dlvinion 3, THE AMOUNT SHOWN UNDER VnLUATION IS Chaptar 9, entl that cuch iicenses ere In tuil force and etfect, or 1 THE PURPOSE OF ESTABLISNING A PERMfT F em eHempt from tha provisions of theStota of alltornia utineu VALUATION PERMIT FEE S anC ProfeulOns Co o, Dlvislon 3, Chepter 9. �D PLAN CHECK 3 �� Slpnature o �, rn BDDD�` Parmittea $ TAX 2 . f Aumorized Apent TOT�aL PAI D S n m > 0 m ] m e n n M 0 f U . ; �� . �. ��"�,.'� �C� � — • C'~P Or BOXE 200 UCOStA M SAFCALI ORNnIA 9 626 T � Far Applicant to Fill in Campletely q � BUILDING .7 �� /� /� _ _ /� . ._ OWNEF MAIL CITV (j�jc CONSTRVCTION BRANCH ADORESS t ARCHITECT CONTRACTOR L ADORESS ],901 arv Ney,�Tt STATE uc. No. 2217fi SIZE OF LOT USE OF EXISTING BLDG. N�tiv e�oc. 6, 000 EXTERIOR W Cl1VFFING iu� TE No� 833-30, CITV LIC. NO. NO. OF BLOGS. 0 NOW ON LOT NO.OF ROOMS � STOF ftOOF COVEqING �llt K TO BE PERFORMED _. -� — _ ,��„ rni_ , -2-�� ,.�.00 �97:> ::,=:•=?2�.11 BUILDING ADDRESS FIRE ZONE APPqO V E �N FOR BUILDING PERMIT DQ�T= ECE V DAT ISSU' � � �-2 �,� f�'(i�f y PEFMIT NO( � A. /9,kcv� Hue � B OR.oLOT/ B�OCK KOLC_. U�A1 E CE.t/. S �A/�j VAWE . % ,y� O 5 Y rruU T PE GROUP �' i � ---_ �?-%%/i ZONE NO.OF USE OF NEw 1�J� � FLANS y2 BUILDING a � VAi1D5APPROVED VARDSAPPROV MAIN BVILDING ACCESSORV BUIL (FFOMGLSTREET) , _ � VAR. aW 1 hereby ecknowlatlBa that I hava redd [his applicetion antl sta[a thac xha above intormation is rorrect end agrae to wmply wi[h ail laws regvlating builtling conrtruct{an, antl I shall not employ � any person in violaHon of Me workman's compensatiOn laws Of Me Smte ot California. ' I hereGy cartity that 1 am properly Iicenmtl es e ton[rec[or untler Sn' the Stato of Cal{fornia Busin¢u antl Profauiona Code, Divisicn 3, THE AMOUN' Chap[er 9, antl [hot such licenses are In �ull force ond afiact, or I THE PVRP06E em exompt irom the prov(sions of tha5cexe of GalHornia Bucinoss VALUATION and Profasslone Cotle, vision 3, Ch pm 9. Sipnature � � /[( (JO�O Permlttoe �^rL $ [( � �� Authorizetl Ageni { & �ATE APPROVED ��t .,.r� 7-30- a b o � IS FOR � \ rnONLV: Q ✓v ry � 7 Z m .,s LL �6 �'I' � � Pfl0.1ELT pDDXE55: 3 i B B AIRWAY AV OWNEfl'SNRME:COLEMAN, KEVIN A ADDPESS:COLEMAN SUSAN C � 3188—F AIRWAY AVE COSTA MESA,CA 92626 APCH/ENGINEEP: flEG.NO.: UNIT: AOONESS: UNIT: PFflMITTEE:HERM CUNDALL ( 714 ) 770-7703 noosess:27162 VZA BURGOS MISSION VIEJO CA 92691 IICENSEO CONTBRCTOP OECLAPFTION: I �ereoy a0um Ilui I am li[en5e0 un0er provision5 0l CAapler 9(commencing wi�� S¢c1i0n 7000� ol Dmsion 3 0l ine BuSineu an0 Pmle55ion5 COGe. aM my licens 4 m lull Iwce anE effe[t. CITY LIC.: �_ STpTE LIC.S Z O Z G B °U 1 e_Z�1 �Ioate: signature: _ Z WOPNEHS'COMPENSRTIONOELUINATIUN: IhereCyattirm�lull�aveaterti teofconsenimseu�insumoracenificateotworkers' '� Compensatwn Inwrance. w a ceNiiea coOY �hereol (Seclion 3800. LaO. C�. I POLICY NO.: EIfP. D�TE: CaMPRNY: � Cehilietl copy is �ereby lum¢�e0- ❑ Cenitied copy a tileE wiU t�e dry Building Ui�ision. Oa�e: Fpplicani: E%EMPfION FROM WOPIIEBS' LOMPENSATION UECIAIIATION: (iltis Sec campletN if the pertm o Im me huMr[d �S70U� or kss�. I cemty that in ihe pedormance ol lhe vrork for wNc� �Ns permi� is' 0.1 not/� ploy son in any manner w as to Eecome su�le[I lo Ihe oders COyrypsensation Laxs ot Cdtifomia. // Oite: /�� /7 Signature: /` NOTICE: Ii, aiter mdlwg iNs aecWration, yuu Shoultl bemme w0jttt to tne Warkers' fAmpenSatiun D��sbns al ine LaCOr CoOe. you mus� brihwilh mmply wit� 5ut� O�ovisiotrs or �1u5 p¢rmi� SI�aO Oe aeemeU fevoke0. CONSTPULTION LENOING AGENCY: I �ereDy attirm itut t�ere 6 a caatruction IenOing apenty lor t�e peAormance al l�e wark lar w�ich I�is permit is i=sue0 (Seclion 3097. Gv. C�. LENOEN: nooecss: OWNEfl BIIILOEB OECIABATION: I �emby atlirm Ilui I am e�emp� Imm Ihe Canlraciars' Sia�e LicenSe Law lar t�e �ollawinA reason (Section 7031,5 8usineu anE Pmi¢ssional CaOe: My dry of coumy wkch requires a Oemu� to mmiruct, atter, impmve. GemolisR or repair any stmclure. Drior to ils issuance. alm reQuires t�e aoD�iCani lor sucn permil �o hle a sipneG Slaiement I�ai Ae/s�e is licensed pursuam to me o�ovisions of ine Comracmrs' State Liunse law ICnao�er 9lcommenunp vnt� Section 7000) ot OHision J ol tne Business antl Pmlesvons Coael orthal ne/she is e.emptlnerelram ana ine Da5i5 far the allege0 exemption. My vialation al Seclion 7031.5 Uy any avPlicant for a permit suojects Ne appliWnt to a tivil Oenalry of not more I�an live nunaRa adWrs (S:AIO�. 1, as owner ot t�e DmOerty or rtry employees xit� wa0es as t�eir sole compensaiqn, will do tAe woM, an0 t�e ❑ s�mcwre is not intenAed ar olfere0 for sale (Section 70a4, Business anU Profeuiawl Cotle: T�e Contractors' State License Law does noi apON �o an owner ol a Dmpeny wtq builds or impmves iMr¢On, anE wtp Eoes su[0 woM1 himsell/l�ersell or t�mup� �is or her own employees, provide0 ihat suM imprwemenis ue not intenEeE or oflered far sale. II, �owever Ihe builtlinp or impmvemen� is so10 wit�in one year ol camWeiion, ine ovmer xill Iwve I�e GurGen ol provinp Aels�e ditl nol Ouiltl ar impmve lor t�e Durpose ol Sale�. I. as owner ol Ihe pmperty. am excluvvety conlrac�inp wit� IicenSeG contracmrs to conslmc� �he pmletl (Seclion 70aa, Business ❑ antl Nolesaons CoGe: Tne Cantractors' State Lice�ae Law tices wt appy ro an owner ol prope�Iy wtro bmlUs ar impmves �hemon anA w�o Wniratls lar Suth pt01etl5 wi�� a Conlratior�5) litenie pUrsuanl �o �he Conirattors' S�ale License Law�. I am aware I�ai O�ool of lheir Warker'S fAmp¢n5atqn in5uranre shoWO Ee prOv10lU Io me. � I am exempt unEer Seclian: B. 8 P. C. lor Ihis reason: Da�e: Uvner. I oo �ereGy certily t�al I am aware ol and unaerslantl ��e repuiremenis ol Calilornia Heat�� an0 Salery Coae Sections 25505, 25537, ana 25534 an0 Iha� I or any INure buit0ing oaupant wilVwill noi (drele One) nee0 to compN �� saiG Slaie toAes an0 �he reQuiremen�s lor a permi� for consiruclion or moaificaiion imm ��e Au Ouality Managemenl DistricL Ne9Centul con5�mclion aDPlica�ions are exem0� ��om these pmvisians. Dale: AODlicani: I hereby cendy that I have reaU i�is application an0 state t�at t�e aUave inioJmaiion is correct. I aA�ee lo camply vn�� all ciiy and coun�y aramance5antl5tatelaw5reWlingtobuildingronSlmctionanCher¢byau� oler¢pr eryativ olthi �oenteru eabov¢�meniioned propetly I r ins ec�mn Ourp es. / �ale: � ��^�� Signature: � � orivefs License ar Social Securiry p: � 1fi4ba6 Whne—Builtling. Green—Cotle Enlorcemem: Canary—A001¢an�: Pink—Revenue; GalEenratl—Assessor CITY OF COSTA MESA — BUILDING PERMIT , PERMIT NO: E 060769 PLAN CHECK NO: N , , CONSTRUCTION TYPE; PERMIT TYPE; ELE PURPOSE: ADD JOB DESCRIPTION : CONDUIT FOR TEMPORARY POWER POLE SQ FT: CLAIM VALUE; CALC—VALUE: GROUP OCC: / COMMENTS: NO OTHER WORK AUTHORZZED BY THIS PERMIT r+tr*��t*�r**r**�t************�e*� �r�r�e*�r�**�rx**�r*�rr**�rx��r�*+t�t�r�t�t*�r+t*�r�r+r��r**�*�-****+r�t* Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT; FT ZN 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 N01'ES> 7 if �f iE k ik �F �f fk If iF fF if iF i! iE iF 1E k if iF M iF if iE if iF if iF iF iF if ik 1E iF 1F k iE k iE iE if iEfF if iE if iEif ik iE iE if k iF iF k iE ff IE 1E iE 1E iFif if iF iE iF if iE iF iE i! iE iF if 1E If 1E D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY , BUILDING APPROVED BY ; APPLICATION ISSUED BY• MiFit�FkkitlfifkikklfiEMM±EfflEifitlfiFiF I iFifkiFklfifitMififikifik7fiFifiFiFiFifilMitilifkiflF LEGALIZATION;N BLDG PMT PLUMBING PERMIT " ' DATE: � DATE; �'' �— DATE: \ 2—� � �3 �3F iFiF7F3FifiFiF�E�FiE1EiFililiFikiF il1E iF ik iE if Mif'!f k if iklf iE iF if iF if ik ik if 4 iF 1f If it if M ik iF k if if k ikik if iF �k if if 1f IFiF k iE iF if 3f iF iE k F E E S U M M A R Y STRUCTURAL SEGMENT;N ELECTRIC MECHANIC FIRE SMIP/RES GRADING 11.00 SOt SMIP/NON—RES PLAN ISSUE FEE 15,00 HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 11,00 15,00 0,00 26,00 26.00 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 26,00 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 26.00 ifififfFMlflkM�FMMiflfMifMMM1fMMMifMfFiflfMifMiliflFifMififlFififififkiEiFkkifififlfifkkklfifiEifMlFkiflkfFik3FlfifiEiE1FM1FiFifiEifk I N D I V I D U A L F E E B R E A}C D O W N TYPE QTY ELE 1 D E S C R I P T I O N UNZT COST MISC CONDUIT NOT LZSTED RE(� PERMIT 11,00 END OF FEES e TOTAL COST 11.00 CONSTRUCTION AND PIANNiNG� � PO. S SPA � ACPROVALS Permit# Date Inspector AppqOVALS Permit# Date Inspector 1. Temporary Electrfcal Servia2 or Pole 52. Pooi & Equipment Location . ,�2: ,Soii Pipe�UndFgrnd. � - ' � 53. Steei Re(nforcement '/ -3: �ICetrical Conduit Utiliry•Undrgrnd. , 54. Forms ' '�4,-'Electrical Con�}uit-Undrgrnd. 55. Electrical Bonding � 5�Steel Reinforcoment 56. Rough Plumbing & Pressure Test � . TB:�IeOtricalUfERGind. �- 57. APPROVALTOCOVER�GUNITE - � jr FoCtings -- 58. ElecVical Conduit-Undrgmd. . � 8. Foundation 59. Gas Pipe, � Undrgrnd., Test .- 9. Water P�pe-Undrgrnd. ` ' 60. Backwash Lines, P-Trap, O Undrgrnd. 10. St�uctural Floor System � 67. APPROVAL TO DECK , 11. Property Sewer Lihe & House Connection 62. Backwash & Receptor-Final � 12. Se�ver Cap ' 63. Heater & Vent-Final i 13. Roof Drains _ �! � 64. Plumbing System � Fina� ,. .^ 74. Rough Plumbing ,. 65. Electrical-Final . 75. Rough ElectriCa6Conduit � 66. Sofar System-Finai i6. Rouqh Electric Wi�ing 67. Fencine� & Access Approval ( i i. Rough Wiring�Sign 68. APPROVED FOR PLASTERING 78. Rough Electrical-T Bar Ceil�ng - 69. POOL/SPA SYSTEPAS FINAL 79. Rough Neating & Air Conditioning . _ F��;iE 4EPT. JiEQUIREMENT � 24� RaUghLLSact6ry{`i;ePlace � _ ' - ' � APPC�OVA[,� � - Pe'r,rnit# � . 2i: Ducts,'ynStruceuYe � � _ _� , 70.;(�Jnderf?ound HXdro :F 22; Ducts,'�Ylent7latiny , ' j :� F� '�: � 71. ProduaS-:P'iping-L7�'�,,as DOii 23. GaSPipe�RoLgh&Test _ • �� i ;•'� `' 7p, Undergroi��dFtuSFi '' J 2H. Ro`of Flaming �" �` � J ' f � 73; Undergrnd.Stor$9eTank OGas OOiI 25. Roof Sheathing'� � �� - _ � . . � 74` Overhead Hydro �' 2G T-6ar Ceiling (Suucturaq Srh(ioaocoai '"�' '' 7� Dry Chemical . �� ' 2 c Frameand Flasbfng �.1:, x>- .- r. �s 76. Dry Standpipe -- - � 28. Lathinq& Siding' ° '�'t ; ' "� `_ 7�; FIXED SYSTEN(-ci'-INA� � � 29. Insulation • � �- 76�. FIRE PREV. FINAL = - 30. Drywall Naihng I�EALTI� pEPT. REQUIREMENT �-, 31. Plaster$ro�vn Cdat . , 79. FINAL LN6PECTION _ - L_ - � 3Q, Electri�l PmveriNeter��inal �' i '' � 8P FOOD CEFTIF�ICai'E I$SWED � . 3� Final Electric . . . `/��1 �l'��otes: - . l ' - - . . � �7.� � • � 34. Final Heating &'A;r Condition'�ng ' ' '�� - ' � -- i� � - - 35; Finai Gas Pipe-Tesi . . > ` _„ �- �.'i � , " �' 36. Hood o� Canopy� ' - � I � }' �. � - 31_ Final Factory Fireplace : � , ' ". ' . . + 3fi. Fin01 Plumbing � � i • - ` � � • . 39. Water 3ervice-Fina! " �" � � , � . , h .. 40. Gas Service-Pinal - ' i � � = _ - • - � 41. Solar pomesticPinaf ' ; =' I�. „ : _ - . - 42� Backflow Preventer - �^ - ` � :� 43. Backflow Iciigation : � � �` � _. ' , . � - 4Q. landscape liripation System - _ - • , - � 45, Sound Att�uation "' � ` � ' �. � 46. Handiwp Regulations � _� '' � } � ' ' ^ i 47. FINAL STRUCTURE & BUIl01NG I ,�,. , . 48: FINAL PLANNING � � � 49. Electric Release to Edison � . ' - 50. Gas Release to Southern California Gas Co I• - � . , 51. CERTIFICATE OF OCCUPANCY . • �> + No. Date (774) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 MECHANICAL PERMIT Job nddress: 3188 AIRWAY AV Suite No B Vicinity: BLDG B, SUITE B(DESIGN DETAIL) Parcel Number: 42719332 ISSUED BY: Applicant: RICK NELSON Address: 7471 SPINDLEWOOD DR _� ��.y �� ,�, � � Phone:� 714-469-8693�CELL ,.ra:.:';�.. - . � CORONA, CA . " . - " � ` Zip: � � 92880 ; • . Owner: WITT,.MICHAEL A Address: 37 POPPY HILLS RD � �'` � ' i • < B �., � Phone. - . �. . � � � . . .;-i , ... .. , ' LAGUNA NIGUEI CA � �� Zip: 92677 - � - - . �s• � � ... . . ��' Contractor.; RICKNELSON;CONSTRUCTION Add�ess: 7471 SPINDLEWOOD DR . � � � � � � ='� . � Phone: „714-469-8693 CELI . �. , - �� CORONA,.CA Zip: �92880 ', _ � � License�833785 � """y l d _ � 4 � �- ' . ` . �� SCOPE OF PERMIT ,- � ��_� �� "`�' --- �,' INTERIOR 4800SP OFFICEkTI FOR "DESIGN�DETAIL" IN'S,UITE B OF��.BLDG�B. ' �REF:BOS-01748 - u ' - ' � �` � • � . , � . �r'� � . �� + 3�REPAIR/AI.T COOLING/HEAT, 2 VENT FANS/SINGLE DUCT � k ' FEE SUMMARY ' _ �° r ,. ; . � �� ` �� ..,. 7�... Quantiry - . %' � " Quantiry � _ ISSUEFEE � �'$23.50 '' " � ` " ' - "' �- ='"��Repaii/'AttAtisorbtion'Unit ` "�� F #$0.00 �0 Inst FAU�<100 k BTU �` $0.00 0 Repair / Alt Refrigeration Unit � �$0.00 0 �F Inst FAU >100 k BTU ' -' � - $0�.00 0 F � � ' � .... Ventillation System � ' � , $0.00 0 Repair/Alt Cooling/Heat . E41.10 �3 �..- , , _„,E"vaporetiveCooler $0.00 �� 0� .� Inst / RepsRecess Wal(Htr �- � $0.00 0 �� - � � � .„. . L Commercial Incineretor� '� - . . $0.00� 0' ; Re(rig Sys 5100 k BTU '- 50.00 � 0 � Domestic Incinerator ,$0.00 0 Re(rig Sys >100 k BTU �; $0.00 ; 0 Co�ressors I Absomtion Svstems . - - . Gas Piping $0.00 0 Up to 3 hp I 100 k BTU .$0.00 � 0 Factory Fireplace �� :2> $0�.00 0 3 To 15 hp / 500 k BTU � ; ,� . $0.00 0 Hood w/Mech Exhaust � $0.00 0 � 15 To 30 hp I 1,000 k BTU - $0.00 0 VAV Box �-� _ . - $0.00� 0 � �- `�� 30 To 50 hp / 1,750 k BTU , � r$0.00'. - �0 Vent Fan / Single Duct , � ; $14.50 2 " � ' „ Over 50 hp / Over 1,750 BTU . �� $0.00 � 0 Appliance , , � ;^� $0.00'., 0 "` � .-� � � '�c' Bo�lers . � - Fire Dampers �' ' , � $0:00 -� 0-� �: � ' ' Up to 3 hp �^�� - � $0.00 0 Smoke Dampers <-�- ,, $0.00 0�-�� ;� �� •r ":. 3�70 15 hp . - :.$0.00 0 Inst or Relocate Appl Vent �- . $0.00 .� 0 � � - -� 15 to 30�hp ,� � � � �. -$0.00 0 Air Handlers < 10000cfin�- .� ; -- $0:00 � 0 � �, � . 30 to 50 hp -! � -' % " ' ' ,�., � , � '$0.00 0 AirHandlers> 10000cfm � - . � $0.00 . 0 �� ' Over50�hp;:.,� �� " � � � � � $0.00 0 FloorFumace - -50.00-�'^0 ,„ - - - �`.Other�MechanlcalFee<��. . ,�� Floor or Suspend Heater . $0.00 ,� 0; t� ` � � - � ` �' Investigation Fee � " �" ' $0.00 �. '-� - . � r�a�; � -� . --„ . „ Plan Check Fee . a , $0.00 ` � - , . ReinspectionFee�� $0.00 - -. ._ _ .�y;, - � � - -• ' " �TOTAL'CALCULATEDFEES 579.10 COMMENTS / SPECIAL CONDITIONS Status: ISSUED Applied: 08R9/2005 Issued: 08/29/2005 NOTICE: The work authorized by thls permit shall comply with all applicable handicap access requirements under Califomia statutes and related ragulations. (Ord. No. 92-28, § 1, 12-21•92) EXPIRATION: This permit shall allomatically expire and become void if work is not commenced within 180 days, or If work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all epplicaDle codes, and all requlred Inspeetlons end flnel epproval must be obteined. Failure to obtain inspections and final approval will result in the ezplration of this permit. FOR INSPECTIONS CALL: (714) 7545828 / zaaaee �eroo� �' WORKERS'COMPENSATIONDECLARATON: . � 1 hereby ettirm under penalry ot perjury ane ol Ihe following declaretlons: ❑ I heve entl will ydelntein a cenificate of consent to self-Insure far workers' compensation, az provided for by sectlon 3700 af t�e Lebor CaAe, tor Ihe pertartnence ai the work for w�ic� In�s permit Is Issuetl. ❑ I �ave entl wlll me�ntein warkers' compensetion insurance, es reqWretl by sectlon 3700 of the Labor Cade, for the pertortnance of the work for whlch Ihis pqrtnit is IssueC. My workers' compensetlon Insurence cerder end pollcy number ere: Carrier: Poliry Number: (fhis sediar nsetl nat be completed if the perm�t fs velued at ona huntlretl tloilars ($700) or Iess.) -�I certify ihat in t�e peAortnen 11�e w�r Ich thi il is issued, I s�all not employ any person in eny menner so es lo betame subject to the workers' /�' compensatlon laws of C�II le, e pr � i 1 i� I become sub�ed to tha workers' compensation provislons 01 Sectlon 3700 ot the Lebar Cotle, I ehall torthwith comply with �hese p e ns. �/��/ � (Apprtcent S(gnetu, r _e:"^ �— Date: \ IARNW�N(3: FAILURE TO b�1FlE WORI(ERS' COMPENSATION COVEMGE IS UNUW R1L AND SHALL SUBJECT M! EMPL��R TO NAL P T1ES AND CML FlNES UP TO ONE HUNDRED TIqUSAND DOLLARE (51�.�)� IN r1DDfTION TO THE W5T OF COMPENSATION, DM4AGES AS VROVIDED WR IN SECfIdJ 31O80F THE LABOR CODE, IMEREST, AND ATTORNEVS FEES. LICENSED CONTRAGTORS DECLARATION: I hereby ePorm �het I em Iicensetl untler pr s�l 9s Chepter (commencing with SeIXion 7000) of OMsion 3 of the Busi s antl Professions Code, antl my Iicense is In full torce and efleci. Lk Y��i�3%�%�Sr�/ � CIaSs�p � _. i , � CONSTRUCTION LENDING AGENCV: � ❑ I hereDy ettirtn Ihet there is a constmctlon lentling epency for ihe pedortnance ot the work for w�ich ihis permit is Issuetl. (Sec. 3097, Clvll Code). Lenders Nema: Lendefs Addreu: Signature: Dete: OWNER-BUILOER DffCLARAT10N3: I hereby etflrtn thet under penalty oi per�ury thet I em EXEMP7 FROM THE CONTAACTORS LICENSE LAW for �he lallowing reawn (Sec. 7031.5, Business and Protessions Cotle: Any Ury or counry which requires e permit to conSWct, eltar, Improva, demolish, or repair any structure, prior to its issuance, elso requires t�e applicant for such pertnit to flle a signetl stetema�t Ihet he or she is Ilcensetl pursuent to Ue pmvisions oi the Gontraaors License Lew (Chapter e(commendng wit� Sectlon 7000) of Dlvision 3 of the eusiness end Professions Coda) or t�at he or she Is exempt therefrom end the basis far ihe alleged eaemptlon. Any vlolation ol Sectlon 7031.5 by flny epplicant lor e pertnit sub�ects the eppllcant to e civll penelry of not more than Nve hundred dollars (5500) J: ❑ I, as owner oi ih6 p��perry, or my employees with wages as Ihair sole compensation, WILL DO THE WORK, end Ihe structura Is not Intentle0 or oHered fo� sale (Sec. 7044, Business 9nd Protessions Catle: The Contrectors LJcense Law tloes no� apply to en owner of properry who builds or Impmves �hereon, flnd who does such work himselt or herselt or t�rouph his or her own employees, provided that such improvemenis are not IntenAed or affered for sele. If, however, ihe building or imprwement is sold within ona year af completion, ihe owner-builder will have ihe burden of proving that �e or she did not bulltl or Improve lor Ourpose at sala.). ' � I, as owner of th9 Property, em EXCLUSIVELV CONTRAC7ING WITN LICENSED CONTRACTORS to construct the prolect (Sec. 7044, Business end Professions Cotle: The conire��ore Licanse Lew does not epply to an owner of propeny wha builtls or Improves ihe�eon, end who coniracts tor such pro�ect wlth e contranor(s) license pursuant to the Cantrectors License Lews.). ❑ I am exemp� under sec. Business antl Professians Code for ihis reason: Signature: Dete: Owner ID verlflad by tl��er's Ilcense. ❑ Ves ❑ No � Drivers License No. Espires: Verlllcation of Ownerel+ip by (lype of tlocumenL i.e. - property tax bill or deed): � CERTIFlCATE OF COMPLIANCE AND AIJTHOHOA710N OF ENTTiV: I certih/ untler penalry of perjury thel I have reetl �his epplicetion and state ihet Ihe infortnetian given is conect. I egree to comply with ell slate laws end clry ordinances releting to building construction, entl euthoAze representetives ot Ihe Ciry oi Coste Mesa to enter upon ihe ahove-described propgfly �ar inspection purposes. I egree not to occupy or ellow occupancy of eny building euthorized by Ihis pertnit until Mal insDection. COUE �. IHSPECl10NTYVE 1678 Fiaed System Finel Fire Preventlon 1266 Pod Spe Final 200 Finel Re-Roof 201 FInaI BIocWRetainlnp Well 202 Final Factory Flre Place 203 Flnal Sign 20C Final Demolltio� p�g �xim�ts COOE� INSVECTIONTYPE 206 Finel Mec�anical 20B Final Plumbing 210 Final Electdcel 212 Finel Fire Prevention 220 Finel Planning Approvel 222 Final Site 250 Final Bullding/Oxupancy � JobAddress: 3188 AIRWAYAV Suite: B Vicinity: BLDG B/ SUITE B(DESIGN DETAIL) Primary Occ: B,S-1 Type of Construction: V-N Parcel Number: 42719332 Zoning: Applicant: RICK NELSON Address: Phone: 714-469-8693 Zip: Owner: WITT, MICHAEL A AND LISA M`'" Address 3188-BAIRWAYAVE � � ,. . - � `� - SUITE B . _ _ - � . Phone: . , COSTA MESA, CA , Zip: 9262fi �� - . . � �+ ' _ .. - .' Y '.. � / � �' -:. 1 . � Contractor: RICK NELSON CONSTRUGTION. -_, a:i;; -`" �_ Address: „7471'SPINDLEWOODDR �� '� �, . - � - � - Phone: 714�69-8693 � ; � OORONA, CA ' . Zip:�' 92880. , ' ' License: 833765 Arth : �d�' Address: ; - �. � , Zip: - �" i;_� . . . Eng: �� Address: Phone: ' �License: � � � �� , , - °> ; Status: ISSUED Applied: 07/11/2005 Issued: 0829Q005 ISSUED BY: � � Phon'e:.... . ' ��License:--�' . ` _ : - SCOPE OF PERMIT , , , INTERIOR 4800SF-0FFICE Ti FOR "DESIGN DETAIL" IN SUITE B OF BLDG B. -" '�' s �` �`��-�-- �� • FEE.SUMMARY ., 4 Plan Check. _��"� $150;1 Y � � " ° ,�: "��Ca�lc Valuation � ,, � 590 000.00 � Permit ;:1�$923.75, � , ��`, � ,_ � .'�_ `' � � ' Claim Valuation sso,000�oo SMIP Res. ,, $0.00-�. , ,, $MIR, Com� -; $18,90 � — �'n, �� 9 � � - . ,q:3d 9 ' .. . .�..,. ,. .t . . . �: .... � J3� . � . �th2f: �' $�.�0 i - .. . . , �- av°-, _ :- . ' . ; _ . ; ..._. . ; � . , , Inspection: ,$0.00 ' � Total: . , $1,092.76 , � , PLANNING & ZONING SETBACKS'" ' "- ` . , �. MAIN STRUCTURE �Front 0�0 '� .. Rear 0 0�. Left � 0 0�'" _ . Right ,�0 0% r-" @ - , - �7 � ' � _ E;�ss,: -: ��-..�- � ACCESSORY�'-� Front 0.0��" �� g�Reat�O 0 ," �° -Lefl�'�:' c0•0, a�,Right �' ^0-0�:�� K ,,� a ; 3 .: "'� . � �. � � - �. ` i ; _ �,� " � . PARKING ��Exishn �, �0 =' Re u�red � 0 ' � Pr000sed r 0' � � �_e,, �' _.. . . . � � . �: , . ... . _ � . ., . ._. � . " � , � '. . " � s ?f.- �� :7'- . . '2 't�i ba. ; "i-� - i� ,rr`i=- i ' , _' ' ' .. ' .. '- . . ��- , � � • � -... _ , ' . _ ;.._ . . _... . �.� _, y.-- _c .; _ _ ,-, _ _ NOTICE: The work aulhorized by this permit shall comply with all applicable handicap access requirements undar Califomia statutes entl related regulations. (Ord. No. 92-28. § 1, 12•21-92) EXPIRATION: This permit shall autometically expire and become void it work is not commenced vnthin 180 Oays, or if work is suspended or abandoned for a periotl of 180 days. INSPEC710NS: In order for the work eu�horized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspeetions and flnel approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545628 f � WOHKEHS'COMPENSAnON DECLARAnON: I hereby ettirtn u�der penalry of per�ury one of the following declareGons: � ❑ I heve entl wlll maintain e certificata of consent to 5eN-Insure for workers' compensetlan, es praWdeA for 6y section 3700 0l ihe LeDor Code, for t�e peAortnence of the work for wd�ch Ihis pertnit is IssueO. ❑ I heve and WIII malntain workers' compensatlon In9urance, as requlred by section 3700 of Ne Lebor COde, for Ne peAortnance af I�e work far which this pertnit ISlssued. My workers' compansatlon Insuranca cartler entl policy numDer ere: Cerrier: Policy Number: (Thls secNon need not be comp/eted // the permlt !s velued ef one hundred dollers ($100) or Iess.J ;�I certity t�el In the perto�oi Ihe work for whlch Ihisp� d is issued, I shall not emplay eny peBon In any manner so es to become sub�ect to the workers' compensellon lews ai Cali a, end e Ihet II I sh a"become sub�ect to ihe workers' compansation provislons ot Sectlon 3700 af the Lebor Cotle, I ahell forthwlih compty wiit+ t�ese Oro ' s. i Applicant SlpnatU�e:+� • i Date:_ � Z�%/� 5 WARNINO: FAILURE TO�RNERS' GUMPENSATIqJ COVERACE IS UNLAWtUL AND SHALL SUBJEGf AN EMPLOYER�TO^CRIMINA� P NALTIES AND GVR FlNES UP TOONE MUNDRED TKKISAND DOLLME (ftOq000�.IN ADIXTIIXJ TO THE C0.5T OF COMPENSATION, DAMFOES AS PROVIOED FOR IN SECTION 3IOB OF TME IABOfi �OE, INTEREST, AND ATTOFiNEV'S FEES. LICENSEDCONTRACTORS DECLARATION: I hereby aHlrtn ihat I em Iicen d untler roNs of Chap�t¢r 9(commencing with Sectlon 7000) of DlNsion 3 of ihe Busine enA Professions Code, end my licen5e is in full farceenAeHecClJc'A—`t�3��-�i i� �Cla A /� . / / _ .... CONSTRUCTION LENDING AGENCV: � ❑ I here6y aHl�n that t�ere is e constructlon lending egency for ihe peAortnance ol the work lor which t�is pertnit is issuetl. (Sec. 3097, Civil Code). Lentler's Name: Lentler's Adtlress: Signature: Date: OWNER-BUIL08A DECLAHATIONS: I hareby eflirtn that under penalry ol pehury thet I am EICEMPT FROM TFIE CONTRACTORS LICENSE LAW for the following reeson (Sec. 7031.5, Business end Professions Code: My ciry or county which requires e permit to consiruct, alter, improve, demolish, ar repair any structure, prior to its issuance, elso reQuires the eppllwnt for such pertnit lo fle e sipnetl sta�ement Ihat he or she is IlcenseC Dursuent lo Ihe provislans of the Contrectors IJcense Lew (Chepter 8(commencinq with Section 7000) ai DlNsion 3 oi the Business end Prolessions Code) or Nat �e or she is exempt therefrom and Ihe besis for t�e alleged exemption. My violation of Sedlon 7037.5 by any applicant for e pertnit subjecis ihe eOPli�ent to e civil penalry a� not more ihen five hunAretl tlollars ($500).): ❑ I, es owner of the property, or my employees with wagas as their sole compensatlon, WILL DO THE WORK. entl the strucwre is not IntenEetl or ottered for sale (Sec, 7044, Business antl Professions Code: Tha Comractors Licensa Law does not apply to en owner of properry who builds or impro�es thereon, and who does such work hlmseN or herselS or ihrough his or her own employees, pmvided that suc� improvemanis ere not intended or oMered ior sele. If, howevar, �he building or improvement is sold within one year of completion, iha owner-bullder will have ihe burden of proving ihet he or she d�tl not build or improve tor pU�pose of sele.). ' ❑ I, as owner o1 Ihe property, am EXCLUSIVELV CONTRACTNG WRH LICENSED CONTRACTORS to construd t�e pro�ecl (Sec. 7044, Business and Professions CoCe: The COMrectors License Lew daes not eppty to en owner of pmparty who 6ullds or Improves thereon, entl who coNrects lor such pro�ect with e contreclor(s) license pursuant to the Conirectors License Lews.). ❑ I am exempt under sec. eusiness and Professions Cotle lor this reason: Signeture: Date: Owner ID venfied by drivers license. ❑ Ves ❑ No Drivers License No. Verlticatian af Ownership by (type oi tlocumenL I.e. - properry ta�c blll or deed): Expires: DIVISION OF INDUSTRIAL SAFETY PEHMR CERTIFICATION: ❑ I hereby cer�ity that no excevetian tive (5) or more feet in depth into which e person is requlred to dascanq will be mada in connec�ion wi[� work authorizetl by this pertnit, end that no building structura, scaHolding, falsework, or demolition or tlismantling thereof, will be more than t�irty-six (36) leet high. (Chap. 32, Grp 2, Art 2, Sec. 347, Title e, Celifomia Atlminisiretive Coda). ❑ As ownar-bUilder, I will nat employ enyone to do work which would require e pertnit irom the Didsion ot Indusiriel Sefery, es noted ebave, unless such person hes e permit to do such work from Ihe dlvlsion. Slpnature: Date: Divislon ot lntlusihal Satery Permit Number. CERTIFlCATE OF COMPLIANCE MiD AUfHORVJ1TiON OF ENiRY: 1 certly untler penalry al per{ury that I have reatl this flpplicaUon antl sWte Ihat ihe into�maGa� gNen is correct. I egree to �mply with all state laws entl clry ordinances releting to bullding consiructlon, antl authonza representatives of ihe Ciry of Costa Mese to enter upon Ihe ebove-described p�oparry for inspection purposes. I egree not to acupy or ellow occupanry oi eny building authonzed by Ihis permil unlil final inspection. COUE I, �$PE�Qj�CE 1616 Fixad Sysiem Finel Fire Preventlon 1288 Pool Spe Finel 200 Finel Re-Roof 201 FIne1 BIOCk�Retaining Well 202 Flnal Fac�ory Fire Place PdIE Ili�i S�Ed MSVECTIONTYPE 206 20B 210 212 220 Finel MeChaNcal Flnel Plumbing Fine� Electncal Final Flre Preventlon Fina� Planning Approval 20.3 Flnal Sign 222 Final Site 20a Flnal Demolition � 250 Final BuiltlingiOccupanry �� .�w. : a (714) 754-5273 • Fex (714) 754d856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 3188 AIRWAY AV Suite: B Vicinity: DESIGN DETAIL, UNIT B Primary Occ: B Eat<50/ O�ce/ Bar<50 Type of ConsWction: Parcel Number: 42719332 Zoning: ApplicanC RICK NELSON Address: 7471 SPINDLEWOOD DR Status: ISSUED Applied: 07/29/2005 Issued: 08/03/2005 , :,;Fhone' 714-469-8693 CORONA, CA . � ,'�Zip' 92880��-�. ` _ , �� .. Owner: WITT, MICHAEL'A " ' Address 37 POPPY HILIS RD '. �� i,,, B , .. .- � x__ • Rhone _z , ` � LAGUNA NIGUEL CAt <,A' . , ;;-Zip 92677:` :: � i�; -` . . Contracror:. RICK,NELSON CONSTRUCTION Address:�. 7477 SPINOLEWOOD DR � - -, . � �� - ' Phone: 714-069-8693 -� � � . . .¢ORONA, CA ; y�. � �" _�- � . , , , Zip: 92880 ." i License: 833765 - Arch :; ' �. Eng: WILLIAM JEIPE ANDASSOCIATE$,JNC Address: - - . ` �� AddreSs: 3164 E LA PAIMA AV � - - .. � :� Phone: - �-- -� <;--:'� _ - Fhone: 714-630•3312 ' � ' — � ANAHEIM, CA '3�' � � 'Zip: . .. ' ; . .- ' License: 92806 � -'.�` �� . �-License: 21838�., SCOPE OF PERMIT � ; SAW CUT AND INSTALL NEW GLASS FOR 4,WINDOWS ON dHE EAST WALL OF�AN:EXISTING SINGLE:STORY BLDG�FOR "DESIGN DETAIL', BLDG B. .? � :: If �� , �-1: rf=< . . . _ � " � , . ,�. _...: .. . . .. _, __ 1'i..... . _.. . . ��i ' ' � : ,.�, ; . , FEE SUMMARY � ; . Plan Check: $108J1 - _ , " ` ,;, -" � ; � ;Calc Valuation: ;, sa;zoo.00 � �� Permit "$16725 � " '""" � - a�� - � -Claim Valuation: � ` � 58;200.00 SMIPRes: $0.00� _ . SMIP Com: ' $172 <`'�Other. ,��, $0.00"' , . Inspection' $0.00� ,, , :��; ,�`. ;;. ; ° � . i. . ti 3�r sx .ee� :.�� ,�„.�a — y. ' . Total "°`$277 68' � ' „ . ,� z , �'• , -,�a - 3 $. � , . . . ��. . . � � '..: •R ...: ,� il,X . . '�l -..�.. - �.��. .� ' -.:'..:.:I.. �' � 1,, � , ; " PLANNING�& ZONING �a.: ' . SETBACKS � � � _ ` ,, _; .. -�� -, ... �i. " MAINSTRUCTURE Front';0-�0�� ; �Rear 0-0``, 'Lett�, 0�0"""� Right�'�. 0-0, '., r; ACCESSORY Front � 0, 0 � � Rear ' :0- O�A � ' - .Left' 0 0�_ -� �' Right ` 0=�0 . ... ,_ , ^€ ; � 33 PARKING Existin : 0 �� `"� Reauired: 0 " . � ��Proposed ��0 � � . , -_. `a< _�K-%�, � NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calitornia statutes and related regu�ations. (Ord. No. 92Q8, § 1, 12•21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In ordar for the work authorized under this permit to be considered legal, such work must comply with ell applicable codes, and all requlred Inspeetlona and flnal epproval must ba obtained. Failure to obtain inspections and final approval will result in the explration of this permit. FOR INSPECTIONS CALL: (714) 7545828 zmetae �a�oo� WORKEHS'COMPENSAnONDECLARAnON: I herehy eHirtn under penalty of perjury one of ihe following declarations: ❑ I heve and will maintain a certificate oi consent to self-Insura for workers' compensation, as provided tor by section 3700 of the Lebor Cotle, for ihe pertormance of the work tor which this pertnit IS issuatl. ❑ I have anC will maintain workers' compensatlon Insurence, as requiretl by section 3700 of the Lebor Code, for the pertortnance oi the work for which this peimit is issued. My workers' compensetion Insurence carrier entl policy number are: Carrier. Policy Number: (lhis section need not be campleted i/ the permif Is valued et one hunUretl dollars ($700J ar /ess.) '�� I.certify thet in the pedortnance ot the work fpr-vlhich Ihis pertnit Is issued, I shall not employ any person in eny manner so es to become suDjact to iha workers' i oompensetion laws oi Califo '�end egr ��yef d I shoulC oma subject to the workers' compensetion provislons of Sectlon 3700 oi the Lebor Code, I ahall forthwlth compl with Ihese rovis � //%/ / �/ i Appfica�l gneture: �, P� / /l il De�e.,�,_ii/�/�� . ARMNGFAIL� U O�WOR RS'�MFENSATIONCOVERAGEISUNLAWFULPNDSHPLLSlIB1EGTANEMPLOVERTOCRIMI P TIESANDCIVI�FlNESUPTOONEHUNDRED THOUSAND OOLLARE (E100,000), IN AODITIIXJ TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SEGTION 31O80F TME LABOR CODE, IMEREST, AN� ATTORNEI^S FEES. LICENSED CONTRAC70RS DECLARATION: Sectlon 7000) ot CantracmYs Prolessions Cotle, and my Ilcense is in full CONSTRUC710N LENDING AGENCY: ❑ I here6y ettirtn that Ihere is a conslruclion lending agency for the peAortnance of ihe work for which this pertnit is issuetl. (Sea 3097, Civil Code). Lentler's Name: Lentler's Adtlress: SigneNre: _ OWNER•BUILDER DECLARATIONS: Date: 1 hereby ettirtn that untler penalry ot perjury that I em EXEMPT FROM 7TiE CONTRACTORS LICENSE LAW for the following reeson (Sec. 7031.5, Business entl Protessians Code: Any ciry or county which requiies a parmit to construct, elter, improve, damolish, or repair any simcNre, prior to its issuance, also requires the applicant for such parmit b fila a signetl slatement that he or she is licensed pursuant to ihe provisions oi ihe Contracmrs Licanse Lew (Chapter 9(commendng with Secllon 7000) of Dlvision 3 of the Business and Professions Code) or ihel ha or she is exempt therefrom end the besis for the allegeA exemption. Any violetion ot Sectlon 7031.5 6y any epplicent for a pertnit subjeds the appliwnt lo a civil penalry ot not more ihan five hundred dollars ($500).): � I, as owner of the property, or my employees with wages es thel� sole compensation, WILL DO THE WORK, and the strudure Is not intendetl or ofleretl lor sale (Sec. 7044, eusiness and Professions Cotle: The Coniractors License Law does not apply to an owner of property who builds or Improves ihereon, end who does such work himself or hereelf or ihrough his or her own employees, provided that such imOrovements are not intended or oHeretl for sale. If, however, ihe 6uilding or improvement is sold within ona year of completion, tha owne�-builder will heve ihe burden of proving ihet he or she tlid nol build or improva for purpose of sale.). ' ❑ I, es owner at the Droperty, em E%CLUSIVELV CONTRACTNG WITH LICENSED CONTRACTORS to cronstruct the D�alect (Sec. 7044, Business and Professions Code: Tha contrectors License Lew does not epply to an owner of property who builds or improves Ihereon, antl who contracis for such prolect with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business entl Professions Cotle tor this reason: Signature: Date: Owner ID verified by dnver's license. ❑ Ves ❑ No Driver's Licensa No. Expires: Verification of Ownership by (rype of documen�, i.e. - property tex bill or tleed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby cenify that no excevation tive (5) or more teet in depth Into which e person is required to descend, will be mede in connection with work authonzed by this permit, and ihat no building s�ructure, scaflolding, felsework, or tlemolition or dismantling �hereof, will be more than ihirry-siv (38) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Titie 8, Califomia Administrative Cotla). � Ps owner-huiltler, I will nat employ enyone to do work which would require e pertnit from ihe Division oi Industnal Safety, es noted above, unless such person has a pertnit to do such work from the division. Signature: Date: Division of Indusinal Safery Permit Number: CERTIFlCATE OF COMPLIANCE AND AUTHORIZATION OF EMRY: I certity under penalry of perjury ihat I have read ihis epplication anC stale that ihe intormation given is wrrect. I egree to comply with ell state laws end ciry oMinances relating to bulltling consWction, and authorize representatives oi the Ciry of Costa Mesa to enter upon Ihe above-descnbed prop§rty for inspection puryoses. I agree not to occupy or ellow occupancy of any builtling auihorized by ihis permit until final inspection. CppEI, INSiECTIONTYPE QOjE INIIilALS 1616 Fixetl System Final Fire Prevention 1266 200 zoi 202 203 Pool Spa Flnal Final Re-Roaf Final Block/Retaining Well Final Fectory Fire Place Final Sign 204 Final Demolilion COOE� INSPEC710NTYPE 206 Final Mechanical 20B Final Plumbing 210 Finel Elaclrical 212 Finel Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/OccuDency / uate fea?¢---�.. PdIE 1t�L�5 (714) 754-5273 • Fax (714) 754•4856 • www.ci.costa-mesa��MBING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Joh Address: 3188 AIRWAY AV Suile No B Vicinity: BLDG B, SUITE B(DESIGN DETAIL) Parcel Nunmber: 42719332 : Applicant: RICK NELSON Address: 7471 SPINDLEWOOD DR Phone: 714-069-8693 CELL CORONA,CA � �, :=� Zip:x„92880 � � _ - ,�e,._ - �. a. :�.�,�. . ,_ .. � . eJ>.,.,. , .. . . . , ' ..: . , v... ownec WIT7,MICHAELA „ Address 37 POPPY HILLS�RD �'-:. � ' �- �- � � , - B,� .' _- . . - Phone:��-. . - . ... .. ,LAGUNA NIGUEL, CA;; , �� :; �� Zip:� 92677 � Contractor: � RICK'��NELSON CONSTRUCTION Addressi --,7471 SPINDLEWOOD DR - . " " Phone: � 714-469-8693 CELL CORONA, CA Zip: , 92880 - - - .License: `833765 � Status: ISSUED Applied: OBY29I2005 Issued: 08R9l2005 ISSUED BY: � " -,- -' . - . � SCOPE OF PERMIT � � '. . . " � �INTERIOR�4800SF, OFFICE TI FOR "DESIGN DETAIL" IN SUITE B OF BLDG��B. -- � �REFt��B05-01146 � _ �,?,:(� � 1 DISNWASHER, 1�KITCHEN SINK, 2 WASH BASWS, 2 WASTE AND VENT�SYSTEMS, 2 WATER ."� � ; CIOSETS, 1 WATER�HEATER/VENT, 2 WATER PIPING �'- �� -.-.: �,-�-: _ � `t. '"-- � � . � � FEE`SUMMARY - � � %��LT �N .�. � AMT aTY - , - ISSUE FEE ' , $23.50 ��; „ - -. Laundry,Tub / Washer' c ' _ $0.00' " 0 , . - Sump Pump Backflow irrigation .,' $0.00 .. 0� �.: Landscape Iriigahon _. ' � �• $0.00 ' :��0�`�-�- � .. Swimming-Pool � Backflow Preventer �" �- - "�� . y ...' $0.00 �0 , ....P-Trap. ":� ' :��'.... .$0.00 :` -0 � �.: �� Trap Primen y ?� �.. Bathtub � � $0��0 0_=?`: PreasureRegulator $0.00 � 0 Urinal ��--- �;-' Clarifier System- $0.00 0�' ," � Process Piping (per 10 ft) �$0.00 0 . Vawum 8rkriBkflow(t-4) Canned (Ice,Soda,etc) 50.00 0 . Receptors �$0.00 �: 0 Vacuum Brki Bkflow(5+) Dental Unils $0�00 0 Septic Tank 50.00 0 Wash Basin.- � � Dishwasher , g9.80 1 . Sewer Cap for Demo :��- 50.00 0 Wash Basin-Set ' Drain, Floor � � $0.00 0 Sewer Connect :'� t .$0.00 0 Waste and Vent System Drain, Rainwater- ;$0.00 ,,�.0 �..-:: Sewer Bri4ate-Line`- $0.00 t'„ 0 Water Closet (Toilet) Drain,Roof `�, $000 �0.: ..Shower; .�- � : $0.00 ��-.0 ��,.,A.,WaterHeater%:vent DrinkingFountain = $000- •0' lSink bar ; '. ��'s� -� $000 �-<0 -.,�WaterPiping(InstorRep.) ExpansionTank .,H., $000 � 0 ,��,;- Sink commerual ��, �, $000 �:�0 ��Water.Re-pipe � � GasEaRhquakeValve � _ $000 �,0 :^�,Sink,Floor �� .. $000 a.�0 �� •�WaterService - Gas (1-4 outlets) , �. $0.00 - � 0�'> � ��:; �Sink,�kitchen -' .�:.�--:-. , $9.80 ,,..9 WaterSokener '' Y- Gas (Over 4 outlets) •� $0.00 � -0 '� � Sink; service/mop:; �- . , , $0.00. �,-e0 OTHER' � Gas Repipe � $0:00. 0 � �Spa (private)- ? - $0.00 ' -0 ` , VIOLATION-. � Gas Service $0.00 .. 0 ' �._-,��, ` �. Spa (public) � �� " $0.00 .. _ 0" � . � . � PLAN CHECK � Interceptors (Grease, Oiq $0�00 . 0 .., � � . ' - ' '-, t ' . � E . REINSPECTION Interceptors(SandAuto) $0.00 ��.0�- ' ,' � ;{ ;- � . ' , . a",;, ,,; .. ^ ;TOTAL CALCULATED FEES: 5133.80 „�,; � AMT . $0.00' $0.00 $0.00 $0.00 $0.00 50.00 $19.60 $0.00 $79.60 $19.60 $12.30 $19.60 $0.00 $0.00 $0.00 $0.00 E0.00 $0.00 50.00 QTY 0 0 0 0 0 0 2 0 2 2 1 2 0 0 0 0 NOTICE: The work aulhorized by this permit shall comply with all applicable handicap access requirements under Calitomia statutes and related regulations. (Ord. No. 92-28, § 1, 12•21-92) EXPIRATION: This permit shall autometically expire and become void if work is not commenced within 180 days, of if work Is suspendad or abandoned for a period of 180 days. INSPECTIONS: In order for tha work authorized under this permit to be consldered legal, such work must comply with all applicable codea, and all requlred Inapections end flnel approval must be obtained. Failure to obtain Inspections and final approval wlll result in the expiration of thls permit. FOR INSPECTIONS CALL: (714) 7545626 /' zaae�e�aoo� WOHKERS' COMPENSATION DECLARATION: � hereby aHirtn under penalry of perjury one of Ue following tledaratlons: � ❑ I heve end will melntein e certiflcete oi wnsent to self-Insure for workers' compensetion, es provltled fw by sectlon 3700 at the Lebor Code, for the pertarmanca ot ihe woAc tor which t�19 pertnit 15 155ued. ❑ I heve and will maintein workers' compensaqon Insurence, es requlred by sectlon 3700 of Ihe LeDor Code, for the pedortnance of the woAc for which ihls pe�mlt is issued. My warkers' compensetion Insurence carder end pollcy number ere: Cerrlec Policy NumDer. (Thls sectlon need nof be complefed U fhe permlf Is velued ef are hundred dollars ($100) or less.) y� I certify thet in the pertortn at th �� whi�rthis pertnil Ig issued, I shall not employ eny person in eny menner so es to become SUD�ect to Ihe workers' compensatlon ews of mia the Yf shoultl bewme sub�ect ro the workers' compensation provlslons of SecUon 3700 ot Ihe Lebor Code, I s�all forihwith wmply wit��ese P ns. �y/ / i ApplicanLSipnature: � � �Dete:._ �� /Z 7/ �� WARNINO: FNLURE TO SECURE WORKERS' COMPENSATION COVERAOE IS UNUWFl)L AND SNALL SU6IECT AN EMPLOVER Tb CRIMIN/ PEe � IES AND CML FlNES UP TO ONE HUNDRED TlpUSAN� DOLLAflE (5100,000�, IN ApDRIIXJ R7 THE COST OF COMPENS4TION, DAMAGES PS PROVIDED FOR IN SECTION 3IOB OF THE UBOR COOE, INfEREST, AND ATTORNEVS FEES. LICENSED CONTRACTORS DECLARATION: I hereby effirtn Ihat I em Ilcen atl untler proN o pter 9(wmmencing with Section 7000) of DNlslon 3 of the Busineu end Professians Cade, end my license Is in full ro�a a�d an��. u�. u R�3� 7 i ci � a_13 . CONSTRUCTION LENDING AGENCY: � �. ❑ I hereby atflrtn that there is a consiruction lending egency for ihe pedormance ot the work Por w�ich 1�I5 permit is issued. (Sec. 3097, Civil Cotle). ' Lendefs Name: Lenders Address: I Signeture: Dare: OWNEH-BUILDER DECLARATIONS: 1 hereby eXirtn that untler penalry ot perjury that I em EXEMPT FROM TME CONTfiACTORS LICENSE LAW tor �he fallowing reeson (Sec. 7031.5, Business entl Professions Code: Any Gry or wunry which reQuires a pertnit to consWcL elter, improve, tlemolish, or repair any structure, prior to its issuance, elso requires t�e applicant for such permit to Nle e signed statement Ihet ha or she is Ilcensetl Dursuam to the provisions of the CoNractors License Lew (C�apter 9(commendng with Section 7000) ot DMsion 3 of the Business flnO Professions Cade) or t�at he or she Is exempt theretrom end the besis for the alleged exemptlon. My violetlan ot Section 7031.5 by eny epplicant for e pertnit sub�ects the eppllcant to e clvil penalry of not more ihen five hundred tlollers ($500).): ❑ I, es owner oi Ihe properry, or my employees with weges es Uelr sole compensation, WILL DO 7HE WORK, end Ihe structure is nat intended or otteretl for sale (Sec. 7044, Business and Professions Code: The Coniracbrs License Lew does no� apply to an owner of property who builds or improves thereon, and who does such work himseli or herself ar ihrough hls or her own employees, provided ihat such improvemenls are not Intendetl or oftered for sale. It, however, the builtling or impmvement Is sold within one year ot completion, Ihe owner-builder will have Ihe 6urdan oi proving that he or she did not build ar improve tor Durpose of sele.). ' ❑ I, es owner of ihe O�openy, am EXCLUSIVELV CONTRACTING WITH UCENSED CONTRACTORS ta construct tha proJect (Sec. 7044, Buslness end Pmfesslons Cotle: The wntrectars License Lew does not eppty to en owner ot property w�o builAs or Improves thereon, antl who contracis lor such pro�ect with e contredor(s) license pursuant to the Contractors License Lews.). ❑ I am exempt un0er sec. Business end Professions Code for thls reeson: Signature: Date: Ownar ID venfied by tlriver's Iicense. ❑ Yes ❑ No Dnvers Ucense No. Expires: Veriticetlan al Ownership hy (type of tlocument, i.e. - properry tax bill or deed): CERTIFlCATE OF COMPLIANCE ANU AllIHOROATION OF ENTRY: I cenify under penelry of perjury that I have reed thls epplication end state t�et ihe iniortnatlon given is cortect I egree to comply with all state laws entl city ordinences relating to building construction, end authodze representalives o� the Ciry of Costa Mesa to enter upon the above-tlescnbed property fo� inspection Qurposes. I egree not lo occupy or ellow occupancy ot any building euthonzed by this pertnit unlil finel inspection. � enrwur nuu�onzea hPVnwm. :�' CODE �, INSPECf10NTYPE f}�jF 1�LS 1676 Fixed System Final Fire Preventlon 1266 Pool Spe Final 200 Flnel Re-Roof 201 Finel Blak/Retaining Well 202 Finel Factory Fire Place 203 Finel Sign 206 Finel Demolltion COOE� INSPECfIONTYPE 208 Finel Mechanical 20B Finel Plumbing 210 Finel Elecitical 272 Finel Fire Preventlon 220 Finel Planning Approval 222 Final Site 250 Finel Builtling/Occupency GAg �/03 � (714) 754-5273 • Fex (714) 754-4856 • www.ci.costa-mess�.�TRICAL PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 JobAddress: 3188 AIRWAYAV Status: ISSUED Suite No B Applied: 08292005 Viciniry: BLDG B, SUITE B(DESIGN DETAIL) Issued: 08292005 Parcel Nunmber: 42719332 npp�icant: RICK NELSON Address: 7471 SPINDLEWOOD DR Phone: 714-469-8693 CELL CORONA, CA Zip ,�92880- y,� . 3 '� _ .y'.'• � � A. Owner. WITT, MICHAEL A � � � . " Address 37 POPPY HILL$�RD �>`:" F�� ' E �� ` B ,,�- , `° = :=-Phone _ . `s: LA6UNA NIGUEL CA r' �?; �'' -:�Zip: 82677:�_� ° °�r _, �� ,�"� ,_ �_ Contracror: .' RICK NELSON CONSTRUCTION Address.� 7471 SPINDLEVJOOD DR � CORONA,CA �� i; Phone: 714-469-8693 CELL Zip: `92880 License: 833765 . . , _,..,. � . ISSUED BY: t"; � �. � ;, �SCOPE OF PERMIT '..; _ ; " INTERIOR 4800SF OFFICE TI FOR "DESIGN DETAIL" IN SUITE B OF BLDG B: � , � � - REF: B05-01148 - � - � � . . ' � _ �+25 LIGHT FIXTURES, 36�OUTLETS, 73 SWITCHES, 2 MOTORS TO 1 HP, 9 COMMUNICATION-�.. �'[ ' ` � �-;-j � � '�DROPS .._.. . ....._ . t „ �' . ..': i - �� E �. `� FEE SUMMARY = �� :`�� . � m..: <�,� � " . __ _ - _ _ - �. . �uantity QuanUry , ISSUEFEE � � � 523.50 � .�, TempDistSystemLLighting . $0.00 O�r � � , Temp�servicetest �?, $0.00 , �_- , ,. _ � Busviaylt00ft, � �-�'.. 50.00 0 � . Res: a7c package � , ' $0.00 �° -*"= -� WORKERS' COMPENSATION tlECLARATION: . � I hereby eflirtn under penelry of perJury ona of the following decleratlans: � ❑ 1 heve end will meintein e certlFlcate of consent to setl-Insure for workers' compensation, es provlOed for by sectlon 3700 of the Lebor Code, for the pertortnence oi Ihe work far whlch ihis permll 15155ued. ❑ I heve and wlll rrieintein workers' compensatlon insurence, es reQuired by section 3700 oi the Labor Code, Por the peAormence of the work for which this permit Is Issued. My workere' comperisatlon Insurance cerrier end policy number ere: � Certier. Poliry Number. (Ptls�ection need not be completed tl Me perm/t !s ve/ued et one hundred dollare ($f00) or less.) �[�j-rl certiy that In the pedormence of the work t which t�is permit is issued, I shall not employ any parson in eny mflnner sa es to become subject b the workers' compensetlon lews of Celll a, entl a af t I sho ewme sub�eq to Ihe workers' campensation provislons of S/eotion 3700 0l the Lebor Catle, 1 shell forthwiN wmplywiththeseProW • 35/ ��/iJi ApplleaM'SlgneNra:. � �Date:- _,..^—. WAfiNINO: FAIWRE TO SECURE W0�71(ERS' COMFENSATION COVEMOE IS UMAWNL AND SHFLL SUBJECT Ml EMPLOYER TO CRI NAL P TIES AND GVIL FlNES UP TO ONE MUNDRED 7HIX15lWD DOLIARE (5100,000j, IN A�DfPON TO THE COST OF CdAPEN5FT10N, DMUGES AS PRONDED FOH IN SECf10N 3]OBOF THE UBOR CODE, INiEHEST, AND ATfORNEYS FEES. LICENSED CONTAACTORS DECIARATION: I hereby eifirtn that I em Ilcensetl under proNs�ons of Chepter 9(commencing wlih Section 7000) of Division 3 af the Busin§� and Professlons Cade, end my license Is in full farce end ettect Llc.-M. � ��' 7�� _ _ _ C{— �egg �p� /3 , , CONSTiiUCT10N LENDING AGENCY: ❑ I hereby eHirm that ihere is a wns�rucllon lentling egency for Ihe pertormance of ihe work tor which this pertnit is issueG. (Sec. 3097, CIWI Code). Lendar's Nema: Lender's AdOress: SlgneWre: Oate: OWNER-BUILDER DECLARATIONS: I hereby etfirtn thet under penelry ol per�ury thet I em EXEMPT FROM TIiE CON7FiAC70R5 LICENSE LAW for the fallawing reason (Sec. 7031.5, Business entl Professions Code: Any ciry or counry which requires a pertnit to consiruct, elter, improva, demolish, or repair any strucNre, pdor to Its issuence, also requires ihe epplicanl for such pertnit to file e slgned atatement ihet he or she is Ilcensetl pursuent to Ihe pravisions oi ihe Contrectors License Law (Chepter 9(commenUng with Sedion 7000) of Divislon 3 of the eusiness entl Professions Code) or that he or she Is exempt therelrom end the basis for ihe allegetl exemptian. Any vloletion oi Sectlon 7031.5 by eny epDlicant for e permit subJects the eppllcent to e civll pe�elry at not more Ihan five hundred tlollars ($500).): ❑ I, es owner oi the property, Pr my employees wlih wages as thair sole compensation, WILL DO THE WORK, and Ihe structure Is not intendetl or oXered for sele (Sec. 7044, Business and Profess�ons Code: The Contrectors License Law does not apD�Y �o an owner of properry w�o builds or Improves Ihereon, enC who does such work himselt or herselt or through his or her own employees, provided that such improvemenis are not Intentled or offered for sele. If, however, �he bullding o� Improvement is sold within one year of Comple�ion, ihe owner-bulltler will heve tha burden of proving that he or she did not bulld o� improve for purpose ai sale.). ' ❑ I, es awner ot t�e propeRy, dm EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the prolect (Sec. 7044, Business end Professions Cade: The comrecrors Llcense Lew tlaes not appty to en owner ot pmperry who builds or Improves thereon, end who contracts for such praJect wit� a cnntractar(s) Ilcense Our9uenl lo lhe ConUeCtors Licensa Lews.). ❑ I em eaempt under sec. Business end Professions Code for Ihis reeson: Signature: Dete: Owner ID venfietl by tlriver's IlcenSe. ❑ Ves ❑ No Orivers License No. Expires: Vedficatlan of Ownarship by (type of tlocument, I.e. - property tex bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMR CERTFICATION: ❑ I hereby certlty ihat no excavatlon Ilve (5) or more feet in depih into which e person is required ta descen4 wlll be made In connection with work euthorized by this pertnit, and �het no building structure, scattolding, falsework, or demolition or dismaniling t�ereot, will 6a more t�an �hlrry-sl: (36) feet hiph. (Chep. 32, Grp 2, Art 2. Sec. 341, Title 8, Cellfomla AtlmlNstretive Coda). ❑ As owner-builder, I will not employ enyone to tlo work which would require a permit irom tha Division ot Indusirial Seley, as notetl above, unleu such person hes e pertnit to tlo such work tmm the division. Signature: Dete: Division of �ndustnal Sefery Pertnit Number: CEHTIFlCATE OF COMPLIANCE AND AUTHORVJITON OF EMRY: I certify under penalry of perjury Ihat I have read Ihi9 epplicetion entl siate t�at �he infortnetlon given Is conect. I agree to wmpty with ell slate laws end dry oMinances relating to Duiltling constmction, antl euthodze representatives ot the Ciry ol Costa Mese to enter upon Ne above-described prope'ty irn inspB�<ia+ p��ses. I agree not to occnpy a afbw occuparn.y of any huiltli� authorixed by this pertnit unUl Onal inspecibn. I � 1 Legal Owner(s) te , - - d z�9�os ndfOcAut�orizedApplicanC• .' � �e� GODE /. INSPECTION TYPE 1618 Fixetl System Finel Fire Preventlon 1288 Pod Spe Flnal 200 Finel Re-Roof 201 Flnal BIaWRetalning We�l 202 Final Fectory Fire Place , 203 Finel Sign 204 Final Damalition QAg I�$ �iQpf.2 INSPECTIONTYVE 206 Final Mechanical 208 Finel Plumbing 210 Final ElectAcal 212 Flnal Fire Preventian 220 Final Planning Approval 222 Final Site 250 Finel Building�Occupency �g � /� f� /�7 /_ PP0.IECTADUflE55: ' 318H AIRWAY p.v OWM?FSNFME: �ICHAEI� A. WIT1 nooness:6615 E. PACIFTC C iiWY LONG BEACH CA 90803 AHCN/ENGMEEfl: � 3 1 �� 4 3 n- 6 � � J qooxEss: flEG.NO.: uxrt: �LD B uxrt: PEHMITTEE:CLZFF BROWN ROOFTNG (7�4)45a-9440 FODNESS: z39SS AZUSA EL TORO CA 92630 LICENSEO CONTBACTON UECIANAT10N: I hereby a�lirm t�at I am licensed unUer Dmvisfons ol Chapter 9(commencing wi�h $ection 7000) o� �ivision 3 oi Ihe Business antl Pro�essions Catle. antl my license is in lullforce antl et�ect. CITY LIC.: �� Y �ysrnre uc.: S U 6 6 6 " / CUI55: C 7 jyte: �� / � Siqnaiure: � �C.� WONREflS' COMPENSFTION DECLANATION: I here6y aflirm Ihai l hificale ot consent �o self-insure or a certi�icate o� Workers' Compensation Insurance, or a ceni�ied copY thereoi (Sec�ion 38 , ab. C�. POLICY NO.: E%P. ORiE: COMPRNY: � Cenified copy is hereby lurnishetl. ❑ Certi�ietl copy is file0 wi�h the ci�y BuilAing �ivision. �a�e'. ApplicanP. E%EMVfION iBOM WOHNEXS' COMPENSFTION OELUPRTION: Qhis section neeU not be completed ii the permii is lor one AunOreO (5100) or iess�. I te�ify al in I�e petlormance o� Ihe work lor whiCh ihis Dermil i5 i55ued 15hall noi employ any person in any mannef 50 a5 io beCome sublec��h,X{orkers' Co�pensa�ion Laws ol Califomia. ^ � d !,- — � � i ,r� "0lfe: � G�-" Signawre: ��-��-�'��ar-T�� NOTICE: Ii, aRer making I�is declaralion, you shoultl become su�le t orkers' Compensalion pmvisions of ��e La�or Co�e. you must forifiwi�� comply wi�h such pmvisions or �his Der Sh e OeemeO revoketl. CONSTBOCTION LENDING RGENCY: 1 here�y aifirm �hat there is a consimction lentling agency br the pertormance ol the work for which �his permii is issuetl (Section 3097. Civ. C). LENUEfl: FDOHE55: OWNEH BUILDEN DECUMTION: I hereDy aifirm that I am exemp� tmm ihe Coniractars' Slate �icense Law for ihe following reason (Sec�ion 7031.5 9usiness ana Proiessional CoOe'. Any cily o� county which requires a permi� to conSlmci, alter, impmve, Oemolish, or repair any simcture. Orior to its issuance, also repuires ihe applicant for such permit to file a signeA statement that he/she is licensed pursuant io Ihe provisions oi ihe Coniracmrs' Siaie License Law (ChaO�er 9(commencing wit� Section 7000) ol Division 3 oi the Business antl Pmlession5 CoOe� or �hal helshe is exempt Iherelmm and the basis �or �he alleged eKemO�ion. Any violafion of $eclion 7031.5 by any avPlicani far a permit subiec�s ihe applicant to a civil penalry of not more tAan five hundretl tlollars �5500). I, as owner ol �he D�operiy or my employees wi�h wages as �heir soie compensation, will do Ihe work, and the ❑ simciure is not inlentle0 or oiieretl for sale �Seclion 7044, Business anA Pmfessional Coae: The Conlraciors' State license Law Oaes nol aDDly to an owner o� a pmperly who builds or imOmve5lhereon, antl who tloes such work �imSelVhersel� or �hmugh his or her own emoloyees, provitlee that sucn impmvemenis are not inten0e0 or onere0 for saie. If. however the builtling or impmvemen� is sold wi[�in one year at completion, Ihe owner will have Ihe bm0en of pmving he/she tli0 no� builtl or impmve lor the ourpose of sale). I, as owner ol Ihe pmpetly, am excWsively conUaciing with Iicense0 conVac�ors lo consimc� �he pmled (Sec�ion 7044, Business ❑ and Pm�essions CoAe: The ConVactors' Siate �itense �aw aoes no� aDPly la an owner o� pmDerry who Owlas or improves fhereon and wh0 Conlratt5 �or Suth proletis with a tonfratmqs) litense pursuam m IAe CONraC�ofs' S[ate License Law�. I am aware thal pmof oi their Worker's ComOensalian insurance shoultl be pmvitled lo me. � I am exempi under Section: B. 8 P. C. �or this reason: Oate'. Owner: I tlo hereUy cer�ify �hal I am aware ol antl untlerstantl t�e requiremeNs of Califomia Health antl Safety Cotle Sections 25505, 25533, antl 2559E ana that I or any future ouilding occuDanl wilVwill not Icircle one) neetl to comply with said state codes an0 ihe requiremenis tor a permil �or cons�mction or modifica�ion tmm Ihe Air Oualiry Managemenl Uistric�. flesitlential consimction applicafions are exemOt �mm these pmvisions. Dale: NpD�icant: I�ereby cerlity��at I �ave reatl I�is aDPlication and s�a�e thai Ihe a0ove inlormalion is correcL I agreeto comply wilh all city and county ar0inance5 an0 statelawsrela�ing�o �uilding con5lmciion antl hereby au�horilerepresen�a�ives o��hisciryto en�erupon(he a6ove-men�ione0 propeny lorinspectrion'purposes. �IiBate.� —� �'1 —� � Signa�ure: �river's License or Social Securi�y a: t64t�a6 WNIe-Builaing', Green-Gotle EntorcemenC Canary-Applicen�; Pink-Revenue; GOltlenroG-Assessor CITY OF COSTA MESA – BUILDING PERN;IT PERM NO: 9 05632; PER,�iIT NO: B 056322 FLAN CHECK NO: N GOVT; N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: STR PJRPOSE: ALT JOB DcSCRIPTION : COMMERCIAL/T/O EXISTING REROOF TrJ/HOT–MOP S�i FT: 6,75U CI,AIM VALUE: 6,750.00 CALC–VALUE: 6,750,00 GROUP OCC; B-2 / CDiVIi'1EiV��JC : � 3E �1E�1M1 �lE ie �k )f ib�lh �]E iE 1F 1E 1F �F �1F �E # 3F iE �lE 9F fE iE j'r iE �E �IE �F K� 3E 3f 3F iE ii� ie iE if�-1F � 3F 1E iE �f� k ie iF le )f iE �Y� K-# 1(� # if� iF 3F iF if-!l 3(� iF iE Y:41E �IE�}!e iF it� 3E K' ii� )e'.4 M:�#: 7. O N I N G R E Q U I R E M E N T S S E T H A C K S ------------ MAIN HUILDING ---------- --------- ACCESSpRY BUILDING.--------- FRNT; FT It�l REAR: FT II� FRNT; FT SN REAR; FT IN LEFT; FT IN RGHT: FT TN LEFT: F2 Ih' RGHT: FT ZN PARKING RE¢• FROV; PARCEL: 42719332 ZNE; REr n0: Pi,ANNING NbT£S> 7 3E-1f K� 3t i4� if 3E k 3i� iF 3f !f iE• �lh # i(• if �)f -%# 3E iE -k # iF #� if i4 iE #�iF # iE iE �k �1P iE �1E if iE �k if- # fF iF # u K� �Ib ii� # 1h-0f # lF #e i(� #� i(� �It # 9f �IF iF }}..1F %� if� i6 #'� 3f iF ic if k#�E D t V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S 20NING APPROVED BY :— — DATE: — � HqILDING APPROTJED BY ; �. DATE; � � APPLICATSON TSSUED BY; ` PATE; � f *��*�-*�*��**�**��!�*��x��'3� ��F`. ��3��r��'��***��*��*�.��a��r # 3F i! �3F IF iE 3F if iE 1E iFif�iF !! 1E ie iF 3F iE iFjf 3F iF� iF iF �7E 3F�IF 1E if af� iF iE ii� �l'r iP 3E if iE iE iE if� 3(• 3E #� iE 3f IF * ii� if k#� 3f iF iQ �7F 3E if i'r ii� iE 3E i! iE 1F 3F 3f iF ie i'r iE ii� k 3�- � i4 if LEGALZZATION:N F E E .?� U M M A R Y STRUCTliRAL SEG�yE1�i:Y BLDG PMT FLUMBING ELECTRZC MECHANIC FIRE SN,IP/RES GRADING PER,�iIT 90.00 PLAN ( ^ SMIPiNOL,-RES ISStJE FEE �•' – BUILDItJG–DIV–> FERMIT ISSUE PLAN–CHECK TOTAL FATD �� ll�E TOTALS----> y1.42 0.00 • 0.00 41,42 91,4?. i ,00 .. R.EVENUE DIVISION TOTALS--> COLLEG�ED: 91,4?. OVER/SHORT:..":� ' ,00 BLDG PMT PLUMBTNG ELECTRIC MECAA'NIC FTRE S�:IP/TOT GRADIN� FLAN–CHECK 90.00 f', 1.42 «� 1e iF iF iF iF iF-%!c if N� %iF�7E �1E iE #� iP �lE #h iE if-iF # If• iF�IE%if iF iF 3E �}:� �E �If IE #(� M lE� lE #E iE iF �lE M� ie it� 1E if� i'r 3�'� �16 if if iE 3f if ii� iF ii� # If 1t� iE 3t 3E iF-I't i(� 3h ie iE iF iF ih i4ii� N� # iF I N D I V I D U A L"� . F E E B R E A R D O W N ;;� TYPE QTY D E S C R I P T I O'•N� UNZT COST ="�� TOTAL COST . SFC 6750 �s�REROOF BY VALUE C6MMERCIAL NOZONE 1,00 6,"150.00 � EI�D �O� FEES EXPIRED ';, ` I�complet? Inspections ": =C'-`=,-r �'� � . �.., ��riF� ,.i-.� , �i t�ate �=--- - Sig - �' ;� 2��,�3�-: ' . �� POO. .iPA i CONSTRUCTION AND PLANNING � � APPROVALS Permit # Date j Inspector pppROVALS Permit # Date Inspector � �. i. 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�Undrgrnd. 55. Electrical Bonding .�' 5. Steel Reinforcement - 56. Rough Plumbinj & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit�Undrgrnd. B. Foundation � 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. �,.• � 60. Backwash Lines, P�Trap, � Undrgrnd. 10. Structural Floor System � � 61. APPROVAL TO DECK ' i t. Property Sewer Line & House Connection 62. Backwash & Receptor�Final ' 12. Sewer Cap / 63. Heater & Vent-Final � i 73. Root Drains " 64. Plumbing System • Final � 14. Rough Plumbing , 65. Electrical-Final " 15. Rough Electrical-Conduit - 66. Solar System-Final 16. Rough Electric Wiring i " 67. Fencing & Access ApProval 77. Rough Wiring Sign � 68. APPflOVED FOR PLASTERING � 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAI 19. Rough Heating & Air Cqnditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. DuCts,in Structure 70. Underground Hydro 22. Ducts, Ventilating 77. Product Piping �Gas OOiI 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 IStrucmral) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 2S. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Naiting � HEALTH DEPT. REQUIREMENT 37. Plaster Brown Coat � 79. FINAL INSPECTION 32. Electrical Power Meter-Final � 80. FOOD CERTIFICATE ISSUED 33. Final Eleciric � Notes: � - 34. Final Heating & Air Conditioning �/ r- /f � U N 0 S fL/� �y1-S/=-c�c�w.-GO ✓i� . 35. Final Gas Pipe�Test - .. 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbin9 39. Water Service-Final 40. Gas Service-Final 41. Solar pomestic-Final 42. Backflow Preventer � 43. Backflow Irrigation - • u 44. Landscape Irrigation System � t 45. Sound Attenua[ion }�9(,y_lnSQgCt10f15 46. Handicap Regulations �� 47. FINAL STRUCTURE & BUILDING ' � �gt@ �""'�� 48. FINAL PLANNING � • 49. Elec[ric Release to Edison ' 50. Gas Release to Southern California Gas Co � 51. CERTIFICATE OF OCCUPANCY , No. Date JOB ADDRESS j1t325 j]ypilvgy pVg. GENERAL CONTRACTOR n Ko AP N 7-0 -10 LOT . INSPECTIONS SOIL GAS WATER 1^ _ ROUGH PIUMBING ' PROP. $WR. LINE ❑ MOUSE CON. SPRINNLING $VSTEM MISCELLnNE0U5 ROUGH NERTING ANO AIR CONDITIONING TEMPOR4RV SERVICE OR POLE UNOERGROUNO � POWER � ROUGN WIRING ,rs h /h�C TRENCMES FORMS � STEEL REINi. � FLOOR SYSTEM ��/ BON� 6EAM (-] STEEL REINFORCE p SNEnTHING FRAME ANO FLASMING LATNING — IN �I OUT � GUSTER. BROwN COAT STRUCTURAL, FINAL HEnTING, VENT., REiRIG. ANO A.C., FINAL PLUMBING, FINAL r1N0 GAS TEST (� .. SUBCONTRACTOR . 4��92� - • "COSTA MESA BUILDING-SAFETY DEPARTMENT ' P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BUILDING _ _ _ _ _ _ _ �_ �__ F � a Q y h � F G W F a c ..7 6 � %" ..1 � k7 O. O � LL z W 3 OWNER MAIL CITV BRANCH ADDRESS ARCHITECT ADDRE55 CONTRACTOR ADDRESS GTV STATE LI0. NO. SIZE OF LOT VSE OF TEL. NO.! \ PAIi! nFr,–z-�s�„—srOD i�3# �*��28.55 FOR STRUCTURAL PERMIT A.P.NO. -7Z�'I��'�z. I BUILDING �' G p � pw ADDRESS DO � TRACT �3 2 8 LOT 2 OWNER L. ry FIRE 20NE APPROVED TEL. , NO. GTV LIC. NO. NO. OF BLDGS. NOW ON LOT Sepazate permits are iequiied for electric, plumbing and heating work. USE OF BUILDING AND WORK TO BE PERFORMED I hereby eeknowletlpe ihat I �Bve reetl thls applicatlon anG stata ihat the ebove Information Is correct antl agrea to comply with ell lawz �ee�iei��e builtlin8 �onrt�uction, and 1 shall not employ any perwn In vlolation of Me workmen'e eompensation law6 of the Steta of Celifornie. I haraby cartlfy chat I am properly Ileented as a contractor untlar the Stata of Californla Buainass entl Protesslons Cotle, Dlvtaion 3, Chapter 9, antl thet such Iican»a ere In tull forea and effaet, or 1 em exempi from the provlsions of tha Steta of Callfornle Buslness entl Profasslonz Cotle, Div(slon 3, Chepter 9. SIB�ature of Parmlttea Authorizetl ABent ZONE MAIN BUI FROM C/L ST VALUE 1 � NO. BLOCK — GROVP %�'L DATE I.� �? �! USE OF � BUILDING APPROVED & VAR.�W DATE C.U.P.qW APPROVED p �. APPROVEDC. /-%�A. nnrc �� v n n m i 0 SQ. FT. a THE AMOUNT SNOWN UNDER VALUATION IS FOR m THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: � VALUATION PERMIT FEE y N $'�� TAX CHECK f � DS o � LL f U TOTALPAID E - ; ; ��. ` - _ - . , � :,815':� . • • COSTA MESA BUILOING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 � For Applicant to Fill in Completely BUILDING S K �U ' ADDRESS OWNER KnTT.ITiE71T7F. (`FT7IR'A CITV 3190 A IY�\V7..R2 BRANCH ADDRESS NEW[JOY't B6 ARCHITECT OR ENGINEER IiEE1SOR Pd AODRESS 44 Plaza .� CONTRACTOR �I] j(p],. ADDRESS 190]_ DQlje � c�r� Nevaport Beach uc No. 221764 SIZE OF LOT VSE OF EXISTING BLOG. Drive TEL. No. g A.P. NO. f, BUIIDING ADDRESS E TEL. ZON � No. 833-3030 CITV �'AR LIC. NO. (� MA NO.OF BLDGS. (FROM NOW ON LOT O FRONT SIZE OF NO. OF NEW BIDG. �I ROOMS 3 STOF EXTERIOR WA ROOF COVEFING I1C. EXA. COVERING Bll]:It.- USE OF BUILDING AND WORK TO BE PERFORMED V AR. �k _ 111��_2_7l�PAICOO 198�:� r:;:,t18�.59 Ct C' TION FOR BUILDING PERMIT Z,Pv�NE C ,�I. � / �/ J . VALUS� Q ,� , al o' � VPE GROUP F� Z � DATE a G ' fS �` BVILDING,("n/�y6�NI B VED YARDSAPPROVED FT & DATE APPROVED .,___ �i- I �ereby acknowlatlge thai I have reatl this application antl state �"' - that the ebove informetion is corraci antl eBree to comply with all laws reguloting builtling consttuction, antl I shell not employ �� any person in violation of the workman's compensation laws of Me State at Calitornlu. m 1 �ereby cerUty that I am properly licen»tl as e con[racmr untler � SQ. FT. �p'X - o the State of Calitornla Businezs antl Pro(assions Cotle, Divizicn 3, THE AMOUNTSHOWN VNDER VALVATION IS FOR 0 � Chapier 9, antl thet such licenses ara In full torca antl etfect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: ¢\ am exemo� from the provisions of tha Stata of Caiifornia Business �^ VALUATION / � D�=� m W antl Professions Cotle ivision 3,�jj�ap r 9. / // � PERMIT FEE $ I � j 1 Signamra of �i��/1 ([ I / _ m � �'�tae �'� �'�Z-� � $3�� PLAN CHECK $ [� � E � \�� TOTAL FEE $ o � �l LL \ _.. 0 � , . � -- CITY OF COSTA MESA BU►LDING DIVISION • .; 77 PAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.wsta-mesa.ca.us FOR INSPECTIONS CALL: (714) 754•5626 PERMIT NUMBER B08-00007 PERMIT TYPE B ROOF2 STATUS: ISSUED APN: 42719331 DATE ISSUED: 01/09I2008 - ISSUED BY: BJK •r'" j JOB ADDRESS: 3188 C AIRWAY AV CM ' Suite/Unit: C Vicinity: BLDG C (DAY CONSTRUCTION) __ Squares: 6500 . • - � ' . Valuation: � �� ,$20,000.00 SCOPE OF WORK: REROOF BLDG C: T/O�B.U.R. INSTALL NEW CLASS A B.U.R. ROOF TO COMPLY WITH COOL ROOF REQUIREMENTS PER TITLE 24 2005 BLDG�ENERGY STANDARDS. 6500 SQ FT ... OWNER: GRD CONTf2ACTORS INC %GRD CONTACTORS INC i Address:- �� . ' � INC Unit: � � , � - COSTA MESA, CA � - PHONE: � -- - .' City/StatelZip: 3788-C AIRWAY AVE , C/O DAY CONSTR APPLICANT: MIKE ROGERS . - " Address: 2626 NEWPORT BL - . ' - . �., Unit� � : • �- PHONE: 949-546•1645 ,� � , . City/State/Zip:COSTAMESA,CA� �� l�t�tE� CONTRACTOR: PETRONELLA ROOFING � -' � Address: 2626 NEWPORT BLUnit: � City/State/Zip: COSTA ME$A, CA �• . 92627 � ARCHITECT: ENGINEER: FEE SUMMARY Reroof Plan Check: Reroof Permit Fee: Reinspection Fee: TOTALFEES PHONE: Licerise No: - � � License No. - � > ''$o.00��.�� $32125 $0.00 ', $321.25 '��..:-�. . '...,..-. . -� � License No. 460707 949-648-1645 CELI: PHONE: PHONE: . . - . . a.� ,.... e � :.7 r,aY G:?;...TR - 'r i^.ii: ,Z:x, � . ,., ...�: .+ :itl i NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all � required inspections and final approval must be obtained. Failure to obtain inspections and fnal approval will result in the expiration of this permit. COOE1. INSPEC110NTYPE DA1,F ' IN1111AL5 CODEI INSPELTIONTYPE DATE INTITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical � 1266 Pool Spa Final . 208 Final Plumbing 200 Final Re-Roof �^�2- 08 210 Final Electncal �, ' ��'�''�'�' �' 20t Final BIocWRetaining Wall 212 Final Fire Prevention 202 Final Facbry Fire Place 220 Final Planning Approval - .:•udl� :e'tj'i�7 203 FinalSign 222 FinalSite -��,��c. 204 Final Demolition 250 Final BuildinglOccupancy .� WORKERS' COMPENSATION DECLARATION� I hereby aKrm under penalty o! perjury one of the following declaralions: ❑ I have and will maintain a certifcate of consent to sel�-Insure for vrorkers' compensation, as provitled for by section 3700 of the Labor Code, for the peAortnance of [he work for which this permit is issued. � I have and will mainlain workers' compensation insurance, as requiretl by section 3700 of the Labor Code, for the peAormance of the work for which this permit is issued. My workers' compensa[ion Insurance carrier and policy number are: L 1 Cartier: S%14�T,e.- �t1 C'4J (This seciun need irol �e mmplefee Afhe permd is valued af one huntlretl dollan (5100) oi less.) Policy Number: �� 7 Q— Z6� � � I certify that in ihe peAormance of the work for which this pertnit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws o( Califomia, and agree that if I shoultl become subject to the workers' compensation provisions of Seclion 3700 of the Labor Code. I all forthwith comply with [hese provisions. O� Applicanl's Signa e D te WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS OECLARATION: I hereby affrm that I am licensed under provisions of Chapter 9(commencinq wilh Section 7000) of Division 3 of the Business antl Pmfessions Cotle, and my license is in full force and effect. Lic. # n�� O'70} �,7 n Class # L' — 3 �i l/w � 'G�c /��ti Comrador's Sign ture D� e CONSTRUCTION LENDING AGENCY: ❑ I hereby affirtn that there is a constructbn lending agency for the pedortnance of the v.ork fa which this pertnit is issuetl. (Sec. 3097, Gvil Code). Lentler's Name: Lender's Address: Dale OWNER-BUILDER DECLARATIONS: I hereby affrm that under penalty of perjury that I am EXEMPT PROM THE CONTRACTORS LICENSE LAW for lhe follovnng reason (Sec. 7031.5, Business and Professions Code: Any ciry or counry which requires a permit to construct, alter, improve, tlemolish, or repair any slrucWre, prior [o its issuance, also requires the applicant for such permit to fle a signe0 statement that he or she is licensed pursuant to the provisions of lhe Contractors License Law (Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code) or Ihat he or she is exempt Ihere(mm and [he basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalry of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with vrages as their sole compensalion, WILL DO THE WORK, and Ihe structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an ovmer of property who builds or improves thereon, and who does such work himself or herselF or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the ovmer-builder will have the burtlen of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the projec[ (Sec. 7044, Business and Protessbns Code: The contractors License Law dces not apply to an owner of property who builds or improves ihereon, and who coniracts for such project with a contractor(s) license pursuant tothe Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: 305]-46(3/O)) Owner ID verifed by driv. ,ice, _,. ❑ Yes ❑ No Driver's License No. Eapires: Verifcation ot Ownership by (type ot document, i.e. - property tax bill or deetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certrfy Ihat no excavation frve (5) or more feet in tlepth into wfiich a person is required to descend, vnll be made in connection with work authonzed by this pertnit, antl that no builtling strucwre, scaffdAing, falsewvrk, a demolition or dismantling thereof, will be more than [hirty-six (36) feet high. (Chap. 32. Grp 2, Art 2, Sea 341, Title 8, Califomia Adminis[rative Code�. ❑ As owner-builder, I will not employ anyone to do vrork which would require a permit from the Division of Industrial Sa(ety, as noted above, unless such person has a permit lo do such work from lhe division. Applicanfs SiqnaWre Division of Industnal Safety Permi[ Number _ HAZARDOUS MATERIALS AND EMISSIONS CER7IFICATION: 1. Will the applicant or present or future building occupant neetl to fle and certify a Business Plan (or emergency response lo release or threa[ened release of a hazardous matenal? ❑ Yes ❑ No (Section 25505 of Ihe California Health and Safery Code requires, with some exceplions, tha[ a Business Plan be filed wiih Ihe Costa Mesa Fire DepaAment by every business which has at any one time during a reported year a quantity of hazardous matenals equal to or greater than a weiqht of 500 pounds, or a volume of 55 gallons, or 200 cubic (eet of compressed gas at standard temperature and pressure). 2. Does or will the applican[ or present or tuture building occupanl need b fle a regi5iration form (Or aCulely hazardous material5? ❑ Ye5 ❑ No (Section 25533 ot the Cafifornia Health and Safety Code, with some exCeptions, requires registra[ion vrilh lhe Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pountls, or a volume of 55 gallons, or 200 cubic feet of compressetl gas at standard tempereWre antl pressure�. 3. Does or vnll Ihe applicant or presen� or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for awtely hazardous materials)7 ❑ Yes ❑ No (Section 25534 0! the Califomia Healih and Safety Code provides thaf the Costa Mesa Fire Department may require the preparation, certifcation antl f�ling with ihe Fire Department of an RMPP by businesses which are required to register acutely hazardous matenals with Ihe Fire Department. 4. If an RMPP is presently requiretl, has Seclion 25534 of the California Heal[h and Safety Code been fully complietl with7 ❑ Yes ❑ No 5. Does or will the applicant or present or future builtling occupant require for ihe vrork which is the sublect of this application a permit for such construction or modifca�ion from ihe South Coast Air Quality Management Disinct or from any o[her air polWtion control tlisMc[ or agency? ❑ Yes ❑ No (Sec[ion 658502 of the Cali(omia Govemment Code requires thal the requestetl infortnation be fumishetl on applications for non-residential builtling pertnits). 6. Will any part of the facility [o be constructed under this permit 6e within 1000 (eet from the outer boundanes o( a school? ❑ Ves ❑ No Qf yes", the facility must meat the requirement of Sec[ions 25534 and 42303 ot the California Health antl Safety Code). 7. If a permit from the South Coasl Air Quality Management DisMct or other air pollution control district or agency is required for the work which is Ihe subject of this application, have all of Ihe disclosures prescnbed by Califomia Health and Safety Code Section 42303 been made? ❑ Yes ❑ No 8. Qf'yes", altach certificate ot compliance from the appropriate air pollution contml oKcer). CERTIFICATE OF COMPLIANCE: I certify that untler penalry of perjury Ihe intormation given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Sgnawre Dale CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty ot perjury that I have read this application and state that the information given is correct I agree to comply with all state laws and city ordinances relating to building construction, antl authonze representa[ives of the Ciry of Costa Mesa to enter upon the above-described pmperty for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspec[ion. Wre o1 Legal wner(s ale E/o�Au�honzeGAPGI¢an� D� � , � "�°"�0ic"L0P'a 310D AIRWAY AV w„�x�r"'E'F��DAY CONSTRUCTION ""�� 18996 WARD ST F.V. CA 92708E CA 92503 714" 9630J71 MR. W1R➢q AODXES3: uxr: C u�wREcra+e+m��n: CHRISTOPHER COLVIN �� C11844 �a+�g�p� 3955 HIRCH ST �NT 202 N,B, CA 92660 coom.c*a+stu� DAY CONSTRUCTION COMPANY ( 719 ) 963-0971 �� ca+m�croxs�,viwo 18448 WARD ST �� FOUNTAIN VALLEY CA � �.: 610693 92708-6890 unr: IJCENSED COHfXACTOFS OEClAR1T10N: 1 hsraby � �vdx penaly d pspvy Mel l un fcsmeE wMr prwmnu d GMpr Y (mmm ' wAh SecUon 1000) d Oiwion � d IM Buaimaa aM Pmlesaiau CoEe. W mY Imw e in 1u01au eM Mea. c uc. . uc.cuss: B uc.xo.: 610/6'43 \E^X'P:\ � /� aie: - — Catlmdor.�` l.� l C\��['1 V��T�Cil� �D OWNE UILOEN OEClAR1710N: 1 MraEy effim+ uMa penely d perj.vy IMI I em eaemq hom the CatlmGm lim�ua lew la IM tal �eeson lSeaion lmt.5 Buaiwss eid Rdeaeb�u COAe: �m cry n counry whidi ipui�w e pxmd io aonotruct. ed«. Impo+a. mdeh, w repei mry evuclure, yn b Gs 6euerca, ebo nQui�m IM epp4renl ta wch pmm �o fJe e vpneE �IetanrM ihn M a�ha Ln 4m�n.ee w�� o �ne a��u a me comreaan Licems Lew IcheNs e(mmm«itlno wan sauun mm) a oiiuon a a �ro �u vd Praleabro Codsl a Ihet M a eM u exemq iherMrtrn erd �M bmo la tlr saped manqion. My voWion d Bw'v� 1W1.5 Ey vry epp4wY la e petmY uNpGf IM eppli�a�Y lo e avd penMy d nol mm Nen M� IuvM2E EOAen �SS00�. � I.mowrerdtMVWMYamYemdWee+x'tAwWmtheicbcanGe��.WIEONexwk.eMiM�NclurteMWmMed a dlared W eeb (Ser.Yan ]OM. Bmren eM Proleaaoru CoEe: Tha Camreqon Liw�ua law doaa nq epply�o en owwd pops�y wlw W We «inpwee tMrean. eM Wa don vuch wak hinaeX a MnM a Uraqh hu a Mr oxn emqryw. pwiEstl thet uM 'unpwemams era m'vueMeJ ar aflaed Irc sab. tl. howww. iM EWdinp a inpvmmatl e mld r.ilho ar yaer d mmqelion. the o.,.r�euuaer .w new ine wd.� d o�+m ne « ene eie na ewd n v�wa. �o �n. awm• a ewl. ❑ �. a. mme. d in. wwaro. em e.tlwrvdr om�reenu ..ah �imiesd convanon ro mmmw me wN� (saaun tow. aein.. ene Pmlevians Code�. TM Coniredas licmae lew doee w� epply to en owiwr W qope�y wM Wada a Impwm 1lwaon eM who coMreW M vudi pqem xnh e muretlor�e) IienaW punueM to Ihe ConVmae L'nema lew). � I em eRemq under SecYon: B. 8 V.C.. for Nu reeam: I ao hweM unJY Net I em ewue a W uMrateM ihe nwimnrM a Caliwnu Heetlh anE sJMY COEe SeUlau?55o5. TSSa3. enE 2553a. eM Ntl I v urv Mure buJEinO �Den� xiA / wil ml (drtb one) neeE m comWY wYA uN mta mdu eM ths nCW��«n fa . v� �«mmm�aia, a mneamion hvnm.�F"8u�"R�ane�nw+0inrid. wnawialmnneutlian wc��... mma �� u.,. a�s�.. Dale: ApplceM: WONKER'S COYVplS�TON OECIAPATION: I herotry elfvm uMr prutly d perµy ar d Na lo�orrinp dMumuro: � IhevaendwilmeiniawecenScqadmroeruioeatlirounbworkriwmpanWcn�npwidedfa0y8acaan3]OOd�MleOa Code, la ihe prlamuKa d Ne xvM1 lar Mich Ihu pemN u ueued. �I heve eM wil meinlen workert wmpeme�ion inwrence. u rpuirad by Sepion 9]W d iM Lebor CoM. br �M paAmmer�w d tM work Iw whirh this pemN ie iwued. My warken' compenwion mare�we mns eM po4cy mimber ma: c�.: STATE FUND EXPIRES Poticy Nivnbr. i�� x n rt - 0 3/ O 1/ 9 B �rn;: �n;� ,�.ed �or ae amde�ee. me v�+o ro� o� nond�w ewiers Is�ool w iw.� cenA' � in ihe peRaemence d IM xrork br wTbh tMa permq la IuueC. I oM1tll M ampby eiry prson In a�ry menrw a n �e ecome wbptl to iM xwkeee' canpaneetbn levn d Ce4lanu. vq yns tIW tl I tlwuk becane nbjW to IM woMn' mpeiumbn pewisima d Setlon �)00 d tM lebor Cgp�,l�hy rlhwu� mmpl� wnh Ooe roNeion� � om.: -I nnws.m: We np: FaNun ro ucun worteri romp�rrutlan eaverep� l� unYwNA �0 �II ui/�cf ur �mployr ro piMml p.n �np flnu up b on� �,ntlrW flpuswd do/4n (ilOq000A ��lM�n b M� ewt ol wmp�nutbr4 Winpw �� prv r In tlon J105 ollM LeDorCob. Irrt�nat ��Y�� I� C TtiUCIION LENDINO A�ENCY: I henby � uMer pauM1y d per'ryry Ihel �Mn b a wn9ruaion Ia�dinp ayanry br IM �no��. d ma won� ror wn�w me w�� o oe�ea csea� aos�. ca. c). . LEN�EN'S NANE: �ENOEP'S ROUflESS: I<aniN �het 1 heve meE �hb eVd'ralion uM nme �tai ihe ebova'udarmetian o canaa. l Wne �o comON xilh M iilY enA oouM�/ adi�w�ca� eM etete lewe mleiip to EuilEinB �� hereby eNMraa represantmivm d Ihn ary b oMar upon tM abaa�manibnM pmpeny lorineqeaion purpoaee. LEBROAH BERG (s�s�se.wP) wnne-euib:q Dtle: � - � � � % / Rnk-Revenw: Oddmm�M�eev PERMIT NO: B CITY OF COSTA MESA - HUILDING PERMZT 084232 PLAN CHECK NO: 03059-97 A _ �� PERM NO:�B 08923" GOVT: N SUPP: N CONSTRUCTION TYPE: 111-N PERMIT TYPE: STR PURPOSE: ALT JGB DESCRIPTION : INTERIOR 6900SF OFFICE ARAE SQ FT: 50,000 CLAIM VALUE: 50,000.00 CALC-VALUE: 50,000.00 GROUP OCC: B. / COMMENTS: XL *�r*�rx��-***�r�t********�t�r*�r***r*********�t***�******�r**�*��*�**x�**+t*�t*�*�t�t*�t�r***+�*�t�t Z O N I N G R E Q U I R E M E N T 5 ', S E T B A C}( S ------------ MAIN DUILDING ---------- --------- ACCESSORY BUZLDING --------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: F.T IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING RE • PROV: PARCEL; 42719331 ZNE: MP REF NO: PLANNING N�TES> INTERIOR ALTERATION FOR A CONSTROCTION COMPANY IN'AN j > EXISTING I�NDUSTRIAL BUILDING. � �t*�r***x��r**x�*x�*�r�*��t**�****�r�r�r�r�r**�t*�r�*�r�r*�*�r+�+t*+��t�ti�+t**�r�t*****+r***�t*��r**��**�r�r** D E V E L'.O P M E N-T 5 E R V I C E S R E Q U I R E M E N T S ZONING APPROVED �BY ' : � � � DATE: BUILDING APPROVE�/BY. : � �r'f A DATE: ��, APPLICATION ISSUED `BY: r ! � DATE: LEGALIZATION:N ' BLDG PMT PERMIT 574.75 PLAN 93.40 F E E S U MFM A R Y �,-' , PLUMHING ELECTRICi' MECHANIC . , • . STRUCTURAL SEGMENT:Y FIRE SMIP/RES � GRADING SMIP/NON RES 10.50 ISSUE FEE � BUILDING-UIV-> PERMIT ISSUE F4LAN-CHECK TOTAL PAID DUE TOTALS----> 585.25 0,00 �" 93.4Q, � 678.65 678.05 .00 � 1� REVENUE DIVISION TOTALS--> COLLEC�!T4ED;c f' ' S85.25 OVER/SHORT; OU BLDG PMT PLUMBING ELECTRIC MECHANI•C �::FIRE SMIP/TOT GRADING PLAN-CHECK 5%9.%5 � l .�'' 1�.5� * it �f it �f �k �F iE if if 1f if if if if if 1E if if iE if 1f iE ie i4 iF iF iE iF if fE �f ff iF if if �E iE iF 1F iF �F if i(� 1h 1t iE �f �f K�f 3E i@ ��1F 1E if fF iE 1f if iE iF iP iF if i"t 1f iE fF iE iF 3F 3E iF iF fE iE iE I N D I V I D U A L.' F� E',B R E A K L O W N TYF�E QTY D E S C R I P T I O N��' •� �• UNIT COST TOTAL COST SFC 50000 ALTER BY VALUE COMMERCIAL� ,.NOZONE 1.00 50,000.00 END OF� F.EES„ � ,, , n T � W °fk euthoriletl b � . . aega r�� all epplloeble ��nit shall .+� /,', etefufg �WIBmg/Ifg h ' � (o ro No BRze § d�2 ao e i'°" A ,, 82� . �� v �8-14-t997/09:?4 Aq/15b5.25 RCDTN:GI-�a1�751 L � PEFtMIT.084232 � • , PO. 4 SPA CONSTRUCTION AND PLANNING 1 APPROVALS Permit# Date Inspector APPROVALS Permit�# - Date. Inspector �1. Temporery Electrical Service or Pole �52, Pool & Equfpment location . �2. Soil Pipe•Undrgrntl. 53, Steel Reinforcement � .3. Electrical Conduit Utility-Undrgrnd. 54. Forms . 4. Electrical Conduit�Undrgrnd. � 55. Electrical Bonding 5. Steel Re�nforcement 56. Rough Plumbing & Pressure Tsst ��, 6. Electrical UFER Grnd. ' 57. APPROVAL TO COVER�GUNITE , " 7. Footin9s � . . 56. Electrical Conduit�Undrgmd. - 6. Foundation 59. Gas Pipe, O Undrgrnd., Test / 9. Water Pipe•Undrgrnd. � , . 60: Backwash Lines. P�Trap, � Undrgmd. . tD. Structurel Floor Synem �- ' 67. APPAOVA� TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Finai , 12. Sewer Cap , � 63. Heater & Vent-Final 13. Roof Drains _ � " . 64. Plumbing System - Ffnal � 14. Rough Plumbing_ � 65. Electrica6Final i � - 75. Rough Electrical•Conduit' � . 66. Solar Sysiem-Final i i 6. Rough Electric Wiring � '. � 67: Fencing"& Access Approval � 17. Rough Wiripg Stgn - �. , 68�. APPROVED FORPLASTERING . � 18. Rough Electrical-7 Bar Ceiling . �' -• 89: POOUSPA SYSTEMS FINAL 79. Rough Heating & Air Conditioning � FIRE DEPT. REQUIREMENT - - � 20. Rough Factory Fireplace - AAPROVALS Permit #' 21. Ducu,-in Struaure• .. .. - 70. Underground Hydro ' � 22. Ducts; Ventilatin9 " - ` 71. Product.Piping Cl-Gas � Oil 23. Gas Pipe-Rough & Tes[ • 7Z, Underground Flush 24. fioof Fwming � • - - - � " 73. Undergrnd,StorageTankOGas ❑Oi1 25. Rooi Sheathing ; _ 7q. Overhead Hydro _ o�=,9 �� 26. T�Bar Ceiling (Strucmral) & Monocoat "��l7�r 75. Dry Chemicai � � s� � �, c: 27. Frame and Flashing , , q-� 6-QZ 76. Dry Standpipe � `, :. �� rar 28. Lathing $ Siding ' � � � 77, FIXED SYSTEM FINAL ��r `+ i,: z 29. Insulation � � . ' 78. FIRE PREV. PINAL �% �� ;... 30. Or wall Nailin HEALTH DEPT. REQUiREMENT'.'., �-� u. � 9 � l�,;Yr�7 _ ..� 37. Plaster Brown Coa: � 79. FINAL INSPECTION ="�'='- �+ ��,, 32. Electrical Power Mecer•Final - 80. FOOD CERTIFICATE ISSUED "" �� J 33. Final Electric � - . ' . Notes: �7��-!!' �-;%'? t/ J� c + �� ' � _ / - - :l�i� / � fi �✓i -l�`r�F .'�.. 34. Finaf H=ating�& Air Conditioniog -_ i � S� .�� ; f:p.. 'r J � r� 'c . � i �� / � ' i .� 35. Final Gas Pipe�7est ` , ', . � , � 9=iz-9� .GN��.� _��_,� � � , 36. Hood or CanoPY ; � � ; ' �l ��_,_`v}/��- 37. Final�Factory Fireplace' - ' ,� ^ _ `� f_YL�a�-r�«-C�D/�,- �`��-� 38. FinaV Plumbing � � 39. Water Service-Final ' . 40. Gas Service-�inal r . � 41. Solar Oomestic-Final ' � 42. Backflow Preve�ter . • . 43. Backflow Irrigation � � , � � 44. Landscape Irrigation System 45. Sound Attenuation' ' ":. Handicap Regulations 7. FINAL STRUCTURE & BUILDING 48. FINAL PLANNlN • - . 49. Electric Release to EdiSon � � 50��. Gas Release to Souther� Califomia Gas Co - - � 51. CERTIFICATE OF OCCUPANCY _ No. Date AOOPESSOFBUILpNO: j18B F�IRWAY AV OIYNERBNAMEIFIQlOWN: LAY CVNSTkUCT20N "0°"�u 18 4 4 8 Wi�t�D s T F. U. CA 92708E,CA 92503 719" 9630971 uv�. �mwo.00nEss: UMT: C i.ITY OF COSTA MESA — BUILLING PERMIT PERMIT NO: E G896�8 PLAN CHECK NO:' N CGNSTRUCTION TYPE: 111—N PERMIT TYPE: ELE i�xc""EMa+�r'� CHkISTOPHER COLtiIN 10NDo Ci1R44 'urcxon�asmoxcss: 3955 bIttCH ST °Mi ["02 N.H. CA 92660 ��T��+u� WISE ELECTRIC COh1PANY (31G)322-6332 CWiRACiORSYYIM� 330 W GRAND AV i �o� £L SEQUDO CA �� 728258 9024� uNT: LICENSEO COMFRCTORS DECLAN�TION: I hereby efiim uMer parely d perjury tlml I em IiromeE wdm pmie'vm d Gheqx 9 (mmnenai0 rmA 6eclion )000) M Di�iaion � d Ihe Buainm ud Pmloon+Coda. ad mY 4orue e m Iu01au end aMw. cmuc.No.: �/O 9� acuss: c��.. uc. �7�2��•J�JXP: � om.: � O H 6UILOEF OECIAN�TION: I haeby dfum under penely d� �hat I ewnq han tM Caqretlav I.bnw lew Iw Ns w'vp �seaon lSepion )W IS &niwae enE Rdeeviona Coda: RnY �Y a caunb whidi nVu'ves e P�n �o oorotrurt Mr. "unpu+. bmaluh, a repar eiry Niuclun, prior lo Ie eeuence, d+o requiroe iha appl'ram la euch pemiX to fik e eqrnE aWsmsM Mtl M a�hs s IiceneeE p�ivuenl to Ihe povieiom d IM Conlredon liume lew �Cheptx e(mmmentliq xilh Sedion ]000) d 0'veion 3 d Ilr Bui�e ard Wdeaiorw Code� a IMt he a ehe u memp ihereimm enE ihe bems fn Ne elleped ssemqbn. My violetion d SWion )OJt.5 by enY aDd�^� la e qrmi euEpa� Ihe applicem ta e riri pvuEy d nd mora Ihen Me hunEiaE EoOu� �SSOOp• • � 1, sa ovmar d ihe prope�y a my empbyeee wih wepae m �hei eob mmpemetian, will Ao Ihe v.oik. eM IM eVuclun w ml iManded • w Mered la eele (Saciion )OM, Bueimea e�M Prdeeeiona Code: TM Con�redae Licenae lew doea ndepplylo en oxnar W prope'ly �� who Wida a'vn0�o�e� Ineieon, eM who dom such xwk himcetl or MiW or Nraph hc or her own empbyee�, qwidad 11� wch impovemema ma nd iMeMod or dlseE la ub. tl. however. tM buJdirp n inpowneM u adC xilNn ans �wr Leomplelion. Ne owixr-0uiltlx will hm�a iM WNen M patieq he a ehe EN nal Wik or imqv.e la IM pu�pme d eW�. � � I. ea owmr M tM AOPM. em a�d�eiwh' conired'mq wuh licamad mnVe 4on ro caMiutl IM 0�9� (5etlion ]ON. Busmw� eM � Pro/enione COEe: TM Lantrrfon licenae law dwe m� eppy w en mmer d qapeM ��iN� ar'vnpwx Ihaeon uM xM� convecla 1« wch pqsrJ� wiN e murmor(s) IicanaeE punueM to iM Jeqore liwnsa Lewl. _.� : '. � I em uanp t�d Senion: B. 8 P.C.. br Nu l� ' 1 Dma: �� ' 1 Eo hxeb�' cMM Net 1 em ewma d md wdrelend Me iw��aqs d Cafiame HaW eM SdaY COM Seaiau Z53o5. RSS�J. rd PSSN. eM tlut I a M' /Wwe EWtlmO �V^^� xiA / wil nd (ade ane) neeE ro oomdY w1h aud alms codn rd tlr nywenen b aM�alacanwnianormoEificmuntromlhe/ir�ty vapxnemDimria.RaudraialomuvfioneppFatiamuaa�anqlmmtMs aa;m�,. Dete: MN'ratl: WOFKEfl'4 COMVEHS�TON DK W1ITION: I hereEy elfum under penMy d perpvy ans M ihe IaOovAnp Eadeeqbm: � IMwaMMilme'vuenecenRreieMoovmlioeettiwnetorwukan'oompemm'vi.npwileAtabySw'vi9]OodtMlebar Cods.la tM pMamuce d tM wak la WicA Nu pemw u usued. � I hew ud N meimeF wakas' oomD�ion imuranw, u ipuvsd bV Sedion 3]00 d tM labor Code. br tM D�� d IM A wwk lar xfiich Uie W�n M isued. MY walen' oom0��ion imurerce mirix end V�KY mimber aro: c�: GAF'Fc^n 7NC EXPIRES POGcyNumbc W('91 QQdR7(1(1 O1 /O1 /98 �rnv a.e;o� ,�..e �a w�d.�.d r w w�e A ro. o,e n��wed em.�. R+ool o. ro�..1 ❑ i oenN �nu m ine v«i«m.�e d ins won� w..ncn m�. w�n re�.e. i wo �a .mqm� rrv w� � dn �,�...o n m bamim wbjrf io iM xoM1ero' m�ro�eetion kws d GW4/�� tIW J I p��dd^�9 ___amjw �o tM wo�bn' c perouian/�J+ '�n� d etlbn 3]W d �he lebar COM. I � mmply MiN �A � e�e: —/ AGO�irary.� � 7/�� • np: F�Ilun ro ucun woK�ri ron�wnutlon rovxep� b un 6 nw.rw� �i.�.,,p�o�w ro am�.r o«nrou.�w nnu w ro aM n�nErM tlnuuM AdYn (sIPO,OWA b bdltbn ro N. roar ol mrrpwwtlon �+ u prvvMW br In Sxtlm 9]lA6 0/ M� LMorCaA, /nt�t, iM+ttomay'a laa. CONSTHUCTION LENDINO �4ENCY: I hereEy dfirtn IIIMM p011GX)' OI pGf�llly IM1B� �M1lA p 6 WIIYNQI011 IOMIIID Gp011t)' IOf �M �IBf�OITBIIt! O��I! MOf�I�G Nillflllhtl OlIT� U 0f11ld�aW011'Mi.CiM.i�ii. IENUEF'S NRME: LENDEF'S RDDXESS: I cMity Iliq I havs roeE thi� epqicelim uM pms ihei Ne ebova iMame�ion b corteu. l ep�ee lo compy vrilh NI rAyW oouMy oNlnenaes e�d �Wa la� MeIM Io WJdip conNWion andlweby eulha¢� iaqmeniativet d �hv tiY lo ana uV� IM abwamWipNE papanY la inpection WN�s. • _ '1'ERRY WTSE (St51�16.WP) wna.-e�'am a smwy: a�-we: o�,: 9 6 amk-a�.: caa.�oo-�..o� JOB UESCRZPTIGN CLAIM VALUE: : INTERIOR b40GSF OFFICE ARAE CALC-VALUE: FERM NG: E "v84bSi GOVT: N SUFP: N PURPGSE: ALT S �i F'I : GROUF OCC: B / CVMMENTS: REF:B-84232 'lt �' x'� � ft')F JC'K' jt x'!{' JE JC ). T 1"R Yf'f � fl' � h 9�'T' x� f�' ltl� ]C'� ��['h' } �(' �T'.' {! ]! ** 9�"K' 9t'�f * 9t ft f')P'�Y h}'h 9! ]�' 1�' 4'1 �' JF � S'x"� 9C )[ � lt lt * f!!�!t ]�' x Z O N I N G k E Q U I R E M E N T S s E T b A C IC S ------------ MAIN HUILUING ---------- --------- [�CCESSORY BUSLUING --------- FRNT: FT IN REAk: FT ZN FRNT: FT IN kEAR; FT IN LEFT: FT IN RGHT: FT IN LEFT; FT IN FGHI': FT IN PARKZNG REQ: PROV; PAkCEL: 42719331 ZNE: KEF NG; PLANNING NuTES> i ;:� •E ic je ie iE �1F ie ii sE ie iE ie ii ie ic ie iE ie if iF �F 9f i'r if 'r. ii� ii ic-k �lf ?E i� �li.ie.�ii t ic iE �k �k it ii� if iF ii i6 �i ic ��1e if ic ii ii� 1f -� iE ie ii 9e iF �1'r r. ti je if i"r if iE ic iE �1'r iE i2 ie iE 1E ic D E V E L O P M E N T S EtR V I C E S R E Q U I R E M E N T S ZONING AFPROVED BY ^'y� DHTE: BUILDING APPROVEL BY : �-� . DATE: I � APF�LICATION ISSUED HY: '"' r DATE: ��,_��`k iF�iEifiE?FiEfEiejEiEiEiE�elEfEiE�IE�iEiFif ae 1t . fe �e . it.. i' tie 'if3EifiEi'tiEaFiEiE�liii x�ei x ex. rE. LEGALIZATION:N F E!E�- S U M M A R Y STRDCTURAL S':GMEN N HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 136.70 50$ SMIF/NON-kE5 PLAN ISSUE FEE 22.u0 bUILDING-DIV-> PEkMIT ISSUE PLAN-CHECK TGIAL P[�IL LUE TOTALS----� 130.70 22.00 0.00 158.70 158.'10 ,00 REVENUE DItiISION 2GTALS--> CGLLECTED: 158.70 Ol'EFt/sHORT: .GO BLDG PMT PLUMbING ELECTRIC MECHANIC FIRE SMIP/TOT GRALING PLAN-CHECK 158.70 �lE iE �R iE �e iE iE iE iE jE i! ie iE iE f if iE iE ih if ih iE if if ii iE iE if iE :�f iE iE iE i'r iE �7F iE if if iE iF if if 4 iF if iF iF iF iF ie iF ie iF ie 1f iE iE �1F fF ik iF iF iE jf if *�lE iF ii� �1f if if # iE 1E ik 1f tf I N D I V I D U A L F E E B R E A K D O W N TYPE QTY U E S C R I P T I O N UNIT COST TtJTAL COST ELE 20 FIXTURES, LIGHTING 1 ST 20 EA, 1.OG 20.00 ELE 90 FIXTURES LIGHTING ADDITIUNAL EA. .65 26.00 ELE 20 RECEFT/O�JTLET 1 ST 2"v EA. 1.00 2G.0"v ELE 5� RECEPT/OUTLET ADLITIUNAL Ef1. .bS 32.50 ELE 20 RECEPT/SWITCH 1 ST 20 EA. 1.00 2G.00 ELE 28 kECEPT/SWITCH AUDITIONAL EA. ,05 18.'LO END OF FEES 09-1C-1997l�4:12 PA/51�6.7� SCFTd:61-351e122 F'EFch7IT:08k658 � i � �, CONSTHUCTION ANDPLANNING � PO� .SPA APPROVALS Permit # Date Inspector p�ppROVALS Permit # Date Inspector t. 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�Undrgrnd. " - 55. Electrical 8onding ' 5. Steel Reinforcement - � 56. Rough Plumbing & Pressure Test " 6. Efectricaf UFER 6rod. 57. APPROVAI TO COVEE3�GUN4TE � 7. Pootings 58. Electriral Conduit-Undrgrnd. � 8. Fovndatipn • 59. Gas Pipe, O Undrgrnd., Test . 9. Water Pipe-Undrgmd. � 60. Backwash Lines, P�Trap, O Undrgrnd. � 10. Structural Floor Svstem � .., 67. APPROVAL TO DECK ' i t. Property Sewer Line & House Connection � , 62. Backwash & Receptor�Final ' , � 12. Sewer Cap � ! - � r ' � • ; � 63. Heater & Vent�Final 73. Roof Drains ' � , , ' � . '! � g4. Plumbing System - Final . , � 14. flough Plumbing ' - � 65. Electrical-Final � � 15. Rou h Electrical•Conduii � �` � � � 9 �, Q-� �-� i� 66. Soiar Svstem-Finai 16. Rou9h EleMric Wiring - � , � ' �f �i �� , 6J. Fencing�& Access Approval� 17. Rough Wiiin9 Sign � - ' 6S, APPROVED FOR PLASTERING � 18. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL � 19. Rough Heacing & Air Conditioning �' - FIRE DEPT. REQUIREMENT 20. Rough Pactory Fireplace APPROVALS Permit # 21. Dutts, in Structure 70. Underground Hydro 22. Ducts. Ventila[ing 77. Product Piping C�Gas ❑Oil 23. Gas Pipe-Rough & Tesc 72. Underground F�ush 24. Roof Framing • 73. Undergrnd.Stor2geTank�Gas rJOil 25. Roof Sheathing 74. Overhead Hydro 26. T�Bar Ceiling (Structural� & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Scandpipe - 28. Lathing & Sidin9 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEAITH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power MeterFinal 30. FOOD CERTIFiCATE ISSUED 33. Final Electric { Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe�Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing , � 39. Water Service•Final 40. Gas Service-Final 41. Solar pomesticFinal 42. 8ackflow Preventet -�43. Backflow Irrigation � 44. Landscape Irriqation System � � 45. Sound Attenuation 46. Handicap Regulations 47. FINALSTRUCTURE&BUILDING 48. FINAL PLANNING 49. Elearic Release to Edison , � 50. Gas Release to Southem Caiifomia Gas Co 51l CERTIFICATEOFOCCUPANCY �,�;� � No. Oate :�_ � 3188 AIRWAY AV °1i' C ' DAY CONSTRUCTION "� 18448 WARD ST F.V. CA 92708E,CA 92503 714" 9630971 � �txirccroeu+m+�x: CHRISTOPHER COLVIN 1CN0' C11844 �XOp�'6"0°"E�° 3955 HIRCH ST �"'° 202 N.H. Ctl 92660 �^""CTO�"� DAY CONSTRUCTION COMPANY (719)963-0971 ca+m�croxs �uiwa 18 4 4 8 WARD S T "�� FOUNTAZN VALLEY CA �"�- 610643 92708-6890 uM: UCENSED COMNACTOfl4 UECLAFATION: I Mroby eRim uMr perely d perjwy Net I em licaned wdr pwvoro d Lheqa B (mmmentlep wilh Section ]OW) d Diviabn ] d the Bu�iiron xM Pmleasione CoEe, erd my lioenae u m NA Iace eM �Ilq. CRY IJC. NO.: L1Q CLASS: IJC. NO.: B w 610643 EX`P-: /� Dmo: �-�O'Ql Comredor��f1�1 (`lY��f('Tl(l!� l (\ OW NER BUILDEN UECLANRTION: 1 MreW elfiim urder pme�y d perjury ihet 1 em e�emp Imm tM Commtlon liosma Lnw la IM lolbw'vp reeson (Sepion ]O�t.5 &unase enE Prolenbns Coda: Any ciy ar mumy v.fiich �uires a pertnil lo mneVUC, eller, Improva, tlmmd'oh, p rapei eiry eWCNre. pia lo ee ovww. e6o repuirea �M applimnt (a wrli permn to fib e eymE swanent 11W M a sM ia lioemed pmuenl m iM prarision� d Iha Convmma Liceme Lew �Cheqa 91�menenp wil� Saaion ]aao) al DiJsian � d IM Bueineae enE Prolenione Code� or tlut M ar eM u exemq �hereimm end the beaia /a Ne dbped uemqion. My videlion d Seaion ]0]t.5 by eny epp4cenl lor s permil wmpm iha eppli�am to e wil penely W nol mors ihen INs huMreE Adlen �SSW��. r] I.a�ownerWiMprtpe�yamyemplqwx'thwpeaothasdecompametbn.wiAEONewark.eMNaevunurae�qlintmdad w ollerad la veb (Sxtion ]OM. Bueimm eM Pm/esamaCOEe: The Contreqas Liwms lew dom eM epply loan owrw d poperry wlqWiMainpwatihe�ean.udWpdae�a AxakFimWlahenNativaqhheahsownemplqvu.qOvidedlhtlach 'mprvw�neNa ve nol iruendeE a dlaad 1« veb, tl, howwar, Ihe britl'vp a inprmanera u wIJ riihm ons yasr d oomplalion. Ihs owrorbuitler vnll heve iM burdan d pwi�p he or ehe Eid nol buJd a imqv.a fw iM qvpwa ot mb�. � I. m onner d IM O�WMY. em udi�dY mm�aen9 x4h fimmeE cant�xYae m mmuua IM PMa (9etlion lW. Bw'vw� end Pmlavum Code: TM CoN�edws L"swe lew dou m� ewN ro an owror M P�W�Y Mn delds a �mPa'm tAs+on and wAo wmmcta la urli popue wiN e catlretlor�e) IicemeE pursueN to iM Comreaae limnaa lex�. ❑ I em aRemH uMs Sedim: B. 8 V.C.. br Nu �eoon: Dme: Owew: I do MebY ��M tMt I em ewera d eM ivtle�sieM Iha npwemaib d CeOmde IIseM end SdwY ('•ade SWiom �5505. RSSJJ. eM 255J0. eM Nei I n erry INure btiMirp ooapent vAA / wil mi (a�cb me) need b camply wIh seid pate coda� eM IM npu'vamxG� br e G� la ame W clion a nwddmion hom I M �r�'v�qenw� Oistritl. flesEeitl iel amYMion eVGkdom en e*emW Imn Nw a�. om.: naa�: WOpKER'S COYPENS�TION DEC Wi�TON: I Mrab� tllmn ivder pmMy d pemvy one d Ne bYowmp Aetlumuro: ❑ 1 hers W wil maieuen a ceMkde d mmsn to vatlanau�s lor xakms' mmpaiupon. m pwidM la by Hqbn T/W d IM leEar coa. ia iro c.�+� d n..,o� io..�n me o� m m�od. ❑ � nw. ene wi� mmmei, wone,s ,vmw�.mo� imu,.�o. o rw��a M s«rion a�ao d m. �nno, code. n. me c.�«mm�ce a �n. wark ta Wiitli Nu W� n ivueE. MY waken' wmPo�satian mw�encs wiw vd pdiy wmbar ua: ' , cemx: STATF FI7Ull EXPIRES Pa�'"°m"�: 1222808-93 03/O1/98 (m,�:.ealo, ro.e nw w m*d�w / u» c«mt u ro. o,» nundred aumi. Is�ool w,bu.) � I cenAy inet in Vro pMo�meza W ihe wwk br wfiih �M1ie permn ie b�uM. I Mdl m� empby ury ps�on n em/ mermer o n �o becoms wbpa ta iM xarkae' mnWametion lev.+ d CeGbmia vM aprae Nm Y 1 Mwk bemro abjw to IM xaM1w�' �o�/�m� /w�w�.o(o7. ^a s.a� s�oo d in. i.m� cod.^i q„u imn,.n` ,W,,, �(1r��T V("±'IG✓� �t1 .de: iS "1 n "7 1 MWcaru: �}��' Wemlip: F�Nun ro ucun workxi rompxuatlon cwwep� l� unlewNl, ensilull ubJcl en xlplqw ro eNMnll pn�ltlw �M c/vll Hnu up ro on� hunOrorl fhousud Jo/Mn lSfOq000A � eWltlon ro tlro ewf ol rompslwfbR demeP� �� p�M� ror In 9�ctlon J]G6 0l IM LMor Cod, Int�rs�f. errtl artomsyY lsu. CONSTRUCTION LENDINO RaENCY: I Mreby elfirm uMar paneXy ol per'puy thet Ihen ie e aonqrudion bMInO ��Y la IM perlormanm d IM wak Iw whiN �tiu prml o owed (�� . G'v. CI. LENDEfl'3 NAME: LRIOEP'S AODRESS: I cerlily O�m I hew reM �M1b µylicqpn eM pma thet �M ebvs iNametion b wrtetl. I egme io camply with M ory aM wmry pd'mvos end staa lewa relelinB to Wik'vp coeuvwbn eM hereEy eulhar¢e repreeenlmivee d �hia cily lo anter upon iM ebova.meMionW pmpeny la i�npedion prpoeva. �� me: � � (515tJ6.WP) �a&nkiq 8 Selely: (3nen-Wa: Cenery-App6wa: Pink-Rew�w:OoNavod-Aeseav CITY OF COSTA MESA - BUILDING PERMIT PERMIT NO: B 084085 PLAN CHECK NO: N PERM NO: B' OFi�108 GOVT: N SUPP: N CONSTRUCTION TYPE: 111-N PERMIT TYPE: STR PURPOSE: ALT JOB DESCRIPTION ; REMOVAL OF NON BEARING WALLS 6900SF TI SQ FT: �10,000 CLAIM VALUE: 10,000,00 CALC-VALUE: 10,000.00 GROUP OCC: H` / COMMENTS: DAY CONSTRUCTION �r�x*�****��r�*��***��**�+r*�r+e�r�r�r�*��e�r*��r��r�***+r�****�*�*�*��*�r**��r+r* x **�r***�r�*�* 2 O N I N G R E Q U I R E M E N T S � S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING --------- FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT: fiT IN PARKING REQ: PROV: PARCEL: 42719331 ZNE: REF NO: PLANNING NOTES> > r�� ik ik iF i! iF if i! i! ik if if it ik �)E �! iF i! if if �f if if ih 1E k k ik ik if 1f i! 1f iF iF iF if M iF if iE ik!! if iF �t �f if it iE 3F iF iF 3E iE if iE iE ff 1k if iP 9k ik iF iF�1f !E iFil�iE iE ik i1 if ik ik M iE df 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 HY DATE; r�i � BUILDING APPROVED HY : APPLICATION ISSUED BY: LEGALIZATION:N F E E S U M M A R Y BLDG PMT PLUMBING ELECTRIC MECHANIC PERMIT 162.25 DATE.: �% DATE: l� �iF�t*x*�t***** ** STRUCTIJRAL SEGMENT:Y FIRE SMIP%RES' GRADING SMIP/NON-RES PLAN % 1 2,10 ISSUE FEE �.: �:' HUILDING-DIV-> PERMIT ISSUE PL•AN-CHECK TOTAL PAID DUE TOTALS----> 164.35 0.00, /c^ �' 0.00 164,35 164.35 ,00 REVENUE DIVISION TOTALS--> COL-LECTED: 164.35 OVER/SHORT: .00 BLDG PMT PLUMHING ELECTRIC'MECHANIC FZRE SMIP/TOT GRADING PLAN-CHECK 162.25 '' -. 2.10 �F iF it iE 1E ik ik i(�!k iE 1Elk �E fE iE iE if 1F iF iF 1E 1F if ik i! iF iF �F it iF if iF fk 1E iF iE k!k!f i! iF it %i41f iE if if iF 3E �E �E 3E �f iE �E �f iE ak 1f ik �i iF iF iF fE iF �1F ff fE 1f ik iE iE i6 iE if 1E iE I N D Z V I D U A:LF ,,^ F E E B R E A K D O W N i'' �' ^ TYPE QTY U E S C R I P T I,�O,:N�' UNIT COST TOTAL COST � /n, SFC 10000 ALTER BY VALUE COMMERCIAL. NOZONE 1.00 10,000.00 ifiND'• OF FEES � ��1 � f� , �I � � �9-06-1997/04:21 PH/416k.35 RCPTa:01-0810348 �- PERhiIT:084085 r�:YION AND PLANNING � POOL & SFF .� „✓.LS Permit # Daxe �inspector Date tnspector APPROVALS Permit # � . amporarY Electricai Service or Pole 52. Pool & Equ�pment Location � � 2. Soil,Pipe-Undrgrnd. � 53. Steel Reinforcement .,�3. Electrical Conduit.Utility-Undrgrnd. � 54. Forms 4: Electrical Cnnduit-Undrgrnd. 55. Electrical Bonding � 5.. Steei Reinforcement� 56. Rough Pl�mbing & Pressure Test - _ 6. Electrical.UFER�Grrid. . - 57. APPROVALTOCOVER�GUNiTE ' -7, Footings'�•� ' , ; � 58. Electrical Conduit�Undrgmd. � 8. Foundation. ' , � 1 59. Gas Pipe, O Undrgrnd., Test ' 9. Water Pipe'-Undfgrnd. _ ' 60. Backwash Lines,.P:Trap, O Undrgrnd. 10. Structural°FloorSvstem ' � 61. APPROVAL'TO�DECK � 11. Property Sewer Line &.House Connection , 62. Backwash & Receptor-Final 12. Sewer Cap '_: '� 63. Heater & Vent-Final � . 13. Roof Drains � � � - 64. Plumbin� SYsrem - Final , � 74. Rough Plumbing, .„� . 65. Elebtricai�Final � 55. Rough E{ectrica{'Conduit- . � � - �66. Solar�SYstem�Finai � . . 16. Rough Elettric Wiring � , 67. Fencin9 & Access'ApProval . ' 17. Rough Wiriag Sign ' , - 68. APPROVED FO�R PL9STERING 1B. Rough Electricat T Bar Ceiling � ' �69. POOUSPA SYSTEMS FINAL 79. Rough Heating & Air Conditioning FIRE �EPT. REQUIREMENT - -- r.. 20. Rough Factory Pi[eplace �, � ' � APPROVACS � _` Pe`rmit # ; , �. 21. �Dutts, in Structur� � ,; .. ,,,.� � � �. , 70. -Wnderground Hydro 22. Ducts; VCntilating-�' � ' � ^ _ r"7�, produciPiping OGas �Oil 23. Gas Pipe�Rough & Test � � �. .,.r _ � � 72, Undergroand Ffush _ �. "� 24. RoofFrami�g�� x � •• � � �� 73: Undergrn?1.StorageTank!OGas ❑Oil . .� . 25. Roof�Sheathing _ f � � � �' '-3 ;�; � 74. Overhead Hydro. � 26. T-BairCeilin9 (Strucwral) & Monocoat � ' ' 75' Dry Chemical � - ' �-' - � + - 27.FFameand,FlashinqF , '� j' 76.DryStandpjpe.,�' j' r„ - 28. Lathing &'Sidin9 � � ^ = 1= ° %� • • 77: FIXED SYSTEM-PINA! � 29. Insulation. � _ ' ' ' � � ; � 7Q; FIRE PREV. FtNAL � � .. � ., _ 30.DrywallNailing �a � ! .HEALTH'DEPT.�REQUIR�EMENT . 31. Plaster Brown Coat ' �. ti ,• - •� 79i FINAL INSPECTiON , _� u � 32. Electrical_�ower MeterFinal . -. � 80.: FOOD CER �'�tCATE ISSUED 33.FinalElectric_ � ., � � '" � � Notes: �(/,r/� rL�k� _ . ��u 9 _ � , 34. Finaf-Heat+ng & Air Conditioning � - � � � - - 35. Finai Gas P�Pe-Test • . - ° �� • • � ' " ' � � . � 36. Hood,or Canopy ; ' _ ` - �:� _ � • � � �37. PinaOFactory Fireplace - " ' '� ^' _ ! � '' _, ' . ,. � , . _ - ,38. FinabPlurribing . ' � � fi , ,+ . . _ :39. Water'Service•Final � -- � ' . - � �"" - 40. Gas Service-Pinal � . _ _ �� ^ , �� - - . � ' 47. Solar pomesticFinal- � � i ^ ' . . � ' 42. Backflow�Preventer , ' , - � �. . . - 43. Backflow Irrigation • ' + ' � - � � . � 44. Landscape Irrigation System - �- - , , _ , -� . _ . 45. Sound Attenuation � • - -� - � � -+ �". andicap Regulations ^ -� � ' � " ; '�'. �_ � - , � �: . 47. FINALSTRUCTURE&BUILDING Q �Z, � �/�� .� ` 0� �ic�"r'• ' � ' - - � . � 40. 1 IIYML LMI IVIIV � .,� � • 49. Elearic Release to Eiiison � � . � � 50. Gas fielease to South:ern Cafifornia Gas Co ' • •, �. - 51. CERTIFICATE OP OCCUPANCY . _ - No. Date / I A°°"�OFB°1°a0` 3188 AIR'vIAY A'v OWNEASWWEIFRlONN: LEiY Ci�NSTkUCT1uN "p0"�' 18 9 9 8 iv?.kL 5'I F. V, �` -,t::A 9�70tiE,CA 9'tS"v3 ur�. Yuur+c �noaEs4 714" 5o3G5"i1 uxr: L urcx�cronam+�nn: LjjRISYVFHER COLVIN 1QND C11844 IPCX.OAFNQ.'S/iWflE55: 3�SS HIRCH S'f uNT: 202 N.fi. CA 926o"v caim�arsxu�: yNUi�Rli�:i IVE AIk 3YS'TEMS ( 714 ) 547-7431 CONiPACTORSYAiIIIlO 915 �: WASHING'lON "0°"E�% ShN i P, Ai3A CA �"�= 3 81 � 2 0 9z%O1 uNf: 110EN5ED COMNACTON4 OELLIXATON: I hseby tlf �d„ o..wv a o.n„Y mm i.m i�.,..d �,b„ pa�. w cnaq« e (canmentiiq x+lh SecUon'lOP0) d Divbian 3 d �M Buaiiru end PNueiau Cods. eM mY lioe�oa b in tu0lau dk elled. cmuc.No.:V j12S� uacuss: � 2� uc.N�381��iG EkP: 03/88 ome: coinreao,: �{�/ �/ f� �—�Z OWNER BUILUEP OE IARAnON: I haeby tlfim� ivds panely tl perjury Ihel I am vem hpn IM Cae�rfus Liwma Lew la Na IdbMTO raeam (Setlon )W 1.5 Butiieaa enC Ralmoia Code: MY aY a couM' wlJrh m�ww s D�E to mrolrud. epar. inVwa. tlemdoh, a ropir ury aV�c�Va. P� b Ia iaiw�ce, ebo rx��vef iM applimm la wd� pemW to Re e ei�wd qelwieM VW M w�he A i��e w�� o ms wo�.� a ub com�a«. w�,.e i.. �cn.q« e t�m�ro wnn s.ao� �aao) a aV:w� s a m. eurin... v,a aodexims coml «�ne� �. a.ne u v,emq tnaMmn end u�e nssi. �« Un dlwb axa�4*�.. �m �owun a s.nun lW 1.5 Ey enY a0d�u^I lor a permi� eubptla IM epplicem to e cnl per�ell/ d eM maa �hen INe huMred Edlen �5500�. ❑ I.aiowmrdiMpopMYormyempbyeeewlhwepaemlheiedemmpenWion,WlAONexvrk.eMNeaWctwewmliMeMeA a oflmed lor eeb (Seciio� )Oa�. Buvma aM PmlesamaCade: TM Conlrmwe Licenve lew tlros nd epplY�oan owrwd popeny who buiM a inV�� IMreon. eM wfio doee euM wark FunaMl a Mne1 a Rvaphlie a Aer own+mdoRm. p^"�d ihet euch impowmmp ve nd'odeMed n a11enA la eeb. tl. howe�er. iM buildiep a inpv.emeM u wN wilhin one yeer d mmp4lion, Ihe ownerdnlder �.i0 heve iha EuNn d G�+�q M a Me Nd nd ddd a'unpa+b the qvpw� d eeb). ❑ I. n ox'w d the pW�1'. am udwn'e!/ canlretlM weh 4mnestl cont�enws ro mmtrW tM pqetl (Setlion ]OH. &s"vw end Profeviwu Code: Ths Gomredon Licenae lew tloee np eppy b en ownx d popMy Mfio WiIJ� a vnpwee iMnm e�d who mnlrecla lar wN pqeda xith e ooMretlor�e) Icemsd WnuarY lo �M CaNredaa limue lew). � ❑ ��..ema��,s«u�: e.av.c..ww,...o�: Dele: �KK: I Eo MnW ceMY thet I em ewera d ud udaeieed ths �eVw�aw d Cdimii�lbeAh end Selery Cotle Sw"nn ]iR05.25519. mA 25531. aM Nm I n ury Muro b�nldiiq �an� xitl / wil np (mcY ons) neaE ro mnply wih mid tlels md� ud �M �opu'vsmrro b aD��Saaam�n�ciionamoOR�ionfranlheN a�1 mupenw�Diwrie.PssiOslWminvf'oneppf�alianaroe*emqimmtl�ess wwiaioru. WOPKEN'S CONPENS�TON DECWI�TION: I Mropy qfiem uMr penelly d prjuy me d IM Mbwinp dedeetlbm: ❑ I hm ad xJ maiman P �e�d��e W mmM lo eatli�wn lor waken' comperiatltlion. n pwidad 1a by Sedion ])IIO d �M lebor code. �« �n. wdomwK. a u» .vx �v wNrJ, mu ro�a a u.�.e. il � naw eiw wll meimen �a• mmv�don inanenm. m nawrse M Seaion r�ao a me lano. Coes. oor ux ro�«mvm d u. � wM tor whirA ihu M�n u wsued. MY waken' oom0�ion imurenca ra�i> vd pdwy rximbx ere: c.mm: FtF.F�iH7."fC 2NiiR.MU EXl%'It(�$ PqiryNumber: blt�J�U� Vb�ZV��2f �,raa��.e�ora. o�w�eerrnso�xnm.w»n�„�a.dadw.Rroolw,�..� ❑ I cMh' Nm in Ne V�amunn W Iha wak Iv which iho V�e b iawM. 1 da0 ml anVM �Y Va� in M' manrw w a �o become wbjetl �o tM �s' �D�� ew* d CeNomie. erd apree tlet L I MwM bemnr wdjotl to IM xalwrs' campamnion P�'mioM d Seaian 3)ao d iM lebm CaEe. I NeA /19��/hw�il� oomPN( �wnA iM�w DA+s�. Dtle: �� !/? � QY Apdiram: �/�r` • {��/ �/ / � •--fr-�— W�mlip: FeNw b asun Wo�kw+'ro�vwv�tlen rovy� l� unIMW, uM �Ivll wb/�er�n r�pleyr bWnYnl prWtlu mJ UMI Iliw �q b om ��n0� flio�uM Wd4n (JfOq000A N Walfbn ro IM cwt ol romp�u�UoR Lmrpm u povltlW br In S�ctlon 91Q6 0l IM l�borCo�. Infw4 �� mry i hea CONSTNUCl10N LENDINO �DENCY: 1 hemEy �rm uMm peneliy d perjury thm the�s h e mnqiutlian bnNnp q�aKy br tle pertormerce d IM v.wk In vA�iM t�a O�Y b eweA (Seaion �09). CH. CI. LENDEF'8 NMIE: LENDER'9 ADOXES3: 1<Mity IIW Ilure ned No epd�� eiM qtla �� tlro eEwe iNametion h conW. I�ae lo ttxnyy Mith eY dy rd mvXy atl'vwaes vd eWa lewe �aIHM lo WJEiM contlWion end hsabY eNhv¢e mP�Wd� dNe rey bWa W� IM ebo.e�mentinNd prtperly ia inpetlian purpowe. 'CUM E'iizEii � Pnn1 Name ' //i1Lf _ ��I Dma:11Z /io� pw .a«� �a« (5151�16.WP) Whne-�dNiqd5e1My;0�eerFla:Cenery-�ppfum:Pmk-Hermua:OdtlsvoA-Avaeemr CI1Y VF COSTH MESA - FSIiiLLINi; PEiiMli 2'EKM rii�: M 06�150 PERMIT NU: M G85156 PLAN CHtCA Nt7: N i;i�Vf: N �urF: N CGNSTRUCTIUN 'TYPE: 111-N FEkMI'P iYrE: MtC P(7cieii5r:: Ai'i :JGH LESCRIPITGN ; INTEkIGR b40�SF i7fFICE AftAt SQ FT: CLAtM VALUE: CALC-VALUE: �ROUP OCC: 8 i Ct)MMENTS: XL, RE:b8923"1 if ii iE'sE iFii iE if ie if if ii if iF iF iF if ie ik jF 3E jf iFii iF ie ie ii iE if iF iF iF if've ii iF iF iF iF 3F iF �iF ii iF iE if ii� ik're ie ie �lf 3e iF ii iE iF iEieiF�le fi if if # iE i' iE if iF i'r ii # ie ie ie ii 1e Z O N I N G R E� 0.( k r: M r: N'T S S E T B A C K S ---•--------- MA1N BUILLIN� --------- ------- ACCE530R'z duiLLING --------- FRNT: F'f TN REAR: E"1' 1N FRNT: "r'1' iN k�Aii: P7 �N LEF'T: FT IN AGAT: FT IN LEFT: r'i IN HGri'I: Fi 1N PAkKIN� RE�: PRiiV: PAki:EL: 42'719331 iNE; itr:r NO: PLANNING NVTES> . j ie ie+t iF if # if ii w ie ii ie iF 1F # i2 i'r if 'se'se w�iF ie ii if iF ii ie iE i't ie if iE ii ie'se �'t ii i@ ii ii iF ie ir+e iE ie iF �li iF ;+ie tif iF if 3(• iF ti ie ii if ir ir'se w ii� iF iF tir i'r i"r i'r iF iF ie :i ie ie i'r '.. L E ti E L i r P M E N I' S E k V I i; i: S R r: ti u L i"t t M't: hi i S ZGNING AYPRVuhL t1Y � LAlt.; _ bUZLLiN� AFFRGticL t1Y : iJ[�"j't;; .. 'APPLICATIGN 155UBir BY: "• uAit: �O �� ) �1t1fjtlFlfillrlF'R1t'Rltllltlhl!'RalY'1t�lft 1tN1'lt 1t91'9t1t1Fllf'ftlt 'R'R'R'RKR R a!'RR'/FltRltR�tltiRRlti!'Ral1t'R1tf''R'K' YtRR'R'RT'R LEi;ALIZA'IIGN:N F t r. S i:r M M A lt Y SIi"tui:iuitAi, f;i�i;M6N'i:N bLD� PMI PiUMaINi; ELEi.ZRIC MEiiiAiVTC rikr. sMIrittE:> Giti�u.iNi; PfiRMZI �5."v0 25i �MlriNi)N-�i2r5 �I,AN ISSUB rEE LL.VG 6UIiLIN�-LIV-> YEkMST IsSUE PiAN-Cri£CK iOiAL FALV L"UE TOTALS----� 45."v"v 22,G"v u.u'v 6/.u'v 6"i.G"v ,G"v kEVENUE L'iVISIUN 'IUiAi,"s--> CGLLECiEL: b'i,"vu v'V'r'I2i5HiiftT: .pii bLLG PM'I PLUMbING ELECThZC MECHANIi; F.TRE SMI'r/'i'0Y' GRA"uTNG .ei:,AN-CIiECK b%.VU ieiewiewifi'tieieieiew+FdiifiFi'txww#iFieiFiFiEiFifiiiiw'seieiiiFiFi'e�l'tiii'rifiiii;?iFw��iewifieif iiir�w"sr7FieiF+iiriiwi'riiietieif�3'r7'ririeiFieiF�ieif+f I N L I V i L U A L F t E b t't E A K ii O v7 N iYPE QTY L E S C R I P'I "t U N UN.L1' t,VS'L TU1l�l, C�5'! MEC 2 REFRIGtRATIGN SY51'EM <= 1"v0 K b'1'UiH 13.�5 26.5"v MEC 1 GAS YlYING SYS 1- 4 uUii�:'i'5 S.�G S.�G MEC [ VtiNTIi,AIIuN FAN CUNN 'i0 SiNi;LE uuCT G, iu 13. "vG ENL UF i� �r.'S 18-IB-1997/11:14 AM/f67.8B RCDTY:81-8B136B9 PERMIT:B85156 CONSTitUCT10N AND PIAtJNiNG POOL & Sr.� APPROVALS Permit# Date Inspectoi - pppROVALS Permit# Date Inspector 7.1Temporary ElecVicai Servica or Pole . 52. Pool & Equipment Location',• . � -2. :biiPipe�Undrgrnd. ', � 53. SteelReinforcement � ' � . .3c Electrical.Conduit Utility-Undrgmd. 54. Forms , • .� 4,'Electrical:C,onduit��lndrgmd, � � 55. Electrical�Bonding �. ,,�; --5. Steel Reinforcementy 56. Rough Plumbing & Pressure Test ` �� 6;. Electricaf UFER Gts`d. 57. APPROVALTO COVER-GUNtTE � '.' 7 _.Fooiings ` � _ 58. Electrical Condeio-Undrgrnd. " � g. Foundation � + =" - - _ 59. Gas Pipe, O Untlr�md.,-Test � '9.� Water PipE; Undrgrnd. '=. . , 60. Backwash Lines; P�•Trap, � Undrgrnd. 10. Structural Floor System - .61. APPROVAL TO DECK '� ' 1 i. Pr,operty Sewer Cine & House'Connection � 62. Backwash & ReeeptorFinal , . 12. Sewer CaP ` .` . ' . �'• . 63. Heater & Vent•Final . 73. Rooi Drains _ . .64. Plumbing System - Final 74, Rougfi Plumhing-� . � . 65. Electrical�Final � . 15, Rough ElectricaHCoriduit - � �,66. Solar SYstem-Pi�al� - 16, Rough Elettric wri g , -_ •'� � 67: Fe�cing & Access Aporoval � 17, Rough Wiring Sign ' ; . � 68. APPROVED F�j2 PLASTERING ' 18, Rough ElectricaG7 Bar Ceiling -� � �'69. POOL/SPA SYSTEMS FINAL � '79, Rough Heaiing & Ai: Conditioning - �� r�/�� ' ,� FIF2E REP7. �7E4UCREMENT i _ , 20. BoughFacmrxFice�llace ; 7 _� ., x �,qPPROVALS-.,=Permit# � '�-� 2L �uct j in Structure��+� .•^ � � '' � 70. t�'ndergrouqd Hydro �r w . � v 22, Duc{s VellYilalin9.�l i e i' '� ��. • �' �., 71. ProduoS��Piping L3Gas t"te.0i1 23, Gas Pxpe•RougM & Tesc �•: _ � �2, Undergro'und FtOslS � - i Z4, Roof Framing" �{ " "_ �. ' c y„ , 73:; Undergrrd.�Stor�a� Tank`� Gas ❑ Oil�' 25, Roof-�Sh¢`2thing .;. !. , r �� i� -� - _ �. .7 . � 74�' Overhead Hydra� r , -.: 26. 7?�Bar Ceiling (StruttGral) & Nlonocoa[ ` 'r '' _ ° 75: Dry Chemiral .. � ` � - �'y" 27. Frame and Flashing ; ` i-• � ^+ 76. Ory Stan�pipe � � �� * 28. Lathing & Siding •� .. _ . ` . '' �: -,. Y ,, , ; � � � '�� ; 77M FIXED SY$TE{j4 FINAL _ ; , 29, Insulation� _ �• � I ;�, 7$; FIRE PREV. FIMAL ' • - 'r ; 30, OrVtvall Nailing �_ �; �' �tiEALTH DEP,j.'REQUIR�MC'NT 31. Plaster Brown Coat � _ -. �+ • �s � 79.� FINAL ti4SPECT101V . :� � -' 32. Electriwl=PoNter Meter�Fi�tal r� , � �� ' 80� FOOD CERTIFI'CATE I�S�JED '. ' 33. �'inaFEleciric-_ w „ ; � � ;� � Notes: - ��' � . . * J ' 34. Finat7ieaiing& Air �o�ditioning `' 'L� ; � - ; r . ' �., . . . . ' ' - 35. �,inal Gas-Piper7est Y ._ ,��c � � ' �„ i p - . - - � 36. Hood^or CanoPY • ' _ ,' _ -. : -` I . ~ � � '• _ - > - � . r ' 37. Final�Faciory Firepiace . � , - . f�. � - . - 3$, Final�Alumbing � i� ' -' ' ' �� _ ' 39. '�^later'Service�final ' � - i � ` ' ' ' - ' ' ; ' �, , , •,« �.:40. Gas Service-Final - • �� ' �^ � - ' _ z � 41. Soiar pomesticFinai, = ' ' - : x - " ,; , . _ 42. Backflow Preventer � � ' ' � _ 43. Backflow Irrigation ', , " - F ; ; : � � . q4. Landscape Ir�igationSystem''T '" � � � � . • - - r_ 45. Sound A[tenuation� '; � � �-� : � ". �� - . , . 46. Handicap•Regulations • ' _ - - _ ,`�., e� c 4T, FINAL STRUGTURE & BUILDIiVG �. " ' - � _ ' , � 48. FINALPLANNING� - � _ - ��'' � ., . 49�. Eiectric Release to Etlison t'` •� � ` . ��. � �E' , 50. Gas eelease to Southern Califomia Gas Co � - ' ' l'� �'• . , .;. > .i, 51. CERTIfICATE OF OCCUPANCY � ' - _� _� - � No. Date ." . �ooness a ea�w+c: OWNEHSNRMEIPIpt1RN: '• �DDNESS APPL. WIIRW ADDPESS: 318i3 AIRWAY AV DAY CONSTRUCTION 18998 WARD ST F.V, c:A 92708E,CA 92503 '714" 9630971 uNr: C CITY OF COSTA MESA — HUILDING PERMIT PERMIT NO: P 089263 PLAN CHECK NO: N CONSTRUCTION TYPE: 111—N PERMIT TYPE: PLU �'�T0"�'ff" CHRISTOPHER COLVIN �� C11894 "'KH0"�''"0°"Ett' 3955 BIRCH ST °"T' 202 N.B. CA 92660 �^"ACTO�""'� H L MOE PLBG CO INC ! 818 ) 240-2040 CONf""Cf01S1"""'� 619 W COLORADO ST 'D0"� GLENDALE CA 1GN0= 254678 91204 � IJCENSED CONiflACTOqS OEC WiAiION: I Maby ellFm �vdr panaly d yapvy Nel I em fcwwE uder prwmms d Cheqs 9 (oomme�r's8 rA� Seclion ]OW) d Oiv'vun J d Cw &uinav eM Rolwnoin Cotle. uiE mY (nm�s u in hA lau end aHetl. /�i`b1Cf"o 069686 uc.cuss: C 36 uc.No.: 254678 EXP: 04/98 IOWN o BUILDEN DECLARATION: 1 hreby efirm imMr pwie�y d pe'ryry �hn I em vamp hpn iM7aun 1 idb remon (�� ]W 1.5 Busi�me eM PMesaions Code: Mry ciY a couMy wt�iN nqu'um e pemitl I� h, or ropai eny slulure, pior b na uwvioa, deo rpuiroe the epplimil la ach pamn lo fib a eqm o lironaed punueeu to the prwiaian d tla CoMewas lianea lew �Cheqs B(cammantip wA�Saaion Bueirieu eM Rdemiare Cadal a �hm M a ehe u memq tMrMmm ud ihe bou la Ns eAepeA mamqia ]0�1.5 by enY ePW�� ta e pemtil wbjetl� �M applicaM to a ad per�My d M maa Ihen Me hundmE'tloAi �] I.avoxnarMiMpropeMYormyempb�eeewil�wepnmlheiwbcampenee�ian.willEOlMwak,enEtl a aRerad br mle (Sec�on l0al. Buvreu e�d Prdessbns Ccde: TM Comredps Llmnes lew dom mt ep Mw buida ar m0� Ihaean. eM xtn do» euch xwk IimeeM a MnM a Wauph lie a hm own ainp imprwaneem ere nd imeMed a Wlaea Ia ub. tl. howa�wr. iM britli�p a inprwvnan is wld wi1Nn a owmr-0uiltls xill heve iha burden d qovirp M or elw d'd �wl Wik a impove /w tM purpose d eab). l'mme law� fa tln N�G. etla. inWo.e. Niucluro b nalintanAeA � I. es owner W Ihe O�VaM. am acdueivaN mmream0 �h liceneed canVmtas ro coneVud iM qol� (Sectian 10/4. Bueliwse md ridesson. coee: rne convmon licen.. l.w eoe. na wch m en w�e, a wwenv .�ho wm. o. �mwwe. �neieon .m wno wnvecla lu A piqatla wuh e mMmtlw(e) licaneetl WA� lo IM CaMreiYm liume law). � 1 � I em a�emq uMer Sxtion: B. 8 P.C.. br Nb reeaan: `�� Dme: Oxner: � � � ro nereM �v wi � em ewme a ene iobssw�d u�e naw�ew a cd�amie Heeen.ne se�en wa. seaion. uws. assro..,e 15SL. ard Net I a enY Mwa buiMi�q oovNw xill / wil nal (acb ans) nead ro mmDN xvh mN nms mdn md th repwremaW br ev�nfaconavuaionamoeifi�ionlrumihslir�y wpmwx0ivria.RedeauWamqrWionePO�iaroenexemqhamiM�e povisians. Dtle: - ApolraN: wonKens couvas�nad oEcurunox: i n«.eY ��a. p«�my a wmw a. w m. ioeo.oy ad.�eo�s: � I heve eM W meiman e cenXka�e d mwnt to mMimura br Mwkm' wmpanWion. o prwfdsd I« by Samon 3]00 d IM lebar Code. la tM peApmvca d Ihe wwk la wlich this pamtit u beued. ❑ inevem,ewmevue:,wonm.•am,o.�:��.��.o�ww.aWs.e'v�arooameieno.coe..aweo�au. R.�od� �s.,ne� w. v.mm e�.w.e. Mv .or�.• �o.o.m� ��.m vos�.v �e.r a..: c�, snccrn0 T1`�G EXPIRESu Pdv.YNumbar. ��rcc�iJ�n07l1l1 01�01�9V �m;., .� ,�e,�a na �o,�wr.e i w wmt a ro. o�e w,�m.e mre... R�ooi o. Mo.l ` I catN Nm in Iha G�amarce d �M wak Ax which �hu O�b u ueued. I NeE mi amGM �Y w� In enY mww a a �o bacome e�Ajae to tM w1kae' mnpmwion lax+ M Cefdm�e. uW piw Ntl i I dpuk Wcmp nbjW to IM wabn' � De�aaian pmo'wro d Seaion 9100 MlheleborCaGe.l�p� Mh �' mmpl� p�vriaiorm. �ome: m � • %S�' 97 �oa�e: /C��'�/S � W�ml : F�Bun ro xwn noilrwi torryw�tlon rovx�p� li wYrM, �rtl NWI rC�cl �n ley�r ro aMlMpaWtlpW eM nu �p ro aw h�norW Mo�untl �dMn lff00,G00A M atlCltbn ro M� ewt ol ronrpwu�tbn ��+po�� Ni In tlon 3)06 0/ tlrs LffiorCodr, InMv( mC �ttomry'� Iw. CONSTRUCf10N LENdNO R6ENCY: I hreby elFrtn uMs pmMy d perjury ilut tMra u e amu�utlion bnd'uq q�erv.y br IM �n�� a m. wx ro..n� ma v�+� 4:�.d (s.a� aos�. c�. q. LENOEfl'S NMIE: LENDEF'S 110DHE55: I cenily ihe� 1 heve reed Nu eppcdm W ame ihet iM �bm� iNwmdbn b cantl. I ro� �o oomply vrilh e0 elyvd cauMy adinr�s vd ewe lexe releliq b buJEiq conmuebn utl hareby eulhor¢s �apeeentetnve d ihu ary b ama upon tM ebove�memivrE piapery 1«inapedion Wrpoees. ROBERT HAYffS. � ��P'tN /�-� Q /� /Jf� _��=-�1 Dme:((l'��rl'�7 / (5151�6.wP) Pink-Rownue: Oddenro�Mwnor JOB DESCRIPTION : INTERIOR 6400SF OFFZCE ARAE CLAIM VALUE: CALC—VALUE: PERM NO: P G8916: GOVT: N SUPP: N PURPOSE: ALT SQ FT: GROUP OCC: H / COMMENTS: REF:B-84232 ****+r****�r*�r*+r*+r**�*� �r**��**��*�r******�r*�r*****�*�*�r*� �*****�**�***+��r�r*�**� �***x Z O N I N G R E Q U I R E M E N T S S E T B A C H S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN AGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 42719331 ZNE: REF NO: PLANNING NOTES> ' > �E �E iE iE iE iFl6 fl� ff iF if if it iE iF iklE 16 it if iE if iE iE i! iF it �F �! fE �! if� iE �E �f jF jE if �1E iE if if if if dE iE 1E fE iE 3E if iE iE iE it * iE iE if �E if iE iE �1E �E iE �)F if iE ib iE it �E �E iE �E * iE jE D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED bY DATE: BUILDING APPROVED HY : t:' DATE; APPLICATION ISSUED BY: DATE; � **�**�t�x**�t�t***�t***�r*�t �r�t***�r*x�** +F*� LEGALIZATION:N F E E�•�5 U M M A�R Y STRUCTURAL SEGMENT:N HLDG PMT PLUMBING ELECT'RZC MECHANZC FIRE SMIP/RES GRADING PERMIT 52.50 J�' ' 258 " SMIP/NON-RES PLAN �, ISSUE FEE 22.00 %f BUILDING-DIV-> PERMZT ISSUE PI;AN'CHECK TOTALS----> 52.50 22.00 �:� 0.00 REVENUE DIVZSION TOTALS--> COLLECTED: BLDG PMT PLUMBING ELECTRIC MECHANIC 79.50 TOTAL PAID DUE 79.50 79.50 .00 79.50 OVER/SHORT: .00 FIRE SMIP/TOT GRADING PLAN-CHECK iE3E*�EiE*�lEifiFiFifitjFikifikiliFifiFikiEiFieiiiElfiE*1EiE�EiE* jE.*jF�E3EiEiEifiFiF*�EiffEif�Flf�f�EMiffEiE1E�1EiF1E�EiEiE�flfifiEifjfjfjfififdFifafjF I N D I V I D U A L; �F E E B R E A K D O W N TYPE QTY D E S C R I P T I O;, N,- UNIT COST TOTAL COST ?. -t PLU 1 SINK, RITCHEN :� J 8,75 8.75 PLU 2 WASH BASIN � 8.75 17.50 PLU 2 WATER CLOSET ( TUIL�T )-�" 8. 75 17 , 50 FLU 1 URINALS, WALL ��"�.��{� 8.75 8.75 �'END10F FEES .� . , � � 88-1A-1997/11:22 Afl/E74.58 �� t RCPTN:61-6AIBd77 � � PEkt'IIT e @84263 � � � ` ��- �j� CONSTNUCTION ANOPLANNING �_ APPROVALS Permit # , �, i. 't'emporary Electrical Service or Pole � 2. Soil Pipe�Undrgrnd. � _, 3. Electrical Conduit Utility�Undrgrnd. . 4. Electrical ConduiDUndrgmd. 5. Steel Reinforcement 6. Etectrical UFER Grnd. 7. Footings, 8. Foundation . • 9. Water Pipe-Undrgrnd. � i 10. Structurai Floor. System 11. Property Sewer Line & 4ouse Connection 12. Sewer Cap � 13. Roof Drains '� � � 14. Rough Plumbing � . = �'�. �3 15. Rough Electrical�Conduit • . 76. RoughElearicWiring 17. Rough Wiring Sign ' 18. Rough Electrical�T Bar Ceiling � 79. Rough Heating & Air Cand'+tioning - 20. Rough Factory Fireptace 21. Ducts, in Structure 22. Ducts, Venti�ating 23. Gas Pipe-Rough & Test ' 24. Roof Framing � 25. Roof Sheathing . ' . 26. T-Bar Ceiling (Structural) & Monocoat 27. F.rame and Flashing 28. Lathing & Siding ' �- 29. Insulation, 30. Drywall Nailing 31. Plaster Brown Coat . 32. Electrical Power Meter•Final 33. Pinal.Electrlc - 34. Pinal Heating & Air Conditioning � . 35. Final Gas Pipe-Test ' 36. Hood or Canopy � 37. Final Factory F�repiace 38. Final Plumbing � � 39. Water Service-Final .40. Gas Service�Final _ , , • 47. Solar pomestic�Final � 42. Backflow Preventer � ��43. Backfiow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation � 46. Handicap Regulations 47`. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Cn §1,. CERTIFICATEOFOCCUPANCY No. Date Date a ; POO L & ; Inspector qppROVALS Permit# Date � 52. Pool � Equipmenc Locatlon. 53. Steel Reinforcement ' 54. Forms 55. Electrical Bonding 56. Rough Plumbing & Pressure Test - 57. APPROVAI TO COVER�GUNITE 58. Electrical Conduit-Undrgrnd. . 59. Gas Pipe, � Undrgrnd., Test • 60. Backwash Lines, P�Trap, O Undrgrod. � 67. APPROVAL TO DECK 62. Backwash & Receptor•Final � 63. Heater & Vent-Final , 64. Plumbing Sysrem - Pinal ' 65. Electrical-Final � 66. Solar SYstem-Final " � 67. Fenci�9 & Access Approval , 68. APPROVED FOR PLASTERING 69. POOUSPA SYSTEMS FINAL � FIRE DEPT. REQUIREMENT APPROVAIS Permit # ' 70. Underground Hydro 71. Product Pipin9 O Gas ❑ Oil 72. Underground Flush � 73.' Undergrnd.Stora,geTank �Gas ❑Oil � 74. Overhead Hydro � 75. Dry Chemical � 76. Dry Standpipe ' 77. FIXED SYSTEM FINAL . � 78. FIRE PREV. FINAL . , HEALTH DEPT. REQUIREMEN7 •79. FINALINSPECTION • B0. FOOD CERTIFICATE ISSUEO � Notes: �-(/1�j'--�'i'% �'n,�.a-..� �✓/fli�� 0 9 0 V Inspeitor . � .-i �+ . :J .. •.. P` +l„l �.�.. . ._. _-. 62� � • '' COSTA MESA BUILDING-SAFETY DEPARTMENT ' P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Appficant to Fill in ompletely — Use Ink Only BVILDING �Y� ADDRESS OWNER � MAIL ADDRESS y�� TEI. CITV l`�� ry�j�� NO. BRANCH ADDRESS ARCHITECT OR ENGINEEF ADDRESS : R Paio ^cr—z-�s�.,5,:00 t3o�+ *��1E13.i5 APPLICATION FOR STRUCTURAL PERMIT RECEI,V�DaV DATERECEIVED npTFICSIIF!' A.P. N . ' BUILDING � ADDRESS � TRACT RMIT NO. BLOCK OwNER 4L�Ji ✓ � VALUE S L $ 0 Q� � FIFE ��/ ZONE TVPE- V GROUP APPROVE � 8V O.�+TE � — � � ADDRESS ZO� NO.OF USE OF NE '� TEL. p�qµ� BUILDIN CITV NO. � y� .F.. STATE CITY YARDSAPPROVED VARDSAPPROVED �� i LIC. NO. LIC. NO. MAIN BUILDING ACCESSORV BUI DING �: {y SI2E NO.OFBLDGS. IFROMCILSTREET) / 1/� 0. OF LOT NOW ON LOT qpN7' F., r/ a USE OF ' ^ E%ISTING BLDG. p y FSeparate permi[s are required for � � si E F. F Q � electric, plumbing and heating work. REAR W USE O BUILPING AND WORK TO BE PERFORMED E" DISTANCE BET. BET. MAIN & �Q MAIN BLDGS. ACCESS. BLDGS. VAR.,N� DATE � � � C.V.P.9W APPROVED ` G � APPROVE .� � } .d LY. W p 1 hereby ecknPwletlpe iheS I have reetl this epplicaiion and stnia � n y' that the above Informetion Is corract antl apree to comply wich a ell laws re0ula2ing builtlln8 conrtr�cilon, and I ahall not employ m z eny person In ��olatlon of the workman's compansetion lews of m x the Stete of Celifornia. 3 I hereCy eertify that 1 em p�operly Ilcansatl af a eont�ecio� untler SQ. FT. N ihe Stata of Ca�ifornle Busine a Professions Cotle, DI ion 3, THE AMOUNT SHOWN UNDEF VALUATION IS FOR m Chapter 9, entl thai such era In full force end e ect, or I THE PURPOSE OF ESfABLISNIN6 �+PERMIT FEE ON�V: � am exampt from Me p of chaScece of Califor Businecs VAIUATION d end Professlons Cotl i n 3, aptar 9. PERMIT FEE E �� N Slgneture of , , �O PLAN CHECK y � s a Permittee S�000 ' TAX S .� O V Authorizetl gent TOTALPAID / / _ -, L1./ . . � �•: • �� a�oo + COSTA MESA BUILDING•SAFETY DEPARTMENT . P.O. BOX 7200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely .. nr _ FA70 i ;4i: � (�� 2-74c�;�•�� 199�� 7.33 �N FOR BUILDING PERMIT DATE RECEIVED nnTo iccui BUI4DING AO�RESS � � � \ (J� i �/q IO'�//• PEH�v11T OWNEP � A.P. N0. 7pc� � O t � MAIL BVILDING /J � ADDAESS 319a A IQQ Di1VA />ODRESS 3� �C �/ Wf7 i/!%G W W ' TEL. S/PU�A%F SNB LO /J3 0. U CITY �S� �� No. 929-9205 TRACT LOT/j BLOGK H Z 2 Q CON3TRVCTION Ii'V1Ile CQII�C3Iiy W A P Om LENDER \/ ��' �J� BRANCH OWNER KoLL I�PdiNE m J ADDRE55 Newport Beach, Ca11fOiT1Sc� VALUE J a OR ENGINE R ��n �'r�i NE`639-5541 �� $� / V N FIRE W� ADDRESS 44 Pl.aza e Oran e ZONE T PE GROUP �� d W 7 JQ CONTRACTOR [xJjj �(Qll InL. BYPROVED ` OATE �%�� m J� ADD:7ESS Z9O1 IXJVE StS'Eit w W TEL. ZONE NO.OF USE OF NEW pI.Q Z� c�rv N� �ch No.833-3030 �i� P�'N5 2 BUILDING �� W � STAYE CITV VARDS APPFOVED VARDS APPqOVED y� ��c. No. 221764 LIC. NO. MAIN BUILDING ACCESSORV BUIIDING �� SIZE NO.OFBLDCS. (FROMC/LnSTREET) OF LOT NOW ON LOT O ROM o� FT. FT. USE OF EXI5T�NG BLDG. I�Q FT. � FT. � S12E OF NO. OF �o� FT. 3� t!J FT. Z NEWBLDG. G 4OO ROOMS STORIES L.SIDE V COVERINGALWIIC ROV�ERING �1�-t, REAR FT. �OT .y FT. � J USEDF$V14DI�,ANDWORKTOBEPERFOFMED DI5TANCEBET. BET.MAIN& a �s�ciiisrr MAIN BLDGS. ACCESS. BLDGS. O CURP,qy.c��Z—I�I APPROVEDI�'I '�%Z ~ APPROVEDl./J � • � 9O'7 N !i!/J U 0 (Bui-ldin #349 HOLD FOR SPECIAL RE 5 VI heroby ecknowl¢tlge ina[ I hava reatl this application antl sta[e s � that fie ebove intormation is cOrract antl eBree to comply wlth � � ell laws repulating building conshuction, ontl I shall not employ !2 :J- F any person in violation of the workman's compensation laws of �+ y the S�ata of California. � M zI hermby ceriify Mat I em properly licensad as a caniractor untlar SQ. FT. �� O � Me $tato ot Calitornia Business antl PrOfessions Code, Divisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR � Chaptar 9, antl that suc� �icensas ere in fuli force antl effxt, or I THE PURPO6E OF ESTABLSMING A PERMR FEE ONLV: m � am eMampt from the p isions Oi Ne $teta ot CelifOrnia Businen ¢ an�P.otessionaCotle, vision3 ptar . VALVATION � � y� � PERMIT FEE $ � � i sie�a.� o, �� m �`X` Parmitte $ PLAN CHECK $ E ` AuthOrizetl ABant � / 7 LL \V TOTAI, FEE $ ( r : . " � . � ' � . � � . .. .._,�' . .. .. �, . • , �. ._ . ;_,,. :s . ' �� . . j .'.' • ' i'City of Costa Mesa �. � . . . ." . , � ' . �" �r x. .. :' . . . . ' . � � � . . . - � , „� . , am�d�ne satety oepartme�t � C E R T I F I C A T E O F,' O C C U P A N C Y iJ�1Q 3 0� 5 - � . ' P.O. Box 1200 . . . � . 1 ' - � , , -�. Costa Mesa, California . . � . . � ��• • , , - ', • - .� ' � - .� . . . . . . . . . ..: The Building located at 3188 `�D" A�.lw�y AVehU� � � � � . �has been inspected and found to comply with �the provisions of all City of Costa Mesa Ordinances applicable thereto � . . . , . -� . . . . . . . . . .. , - for a Group R-2 Occupancy. . ' ' �- ,� � � . � . .. � � Use of Building � CbRit�YCldl �— Sri�T10Y A1tiGTdt10I15_� � � - � - Legal Description A_P.P�9.7=193-30 ; � � - .i ;: . . � (See reveise side for Metes and Bounds) � ' , -- --Building�PermiUNo �-��' Electrical.PermitNo:-�-?��- =- - Plumbing Permit�No-�2��-$Y�� -- � . . � . . ; � . .• t � ' � ` � . . . ' . ' . ' - � Number of apartments� � —f1=.� and/or guest rooms —0— - � � . ISSUEDTO: - BuildingOfficial� / . � ��,��i L_r ��:'i.�.y.�_'.. • , bY- i5r.C3. J. V�.'i'I�R victc�r c:. cves,rncn—uuec�or uuiic7a.ny a,iv,_.:.-, :' . - Date Allgu.�t 19 � 1481 �• � This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT.BE removed except by the � Building Official of the City of Costa�Mesa under Sec. 306 (el U.B.C. - ' . � � Form BU 34 Rev. 11'p0 � ' ' ' ' ' � • ' � � . . _ . , . . . . , _ _ - . , . � � ' � .. '� , . ' _ " • : . . . . , . . . . F C 6Wi a h y _ F O F Q 7 r .� � � a � C o. z 'yn 3 � --- " • COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 RECEIVE B RMIT � / For Applicant to Fill in Completely — Use Ink Only � BUILDING .2T �'D Q�' r A.P.NO. .�Jr'/' '�I�9. � 13 .52 TL ADDRESS �J G . OWNER OR y-� -�J" n ADDRE55 �/ � TENANT VI� D V�(/�F� VNIT OR MAILING �� ^ �, I � SPACE NO. ADDRE55 �� b TR.NO. L BLK. TEL. GTV NO. NEW ADD LTE REPAIR MOVING DEMOLISH CONSiRUCT10N LENDER BRANCH OWNER �, ADDRESS LUE ARCHITECT TEL. USE y� � y OR ENGINEER N � CONTRACTOR ADDRESS CITY STATE LIC. NO. SIZE OF LOT USE OF TEL. NO. CITV LIC. NO. NO. OF BLOGS. NOW ON LOT Separate permits are required for electric, plumbing and heating work: UILDING AND WORK TO BE PERFORMED I �e�eEy acknOwlatlBe ihet I hava reatl this application end sta�e <hat t�e above Information is corraci and agrea to comply with ell laws reBulatinp b�iltlin9 �onstructlon, antl I shall not employ any penon in violation of Me workman's comp¢nsation laws ot the Sroca af CaliforNa. I hereby cartity ffiet I am properly Ilcensed es a conbactor undar the State ot Californte Business antl Professions Cotle, Divfsion 3, Chaptar 9, and that such Iicanses are in tull force and aftect, or I am axampt from t�e prpvialons of the Stata ot �Iifornia�8 sinass end Professions C de" Ivlsion 3, Cha e� 9. � SiB�eture of / Parmlttee �, S�, �l Authorizetl Agant Date APPROVED PLANNING AGTION THE AMOUNT 51 THE PURPOSE OF VALUATION E � �i i DATE DATE APPROVED a m' � N 7 JN UNDER VALUATION IS FOR m 'ABLISHING A PERMIT FEE ONLY: e PERMIT FEE 5 'O� y N m PLAN CHECK E ,3 m 0 TAX E � LL f � TOTAL7AtD� - �a F � a Q H y 'y. F G W F Q Li ..1 a > r � a w 4 O LY. G. {Z� S 3 �COSTA MESA BUILDING-SAFETY DEPARTMENT P,O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fi11 in Completely — Use Ink Only OWNER MAIL ADORE: C1TY � R CITY STATE LIC. NP. SIZE OF LOT TEL. CITV 11C. NO. NO.OF BLDGS NOW ON LOT Separate permits are required for electric, plumbing and heating work. USE I horebY eeknowlatlpa chet I heva raatl thie eppllcetion antl smm t�at ihe above Into�motion Is corract end aprea to camply wiih ell low! �eBuletlnB bulldinp eonRructlon, and I shell noi employ any pafson �� loletlon of the workman's companwtion lew� of tha Stata of CelNornle. I har¢GV eertify Mat I am proparly IfcenseA aa e contreetor untler Me Stata of Calltornia Busineu entl Profeulons Cotle, Dlvislon 3, Chapter 9, entl t�at 6uch Ileanaea ere In full force anG affect, or I am axampt irom Ma pravisioro of th Smte of Callfornle Businau entl Prtltau5om Cotle, Divl:fon 3, Ch � r 9 Sipnetu� of Permine ��+- Aut�or�iatl Apeni �f.0 76-75PAI�OO 656�+ �¢�tr59.90 � crosn APPLICATION FOR STRUCI'URAL PERMIT A,P. NO. l��—J-/3� BUILDING p * ADDFESS ��SO 'y APPROVE �-- VALUE r p DATE ZONE NO.OF n USE OF NEW MP Pu+� f� BUILDING YARDSAPPROVED VARDSAF MAIN HUILDING ACCESSOR' DISTANCE BEf MAIN BLDGS. VAR. 9Y+ C.U.P.Mb APPROVED /� rc BET. MAIN & ACCESS. BLD OATE /� -i6—�B N n m 'e S�. FT. a THE AMOUNTSHOWN UNDER VALUATION IS FOH m THE PURP06E OF ESTABLISHING A PERMIT FEE ONLV: � VALUATION PERMIT FEE S � J� Q � PLJ N n �' PLAN CHECK $ � ^� 0 s� �� _ rax g O u f u TOTALPAID S � � . • '-,� . �, . . . . � ., .. . COSTA MESA BUILDING-SAFETY DEPARTMENT ' P.O. BOX 1200 COSTA MESA, CALIFORNIA 926% For Applicant to Fi!l in Completely BUILDING � � �v ADDRESS � OWNER }[(�TT./TocTrt.TC l�Gntman AODRESS 3190 A A c�Tv Costa Mesa corsr eucnoN Irvine Drive No`'929-9205 BRANCH ADDRESS •^'^Y"� �Ch/ �311f�rn].d ARCHITECT r_____ �________ TEL.�,� ADDRESS CONTRACT ADDRESS cirv 1 STATE LIC. NO. SIZE OF LOT USE OF EXISTING BL SIZE OF NEW BLDG. EICTERIOR W COVERING USE OF BUI TEt. Beach No. 833-30: CITV LIC. NO. NO. OF BLDGS. NOW ON LOT O NO.OF FOOMS 3 STORIES ROOF �.�[�T _ COVERING li'�t.--t� D WORK TO BE PERFOFMED �.u� -2-�4�W�°00 zoo:} :+*:;:161.S9 1 FOR BUILDING PERMIT ig,Ti jECEf� DATE ISSU D ia� .i" 1 � � �YI A.P. NO. YoG BUILDING . ADORESS �'S owNea/�.04C lh $ ��//�'/I FIRE ZONE TV APPROVED BV ZONE NO.OF PLAN$ VARDS APPROV ED MAIN BUILDING (FROM UL� �SpTREET) d FROM ,S �l FT. O R. SIDE _� FT. � ,L I/ L. SIDE y FT. 3 REAR �/ FT. �I DISTANCE BET. VALUE USE OF NEw ,ziyp�u�J7�'/ BUILOING �l/�� VARDSAPPHOVED ACCESSORV BUILDING FT BET. MAIN & CURP.��E'72�/�� PPROVED I.2�IlY' APVROVED ' 7�0=� � tlOLD FOR SPECIA REQUIREMENi'S I heroby ack�owietlpo thet 1 have reaG ihis application antl rtate that the abova information is corract antl epree to comply with all laws ragu�etinB buildlnB �onsvuciion, antl 1 shall not employ any Derson in violation of tha workmen's companaation iawz af t�o Stata of Califomie. I he�aby cert�fy Ihat I am p�opa�ly lice�sed as a cont�ector untle� SQ. FT. che State ot Californie Businezz entl Profassions Cotle, Oivisicn 7, THE AMOUNT SH( Chapter 9, and t�at such li nses are In full forca antl effect, or I THE PUfiPOSE OF E am ezempt from the prov' ons of tha Siete of Colifornia Business VALUATION antl Protassiqns Cotla, D' slon 3, Chap SIO�etu e o ��M� � Parmltt e $ �,(,� Authorized gent A � �� I (w I m7 v` O r` \\ IS FOR � V� ONLV: m \ ¢ / � N J 3 �s m � �t o \ J LL /nppilcant to till in all Spaees wit�in neavy borEer lines anC 61gn all appropriata Eeclar CITY OF'COSTA MESA PERMIT NO. TRACT NO. LOT NO. �BLDG.�NO: CONSTRUCTION PERMIT E/« ' � I I Addrea - (� Aj--�= \(i � -� Arch/Eng. License No. - Address " ContractorjQv{�yj /Nr% �� :Phone 'j��(�i Address �a� ti�J.vG N�- �+/� � LICENSED CONTRACTOR �ECLARATION I h¢raby df(IrT thdt I aT licensea Untl¢r plovislons of Charler 9(com- mentln9 with seCtiOn ]000) ot Dlvlsion 3 of the Buslness antl Professlons Cotle�antl my� Ilcense is In (ull forse ap❑ Llcente CI s ^�� Ic s N � Date Sl9nature WOR ERS' OM9ENSATION �ECLARATION - I hereby affirm that 1 have a certificate ot <onsent to self-i ure or a certlfifate of Workeri' Compensatlon Insurance, or a iUti copy Ihereof (Sectlon 3800, Lab. C.). � � � 'Pollty No.� - Company �Certi(letl copy is hereby turnlshetl. � Certl(letl copy is fileA with the city Build�ng Oivislon. EXEMPTION F0.0M WORKERS' COMPENSATION DECLi} ATION (� - sectlon n!¢tl nOf be Completetl It th8 pe�Tit.IS (o� qf(e huntlretl ) or leu). � Ify that in Ihe pe�(o�mance of th¢ wOrk for whic� this pe�mit is ISSuetl. I shall not tmDloV anV D¢r50n In a�Y mdn!/C! SQaS t0 b¢come Date ��' o` `�� Si9nature NOTICE: If after making this tlaclaratlon, You sh ultl become subject to the Workers' Compensation pmvi5ions o� the Labor Cotle, you must forthwit� mmply with zuth provisions or this permit shall be tleemetl �BVOketl. � CONSTRUCTION LENDING AGENCV I he�eby atfi�m tha[ [h¢re IS a con5t�uction lentling age�cy fo� the pe�- formance ot the work for whith this perrt�it is issuetl (Section 3097 Civ. CJ. . . . txntl¢r'S Name Lentler's Adtlress' � � �+.ny ory or coumy wmtn repwres _a permrt m cons[rucq a¢eq Improve, tlemoltsh or repair any ztrutture, prior to its issuance, also re- quirGs the appliWnt to� Such�pe�mit [o fil¢ a Si9netl Statement [hat he Is licensetl pursuant to-[he provisions of tbe Contra<tor'S License Law fChapter 9(commencing with Section 7000) ot Division 3 of the 9u51ne55 antl PrOfe55ions'Cotl2) Or thd[ Ile 14 exempt thefefrom antl th¢ basis for tne alle9etl exemption. Any violation of Sectlon 7031.5 by dny applicdnt fo� a p¢�mit subjeGis the dPPIIt'ant [o'a'Uvil penalty of nof more than tive �untlretl tlollars ($500). � I, a5 owner ol the O�ope�ly, O� my ¢mPloyee5 with wages as tnei� �:'ractor•5 LJcenSe Law tloes not apply to an owner ol a property „'�builtls or improves t�ereon, antl who tloes such work himsel( or tinbugb N5 own employeGS,.provitled.that Suc� improvements a�¢ n0[ IntCntletl or offer¢tl to� sale. If, howeveq tpe bailtling or impmvemen[ is sold witnin onc year ot completlon, the owner will have the burtlen of p�oving he tlltl not builtl or improve (or the purpose Of Shc¢). ❑ I. as owne� of th¢ oraoertv. am exclusivelY contractinq with antl Professions Cotle: Tne Contractor's License Law tloes not apply to an Own¢r o( p�ope�ty who builtl5 or imp�0�es thereOn, antl who con- t�acts trom Suth p�ojeG[5 with a Contracto�(5) Ilcesnetl pursuant fo the Contrattor's License Law). ❑ I am exempt untler Section B. 8 P. C. for this reason Date Owner I �er¢�y c¢rtify that I have reatl thls applicdtlon antl State that the above Info�mation is tOrrect. 1 agree to comply with all City antl county ortlinances antl state laws relatin9 to construt�ion, antl hereby authorize r¢P�esentatives of [h6 cijy to eqt¢r upon th¢ above menti0 tl p�operty f� inspet�tion� aG�dCSes.n _ _�� TYPE OFACON6TRUCTION ❑ NEW t O ADD ❑ ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISFV ❑ OTHER DESCRIPTION�OF WORK �C 1 TVPE OF PEHN ❑ GRADING ❑ TENANT ❑ ❑ OTHER _ PROJEC7 DESC Sq. FT._ OCCVPHNGY_ V ALUATION _ GRADING CU.' REMARKS: � TOILETS LAVATORIES KIT.SINKS SERVICE $INKS FLOOR SINKS DRINKING FOUI INTE0.CEPTORS ❑ FOUNDATION ❑ STRVCTURAL :LECTRICAL ❑PLUMBING ❑MECHAI ',UCTtOPITYVE. 20NE _ ACRES _ PLANCHECK SHOWERS URINALS DOUBLE �AvS DISHWASHER$ SUMPS FLOOR DRAINS CLARIFIERS � PTRAP WATERSERVICE ALTERATION GASSERVICE OUTLETS . WATER HEATERS BTU 04TPUT SEWERCONNECTIONS " SOLAR TANK COLLECTORS SOLAR PIPING SVS. ISSUE FEE MECHANICAL PLANCHECK HEATING SVSTEM 0-100,000 BTV _ AND DUCTING ' 100,000 + BTU _ REFRIGERATION O�100,0008TU_ SYSTEM 300,000 + BTU _ BOILERS BTU SVSTEM REPAIR,ALTERATION EXHAVSTSVSTEM MULTIPLE Signature �14 `� r"�✓�� Date �' Orivers' License or 55 � --� � ISSUE FEE CMF 0865-46 White-Builtling; Canary-ApP��canh Pink-Accountin9: Goltlenrod-AssesSor l A.P. � ZONE PKG.SPACE RE�. STREET WIDTH ZONING APPROVE[ SPECIAL CONDITIO ELECTRICAL 8325 7/pB/F�� PLNG.REF. PROVIOED PARK FEE S PLAN CHECK GENERATOR 0-1 KW �-10 KW _ TRANSFORMER ' AGPLIANCE ]0-50KW=-iO�+KWs MOTORS 0-1 HP= 30 H7 _ (INC. SOLAR) 30-50 HP-=-50 * HP � FI%TVRES OUTLE SWITCHES GAS TUBE SIGNS - POLE LIGHTS -' �— ' �PANELS ��MAIN ' SUB � SERVICE - AMP ...� ISSV E FEE APPLICATION 17.32 TL SUMMARV OF FEES BVILDING PERMIT S SMIP E PLAN CHECK S PERMIT .00 PLUMBING g �SSUANCE $ GRADING S �PLAN CHECK b ELECTRICAL S� s PLAN CHECK $ MICROF111N S MECHANICAL E TOTAL FEE $ PLFN CHECK '$ LE55 AD- VANCE PC S _ FINALFEE E.L7:3z r CONSTRUCTION AND PLANNING .1 POOL & SPA �" -_ APPROVqLS Permit # Date Inspector qppROVALS } Permit.# \' \ Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Soil ipe-Undrgrn 44. Steel Reinforcement - 3. Electrical Conduit Utility-Undrgr� � R5. Forms � 4. Electrical Conduit-Undrgrn 46. Electrical Qonding . tee ein orce 47. Rough Plumbin & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE � � 7. Footings 49. Electrical Conduit-Undr rn 8. . Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn � 51. Backwash Lines P-Tra ❑ ndr rn 10. Structural Floor System • 52. � APPROVALTO DECK 11. Property Sewer Line & House Conneccion 53. Backwash & Rece tor-Final 12. Street Sewer Connection 54. Heater & Vent-Final 13. Rough Plumbing ' 14. RoUgh Electric-Conduit _�56. Electrical-Final 15. Rough Electric-Wiring G �57. Solar�System=Final � � 16. Rough Heating & Air Conditioning - I • encing & Access Approval „ � 9. APPROVED FOR PLASTERING ' � 1.7. Ducts, in Structure � � 18. Ducts, Ventilating . . � 19. Gas Pipe-Rough & Test - . 6D. POOL/SPA SYSTEMS FINAL 20. Roof Framing 21. Roof Sheathin 22. Frame and Flashing NOTES: � 23. Insulation - - �) -D1 � 24. Lathing & Siding � i - - 25. DrywallNailing �/L- � 26. Plaster Brown Coat o�,r..r o/ roa � 1' ,� 27. Electrical Power Meter-Final � L 28. Final Electric - i 29. Final Heating & Air Conditioning 30. Final Gas Pipe-Test 31. Final Plumbing � 32�. Water Service-Final ' 33. Gas Service-Final 34. Solar pomestic-Final ' 35. Landsca e S rinklin S stem 36. Sound Attenuation ' � 37. Handicap Regulations 38. FINALSTRUCTURE&BUILDING 39. Special Requirements Com{ileted 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42: CERTIFICATE OF OCCUPANCY. No Date `� �C��7V OF �„ CO.NSTF ' I Address ADG��ant to flil In all 5 ISTA MESA - aea IT NO. CTION PERMIT � License Na. Address Contrector (�C �h1E V� L� Phone Addren within I'here�y a!(irm thd[ I aT IICBn580 Untllr prOvisions ot Charter 9(com- TBntin9 wlth saetion ]000) Of DlviSiOn 3 of th0 BuSinlzz anA Profestlons Cotla, antl my Ilcense is In lull force antl effect. Llcense Clais Licensa No. Date Signature WORKERS' COMPENSATION DECLARATION I h8reby dfflrm that I hdve d CertHlcata ot COnS¢nt to ulf-7n5ur8 Or a cerH(Icata of Workers' Compensatlon InSurante, or a certifietl copy thereof (Section 3800, Lab. CJ. Pollcy No. CAmpany r^srtlTieU COpy is hlrGDy turnisheU. . lrtltietl COpy Is filG� with the city Builtlin9 DivlsiOn. c..eMPTION FROM WORICERS' COMPENSATION DECLARATION (This settion neatl not Ee completetl if the.permit is for one nuntlretl SS3001 or less). cort(fy that in tha per(ormance of the wOrk for which thi5 permi[ IS IssueO, I shall not emPloy any person in any manner so as to Cecome sub7ect to tha Workers Compansatlon Laws of Glifornla. Date 99nature NOTICE: If aftr� making this tleclaralion, you shoultl become subject to the Workef. CAmpenSatiOn prOvisions Of the Labor COOe, you must forthwith comply with suth provislons or this permit shall be tleemeE �evoketl. . CONSTRUCTION I.ENOING AGENCV I hGrlby efflrm thdt th¢re ii d cOnStruttlon IGntling agency tor the per- formance Of [he wOrk f0/ whiCh [hi5 perTit is ISsu¢0'(SGCtlOn 309] Clv. C.). l.enaer's Name Lentler's Atltlress OWNER BUILDE0. DECLARATION I heroby aHirm tnat I am exempt trom the Contractor's License Law for Any Oty Of counry wpICO tBqulle5 a petTlt to cOnSUuti, dlt¢r, Imp rove, tlemolish or repair any structure, pr(or to Its iisuance, alio re- aulfes tha aoolifdnt tor Such oarmit [o t118 d SlOnetl S[atem@nt thdt h0 :55 dOtl.FfO�¢5510! for ttie 511e9etl e'. ppliwnt for a p� t'more t�an five d5 OWOBf'Of I�18� ompansatlon; will eretl for Saie. (SC actor's LI<enso �L �UIItlS a� Imp�ove 3h hi5 own eTplc letl or offerea fo� I within onu year oving ha tlltl nc It sub�etis [M1e applltdn[ [O B,tivll penalty �tlretl tlollars (5500). . per[y, p� my employee5 wittt wages ai thelr. tha work, dntl th¢ itructurB'is nOt intUntlGtl n 7044, BuSiness antl Protessions Cotle: Tne aoes mt aooW to an owner at a orooertv or 3pp YfOtM510lIS COQE: I IIB COIILfdCiOf'S LICC�58 Ldw QOCs nOI dpPry m an owner ot property wno builtl5 or Improves thereon, antl who con� tfact5 flom Suc11 projeCtS with d<OOtraCtor(5) IlceSnatl pu6uanl to the Contrac[or'S License Law). ❑ I am exempt untlGr 5¢ction 8. & P. C. tor this reason Date - Owner 1 hereby tertitythat I hava reatl tnis applitation anE state tha[ the aDove IntOrmd[iOn Is cOrrG<t. I agree to comply with all cliy antl cOunty ortllnances antl state laws r¢latln9 to conStrU<tion, antl h!r¢by duthOrize �ap�e5entative5 of thi5 clty f0 ent¢r upon tne above mentlon¢tl property tj� Ins t urposes. _ � Signature �`�- D t � � Drivers' License or 55 $_ �� CMF 0865-46 White-Builtling; Canary-Applicant; Pink-Accountin9:6 bOrEer TVPE OF ( ❑ NEW . ❑ REPAIR ❑ OTHER all approprlate Eeelarations. LOT NO. BLOG.NO. ADD ❑ ALTERATION �CONVERSION ❑�EMOLISH TVPE OF PERMIT ❑ C�RADING ❑ FOUNDATION ❑ STRUCTURAL ❑ TENANT ❑ ELEGTRICAL ❑PIUMBING �FiIECHAN ❑ OTHER PROJECT DESCRIPTION 54. FT. OCCUPANCY_CONSTRUCTION TYPE VALUATION ZONE GRADING CU. VDS. ACRES REMARKS: PLUMBING � PLAN CHECK BATHTVBS SHOWERS TOILETS' URINALS � LAVATORIES DOUBLE LAVS K�T. SINKS DISHWASFIERS $ERVICESINK$ $VMPS FLOOR SINKS FLOOR DRAINS D0.INKING FOVNTAIN$ INTERCEPTORS CLARIFIERS WATERSERVICE ALTERATION GASSERVICE OUTLETS WqTER MEATERS -�' BTV OUTPUT�•'' SEWERCONNECTIONS � • . � SOIAR TANI( COLIECTORS SOLAR PIPING SVS. ISSUE FEE MECHANICAL aLAN CHECK HEATING SVSTEM 0-300,000 BTU_ AND OUCTING 100,000 i BTU _ REFRIGERATION 0-100,000 BTU SVSTEM ' 100,000 i BTU_ BOILERS BTV SVSTEM REPAIR,ALTERATION EXHAUSTSYSTEM MVLTIPLE ISSUE FEE 9fi55 7/16/81 ZONE REAR YARD (TO P/l) PKG.SPACE RE�. STREET WIDTH ZONING APPROVED BV SPECIAL CONDITIONS: ELECTRICAL PLNG. REF. qp PROVIDED PARK FEE PLAN CHECK GENERATOR p.l KW_1-]0 KW _ TRANSFORMER APPLIANCE ]0•501(W_50 t KW _ MOTOR$ ' 0-1 HP_1d0 HP _ (INC.SOLAR) 10-SOHP SO+HP_ FI%TURES OUTLETS SWITCHES GNS TUBE SIGNS POLE IIGHTS 7o�C PANELS MAIN SVB SERVICE ' AMP' ISSVE FEE qPPLICATION APPROVED BV DATE SUMMARV OF FEES BUILDING PERMIT S SMIP E PLAN CHECK E PERMIT ISSUANCE S PLUMB�NG 5 GRADING E PIANCNECK 5 � ELECTRICAL S S PLANCHECK S MICROFILM E MECHHNICAL S� TOTAL FEE E PLAN CHECK 5 LE55 AO- VANCEPC S_ / FINAL FEE E . �� CONSTRUCTION AND PLANNING POOL & SPA .��. � APPROVALS Permit # Date Inspector qppROVALS ''Permit # ' Date Inspectof 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location � '� � il ipe- n rgm 44. Steel Reinforcement - �• 3. Electrical Conduit Utility-Undrgrn � 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding . tee ein orce 47. Rough Plumbin & Pressure Test 6. Electrical UFER Grn , 46. APPROVALTO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Tra ❑ ndr rn 10. Structural Floor System 52. APPROVALTO DECK 11. Property Sewer Line & House Connection 53. Backwash & Rece tor-Final 12. Street Sewer Connection 54. Heater & Vent•Final 73. Rough Plumbing 14. Rough ElectricConduit -•56. Electricai-Final 15. Rou h Electric-Wirin 57. Solar System-Final � 16. Rough Heating & Air Conditioning • encing & Access Approval 17. Ducts in Structure APPROVED FOR PLASTERING ' 18. Ducts, Ventilating 19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL 20. Roof Framing 21. Roof Sheathin w . � � ^�13� Z 2z• Frame and Flashin NOTES: J +-� a� n r� `, 23. Insulation - 24. • Lathing & Siding 25. Drywall Nailing 26. Plaster 8rown Coat 27. Electrical Power Meter-Final - - � 28. Final E - - a 29. F' Heating & Air Conditioning / 7✓ //Jl�.^ 30. I Gas Pi - 31. Final Plumbing ' 32. Water Service-Final 33. Gas Service-Final 34. Solar pomestic-Final 35. Landsca e S rinklin S stem 36. Sound Attenuation . 37. Handicap Regulations 38. FINALSTRUCTURE&BUILDING � 39. Special Requirements Completed 40. Electric Release to Edison 47. Gas Release to Southern California Gas Co. 42. .CERTIFICATE OF OCCUPANCY No Date Applicant to fiil in a11 spaces within neavy bortler lines antl sign all appropriate Oeclarations. vQ-� �� G/fl'J /G,7 I/ �.(1 T 'GTYOFCOSTAMESA PERMITNO. TRACTNO. LOTNO. BLO�j- �NO. _ �� - ' ' •�- -- COIVSTRUCTION PERMIT aZ.. {J ' ' . ' Project Address /V// TYPE OF C�OyNSTRUCTION 7067 (/OB/82 � 11.5� T�� Ow�2t � � Q�hone � ❑ NEW L+1I ADD ❑ ALTERATION � ' - Address�- / (/�✓/ j �°y ❑ REPAIR ❑ CONVERSION ❑DEMOLISH _ Arch/Eng. License No. ❑ OTHER • - ZONING REGULATIONS �- �Address' - . _ OESCRIPTIONOFWORK A'P'� � � . � . ZONE PLNG. REF,. � ' - - Contractor �t� ��p�J Phone d TVPEOF�PERMIT � � -'- TpgU i LpiNG� -, SET ACK PROPEPTV LINE � ��Address' ,j,s � �y �f � �J%f ❑GRADING� ❑ FOUNDATION ❑STRUGTVRAL ID VARD - � � - - LICENSE COtJTRACTOR DECLARATION �' � y/ Ep .❑ TENANT.�� O ELEGTRICAI ❑PLVMBING p1.MECHANICH - ��IGHT , I hereby attirm th6t I am licanzetl �untler provi5lons of Charter 9(com- � , 'men<In9 with -section- 7000) of' DiNsion 3 ot .the Buslness anC � � OTHER ' �Professions Cotle, �antl my license is In fu❑ forc ' antl �etfect. � REAR VARD (TO P/L) ' - ' . PROJECT DESCRIPTION ' License�Class � LicenseNo. SQFT 4(0� �� ' " - ' - "PKG'.SPACEREQ. - PROVIDED ' Date� %q7'Ry 519nature ' . ' --' ' ' '- " - i� �STREET WIDTH PARK FEE 5 WORKERS' COMVENSATIONDECLARATI OCCU7ANCV_CONSTRUCTION TVPE ' I hereby affirm that I have a certi(iwte of consent to self-Insure or a VALUATION � ° ZONE � ZONING APPROVED BV' ' - - DATE --� � certifiwte of-Workers'-Compensation Insurance, or- a certifietl copy . _. _ . __. _ _ . _ _ _ . __ � - . � thereot (Seyi r�tiol L�p. c.1. ' I GRADING CU: VDS. ACRES ' SPECIAL CONDITIONS: _ _ ' ' ,JicY'No.Y� '1'� ' ComPanY �GHNIY� ' "' ' ' ' _ ' ' . _ D4Certifletl mpy is•hereby fumishetl.�- �.v MIjJ -�� REMARKS�� ' 'ertifletl wpy is filetl with t�e dty Builtlin9 �ivision. ~S!�''� ' VN�-r- � - - - � -� - - - � :MPTION FROM'WORKERS' COMPENSATION'DECLARATION C� {/ CO � � � [fhis section neetl not �e completetl it the permit is (or one huntlretl � � • •- � (E300) or less). - � - " /� � ' - - -- - � I certify thal in lhe performance of the work for which this permit is , ,. -. , . � Issuetl,- 1 shall not employ any person in any manner so as to become .'PWM8ING ,- - �..•PLAN CHECK ' '; ELECTRICAL -' PLAN CHECK - - � SubjGct t0 th¢ Wo/kers' CompGnsatlon Laws of CalitOrnid. ' ' Date � Signature � 'BATHTUBS �— -" SHOWERS' "' " " - ' ' '- �- '- • NOTICE: If after makin9 this tleclaratlon, you shoultl become subjec[, ,TOILETS . URINALS "- ' - �GENERATOR p-1"KW_110 KW '--" , to the Workers' Compensation provisions of the Labor Cotle, you must � �� TRANSFORMER � .. . � � ,for[hwith mmply with such provisions or this permit shall be tleemetl �VATORIES DOVBLE LAVS - AVPLIANCE 10-50 KW=50�t�KW -' 4 ' h revoketl. � �.. . . . .. ._ _ . �. . �CONSTRUCTION LENOING AGENCV ' -KIT. SINKS - OISHWASHERS- � - MOTORS � - -- �0-1 HP_3-lO HP - - _-- �I hereby aftirm that there is a construction IenUin9 agenry for the per- SERVICE SINKS •• i'SVMPS - UNC. SOLAR� .. .30-50 HP 50 t�HP � ._ _ formance of the work tor whith this permit is issuetl (Section 3097 1 Civ. CJ. - - - - — -- � - - - - -- -- 'FCOOR SINKS - ' FLOOR DRAINS -' - � FIXTURES OVTLETS - - SWITCHES' ' - '� 'LenUer's Name �¢ntler's Atltlress � 'DRINKING FOUNTAINS " " -' ' � ' GAS TUBE-SIGNS - --�-� ^ �� - - - - �OWNERBUILDER'DECLARATION - - - - "INTERCEPTORS - - 'CLARIFIERS' ' ' POLECIGMTS ---' - - -- - � - - I h¢reby aftirm that I am exempt from the Contractor's Lic¢nse Law ior [he tollowin9-reason (Sec[ion �031.5 Business antl Prote59ons Cotle: �SWIMMWG POOL- - „P TRAP •� • - � Any city or� county+which� requires.a. permi[ to•�mnstruct,�altar� - �•POLES�� -- - ' METERED -.SUB - improve� tlemolizh or repair auy�structure,-prior [o its isivante; also re- `"yyqTER SERVICE ALTERATION -' - i PANELS MAIN - SUB� - -� quires the apFlicant for such'permit to,iile a,signetl state�nent Inat ne, •� . - �� iz II<ensetl �pursaanfto the provisioni'ot tH8 Contrac[or'S•License•Law; --GP.S SERV ICE� � � ' OVTL'ETS ' �" . SERV ICE� -- - - - � - - AMP - - (Chapter 9(commencing with Section 7000) of Division 3 of [he - Businessand PrWessions�Cotle)�orthat he isexempt�[heretromantl the yyqTER HEATERS '-' BTV OUTPUT � ' -� � - - -- • - - - - -- basl5 for the allegetl exemption. Any viola[ion of Se<[lon 7031.5 by - ' any appliWn[�for a�'permit-subjetts the applicant to a civil penalty -,SEWERCONNECTIONS � .. �•- • - �-'� -_ — �- -�- �r. - � - -� - --- ?.�oi more tban five hunEred Oollars.(E500)., • �' \ '. • '' ' ` � ' - �!, as owner of the properry', or my employees with wa9es as�tneir SOL'AR TANK COLLECTORS - - --�_ . . -- - !.a compensation, will tlo the work, antl the sfructure is not int¢ntletl Ji'offeretl for zale. (Section 7044, Business antl-Protezsions Cotle:.The SOIAR PIPING SYS. - �,�- - " ' '�SSUE FEE - - - '^- - --- - 'COntractor's'License' Law'tloes not appry to.an owner.of a propmty� - ,AP�LICATION�APPROVED-BV " who bulltls ar Improves thereon, antl who does such work himself or -'ISSUE FEE "` ��' '' '" ' -- -- � DATE 4Mough his own employee5; provitletl that such improyements are n0[ '� ' � intentletl or o(feretl for sale. If, however, the builtlin9 or improvement - MECHANICAL PL'AN CHECK � �� SUMMARV OF, FEES � � is soltl wi[hin one year of'comD�etion, tM1e owner will have the burtlen � ,�� . _ ot provinq he tlitl not`tiuiltl or•improve tor the purpose of sale). ' - � - -� ,BUILDING - - - - - --- � - - ��I,-as� owner of. the property,�am.exclusively-contracting with HEATINGSVSTEM 0-IOO,OOOBTV PERMIT E SMIP E licensetl contraclors to construc[ the ro'ec[ Sectlon 7044, Business AND DUCTING - /� - �- � - - - ' �' - � - — : P 1 ( 300,000 + BTU •T � PLAN CHECK E � PERMIT- � 'antl�Professions Cotle:�The Contractor's Llcense Law tloes.not apply to _ ISSUANCE� S an owner ai properry who builtls or improve5 thereon, antl who ton- REFRIGERATION Od00,000 BTU % lPLUMBING S � . �,�� trac[s from sucb pro�ecis with a contractor(s) licesnetl pursuant [o SVSTEM �-• . I GRADING S the ConVaclor's Licenze law). 100,000 + BTU PLqN CHECK �f - � . �-I am'exempt untler Sectlon' ' B'& P. C. for this ' � - - -- - - - - - - - � - � � - � - s BOILERS BTW 'ELECTRICAL`E�' reason - �-� �' ' 'MICROF�LM S' � PLAN CHECK'- E �Date Owner SVSTEMREPAIR,ALTERATION .�/-p� TOTALFEE'y " t :1 herebycertifythat I have reatl this application ana state that ihe above EXHAUST SVSTEM MULTIPLE MECHANICAL,.E-L_ - , information"is'correcL"I a ree to com I wlth"all"U[ 'antl'couM �PLANCHECK �S �`� LESS.AD- ._ 9 PY Y Y VANCEPC §_ ortlinances antl state laws relaling to constructiOn, antl Ite�eby autho�lae ., r2presentatives-of-tqis'city [o enter'u on' be-above mentlonetl � • • � �'�' '� . ^ property for i <ton purpos s 9 (}� � �(. ` Signature � � Date'.�./Cy�' a v � ^ , _ _ FINAL FEE $ � � • v v Driver's' Li'cense ur ss � � 65UE FEE -- .��' - "6" Oa ' ' ' , - J CMF 0865:46 White-Builtling; Canary-Applicant: Pink-Accounting; Goltlenrotl-Assessor '_' " _ " _ . .. . .... ' .'S �� _r . .. i :ITv OF coS7A Mes9 CONSTRUCTION PERMIi __ Projec[ Address � 3188 Ainaay, 'STe. D. Costa Mesa, C�A Applicant's Mailing Addre� 3005 S. Halladav Santa Ana; Dwner's Name ��YlOY D251CJI1 D2V210Tdho�e 556 -80 4ddress 3188 Airwav, Ste. D Costa Mesa, CA. 4rch/Eng. License No. 4ddress Contracmr,'s Name�I �3� ile � __ Phone 545-5542 4ddress (mailing) ��5 G Hal adav Santa Ana, CA Ciry License Na ._�� ' LICENSED CONTRACTOR DECIARATION I hereby aifirm [hat 1 am licensetl untle� provl51on5 0( C�arter 9(commencing with 5ection ]000) ot DiVision 3 Of the Bu5Ine55 antl Profeszion5 Cotle, antl my license is in (uu force a�p r��¢�,. , Zg0319 License Clps� U Llce�jOT D-j^'�e Date / c'o,.�� . Vi�NI�A Z j�I1 WORKERS' COMPENSATION DECIARATION I hereby a(/irm that 1 have a certificate of consent to selbinsure or a certlticate of Workers' Compensa[io❑ Insurance, or a certlfietl copy thereo/ (Sectlon 3eoo, �b. c.�8614869 Brakke-Schafnitz '�Cy No. Company .�j'tifietl copy is he�eby fumishetl. � .. Gbrtifi¢,tl�c,op�j5,{iletl With [he city 8�yiltli�$ DI�{1jion. � �' Date �/17 ZSif Applicant U• �`'• ra ne EXEM7TION FROM WORKERS' COMPENSATION DECLA I N �This section neetl not be com0letetl if the permit I5 for one h ntlre (5300) or ess). I certlfy tnat in the'performance ot the work for which this oermR is issuetl, I 'hall not employ any person in any manner so as to become subject to the vVorker5' Compen5ation Wws ot CalifOrnia. Dale Signatu�e NOTICE: It, aiter making.(his tleclaratlon, you Shoultl become subject to tlte JJorke�s' COmpensation provi5ions of tne Labor Cotle, yop must for[hwith comply with such provisions o� IhiS permlt snall be tleemetl revoked. CONSTRUCTION LENDING AGENCV 1 hereby aillrm Iha[ the�e is a construCtlon lentling a9ency for ihe performance of the work for which �pi5 permil is issuetl (Seclion 3097 Civ. CJ Lentler's Name L.enEer's Atltlress _ OWNER BUILDEH OECLARATION I hereby affirm that I am ¢xempt from the Contractor'S License Law for the followinq reason (Section �031.5 Business antl Professional Cotle: Any city or wunty whl<h requires a Germit to construc[, alter, improve, tlemolish or repalr any structure, prior to its issuance, also requlres the applicant for such permit to fiie a siqnetl statement that M1e/she is IicenSetl pursuant to tM1e provisions ot th¢ ContraCtOr'S License Lyiy (Chapter 9(commencin9 w�th Section ]000) of DivVSion 3 of the Bu5ine55 antl Professionz Cotle) or Inat he/she is exemp[ ih¢�efrom anU the Dasis tor the allegetl ezemption. Any viola[ion of Sec[ion 7031.5 by any ap0licani for a p¢rmit Subjectz [he applicant to a civil penalty ot not more Man five huntlretl tlollars (5500). I,�as owne� of the P�operty o� my employees with WageS as th2ir sole ,ipensation, will Oo'tha N.o�k, antl the Struclure i5 not intentletl ot oHer¢tl .' sale (Soction ]044, Business antl Professional Gotle: The Contractor's LicenSe l.sw aoes not apply to an owner of a property wFio builtls or improves thereon, antl who tloes zuch work himseli/herseli or tnrou9h his or her own employees, provitletl lhat such improvemen[s are not intentletl or offeretl for sale. If, howeveq the builtlin9 or improvement Is soltl within one Year of com� pletlon, the owner wlll have tne burtlen oi proving he/she tlia not builtl or im- �prove to� lhe pu�pose of sale). ❑ I, as owner of thC pr9perty, am extlusively cont�actin9 with licensetl COh- tractor5 to mnstruc[ [M1e projec[ (Sectlon 7044, Business antl Proiessions Cotle: The Gontraclor's License �aw does not apOty to an owner of property who builtls or Improves fhereon, antl wno contracts for such projects with a mn- tractOr(sl ucense pursuan� to the Contractor's License Law). I am aware"that proof of thGir Worker's Compensalion insurance shoultl be provitletl [o me. ❑ I am exempt untler Settion � B. & P. C. tor this reason oate Owner _ I hereby Certity thal I have reatl [h15 : intormalion IS Correc[. I egree to compl� antl state laws relatin9 t0 builtling consi s s ol this to enter upon spec i u�0 �.+ ' - Si rivers' License or 55 qk C, . i sta[e that the above antl countv orainances �plicant to fill in all spaces except those within heavy bortler lines antl si9n all appraD�iate tleelarations. PEFijNlj N�� r,� TRACT NO. LOT NO. UNIT NO.' ' • M / TVPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR a ❑ CONVERSION ❑ DEMOLISH ❑ OTHER � q,p.# , DESCRIPTION OF WORK/USE OF BLDG. S Main Buildi E TYPEOFPERMIT GRADING FOUNDATION STRUCTURAL � T F�ont ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear ❑ OTHER A` PROJECiDESCRIPTION St�.FT. OCCVPANCY C Right K Le(t CONSTRUCTIONTYPE VALUATION$ $ ONE GRADING CU. VDS. ACRES Ping. Ref. # m rk . , � Planning Notes: ear Sink Backflow Preventer Backflow Irrigation eathtubs Clarifiers Dishwasher - Drinking Fountains Floor Drains Floor Sinks Gas Service OuUees Kimhen Sink � Lavatories � P=Trep Roof Drains Reinspection Fee $15 Boiler Duc[ - Under Ground Duct - Ventilatin9 Exhaust System ❑ Multiple � FirepVFact BIL ICBO # Heacing System & Oucting ❑0.100,000 BTU � 100,000 B7 Reinspection Fee ite - Building: Canary - A�Plicant Pink - Accounting; GolCenrotl - Asseszor $15 Showers Service Sink Sewer Cap Sewer Connection : $olar Collectors . Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet � Water Heater Wacer Service �i Sysn Fire � Auwmatic Washe� ' - ConstructionPoleSub. ' Cooking Unit � = Dishwasher ' Dryers OGas ❑Eleci Fan � F.A.U. Fixtures Device Boxes Outlets Isue Fea � , $ 3 . Zona Accessory Building: Z O , � N I . N G � R Parking Req./Provided E Q M T S ELECTRICAL, FEES - 0 Garbage Disposal ' Generator �0.5 KW �5-15 KW Transformer ❑ 15-50 KW ❑ 50+KW Meter ❑up to 100 amps Meter ❑over 100�amps Sub PaneP Motors �61 HP �i'r5 - 8 Inc.Solar �9-15 HP �16-15+ Microwave Pole Lighc � Range Standing Sections Trash Compactor Roinspection Fee $15 luue Fee FEES Type I ❑ DEVELOPMENT SERVICES RE�UIREMENTS: Type I I ❑ 2oning Approved By __ . . Buildin9 APProved BY ,A. � 3L10f1 $y5iEf11 ,OOOBTU ❑100,000 Repair/Alteration Issue Fee 16 :� $ 3 - - � SUMMARV OF FEES � � � � ' BUILDING PEFMIT $ SMIP _ $ - PLAN CHECK $ PEFMIT y�(�y PLUMBING S ISSUANCE' � $ r—�— PLAN CHECK 25% S ENERGV�P.C. S - ELECTRICAL $ - GRADING $ � PLAN CHECK 50°b S- MICROFILNt $ ' MECHANICAL. $ ��QOTAL FEE , $ � 3L. SO � PLAN CHECK 25% $ ' � � CONSTRUCTION AND.PLANNING POOL&SPA - , •�� Date Inspector Date Inspector APPROVALS Permit # APPROVALS Permit # � �-' i. Temporary;'Electrical,Service or Pole 52. Pool & Equipment Location 4 r o_ . 2. Soil Pipe-Undrgrnd. ��J 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms ' 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding ' C 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6_:`.(,lectrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7',Footings 58. Electrical Conduit-Undrgrnd. S.�Foundation -� i 59. Gas Pipe, O Undrgrnd., Test ' 9:_UJater Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, � Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connectiom • � 62. Backwash & Recep[or-Final , 72. Sewer Cap � 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final - 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring . - 67. Fencing & Access Approval ' 17. Rough Wiring Sign � � 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Firzplace APPROVALS Permit # _ ' 21. Ducts, in Structure � 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping � Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oif � 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. FrameandFlashing 76. DryStandpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL . 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT _ y 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: y•- 34. Final Heating & Air Conditio�ing �0.�� L� , 35. Final Gas Pipe-Test _ 36. Hood or Canopy � 37. Final Factory Fireplace � � ', � 38. Final Plum6ing . : f r 39. Water Service-Final� - � � - - � � 1 ! i ' 40'GasService-Final � _' f•, � �_41.-Solar pomestic-Final I t ' 42. Backflow Preventer � � • I ' "43. Backflow Irrigation � -rsf �44. Landscape Irrigation System : .'. I . ` �- 45. Sound Attenuation , �.' I" , 46. Handicap Regulations • 47. FINALSTRUCTURE&BUILDING � ' I , 48. Special Requirements Completed �J 49. Electric Release to Edison - ' 50. Gas Release to Southern California Gas Co -"' ; 51. CERTIFICATE OF OCCUPANC� No. � Date � ' • COSTA MESA BUILOING—SAFETY DEPAHTMENT ! � P.O. BOX 1200 ; Coata Mesa, California ' CONTRACTOR G Q Z Address Q/r O Y Ciry ,e,s'�, Zip Code 9Z6 Stafe License No, 3 G'O CI°ss• G' � w City License No, Tel. No. F Q NUMBER TYP� OF FIXTURE OR ITEM FEE � Bathtub Laundry 7ub or Tray > Automa�� Wathing Machine } Showet J Sink, Bar � Sink, Kitchen aWashBasin(Lavatory) 0 Water Closet (Toilery „ �1 � Drinking Fountains ,� ` � a I•loorUrains _�( i �rd� Z Intercep[ors � '�y �� w Rece tors • �i. � Sinks Commercial orylndUStrisl Sinks F�oor _.�(� U L � F- Sinks, Shrvice ��( y �" � SwimmingWooY � w � Vrinels S "\� disliwasher � f� Carege UisDasal 7 Water Sqftener n Waler Hpater and Vent Gas System .. . Outlets . .. — � Roof Drains y Water Np��g q7�era�ion = BackFlow Ikeven�er F.. Lawn Sprinklers (Res or Non-Res Ro erty Sewer . . . Feet Solar Pi ing CessOoo�. $eo�ic Tank '1'O'CAI. FEE I � I �..- .. --__ !`` � rnwcr lOT N� neco. DATE IB6U6O BUILDING USE 7 c?D �/ Address � ,.f$ / l�l� ^%J� �� Ownex � / 1". �� ! / ! Mail J / g / n �,/ Address /l 4'- G t hereby acknowledge, Uia[ I1h5ve read Ihis application and state Na[ lhe above is cotiect and agree [o comply with all City Ordinances ariJ�SU�e I,aws regulating plumbing. 1 cerfify�that I,possess the above valid State of Califocnia classi- fica[iony ��1 am the legal owner of [he residential property de• scn6ed�above. 1 c'ertify Ihat I have ob[ained a permit from the State Division of n�$ustrial Safety for excavations, other than swimming pools, five feet deep or deep�e/��/q d into w,/h�ich a person is �� e9u'ved to eseend. Signatureo)�-�/� � / 3' Permittee �� INSPECTION RECORD CMF 0450-46 s�d• 0 � � � CITY OF COSTA MESA � -� BDILDING DIVISION " 77 FAIR DRIVE, COSTA MESA. CA 92626 •(714) 754-5273 • Fax (714) 754•4856 • www.ci.costa-mesa.ca. , FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER 608-00261 PERMIT TYPE B_ROOF2 APN: 42719333 STATUS: ISSUED DATE ISSUED: 0911812008 ISSUED BY: YH JOB ADDRESS: 3188 E AIRWAY AV CM Suite/Unit: E Vicinity: � UNIT E , , _ . , Squares: 0 . � � Valuation: �� 575,000.00 SCOPE OF WORK: REROOF UNIT E ONLY: TEAR OFF BUR, REPLACE DRYROT WOOD AS NEEDED & INSTALL 42 SQR'S OF OF BUR ROOFING SYSTEM. , " � � � OWNER: M P PROPERTIES PHONE: APPLICqNT: MARTINEZ, LEONARD PHONE: 714d93-7859 . CONTRACTOR: Address: Unit: - City/State2ip: .- � � ARCHI7ECT: ENGINEER: FEE SUMMARY Reroof Plan Check: Reroof Permit Fee: Reinspectian Fee: TOTALFEES $0.00 $251.25 $0.00 $257.25 Add�ess: 3788 -A AIRWAY AVE Ciry/State2ip: COSTA MESA, CA Address: 1333 GAZANIA CIR. , � City/State/Zip: RIVERSIDE, CA � License No. • PHONE: CELL: Ucense No. License No. PHONE: " PHONE: � Unit: Unit: : ,,r-: ;��,�t NOTICE: The work authorized by this permit shall comply with all appliwble handicap access requirements under Califomia sWtutes and related regulatlons. (Ord. No. 92-28, § 1, 12-21-92) ' EXPlRq710N: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPEC710N. INSPECTIONS: In order for fhe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requirad inspections and final approval must be obtainetl. Failure to obtain inspections and final approval will result in the ezpiration of this permit. cooe". ixsrEcnoxirre D� �� SQ�Sd INSYEGTONTYPE Q� iNTIi1�L5 1616 Fixed S}5tem Final Fire Prevention 208 Final Mechanical 7268 Pool Spa Final ZOB ' Final Plumbing 200 Final Re-Root ��.Ct � 210 Final Eleclrical 201 Fina181ock/Retaining Wall 212 Final Fire Pievention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final BuilOing/Occupancy WORKERS' COMPENSATIOPLDECLARATION, I hereby aKrm untler penalty ot perjury qne of the followinq declarations: ❑ I have antl vnll maintain a tertifcate of consBN to 5el(-InSure (or workers' compensation, as providad, for by seclion 3700 of the Labor Cotle, for Ihe peAormance of the work foi vfiich this permit is issued. � I have and will maintain workers' compensatbn insurance, as required by section 3700 0l [tie Labor Code, (or lhe peAortnance of Iha work 1w whic� Ihis permil is issued. My workars' compensation Insurance carrier and policy number are: �� Camer. A .2 U'i� (ifYs secfim neM rpi 0e mniyeteUGlNe pemW 6 va5retl er me �urqre0 qXars (5�00) akss ) Policy Number: %��q n 7 �'— Q � �_ ❑ I certity that in Ihe pedormance of t�e wnrk for which this pertnit is issued, I shall not employ any person in any manner so as to bewme subject to the vrorkers' compensation laws of Califomia, and agree Nat if I s�oultl Decome subject to the workers' compensaGon provisions of Section 3700 0l the LabosCy e, I 5hall (o wit these provisions. c C/ �(l'�� Mdicant's S�9naw e � Daie � WARNING: FAILURE TO SECURE WORKE COMPENSATION CAVERAGE IS UNLAWFUL AND SHALI SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CNIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE CAST OF CAMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND ATfORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm Ihat 1 am licensed under provisions o( Chapter 9(commencing with Section 7000) ol Division 3 of the Business and Professions Code, and my license is in full force and eRect. ��.� ' � �p �9 p/ /"`� �S-O f\ ConVac r'S $ie��u e Daie CONSTRUCTION LENDING AGENCY: ❑ I hereby aNcm [hat [here is a const ction lending agency fa lhe per(wmance of Ihe Hork fa wfiich this permit is issued. (Sec. 3097, Civil Code). Lender s Name: Lender's Address: Sie�Wre OWNER-BUILDER UECLARATIONS: I hereby aRrtn that under penalty ot Derjury that I am EJ(EMPT FROM THE CONTRACTORS LICENSE LAW (or the followinq reason (Sec. 7031.5. Business and Professions Code: My city or wunry which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requiras the applicanl for such pertnil to file a signed statement that he or she is IicenseC pursuant lo t�e provisions of ihe Cont2ctore license Law (Chapter 9(wmmencing with Section 7000) ol Division 3 of the Business and Professions CoOe) or that he or she is exempt therefrom and the basis (or Ihe alleged exemplion. Any violation of Section 7031.5 Dy any applicant for a permit subjecis Ne applicant to a civil penalry ot not mora than five huntlretl Aollare ($500).): ❑ I, as ovmer ol the property, or my employee5 wi[h wdges as their 5018 compensation. WILL 00 THE WORK, and the sWcture is not intentlad or offered for sale (Sec. 7044, Business and Prolessions Coda: The Contractors LitenSe Law tlo85 no� apply to an Owner of propeRy wh0 build5 or improve5 thereon, an0 vfio dces such vrork himselt or herself ar through his or her ovm employees, providetl that such improvements are nol intended or oHered for sale. If, however, t�e GuilCinq or improvement is sold within one year of wmpletion, the ovmer-builder will have lha burden of proving that he or she did not build, or improve lor purpose of sale.). ❑�I, as ovmer�of the property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construcl the projact (Sec. 7044, Business and Pmfessbns Code: The cont2ctors License Law dces not apply to an owner of property who builds or improves thereon, antl who cont2cts tor such project with a contracta(s� license pursuam to tha Contractas License Lavs.). ❑ I am exempt under sec. Business and Protessions Cotle for this reason: ]OA46 (]N]) Owner ID verifletl by dri�ense. ❑ Ves ❑ No a ' Driver's License No. Expires: Verification of Ownership by (lype of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: �� ❑ I hereby certi(y that no excavation frve (5) a mo2 feet in depth into wfiich a person is required lo tlescend, will be made in connection wiN vqrk auVnr¢ed by ihis pertnil, and Ihat no building struclure. scafldtling, lalsewnrk, or demoliUon or dismantling Ihereot, will be more Ihan [hirty-six (36) feel high. (Chap. 3.2, Grp 2, M 2, Sec. 341, Ttle 8, Califomia Administrative Cotle). ❑ As owner-builder, I will not employ anyone to do vrork which would require a pertnit from t�e Division of lntlustrial Safety, as noted above, unless such person has a permit to do such work Irom the division. NppliGanl's Sipndlure Qdle Division of Industrial Safaty Permit Number: MAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 7. Will Ihe applicant or present or fulure building occupant need to file and Certify a Busines5 Plan (Or emergenGy re5Dan58 ro felease or thfealenetl release of a hazarCous material7 ❑ Ves ❑ No (Section 25505 of Ihe Califomia Health and Safety Code requires. with some exceptions, that a Business Plan be filetl with t�e Costa Mesa Fire Department by every business which has at any one lime during a reported year a quantiry of hazardous materials equal to or greater than a weight of 500 pounds. or a volume of 55 gallons, or 200 cubic feet of wmpressed gas al standard lemperature anA pressure). 2. Dces or will the applicant or present or future building occupant need to fiie a registralion fortn for aculely hazartlous materials? ❑ Yes ❑ No (Section 25533 of Ihe Cali(omia Health and Safety Cotle, wilh some exceptions. requires registration wiN the Costa Mesa Fire Department Dy each business which al any one lime has on hantl a quantiry of acutey hazartlous matenals equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard tempereture antl pressure). 3. Does or will the aDP�icant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Progrem for acutety hazardous materials)? ❑ Yes ❑ No (Section 25534 0! the California Health and Safety Cotle provitles that the CosW Mesa Fire Department may require the preparation, certifiwtion and filing with the Fire Department of an RMPP by businesses which are required lo register acutely hazardous matenals vrith the Fire Department. 4. II an RMPP is presently requiretl, has Section 25534 of Ihe Califomia Health and Safaty Code been fully complietl with7 ❑ Yes ❑ No 5. Does or vnll the applicant or present or future building occupant require (or lhe work which is Ihe subject of Ihis application a permit lor suth consWcGon or motlifiw�ion from Ihe South Coast Air �ualiry Management Oistrict or from any olher air pollution control district or agency� ❑ Ye5 ❑ No (Sec�ion 65850.2 of Iha Calilomia Govemment Cotle requires that the requestetl information De lumis�etl on applications Ip non-residential builaing pertnits). 6. Will any part of tha facility lo be consiructed untler this permit 6e within 7000 (eel from the outer boundaries ol a schooli ❑ Ves ❑ No (I( yes', the faciliry must meet the requirement of Sections 25534 and 42303 ol the Califomia Health and Salely Code). 7. II a permit !rom the South Coast Air Oualiry Management Dislricl or other air pollution coMrol tlistricl or agency is repuiretl for Ihe work which is the subject of this applicalion, have all of the disclosures prescribed by Calilomia Health and Salety Code Section 42303 been made? ❑ Yes ❑ No 8. Q( yes", altach certificate of compliance from the appropriate air pollution control oKcer�. • • � CERTIFICATE OF COMPL'IANCE:'I certify lhat urMer penaltyof Oerjury Iha information given above is cortect. I agree to wmply with all state laws and city�ortlinances regarding Hazartlous Materials'and Emissions." ' � .: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury thal I have read lhis appliGation and 51ate lhal the information given is correcl. I agree to comply wiN all state laws antl ciry ordinances relating to building conslruction, and aulhorize representatives of the City of Costa Mesa lo enter upon the above-tlescnbed property for inspection purposes. I agree not to occupy or allow occupancy o� any building auihOrized by Ihis permit until final inspection. _ ie aWre ol Le I Owner s) Da�e- O' ��— � � AntllorAulhon e09 01¢onl Oale �.'- . 4�74�. � � ''COSTA MESA BUILDING-SAFETY DEPARTMENT � P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BVIIDING /�/Q�� iin ADDRESS ( O U L.� l. OWNER �AN/✓ MAII �� ADDRESS �' �]� TEL. CITV OSfC�A- /�/�R NO. BRANCH ADDRESS ARCHITECT TEL. OR ENGINEER ADDRESS CONTRACTOR ADDRESS � � TEL. CITV �(/�— NO. F STATE �7 � CITY � LIC. NO. p� �„� LIC. NO. {s� SIZE ' NO.OF B�DGS. 4 OF lOT NOW ON LOT a USE OF ,.�. E%ISTING BLOG. y FSeparate permits are required for Q electric, plumbing and heating work. [.W. USE OF BUILDING AND WORK TO BE PERFORMED Q Li / a 2 oN 7 � f ✓ .7 CC w 0 1 hereby acknowledge tnat I have �ead thla epplicatlon end siate � y� ffiat ffia above information is correct-antl aprea to comply with m a ell laws rapuleting builtlin8 �e�rtrucNon, antl I zhell not employ 'Z any permn in vlolation of Ma workman's compenaation laws of m � the Stata ot Californla. 0 3 1 hereby cartify that I am pro0arly Iicenzetl as a conttetior undel SQ. FT. rv the Stete of California Business and Professions Cotle, Dlvision 3, THE AMOUNT SHOWN UNDER VALVATION IS FOR m Chapter 9, entl thet such licenses ere In full force entl effect, ar I THE PURP06E Of ESTABLISHING A PERMIT FEE ONLV: � em ezempt from the provis s of tha Steta of Celifor Ie Business VALVATION PERMIT FEE E p entl Profenlons Cotle, Div' n 3, hapter 9. Jr m C�"(� PLAN CHECK S p Signatura of �� Parmlttee � s � TAX $ � � u Authorizad ABant TOTA� PAID E 8� �j ��PAlu r. �`'�ir:.''s T 17-75��,5,00 755 8.5C APPLICATION FOR STRUCTURAL PERMIT BUILDING ADDRE55 EF FIRE � IPLANSZ I BUILDING EW I �y ,� /�l_ VARDSAPPROVED VARDSAPPROVED DISTANCE BET. BET. MAIN & MAIN BLOCaS. ACCESS. BLd VAR.# DATE C.U.P.#E APPqOVED AOP��cant to fill in all soaces withiN heavy boraer lines antl sign all apP�opriate tleclarations. GTY OF COSTA MESA — Pe_gmiT O.' ^ TRACT NO. - LOT N0.�,:; BLDG. N0: � __ " _ _'_'_ .. . . . . .-_ �. i CONSTRUCTION PERMIT L� 3 Z -- i; � ,,; ••,! . .i , : � :. � � � Project� dress� �' �' TVPE OF CONSTRUCTION � `' ` y� �� - ��, �_,,_ 5,1,2Q�• .8/03/82 . 8 � T�.: ,� •- - . . _ _ - .r-.: ,,.•.9 . ; Own¢I • . � . . ` .. Phone J ' O''NEW' :O ADD - � ALTERATION- ' " 1' ' =� "' '" ' �-� - -- - _ r.. � , ' � Addres /7 � -- � � - O'REPAIR. ❑ CONVER9oN; O DEMOuSH. __ . -._ - - - - - � 20NING REGULATIONS ,, ,: - • ' � � Arch/En9.---'-"� ��. - , - License�No.^ -_. _ . . _ ❑ OTHER_r � • .. . . _. . _ _ . . ' __ - _- _ _ " _ t'Address"' ' - ' �` ' '-. .. _._ ._ .. DESCRIPTIONOFWORK , _ " ' " _ '_ �'A.P'�" _.. `-" . ., .. 'i . �, ., , .. . . � ` " . `�ZONE" "" "' "PLNG REF. � , - �{ ;-Contractor- • 62sf.�jtl�.��i- - - -�-- � -Phone�%7�� TVPE OF PERMIT' " '�' } - '--� --� N ��-- 7Q BU ILDING _ _ . � � i.�r. r��. �� ! "'_ - ISETBACK PROPERTV.LINE t ;'AddIC55 /� �Z�I ' - ' - �% "." U -C '=- -- O�GRADING - ❑ FOVNDATION� ��-$TqVCTURAL- �- � SIOE-YARD -- -�- � - -- _ IIICENSEO CONTRACTOR.pECCARAT.ION.__ . - �` �� LEFT . f'��:I � � O-TENANT�LECT.RICAL.�PLUMBING_OMEGiAN1CA 5 p il hereby affirm tbst I am IicePsetl untler provisions of�Charter 9�(com- .ji- 3 � R�IGHTA � � � �+ mencing-with��seciion-J000)-of;Division-3-ot.the..Busine55�antl.L�'OSHER' '�� Protessions Cotle, �antl my ❑tense is in full torce antl ef(ect. �� • � REAR VARD (TO'P/L')'-- - ' "' '" -� ' - ' ' "'j , ,T �' ^ PROJECT DESCRIPTION- ' - ' i LlcenieClass �`--�� -�' ' � ��LicenseNo-- . - '� '— "�'"- ' - ' - '`PKG:SPACEREp-'- ' -"' PROVIDED - 1Date " _ L � 519natUre_ � " _ ' _' "" ' � 54. FT. a � f 1F ' _ "_ "�" _ _ '_ . ' ' ' _� .WORKERSCCOMPENSATION OECLARATION._ _• - '��n'� �STREET'WIDTH'- ' .�PARK'FEE,$, '�OCCUPANCV CONSTRUCTIONTVPE �I hereb affi�m that I have a certificate of consent to self-insure or a � „� � � � �-� �� - - ' ' " (Z�NING'APPROV ED BV "' -- ' "DATE� � • - 'certiticate-of Workers' Compensation-.Insurance,.or.-a.rertifietl^.copy_ _ VA�UAT.ION�_ �_ ° ZONET ��- �.� . �� ^ . � . .. � ., . . ,_ . � ' -'-� ""'- - "SPECIALCONDITIONSo '- -'" ' '�'- '- . •'"' �thereof (Section 380Q lab. C.). ( _ GRADINGCU. V.DS. ACRES �. � . - ,. � � PoiicY No.' _ '_' � _ '._ _' GomPanY _' _.._ . _ ' _'_ _".-.'" "... ' '_' ' _' � " '. �. _�._.: .,'_ "_' _ � _. _ . . ... .�. � i. . _ _ . . _ in,,Certlfietl copy_is,hereby_turpishetl.__ _ .___ _ ,, Y� L'REMARKS:.•��i�.Z�_, _ �C4' � ' r. '� � ', " � �s. t,;ertifietl coPY Is filetl with the citY Builtlin9 Division� " " ' - ' � -' �-' ' - ' ""-` --- ' --' """ " '- '^` �{,�MPTION'FROM WORKERS"COMPENSATION'DECCARATION' - -�--y��-- - ��'n' � -'+1� �{ ^ i. �('f'}ii5 section neetl not b¢ con7P�etetl_ if the permit i5 tor one huntlretl • ' �;,� „ +, ��. �,j.� „y� j' � � . .. . . ` .. - . 48300) or less). '; _ _ " , "' �„ ; . " . .,... ��_._._._ ." ". "' i �' �_'__ _ _. _.._�_.. _ _ . _s. _ ,'..� " ' "' I certlfy that In the performahce oi the work for w�ich this permft �is . . . _ , issuetl, I shall not employ'aoy`Pe�son in any'manner,5o a5.to become � PL'UMBINGr��,. �.j' .a��l?N'CHECK- � -j -- ^- =ELECTRICAL"-' --•-' PLAN CHECK- - - subject.to_ e brkerS.CompePsafio t C�alitor�s(�a�v��Q ' ' -. ! Date � Si9natUr�'� '��'��-�-�^ BATHTOBS-" ' '- ' SHOWEftS'�""-- "'-'-' " � '�" --' -- - - : i �NOTICE: If after making.thi5 tleclara on, you shoultl become sublect ;TOI�ETS. � �,-. URINAL'S� ---�� -� - - -�GENERATOk--- •� - - % .!"t� 0=1'KW=1 30 KW to the Workers' Campensatian provisions of [he Labor Cotle,-you'must � •TRANSFORMER r>>,� �� y', forthwltM1 comply with such pYo��zions Or this pe�mii shall b¢ tle¢metl LAVATORIES � DOUBL'ECAV$ -- .` �-- `- 'APPLIANCE " -30-50 KW_50 + KVJ-- ._ ___ :_�. } ievoketl, �_1...._._._.-... _{_ _.T'__--..� .�.___ " _ _ � . . .... ' �� .. i 'CONSTRUCTION LENDING AGENCV "KIT. SINKS'�"'^- �"'DISHWASHERS' -'- --- - ,MOTORS - �� -0-1-HP---- �1-30'HP- -� ' ^ - -- --� + �Iherebyaftirmthattherei5acon5t�uctionlentlingagencyfo�thePer- SERVICESINKS; i5UMP5'�"""- -- -'❑NC..SOLAR)_�10-SO�HP_50+.HF��"�0i�`�_'�'}iy�(C ( formance of the work for which this permit is Issuetl (Section 309] ' 7 J'. � ---"� �Civ:Q�:----�--- -----�-- ----- -- �-- ----- -FCOORSINKS'-""'FLOOR'DRAINS"-"'- ^" '-"jFIXTURES-�'^�-OUTL-ETS�-�SWITCHE$-•�� - �-- -^ � Lentler's Name � � �"'�" "-'""" '"'--.." `"'-"- '-' -""-"'� -""' 'DRINKINGFOUNTAINS` -�f- . ^-�' ' ;GAS�TUBESIGNS-.. yLentler's Atltlress -"`�--`- '-` ` '� ' -' `- "'. - --- -- OWNER'BUILDER�DECIARATION --- 'INTERCEPTORS`---' -CL/iRIFIERS-- '1 "�"-" ^P�LE-L-IGHTS'�- -- ---- -' - ^-- -- - "_._." _'"" '.. " � I hereby affirm lha[ I am exemat from the Contractor'S �icense Law for .. '- � �� .� . _.�_ , Ihe•tollowing reason (Sactiom-7031.5-Business-antl-Prof¢SSions Cotle:. ._ - . � � � � �� P.ny city or rounty whicM1 requires a permit to construct, alt¢r, SWIMMINGPOO�""-'-'PTRAP�"�-�^----}-----•'--� �'�pOLES`-"-" "�METERED' '-SUB�"� � Improve�, tlemolish orvrepair-anY ztructure; prior lo�its�issuanceyalso�re- �-y�rp�TER'SERVICE "'- ' ALTERATION �,- - ��'�- - PANELS - - - - --MAIN- -- SUB- �-- - - -- quire5 the aptlicant fo� zuch permit to file a Signetl statement tha[ he is�licensetl-pursuanbto-the�pro��sions�of the�Contracto�'S 6icense�Law� - GASSERVICE '--'"'OUTLETS' -'"`�"-" - ' ERVICE -+---- ---- -- - AMP^- --- � � (Chapter 9(commencing with F.ection 7000) of Division 3 of the � Da� � BuSiness-and-Profe55ions�Gotle)-orthatnelsexempftherefrom�antlth¢��-yyqTER'HEATERS�'�-BTU'OVTPVT� "---�°-` -4 ----•---- - -- -.i basis for [be allegetl exemption. Any violation o( Section 7031.5 by - �� 8nY-appllCdOf-�Ol-d-p¢�Tit-SVbj¢C25 the-apP��nt-to a Civil �penLlty � � SEWER'CONNECTIONS" ''� -- ' � ' �-- •4-• � - ---- -- --•- - � - � �"- no[ more than five huntlred tlollars (E500). ' � ^ -as owner-ot-the property: � " ' - ' �SOCAR'TANK- �-�---COLLECTORS �- -f- - � r � ^ - ---- � .�som�eq_saEien, will tlo the rk, antl the struCture is not intentletl' " ' - - -- '� or offeretl for sale. (Section 70A4, Business anB-Professions Cotle: The --SOLAR PIPING SVS:� � '-Ij "'-. ' ' '� ' 1"'�SSUE�FEE�'- �- ' -- - - -, ' F O Contrdctor's License Law tlae5 �ot apply to;an owne� of a prop¢rty � who bwltli or improves thercOn, antl who tloes such work himself or' ' ISSUE FEE '+1" -'#�' - � iAPPLICATION�.4PPROVED BV -- -- -DATE- - -� Q[hrough his own emp loyees, provitletl that such improv¢ments are no[ � � intentletl or offered tSr sale. If, however, the'builtlin9'or imprbvement MECHANICAL � PLAN CHECK f� i � �� "- ` � � is soltl within qne year, oi comP�etion, the owner will have the burtlen i SUMMARV OF FEES �� , � F , of.proving Fe tlitl�not-bwltl or �imp�ove'for'the�purpose"ot'SaIE)C - --- ' ' --' ' • -'- - - -- BUIIDING- - - � -- - -• - -- � _ �HEATING SVSTEM O 100,000 BTU _ _ _ _-^ __ _ _ _ , - i_ �.�1,�-as. owner_-of-[he�property,-.am-extlusively-mn[racfing wi[h_ qNDDUCTWG- - ��-�-� •PERMIT E y n�,SMIP� _ � S ��! licensetl contractors to mnstrVct the project (Section 7044, Business 100,000 � BTV � �pLAN CHECK $ � PERMIT y i antl��ProfessionsCotle:-The-Coqtractor's-LlcenzeLawtloesnotappryto- _ISSUANCE .Sr"�� " _ _ "' " ...' '_ _'" ..._ - "� _ � an owner of property who bu�ltls or Improves thereon, antl who con- REFRIGERATION 0-300,000 BTU r ' 'PLUMBING $ � � � tracts-trom-such_pmject5-with-a.contractor(s) Ilcesnetl.pursuant.�o. �SVSTEM- �--�. - � ' . __ .. ...� __ _ } . , ___ _ �i��GR�ADING.�E�'� � " � i lhe Contractor's l.icense L.aw). 100,000+8TU ; P�AN CFfECK 5- • � .� -�� ,." � �� I'am-exempYuntler'Settion^" '-" - B'&'P: C: for this' "- -- � - - • - - � �-- - - �r � - . � � O� • • � flu , y ��7 �`_ �$ / ,'i i. _ F � BOILERS BTU � tE�ECTRICHC"$� ^"^ �-' . �aLL:.i^ ^'MICROFILJvt'S"`- �'l' 1 reason- � SVSTEM REPAIR, ALTERATION - � ' �PLAN�CHECK��-E� � - - - - - - { � Date, pwner . � _ ��_ TOTALFEEE_._'._ ' � EXHAUSTSVSTEM MLILTIPLE '�MECHANICAL-E'� --- � I hereby certlfy tha[ I have reatl this application antl state th5t the above n:.� �. ��')�."' 1; -"�CE55 AD- . 7�� '!� C infovmation-is'correcP: I'agred�to- mply with all city antl'county' ��PLAN�CHECK�-g --� --iVANCE'PC -S_""'"•- ` brtlinancesantlstatela tin9 nsiruction,antlherebyauthorize fi � ytf-�el q f¢ re5¢ntatives�Of�'tT �IS�c C CRter'u oT the above' ntio etl - - � � �7•�"�� '� :'� "'� �t ptoperty for i e¢e "�rp s P �� Q �^ " "_4 _ ` _' _' � _ ' .. . ._ . ..: ' � FINAL FEE $� � Signature Date � ----- ••- _. Drivers' Lic'ense or �_ / � � /� �: - ' ISSUE FEE-_ .. ,, �.. . _ U _ . . _ _ _ _ . _ _ _ , _ � CMF 0865-46 White-Builtlin9; Unary-Applicanp Pink-Accountin9� Goltlenrotl-Assessor CONSTRUCTION AND PLANNING ' '-' �� POOI & SPA � � - -• - � APPROVALS � � Permit # �LN.3�� Date '�Inspector qppROVALS -• � Permit # Date Ins�etar`^ 1. Temporary Electrical Service or Pole "' - 43. Pool & Equipment Location' � � -� � - t Soil..ipe-Undrgrn 44. Steel Reinforcement - -- � - - - - ' 3. --Electrical Conduit.Utility-Undrgrn. _ � � 45.� • Forms. :�..r - - � :._4._Electrical_ConduirUndrgm_..._ .._ �_ ..-'_ __ _ . 46._._ElectricalBonding F �-- -- -- � �--�---� �_,. . _ tee em orce - __ �•_ _ , . ___,__._ _� , _ •., 4 47. Rough Plumbin & Pressure�Test - -- - -- - - - - - --- - 6.. Electrical UFER_Grn - � - � ' 46. APPROVAL TO COVER-GUNITE - -- - � _ 7. Footings 49. ElectricalConduit-Undrm �� - '�' } 8.--�Foundation _ _ . ' ' ' 50. � Gas Pipe,-� Undr m, Test � � • ' ' � �- 9. - Water�?ipe-Undrgrn. _ ' � 51. Backwash Lines P-Tra ❑� ndr rn' - -� " ' - " - � 70. Structural Floor SYstem ' � 52. APPROVAL TO DECK � � � - 11. .Property.Sewer.Line & House Connection. _ � _53. Backwash & Rece'tor-Final�� - -� ' � " ' ., 12.� Sireet Sewer Connection ' � - - ` - -� - 54. Heater & Vent-Final � C 13. Rough Plumbing _ ,' ' ' � - � � -' � - - - - � � 14. Rough ElestrioConduit ' - '� '56. - Electrical-Final- �� ' • .15. RoughElectric-Wiring - - �'- - - '57. �SolarSystem-FinaF�' � ' " - ""' "' '� � ` ' i6. -Rough-Heating &�Air Conditioning -" - " � � -�- - - • encing & Access Approval ' - ' 17. �Ducts, in�Structure "' " " " _ APPROVEDFOR PLASTERING ' ' ' ' 18. Ducts,Ventilating � ' - �-- � - - � - _ . _.._ . .'. 19. Gas Pipe-Rough &Test - - - - -� -� 60. POOL/SPA SYSTEMS'FINAL'- " � • � . � ,. � . , ' �' 20: -Roof F�aming- - - ' - - - -- - - ' � ' ' 21. Roof SFeathin � � � - - - - - - - � - ' ' � " � � � � - 22. Frame and Flashin - - � . �NOTES: � ' - � ' - - � . ' -' 23: Insulation - - ' - - - _ " - - - ' ' ' �- 24! Lathing & Sidin9 - - - ' - - ' - - ' . ._ . _ _- -' . . - - -. . . 25. Drywall Nailing - - - � - - � � � � � � � � , 26. Plaster Brown Coat ' - � � ' � � - 27. Electrical Power MeterFinal � � �- -� .�L C�.. � � � � ' ' � , 28. Final Electric - - -- - �- -- � � • � - 29: Final Heating & Air Conditioning � --- � - � �� - - - - - - � � ' - ' - � ' � 30. Final Gas Pipe-Test - � � - � -- - - � � � - `� - � • � 31. - Final Plumbing- - - ' ' ' � ' � 32. �Water Service-Final - � -- - ' -' � � -33. -GasService-Final . � ' i 34. Solar pomestic'-Final ' i ` � ' }�-' `' ' ' � � ' �� 35. Landsca e S rinklin S stem � r '' � � i 36. Sound Attenuation ' ; - � - � � • � 37. Handicap.Regulations • � 1 - - --- - � ' ' ' ` � � - �, � - � ' - 38. FINAL STRUCTURE & BUILDING ' � - � � - � 39. Special Requirements Completed - � � " ,, � � � � � 40. Electric Felease to Edison � � ' � ' '� � ` 41. Gas Release to Southern Califomia Gas Co. ' -' � � � 42. CERTIFICATE OF OCCUPANCY , -- � ' , ;:. No. Date " ' . - AOP��ant to fill In all s0aces except thosa wi(Fin heavy Eortler lines anE slgn all appropriate Oeclarations. FCOSTa,MESA �ONSTRUCTI,ONPERMIT Address3�f�R_r�'_2�iA-iJE #E • Cb Address ��rc,�lt`�Nti'fh�raf'77Ur •ci��2�� Arch/Eng. License No. Address Contractor's Nam a.(_�one Address (mailing) � City License No. IICENSED CONTRACTOR DECLARATION � I hereby a/firm that I am licensed untler provisions ot Charter 9(commencing with section ]000) 05 Oivislon 3 01 1tie Business antl Professlons Cotle, and my license is in full torce antl e(focL � License Class �Icenso No. Date - Signature - WORKERS' COMGENSATION DECLARATION I hereby affirm thdl I have a c¢rHfita�e of mnsent to selbinsure or a CCrti�iCate ' Workers' Compensation Insuran�e, or a cartifietl <opy thereof (Section .00. Lab. CJ ' ' , � Policy No. Company eCertlfietl copy Is nereby fumished. � � Certlfletl copy Is�filetl with the cicY Builtling Division. Oate Applicant � ' E%EMPTION FROM WORKERS' COMPENSATION pECLARATION (This section neetl not be complatetl �f the permit is for one huntlratl (E100) ar less). I certily tha[ in the p¢rfOrmante of the wo�k fo� whlch thi pCrm�t i5 ISSuetl 1 shall'not e loy any person in anv manne s o b .ortya�fybject to [�e Worker e s ti Laws of Cal�fom' . /� Da`te �Slgnature — NOTIGE: t, I er aking this tloclaYatl ou sh e�subject to the Workers' Compensatlon provi5ion5 of the or otle, you mu5t forthwith Camply wllh such' p�ovisions o� [nis pCrmit Shall be tleemeE �evoketl. CONSTRUCTION IENDING AGEHCY ' . I hvreby a111rm tnat there is a constNctlon lentlinq agency for the Oerformance of tha work for which thi5 pe�mlC is issuetl (SectlOn 309] Civ. C.) Lentler's Name Lentler's Atlaress � OWNERBUILDEN OECLARATION I hereby affirm that 1 am exempt from the ConVactor's License �aw tor the following reason (Section �031.5 Business antl Pwfessional Cotlei Any city or as � le lam that and lhe ba5i5 for the allt9etl ex¢mpUon. Any vbldLon ot Sectlon y any applitant ror a permlt subjects the applicant to a civil ' nol more than five nunEretl tlollars (5500�. >wner of the p�operty t�^" will tlo the work, antl the SVucture Is not in[entletl or o tere �Section• 7044, Business Jntl Professional Cotle: The Contractor's aw tloes nol apply t0 an oWne� o� a p�ope�ty who builtl5 or imp�Ov¢5 �ntl who tloe5 SUCh wo�k himself/hCrSelt or through h15 or ho� own S, provitl¢tl thdl suGh Improvemmts aro no[ Intentletl o� offeretl tor owaver, the builtling or imProvement is soltl within ono year of com- ie owner wlll have Ihe bultlen Of prOving he/Sh¢ tlitl not builtl o� Im- the purpose of sale). � wner o/ the.property, am ezclusivery contractin9 w��h Ilcensetl <on- i construct lhe prolect (Settlon 7044, Business antl ProfeSsions Cotle: rattor'S license Law doe5 �ot apply to an owner of p�operty who Im0/oves�lnereon, antl wPo contract5 for suGh project5 wi[n a con- 'IICBlISC pursuant to [h¢ CPntraG[Or'S L�CCfISE Law). I.am aware that their Worker's Compensatlon insurance shoultl be provltletl to me. �empt untler Section— �. , Q/��,C. for this reason Signd[ure C '� 'Drivers' �icenze or 55 � CMF OB65-46, rev. 10/84 � _ Owner � --y¢�G have reatl Chis applma�ion antl a9ree to comply with all clty x o builtlin9A�5truction, antl h� G' o< y � �� TVPE OFCONSTRUCTION NEW ADD ALTERATION REPAIR ❑ CONVERSION ❑,DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLDG. TVPE OF PERMIT LI GRADING LI FOUNDATION LJ STRVCTURAL .•� TENANT � ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION Sa. FT. � oCCUaANCv_ �CONSTRVCTIONTVPE � VALUATION$ ZONE GRADINGCU.VDS. � ACRES— Remarks: , � ' , Bar Sink Backflow Preventer � Backflow Irrigation Bathtubs � � Clarifiers . Dishwasher Drinking Fountains Floor Drains - Floor Sinks � Gas Service � Outlets Interceptors Kitchen $ink � ' Lavatories ` • P—Trap Roof Drains � Reinspection Fae $75 Boiler Duct- UnderGround Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. BIL ICBO # Heating System�& Ducting ❑0.100,000 BTU O 100,000 BT Reinspection Fea Itling; Canary - Applicant; Pink - Accountin9; Goltlenrotl - Asseszor $15 Showers Service Sink � Sewer Cap Sewer Connection . Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa' Urinal Water Closet Water Heater � Water Servica Auto�Wash Isue Fee Hood or Type I ❑ Canopy Typell ❑ Refrigeration System 00-100,000 BTU ❑ 100,000 System Repair/Alteration ' Fire Dempers Registers • . Iwue Fee 0 $ 3 $ 3 A.P. # ' S Main Building: E T Front � A Rear C R�9ht K Left S Ping. Ref. # Planning Notes: 099,b��'�B/07/86- , � .- f" . .. i � , � i 2ona ' Accessory Buildin9: ' Parking Req./Provided ; .. I ECECTRICAL� " � Aummatic Washer ' Trensformer �❑ 15-50 KW ConstructionPoleSu6. ' ❑SO+KW� Cooking Unit - � Merer ❑up fo t00amps Dishwashei � � . ' Merer over100amps Dryers ❑Gas ��Electric Sub Panel Fan � i Motors OO-1 HP O1 %� 6 F.A.U. �� Inc.Solar 09-15 HP �16-' Fixtures Device Boxes ' �U11EI5 Switches -- ; Garbage Disposal Generator �0-5 KW �5�15 KW Pole Light Ran9e Sign , ' Standing Sections Trash Compacmr i�a.��q j �� i l r FEES � � i z O N I N G R E Q M T S ' Reinspection Fee � $15 I � Issue Fee � ' ' I ' , $ 3 I' .DEVELOPMENTSERVICESREaUIREMENTS:. _ - � . ' 2oning Approved By � � Date � Building Approved By ' Data Appliwtion Issued By � � Dat � ' � SUMMARV OF FEES , _ � . , � � BUILDING PERMIT $ SMIP , $ - PLAN CHECK � $ PERMIT ' PLUMBING . $ � ISSUANCE $ PLAN CHECK �25% $ ENERGV P.C. $ ' � • ELECTRICAL . �� $.� GRADING�. $- - ' PLANCHECK .50% $. MICROFILM $- ' ' MECHANICAL '$ TOTALFEE �$ �'S PLAN CHECK 25% $ ' � . CONSTRUCTION AND PLANNING ' POOL & SPA ' APPROVALS Permit # Date Inspector qPPROVALS Permit # Date InspectorA � 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�Undrgrnd. 55. Electrical Bonding ' 5. Steel Reinforcement .56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNtTE t. 7. Footings � 58. Electrical Conduit-Undrgrnd. '� �3 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. PropertY Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Ven't-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing � 65. Electrical-Final 15. Rough Etectricat-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 �Gas ❑Oil 23. Gas Pipe-Rough & Test 72. Underground Flush � � 24. Roof Framing 73. Undergrnd.StorageTank �Gas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical � 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & 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 -$-gG �� 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning ' � vr � , � � " Y 35. Final Gas Pipe-Test 36. Hood or Canopy . : 37' Final Factory Fireplace • � 38. �Final Plumbing � � 39. Water Service-Final � ' 40. Gas Service-Final � . 41. Solar pomestic-Final : � • � 42. Backflow Preventer . . � � ' 43. Backflow, Irrigation � , � � . 44' Landscape Irrigation System � � I 45. Sound Attenuation ' - 46. Flandicap Regulations . - 47.' FINAL STRUCTURE & BUILDING ` � 48. Special Requirements Completed ' 49. Electrie Release to Edison � 50. Gas�Release to Southern California Gas Co -� 51. CERTIFICATE OF OCCUPANCY „ No. Date � � � �C,: , �' 3 88C2 For Applicant to Fill in Completely BUILDING � i y�/ � /n n ADDRESS f)� /*//� L{%/}1/ I/c�/ OWNER �L'LIIR�TNE (�F!R ADDRESS 3190 A Aixport Ioop Drive aTv Costa Mesa No`.�929-9205 CONSiRUCTION I1v1Ile �Y � I FNf1FG BRANCH A�DRE55 NE'�ijJ� ARCHITECT OR ENGINEER LP3E ADDFESS 44 P1 CONTRACTOR �' ADDRESS 19�1 cirv NewppYt E � c No. 221764 SIZE OF LOT USE OF E%ISTING BLDG. TE TEL. No. 833r CITY uc.No1484 INO.O LBF� NOW ON LOT $12E OF NO. OF NEWBLDG. 4�1SO ROOMS 3 ST( EXTERIOR WAIL �ROOF COVERING �n(,7, �,dj COVERING }��j`jt USE OF BUI�DING AND WORK TO BE PERFORME A.P. NO. BUILDING ADDRESS OWNEfl FIRE ZONE APPRO V E P A 11: Itg-?_-74t::s��0 201;s ;.�;;r�$5.�� FOR BUILDING PERMIT �TE RECEI . D DATE ISSUED 2' L/d•i/- ti� PE�i I � F_ A/.e%�%� /�rrl. �/. '�ej 67 LOT BLOCK P <.�vi.v� � �/ / VALU$ n_y„a 0 LU /J PE GROUP ✓ ' DATE �•Z�� ZONE `^A NO.OF USE OF NEW �.r PLAN$ � BUILDING VARDS APPROVED VAFDS AI MAIN BUILOING ACCESSOfl (FROM C/L STREET) DISTANCE BET. BET. MAIN & MAIN BLDGS. ACCFSS. BLD VAR.# DATE c.u.P.#r��1.2•Ia/ a,aPaoveo/ APPROVED PU• � HOLD F�R SPEClA REQ I hereby acknowledge thet I liave read this application antl state that the above intormation is correct and aqree to comply with all laws regula[Ing builtlinB consttuction, antl I shall not employ any person in violation of the workman's compensation laws of Me State of California. i �ereby certify that I am properly licensetl as a contractor untler SQ. FT. the State of Calitornia Business antl Professions Cotle, Divisicn 3, THE AMOUNT SF Chapter 9, antl that such licansas are In full torce antl affact, or I THE PURPOSE OF em ezampt from the pr i ions of th tat¢ ot Calitornia Business VALUATION antl Pro sio Cotla, i' ion 3, p er 9 5i0�a<� e o, �t�i.;�L ��' /�D � Permittee� $ L O Auihorizatl Agant � m I� Tnx• % � o �VA�UATION IS FOR � A PERMIT FEE ON�V: m � a \ E $ � � v �' � m � K $ � E \ �O %'� ' LL $ �� '—�--- Aop�lcant to ftll in all . �-C,1TV OF COSTA MESA carn�ri�; 'CONSTRUCTIONPERMIT �`��7•- Addrea"I"JqrZ CaW/a/.� S'T '.%.QU/�1E Arch�Eng. �� Licenu No. Address '-�- ' � Contractor('nA7GiLN-T E�GEYTwcic Phor wlthin ;LICENSED COIVTRAGTOR DEGLARqTION ' ' :1 heraby aflirm thtl 1 am IlcenSatl untlGr p�CvislOns Of Cbdrte� 9(com- �mencing-wlth sectlon-7000) of'OWislon-3 of the� Buslneis and �PfO}OSSIOf15 Coae, anC Ty IIC81150 IS I� fUll tO�CB d�tl 81fBCt. ?Nf 711 Licenie Clais '� - v �Lcansa N .�t.7�Ll�LL ;oata'�'��' 9Z � S�gnature "' �WORKERS' COMPENSATION DECLARATION ' �I bereby af(Gm that 1 M1ave a certHicate of consent to SelNnsure or a ,cmtiflcate� of- Workers' Compensatlon� Insurance, or a•certilietl-copy thereo( (Se<tion 3800, Lab. C.). � 'Pollcy No. � ' Company - ' - " � ' j� CertHletl.copy.is�h¢r¢by tumis�etl. . .__ _._ . . _ ' _ ,�.Certifletl copy iz�tiletl with t�e tlty Builtling �ivislon. �--�,MPTION �FROM WORKERS' COMVENSATION.DECLARATION �r3 section neetl nat.be complete0 if, t�e Oermit Is for one huntlretl ��:00 or leu�. . r . �_cert�ry that m t�e_performance of Ihe work for wbich thii permi[ is �Issuetl, I shail not employ any porsQ[� In any manner so as to become Subtett t0 tht Vi0(kefs:_Gompeniilljp'.L.dd/Sp{ GII(o!n{@. /,, INOTICE: H afte� making this tlG<Idratlon, you shoultl4/BCOme sub�¢ct !to th0 WOrkGrS' CompensaHon provl5ions ot lhe LabOr Cotle,'you must Yo�thwltM1 comply�wifh suGh provi5ions o� Ibis permlt Shall be Ueemetl .revOketl.. ' _�' _ ' " " " _._"' ' _ ' '" ' �CONSTRUCTION LENDING AGENCV I hertDy atfl�m lhaf thlre IS a ConsV uction lentling agenty t0/ t�e per- �formance of the work for which lNs permit Is issuetl (Section 3097 .Civ. C.). " ' � ' '" "' . "" "' ' 'LlntlGr's Name .Lenticr'i Atl�ress OWNER BUILDER'DECL•ARATION -' ' �I heraby affirm tnat I am exempt Irom tne Contractor's Ucenu law br tbe'following rcason (Section 7031.5 Business�antl�Professloro-Coae: �Anv [Itv o! countv whlCh f0O1111¢5 2 D¢lTit t0 WOSf�UCt. dltCl, I5 Iltensetl pursuant to [he provisioni of [he Contractor'S License Law '(Chapter 9(commencing witn Settlon 7000) of Divislon 3 of [ne 8u51ne55'dntl R'dMsionS CotlO) Or that be 12 exGmpt th<r01rom antl IhG basis /or cne aliegetl exem0��on. Any violation ol $oction 7031.5 by any applitant-'lo� a'permibsUDjecK Ine appllWnt t0-a�clvil penally of nol more than liv¢ huntlrotl tlollars (E500). n�I, d5 ownef�of thC propCfly, Or Ty employee5 W(tb wagez ai lheir COmpe05dtlon, wl�l tlo lh0 w0/k, antl th¢ st�ucture Is not Intentled 'lerotl for wle. (Settion 7044, Business and Rolesilonz Cotla: ThE � atractor.'s Llcense_law tloos nol apply lo an owner ot a property wh0 bullCi or improves lhereon, dntl wno tloe5 Sut� wo�k himself or �th�ough hii own.employecs„ provitlap tbdt sucb improvemen[s ar¢ nat lntentletl or otlere0 for sale. It, howeveq [he builtling or improvement is soltl_within one year oi tompletion, the owner wlll have tno burtlen ol proving he tli0 nol bulltl or improve for thC pu�po50 0l salG).' ❑�P;-es �owner-ob the proDerty, am exclusively <ontracting-with Iicensetl contractors to construct the project (Section 7044, Busineis 'antl�Professlons Cotlr. Tha-Contractor's License Law tloes not appry to 'an owner oi p�operty wh0 builtlt or improves tharaon, antl who COp- Sra<ts�irom-zuth-projects-wllh� a COnt/acto�(5)-II<esneA pu/suant t0 't�e Contra<lor's LicenSe Law�. ' ❑-I'am exempt untler'$ettlon " B. S' P. C. �or Inls 1 h2/¢by cerlifythat 1 hava reatl Ihis appliwtion an0 S[dlG thal th� infO�rtidtlon is correcC.�'1 agree [o comply with all Ciry�antl Oltl�fIdOCCS dOtl SLdIC IdWS l81d1�l19 [O C0115[lUCIlOf1� dOd 118!!bY dU rep�e5¢ntdtiv of "[his'city to enter upon the above me� property_ fo , ns ctio putpo5 _ SlgnaWre ' '� Date -��_ oNvers' l.icense or 55 � .�. - CMF 0865-46 Whi[e-Builtling; Canary-Appliwnt: Pink-ACCoui Uo�Glr Iines an0 si9n all aOPrOpriale Occlarations. ' J TRACT NO. LOT NO' BLDG,J`10. TYPE OF CONSTRUCTION ❑ NEW ❑ ADD ❑ ALTERATION � ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER DESCRIPTION OF WORK i . t . � TYPE OF PERMIT, - � � ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL ❑TENANT�ELECTRICAL ❑PLUMBING ❑MECHM ❑ OTHER � P.ROJECT DESCRIPTION�. . ; _ SQ: FT. ' ' 'r 1' . _ " OCCUPANCV_CONSTRUCTION TVPE _ VALUATION, � ZONE GRADING CU. VDS. - ACRES • _A . REMARKSi � G. �' '_ - ' " � PCUMBING �r ' • � � PLAN CHECK " ' �f ` - " BATHTUBS " '� -SHOWERS - � - TOILETS�- ��p , VRINALS -"�-' 'f"' '- LAVATORIES DOVBLELAVS' ' - ' KIT.SINKS� - " "'DISHWASHERS ' - $ERVICESINKS' ;, �, �SUMP$ . -'- - '^ ' FLOOR SINKS - .��FCOOR DRAINS - �' - DRINKING'FOUNTAIN$' - - ^ - ' INTERCEPTOftS �CLARIFIERS � � WATER SERVICE -' - ALTERATION ' ' GASSERVICE -OUTLETS' y-�'-=-�` -� WATEF HEATERS ' -' BTU'OUTPUT"� ' " SEWER CONNECTIONS" " " -' ' ' cni ao Terav -- rni i rr-rnoc -- - ISSUEFEE �� - � - � -- MECHANICAL ' PLAN CHECK � HEATING SYSTEM 0-]00,000 BTU AND'DUCTING' 100,000 + BTV REFRIGERATION 0-100,000�BTU SVSTEM • - � -- - 100,000 �+ BTU BOILERS BTV � SVSTEM REPAIR, ALTERATION EXHAUST SVSTEM MVLTIPLE ISSUE FEE � - �� - I - � A.P. q ZONE 5844 '8/II/B2 28:00 T� � PCNTGp. gRUEF�. p�N - - PROPE�RTV LGNE f ' 0.EAR YARD (TO P/L) - PKG.SPACERE�. � � PROVIDED STREET WIDTH . . �PARK FEE E :SPECIALCONDITIONS: - - � ' - ELECTRICAL - "aLAN CnEC,K -' - � � SQ_FL . _. r. __ , .� SQ_FL -GENERATOR 0-1 KW_1"-10�KW, � "� "" � TRANSFORMER �. . � ?1 •APPLIANCE - - 30•SO�KW_50 � KW -- - - - y � MOTORS ' -- � p-1 HP=1-30 HP -" � � (IN0.50LAR) . ]O50 HP_--50! HP �� •r � FIXTVRES' "'OVTLETS '-SWITCHES -� '• ' - GAS TUBE SIGNS - � - - - - POLE CIGHT$ '- " - - - . ' - - PANELS - ' MAIN ' - • SVB' / • p ISERVICE -� -. - �- AMP--- � - -- , ' _' -.. . i _ - � ... � - ^ ' "" ISSVEFEE ' -�'--- '- OZ �FPPLICATI�NAPPROVEDBV� -- !�-N fIATE----. SUMMARV OF�FEES �� ' - -- BUILDING � � �� PERMIT y"" " ' '.��,...SMI�_,_ •S-. �_ _ � PLAN CHECK b� ` PERMIT. ^� � - t ' ISSUANCE 5• - �PIVMBiNG E GRADING .E� '�r PLFiN CHECK �5 � - - - � � , -�S ;, .� Oo � �ELECTRICAL 5� ,� _ ' MICROFICM 5 � � PCAN CHECK - E '� �_ - - - � •�TOTAL'FEE S ' MECHANICqL E ' ' ' - � ' - 1 '� LESS�AD- � �'PLAN CHECK S• �� - -' VANCE PC ' E _ ' -- . . _ � . i� � - "p �� , PINAL FEE E �� CONSTRUCTION AND PLANNING I- � POOL & SPA . -. - APPROVALS Permit# ��y'}'w Date Inspector pppROVALS . Permit� Date Inspector. ! � � ', 7. Temporary Electrical Service or Pole � � 43. Pool & Equipment Location �- � �• . Soi ipe-Undrgm:, • 44. Steel Reinforcement � � - -- � � "�- ` •�-.�'•'•- . 3. Electrical �pnduit,Utility-Undrgrn. 45. . Forms � - 4.. Electcical Conduit-Undrgrn 46. Electrical Bonding ' - � tee em orce 47. Rough Pluinbin & Pressure Test �� - ' � ' � 6. . Electrical_UFER Grn 48. APPROVALTO COVER=GUNITE • " - � 7. ootings 49. Electrical Conduit-Undr rn � � _ 8. � Foundation _ � 50. Gas Pipe, ❑ Undr rn, Test . � � _ 9. Water Pipe-Undrgm 51. Backwash Lines P-Tra ❑ ndr r �'` 10. Structural Floor SYstem 52. APPROVALTO DECK " ' 11. Property Sewer Line & Nouse Connection 53. Backwash & Rece tor-Firial 12. Street Sewer Connection ' . 54. Heater�& Vent-Pinal � 13. . Rough Plumbing ` � ' ' -' - 14. Rough ElectricConduit � •56. Electrical-Final � � � 15. Rough Electric-Wiring � � - 57. Solar SYstem-Final- ' � i 6. Rough Heating & Air Conditioning � - . • encing & Access Approval - ' -17. Ducts in Structure '� APPROVED FOR PLASTERING ' ' � 18. Ducts,Ventilating� � � - - � � . . - � • - .;�_ ' `' , '�.4 � 19. Gas Pipe-Rougb & Test � - _ . . 60. POOUSPA SYSTEMS FINAL � , - -, ' 20. Roof Freming � - - - - ' 21. Roof Sh"eathin - � - � � - - '- 22'. Frame and Flashin - `�NOTES: �' • � ' ' ' ' � ' 23. Insulation - - ' �- ' - � ' � ' ' - 24. - Lathing & Siding - � - - - ' � 25. Drywall Nailing - , - ' ' � � 26. Plaster Brown�Coat - - � � � � • �� 27�. Electiical Power�Meter-Final ' ' i � � 28. Final ElecYric - � � � � 29.- Final Heating & Air Conditioning - - � - ' ' , 30. Final Gas pipe-Test - - ' � - 31. Final Plumbing � '� 32.' Water Service-Finai- � � - ' � 33. Gas Service-Final - � ' 34. So�ar pomesticFinal � ' - � � � � � � � - 35. Landsca e S rinklin S stem � �' � � 36. Sound Atteriwtion ' � � � • � ' � � 37. Handicap Regulations ' � � � - 38. FINALS7RUCTURE&BUILDING 39. Special Requirements Completed ' � - � � � • 40. Electric Felease to Edison ' � --� 41. Gas Release to Southern California Gas Co. ' 42. CERTIFICATE OF OCCUPANCY No- Date r : �� _ � - ,- . .�.,'. Ci[y of Costa Mesa Develo�vient Services Department Building Safety Division �� P. O. Box 1200 Costa Meu, California CERTIFICATE OF OCCUPANCY No. OO��.02 The Building located at �1AA Air�aa�s H�mntia� ifiit F has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group R—� Occupancy. Use of Building Arin1-inrt chnn Lega� Description fl�7—.lq'3—�R ISee reuerse side for Metes and Bounds) Building Permit No n ��17n�a1avoo� Electrical Permit No.� �']��n Plumbing Permit No. n�� Mechanical Permit No. M�7F�A Number of apartments and/or guest rooms ISSUED TO: BuildingOfficial n:ti u•.�,_.a Glmther anrl Colette �m��ra.r i „E' ,��/ 3188 AiYvr� Av�enue, Unit F by .1: ,a..� � 5 ��'�ii� ./%v� Oosta Mssa. CA 9262F / ✓ Date �/ %��% This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. CMF 3015-46 rev. 1/83 White -Owner, Canary - Numerical File: Pink - Bldg. Permit File i PF0.IECT AUOflESS: j 1 8 B AI RWAY AV owNeesxamE:COLEMAN, REVIN A aonsess: COLEMAN SOSAN C 3188—F AIRWAY AVE COSTA MESA,CA AFCHIENGINEEfl: F�ONESS: � UNIT: 9267.6 flEG.NO.: UNIT: PENMITTEE:A—AMF�S PLUMBING 6 HEATING ( 714 ) 530-2440 aooxess:10422 TRASK AVENUE GARAEN GROVE CA 92642 LICENSEO CONTflRLTOP OECLAPATION: I herehy aliirm �Aal I am IicenSeO unaer pmvisions o� Chapler 9(commencin0 wi�� Se.ction 7000� ol �ivision 3 0l �Ae Business and Prolessions COGe. antl my license is in full lorte an0 eifec�. cirruc.:006664 STRTELIC.zSO3n7�) cuyss�:C-36 oaie: j S Signature: V�_�_!�� WORNE 5'CO PENSRiIONOECNflATION: I�ere�yaflirmlhail�aveacertilica� tconsenl�oself-in5ureoracetliticateofWorker5' Compensalio r�p r rplied y �hereol (Seaion 3800. LaD � PDUCY N0. ��y�j ��Y •�� E%P. ORiE: � I O 1 I9 Q camPnxv:REPUBLIC INDEM ❑ Cetldied copy is here�y fumi5hed. � Cerli�ietl copY i5 �ile0 wiih the ciry Bui�Oing Oivision. oaie: � / 5 nnPaczoc��""-�` �X.�/�lr EXEMPTI N FA WOBKEflS' COMPENSPTION OECIAPNTION: Qlis Seclion neM not be mmpletetl i� the perrtut is lor one hurArea (5100) or less�. I cenily that in Ine petlorma�e of ihe work for which this permit is iuueA. I shall not emoloy any person in any manner so az to become subiecl lo Ihe workers' Comoensalion law5 0l Calilomia. �aie: Signature: NOTICE: II. alter making Ihis detlaration. you S�oNd �ecome 5u�jet� �0 �A¢ Wofn¢rs' COmpenSalion D�avisi0n5 oi the Labor CoGe. you mu5i Iorthwii� comply vnth such pmvisions or IN5 Oermi� 5hail be aeemeA revoked. CONSTHUCTION LENOING FGENCY: I hereby atlum �Aai t�ere is a con5imction lentling agency for ihe pedormance o� �he worN �or w�ic� I�is permn is issuetl (Section 3091. Civ. C�. ' LENOEX: AODflESS: OWNEfl BWLUEP DECLABATION: I �ereUy allirm I�at t am exemp� imm I�e Coniractors' S1ate License Law lor Ihe lollowing reason (Seclmn 70J7.5 Business ana Pmlessional CoEe: Any city of tounty whfcn r¢Quire3 a permil to conslNc�, alter, impmve, aemolish, or repair any simclure. prior lo its issuance. also reduires ihe applicant lor such Detmit to file a signea stalement ihal nelshe is licensee pursuam to �he pmvisions of t�e Contracmrs' State License Law (Chapter 9 �commencing vnlh Section 7000) of Division 3 af t�e Business and P�o�eSAons Coae) or tAal he/s�e is eMempt Ihetelmm anOl�e basis �or ��e alleAeU eKemption. Any uiolaiion ol S¢c�ion 703L5 6y any applicant lor a Dermi� suble��s Ue applicani lo a civil Denally o� not more I�an five huntlre0 dollars (E500�. I. as owner ol �he Owpetly or my employe¢5 wi�� wap¢5 a5 Iheir Sole tampensalion, will do Ihe wOrk, anA Ihe ❑ s�mcwre is not inlen0etl or oilereG for sale (Sec�ion 7044, Business anE Pmlessional Catle: T�e Caniraciors' S�ate License Law 00¢5 nol appty lo an owner oI a pro0eny wtq bui145 or im0�ovu lhe�e0n, anE wh0 doe5 5uch wOfk him5ell/hersel� or IhmUgh Ai5 or her own employee5. D�ovitleU Iha� Suc� impmvemenls are no� intendetl or o��ered lOr Sale. II. howevef Ihe bUilOing or imo�ovemenli5 Soltl witnin one y¢ar ol completion.lne awner will have Ihe butEen ol proving Ae/sAe OiA not 6uiltl orimprove ' for ine Durpose ol salel. I, as owner o� Ihe prop¢hY. am ¢x[lu5iv¢Iy tonlrac�ing wiN licensed Conlratlor5lo tonslrut� ��e prolet� (Setlion 704E, Bu5ine55 ❑ anG Pmlessions Code: 7he Camracmrs' State license Law Goes nat apDN �o an ovmer of property wlw builUs or improves tAerean and wha ConVatls lor SUCh pmject5 wii� a tonlratlor(S�licens¢ pursuan�lo Ihe ConUaCtorS' S�ale License Law�. I am aware Ihal pmo� ol I�eir Worker'S Compen5aiion insurance 5�ou10 be provitleG lo me. � I am eaempi untler Section' 9. 8 P. C. for ��is reason: �aie: Ovmer I Oo hereby ceney Iha� I am aware of ane unaers�anU I�e reQuiremenis of Califomia Heali� ana Salery CoOe Sections 25505, 2553�, and 25534 antl �hal I or any INure �uilaing occuDani wilVwfll no� girG¢ one� nee0 to comply unih SaiG S�a�e cotle5 anU lhe reQuiremen�s lor a permil lor conslmclion or mo4Aica�ion Imm Ihe Av Ouali�y Managemen� Oistrict. ReSiAeniial consiruction applications are erempt Imm Ihese ptovisions. Date: ApplicanC I M1ereOy ceruly ��al I have read tAis ap0licalion antl state I�al l�e above fnlormalion is correcl. I agree �o comply wi�h all ci�y antl county oramances and sta�elavrsrelaiinglo OuilOingconslruciionantl �ereby aWMrize represen�atives ofth¢ pryto enteruponihe above�menlioned proper�y lor mspeclio�n}purpo5es. / Daie: 7/�S// J Signature: HL�'��eii"s9 oriver's License or Socia� Secunry n: 164La6 Whne-9uildlnq: Green—CoDe EntorcemenL Canary—Applicanl: Pink—Revenue; Goltlenrod—Assessor CITY OF COSTA MESA — BU7LD'ING PERMIT PERMIT NO: P 063006 PLAN CHECK NO; N �, t ; urr; � CONSTRUCTION TYPE; PERMIT TYPE; PLU PURPOSE; OTH �JOH DES'CkIPTION ; IN5'PALL ONE BACKFLOW PREVENTION PEVTCE SQ FT; CLAIM VALUE; CALC—VALUE; GROUP UCC; / COMMENTS: NO 'H' PERMIT INVOLVED. PLUMBING WORK ONLY, �*+�*��x��****��*�r�r*�*��r�*x��r**�***x**��rx�r*��r�*� x�*x***��*�x��***��x�x�rxx��rx*#�r� Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING -------- FRNT; FT IN REAR: FT IN FRN1': F'T IN REAR; FT ZN LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN PARRING REQ • PROV; PARCaL; 00000000 ZNE:; ftEF NO; PLANNING NOTES> i iE if if iE !E iE fE it if k it if if ik if it 3t ik iE iE k it it iE if it iE iE it it iE iE 1E 1E iF iE iE iF ik iP if iF iFiF iE tE iF.if.it iP itlf i(� iElf iE iE �lE �k iF iE iF if #-� iE :Y� 3E iE iE iF if� 1f i! iE i(� iE iE 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 k E M E N T S ZONING APPROVED BY DATE; BUILDING APPROVED HY ; �� DATE; APPLICATION ISSUED BY; - ��1� DATE• �3 t 1EiE1E3Eklf1E1FlFiFit'.fiFfFlFiliElfiEkifitif�Fii � � if�iiiF � e i! ..iF'fY.-...�if�A��. . x 1t7klElfiEiFlF9FikiE cfr !e te !E!f ��f�k1EkMlflEiEiEillEikiflfiFfEf(-ifkitiliFiflEifiEitltikifiF�fif�FiFiFitifilikiEiE�EN�i(�lE�/kjFiE �fEifitffiFitft�fitititiF�klkikifftkiElkikkkiFiF3E LEGALIZATION;N F E E S U M M A�!R V STRUCTURAL SEGMENT;N HLDG PMT PLUMBING ELECTAI-C MECHANIC FIRE SMIP/RES GRADING PERMIT PLAN %.0� �v 25R � '/ SMIP/NON—RES ISSUE FEE 20,00 ,± BUILDING—DIV—> PERMIT ISSUE PL'AI�i;CHECK TO'I'AL PAID DUE TO't'ALS----> 7,00 20,00 / ;; 0.00 27,00 27,00 ,00 N REVENUE DIVISION TOTALS--> COL'LECTED: 27.00 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRAiJING PLAN—CHECK 27.00 ;;. ik 1f !t if �IE 1E lE if iElE 1F 1E if iE if !E ff iE iE iE iE if iE it iP if�%1E iE 1F %� iF iE iE i4 iF iE �1E�lElE iE N� ih 1P it iF 1h �14 lE # iflF�lh�K� 1P M� W iE iF It iF K� W ih iF if 3F iE if• �E iF iE if ik �)f iE * ik �k Z N D I V I D U A li� i'F E E B R E A K D O W N � TYPE QTY D E S C R I P T I O�N'" UNIT COST TOTAL COST PLU 1 BACKFLOW PkEVENTERV.; �;, 7,00 7,00 END'OF FEES / �, r /i 01 0014?752-0014?752 T�7 T 27.OQ DATE: a7/13/93 ?ItfE: 14:35 CONSTRUCTION AND PIANNING APPROVALS Permit �;`-__t__� t, Temporary Electrical Serv�ce or.Po�e 2. Sod Pipe-Undrgmd. 3. Electrical Condu't Urt�!��Il�C�gnrJ. A. Electricai Condurt�UnC*q�uil. 5. Sted Rcinforc_m:nt 6. Fleancal UFER GmJ 7 FooUngs $, FoundatiOn -+-� 9. lYdter Pipa�Untirmnd. }Q. Structural Floor Svstem y �it. ProP�'�ty Sev:er Lin� �t. Ho��e Cnrrcct�o❑ 12. Se�ver Cap 13. Roat Did�,ns f 14. Rough Piumhing 15. Rough Eiettncdl-Contlu.: � 76. Rough Eleetric�V�nna }7. Roughl".'�r�.^gS�gn � 18. Rough Elea�ic3l-T B�� Ce1��c? T9. Ruu�h Hcat�n� & A,r Cord�.t�.e��.^.3 20. Rough Faetory Flrep�acu 2�. DLClS� IO $;� UCS.ifO 22.Oucts,Vcnti�atinp ___-� 23. Gas P�pz-Ro�gh & T�� 24. Roof Frami��n � 25. Foaf Sheatn�n� Y 26. T•Bar Ce�lina �Sb�;,-t:..�. C"�-.o:,�t POO. SPA I Date Inspector EyppROVAI.S Permi.'� I Date � Inspector 52. Pool & Equipment LocaUon � � i 53. Stecl Reinforcc:ncnt 54. Forn�s----�-- 55. Eler.trical Bond�ng 5G. Flo�gh Plurt6inp $ Pres�U�: T�St i � -- -'- ------+----- 57. APPROVAL TU CUVER�GUt:� � E � i - ----- ------ - t ----�--.. 58. Electnca; Co��du'*.l1rd�..•na. � i . - - - �-- ---'--�- -� 59. Ges Pipe, L7 Unw nroJ., ,-e5•. I , 6�J. 9ac!�w.:sh Lln� -., P�'rdP. ", C_a. -�� d--�-_rt-� �__ _ I '_ _f_-_______ ____' _y-.- . 67. APPROVAL TO UE CK j ' � 62. Bar:c:._�h & Rccc:.t.� 'u,.�� t-- - -� -- - � ------ --- -- --- -'- - � - 63. Heater & Ven1�Pi: a! � � I - -- i i----i G4. Pl�n�binq Systcm �-F �-�--- - I -�- -- -' 65. Electrical�F.nal � j -_ _ "T_._'-`-' _ -' 66. Solar Syswm-Fln:.' � � � - ---- - - - �--- - -- - 67 Fencing & Accc�ss Appru�:�i! � ' ------{..- -� --- 68. APPROVED FOF PLASTERISG , , 69. POOL/SPASYSTE":;SFINAL ' -1 -- - +---- FIRE DEPT.'iE:�UIPE(�.;E�.T ' . ; I APPFlOVALS Perm!t ': _ �{_. , +-- -- 70. l.ndcrqiountl H;_:io ` .� -_ 7 i Pro!:�c• P:pinG •, C.r. i O�.' _.--�--T- --�-r_ _ _ ____-___ --,� . _ _--� -- 72. Unciurgroun,i Flus^ - ------- - ----- - 7�. Lr.de:r.nd.5tri.;' - r , i; " G.,+ �� ^ i -_ !,-___'_____ . ... , _ ' _ __-�_.--_-,- _-_ r � 14. Ov� � hra-I HVdin � I --.� �____-____ __. -___-_-_ __�_.- _. +-..__ - _ /5. D•y Chem c.,� , � ---t-- - --1'- ----- - - ------ --'- -+ --- - -i - - 27. Prame and Fla;h,-�q - �� - � 7G. Dry St�nuf�i�•� i -� -- - --- - - -- - i---- -- - - - 28 !:�th:ng&Sdr� _ .-,___ �`____t__ _- i 77 ��X6D`Y°I ''�'AL -'�- � 29. Insulation _-�-_--. I -{-- 3D. D�vr:a!I N�ihnp + 31. Piaster Broc.n Coai � 1 --- ------ -�- - -i'_ 32. Electncal?o�:��'^�t��F��..'T ' J_- ----- -- - - i. 33. Final Electric � 34. F,n;l Neat�rtq �: F,i� C.^.i.t-:.:. 35. Fincl Gas Pipe.Tat: ------' - 36. H�od c� Car.opy � 37. F�nat Factorv F'rrp!ace 38. Pinal Pl�mb�ng � � � 39. VJater S.rvice-Pinat 40. Gas Service-Finat . 41. Sola� DomestioFir,al 42. Backflow Preventcr 43. Backftow Irngation 44. Landswpe Irnqauon Systcm 45. Sound Attcnuation 46. Handieap Regulat:ons 47, FINAL STRUCTURE & BUILDI;VC 48. FINALPLANiVI�G 49. Electric Rele:.se to Ed.son 50. Gas Release to Southern Catifornia Gas Ca 51. CERTiFICATE OF OCCUPANCY lo. Date _ I _ _ - -- - -�-- - I - -- i-�- 7E. FIHE PREV F�'�. t�. i ' --^-'�-r----- - -- - ' - - - - _. . . _ , }�I:ALT�:'�EPT. RE�UIP�E;.;.?.T --�-.'.- --- -- - ---' --- ---- - -- - - -- - ; 7�. FINAI I�,�.PECT.U'd - -- -i---t ------- - - -� - -- � -� - --, . I 97. FCODCERTIF;C..-l',i`.;UFD ' a- }`I -+- � . --'_ I I ' � I�GlLS:- +/�� . /a - _ _ � _ _ _ _ - _ . - -^�I' . - ! -/ / - ' yl_A!/%T� i� � p �s �� , �L:�.�S_.GNr-- 4.'l�CIiJ� � �O G�f��iY_.y./l_�I� --r t - -+ n - �- -- i � � - „ --r-- - �. �wi�Wif�7+L7',%�': � � CITY OF CC MFSA BUILDING SAF. . DIVISIO�iV POST . IN CONSPICUOUS PL� ON THE 106 NOTICE Yau must furnigh PE(iMIT'NUMBER and the JOB FOR EACH RESPECTIVE INSPECTION. CALL APPROVED PLANS SHALL BE ON JOB AT A - ( 3 �' � GROVPn - R .. BUILDING-AOGRE55 3/ g�S'�' � it�'c�Ja TRACT � �� LO � � NEW .� AUD HLTER � REPAIR h R 0 SE.TEACKS Fro.it Yd._ Side Yd. L � � . Side Yd. L _ CONS'i RUCTION .1ND PLANNING APPROVALS Permit# Il' NO. a; r. R __Rear R Rear . 1. Temporary Efect�ical Service or Pole 2. Soil Pipe�Undrgrnd. 3. Electrical Cpnduit Utiliry-Undrgrnd. 4. Electrical Cvnd�iit-Undrgrnd. 5. Steel ReirfOrcement S. Electrial UFE�i Gmd. 7. Footings _ � S. Foundation � 9. . Watar Pipe-Undrgmd. ' 10.' Strucural Floor SYstem � 11. Property Sev•er Line & House Cunnection 12. SeMvr CaP 12. �Roof Drains 14.� _Rough Plumbing � io. Rough Electrical-Conduit 16. Rougti Electric \Niring � � 17. Rough WirinS'�Sign 18. Rpugh Elecirica6T Bar Ceiling i9. 'Ro�.;gh Heating & F�ir Conditioning 20. Rough Faccory Fireplace 21. Ducts,in Structure . ' 22: Ducts, Ventilating 23. Gas Pipe-Rough & Test 24. 'Roof Framing � '25. Roof Sheathing - 26. T�Bar Ceiling (Structural) & Monocoat 27. Frame and Flashing 28. Lathing & Siding 29. �� Insulation � 30. Orywail Nailing � 31, P!�ster Brown at � CMF 0559-46. rav. 12/82 t �-- ' �) � 32. Electrir � 'ower Meter�Final y . 3S Final Elec[ric F 3h 3. 36. ESS . ' ;?]. 3a. F Date � I�spector 2-LI-4�7 � C (c0 � a-l6-e� I zr[o & Air Cor�itioning or Canopy � y-�y7 � c.s� 41. Solar pomestic-f•inal . 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations � 47. FINAL STRUCTURE & BUILDING 48. Special Requiremerits Completed POOL & S?A APPROVAI.S �Permit# _ 49. Pool & Equipment Location 50. Steel Reinforcemen[ � 51. Forms 52. Electrical Bonding 53. Rough Plumbing & Pressu�e Test 54. APPROVALTOCOVER-GUNITE 55. Electrical Conduit-Undrgrnd. 56. Gas Pipe, O Undrgrnd., Test 57. Backwash Lines, P-Trap, O Undrgrnd. 58. APPROVAL TO OECK 59. Backwash & Receptor-Final 60. Heater & Vent-Final 61. Plumbing System • Final . 62. Electrical-Final � ' 63. Solar $ystem-Final 64. Fencing & Access Approval � � 65. APPROVED FOR PLASTERING 66. POOL/SPA SYSTEMSFINAL FIRE DEPT. REQUIREMENT .APPROVALS Permit # 67. Underground HYdro 68. Product Piping L Gas� OOiI 69. Underground Flush , � - 70. Undergrnd. Storage Tank O Gas ❑ Oil ' 71. Overhead Hydro - � 72. Dry Chemical � 73. Dry Standpipe 74. FIXED SYSTEM F�NAL 75. FIRE PREV. FINAL Notes:� �...y ; Wq�Q� ��T Ol' .L� �Y i0/�A. _ A]i��.� i1.C, r /.5( / (see • . . 9 � - --- . , � �1i�¢.i✓ ) AVV��ant to flll In all spaees except ihose within neavY Doraar Iines ana sign a11 apv�oVrlate aeclarations. CI.TY OF COSTA MESA r1CON"( �SIT�jRUCTION PT.F�RMIT PERMJjLNO. �� TRACT NO. LOT NO. �UNIT t1(C3, Project Address 3lgCJ T"`I�Ui� . J�i t lE' � ,AnnlicanYs Mail'ing� A,�d•dress �� C� �LZ�- Owner's Name �n� 5--�� .N nl�L�hone Address 3l O �L'U: �y �L/ ) %�-� Arch/Eng. License No. Address �[ Con[ractor'S Nam i � S� �Z �%� hone ��7 Address (m�'�'�� % ✓�t-Z-�-- Ciry LicenseNo. �30 �� r � , LICENSED CONTRACTOR DECLAftAT10N ' I hereby allirm that I am licensetl uhtlar provislons ot Cnarter 9(commencing with settion ]0007 oi Diviston 3 of tha Husine antl,Professlons Cotle, antl � my license is in f farc ntl effect. f/� '- UC2lISC CId55 LC ��"�� ate��_ Si9nature 1 WORKEFS'COMPENSATIONDECIARATION � I hereby aHirm that I have a certititaGa ot wnsenc to zelfa re or a certinwta . of Workers' Compensatibn Insurance, or a c¢rtlfietl copy thereof ( tl n 3800, Lab. �.�� _/. �� / P�IG� Poiicy No. C c� / �r ' Company A CertifieC coOY is �ereby tutnished. Certiti tl c s filea with the clty B' � � 'i�;�i ate ��T'" Applicant ' ;'�:m%EMPTION FROM WORKERS' COMPENSATION �E A TION `��Thi55¢ction noed not be completetl if the permlt is Por one hu red ($100) o� less). I certity [ha[ in the' pertormanCO o( the wo�k fo� which Ihls perm�t is ISSuetl I shall not Bmploy any pe�son In any Tdnn¢r So a5 to become subjett t0 t�e '� Workers' Compensation Caws of CaIl�a�nia. Date SignaWre � NOTICE: If, alter making this�tleclaralion, you shoultl Decome sub�ett to the ' Worker5'"COmpenSatlOn prOviSiOns Of Ihe Lnbor COAe, you muSt brthwith� comply wilh suc� provisions o�'this permit Shall �be tleemed revOkeC. CONSTRUCTION LENDING HGENCY I heraby aHirm ihat tnere is a conztruclion lentling agency tor the performance of the work lor w�ich [his pOrT�t I5 ISSuatl (Section 3097 Civ. C.) �ontle�'s Name Lontler's AtlOress - � OVJNER BUILDEH OECLAR�ATION ' I horeby aHlrm thaf I am ¢zempt frOm th0 ConVacto�'S License Law for the fo�lowing reason (Sectlon 7031.5 Buslness antl Professional Cotlo: Any city or county whicn requires a permlt to cO�struct, alter improve, tlemollsn or rapalr any sbucture, prior to It5 ISSUdn<e, ?�so teqW/es II�e applicant to� Such Oa�mit lo flle a SlgnOtl 5(atGm¢n[ thal he/zlle I5 Ilcen50tl pufsuant to th8 prOVI510n5 Ot the CONractor's License Law (Chapter 9(commenUn9 wi[h Sectlon 7000) of Divliion 3 ot [be Business antl Pro�e551on5 Cotla) or fhat h0/ShC IS Ox�mDt Iher0lrOm an0 tne Dasis tor Lh¢ a1109otl exempNon. Any viOlalion ol SocHon 7031.5 by any dp0��<ant fOr d PP/mIt sub�ec[5 Ihe apP��ant (O d CIvII py-¢�nalry ol not mOr¢ [han five huntlratl tlollar5 (5500). LJ 1, a5 Ownar of Ihe plopelty Or Ty OmO�oye05 with wages a5 tholr SOIB compunsation, will tlo tha work, and the structure is not Intentic0 or ollcrotl fOr sala ($action 7044, Bus(ness a�tl PrOtlSSiOndl Cotle: The Contratto�'s � Icnnse Law aocs not aooW co an ow�er of a properry wno bulltls or Impmvez m0�oy ae5, provlOetl [hat suc� ImprOvamen[S are nOt intena¢a o� onerea �or sala. I1; hOwever, tne builtling or imProvement Is soltl wit�in ono year o/ com- pletlon, tne owner will have tna burtlen of proving he/she tlitl not bulltl or Im- prove for ihe purpose ot sal¢�. ❑ 1, a5 ownBr ot tM1e prOperty, am Cxcluslvely mntracting wilh IiGensetl con- tra<too to constru<t the project (Sad�on �044, Business antl Prolessions Cotla: Tha Contractor's License law does not app1Y To an owner of pro0erty who builtls ar Improves Ihereon, antl who <ontractS for Such prOjeclS wilh a Con- tractor�s ucenso purouant to �Ihe ConVactor's Licens¢ Law). I am awaro t�at prooi o� th¢ir Worker'S Campenzation InSuranGa s�oultl be provltletl t0 m¢. ❑ I am exempt untler Section B. 6 P. C. for tnis reason Date Owner I hereby certity tnaEi �ave reai intormaUon is corrrpt� I a9ree to ' Signature � � Drivers' Llcense or 55 ,'MF OB65-46, rev. 30/04 � TVPE OF CONSTRUCTION' . LJ NEW U ADD �LTERATIO F ❑ CONVERS�ON� ❑ DEMOLISH � OTHER DESCRIPTIONOF WORK/US OF BL ,'-,�c�r� ,�� -- TVPEOFPERMIT�( GRADING FOUNDATION STRVGTURAL ❑ TENANT JfSELECTRICAL ❑ PLUMBING ❑ MECHANICAL Q OTHER •PROJECT•DESCRIPTION Sp.FT. OCCUPANCV_ CONSTRUCTIONTVPE VALUATIONS • ZONE GRADING CU. VDS. ACRES_ Sink . kflow Preventer kflow Irrigation � rtubs . - ' ifiers rv.asher iking Fountains �r Orains GasService " Interceptors" Kimhen Sink Roof Reinspection Feo; Outlets 575 Boiler Dutt - Under Ground Duct - Structural Duct- Ventilating Exhaust System�❑ Multiple Firepl/Fact. Blt. ICBO;f`- Heating System & Ducting � ❑0.100,000 BTU 0100,000 � �� -- - — - I � - I ReinsPection Fea : Canary - qppllcant;-Pink - Accounting; Goltlenrotl - Aszessor Showers Service Sink SewerCap Sewer Connection � Solar Collectors , Solar Piping - Solar Tank Swimming Pool wlSpa Urinal Warer Goset � ' Water Heater Water Service AutO-WeSh Isue Fee Hoodor Typel ❑ CanoPY TVPe II .O Refrigeration System ❑o-ioo,aooeTu Oioo,000 System Repair/Alteraiion Fire Dampers Registers� - 0 C � � {��. # S Main Buildi E T Front B Rear A C Right K Left S Ping. Ref. # Planning Noces: Au[omatic Washer Canstruction Pole Su Cooking Unit � Dishwasher Dryers �Gas ❑EIE Fan � F.A.U. Fixtures Device Boxes � Outlets SwitChes Garbage Disposel Generator D0�5 KW� �a5u 2i��ie� Zone Accessory Building: Parking Req./Provided I ELECTRICAL ' Transformer ❑ 15-50 KW — ❑ 50+KW 5KW Meter LJup ro 100 amps Meter �over 100 amps Su6 Panel ' . Motors O0.1 HP � 1 X- 8 Inc. Solar 09-15 HP 016-75+ Microwave Pole light � Range Sign . Standing Sections • Trash Compactor g 3 ' Rainspection Fae 515 laue Fee FEES �DEVELOPMENTSERVICESRE�UIREMENTS: Zoning Approved By Building Approved By � �Aoulication Ittued Bv S15 � � Isua Fee . . E,3_ 85065 TL 2 O N I M G R E � M T � FEES 3 � i � SUMMARV OF FEES ' - � BUILDING PERMIT $ SMIP $ � PLAN CHECK �$ � ,-PERMIT PLUMBING ' $ -- ISSUANCE 5 PLAN CHECK 25% $� ENERGY P.C. S� ELECTRICAL . $ GRADING S_ PLAN CHECK 50% $_ a�,55 MICROFILM S MECHANICA�- $ TOTALFEE S � P.LAN CHECK 25% $ _ I _ CONSTRUCTION AND PLANNING ' POOL & SPA APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrica� Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test � 6. Electrical UFER Grnd. . 57. APPROVAL TO COVER-GUNITE 7. Footings � ' 58. Electrical Conduit-Undrgrnd. � 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-7rap, O llndrgrnd. 70. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing SYstem - Final � 14. Rough Plumbing ' 65. Electrical-Final 75. Rough Electrical-Conduit 66. Solar System-Final i 6. Rough Electric Wiring � � 67. Fencing & Access Approval � � � 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING .._ 18. Rough Electrical-T Bar Ceiling �3 � G 69. POOUSPA 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 77. Product Piping O Gas ❑ Oil • j. 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.StorageTank �Gas ❑Oil 25. Roof Sheathing 74. Overhead Hydro . 26. T-Bar Ceiling (Structuraq & Monocoat ' 75. Dry Chemical � , 27. Frameand Flashing 76. Dry Standpipe �,: 28. Lathing & Siding 77. FIXED SYSTEM FINAL I'; � 29. Insulation 78. FIRE PREV. FINAL L 30. Drywall Nailing HEALTH DEPT. REQUIREMENT • 31. Plaster Brown Coat �79. FINAL INSPECTION ' it L♦ 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: � � 34. Finai Heating & Air Conditioning - � 35. Final Gas Pipe-Test �N � 36. Hood or Canopy . ' ; .. .' 37:�Fina1 Factory Fireplace _ , " '` � 38tFinal Plumbing ,� �� . ` • � . 39.•Wa[er Service-Final . �. , ° • . � _ �40. Gas Service-Final � � � � � �� ' � , _� ei • . 41. Solar pomestic-Final �" ' f , : ^ ' +� /,. � �42. BackflowPreventer w.' �. `� ` .. �43..Backflow Irrigation � �� ' • � ' 44. Landscape•Irrigation System - � „ � . 45.'Sound Attenuation y, � � � ' 46.` Handicap Regulations • • ' �' �' ;' '� 47. FINALSTRUCTURE&BUILDING b (+. � �t' , 48: Special Requirements Completed _ ✓' - v w •. 49. Elec[ric Release to Edison �'� � . . •'� '., 50. Gas Release to Southern California Gas Ca % �� t 51. CERTIFICATE OF OCCUPANCY .� No. Date � • ' � � 87-03 ACP�icant to fill in all spaces exceD� those within M1eavy OorOer lines anE sign all appropriate Geclaralionz. CITY OF COSTA MESA CONSTRUCTION PERMIT PER IT NO. TRACT NO. � LOT NO. UNIT . ; ProjectAddress 3188 A� Wav l�ve. Ste. F �- � Appfcant'SMBilingAddfess �7�n r.aG $i1Sd5 TVPEOFCONSTRUCTION NEW ADD ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER p�p # ' Owner's Name _i�illIIt}1P�" Pri nti nq Phone DESCRIPTION OF WORK/USE OF BLDG. Address 31a8 AlYWdy� Ste.E S MainBuildin9: E Arch/Eng, LicenSe No. TYPE OF PERMIT ❑ GRADING FOUNDATION STRUCTURAL T FrOnt AAdf2s5 � � ❑ TENANT ❑ ELECTRICAL ❑ PLVMBING ❑ MECHANICAL B Rear Contractor's Nan�e Air Unlimited Pno„Q 632-531 ❑ OTHER A PROJECT DESCRIPTION 54. FT. OCCUPANCv C Righ[ ' " Addresslmailing) 1�2y3y�� yI+dS Brisas, Anaheim K CiLyLicenSeNo. �M�•uv�� 11060 CONSTRUCTIONTVPE VALUATION$ g Left ZONE GRADING CU. VOS. - ACRES p�n Ref. # IICENSED CONTRACTOR DECLARATION � 9' I nereby ai(irm Ihat I am licensetl untler provislons of Charter 9(commencing qemarks: • Planning Notes: wi[h sectlon 7000) of Divislon 3 oi the B siness antl Prof¢ssions Cotle, and my Iicense is In fu (o c antl effect. � . ,.�__._�,_.. �-�1�5 ,r ,:__�._�32i2935 Date �—��—o � Si9nature WORKERS' COMVENSATION DECLA� I 1 hereDy ailirm that I have a certificate ol cons i to self- sure or a certiticate of Workers' Compen5ation Insu�ance, o� a e ifietl cOpy th<reof (Se<tion 3800, Lab. G�1O713 State Fund Pnµolicy No. Company lA Certi'ietl Co�py is f cetlbwithrthehclty Buil � q OiviSio . `Date �—�"�� APPlican[ EXEMPTION FROM WORKERS' COMP N TIO CL ATION (Thissection neetl not be comp�etetl If the rmit i or one huntlretl (SI00) or less). I Certity that In the pe�fo�mance o( lhe wo�k Ich Ihis m�t is i55uetl, I shall not employ any Oerson in any mann¢ o �o c su{ �ect to WorkerL�Sa�on Laws of Calii rnia � �1 Da[e Si9nature � NOTICE: If, after making tnis declara[ion, sh tl ec ie subj ct to the Workers' Compeniatlon provis�ons of tne bor Otle, you must forthwith Comply with such provision5 or thi5 permit 5 all be tleCmetl �evoketl. CONSTRUCTION LENDING AGENCV I hereby affi�m that there is a Construction lentling ency (or the performance of lhe wo�k for which thi�petmii is issuetl (Section 3097 Civ. C.) Lentler's Name lJ1VL lentler's Atltlress OWNER BUILDEH OECIARATION 1 �ereby ai/irm that I am exempt lrom tne Contractor's License Law for the following r¢asOn (Set[lon ]031.5 Business antl Prot¢Ssional COtle: Any city or tOunty which requires a permit to con5truct; alter, improve, tlemolish or repair any structure, �prior ro its issuance, also requires tne aoP�icant ror sucn permit to file a signetl xtalement tM1at he/she Is IiCenS¢tl pur5udnt t0 the p�ovi5ion5 of the Con[ractor's �icense L, w(CM1apter 9_(commencing with Section 7000) of Division 3 of the Business antl Professions Gotle) or lha[ he/she is exempt lherefrom antl lhe basis for the alle9etl exemOtion. Any violatlon of Section �031.5 by any ap0�icant for a Permil subjects the applicant to a civil �enalty of not more Man tive hunaretl tlollars (S500j. I, as owner ol lhe 0/operlY or my amployee5 with wag¢5 as [hei� sole Compensation, will Eo the work, antl the st�ucture i5 not inlentled or oftcretl for sale ($ection ]044, Business and Protessional Cotle: The Contractor'S License Law Uo¢s not.apply to an own¢r Of a Droperty who builtls o� imp�oves ther¢on, antl wim tloes such work him5elf/he�self or througM1 his o� her own employees, provitletl that such improvements are not inteneetl or offeretl for sale. If, however, the builtlin9 or improvement I5 soltl within one:year of com- pletion, the owner wlll have the burtlen of proving he/she tlitl not builtl or im- prove for the purpose of 5ale). ❑ I, as owne� ot the property, am extlusively contraCting with IlcenSetl Con- tractorstd canstruct the project (Section 7044, Business antl Protezsions Cotla: The Contrattor's LitenSe Law does not 9PPIY to an owner Of Property who builds or improves tnereon, antl who conVacts for sucn oro7ects with a con- tractor(s) license pursuant co the Contractor's License Law). � am aware that proof of their Wo�ket's Compensation insu�ance Thoultl be Provitletl to me: ❑ I am exempl untler Section . B. & P. C. tor this reason Date I hereby cer[iiy tha information is tonec dOtl"Stdt¢ IdwS Illdlil SenldtiVeS Of Ih15 inspec[lon purpose Signature �Driverz' License o CMF 0865-46, rev. 30/B4 have reatl Ihis application antl state that the above a9ree to comply with all city an� county ortlinances o bviltling copstructlon, antl hereby authorize repre- to'� epjer uP�on tt�e above-mentioneA property tor PLUM8ING Sink � Showers <flow Preventer , Service Sink <flow Irrigation • Sewer Cap� itubs � ' Sewer Connection ifiers ' _ Solar Collectors Drinking Fountains Floor Drains Floor Sinks GasService Outlets Intercepmrs • Kitchen Sink Lavatories P,=Trap ' Roof Drains � Reinspection Fee $15 Boiler Duct- UnderGround Duct � $tructural Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact. Blt. ICBO # Heating System & Ducting 2 1�0.100,000 BTU 0100,000 Reinspeaion Fee Bulltling; Canary - qpplitant; Pink - Accounting; GoltlemOtl - Assessor $15 Solar Tank Urinal Water Closet Water Heater Water Service Auto-Wash Laundry Trays FEES Auromatic Washer Construction Pole Sub. Cooking Unit Dishwasher . Dryers OGas ❑Electric Fan w/SPa F.A.U. - . . � � Fix[ure5 DeviceBoxes • Outlets Switches ' Garbage Disposal ' Generamr �0-5 KW � I�sue Fee Hood or Typel '❑ Canopy Typell ❑ Refrigeration System ❑o-ioo,000sru ❑ioo,000eT System Repair/Alteretion Fire Dampers Registers Isue Fee $ 3 § 3 •�{i651 3/09/87 , t ' Zone Accessory Building: Parking Req./Provided � ' ELECTHICAL � Trans(ormer ❑ 15-50KW - ❑ 50+KW Meter ❑up to 100 amps Meter ❑over700amps Su6 Panel Motors OO-1 HP O1'/: - 8 Inc.'Solar 09�75 HP �1645+ Microwave' ' � Pole Light flange ��y� _ Standing Sections 5�15 KW . Trash Compactor Fee �$15 � � Issue Fae DEVELOPMENTSER 2oning Approved By— Building Approved By RE�UIREMENTS: 24025 TL FEES $ 3 2 O N i N G R E � M T S SUMMARV OFFEES BUILDING PERMIT $ SMIP $ ` PLAN CHECK $ � PERMIT P�UMBING . $� ISSUANCE �$ � PLAN CHECK 25% $ ENERGV P.C. '$ � ELECTRICAL § GFiADING $.� PLAN CHECK 50% S ��'j�� MICROFILM S� MECHANICAL $ � TOTA� FEE $ � PLAN CHECK 25% $ ' � , CONSTRUCTION ANq,PLANNING . FOOL & SPA � � APPROVALS Permit# Date Inspector AppROVALS Permit# Date Inspector 1._ Temporary Electrical Service or Pole 52. Pool & Equipment Location . 2. Soil Pipe-Undrgrnd. ' 53. Steel Reinforcement 3. Electrical Condui[ Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. � � 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test . - 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7.. Footings � 58. Electrical Conduit-Undrgmd. .8. Founda[ion •� • 59. Gas Pipe, � Undrgrnd., Test � 9.'Water Pipe-Undrgrnd. - 60. Backwash Lines, P-Trap, O Undrgmd. � 10. Structural Floor SYstem 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final . 12. Sewer Cap � 63. Heater & Vent-Final . 13. Roof Drains 64. Plumbing System - Final . 14. Rough Plumbing � 65. Electrical-Final 15. Rough 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 Struaure 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.Storage7ank OGas ❑Oil 25. Roof Sheathing � � , 74. Overhead,Hydio � . . " 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 Notes: 34. Final Heating & Air Conditioning �� f _ 35. Final Gas Pipe-Test � 36. Hood or Canopy 37. Final Factory Fireplace ' 38. Final Plumbing' � 39. Water Service-Final , . 40. Gas Service-Final � ' 41. Solar pomestic-Final . - .42. Backflow Preventer 43. Backflow Irrigation . . . 44, landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. �Special Requirements Completed . , 49. Electric Release to Edison • 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY - No. Date _ , • ` ' , � Applicanl lo fill in all ipaces exee0t lhose witnln heavy �ortler Iines anC si9n all ap0/oprlata Geclarations. CIrY oF COS7A MESnQ CONSTRUCTqI�O�N PERMIT Project Address ��p � �% �___C� v a # � ApPlicant's Mailing Address �/7 Owner'sName ��—�L �,��`Phone Address ��—h2 �[.JN'N�n�-n�Je '�'� ��i�'�"'� ' r Arch/Eng. License No. Address � � U Convacror's Nam GCX�%��(1LU��Phone �O Address Imailing) Ciry License No. LICENSED CONTRACTOR OECLARATION 1 her¢by allitm tna[ I am Ilcensetl untler provi5ion5 of Cnarter 9(commencing witn settion 7000) oi Olvision 3 of the Busineu antl Professlons Cotle, anA my license is in lull force ana eftect. License Class License No. Date Signature WORKERS' COMPENSATION DECLAFATION I hereby atfirm tM1at 1 nave a certiti<ata of consent to Seli-insura or a<ertificate of Workers' Compensation Insurance, or a certlfietl copy thereof (Se<tion 3800, Lab. C.) Policy No. Company eCerti/ietl cooY �s nereby fmnishetl. CerBfietl copy Is filetl with the city Bulltling Division. rt¢ APPlicant 'EMPTION FROM WORKERS' COMPENSATION UECLARATION Ihis section neetl not �u com0�etetl it the perml[ is for one huntlretl (E300) or I¢55). I certify that in Ihe petfo�mance of th0 wOrk fo� w h Ibl e�LnJt i5 iSSuetl, I snall not em loy ny oarson in any manner s e sub' ct to the Workers� p t' ws o/ California. � Oate Signa[ur¢ NOTICE: If, a er mak�ng this tleciaration, ecome sub7ect to the Workers' CompCnSation provisions Of the Ldbor CoaC, you mus[ forthwith comply with sucn proNsions or this permk shall be aeamea revoketl. CONSTRUCTION LENDING AGENCV i nareby atiirm that thern is a cpnstruction lentling agency tor the perrormance of [he wark for wnich tnis permit is issuetl (Section 309] Civ. C.) LentleYs Name LenOer'z AtltlreSs OWNER BUILDEH UECLARATION I hereDy affirm that I am exempt trom the Contractor's License Law tor the /ollowing reason (Section 7031.5 Buslnets and Professional Cotle: Any city or county whfch reQWrns a pe�mil lo Conitrucq dller, improve, tl¢mOlis� o� repair any Structu�e, priOt to I[S ISSuan<¢, also reqWres lhe applicanl 10/ Such permit t0 file a signetl zlatemint thdt he/slle 15 IlcenSBtl puriudnt to [be prOvisions ot Iha Contractor's Ucenze Law (Chapter 9(commencing witn Section 7000) ot Dlvtslon 3 0l the Bu5lness antl Professlons Cotlo) or tnat ne/she Is exempt Iherelrom ana the basis for the allegetl azempHon. Any vlolatlon ot Se<tlon 7031.5 �y any ap0��ant for a permit sub)ects tho aOPlicant to a civll �alty of not more tnan fivc huntlretl tlollars (E500). I, as owner ol tha propmty or my omployees with waget as lh¢ir sole compensation, will tlo tnu work, antl tno s[ructura I5 not InlanOetl or oiferetl for sale (Sectlon 7094, Bu51ne55 antl Protessional Cotla: The Con[ractor'S '�cense Law tloes nol apply to an ownar ot a property who bulltls or improves ereon, antl wno tloes such work himsetl/herseli or tnrougn hls or her own �plOyees, prOvltlCtl Ihat such improvements arG nOt inlontleU or olfe�etl tor ale. If, hOwever, tna builtling ar improvament is soltl wit�(n one year Of com- plpUOq the own¢r wlll have Me bu�tlen 01 P�ovin9 he/She tlltl not bui10 or im- prova for the purposo oi zale). ❑ I, as owner ol the property, am nxclusivoly contractin9 wlth Iicensed con- tfactors to con5truct tllo Projec[ (Sectlon 7044, Business antl PrOfe55iOns Cotle: The Contractor's License Law tloes not appty [o an owner oi property who builtls or improves thereon, antl who conVacts tor such projacts wlth a con- trdctor(51 I¢ense purouant to the Cont�actor's LlcenSe Law�. 1 am aware that proof of tneb Worker'S Compen5ation inSUrance shoultl bo provitletl [o me. �] I am exeg�pt untler 5ection—T�.B.l. G. C. for (his r¢ason Date Owner 1 �er certify tnat I have reatl n antl state tnat the above Infnrmatlon is mrrecL I aaree to comoiv with all titv antl countY Ortlinances inspet[ion purpases. / �/ Signature � Orivers' License or 55 $ _ 6 2� q 8 S I� 3z� ��7. I�� TVPE OFCONSTRUCTION NEW ADD ALTERATION REPAIR �O CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WOftK/USE OF BLDG. OFPERMIT LI GRADING LI FOUNDATION `L� STRVCTVRAL TENANT ❑ ELECTRICAL ❑ PL�IMBING ❑ Po�CHAdICAL� , VROJEC7 DESCRIP710N 5a. FT. - OCCUaAraCv. ,CONSTRUCTIONTVPE � �— VALVATION$_� �ZONE GRADING CU.VDS.� ACRES_ Remarks: 2_/ �� 1i �Q�G � IR,Jr �pf7 Z'� � � R l 1 . w/ �LLTi7/ !�%�✓l1 S 9%1 1 � Bar Sink Backflow Prevencer - � Back(low Irrigation Bathtubs Clarifiers Dishv.asher Orinking Fountains Floor DrainS Floor Sinks Gas Service Out�ets Interceptors Kitchen Sink Lavatories P—Trap Roof Orains Reinspaction Fea $15 Boiler Duct � Under Ground t- tructural Duc S Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. ICBO # Heating System & Ducting ❑ ai oo,000 aTu � i oo,000 sr Reinspection Fee �� b15 CMF 0865-46, rev. ]0/84 White - Builtling: Canary - AOP�IwnF; Pink - Accounting; GOItl¢nrotl - Asseisor $hOwers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping $olar k Pool w/Spa Urinal Water Closet Water Heater Water Service Auto�Wash laue Fee Hood or Type I ❑ Canopy Type I I ❑ Refri eration S stem 9 V ❑0-100,000 BTU C SVstem Repair� er Fire Da rs Ittue Fee ES $ 3 A.P. dk — 3 — S Main Building: E T Front A Rear C Right K Lef S Ping. Ref. �h Planning Notes: !L�(,C Automatic Washer Cons[ruction Pole Sub. Cooking Unit Dishwasher � Dryers OGas ❑Electric Fan F.A.U. Device Boxes Outlets Switcher Garbage Disp � 0 198-� 1 Parking Req./ProviUed ELECTRICAL Transformer ❑ 15�50 KW ❑ 50+K Meter ❑up to 70 amps Meler �ov OOampS Sub Pa ors �0-1 HP � 1'/, - 8 Inc.Solar �9-15 HP �16-75+ Microwave Pole Light � I I Stending Sections 0�5 KW 05�15 KW Trash Compactor FEES I Reinspection Fee I$15 I I laue Fee I S 3 DEVELOPMENTSERVICESREQUIR�MENTS: / r, Zoning Approved By �� Doto �� b Building Approved By Date A lication Issued B Dat PP Y SUMMARV OF FEES BUILDING PERMIT 5 �I •�� SMIP $ ' S 0 PLAN CHECK $ � �� PERMIT PLUMBING $ ISSUANCE 5 PLAN CHECK 25% $ ENEFGV P.C. $ EIECTRICAL $ GRADING $ PLAN CHECK 50% $ MICROFILM $ MECHANICAL S TOTALFEE $ Iq.4� PLAN CHECK 25% $ � Z O N I N G R E � M T S CONSTRUCTION AND PLANNING POOL & SPA 'APPROVALS Permit# Date Inspector qppROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soii Pipe-Undrgrnd. � 53. Steel Reinforcement 3. Electriral Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrica� Bonding 5. Steel Reinforcement - 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. ' 8. Foundation � 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgmd. 60. Backwash Lines, P-Trap, O Undrgmd. 10. Structural Floor System 61. APPROVAL TO DECK • 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final ' 12. Sewer Cap 63. Heater & Vent-Final - 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electricai-Conduit 66. Solar System-Final 16. Rough Electric Wiring - 67. Fencing & Access�Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Elearical-T Bar Ceiting 69. POOUSPA SYSTEMS FINAL , 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT i 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. UndergrounQ Hydro . 22. Ducts, Ventilating 77. Product Piping OGas ❑Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roo( Framing 73. Undergrnd. Storege 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 Nailin9 HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: � � 34. Final Heating & Air Conditioning � 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace ' 38. Final Plumbing . 39. Water Service-Final 40. Gas Service-Final 47. Solar pomestic-Final ' 42. Backflow Preventer 43. Backflow Irrigation 44. Landsrape 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 57. CERTIFICATE OF OCCUP�NCY No. Dat� � crrv oF cos`9�g�s , � Project Addres � Applicant"s M�ailin,9, �A�d�d.r,e�sys� Owner's Nart��.ylS!_!�2 IT Applicant to fill in all spaces exceD� ��ose wi�hin heavy bortler lines anE sign all aoo�opriate tleclarations. Arch/Eng. License No. Address s� Contractor's Nam / u�' �� hon Address (mailingl�� y�' /JU��GG �� G • City License No. 0`��xj � LICENSED CONTRACTOR DECLARATION � I bereby af(irm Ihat I am Iicensetl untler provislons of Charter 9(commencing j� with section 7000) of Oivision 3 of tho Business antl Professions Cotle, antl , my license is in i 1(orce antl eflec[. � �LJC2f15C 1 ss � Lice SC O Dat�� 7 519 t ' � it 6 WORKERS' COMPENSATION DECLARATION I nereby afiirm that I have a certifiWte of consenf to selt-insure or a certificate � of Workers' Compensation Insurance, or a certified copy thereof (Section � 3800, I..ab. C �j ? �-�i ^' ? ' ^ Policy No.�/��J CompanyT�`/��// �/ j B Certitietl copy is hereby (urnishe Certi ' Bletl with the tlty � in ivis'' .�// `ate� Applican Le1�/LiL iC PTION FROM WORKERS' COMPENSATION OECLARATION , fhis uction neeC not be completetl if the permil I5 for one huntlretl ($300) Or less). I t¢rtify that in lne Oerto�mance o1 t�e wo�k fo� whlch this perm�t iz i55u¢tl, 1 shall not employ any perSon in any manner so as to become 5u0ject to th¢ Workers' Compensation Laws oi California. Date Signature NOTICE: If, after making [his tleclaratlon, you shoultl become subject to the Wo�ker5' Com0en5aUon provi5ion5 ot [he Labo� Cotlo, y0u must forthwifh comply with Such O�ovisions or [his permit SM1all be tleeme0 �evoketl. CONSTRUCTION LENDING AGENCV 1 hereCy alfi�m Ihat tnere is a constructlon lentllnq ag¢nCy fo� the pertormdnCe of the work for which lhis permit is Issuetl (Sectlon 309� Civ. C.) LPnder's Name Lentler's HOtlre55 OWNER BUILpER �ECLARA710N I M1ereby a(flrm [hat 1 dm ezempt from the Gont�acto�'S License Law for the following reason (Sectlon 7031.5 Buslness antl Professional Cotle: Any city'or county which requi�es a pe�mll to conStvUct, aREr, improve, tlemoli5h or repair any sGvcture, prior lo its issuance, also requlres tne applicant for such permit t0 file a signetl Stdtement thdt he/she is IicenSetl pur5uant to [he provisions of the Contractor's License Law (Cnapter 9_(commencing with Section 7000) ot Division 3 of Ih¢ Business antl Professmns Cotlo) or that he/she is ex¢mp[ � therefrom antl tne Uasis for tho allegetl exemption. Any violation of Sectlon 7031.5 by any applicant for a permli sub�ects th¢ applicant m a civil �enalty of not more than five huntlretl tlollars (5500). . I, as owner of the property or my employees with wagez as their zole wmpensation, will tlo the work, antl the structure is not inienEetl or'offerea for w1e (Section 7044, Business antl Professional Cotle: The Contractor's ' icen5e law tloes not app1Y to an owner ot a,properry who builtls or improves eteon, antl who does sucb work himself/nerself ot [hrou9h his or her own nployee5, prOvitletl Ihat Such improvement5 are nOt Intentled of otf¢retl for ..ale. If, M1oweveq IhG bulltling or imprOvament i5 sola within One year o( mm- oletion, tne owner will have the burtlan oi oroving he/she tlitl not builtl or im- �rove tor the purpose of sala). I, a5 owne� of [he property, am excluSlvely Cont�acting witn litensetl con- trac[ors [o wnstruct the project (Sactlon 7044, Business antl Professions Cotle: The Contractor's License Law tloes mt apply to an owner oi property who builtls or'improves thereon, antl who contracts for such projects with a con- tractor(s) iicense pursuant ro the Contractor's Llcense �aw). 1 am aware that proof o( tlteir Worker'S Compensation insurance shoultl be provitletl to me. ❑ I am exempt untler Section B. & P. C. for Ihis reason ,\ oate I he info� Signatu Drivers' Owner � that l have reatl tnis application antl state that tne above errect. I a9ree [o comply wi[n all city antl county ortlinances� ¢la[ing to builtling COnSt�uCtlOn, aptl hereDy aufhorize �epre- d� t�r n the above-meniionetl pro erty�Por � ,Data � Ql or 55 if �'�' � 0865-46, rev. 10/ 4 White TVPE OF CONSTRUCTION LJ NEW U ADD L�ALTERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER Dfc�9 , �PTI �, Fy �E OF BLDG. � �iC/�K�� TVPE OF PERMIT GRADING FOUNDATION STRUCTURAL ❑ TENANT ❑ ELF_CTRICAL ❑ PLVMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION 5(l. FT. oCCUPANCv � CON STRUCTION TVPE VALUATION $ _ ZONE CoRADING CU.VDS. ACRES_ qemarki: J, 3ackflow Preventer 3ackflow Irrigation � 3athtubs Clarifiers Jishwaiher Jrinking Fountains 'rloor Oreins . ' Floor Sinks 3asService 50utlets Interceptors Kitchen Sink __ Lavarories � P—Trap Roof Drains Reinspection Fee $15 Boiler Duct- Under Ground Duct-StruCtural � Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. ICBO # Heating System & Ducting ❑ 0-100,000 BTU O 100,000 BTI Hainspaction Fee I $15 ; Canary - Appp�ant; Pink - Accountlnq; Goltlenrotl - A55essor Service Sink Sewer Cap Sewer Connection Solar Collecmrs Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Hearer Water Service AUSO-W35I1 Laundry Trays Issue Fee Hoodor Typel ❑ Canopy Type I I ❑ Refrigeretion System ❑6100,OOOBTU ❑100,000 System Repair/Alteration Fire Dampers Registers � luue Fee $ 3 FEES $ 3 A.P. qW S Main Building: E T Front B Rear A C Right g Left Ping. Ref. # Planning Notes: Auromatic Washer , Construction.Pole$ub. Cooking Unit Dishwasher �_ Dryers �Gas ❑Elec1 Fan , F.A.U. Fixtures ' Device Boxes Outlets Garbage:Disposal Generator �0.5 KW Fee 1580 2/02/87 Zone Accessory BuilAing: Parking Req./Provided ELECTRICAL � Transformer ❑ 15-50 KW O 50+KW Meter ❑up to 100 amps Meter �over 100 amps Sub Panel Motors �0-1 HP � 1 h- 8 Inc.Solar 09-75 HP �16�15+ Microwave Pole Light Range ' �Bo63 .TL FEES Standing Sections �� 5-15 KW Trash Compactor , i� $15 Issue Fea $ 3 DEVELOPMENT SERVICES REQUIREMENTS: 2oning Approved By Building Approved By Appliration laued By Z O N I N G R E Q M T S SUMMARV OF FEES - BUILDING PERMIT $ SMIP �5 PLAN CHECK S PEfiMIT PLUMBING . $ ��UANCE $ PViN CHECK 25% $ � ENERGV P.C. $ ELECTRICAL S GRADING $ PLAN CHECK 50% $ MICROFILM § MECHANICAL $ TOTAL FEE $ �� PLAN CHECK � 25% $ ' \ , � CONSTRUCTION AND PLANNING ' POOL & SPA / APPROVALS Permit# Date Inspector �AppROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location ' 2. Soil Pipe-Undigrnd. z-t�tS�J �,�0 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms • 4. Electrical Conduit-Undrgrnd. 55. E�ectrical Bonding . 5. Steel Reinforcement . � 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings ' 58. Efectrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe�Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System 67. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. .Backwash & Receptor-Final 12. Sewer Cap � 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. RoughPlumbing � Z��7(�� 65. Electrical-Final 15. Rough Electrical-Conduit � 66. Solar System-Final i 6. Rough Electric Wiring '� 67. Fencing & Access Approval 17. Rough Wiring Sign '� -' ` 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling � 69. POOL/SPA SYST.EMS FINAL 19: Rough Heating & Air Conditioning � FIRE DEPT. REQUIREMENT .�� 20. Rough Factory F.ireplace APPROVALS Permit # � _ 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping � Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.StorageTank �Gas ❑Oil 25. Roof Sheathing � 74. Overhead Hydro 26. T-Bar Ceiling (Structuraq & Monocoat 75. Dry Chemical � � 27. Frame and Flashing , 76. Ory Standpipe �r' ' 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 � Notes:j,-y_y7 wyZ.s(k � ur,,•,r cvt. �o ' 34. Final Heating & Air Conditioning ,�,�_�J�_ �r�q. �.,� . � � 35. Final Gas Pipe-Test' l�-{�fY% •(�fj . 36. Hood or Canopy . 37. Final Factory Fireplace � 38. Final Plumbing � f�-(�-�f [�p � 39. Water Service-Final • � • 40. Gas Service-Final . ' 41. Solar pomestic-Final _ ' ,� � 42. Backflow Preventer � - � 43. Backflow Irrigation - , ' 44. Landscape Irrigation System . I 45. Sound Attenuation � - � ', i 46. Fiandicap Regulations � ,i� 47. FINALSTRUCTURE&BUILDING - � . �. 48.�Special Requirements.Completed , ' •', ' ' ' � 49., Electric Release to Edison - ' - ° . � 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY - ' i No. Data I` - _ I/ � I � ' . AVD��ant to fii� In all soaces excev� ihose witnin neavy Doraer Iines antl sign all avvropriate tleelarations. citY OF GA$TA naEsa CONSTRUCTION PERMIT; PERMIT NO. TRACT NO. LOT NO UNIT NO . 3EOoS'S . I �_ �i ,:.� .� a 8 i 1399 I/30/07 ' Proj2ctAddress 3��F' �tlo� .-%�QWi¢�� . , � � ' ' . Appiicant�s Mailing Address �_3�SS �' A��ay �� ,TYPE OF CONSTR CTION NEW ADD L RATION REPAIR . � CONVERS�ON ❑ DEMOLISH � OTHER 0'wner's Nru�+ye. �V��yEZ�O=U�+'��.L�oi%E�OE,Q. DESCRIPTION O WORK/USE OF BLDG. ¢'x� 5 i�!/��1 A P� �� Z��e � AAd:ess' ^I�✓�• 55�'3G6d � ��Q,,,� p'��C� � � S MainBuilding: Acces � B ilding: Arch/Eng. ��'� �Z License No. a�y3 , TVPE OF PERMIT RApING FOVrvDATiOnI 7RUCTURa� � T Front . p AAdress �2g�� V��'�'/� W'�y NrPaz7 dc.r' ❑ TENANT' ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICA� , B Rea� N ❑ OTHER A � Contractor's Name—O�N62. flv0�, ' Phone pROJECT DESCRIPTION 5. FT. oCCVPaNCV C� Right ' � N Addfe55�mailing) '�/ CONSTRUCTIONTYPE �� VAlUAT10N$��/�� g Left' � ' G City�License No. � � i R LICENSED CONTRACTOR DECLARATION •"" � � ZONE CRl1DING CV.�'O5. ACRE$ P�ny. R¢f. {� Pe�king R¢q./P�Ovid2d E I hereby affi�m that I am licensetl untl¢r provisions ot Charter 9(cOmmendng f Remarks: ' '# � ' - � PIBnnIOy NOtCS�: M with section 7000).of Division 3 of [he Business antl Professions Cotle, antl � L:-i)� � T my license is in full tOrce antl Gttect..' � . ' ' ' ` ' ' License Qass '� License No: ' �� . S Date Signature ' � PLUMBING '� =:FEES ' ' WORKERS'COMPENSATIONDECLARATION Ba�Sink " •Showef5 ' � ' " ' 1 hereby aftirm tnat I have a certificSte nf consent to selNnsure or'a certificate � � ELECTRICAL � , . �ES of Workers' Compensa[ion Insurance, o�. a certifietl�copy ihe�eot (Section ' . , — �, , � � Backflow Preventer . Service Sink 3Boo, i.ab. C.) � � ' � C " Automatic Washer � � Trensformer` � 15-50 KW . � Poiicy No. Company eackflow Irrigation . SewemCa � - � � '� SO+KW� ' 8 Certified copy is.hereby �umishetlC . - P Conitruction Pole�Sub: . � � Ce�tifietl copy i5�fil¢C with tne city Builtling Division.'�� , Bdthtub5� Sew¢� C0�02CIiOn I' i Oate Applicant ' ` Cooking UniT � , Meter Dup to 100 ps - EMFTION FROM W00.KER5' dOMPENSATION DECLARATION � Clarifi¢rs ' ' ' Solar Collectofs � Di5hwa5her �- , • Meter �over 0 amps • ssection nee0 not be completeE it the'permit is for one huntlretl (5300) or ' " ' ' ,�, i _�' . � , . , Dishwasher--, . Solar Piping � Dryers ❑Gas ,DElectric Sub Pan - � I certity thal in the� performance ot tbe work for which tqi5 p¢rmR'i5 i55uetl; I � . _ . , • ' '' shall not ploy ny p¢rsOn in any manne� to betome sutiject to the , Drinking Fountains � Solar Tan . � Fan ' ' M rs �0.1 HP �1X - 8- Workers �e�ay Laws ot CalifOmi� ' , Date �f1/12�_Signature • �D/^�ij� � ' FloorDrains Swim mg Pool w/Spa � � F.A.U. ' " NpTICE: If, after making thiz tleclaration,.you.shoultl become suDject to tna . Inc.Solar 09-15 HP 016-15+ Workers' Compensation- pwvi5ions o( the Ldbor COtla, you must forthwith ' FI00� SinkS ' �ndl FixLu�25 � comply wilh such O�ovi5ion5 or. this Oe�mit shall be tleem¢tl revOketl. MiC�oWdv¢, CONSTRUCTION LENDING AGENCV ' � Gd55ErviC¢ .Outl¢ti Wdt¢fC105¢t DeviceBoxes ' I he�eby alfirm that ftier¢ is a Consiruction lentling agency to� the perfo�mance PoIE Light .. � of the work fOr which this permit is Issuetl (SeC[ion 309] Civ. C.) Interceptors Water Heater Outlets Fan e ' LenCer's Name � 9 Lenaer's Aadress � . Kitchen Sink Water Service . . � - Switches - — Si n � ' - OWNER BUILOER OECLARATION 9 I hareby SRirm [hat I am exempt from the ConVactor's Licenze Law for the Lavatories Auto-Wash � , (ollowin9 reason (Section.7031.5 Business antl Protessional Cotle: Any dty or � Garbage Disp I . Standing Sections county wnicn requires'a permit to construct, alter, imorove, tlemolish or repalr P—Trap �' . Laundry Trays ' ' Generet 0-5 KW �5�15 KW � any slruCture, prio� [o Its Issuance, also �eQW�es the applicant fo� such Oe�mlt . T/d5h CORIpdCtO� to fi�e a signetl statement thal he/she is li<ensetl pursuant to the provisions of RoOf Drain ' ' the Contraclor's Li<ense l.aw (Chapter 9(commoncing witn Section 7000) of "' " i . ' Division 3 of tha-Business and ProlCzsion5 COUe) or tha[-he/she is ezempt - . _ ,._ . . theretrom antl th¢ baSis fOr [hG allegeC exemplion. Any violation ot SocOon . ' � � - , � �031.5 by any applicant for a�Dermit subje<ts the appliwnt to a civil , eenalty o1 not more than five huntlretl tlollars (E500). ' . i . , r ' , � Ll I, as ownor of the property or my emv�oyees with wages as their sole einspeetion Fee $15 ��ue Fee $ 3 ' ' compensation„will tlo lhe work, antl the structure 15 not intentletl or offeretl Reinspection Fee �$15 ISsue Fee � � $ 3 . for sale (Settion 7044, Business antl Protessional Cotle: The Contractor's ' . MECHANICAL FEES License L.aw tloes not"applY to an owner of a property who builtls or Improves «>reon, ana wno tloes 5ucn work nimsoif/nerselt or tnrcnigh hiz or her own .DEVELOPMENT SERVICE$ FEQUIREMENT ', , �loyees, provitletl mat such improvements are not Intenaea or otterea mr � Boiler ' Hood or Type I ❑ ��J � �. �•� If, however, the builtlin9 or improvemant is zoltl withln one year oi com- C2nopy Type 11 ❑ ' .2oning Appraved By Date I9� , the owner will have the bu�tlen ot provin9 he/she tlitl not builtl�Or Im- DUGt - Und2� Ci�OUnd BUiiding App�aved By Date prqYB tor[he purpose o1Sal¢). , .,%� i� I, as owner of the o�oDerty, am exclusively <ontractin9 with ncenseE con- Duct - Structural Refrigeretion Syste �Appliwtion Issued 6y Dat �'� tractorsto constructthe project (Section ]044, Business antl Protessions Cotle: � � The COntrattOr's License Law does not apply to an owner ot property who Duct - Ventilating ❑0.100,000 ❑100,000 BTU ' '� SUMMARV OF FEES ' � � � builtls or imp�oves lhereon, antl wno conf�acts to� suCh proj¢cts with a cOn- � � tractor(sI ncense pursuant to tne Contractor's License law). I aEn aware that - ' ' ' ' BUIL'DING PERMIT $� 367.C7D� SMIP $ ��.06 proof of their Worker's Compenwtion insurance shoultl be provitletl to me. Exhaus[ System ❑ MWtiple ❑ Syste epair/Alteration ❑ I am ezempt untler Section �. & P.'C. for tnis reason FirepVFact Blt. ICBO # ire Dampers . ��• P�N CHECK $��.� PEFMIT � PLUMBING .. $ - ��UANCE � $ � naea 1 �'3 0 .GG Heating System-& Ducting • Fegisters .._ - � PLAN CHECK 25% $� ENERGV P.C. $ � I hereby certity that I have reatl Ihis aoo �ca ion antl state tnaf the aGove' 00.100,000 BTU 0100 BT ' GRADING $ intormation is mrrect. 1 agree to comob with all Uty antl county ortlinanres ' ELECTRICAL � $� , antl state laws relating to builtlin9 constructlon, antl hereby aut�orize repre- . � • ' , PLAN CHECK � 50% $ MICfiOFILM $ sentatives of thi5 aty ter LpOn, the dbove-mentioned prop rt�y' /fp�.�- '' > �� inspection purposes. � � _yl n , oate /�C-/L',7 ' ' � MECHANICAL � $ TOTAL FEE $ � Signature I7`'Cl�Pl E � Drivers' License or 55 � Reins -$15 Issue Fee � $ 3 PLAN CHECK �25% �$ =MF 0865-46, rev. 30/B4 White - Bulitlin9; Canary - qpplicanp Pink - Accountinq; Goltlenrotl - Assessor CONSTRUCTION AND PLANNING POOL & SPA APPROVALS Permit# Date Inspector AppROVALS Permit# Date Inspector 1. Temporary Electrical Service.or Pole 52. Pool & Equipment Location 2. Soil Pipe�Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility�Undrgrnd. 54. Forms 4. Electrical Conduit-Undr9rnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK _ 17. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 72. Sewer Cap 63. Heater & Vent-Final 13. Roof Dreins 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final � 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOUSPA 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 3! �"J 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 b� HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Elearic Notes: �/p j ` 34. Finai Heating & Air Conditioning �� ,�� 35. Final Gas Pipe-Test � � 36. Hood or Canopy Z a 37. Final Factory Fireplace ' 38. Final Plumbing � / !�(/ 39. Water Service-Final ' . + 40. Gas Service-Final ' • • 41. Solar pomestic-Final � . 42. Backflow Preventer , . � � 43. Backflow Irrigation � � '. . ; .' 44. Landscape Irripation System �,lf , � 45. Sound Attenuation , � .. , 46. Handicap Regulations . _ 47. FINALSTRUCTURE & BUILDING • � � 48. Special Requirements Completed 49. Electric Release to Edison .; ;� � 50. Gas Release to Southern Califomia Gas Co '�� 1 57. CERTIFICATE OF OCC'� `NCY .' '� j � No. Da._ � � . �"� 40033 ' ' ' GOSTA MESA BUILDINGSAfETY DEPARTMENT ' P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fi!! in Completely BUILDING •2I I1 F��1 i��A.� A�� ADDRESS J CJ OWNEF II � �II I.�E C�lJ •("') ' ADORESS 2`ZZ C�-'mpUS ✓� . Z ? aU ci7v y�.VIIJE Z2 Q CAN5TFUCTION �r� O � LENDER 6. m J � BRANCH ' '— J N m J ADDRESS — m ARCHITECT J a OR EN INEER ��M U N ) ��J W 2 ADDRESS L.�.� j'LAZ. aw J O CONTRACTOR (JN mZ 90 'p J � ADDFESS W {y� �= c�Tv �E o — ZF — O STATE � o ��. No. 22 l �6 SIZE OF �OT '�' USE OF E%ISfING BIDG. TEL NO. CITY LIC. NO. �S NO.OF BIDGS. NOW ON LOT LI l RE n.. o. � BUILDING �ADORESS a�-f; TqACi OWNER US� FIflE 20NE APPROVED BY Z E N Pi VARDS APPf MAIN BUIL (FROM GL STR �ir. Pa:O � i;%t's{; Z ,.v2�-75�,;«ODiois 5,.30 Z NEW BLOG. �� DOp � ROOMS � STORIES I L. SIDE F a EXTERIOR WALL ROOF Q U COVERING �NC' COVERING ✓V�I U FEAR FT. J� USE OF BUILDING AND WORK TO BE PERFORMED p�{ANCE BET. 0. MAIN BLOGS. � � h�175��1A � I G� � I �1 �2�'10 C.V.P.aW (A ��'N r��i�l� � �A� � (i APPROVED � O UI horeby acknowladBe the[ I hava raad tAis epplitetion anE stata +� the[ the obove Informe[ion le cOrract entl ey�ee to comply wlth � a�l laws repuleHnp builtlinB conctruction, antl I shall not emp�oy r any porson In violation of tha workmen's compenfation lewe of N tha Smte of Californie. � I hareby carNfy r�ai I am proparly licansetl a� a contreetor untler SQ. FT. tha Stata of CalNornle Buaineas entl Professlo Cotle, Dlvlsicn 3, TNE AMOUNT S/ Chapter 9, end t�at aue e a r full o a antl affxt, or I TNE PURPOSE OF em axompt fro tha s n t S e[e f alifornla Busineas ontlProf¢as(ons o' s n p[r9. VALVATION SIB�eture of ' � PBrmltte9 § � I%, D � �. Autnorizatl Apent ��V� `, � . �y�G- FOR BUILDING PERMIT � VALUE �f-��V $ V(� � GROUP F�'/ �/ DATE .7��1 _I � DF N ! JI 4ROS APPROVEO DATE � O � �`� '1 • � � UNDER VALUATION IS FOR ' LISHING A PERMIT FEE ONLY: Q 32= m RMrt FEE $ � �/� ] 4N CMECK $ ��/ �� E p-7� o` O — '� TAL FEE $ � , COSTA MESA BUILDING-SAFETY DEPARTMENT , P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 Far Applicant to Fill in Completely o�„� .,�,.��_.... -•-. � .. ... 2 . wW aV 2 ZQ Oy am J7 J � ¢w Q] J J m Q U N Za W � aw W Z J Q m Z J � w w 0 ZH � N Q �O � z Q U J a a Q O F y Z O F- U � � F N Z OWNER j(Qj�]�%II.]}' ADDRESS 3190 A Airn arv COSt3 MESd CONSTRoUCf10N IYV1Ile C BRANCH ADDF ESS ADDRE55 44 P1 CONTRACTOfl �j] ADDRESS 190�, [�' CITV [�]�J�� uc ko. 221764 SIZE OF LOT SIZE OF NO. OF DL'].V(' No`.929-9205 [�1 � fornya rT,o`.' 833•. CITV LIC. NO. 1�]� INO. OF BLDGS. NOW ON LOT WA y��..� ROOF G ��• '�"'t'• COVERING �1� UIIDING AND WORK TO BE PERFORMED I hareby acknowletlBe thac I have reatl this appllcation and stata [hat the above Informo[ion Is corract antl apree to comply with ull laws repuloHnB builtlinB consttuction, and I shall not employ any peraon in violation of Me workman's compansetion laws o! ffi8 Sta[e of Caiifomk. I hereby cerUty [het I am pro0arly licansed es a convactor under the State of Californie Busineu antl Professiona Cotla, Dlvisicn 3, Chapter 9, ontl thet s�c� licansaz are In lull forca entl etfeet, ar I am ezempt /rom the p oWs7ons of ihaStnte of CaHforNa Businep antl Profeasions Cotla ivision 3, ter Sipneture f _ p Permittea �� AuMor(zatl Apant A.P. NO. i 8V ILDING ADORESS �� -2-7yaa,u ..;:t� cr��•00 7_0?_�` 161.`;9 FOR BUILDING PERMIT L G Z�di.vE �I�/A� �I�9. VALU$ ,/ZDAO TV E GROUP � DATE V -` ZONE�� NO.OF P�qN$ YqqOSAPPROVE MAIN BUILDlNG (PFOM GL STREET) USE OF NEWZ'N 4J7 BUILDING YARDSAPGR VED VAR. W+ DATE c.u.v.swZ�E�7�-�2/ APPROVED�.Z nwaoveo i, 4!'1 P•� z�. THEAMOUNTSH THE PURPOSE OF VALUATION � $ ,32�YIo U � � � �O ^. I FOR � V� �NLY: Q � ry V � ] m ` -I E \ , o - LL . • AVP��anl to fill In all ipacas wit�ln �lavy Do�Ce� lines antl sign all appropriate Eeclaralions. CITY OF COSTA MESA PERMIT NO. � TRACT NO. - LOT NO. BCDG. NO. '�ON8TRUCTION PERMIT �',S ' ' Prolect Address 31 g�' F �QW �i ��L�— �� TVPE OF C�O/NSTRUCTION OwnerELRo • PRomc�L�'S GO PhOne,;�/ -�� ❑ NEW QQADD � ALTERATION Addless3� pj8`�F 4 /:�\(ZWg /��Qf� - ' �� ❑ REPAIR L�"CONYERSION .�DEMOLISH ArchlEng. ' - � - License No. ❑ OTHER Addre55 " ' � - � . _ DESCRIPTIO -OF WORK S OO / Convactor ' - Phone � TYPE OF PERMI7 �' '- Address " " ❑ GRADING" ' ❑ FpUN�ATION �,STRUCTVRA� LICENSEO'CONTRACTOR DECLARATION ❑ TENANT O ELECTRIGAL �PLUMBING� ❑MECHAI 1 hereby afflrm Nat I ar� Iitansetl untler provislons of Charter 9(com- � , � � mancing wlth sectlon 7000) of Divlslon 3 0/ the Buiinass anA ❑ OTHER , ai,a��in, �u.�2 :TL �, � � ZONING . PLNG. REF. � ' , Protesslons Cotle; anC my Ilcense is In tull lor� antl a/fect. REAR VARD (TO P/L) " - ' Litenso Class � License No, ' Pp��ECT DESCRIPTION � � -' PKG.SPACEREO. PROVIDED Date Sl9nature � 5�. FT. • ' WORKERS' COMPENSATION DECLARATION � OCCUPANCV' CONSTRUCTION TYPE STqEET WIDTH PARK F.EE § I hereby aHirm thal I Aave a certlliwte of consent [0 selt-Insure or a VALVHTION�n7� ZONE Z�NING APPROVED BV DATE - cerlifiwte of'Workeri' Compen5ation Insurance, or a certifleC copy - SPECIALCON�ITIONS: " thereof �Sectlon 3800, Lab. C.). � GRADING CU. YDS. ACRES Pollty No. �ompany ' " ' - ' � � � 0-Certlfietl copy is h<r¢by fuml5tietl. � � . . _ � REMARKS: _ - . ._ . n Curtlfletl copy is ftlea w.��h the Nty Build7ng Dlvision. , /�/ � , 'MFTION FROM WbRKERS; COMPENSATION DECLARATION . ' DY' [ ' s se<tlon neetl� not 4e.completetl if the.permit is for one huntlrea -' • (D100� Of I¢551. � � � - " . I cert fy that ln the pe�fp��nce Of the wo�k tOr which tni5 p¢rmit is . issuetl, I ihall not�emPlpy any person in any manner so as to become � PLUMBING PLAN CHECK ' " ELECTRICAL' "' ' PCAN CHECK �- - suDject lo the Workers Gpmpensatlon Lawi ol Callfornia. _ . ,. _ Dat¢ $ignalure BATHTUBS � SHOWERS ' " " - ' ' �. NOTICE: 11 after making [his OeclaraUon, you shoultl becoma'subjoct TOILETS URINACS '' -- GENERATOR- � 0•I KW_ 1'40 KW - - ' to the Workars' Compen�tion provision5 of the labor Cotle, you must - � TRqNSFORMER . , .. . for[hwith comply with such provisions or this permit shall be deemetl LAVATORIES DOVBLE L'AVS APPLIANCE- � 10-50 KW_50 + KW �revOketl. • . . . '- " ' ' ' ' � CONSTRUCTIONLENOINGAGENCV � ' � KIT.SINKS - DISHWASHERS" ' '' MOTORS -- -O-YHP_1d0HG - ' 1 heroby afflrm tha[ the�e is a construclion Ientling agenty for tne per- SERV ICE SINKS'-' SU - . UN4 SOLAR) __ �0-SO�NP 50 + NP � ' ' . formance at th0 wOrk fpr whlCh thls permit is issu¢tl ($ection 309] � CIv.�CJ. ' ' ' ' , r" - \ ' , F IN FI%TURES �OUTLETS SWITCMES� � -� Lentler'S Namo �"��' " •-. ., Lantler's Atltlrezs ' � � - � R 1 OU � 5` �'s - GASTUBESIGNS � - '�- - OWNER BUILDER DECLARATION ' ' "-" ' -' ' T R �R I POLE'LIGHTS � - ^ � - -- ' � � I nerobY al/irm inat I am exempt from tna Contracror'S License Law fo � the lollowing roason (Seotion 7031.5 Buslness and�GrofeSsions�CoOe G TR P LES - �� METERED "-SUB� ' � Any_ tlty or county w�ich reQulres a permit to tonstruct, alter, 'improve, tlemolish or repair any structure, prior to I[s Issuance,-also re- ER SERV E ALT RA �iION ANELS' �-� MAIN -��SUB -- quires lhe applican[ IOr such pe�mit l0 flle a Signetl StatGment tbat h0 'Vs liconsetl pursuant to lpe'provi5ionsol lbe Contractor's-license'Law G SSERVIC CE SERVICE ••- - 1� � -� AMP� . (C�apter 9(COmmencing with SeGtbn ]000) of Division 3 Of th! _ Bu57nes5 antl RofMziOns �ptle) o� ihat h¢ is exom0� tqerefrom'antl t�e H -r� � basls for the allegetl exemption. Any violatlon of Sec[ion 7031.5 by . . any'appllwnt tor a permit'suD�ects'tne"applicant to a civil-penalty CTIONS" ' " �-" " "" ' ' ' ' ' - ' ' " --- � of not more than five nuntlretl tlollars (E500). �' ' ds owner Ot the p�operty, or my employee5 with wa9es as their $OL'AR TANK" '-' " COCCECTORS,' �' � � " " - - - ' ' ^ - -- - _ '.ompen5ation, will tlo.the.work,.antl the s[ructure,is not intenaetl . feretl for sale. (Section 7044, Businoss ana Pro(eisions Coae: The SOLAR PIPING 8V5. � � � �SSUE FEE •-� ��-� -Go.�VaCto�'s�Licanze LaW tloes not apply [o an Own¢�_Of a property , . . - -_ � � APPLICATION�APPROVED BV - . - � ��OFTE+ �= who bulltls or improves [hereon, antl who tloes such work himielf or ISSUE FEE ' -throu9h hiz own employees, provitletl lhdt sucn improv¢ments are not. intentlna or olleretl lor sale. If, howeveq the builtlin9 or Improvemont MECHANICAL PLAN CHECK $UMMARV OF FEES . ' Is soltl within onu year Of completlon, the owner will have the burtlen gUILDING ��p�� ' Q/.� proving ho ditl not Duiltl or improve for the purpose ot Sale). HEATING SVSTEM 0-]00,000 BTU PERM�T E Y'�� .SMIP. , 'S ' S� j$ I, as owner' ot -thk proper[y, am excWsivaly mntrac[ing with qND DVCTING' 91c0nsetl conVactors to �onsvuct the project (Sectlon 7044, Buslness 100,000 + BTV ^ �i P�AN CHECK S a�• �� - PERMIT . , and Prolesslon5 COEe:� The Contractor's Licanu �6nw does not apD�Y �o _ _ ' ISSUANCE 5 an owner oi praperty who builtls or improvos thereon, antl who con- REFRIGERATION 0-300,000 BTU PLUMBING E �' ^� trdtlz from Such projepts with a•contrattm�s) IlceSn80 Purzuan[ t0 $YSTEM� . � --� � . ' GRADING E .. the COnl�dCtO�'T Llt¢�SC �yy/), 300�000 + BTU� PLAN CHECK . 5� _ _ ❑ I am exompt untler Sqction 8: 6 P. C. for lhis� - � ' ECECTRICAL E � ' ' E' ' BOILERS BTV . . � 'reason ' - � - - - - ' - PLAN CHECK b �� _ MICROFIINI E _ , •Date '- - Owner SVSTEM REPAIR, ALTERATION `' ' TOTAL FEE S" �� .I.hereby certirythal I hay� reatl this appllcatlon antl state tnat the above EXHAUST SVSTEM MULTIPLE MECHANICAL, E' - : - ^PLAN�CHECK � S- LE55 AD- Inlormatlon is correct. I agree to comply with all �ity antl county - •�VANCEPC E .ortlinances ary[� slate laws relaUn9 �o constructlon, anG hereby authorize representatl�/�!� of th6 ty to an r upon tha above mentionetl' � '� '� � C��% �� proPertY jW / , sPectidq ' urP �- �3 ♦ . _ . . . . . . . . . Signalur�e�� Dale . . . FINALFEE EllG� Drivers' Litense or 55 � ISSUE FEE � . ._ . _. _. � CMF 0865-46 White-Builtlin9: ��ary-Applicant; Pink-Accounting: Goltlenrotl-Assessor il'•.y \ • ' � ' CONSTRUCiVON AfJ� PL�NNING 3.;��, t ' � POOL & SPA � v` ,: ' APPROVALS �^ 1 �ermit � � �ate Inspector . qppROVALS Permit # � Date Inspector � 1. Temporary Electrical Service'or ola�,i� �� 43. Pool & Equipment Locatioh " - � ' -� .-Soi ipe-Un rgcn ' 44. SteelReinforcement � � - � -- �- � 3. Electrical Conduit Utility-Undrgrn - 45. Forms �• 4. Electrical Conduit-Undrgrn - ""` . 46. Electrical Sonding � - . tee . ein orce 47. Rou h Plumbin & Pressure Test - - 6. Electrical UFER Grn 48. APPROVALTO COVER•GUNITE 7. .00tings _ 49. Electrical Conduit-Undr rn � 8. Poundation - . . � 50. Gas Pi e, ❑ Undr m, Test � � 9. Water Pipe-Undrgrn - 51 Backwash Lines P-Tra 0� ndr m � � � - 10. Siructural Floor System � 52. APPROVAL TO DECK - - - il. Property Sewer Line & Hou:e..Connection 53._._Backwash & Rece tor-Final � ' � � 12. Street Sewer Connection. .- - - -- 54. Heater & Vent-Final 13. ...Rough Plumbing. - - � - 74. Rough ElectricConduit � "'- � "`561• Electrical•Final - � • 15. Rough Electric-Wiring -� - � - ' 57. Solar System-Final -' - - ' ' 16. Rough Heating & Air Conditioning � � � � • encing & Access Approval � 17. Ducts in-Structure ' APPROVED FOR PLASTERING �� ' 18. quc[s, Ventilating �' - - - - � . _ 19. Gas Pipe=Rough & Test � • � -f . _ 60. POOL/SPA SYSTEMS FINAL •� .. � 20. Roof Framing - - � - - � ' � � 21. Roof Sheathin � ' - - � . ' � � � . � � _�- - . . �� __..�,.. ,.;. .,NOTES: 22. -Frame�and Flashin - - � � � - ,.,.. � � -23. Insulation - - - � � � i ' ' • • �� `� � ' 24. lathin & Siding- ._ � . . F ' Y. > • • . ; _ .. . 25. Drywal6Nailing - � - - ; "'y' `•`�.: � "' � � � • ' ' 26. Plaster - , , r" �- ''..� � • � . ncal Power eterFina i - ' � ' � � 26. F(nal Electric - - - � -� �^'� � � v nditionin9 - - "'"" - ' - - � +�.(; j � . . 30. F' . . . -�.-.._,_ Final umbing ._ � � � 32.� ater - na � ' 33. Gas Service-Final ' 34. Solar pomestic-Final 35. Landsca e S rinklin S stem -�� 36. Sound Attenuation - -- � ' 37. Handicap Regulations ' ' 38. FINALSTRUCTURE&BUILDING � 39. Special Requirements Completed � 40. Electric Release to Edison ' ' - � - - ' " 41. Gas Release to Southern California Gas Co. � �- - 42. CERTIFICATE OF OCCUPANCY � � � 'IVo Date Applieant to 1111 In ail s0aces withln CITY OF COSTA MESA PE�R T No. CONSTRUCTION PERMIT 1� I„ /n � Addrea Address C,OntlBCtOf Add� - License No. I nereby afilrm that 1 ar� Iicensetl un menNn9 with 5ettiOn 7000) o/ ❑ Professlons Co=e, �nU my 1lcenso Si9nature :�.�[�s WORKERS' COMPENSqT10N DECIAR"IITION • L/ I hereby affirm [hat I have a certHicale of consen[ to selhinsum or a cerHflcatO ol Work¢r5' �ompenSatiOn Insurante, Or a Certi/i¢G CopY thereof (Section 3800, Lab. C.). � Polity No. Cqmpany ❑ Ccrtifletl copyis hereby furnishetl. -- � CerUfleU copy is flleG wtN the clty Builtling Divlslon. ',EMGTION FROM WpRKERS' COMPENSATION OECLARATION ui5 Settion neeG noTbe tomple[etl if lhe permit is for ona hunGretl ly100 or less). 1 cert�(y thal Imlhe perYormante ot tne work for w�ich I�IS permit is Issuetl, I shall not�emplpy any person any manner so as to bac e SUDj¢CYtOIha W rs' CqmpenSatiOn v� ahGllfor Date i.�.$�Signature NOTICE: If aftar maki�g �hiz tleclaration, you shoultl bnco e bjecl to the Workar5' Compe05atlon proviSiOns Of Ihe Labor Cotl¢, y0u must forthwith tomply wlth Euch provizlons or this permit ihatl be tleemetl /lvok¢tl. ' �— - CONSTRUGTION LENbING AGENCV I her¢by alfirm inal [here IS d ConsVUctlon Iantlin9 dglncy for tha per- formanca of the work ror.wnlch tbit permit Is IssueC.(Section 3097 Civ. C.l• LaOder'S NdmC Lentler's Atltlrezs OWNER BUILDER UECIARATION � I nereby atflrm lhat I arri exem0� �rom t�e Contractor's Llcense l.aw for tha following roason (Su�tion 7031.5 Business antl ProtasSions CoCa: Any Nty or county Which reqW�es a Oermit lo construcq altor, Improve, Cemolish or repalr any sbucture, prior to iti iisuan<o, also re- qWres the ap0�� or such permit [o tlle a 5i9netl ttatement tnat ho is Ilcensetl pursuant lo �he proNsions ol tbe COntra<lor's LlcanSa l. w (Chapl¢r 9(COmm¢ncing wlth Sactlon 7000) OI Dlvlsion 3 0l th< 6u5intss antl Prdezsiong Cotle) or lhal he is C%empt I�erelwT antl [he basis lor thc�allegetl exemptlon. Any vlolatlomol 5ottlon 7031.5 by any appllcant lor a permil subjects the applicant to a civil ponalty of not more than Ilve huntlretl tlollars (E500). �.I, as owner of tM1e p�operty, or my employeai wl�h wagas as Neir k`��", CpmpGnSaHOn, will tlo the w0/k, antl [he ztructuro Is not IntOntlutl '�%<"�ifferotl for wle. (Secpon 70a4, Businass antl Prolessions Cotle: The �l�'JOIfdCtOf'S LIC8n5e Llw tlOCs nol apply IO an ownel ol.d PlOpBfly wna bulltls or ImprOv¢S th0/eon, antl wh0 tlOes Such work himsel� or tM1rough h15 own Cmployees; O�ovitlOtl lhdt such ImprOvnmenli a�a n0[ intentletl or otlared for sale. It, however, tha Duiltling or improvomont Is sold witnin ono yEar ol comple�ion� �h0 owner. will have tne buraen of proving he tlitl not builtl or Improve tor the purpoze ol sale). ❑ I, �as oY/ner OI' [M1O pfopOrty, dT 0%c1U51vBly CoOtldCtl�g wlth Ilcensed cOnlydttors to �anSVutt Ihe pro�ecl (Sottlon 7044, Bu51nes5 antl Professions Cotlo: The Contractor'S Llcenso Law tloes not apply to an owner ol p�o0erty Wh0 bulltl5 or imp�oves [�e�eon, antl wh0 con- tracts irom such projetls with a contrattor�s) Iiteinetl pursuant lo the Contrattor's Licensa �y�y). . ❑ I am exempt untlor Spction B. & P. C. for this reason Da[a Owner that 1 haya r0atl t�is application antl state [haLthe abov¢ w�rect. � agree [o comply wi[h all City antl county state laws relatlng to construttlon, antl hereby authorize of this ��y to en[er upon th¢ abov¢ m¢ntlonatl n�ectl . pu oses. � � 3 . Date DorEer Iines anG slgn all apPropriate Geclarations. TqACT NO. LOT NO. BLDG. NO. � S.�V(PE OF CONSTRUCTION 16j NEW ❑ ADD ❑ ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER DESCRIPTION OF WORK �rfYPE OF PERMIT . ❑ GRADING ❑ FOVNDATION ❑ STHVCTVRAL ❑ TENANT ❑ ELEC7p RICAL ❑P FVMBING ❑MECHAI �OTHER F�h—`re..e-�V�Of� — PROJECT DESCRIPTION � SQ. FT. OCCUPANCV CONSTRUCTION TVPE VALUATION �n�•/ry�ONE GRADING CU. VDS. ACRES � REMARKS: � � - BATHTU95 TOILETS KIT. SINKS SERVICESINKS� ' FLOOR SINKS DRINKING FOUNTAINS INTERCEPTOR$ SWIMMING POOI. WATER SERVICE GASSERVICE PLAN CFIECK � SHOWERS URINAL$ DOUBLE LAVS DISLiWA5HER5 FLOOR DRAINS CLARIFIERS PTRAP ALTERATION� OVTLETS WATER MEHTERS BT�U OUTPVT SEWERCONNEGTIONS " SOLARTqNK COLLECTOR; SOLAR PIPING SVS. ISSUE FEE MECHANICAL PLAN CHECK HEATING SVSTEM 0-100,000 BTV _ AND DUCTING 300,000 + BTU _ FEFRIGERATION 0-300,000 BTU_ SYSTEM �00,000_+BTU_ BOILERS _. BTV SVSTEM REPAIR,ALTERATION EXHAUSTSVSTEM MULTIPLE Drivers' License or 55 � � °/� ' ISSUE FEE" ' � CMF 0865-46 White-Bulltling; Canary-Appliwnt: Pink-A<counting; Goltlenrotl-Assessor REHR VHRD (TO P/L) PKG. SPACE REQ. STREET WIDTH CONDITIONS: ELECTRICAL l'icOFl"I"i1Ql_^ PLNTGp.Rg�EJFL.p#� PqpPE1RTY LIIVE' • PROVIDED ' PARK FEE E DATE " PLAN CHECK � - I � -.. GENERATOR '0-1 KW_ 1d0 KW - TRANSFORMER . APPLIANCE 30-50 KW_50 * KW MOTORS' ` -"p-1 HP_1-10 HP ' (INC.SOLAR) � �0-SOHP_� SO+HP � FIXTURES OUTLETS ' SWITCHES - GAS TUBE SIGNS ` ' ' • oOLE LIGHTS ' ' - ' . ��-� ■�� ■�� .�-- ��-� �� BUILDING Q GERMIT S • 7LAN CHECK S �� GLUMBING S PLAN CHECK E . ELECTRICAL E � PLAN CHECK E . MECHANICAL $ VLAN CNECK E SUB . OF fEES ; � � SMIP E •�� PERMIT ISSUANCE S � GRADING S. • s . ,. ' MICROFILM E TOTAL FEE E �LESSAD- � - VANCE'PC S �FINAL iEE E.�z 1 CONSTRUCTION AND PLANNiNG ' ��; POOL & SPA � � . APPROVALS Permit# '��.j Date Inspector, APPROVALS � Permit#, � ' .. Date Inspector 1. Temporary Electrical Service or Pole 43. �Pool & Equipment'Cowtiori � - � 2. Soil_ ipe-Un rgrn � � ' ' 44. Steel Reinforcement - -a 3. . Electrical Conduh�Ucility=Undrgr '=5�7 45. Forms ,. 4. Electrical Conduit-Undrgrn -' 46. Electrical Bondin . tee em orce - 47. Rou h Plumbin .B�Pressure Test ~ ' 6. Electrical UFER Grn � - � 48. APPROVALTO COVER-GUNITE _ 7. Footings - 49. Electrical Conduit-Undr ro � 8.. Foundation ' � � 50. Gas Pipe, ❑ Undr rn, Test ' � .. 9. Water Pipe-Undrgrn ' .51 . Backwasfi Lines P-Tra �-0 dr 7n ��' ' 10. Structural Floor SYstem 52.' A�ROVALTO DECK --,.. ..- -_ 1.1. Property Sewer Line & House Connection 53. Backwash & Rece tor-Final .12. . Street.Sewer Conneqtio� - 54. Heater & VenbFinal 13. Rough P.lumbing � - � 14. Rough Electric-Conquit �56. Electrical-Final 15. Rough Electric-Wiring 57. Solar System-Final 16. Rough Heating & Air Conditioning - • encing & Access Approval 17.- Ducts in Structure - � APPROVED FOR PLASTERING • 18. Ducts, Ventilating - - � � � ' 19. Gas-Pipe-Rough&Test ' � 60. POOL/SPASYSTEMSFINAL � � . , - �20. RoofF"raming�-- � - ' ' - - � � �� 21. Roof Sheathin ` - � �. . 22. - Frame and Flashin � NOTES: . - � . � ' - 23.- Insulation---'- �- � ' � - � 24. �Lathin &�Siding - ' ' 25. Drywall Nailing � ' � ' ' - - 26. Plaster Brown Coat � ' - � � 27. Electrical Power MeterFinal � � � -" � 28. Final Electric � � ' ' � � � � ' � 29. Final Heating & Air �nditioning • ' - � ' � - 30. Final Gas Pipe-Test • � ' ' � 31. Final�Glw�iw9 - 32: Water Service-Final � - �33: Gas Service-Fi�al �� - � � 34.' Solar pomestic=Fina1 - � 35.' Landsca e S rinklin S stem . � 36. Sound Attenuation • • 37. Handicap Regulations � 38. FINALSTRUCTURE&BUILDING - - 39. Special Requirements Completed � - - `-- - 40. Electric Release to Edison - �� - - 41. Gas Release to $outhern California Gas�Co. �. 42. CERTIFICATEOFOCCUPANCY � • No - - Date � City of Costa Mesa Development Services Department Buildin9 Safety Division P. O. Box 1200 Cosca Mesa, California CERTIFICATE OF OCCUPANCY No. OU�jJ� The Building located at 71RR Airur� Avanna Siiha C has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicabie thereto for a Group R� Occupancy. Use of Building Off�c@/StoLaqe Legal Description 427-193-27 fSee reverse side for Metes and Bounds) Building Permit No_ r aR(1fi'� Electrical Permit No.C+49063�F/d9169 Plumbing Permit No��3�� Mechanical Permit No. G 4$Q63 ISSUED T0: Kevin A. Coleman 3188—F �way Ave. Costa [�4esa. CA 92626 Number of apartments and/or guest rooms Building Official Tonv C�t?a Baca by . Date Novamhar �� 19� This Certificate of Occupancy SHALL BE posted in a eonspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 ie� U.B.C. CMF 1015-a6 rev. 1/83 White-Owner; Canary- Numerical Fii¢; Pink - Bldg. Permit File Ciry of Costa Meu Development Services Departmenf Building Safety Division P.O.Box 1200 Costa Mesa, Califomia J CERTIFICATE OF OCCUPANCY No. The Building located at 3188 Aicwav Av�?�uA. RnihP (. has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group 82 Occupancy. Use of Building Printina Legal Description 427-193-27 (See reverse side tor Metes and Bauntls) Buitding Permii No. R �7115 Electrical Permit No.E27349kE26771 plumbing Permit No. p 27165 Mechanical Permit No. � 2�635 ISSUED TO: Gunthers Printing stti8 Air�tay Ave., Ste. G Costa M2sa, CA 92626 Number of apartments and/or guest rooms Building Official �nv C'0. Baca by .� i- � �i. �— Date June 24� 1987 Yhis Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Me3a under Sec. 307 (e) U.B.C. CMF 1015-46 rev. 1/83 White � Owner; Canary - Numerical File; Pink - Bltlg. Permit File AVPlicant to fill in all spatts axcaD� ihosa within peavY Doraer ilnas anC si9n all approvriate tlaclarations. e.,'�'OF COS7A MEsa CONSTRUCTION PERMIT � j' �r:. 3/ 8J� 1�IQ1U/�y BL D('s. n�•r n . Pr,�jechA��ess- � Applicant's Mailirg Address 3%e'b'—F_ /q��((��y Owner's Name CU�7/vTN��S PRI/UTIIU�phone -f�✓l� Address �%�d —` � A/�?wi4 Y i �, I�. �C�i7•� Arch/Eng. License No. Address Contractor'sName nT� ELFC�j � Phone � Address Imailingl -�%90 — !� . /9//�PO�T �OdP .7JIQ � Ciry License No. ��0�6 LICENSED CONTRACTOR DECL RATION � I hereby affirm that I am licensetl u tler o s of Charter 9(commencing with section 7000) of Division 3 o the us tl Profes5ions Cotle, antl 'my license is in full (orce antl etiect. � / Q License �Id55 (O/ Date — .. Si9nature \ W00.KER5'COMVENSATION DECLA T10 I hereby aftirm Ihat I have a certifica e of consen to self-insure or a certifiyte � of Workers' Compensation Insuranc or "etl copy [hereof (SeEion 3800, Lab. G / � � aoncy Na. ��i�c17939a7A� ;n � �Certi(ietl coOY is nereby fumizhed. Certifietl op�j 1S,tiletl with tM1e "ty i iate �� * / Applioan EXEMPTION FROM WORKERS' COM A ECLARATION (This sectlon neetl no[ be Complet¢tl if the permit is for One huntlr¢tl (E100) � less). 1 certify thal in the p¢rformance of th¢ wOrk tor which this perm�[ is issuetl, 1 shali not employ any person in any.manne� so as to become subjec[ to the Workers' Compensation Laws ot California. Date Signature 'NOTICE: H, after making ihis tleUaration, you shoultl become subject to the Workers' ComOensalion provisions ot the Labo� Cotle. You must forthwlth comply with such O�o�lsions o� this Oermit shall be tleemetl revoketl. CONSTRUCTION LENDING AGENCV 1 herety a(Orm that tM1ere is a con5truttion lentlinq agenty for (h2 performance of [he work for which Ihis permit is i55uetl (Sectlon 3097 Civ. CJ Lentler's Name Lentler's Atltlress OWNER BUIL�EH UECLARATION I heroby a(firm that I am exempt irom the Contractor's Licenze Law for the /ollowing rea50n (Seclion ]031.5 Business antl Prof¢SSional COtle: Hny city or county which requires a permit to construct, alter, improve, Oemolish or repalr any structure, prior to its issuance, also requlres the applicant (or such permit l0 111e a signetl statement thdt he/she I5 IlcenS¢tl pursuant to lhe p�ovi5ion5 of [he Contractor's License Law (Chapter 9,(commencing with Section �000) of Division 3 of the Bu5ine55 antl Protes5ion5 COUe) o� that he/she i5 exempt therelrom antl tne basis for the alle9etl exemOtion. Any violation of Section 7031.5 by any applicant for a Permi[ subjects tbe applicant to a civil penalty oi not more than tiv¢ huntlretl t1011ars (E500). - LJ I, as owner o/ the property or my amployees with wag¢5 as tbeir Sole ��mpensation, will tlo Ihe work, antl Ihe sVucture is no[ intenCetl or ofleretl sale ($eclion ]044, Business antl Professional Code: The Contrac[or's :nse Law tloes not apply to an owner of a property who builtls or imoroves :reon, antl who tloes such work hlTself/ha�i¢It or thrOugh hls ot ber Own Cmployees, provitletl that suCh improvemen[z are nol Intentletl or offereC tor wle. It, however, the bulltling or Imorovement is soltl within one year of com- pletlon, tM1e ownet w111 nave lha burtlen of proving he/s�e tlitl not bulb o� im- � �/ova for Ihe OurOose of sale). I, az owne� of the property, am exclusivary contracting with lic¢nzetl Con- lraCtors to conztruct the project (Section 7044, Business anC Professlons Cotle: The Contractor's License Law tloes not apply co an own¢r of property who builtls or imoroves thereon, antl who contracts for such projects with a con- bactor(sl license pursuant to ine ConVattor's Ucense L.aw). I am aware that proof o/ tbei� Wo�keYs CompenSation Insutanca Shoultl be provitletl t0 me. ❑ I am exemp[ untler Section B. & P. C. for this reason Date I �he�eby certi infOrma[iomis antl state laws i sentatives qqqf tt insoection p� Signature � Orivers' License thi5 20y autnorlie reple- Ionetl pIropertyU �or Dat¢ /�7� a� �iv��-� I •�=�� v. rv...v. 1 VIV11 IVV. TYPE OFCONSTRUCTION NEW ADD ALTERATION REPAIR — ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A p,� DESCRIPTION OF WORK/USE OF BLDG.� S Main 8� E TVPE OF PEflM1T GRA�ING FOUNDATION STRUCTV RAL T Frant ❑ TENANT ,�ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Reaf ❑ �OTHER ' %� PROJECT DESCRIPTION Sp. FT. OCGUPANCV ' C Right K Left CONSTRUCTION TVPE VALUATION $ $ ZONE GRADING�CU.VDS. ACRES� PIng.Ref.# Remarkz: Sink Preventer Irrigation Floor Drains Floor Sinks Gas Service Interceprors Kitchen Sink Lavatories P—Trap Roof Drains Reinspec[ion Fee . - ServireSink � Sewer Cap Sewer Connection ' Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Outlets Water Closet Water Heater Water Service � � Auro-Wash $15 Boiler Duct - Under Ground i Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple FirepVFact BIL ICBO # Heatirig System & Ducting Oai oo,000 eTu � i oo,000 Reinspection Fea ' � $15 CMF OB65-4fi, rev. 30/84 White - Builtling; Canary - Applicant Pink - Ac<ounting: Goltlenrotl - Assessor laue Fea Hoodor Typel ❑ Canopy Type I I ❑ Refrigeration System ❑6100,000 BTU ❑100,000 BT System Repair/Alteration — Fire Dampers Registers Issua Fea m FEES• Automatic Washer Constructian Pole Sub.' Cooking Unit Dishwasher Dryers ❑Gas ❑Elect Fan F.A.U. FixWres - Device 8oxes Outlets Switches Garbage �ispoul Generator 00.5 KW ❑ S 3 I.: 9871 1�07/B7 0 Zone � Accessory Building: I Parking ReqJProvided � �v a � �xc�l.. lTcr � ELECTRICAL ' Trensformer 15-50KW �' ❑ 50+KW Meter ❑up to 100 amps / Meter �over 100 amps Sub Panel Motors O0.1 HP O 1%- B ' Ina Solar �9-15 HP �16-15+ Microwave ' Pole Light Range _� ; Standing Sections 5-15 KW � Trash Compacmr { 14e90 TL 2 O N I N G R - E Q v M T $ FEES � Reinspection Fee $15 Issue Fee � $ 3 FEES , DEVELOPMENTSERVICESREQUIREMENTS: ��- � -� �� Zoning App'roved By Data Building Approvad By ' Date Application luued By Dat � � SUMMARV OF FEES BUILDING PEFiMIT $ � SMIP $ � PLAN CHECK $ PERMIT ' PLUMBING $ ' �SSUANCE $� PLAN CHECK 25% $ ENERGV P.C. $ ELECTRICAL � $ � GRADING $ PLAN CHECK 50% $ MICROFILM� $ MECHANICAL $ TOTAL FEE $ � $ 3 PLAN CHECK , 25% $ � � i � � ' � - POOL&SPA'" - " �'f CbNSTRUCTION AND PLANNING �/ A�'PROVALS � Permit# Date Inspector p�ppROVALS Permit# Date Inspector ' t�.�Temporary Electrical Service or Pole 52. Pool & Equipment Location � 2. 'Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3!�Electrical Conduit Utility�Undrgrnd. 54. Forms , 4. Elect�ical Conduit-Undrgrnd, � 55. Elec[rical Bonding � 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8.. Foundation � 59. Gas Pipe, � Undrgrnd., Test 9. Water Pipe�Undrgrnd. - 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap � 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 74. Rough Plumbing 65. Electrical-Final. 15. Rough Electrical-Conduit 66. Solar SYstem-Final . 76. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T•Bar Ceiling 69. 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. Undergmd.StorageTank OGas �Oil � 25. .Roof Sheathing - 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat - 75. Dry Chemical 27. Freme 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 8rown Coat 79. FINAL INSPECTION � 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric I.'� id Notes: G� p 34. Final Heating & Air Conditioning 35. Final.Gas Pipe-Test . . - , � 36. Hood or Canopy � � - ' 37. Final Factory Fireplace ' � 38. Final Plumbing -� � � 39. Water Service-Finai 40. Gas Service-Final •r • � 4` 41. Solar pomesticFinal � ' � � 42. Backflow Preventer � _ • _,_�Backflow Irrigation � 44. Landscape Irrigation System . -{- ' 45. Sound Attenuation . : � � 46. Handicap Regulations � . � � 47. FINAL STRUCTURE & BUI�L'DING 46. Special Requirements Completed �'- , 49. Electric Release to Edison • � 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY - No. Date � AVP�Itanl l0 fi�� i� all spaees exeeDt those witnin neavy DorOer Iines antl sign all aoo�opriate Geclarations. Ci7Yq rCos��,nne`q CO dSTRUCTION PERMIT G PERf�J2 NO� ,��_ TRACT NO. LOT�NO. UNIT N0./9 ' Projett Address ` s Z� _ �Applicant'sMailin Address -' Owner's Name � - S hone Addreu � � Arch/Eng. � License No. � Address yyy��J,,,---,,,��...,,,��'��I Contracror'sNeme �S•S_i_�,f��Phone � Adtlresslmailingl�� - City License No. 1 �Q� � LICENSED CONTRACTOR DECLARA7�ON ' I bereby attirm that I am iicensetl untler Provislons o1 Chartar 9(commancing wi[h soction 7000) of �Ivision 3 of the Business antl Professionz CoOe, anU my Iicense is in / I1=orp¢a{�tl eHect. 4cense Class � � L� ��<e s Dale - $i9na[ure WORKERS' COMPENSATION DE A 10 I hereby aftirm tnat I bave a certiticate of consent to bin or a mrtififate ot Workers' Compensation Insuran e, or a certltietl copy tnereol (Section 3800, Lab. C.C) �� ////� I POlicy No. Z 0� CortlPany � f,� • �Certiliea cooY iz hereby furnishetl. Cer[ifle0 c 5 filetl with the city B� � Oate �n � Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLAR 'ION (This section need not be'comple[etl if th8 Permit is for ona hu retl (E300) or less). • 1 ce�llty thal In Ihe perf0/mance Ot [he Work ior which this pe�m�t Is Issuetl, I st�all not employ any person in any mannar so as [o betome subject to lhe workers' Compen5ation Laws of Californ�a. ' Date, Si9nature ' � NOTICE: If, aftcr making this tleclaratlo�. You shoultl becoma subject to the Workers' ComDensatlon provlsions ot tHe Labor Cotlo, you must forthwith Comply wilh suc� 0/ovi5lOn5 Or [hiS Permlt Shall be tleCmotl revoketl. CONSTRUCTION LENOING AGENCV ' I horeby alllrm tnat there is a<onstrucUon lentling agency for tne pertormanca ot ihe work lor wblch thls permlt iz Issuetl (Snctlon 309] Civ. CJ LCntler'S NdT! Lenaer'z Htltlress OWNER BUILDER �ECLARATION I hereby altirm that I am exempt from� lhe ConVactor's �icense taw for [he following reason (Section 7031.5 Business antl Prolestional Cotla: Any city or to nie a s�gnea sta[emen[ [na[ ne/5ne is ��e�ue� Nwaua�� w u�n ��w�� tno Convactor'S License Law (Chap[er 9(�ommencing with Section 7000) of pivisiOn 3 ot th¢ Business antl.Protessions Co�O) o� Ihat ha/Sh¢ I5 exem0� Iherett6m antl [he �basis to� t�e allegetl exeTp[lon. Any violation of 5¢ction 7031.5 by any applicant tor a permit subjects the aooncan� to a civll penalty of not more than five huntlretl tla��ars (5500). ❑ I; 5s owner of the property or my employees witn wagez as thelr sole - COmpenSation, will Eo'the work, antl the structure is not IntenOetl o� Offer¢E 'r -,sale (Section 7044, Buziness .antl P�o/essional Cotle: Tha Contractor's :en5¢ Law AoeS not apply to an Owne� of a prop¢rty who bulltls o� improves ' ereon, antl who tloez such work nimself/hersell or ihrough hls or her own <mployees, provitletl that sucn improvements are not Intentletl or offeretl tor Sale. It noweva�, Ihe bulltling or imp�ovement IS Soltl withln ono yea� ot Com- � pletion, Iha�owner will hav¢ the burtlen of proving hc/sne tlld not bulle or Im- p�ov! 10/Ihe purpo50 otsale). � � � I, as Own¢r ol Ihe property, dT o%clusively COntraGtlng with Ilcan58tl COn- [ractorsto wnsVuct the vroject (Section 7044, Buslnass antl Profaislons Cotle: ThC Contractor'S LiCGnSC Ldw tlo<s not apply lo dn Owncr ot proparty wh0 builtli Or ImDroves IhnreOn, antl wtto cO��rdClS lo� sUth p�o�Octi with a con- trd<tOr(SI,IICen58 pufsuanl t0 [he Contrattor's Llcenz9 Ldw). I am dwafe that proot ol [h0i�' Worker's COmpensdtlon'�nSuranCO ShOultl be provitletl t0 me. ❑ I am exempt unCer Section � B. 6 P. C. lor t�is reason Date ' Owncr I nereby cerUty Nat I �ave�reai iniormatlon is correcL I agree lo antl state laws relat' Itlin sentatives ol th' nt insvection pur Signature � Ortvers' Licensa or 55 $ _ CMF 0865=46, iev. 10/84 � TYPE OF CONSTRUCTION LJ NEW lJ ADD J�LaLTERAT ❑ CONVERSION ❑ DEMOLISH � OTHER �-p��,q�r— DESCFIPTION OF WORK/USE OF BLDG. ��, (1�. TVPE OF PERMIT LJ GRADING lJ FOUNDATION LJ STRUCTV RAL � � TENANT �ELECTRICAL ❑ PIUMBING ❑ MECHANICAL ❑ OTHER ' � ' � . PROJECT DESCRIPTION � Sq. FT. oCCUaANCv_ CONSTRUCTION TVPE � VALUATION 5 ' � ZONE GRADINGCV.VDS. ACRES_ Bar Sink eackflow Preventer - Backflow Irrigation - � Ba[htubs - - . Clarifiers Dishwasher ' ' DYinking Fountains Floor Drairis • ' Floor Sinks Gai Service � OuUets Interceptors Kltchen.5ink La�atories ' P-Trap Roof Drains ' - Reinspection, Fee S75 Boiler � Duct� UnderGround � Duct-Strucmral ' Dut[ � Ventileting Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. ICBO �1`- Fleating $ystem & Ducting �0.100,000 BTU 0100,0006T1 ~� �atez' �<-CJ/. ' �� aat�:vap�o� F� nary - Applicant; Pink - Accounting: Golden�od - AsSessor 515 PLUMBING Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Pipin9 Solar Tank ' Swimming Pool wlSpe Urinal Water Closet Water Heater Water Service Auto�Wash Laundry Trays Issue Fea � $ 3 iqrv�cAL -FEES Hood or � Type 1 '0 , _ Canopy Typell ❑ Refrigeration System ❑aioo,000aru �ioo,000eru System Repair/Alte2tion . Fire Dampers Registers � Iszue Fee § 3 � � A.P. # S Main Buildi E T FronC B Rear ' A C Right K Left S Ping. Ref. # ' Planning Notes: Automatic Washer� Cons[ruction Pole Sub. Cooking Unit . Dishwasher - Dryers �Ges ��Eleci Fen F.A.U.' � � Fiz[ures Device Boxes 0 2351 2/17/8T _ Zone Acceuory Building: � ELECTRICAL . ' Transformer 0 15-50 KW O50+KW ' Switches . � Garbege Disposal Generator 00.5 KW 05-15 KW Meter LJup to 100 amps Meter �over 100 amps Sub Panel � ' Nlotors O0.1 HP,$I1 h� 8 Inc: Solar 09-15 HP �7fi�15+ Microwave ' Pole Light� ' Range Sign Standing Sections Tresh Compactor ' I Reinspection Fee �."I §15 I ' Issue FeB DEVELOPMENT SERVICES REQUIREMENTS: , �2oning Approved By Building APproved By �,� SUMMARV OF F BU�LDING PEFiM1T $ PLAN CHECK - $ PLUMBING . $ PLAN°CHECK 25% $ � ELECTRICAL • $ � PLAN CHECK 50% $ MECHANICAL $ � PLAN CHECK 25% $ � 47Q10 TL 0 FEES n u $ 3 Z O N I N G R E U M T S SMIP $ " PERMIT ISSUANCE . $, ENERGV P.C. $ - GRADING $ � MICROFILM _ $ � TOTAL FEE ,$ I ► CONSTRUCTION AND PLANNING POOL & SPA . APPROVALS Permit # Date Inspector qppROVALS Permit # ' Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test . 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE. 7. Footings 58. Electrical Conduit-Undrgrnd. � 8. Foundation 59. Gas Pipe, � Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 71. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final , 13. Roof Drains 64. Plumbing SYstem - Final 14. Rough�Plumbing 65. Electrical-Final � � 15. Rough Electrical-Conduit 66. Solar Sys[em-Final i6. Rough Electric Wiring „ � 67. Fencing & Access Approval � 17. Rough Wiring Sign � 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Duc[s, in Structure 70. Underground Hydro ' 22. Ducts, Ventilating 71. Product Piping OGas ❑Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing - • 73. Undergmd.StorageTank OGas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing , 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIREPREV.FINAL �� ' I 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 0. FOOD CERTIFICATE ISSUF,I7 � 33. Final Electric 1,� tes: 34. Final Heating & Air Conditioning � 35. Final Gas Pipe-Test � 36. Hood or Canopy . . ,.,, 37. Final Factory Fireplace '' i.� :i 38. 'Final Plumbing . ��+' .1 � . 39. WaterService-Final '� ' 1 � � •. 40. Gas Service-Final � � ' � � 41. Solar pomestic-Final . , � � , �: 42. Backflow Preventer ' - ✓ (., J ✓ 43: •Backflow Irrigation � ; � ��! � r 44. Landscape Irrigation System � r 45. Sound Attenuation �J 46. Handicap Regulations �� 47: FINAL STRUCTURE & BUILDING �c; i 48.Special Requirements Completed � ;� 49. Electric Release to Edison . 50. Gas Release to Southern California Gas Co • 51. CERTIFICATE OF OCCUPAN�Y . No. � Date , , 87-03 Appllcant to flll In all soaces except those wlehin neavy Doraer Ilnes antl sign all aoo�aorlate aeclarations. CI7YOFcoSTAMESA CONSTRUCTIONPERMIT ProjectAddress 3188 Airway Ave. Ste. G Applicant'sMailingAddress 1z3� I+dS Brisas Owner's Name _Gyt21.tt1C'S—�T,1ILt1IIq —Phone Address 3188 Airway Ave, Ste. E Arch/Eng. Licenu No. Address Convactor'sNama AlI Unlimited Phone 632-531 Addresslmailing) 123� LdS BL1SdS� Anaheim City Licenu No. 11�60 LICENSED CONTRACTOR DECLARATION I hereby aifirm that I am licensatl untler provisions ot Charter 9(commencing wi[h sectlon 7000) ot Divislon 3 ot t�e Buslness antl Professfons Cotle, antl my license is in fu}:to�} antl eflect. ^ License class `�—`� Licen � ' 32¢I 2935 /\ Date.�2.(�8� SlgnaWre � WORKERS' COMPENSATION DECLA /{ 10 I hereby aifirm that I hava a certificate of�cons n to 5¢Iftinsure or a cerUflcate of Worke�s' Compensation Insurance, or a e� ifietl copy thereof ($ectiOn ` 3800, t2b. C.)�f State Fund ` Pnoli,c.y No. / 10713 Company lJ�certK_tLCPPyK�4ieabwimrmehci�tr wltll vi IOn �I„ Oate L LO O/ APPlicant � EXEMPTION FROM WORKERS' C MPENS 10 ECl � ATION (This 5ection neetl not be compietetl ii tne per I[ 6 � One h ntlretl (E300) or less). I certify that in the pertormance o/ [ne worl Ror w �II h thls ¢r R it i55uetl, snall not emo�oy any person in any man so as�fl be e 0ct t worker�,', Cq(�Pen��on taws o1 Califomi � Date �"+"'�'a�5ignature � NOTICE: It, after making this acclaratlo u oul oma sub�et o t e Workers' Gompen5alion provisions ot th Ld COtlO, Ou mu5l /Orlhwith comply witM1 such proviSionS or Ih15 pe�m t Shall be tleemed �evoke0. CONSTRVCTION LENDING AGENCV I hereby atfirm thal there ii a construttlon lentli agency tor the pertormance of the wark tor which this pormlt I5 issuatl (Settion 309� Civ. C.) Lentler'S NamO Lentler's Atltlress NQNE OWNER BUIL�EH OECLARATION I here�y a111rm that 1 am exempt lrom the Contractor's Licenso Law lor tho following reason (Sectlon 7031.5 Business antl Proto55ional Cotlo: Any city or county which requiras a permit lo construtt, allor, improva, aemollsh or rapalr any slructure, prior to its izsuance, also requires the appllcant tor such pormlt to filn a slGnetl Stal¢TOnt that be/Sh¢ IS IlcenSetl puRudnt (O tha prOVISiOns of thC Contraclor's LIcenS¢ Law (CM1aptcr 7(commonclnq with SOCHOn 7000) of Division 3 af th0� Butinoss antl ProlGsSions Cotle) or thdt ho/ihe 15 Oxumpl thme/rom antl lhe basis fo� Na allegetl oxomptlon. Any viOldtlOn ot $ection 7031.5 by any apO��Cant fOr a permit Subjatts the applitant to a Civil penalty of not more Ihan flv0 huntlrotl t1011ars (E500�. ' LJ I, as owner of mo property or my amD�oyeos wilh wages as thoir sole compensatlon, will tlo the work, antl the structuro I5 not IntonGetl or offeretl for sale (Soction 7044, Businoss and Professlonal Cotic: Tha Con(ractor's License Law tloes nol apply to an owner of a property who builtls or Improves thareon, antl wno tloes such work himsoli/horsolf or through his or her own ¢mployees, provitlatl thdt Su<h improvamenl5 are no[ Intoneatl or offaretl tor sale. If, bowevor, thc builtling or improvoment is soltl within ona yoar of com- plelion, tho owner wlll have tho burtlen ot proving he/sha tlltl not builtl or im- provB tOr tM10 purpoio of Salo�. ❑ 1, as owner ot t�e property, am exclusively contracting wltn Iitensetl con- Vactors to constru<t the project ISetUon 7044, Buziness antl Protesslons Cotle: The Contractor's Ucense Lnw doos not apply to an owner of pwperty who bulltls or improves tnereon, antl who contracts for zuth pro�ects wlth a mn- tracior�sl ucensa pursuant to tne ConlracioCs L�<onze Law). I am aware that proof of tneir Worker's�Compenution insurance shoultl ba provitle0 [o mo. ❑ I am oxempt untler Sectlon , B. & P. C. br this reason Date .Drivers' License of55 $ CMF 0865-46, rev. 10/84 Owner Ihis above iances rep�e- Y tor / dJ (3 TVPE OFCONSTRUCTION NEW ADD ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A p.�y DESCfiIPTION OF WORK/USE OF BLDG. S Main Building: TVPE OF PERMIT GRADING FOUNDATION STRUCTURAL T Front ❑ TENANT O ELECTRICAL ❑ PWMBING MECHANICAL B Rear ❑ OTHER %� PRQIECT DESCRIPTION 5�. FT. OCCUPANCV ' C Right ' CONSTRUCTION TVPE VALUATION 5 S Left ZONE G0.11DWG CV. VDS. ACRES ping. ReL q�' qemarts: Planning Notes: 3ar Sink 3ackf�ow Preventer 3ackflow Irrigation 3athtubs Clarifien � 7ishwasher Jrinkin9 Fountains Floor Orains Floor Sinks 3as Service Outlets Iritercep{ors Kitchen Sink Lavatories P—Trep Roo( Drains ReinspeMion Fee - Showers . Service Sink � Sewer Cap Sewer Connxtian � Solar Collectors ' Solar Piping . Solar Tank Swimming Pool wlSpa Urinal Water Closet : Water Hearer Water Service Auto-WAsh $15 Boiler Duct� Under Ground Duct - Structural Duct - Ventilating ExhaustSystem ❑ �MWtiple Firepl/Fact Blt. ICBO # Heating SVstem & Ducting ' 2 f�aioo,000eruOioo,aoo Reinspection Fee I $15 Builtling; Canary - Applitdnh Plnk - ACCOunting; GOItlGnrotl � Assessor Isue Fea Hood or Type I ❑ Canopy Type I I � Refrigeration System ❑0.100,OOOBTU ❑100,000 System �Repair/Alteration FireDampers � . Registus ' Issue Fae Automatic Washer Construction Pole Sub. Cooking�Unil . . Dishwasher Dryers �Gas ❑Electri fan F.A.U. Fixtures Device Boxes �� Outlets Switches Garbage DispOsal Generaror DO-5 KW �5 366e 3/09/B7 Zone Accessory Building: ELEC7RICAL Transtormer ❑ 75-50 KW ❑ 50+KW Merer LJup to 100amps - Meter �over100amps Sub Panel Motors �0.1 HP � 1 h- B Inc:Solar �9-15 HP��16-15+ Microwave Pole Light Range � Standing Sections 5 KW Trash Compactor S 3 � � . Reinspection Fee $15 luue Fee FEES DEVELOPMENT SERVICES REQUIREMENTS: 2oninB Approved By BuildinB APP�oved By � Aoolintion Issued Bv_ / 5 3 - 31,75 T� Z O N I N G R E Q M T S FEES S3 � SUMMAFV OF FEES , . ; BUILDING PERMIT $ . SMIP �§ PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE S � PLAN CHECK 25% $ ENERGY P.C. S ELECTRICAI § GRADING S PLAN CHECK 50% $ �'/��' MICROFILM $ � MECHANICAL 5 ��"'�"�� TOTALFEE $ �1.75 PLAN CHECK 25% $ J . ! :✓ CONSTRUCTION AND PLANNING POOL & SPA ' APPROVALS Permit # Date Inspector pppROVALS Permit # Date Inspector 1: .Temporary Electriral Service or Pole 52. Pooi & Equipment Location 2. Soil Pipe-Undrgrnd. / 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms � 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test ' 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings . 58. Electriwl Conduit�Undrgmd. 8:"Foundation ,� 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. . 60. Backwash Lines,�P-Trap, � Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK i t. Property Sewer Line & House Connection 62. Backwash & Receptor-Final' � ' 12. Sewer Cap ' 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit � 66. Solar System-Final i 6. Rough Electric Wiring � 67. Fencing & Access Approval ' 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough�Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. FEQUIREMENT 20. Rough Factory Fireplace , APPROVALS Permit �p _ 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 77. Product Piping �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,Hydio � � � � _. , 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Wthing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78, FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT i� 31. Plaster Brown Coat � 79. FINAL INSPECTION ' 32. Electrical Power Meter-Final 80. FOOD CERTIF�CATE ISSUED 33. Final Electric Notes: ' � 34. Final Heating & Air Conditioning s-�rf �'O� , '. � i' 35. Final Gas Pipe-Test � 36. Hood or Canopy 37. Final Factory Fireplace . 38. Final Plumbing 39. Water-Service-Final 40. Gas Service-Final . - 41. Solar pomestic-Final " 42. Backflow Preventer 43. Backflow Irrigation - , � � 44. landscape irrigation System 45. Sound At[enuation - 46. Handicap Reguiations 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 AOp�icant to fi11 in a11 soaces except those within heavy oorEer lines anC sign all appropriate tleclarationz. CITY OF COSTAA�i Esn ' CONSTRUCTIO,/N PAERMIT PERMIT . �TRACT NO. LOT NO. uNiT nn'i ProjecOAQdress'✓��jC �/:�E Applicant's Mail� g Address�` Owner's Nam�U�T�'-'"� �� ArchlEng. _ License No. Address � Convacmr's Na ''/ Q� �� )�� Ppho �� Address Imailingf 7 �l-��l ��/�iC.., �i G .l� �� . � ' City License No. LICENSEp CONTRACTOR DECLARATION 1 hereby affirm [hat I am licensetl untler provi5ions of Charte� 9(commencln9 with secEion ]000) of Oivision 3 ot ttie Business antl Profes lons Cotle, antl my Iicense is ih orce antl effect. ' �pG „/ License C ss Licen N�� S� Date Signature � WO ER COMPENSATION DECLARATION I nereby attirm that I have a certi�icate of consent to self-insure or a certlficate of Workers' Compensation Insurance, or a certi(ietl wpy thereot (Section 3800, Lab. �% /J ��/'� Poli[y No �! � Compan�ry��W �� 8 Certifietl coP, irtiletlbwRhYthehctY B�I�g� J�ysio��s pate aooiicant 6 c�G �. EX PTION FROM WORKERS' COMPENSATION DECLARATION (Thissection neetl not be completed it the pe�mit is to� one nuntlretl ($100) or less). 1 tertify that in tM1e perto�man[e ot the wo�k tor which tnis permjt i5 issuetl, I shall not employ any perzon in any manner so as to bemma subject to the Workers' Compensation Laws of Califomia. Date Si9nature . NOTICE: If, after.making this tleclaration, you shoultl become subject to tbe Workers' Compensation provision5 ot th¢ Labor Cotle, you must to�thwith comply wi[h SucM1� P�ovisions or tnis permlt shall be tleemetl revoketl. CONSTRUCTION LENDING AGENCV 1 hereby affi�m that there is a construction lentling agency fo� the performancC of the work for�which this permit i5 issuetl (Section 3097,�Civ. CJ Lentler's Name Lentler's AtltlreSs 'i OWNER BUILDER DECLARATION � I hereby affirm that I am exempt from the Contractor's License �Law for the following reason (Section 7031.5 Business and Professional Cotle:�Any city or county which requires a pe�mil to construct, alter, improve, tlemoliih or repai� any structure, p�io� to its issuance, also �equires [he applicant tor such pe�mit to fiie a si9netl statement tnat M1e/she is licensetl Oursuant to [he provisions of the Contra[tor'S License Law (Chapter 9.(commencing with $ection ]000) ot Division 3 of the Business antl Professwns Cotle) or that he/sne is exempt tM1eretrom antl the basis for the allegetl ezemption. Any violdtion'o( $ection �031.5 by any applicant for a�permit subjects the applicant to a civil �enalty of not more lhan five huntlretl tlollars ($500). 1, as ownet ot�th¢ prope�ly o� my employees with wages as their sole eompensation, will tlo4he wo�k, antl the st�ucture is not intenGetl o� offe�ed r sale (Section 7044, Business antl Protessional Cotle: Tne Contractor's cense Law tloes not apply to an owner ot a property wno builtls or improves .iereon, antl who tloes such work himself/herself or through his or ner own employees, provitletl Ihat such improvem¢n[5 a�e not intentletl o� offeretl fo� sale. If, howevEr, tM1e builtling or improvement is Saltl within one year ot com- pletion, the owner will have the buraen ot provin9 he/she tlitl not builtl or im- �rove for the purpose of sale). ' I, as owner of the property, am exclusively contraCting with licensetl con- Vactors to mnstruct the projeot (Section 7044, Business antl Protessions Cotle: The ConVactor's License Law tloes not apply-ro an owner of property who builds or improves thereon, antl who contracts for such projects with a con- tractor(s) license pursuant to the Contractor'S License Law). I am aware tM1at proof of Iheir Worker's Compensation Insurance shoultl be provitletl ro me. ❑ 1 am exempt untler'Section B. & P. C, for thi5 reason Date Owner I hereby certify that 1 have reatl this application antl state that the above infOrmation I5 wrrecL I agree to comply with all tlty antl counTy ortlinances antl state laws relating to builtlin9 construction, and hereby authorize repre-. sentatives this ciry to nter u on the above-mentionetl pro ert !or inspection p o s� /� � Si9nature �+iC. Date � $ � � TYPE OF CONSTRUCTION LJ NEW LJ ADD Iv�ALTERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OT R � DESCRIPTION OF WORK/USE OF BLDG � � T � �' TVPE OFPEFMIT LJ GRADING LJ FOUNOATION LJ STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ OTHER. PROJECT DESCRIPTION 5�. Fr. OCCVaANcv � - CON'STRUCTION TVPE VALUATION $ _ ZONE GRADINGCU.VDS. ACftES_ Remarks:: , . ar Sink ., ackflow Preventer ' ackflow Irrigation - athtubs ` larifiers ishwasher rinking Fountains loor'Drains a loor Sinks as Service �lIL�2L5 Kitchen Sink _. lavatories P—Trap Roof Drains Reinspection Fee� $15 Boiler Duct� Under Ground Duct - Structural Duct - Ventilating Exhaust System �❑ Multiple ❑ FirepVFact Blt. ICBO # Heating System & Ducting ' ❑0-100,000 BTU � 100,000 BTi Rei ct' F IDrivers' License or Sc � � / � I I nspe ion ee CMF OBfi5-46, rev. 30/B4 White � Builtling; Canary - Applicanh Pink - Accouniing; GoltlenrOtl - Assesso� $15 PLUMBI Service Sink " SewerCap Sewer Connection Solar Collectors Solar Piping � Solar Tank Swimmin9 Pool w/Spa Urinal Water Closet Water Heater Water Service Auto-Wash LaundryTrays ' Isue Fee Hood or Typel LJ Canopy, Type II ❑ Refrigeration System ❑0-100,OOOBTU ❑700,000 System Repair/Alteretion Fire Dampers Registers Issue Fee F $ 3 FEES $ 3 .P. # S Main Buildi E T Front 6 Rear A C Right K Left S Ping. Ref. # Planning Notes: Automatic Washer Consvuction PoleSub. Cooking Unit Dishwasher Dryers ❑Gas ��Elec Fan F.A.U. Fixtures � 1579 2/02/87 — � Accessory Building: Parking Req./Provided ELECTRICAL Transformer ❑ 15-50 KW � ' ❑ SO+KW Meter ❑up to 100 amps Meter ❑over100amps � Sub Panel ' . Morors O0.1 HP O1 %- 8 � Inc.Solar 09-15 HP �i6-15+ ' Microwave Pole Light � -� Outlets- - , Range � , _ Switches � � Garbage Disposal Generator DO-5 KW �5-15 KW }� Standing Sections Trash Compactor Fee �$15 � � Issue Fee 8._00 TL FEES $ 3 Z O N I N G R E Q M T $ DEVELOPMENTSERVICESREQUIREMENTS: - � Zoning Approved By Date Building Approved By Date Appliwtion Issued By � Dat �' y SUMMARV OF FEES BUILDINGPERMIT ,$ SMIP $, PLAN CHECK $ PERMIT PIUMeING $ � ISSUANCE - $ PLAN CHECK 25% $ ENEPGV P.C. $ ELECTRICAL $ GRADING $: ' PLAN CHECK 50% $ � MICROFILM $ -� MECHANICAL � $�� TOTALFEE $ � D . PLAN CHECK 25% $ � � CONSTRUCTION AND PLANNING POOL & SPA !• Date Inspector Date Inspector APPROVALS Permrt # APPROVALS Permit # � 1. Temporary Electric2l Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. �.y_y'7 L�O 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgmd. 55. Electrical Bonding 5. Steel�Reinforcement 56. Rough Plumbing & Pressure Test �6. Electrical UFER Grhd. 57. APPROVAL TO COVER-GUNITE 7. Footings - 58. Electrical Conduit-Undrgrnd. $. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing � Z+��j�' (�� 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final ' �* 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign � 68. APPROVED FOR PLASTERING � 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT � 20. Rough Factory Fireplace APPROVALS Permit # _ � � 21. Ducts, in Structure � � 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd:StorageTank OGas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical ' 27. Frame and Flashing 76. Dry Standpipe � 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL • 30. Drywall Nailing . HEALTH DEPT: REQ�UIREMENT . 31. Plaster Brown Coat 79. FINAL INSPECTION . 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes:.� Z�-Y7 w,��rQ ' Va.��r Oi�� Ls J 34. Final Heating & Air Conditioning �� ' � 35. Final Gas Pipe-Test � 36. Hood or Canopy ' I 37. Final Factory Fireplace , I 38. Final Plumbing �� (�i� - 39. Water Service-Final � � 40. Gas Service-Final - 41. Solar pomestic-Final . � �42. Backflow Preventer � `� ' � � � •43. Backflow Irrigation • , �44. Landscape Irrigation System ' • �� . �45. Sound Attenuation � � • �46. Handicap Regulations ' , ' 47. FINAL STRUCTURE & BUILDING � 48. Special Requirements Completed � . ' ' � . . � ' +� 49. Electric Release to Edison � � . • � " . 50. Gas Release to Southern California Gas Co ' � • 51. CERTIFICATE OF OCCUPANCY , No. � Date , � . 1 1 I i ADo��ant to fill in all spaces e�ceot those within heavy porCer Ilnes antl sign all aoP�opriate Geclarations. ciTY OF COS7A MESA CONS�R�CTION PERMIT . Project Aduess ' 3�C�$ � p�A �r�l'�Ay �}y� Applicant'sMailingAddres�o� ��y'�!�•, Owner's Name� GUN%�1� �eI G'aG�%� � ione Address /4�' ✓� ' � 5�i � 3lCG .'�,w� �' Arch/Eng. �'�G�'� /'+�+'�License No. ��3 Address '��% y�� '✓/ly �.'U� `��%'/s�j�!�%`". Contrector's Nam (i4�NF1L �L✓4�'S'L Phone Address (mailing) City License No. LICENSED CONTRACTOR DECLARATION � � I hereby atfirm that I am licensetl untler provisions of Cbarter 9(commencing ., with section 7000) of Division 3 oi ihe Business antl Professions'Cotle, antl my license is In full force antl effecL , ' License Class License No. Date Signature � WORKERS' COMPENSATION DECI�ARFTION � ! 1 M1ereDy affirm tM1at I have a certiticate of consent to selhinsure or a certificate� of Workers' eompensation Insurance, or a certitied copy thereof (Section'` 3800, Lab. C.) . � � - � �Y I � . Policy No. - Company , ❑ Certifietl copy is h¢reby lumishetl, , . � Certifietl copy is tiletl with the city Builtling DIVISion. Jate Applicant EXEMPTION FROM WORKERS' COMPENSATION DECIARATION (This sectibn need not be completetl if the permit i5 (or one huntlretl ($100) or Iessl. ' . . . 1 certify lhat in the perto�mance ot the work (or which this perm�Yis i55uetl, I shall not employ ny person�in any maJ�� so f0 become SUGjecYto the Workets', pe ation Laws of Califopfre! G�,/ �. '� Date Signature � �CCL� .NOTICE..I , a r king this tleclaration,. u shoultl become,subject.to.[he - Worker5' Comp¢nsation provisions ot the Ldbor Cotle, you must forthwith compty with such provi5ion5 or this pe�mit shall be tleemetl remketl. CONSTRUCTION LENDING AGENCV � 1 hereby affirm that there i5 a mnStruLtion lentling agency fOr the performance of tne work for .which this perrnit is issuetl (Section 3097 Civ. C.) tPntler's Name l¢Od¢I'S Atldl¢55 � � OWNER BUILDER �ECLARATION I M1ereby affirm that I am exempt from the ContractOr'S License Law for the following reason (Section ]031.5 Business antl Protessional Cotle: Any city�or county whith r¢quiresa permit to wnst�uct, alter, improve, demolish o� repair any structure, prior to its issuance, also requires the applicant tor such permit to file a siqnetl statement that he/shd is licensetl pu�suant to the provisions of roe ennvactnr•< � icense I aw IChao[s� 9(commencing wlth Section ]000) ot LJ I, az owner ot tl �mpensation, will tic r sale (Settion �0 .cense law tloes not �hereon, antl who tic employees, provitletl sale. If, nowever, the •pletion, the owner wl ove for tne purpose 1, as owner oi the I dCI0I5 SO COOSSIUCI I he Coniractor's Lic builtls or impraves tl bactor(sI ucense puc proaf of their Work� ❑ I am exempt Untlei � Date nt tor a p6rmlt Subfect5 [he applicant to a civll i five nuntlretl tlollars (y500). property or my employees with wa9es as their sole ie work, and the structure is not intentletl orbfferetl , Business antl ;Professional Cotle: The ;Gontractor'S iply [o an oWner of a property who builtls or improves such work himself/lierself or ihwugh his or her awn t such impro�ements are not in[entletl or offeretl for iltling or improvement is soltl within one year of com- iave the burAen of provin9 he/she tlitl,not build or im- Sale). � �operty, am Cxclusively contracting wlth IicenSetl con- project (SecC�on ]044, Business and.Prote55ion5 Cotle: ��e Law does"not apply to an owner of property who eon, antl whP mntracts for such project5 with a con- nt to the Contractor's License Law). I am aware thaf Compensation insurante Shoultl be provitletl to me. :ction B. & P. C. for this rea5on ISi9nature � '+'%� �rivers' �icense or 55 � `'MF 0865-46, rev. 30/B4 White L---�� TVPEOFCONSTRUCTION � LJ NEW LJ•ADD W�iaLTERATION U REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER ' DESCRIPTION OF W RK/USE OF BLDG. �� 5 ��_ aT ' �� a N ]� � P4 G-C ' TVPEOFPERMIT �. GRADING FOUNDATION STRUCTURA� � ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ OTHER ' PROJECTDESCRIPTION 5(.1.FL 6 oCCVaa Y CONSTRVCTIONTVGE �_ VALUATIONS�y_C'L��= �� ZONE 'GRA�INGCU.VDS. ACRES � Remarkr� /"Y�`= G �.Cl� A Bar Sink Backflow Preventer Backflow Irrigation Bathtubs � Clarifiers n Drinking�Fountains Floor Drains Floor Sinks Gas.Service Interceptors ' Kitchen Sink � Lavatories P-Trap Roof Drai �' einspection Fee Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tan e A.P. � a - S Main Building: E T Front � A Rear C Right S left . Ping. Ref. # Planning Notes: < 1711%//�LT/�►"a�iTl_ /�!►UA� � � � - i ! ^ 1� • �■■ ' . . . . �e� -■ � � Swi irig Pool w/Spa � mal Jutlets � Water Closet , � Water Heater Water Service' . � .. ' Auco-Wash ' ' ' Laundry Trays � $15 Duct- Under Ground • Duct-StrucNral , Duct - Ventilating Exhaust System ❑ Multiple Firepl/FacL Blt. ICBO # Heating System & Ductin 00.100,000 BTU ,000 ReinspeMion Fee -� � $15 Canary - Applicdnt; Pink - Accountinq; GoltlenrOtl - Assesso� Issue Fee Hood or . Type 1 ❑ Canopy Type I I ❑ fiefrigeration Syst ❑0-100,00 U 0100,000 S m Repair/Alteration Fire Dampers _ . Registers luue Fee $ 3 $ 3 Oryers lec[ric F.A.U. ' Fixtures Device Boxes � Outlets Switches ' ' Garbage Disposal Generator ❑ KW �5-75 KW I ReinspeMian Fea �$15 I DEVELOPMENTSERVICESREQUIR �Zoning Appmved By--� ' Building Approved By Application Issued BV 1400 I/30/Q7 2one Accessory Building: Transformer Ll 15-50 KW • � . � ❑ 50+KW Meter LJup to 100 amps - Meter ❑over 100amp SubPanel' ' � � Motors�0. . P�1%-8 Inc.S r �9-15 HP �16-15+ n �.....,�„o � Pole Light' Range Sign Standing Sections � Tresh Compactor � � luue Fee u"-- � DateJ� ' � SUMMARV OF BUILDING PERMIT $ �.�DO �° PLAN CHECK $ Su g�J PLUMBING $ PLAN CHECK 25% $ " ' ELECTRICAL $ PLAN.CHECK 50°,6 $� MECHANICAL $ � � PLAN CHECK 25% $ ' \ 368,�6 TL Z O N I N G R E Q M T S $ 3 � ' SMIP $ �O PERMIT ISSUANCE $ . ENERG� P.C.� $ GRADING $ - MICROFILM $ -- �{�/� �� p�/ TOTAL FEE $. � , � .. POOL & SPA � CONSTRUCTION ANDPLANNING APPROVALS Permit # Date • Inspector AppROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole � 52. Pool &• Epuipment Location � 2. Soil Pipe-Undrgmd., � ' 53. Steel Reinforcement 3. Electrical Conduit Uiility-Undrgrnd. , 54. Forms 4. Electrical Conduit-Undrgmd. � � 55. Electrical Bonding . 5. Steel Reinforcement�„ � 56. Rough Plumbing & Pressure�Test � 6. Electrical UFER Grnd: � 57. APPROVALTO COVER-GUNITE 7. Footings , �. - 58. Electrical Conduit-Undrgrnd. S. Foundation , � � �' 59: Gas Pipe, O Undrgmd., Test . 9. Water Pipe-Undrgrnd. . 60. Backwash Lines, P-Trap, O Undrgrnd.� � 10. Structural Floor System 61. APPROVAL TO DECK 71. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap ` - 63. Heater & Vent-Final 13. Roof Drains � � 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final - 16. Rough Electric Wiring - � 67. Fencing & Access Approval 17. Rough Wiring Sign ', � 68. APPROVED FOR PLASTERING � 18. Rough Electrical-T Bar Ceiling � 69. POOUSPA 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 .�y. 1 . , 24. Roof Framing ,. � 73. Undergrnd.StorageTank OGas ❑Oil 25. Roof Sheathing ', �� '. ' 74. Overhead Hydro � . i 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical, , . �• 27: Frame and Flashin ' - 9; 2�,p 76. Dry Standpipe . �. 2S. 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 Metzr-Final 80. FOOD CERTIFICATE ISSUED, 33. Final Electric i Notes: B� ��' ?j 9 34. Final Heating & Air Conditioning r , �, 35. Final Gas Pipe-Test � c� � Cd a! 36. Hood or Canopy � �. �.L 37. Final Factory Fireplace � j �. z 38, Final Plumbing � • ��y Q � . 39. Water Service-Final � � . .' " r - . 40. GasSer�vice-Final � ;' �. '� 41. Solar D,omesticFinal , r, . � - �'42. Backflow Preventer � � ,�k . . t� ' . 43. Backflow Irrigation ' . . � � - . �,� 44.. Landscape Irrigation System � , � 4 ' SL1 �45. Sound Attenuation ' � r ' � . � _ t 46. Handicap Regulations � ' �� I 1 � • 47. FINALSTRUCTURE&BUILDING _ � � � � ` , 1,. . 48. Special,Requirements Completed � � � i% � ., � � 49. Electric Release to Edison '�' ` . . . �, 50. Gas Release to Southern California Gas Co � � 51. CERTIFICATEOFOCCUPANCY , No. � Date veaetr�ooxess: 3188 AIRWAY AV uxR:G OWNEfl'SIMME: KEVIN A, COLEMAN - �ooncss: 3188—F AIRWAY AVE COSTA MESA CA 92626 (714)754-4446 RflCNIFNGINEEfl: AICHARD CLAAKE ��'x�'Ci4522 �ooaess: 23117 PLAZA POINTE uxrt:150 LAGUNA HILLS CA 92653 PEHMRTEE: J—MONT ELECTRIC ( 714 ) 272-9432 ROOflESS: $15 CAMINO CORONA CA 91720 LICENSED CONTMCf08 OECL4MTION: I �ereDy atlirm ttwt I am Iicense0 un0er proviswns ol CAapter 9(commencin0 �h Section 7000) al DNaion 3 0l tAe Busineu and Professions COAe. an� my license is in full force and ellect. cmuc.:051468 �TA*��•511913 �u� C—LO oate: ��.,.ra'_�� sro��uro: NIfEBS' COMPENSRTION OECUMTION: I Aerehy aflirm at I I va a ceR te oi consent to SelFinsure or a certifiwta o/ Workers' ensation Insuance, or a urtilie0 copy Ihereol (Sectlon 3800, LaU. C). yxo.:80016764 �cr.o�h: 08/09/91 cornr�Hr: TRANSAMERICA ❑ CeNfieG wpy is Aereby IuMSAM. � CeNfieO wpy is tle0 wiU the dry BuilNnp ONNm. _ / �% ��t�3%/�R,ffi�A IXEMPfION FNOM V/OHKEHS' LOMPENSITION OEIXAMTION/(11is sE'cdm nee0dol be comWeteE if Na permt u iw me hwtlaU (5100) w less�: �, I urUty tlat in the perlarmance ol Ihe work for which t�is permit is issueE. I shall not emDloy any person In any manner w u to become� suCl� �o the Wohsrs' Campematron Lam al Califomw. Oaie: Slpnature: NOTICE: II, aner maldnq iks aeUaraelon. rou slroula 6ecome suoiM to tLe workers' Campensafion o�� oi ttce Labor _�. CoEe, you must forl�wit� comply rAth wc� Dravaions or Ihis permit shall he CeameE mroked. �..� fAN%TBUCTION IFNDINO AGENCY: I hereEy atfirm ttwt there Is a cansWctbn lendinp a0ency for the petlormance al the work tar wkch tNs Dermit a issue0 (�tion 3097. Civ. CI. _, lENOEH: , � nODtIESS: OWNEN BUIIDEH OECLANI7ION: I here�y aHirm that I am axempt irom the Contactors' Slaie �icensa Law tor Ihe follovnnp reason (Section 7031.5 Business an0 Pmfessional COEe: Any clty ol caunry which reQuires a permit to consbuct, atler, improve, Uemalish, or repair airy sWclure, pnor m tts Issuance, also reyuires I�e aD7��nt lor SucA permit to /ile a sipneE slatement tha� hUshe is lic¢nse� pursuant ro tAe O�o�ons al t�a Contracrors' State License Law (ChaD�er 9(commencinp witA Sectlon 7000) at Division 3 at the Business anA Pmfessions Coda) or that he/she is exempt t�areirom an0 Iha basis tor t�e allegetl eeemD�ian. My vialatian of Section 7031.5 hy any aqDOcant lor a Dermit suhlects the aDP��nt to a ciNl penalry of not mom than tive Auntlmtl Oollars (5500). �I, as owner of I�e property or my emVloyeas with wapes as Ihelr sole compensation, vrill tlo Iha work, anE tAe stmcture Is not imentled or ofleraE for sale (Section 7074, Business an0 Professional Cotle: TAe Contractors' Stata License Law Oces not apDN �o an awner ol a D�operry wlro Ouilas o�improves IAereon, anE wAo Oaes suc� work himsett/Aerseltorthroup� his or �er own emplayees, proviUetl IAat such imDrovemanis am nai intentlad or atlere0 far sale. II, however I�e buildinp or �` impmvement is sola within ana year ol completlon, IAa awner will have the OurCen ai Dmvinq Ae/she tlltl not build or improve for Ne purpose ot sale�. I, as owner oi the D�aPeny, am exclusively contractin9 with licensad contractars to consimct Ihe pmlect {Saction 7044, Business ❑ and Professions CaEe: The Coniractors' SWte licensa Law tices not apply to an awner al O�aOeM �o GutlOs or improves Ihereon an0 wM contracts for such prol�ts q�� a contractaqs) license pursuant ta Ihe Canlractars' 9tate �cense Law). I am awam ihai Droof oitheirWorker's Campensetlon in5urance shoWA be Drovitled ta ma. � I am exempt unAer Section: B. d P. C. lor this reason: Oate: �wner. I do hereby ceNty Ihat I am aware ol anE unEerstanE the reQuiremenis al Califomia Health anE Salery CoAe Sections 25505, 25533, an0 25534 anE that I or any luture UuilEinA acupant will/will no� (cirde one) neetl to comDN �+�� a state co0e5 anG t�e reQuirertren6lor a ' permit for constmction or moEification Imm the N'r u� ManaOement District. Besidential constmction aDD��cations are exemD� �ram chese o�ovisions. Date: Fpplicant: I nereGy certiy tlwt I nave rea0 tks aDDliwtion anE state ttut tM abwa intormaUon ¢ cortecl. I a0�� ro wmpty with a0 dry anE counry ar0inances an0 state Wvrs rela6np to UuilEinp construpion anE Aeaby aNlwrixe reDreseronthres oi Mis ciry la emer upon � a0ovo-me pmPerry lor inspectian Puryoses. _ oa�e: 9—iS— 9r'� Sipnature: � oriver's �icense ar Soda� Securiry 1&it�A6 W�iie—BuilEirp; GrearCaOa Enlorcament; Canery—ApW�cant: Pink—Revenue; GOIEenroE—A�ieswr CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 049169 PERMIT NO: E 049169 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: 5—N PERMIT TYPE: ELE PURPOSE: OTH JOH DESCRIPTION : COMMERCIAL T,I. (OFFICES 6 STORAGE) SQ FT: CLAIM VALUE: CALC—VALUE; GROUP OCC; H-2 / COMMENTS; RE: B49063 PRIMARY BLDG, PERMIT. +r�r*x�*�er*�r**rx�r*****rrrr**r****r***�xwr**�rxr�r*****��r+r+tr**�r�r�*�r+r��*�**+r��r**�r�e�* Z O N I N G R E Q U I R E M E N T S S E T H A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IN AEAA: FT IN FRNT: FT IN REAR: FT ZN LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN PARKING REQ• PROV; PARCEL: 42719327 2NE; REF NO: PLANNING NdTES> > iFMiFikifitMitififkikikkifkikMMMNM1FMifMlfMlffflf�Flkifif.lFkikifikNflfFfF1lkMikiF%kiFikMiEikMiElFiFififiFikiklElEififikiFikiFMiFNMlfiF D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S 20NING APPROVED HY {� _ DATE: BUILDING APPROVED BY : APPLICATION ISSUED HY: LEGALZZATION:N -` DAT E : ' DATE : *��;fsF'i� ifkifiEiFiElFlEif iFiF MiF1FMit MkfflklffFiF ikMMMiFMifkIfIFM1EiF1EikMM1lfFitifiFif%MMlEiFiEikiFMif1E F E E S U M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 54.30 50! SMIP/NON—RES PLAN ISSUE FEE 15.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 54,30 15.00 0.00 69,30 69.30 � ,00 REVENUE DIVISION TOTALS--> COLLECTED: 69,30 OVER/SFiORT: 00 BLDG PMT PLUMHING ELECTAIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 69.30 ifiFiFiFikkifMifkikiFikMikMMititMitikifikkiFMMMikkiFMMikitiFifMiFitifkikMlkMMk!lMifMiFitifikiEMifififiEKiEiFiFiElfififiFiFifikikiFMM I N D I V I D U A L F E E B R E A K D O W N %�� ELE ELE ELE ELE ELE QTY 2� 19 20 9 D E S C R I P T I O N FIXTUR£S, LIGHTING 1 ST 20 FZXTURES, LIGHTING ADDITIONAL RECEPT/OUTLET 1 ST 20 RECEPT/OUTLET ADDITIONAL REC£PT/SWITCH 1 ST 20 END OF FEES UNIT COST TOTAL COST EA, .75 15.00 EA, .45 8.55 EA. ,75 15,00 EA. .45 9.00 EA. ,75 6,75 . J �1 �007n37a-1007t]374 Tr1 T 59.?? DATE: OS/ZSI90 SIi7�: 1'st33 �CONSTRUCTION AND PLANNI� �L & SPA �'APPROVALS Permit # iDate Inspector AppROVALS Permit # Date Inspector / •1. Temporary Electrical Servtve or Poo� L� 52. Pool & Equipment Location � ,$:.;,$qi7-�.ip��Jpdjgcnd;� � � ..�5 �� 53. Steel Reinfortement y•� r3.��E�tr�C��clviy-�kility-Undrgrn�s .j � 54. Forms �. ��.I=Eleetrica�G�o , ii drgrnd.�, 55. Electrical Bonding �' `"� 5t�€ARe�f,H¢,r�t �� ' ^X ' S6. Rough Plumbing & Pressure Test � ��,s ct� la�§md. � 57. APPROVALTOCOVER�GUNITE �n°„ rT,.>FootirtgECC � 58. Electrical Conduit-Undrgrnd. �% ''��oundatio� n � � 59. Gas Pipe, O Undrgrnd., Test .,' 9� Water Pip�Undrgrnd. _ . 60. Backwash Lines, P-Trap, O Undrgrnd. 70. Struccural Floo� System � x � 67. APPROVALTO_DECK � • 11. Property Sevagr Lin�& House Conrg`ction • 62. Backwash & Receptor�Final 72. Sewer Cap %% �' � � °1 , 63. Heater & Vent-Final � U ..� � . .y . 13. Roof Drainsrv-- cn • 64. Plumbing System - Final , 74. Rough P�umbiiS� " - 65. Electrical-Final 15. Rough �ectrira�•Conduit � 66. Solar SYstem-Final '' � 6. Rough �7ectribWiring 67. Fencing & Access ApP�oval �. 17. Rough Wii�g ^�'gn � � 68. APPROVED FOR PLASTER WG � , 18. Rough ElectricAt-T Bar Ceiling O-�.� L 69. POOL/SPA Sl'STEMS FINAL 19.�Rough Heating � Condityo�ljqg Q,t„ * y y�� *� � Flf}E-0�2T. C�EQUIRFMEN�. t�??] .tr!m v v . •. � Cf '7fJ��J IT? 7 i� `..� .•7� 20.�ioggh �ctop� FIIaP�ace i StT' GC �x S+-+ �� x PPR6VAL6��F-PerYait #* '^ "+- c x -� n- 21."�uc,`f�, i`- tr�ctuCe* t.. .. �-;5 � S O:-��c x. ry h7 * ,,, �j _:* t S� �k (� i-+ C'�x � 70. l�l�der9roµyidHy�ro * 22.�uCts, �tentiFgtingy* i � CJ x 7 �!J �M � 71. Produc �ing s OrOil � 23.'Gas�ip�fioq�gh 8,�,�est i RS r"i "'Q O� �: o' '_'� * `•" � r�. �.p x M �, :,*,� 2. Undergrou{�c}Fl�h * �, �.:., ;,� 24. Roo Framing ••:�: � [:f � ` > � r-i* � •q3: dlndergmd'.Storaga7ank�Gas ❑Oil 25.� oo�Sh�ething 4* � ��M .� � r�'* * 7q�Overhead HydroSc * 26.y�`f�Bai Ceiling l�tr�ciurall &� p�.gcoat r., p �. v �q�� x. 757Dry CherzttCa{ F� *� �-+� ,!'�;:'t � n � 7:�rai`ie a?d Flashiriy� H�� c � �" �' mM * 76. Dry Stan� pi g;e:' M O N �� ,._r',^ �8. Lat�ng�Siding,',��*" pc�F O * I � 77."�FIXEDS�SfEfWFINALk`-� !� [�*7,CT% i� r n ,�29. Insulati� �* 5 CSJ �s S I( b�'c ��BmFIRE PREV. FIR}A� *' � � r_.�.,H �'30. Drywall�lailing �x i-+ i �'r �,'� * S FiE�LTF{'4JEPTxREQUIREIVFERth7Cl - r- c. � �^ ' 7. Plaster B�own Co � S i�"�" � �I .��'79. FINAL If��CTI�' � xF � y �7 F H yE"32 �Electric�l�Pow,er hAeEei�F��al � x I x` O.=�OOD CERTIFI�Q4TE ISSI�tfDH SS �33.=�in5'C Electrie'� * �''� � '¢ h f/11 � � � * NoC�s'v `"`� '^� �' '' p `"• T n r- �:-.H Vcbb-4. �e M a �� nn x .� 'n'�34.yFin� Heatin� /�r��itionilig`' � * � � I/^�y # N i-�+ao o t [-K � u �O� `� �35.('Final GarPipe-Test* � •• x i-+ , � : �c * D ^c 0�- :K :ii�[U�-+:LLT' c.. � x n. .. � M m c.. e. ;. c, i.. �6.SNoo� o�tifanopY �X �n i�m u x n �:� m zo T tn NUN��IIT; I , r, r,; "'87. •Fina1•FaQory Fireple ex i ;-�F � � � :' �'�'�' z � � G ti � . O+ .K [li � � '. H� � '� �:. lT �K '7 �38. Fin3�jPl'uR'p�bing � rr;N j r,^'n * _ *,� t•. cr, 7 y '39. Water S�viGe-Final* e^, 1 � G I ` 4� *>+ c�~ � [an9tna7tT7 r u, W CK M F/'J # m �.."Q�4'� ;�0. Gas Ser�e-Final *'� Q�"�" � � � �' * , ' � i.; .c !l'ni-+ t+i k I �% i �`L X 4 �11. Solar pomestio-Pinal �r; � `� I � f� � ;r� '-o O' s. ^ D - c.. �c flc �e ti Ci x: S •42. Backflow Pre.v,snter� �u M i 1 R� �. ; v IU = :U OF;:-; � � * x � -,p . �_. 43. Backflow Irr�tion� �� M G * � c� i � ^ (� • • • • • � x: � F ti x 3 O %� t� cL -� x (L[�]�J CC * ?i G � �K � � u t� � t�: � �..��. �� "0.`.�j4.�Landscap�elhigatioqSysrem.-. T �; =�r �,... �' � �n � K w �." eC �t �: � � E f � �. ., :i: S V M `n. . . . .. . .y� ... 5.�und Atterivationr '� •• •� � �� :T.� T :^.* x F c � • F�o * r+ r •.� dC i / HLl ^H K • �46. 4ian,�;cap'flegulatio�ls '" O x �� * "' "`'' • s s I I �4 m O :� * ;.47."FIPF�L STRUCTUf�E & BUI`�DING � ti � I ; �� * � V * � � �� m x n �i LC k" O 46.�INAL P�ANNIN� i `"F � :� I I ,' � * `r�j rj ;j S � ¢ ..49. lectiic Release to �dison � � � � '�� tr• � •C� � ~ �- --� Y � - - � n -�xr�_.� 'BO.�asSAelease to Sout�em Califor,aia.GasCo * � � �� M `� '" � �`�' * � �, � � x� • S �o l� � n� cruoo�� '51. C6RiIFICATEOF'OCCUPANCY ' - ' No. Date PN FCT 110DHE3S: 3 1 S B AI RWAY AV owxen�srntne: ALPINE SERVZCES , �ooxEss: SAME AS ABOVE 7i4/754-4946 1RCHIEMGINFEfl: �ooxess: REO.NO.: UNR:G I CITY OF COSTA MESA - BUILDING PERMIT PERMIT NO: P 04908II PLAN CHECH NO: N CONSTRUCTION TYPE: PERMZT TYPE: PLU uxrt: � PEHMITTEE: A—MAC' S PLUMBING INC. ( 714 ) 997-8877 �ooxess: z101 S HELLMAN B ONTARIO CA 91761 LICFNSE� CONTMCTOH UECUIUTION: I hereby allirm t�at I a�I censeV11AII0�y visions ot Cluphr 9(commencinB with Section 7000) ol Division 3 al the Busineu an0 Pmfessions CoOe. �licenu is in lull f ca and eflect. ciTr uc.: n q 6 0 3 2 sTnr� uc.: 4 6 7 2+ 4 �- 3 6 Da�e: �� Sig ra: WONKEBS' COMPENSRTION OECUMTION: I �er ertifipte oi consent to ulbinsure or a cenifiwro ol Warkers' fqmpenution Insurance. or a ceNfieO mpy Nemoi (Secuon 3800, Lab. C�� ucrxo.:PWC1Utlb41 ur '�4/90 rnrnxr: IND INDEM � J Cen/llle1E copy is herzEy tumi50ed. � ieE wpy b fil vAth a ciry B iINnO ��an. Date: r ��,�j' 9 v . -. IXGIPfION FNDM WOPMERS' COMPENS1itON 0 TION: (tles section eed not Ea comD�eteE il Ihe pemut a tor ane hunOreO �f700) a kss�. I certiry tlat In tAe DeMormanca of ��e work lor whic , I shall nat emD�oY any person m any manner m az to Eewma subject to tAe Wohzrs' Compen5aiion Laws of Calitomia. ; � Uate: SignaNrz: NOTICE: It, after makinq I�is Oecla2tion, you shoWU �ecoma su0iact ro tAe Workers' Compensa[ion�piansions oi the Labor Cade, you must Io�hwiN compty with such Dmvisions ar Ihis permit sAall 6e tleemetl revoked. yj CONSTPUCTION IENDIN0110EXCY: I Aerehy aflirm tAat t�ere Is a consiructlon IenEinp ap¢ncy tor Ihe Detlormance of tAe work for w�ic� I�4 permitis issuad (Seclion 3097, Civ. q. LENOER: aooxess: OWNER BUILDER OELUMTION: I �ereEy aifirm ttwt I am exemD� �rom tAe Cantractors' SWte License Law lor the tollowinp reason (Sectian 7031.5 Business an0 Pmfessional COEe: My dry at counry which repulras a permit in cwstmct, alier, improve, Eemolis�, or reDair any stmcture, D�or ro tts issuanca, alsa reQuires the apD�icant for sucA Oermil to fila a slpneA statament t�at �e/s�e is Iicense0 pursuant to IAe Orovisions al Ihe Contrzctors' State license Law (CMpter 9(commencinq wtth Sectian 7000) at Oivision 3 al IAe Business an0 Pmfessions CaEe) ar Itut MJshe is exempt Iherefrom anE Ne Easis tor t�e a11e0� exemptlon. My WolaGon af Section 7031.5 by any apDlkant lor a permit su0jec15 Ne appGwnt ro a uvil penalry ol not more than Me hunCreO Uallars (5500�. � I, as axner of ihe propeM or my employees witA wapes az IAeir mle compenution, will Eo the wor�, ana me stmcNre is nol intenOeE ar ottered tor sale (Section 7014, Business anE Prolessional CoCe: Tha Contrzdors' State Licensa Law Oces not apDN �o an awner ol a proce�Y � �ui1Qs or impmves IAereon, anE who tloes such xvM �imself/�ersell or tAmuOh his or Aer own emplayees, proviOeE that 5uU improvements are mt InteMed or ollereE far sale. Ii, Ipwever t�e hinlain0 or improvement Lt wIG within ona year of completim, the owner vtil luve tAe OurEen of Drovinp hels�e Eid not buEE or improve Ior tne purpose ol s�le). I. as owner ol t�e proper1y, am exclusNely coniracWA ��h Ilcensed contractors to canslmci Iha pmjeci (Section 70/4, Business ❑ anG Protessions Cotle: The Contrulors' State Livae Ww Eces not appty ro an owner ol properry who builQS or improves Nerean anA wM coniraps for suc� Drojects qU a caMracroqs) license Dursuant to I�e Cantractors' S[ate Luense Law). I am aware that Oraol of Iheir Worker'S CompensxVan msurance shoNA Ue Orovi0e0 to me. � I am exem0� untler Section: B. 8 P. C. JOB DESCAIPTION : PLMB FOR INDUSTRIAL HLDG T.I. CLAIM VALUE: CALC-VALUE: PERM NO: P 04908E GOVT: N SUPP: N PURPOSE: OTI-I SQ FT: . GROUP OCC: / COMMENTS: H-99063 ��*��r�**#*�r****�*�#+�*x�*��*��****x��r�*�r�*�r*�r**#��r�*�*�exx*��r*#�*��e#x x��r�r x'�a��x#�* Z O N I N G R E Q U I R E M E N T S, S E T B A C'K S ------------ MAIN 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 ZN PARKING REQ; PROV: PARCEL: 00000000 ZNE: REF NO: PLANNING NOTES> > ik iE if ik if iE it iE ff i6 it it iE iE iF iE iE iF it it if iF �E iE i!!E k if it iE iE iE jt it iF iE it 1:-'.E 3F j(- iE 3F iE it �k itit ik if ih iE iF iE iE �1E iE iF 3t # iF if It iE #�1F # i6 if # it iE �lE # iE ### k 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 APPAOVED HY , DATE: HUILDING APPROVED BY ; � DATE; / APPLICATION ZSSUED HY: � ' DATE; �/ �/9 C� �fiFillE�tiElEiE9EikiEiEjE�EiFiEiEiEjtiEildt iEiEiEiEiFiF3FiFiFiF�F3Fit�Fik�FiFiFiFiFifiF ik it iE!(� it it it iE iE ik it iE iF 3F iE * iE if k iF if it it iF # if iF iE �IE 1E iE it iE 3E ik iE iE �h iE iE �lE it �1E 34'k if iE ik iE *%iE iF jE iE iE 1f iF �Ih 3E fF iE it if iE iF d4 �I4 �lf iE �(- if iF iF iF ff� 3F jf # LEGALIZATION;N F E E 5 U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 8�5$ SMIP/NON-RES � PLAN ISSUE FEE 3.00 BUSLDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL ' PAID DUE TOTALS----> 8,00 3,00 0.00 11,00 11.00 .00 REVENUE DIVISION TOTALS--> COLLECTED: 11.00 OVER/SHORT: ' 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMZP/TOT GRADING FLAN-CHECK 11,00 i! iE 3F iE iE it �lE jE iE iE �F *�IE iE if iE iE �E iE i! iE iE i(� iE iE ik ik iF ff %if iE dE �1F it iE 3E iF 3E iE ik ik if dk �1! iE iF iF �)t iE �t iE iE if if iE it iF iE iE iE i(� �lE i(� �k iE * if iE iE 3E ik i(� # iE iE ik �IE iE I N D I V I D U A L F E E B R E A K D 0 W N rorihisreasan: TYPE QTY Date: Pxner: PLU � 1 I Ao Aem6y certiry Ihat I am awam ol an0 unGerstand tAe reQuiremenis of California Mealth anU Safety Catle Sectians Z5505, 25533, anE p j� U ], 25537 antl Ihat I or any IUWre buittlinp occupant wilUvnll wt (circle one) nee0 to comply wit� saitl stata codes anA the 20uiaments for a pLU 1 permit lor canstmction or �roEifiwtion Iram the Nr Uuality Manapement OistdcL Nesidential consWctian apDliwtions are exempt Imm pLU 1 �nese provisbn5. Uate: Appliunt I hereEy certlry tAat I Iwve rea0 this appliw6on antl state that t B n ormatlon ¢ wne pree ro comDN �N �I cRy an0 caunry arEinances arb state laws reWGnq to WtlGinO cortsvucGon a� rtDy auNor¢e re an tiuu al Uo ciry to e�rter upon tAe aEove�mentianM DropeM lanr inspeNon Duryoses. Oate: ` .�`�� SiOnaNre: oriver's ucenu or Sa� secunry x: " 18a�<e W�ita—BUIMiep; Green—Catle Enlorcement: Cenery—ApP�icem; Pink—Revenue: GolEenroE—Nssessor 7 D E S C R I P T I O N SHOWER SINSS, KITCHEN WASH HA5IN WATER CLOSET (TOILET) END OF FEES UNIT COST 2.00 2.00 2.00 2,00 01 OOi77 Q�3S'-Oi1070034 DpTE: U9/20/S4 TIi7E TOTAL COS - 2. � 2 ' V Zj .+�fl .1� - r ; � .� CONSTRUCTION AND PLANNING � P. _& SPA � � APPROVA4S Permit# Date Inspector qppROVALS Permit# Date Inspector t. Temporary Electrical Serv'ice or Pole � 52. Pool & Equipment Location i . 2. Soil Pipe•Undrgrnd. � � p j�- 53. Steel Reinforcement 3. Elec[rical Conduit Utility-Undrgrnd. 54. Forms i 4. Electrical Gonduit�Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test � 6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE 7. Footings • � 58. �Electrical Conduit-Undrgrnd. 8. Foundation � 59. Gas Pipe, � Undrgrnd., Test r 9. Water Pipe•Undrgrnd. � 60. Backwash Lines, P�Trap, � Undrgrnd. 10. Structural Floor System � � 61. APPROVAL TO DECK 71. Properry Sewer Line &�House Connection 62. Backwash & Recepror�Final � 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains ' � 64. Plumbing System - Final 14. Rough Plumbing Q y� 4Q � 65. Electrical-Final F 75. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring , 67. Pencing & Access ApProval 17. Rou9h Wiring Sign - 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 79. Rough HeSting & 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.StorageTank OGas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T�Bar Ceili�g lStructural) & Monocoat 75. Dry Chemicai { 27. Freme and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. F�NAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test � �_� 36. Hood or Canopy . 37. Final FactOry Fireplace 38. Final Plumbing �p�/�ij�J �{) 39. Water Service�Final 40. Gas Service�Final 41. Solar pomestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING ,/ � �, 49. Electric Release to Edison � 50. Gas Release to Southern Califoraia Gas Cn -�y / 51. CERTIFICATE OF OCCUPANCY : / ' No. Date Pfl0.1ECF(fODflE83: 3 S B B AIkWAY AV uxir: � ' OWNEfl'SN�ME: KEVIN A. COLEMAN nooeess: 3188-F AIRWAY AVE ' COSTA MESA CA 92626 (714)759-4446 �xcxrtecixeex: RICHARD CLARKE �o.xo.,C19522 �ooxess: 23117 PLAZA POINTE uNrt:150 LAGUNA HILLS CA 92653 ��E;ISEVIN COLEMAN (719)754-4446 RDOflE53: CM1SS AIRWAY CA 92626 � LICENSED CONTMCTOB OECIAMTION: I here�y affirm that I am IlcenseU un0er proNsions oi Chapter 9(cammencinp with Seetlon 7000) ol Division 3 0l tAe Business an0 Pmfeuians CoOe, and my Iicense is in lull torce anG ellect. CITY LIC.: ST1TE 11C.: CU83: ' Date: Sipnaiure: WOHKEBS'COMPENSRTIONDECUMTION: I�ere affirmthatlhaveautlificatealcrosen(toself-in5ureoracertilicateofWaBers' ComDensation Insurance, or a certifietl coDY Ihereot�5ection 3800, LaE. C�. Po41CY NO.: EXP. O�TE: CenllieE coDY is heraGy fumiS�eG. ❑ Certitie0 copy is tile0 wit� t�e ciry Builtlinp Division. oate: Npv�icant: IXEMPfNN FROM WOflKEH3' COMPENSITION OECUM710N: (ih6 sec6on mN not Oe rompleteE if ihe pemit's fa one him7re0 (5700� a lus). I certiry tlut in t�a perlormanu ol the vrork far which tltls permit is iuueE t emD�M' �Y De�n in any mamcer w az to Oecome suGject ro ��e Workers' Compensatron Laws ot Califomia. oate: '�-` �`�' '� sipnar��-� � NOtICE: II, alter maMing tAis Ueclaralian, you shoultl 6ecome subject Io the Workers' Campensation provisions of tAe Lahor CaOe, you must lart�wi[h wmpry with sucA proviUons or ttus permit shall De Eeemed revoke0. CONSTHUCTION 1EN01N011UENCY: I hereby aflirm [hat there is a cansiructlon lentlinp apency lor Ne perlormance of Ihe work lor wtnch IAiS pErmit is is5ue0 (Se[Iion 3097, Civ. C�. LENOER: ' pooaess: CITY OF COSTA MESA - BUILDING PERMIT PERM NO: H 0�9063 PERMIT NO: b 049063 PLAN CHECR NO: 05695-90 L GOVT: N SUPP: N CONSTRUCTION TYPE: 5-N PEkMIT TYPE: STR PURPOSE: ALT JOH DESCRIPTION : COMMERCIAL T,I. (OFFICES 6 STORAGE) SQ FT; 3,986 CLAIM VALUE: CALC-VALUE: 40,338.32 GROUP OCC: B-2 /; COMMENTS: (�)(*)(*T(*)(*)(#)(�)(#)(�)(#)(*)(#)(�) 3E i4 it iE iE iE'lk �)f if it if ?f� if iF �lk �lf?k �Yk if if� jt itlF �IF if iE iE 14 �!E if iE iE �)E 3F �3f it iE iF jF iE iE jE iF iE �k'h if iE iE iE if �1(-iE 1k iE if 3FiE 3F iE if iE iE iE iE # it d(� iF 3E iE �)t IF 3l-� iE ## iF Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING --------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: , FT IN LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT ZN PARKING REO• PROV: PARCEL: 42719327 2NE: MP REF NO; PLANNING NZSTES> INTERIOR ALTERATION FOR AN EXISTING CONTRACTOR'S OFFICE. > NO NEW FLOOR AREA PROPOSED. *�e****�r��***�t**i�*�r*it**�t#*#*+t***�t*�t**x�*�t�tw*irit-�-*+t**�t*x�*�r*�**+F***�t�t-+r*i�+4+E�t�t�se�***�t* 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�'��S ZONING APPROVED BY DATE: _ BUILDING APPROVED BY : DATE: _, APPLZCATION ISSUED BY:� �j . DATE: O ifiEiaitiEififitit3tikiE3t3Eif#jFif'k3tiki(-3F�'iFxi'FiFiF3FiEitxx�e �s raav . ��-�FltifiFiEif3F�1EiE�1F�1EiF7 ik it it iE it iE if 3f iE if i!'.f� iE iE �)k 3f� 3E i£ iF # jF iE iF it k it ik it ik iF iE �1! iE iE iE jF ik i� .. ,. x iE k 3f-" k ik iF ih it ik iE iE dE iE iE �E *�)t �)F iF iE it 1F iE # it dF! LEGALIZATION;Y F E E S U M t. A R Y -STRUCTURA� iFit 9k dF iF iE iF 1E ik iE �SEGMENT:Y OWNEBBUILUEBOEClAMT10N: I�erehyaffirmihatlamasempifmmtheCaniractars'StataUcenSeLawiortAefollowin9ressan BLDG PMT PLUMHZNG ELECTRIC`-MECHANIC FIRE SMIP/,RE'.i' GRADING ,(SecGan 7037.5 Business an0 Profeuional CoCe: My nry of munry whic� requires a Oermit lo consWct, alter, improve, Eemolis�, ar P ERM I T % 1 1. � � �� repair any stmcture, Dnor to ils issuance, also reQuires Iha apD�icant for suc� permit to fila a siqnaO stat¢ment that he/sAe is Iicense0 S M I P/ NON — RE S pursuanl to tAe D��sians al the Con[actors' State Licenu Law (Clwpter 9(commenUnO wiN Sectlon 7000) of Division 3 0l IAe Business P j, j{j.] 4 6 2. 8 0 . 6. 0 5 anE Prohssions CoOe) ar that Ae/she is exempt Ihereimm anE t�e Dasis far ihe alle0e0 eMemD�ion. My Nolation oi Section 7031.5 by I$$ UE F E E anyapPikantmrapermitsuojxtsmeapp�icanuoadviipena�tyo�notmomtnan�roenundreaamiars(55o0). HUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE �, as owner a� tne umcehv a� my e �oyees wsm wayes az tnur w�e wmpensa6on, will do the xroM, an0 Ne TOTAL S----> 718 . 0 5 0. 0 0 2 31 . 9 0' 9 4 9 4 5 9 4 9 4 5 0 0 SlrucWm is not intentleC ar aflered for ule (Section 70CI, Bus�ness an0 Pmlessional Cotle: The Contmcrors State Licerise Law Oces not apply ro an awner of a pmpeM who Euil0.s or imDroves t�ereon, and wlro Eces such work himself/hersell or tAmuph Ns or �er own employees, prouiOeU Nat suc� imDrmemen6 ara nat intenOeO or ottereE for sale. If, Mwever Ue DWOInO or improvament is SOIG wit�in one year af compleqon, tAe owner wi0 have I�e �urEen al proMnO Ae/she tli0 not Oui10 or imDrove i� for tne purpou oi salel. � I, as owner of the D�oDeM. am exelusiveN wmractin0 ��h IicenseE conlraclors to construct [he pmject (Sectlon 704A, Business an0 Prolesslons COUe: 7he Contactars Stata Liceise Law 0ces �rot appty to an ovmer al D�rty � bwMs or improves Nerean antl who eoniract5 tor such pml�s c�ih a conirattoqs) license Dursuant to I�e Cont2etors' State L¢ense Law). 1 am awam that Droof ol Ihelr Worker'S CompensYrmn insuraue ShoulE he O�de� to me. �� I am eKempl unEer Sectlon: B. d P. C. � Por ihis reasan: � � Date: `� ` 14 " `!�+ 0 ' I Oo hereEy certiry t�at I am awam ai antl undersWnd t�e mQuiremenb ol Calilarnia Healt� anE Salery CoOe Sections 25505, 25533, anA 25534 and that I ar any futura bullEinp occupant vnll/vnll not (circle one) naeE to comply with saiE slata coEes anE me reQuiremenis lor a � permit lor canstmction or matlilication Imm t�e Nr �ualiry Manapement District. FlevOential wnstruction aDDlicatlons are exempt trom tAese proNsionS. Date: Applicant: I nere0y ceniry that I Iwve rea0 tNs apDliratlon ari0 state Ihat Ne aDove intamutlo 's cortect. I apree to compy wrth a0 Ury anO counry orAinances anE state Wws reWtlnp to UuiWinA consWcoon ana heaEy autlw' sentatives of Nu dry to emer upan Ne above-memlorreE oroDahY br ins0�ibn ourposes. —� Date: � ' I `1 �' `�'� SipnaG Drroer's Liunu ar Sodal Secudry 16a1J8 W�ile—BUIIEhq; OreBrCatle Enlorcamen�; Cenery—Appllcent: Pink—Revanue: GolEenraE—Avessor REVENUE DIVISION TOTALS--> COLLECTED: 718.05 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTkIC MECHANIC . FIRE SMIP/TOT GRADZNG PLAN�CHECK 712.00 6.05 ik �)E i! �1F ik �E ik jf it if ik iE i! iE iE iE iE iF'�(� iE iE iE �E iE iE iF dE # iE �F iE iE iE iE �E ik iE iE if-iF iE iE iE jE iE 3E it iF iF iP �lE �F iF iE 3F jF �3f iE if 1t 1E #�f 3F iE �E # jF iE iE ii� iF 3!-it ie �l- iF 3t 3f I N D I V I D U A L F E E. b R E A K D O W N TYPE SFC QTY 3986 E��.'ry:i��i11E�i7J OFF-INT. ALTER TYPE V-N -AVER END OF FEES ✓' UNIT COST 10.12 TOTAL COST 40,338.32 V O1 OOOb9417-COQ69913 7 C9S "`�� DATE� 0?J19/SO T:r • � _T_� �� - I � ! I • CONSTRUCTION AND PLANNING • P $ SPA � APPROVALS . Permit# Date Inspector qppROVALS Permit# Date Inspector � 1'. Temporary Electrical Service or Pole 52. Pool & Equipment Location • - 2. Soil Pipe�Undrgrnd. 53. Steel Reinforcement ' . 3. Electrical Conduit Utility�Undrgrnd. 54. Forms � 4. Electrical ConduiFUndrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. flough Plumbing & Pressure Test 6. Electrical UFER Gmd. 57. APPflOVAL TO COVER�GUNITE ' � 7. Footings ; 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe�Und�9rnd. � 60. Backwash Lines, P-Trap, O Undrgrnd..• � 70. Structurol Floo� System 61. APPROVAL TO D6CK "�' �� 11. Property Sewer Line & House Connection j 62. Backwash & Receptor-Final �� ' � 12. Sewer Cap 63. Heater & Vent�Final ' �� 73. Roof Drains 64. Plumbing System � final 14. Rough Plumbing "� 65. Electrical-Final . 75. Rough Electrical-Conduit .' 66. Solar System-Final � i6. Rough Electric Wiring � 67. Fencing & Access ApProval ' : 17. Rough Wiring $ign ( 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Fough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilat�ng 71. Product Piping O Gas ❑ Oil 23. Gas Pipe�Rough & Tes[ 72. Underground Flush 24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling ($tructurall & 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 � J HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final ' S0. FOOD CERTIFICATE ISSUED � 33. Final Electric � ,� Notes: � 34. Final Heating & Air Conditioning � i,A ' i , 35. Final Gas Pipe•Test � � i 36. Hood or CanopY �� / 37. Finat Factory Fireplace � �� ✓ 38. Final Plumbing �.�1� i. 39. Water Service-Final !; 40. Gas Service�Final � 41. Solar pomestic�Final 42. Backflow Preventer 43. Backflow Irrigation '44. Landscape Irri�ation SYstem 45. Sound Attenu8tion 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING o L PO 48. FINAL PLANNING � :.. 49. Electric Release to Edison �_ - 50. Gas Release to Southern California Gas Co � 51. CERTIFICATE OF OCCUPANCY No. Date vnn � n ........ �... ....�, ..�...�.... JOB ADDRESS31 G A rvq}r Ave. GENERAL CONTRACT n o o. DESC AP No. 27-0 2-10 • LOT TRACT FIRE INSPECTIONS Si nat�ra Date T� soi� q �o GRS W�TER j �2. POUGH PLUMBING PROP. $WR. LINE � HOUSE CON. � �/ � f' SPRINKLING SYSTEM MISCELLANEOUS ROUGN HEATING RND RIR CONDITIONING UNOERGROUND U POWER U ROUGN WIRING TRENCHES FORMS STEEL REI FLOOR SYSTEM BOND BEr1M � STEEL REINFORCE [7 SHEATHING FRRME AN� FL/SHING LATHING - IN n OUT n PLr15TER. BROWN COAT SiRUCTURAL FINAL HEATING. VENT., REFRIG. AND A. PLUMBING, FINRL AN� GAS TEST ELECTRIC,FINAL BUILOING, FINAL FINAL BUILUING PERMIi N0. SUBCONTRACTOR , . � iA . COSTA MESA BUILDING-SAFETV DEPARTMENT . P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely BUILDING ADDRESS �J 't ti OWNER aw+uy IRVB� �'� MAIL"'� _ '__- __� '___ .�"� CITY �Stci MESd NO. OOKSTfiUCT10N I��e �y i cninm BFANCH ADOFESS ARCHITECT CONTRACTOR ppn I(pll W[Qk'iT1y, lS1C. ADDRE55 1�Oj �Vp Gtrppt TEL. c�rv New��ort Beach N�• 833-30 STATE CITY uc. rvo. 2217(¢ ��c. No. 1484 SIZE NO.OF BLDGS. OF l0T I NOw ON lOT Q VSE OF E%ISTING BLDG. SIZE OF NO. OF NEW BLDG. i ZSO ROOMS STORIES EXTERIOR WA ROOF COVERING ��. COVERING B�11t�1� USE QF ByIL�IN['i �jND WORK TO BE PERFORMED 1I1C1USTY� a � I ho�eby acknowletlBa tha� I have �aetl this appllcation antl stete thel Me above informetion Is correei antl eB�ee to eomply with ell lows repula[inp buildinp c0�struc[ion, ontl I ahell not amploy eny Oerson in violation of tho workman's compensatlon laws of tna State of California. I hareby ca�ii(y that I em proPerly Iicensetl as a contractor �ndar Ma S:am of Califomie Business and Professions Cotle, Dlvisicn 3, Chepter 9, and that such Iicenses era In fuil forca antl effoct, or I em exompt from tha p ovialons of Na Stem ol Calllornia 8u�iness antl Professlons Cotle Ivlcion 3, ror 9 SlBnetur of i s /i PormittB �.o ✓a.L/ Au[horizatl ABant vain \:;;�- ,�,� -2-�a�:�� 00 zn,.. •. , FOR BUILDING PERMIT BUILDING ADDRESS, OWNER VALUE FIRE 20NE NO.OF I USE OF NEW � PIAN$ 2 BUILDING � VARDSAPPROVED VARDSAPPROVE MAIN BUILDING ACCESSOflY BUIL[ DISTANCE BET. BET. MAW & MAIN BLDCS. ACCFSS. BLOGS. VAR.31`- DATE c.u.P.�wZE-7�-i�/ qppROVED�.Z— APPROVED/, �QD f nn�r� � �(i� RV WV I�� SQ. FT. TNE AMOUNT SH THE PVRPO6E OF I VALVATION s�33�� s ,� Y7 il � � � W 0 IS FOR � ONLY: ¢ (` �� m � � \E 7 1� ° LL JOB ADDRESS 31W .H� GENERAL CONTRACT01 AP No.t�7_042-10: ' INSPECTIONS ' $OIL GAS W RTEF ROUGH PLUMBING PROP. SWR. IINE ❑ NOUSE SPRINKLING SVSTEM MISCELLANEOUS FOUGM HE�TING ANO �IR C0� TEMPORnRV SEAVICE OR POl UNOERGROl1N0 � POWER ROUGN WIRING TRENCXES FORMS FLOOR SVSTEM BONO BE�M ❑ STEEL RE $HEATHING FRqME AND FLASNING Lr1THING - IN n OUT [ PL�STER. BROWN CO�T SUBCONTRACTOR � • COSTA MESA BUILDING-SAFETY DEPARTMENT • ' P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 • For Applicant to Fill in Completely — Use Ink Only BUIIDING � /� A DDR ESS /__I OWNER OR � TENANT MAILING �� ADDRESS TEL. CITY NO. CONSTRUCTION LENDEF BRANCM ADDRESS ARCHITECT 'Li��u !'r��u.w.-,� TEL.QIii)19 REC BV A.P. NO. BUILDING � AODRE55 UNIT OR SPACE NO. TF.NO� NEW AOD OWNER USE �lW� 20NE /{�//� FOR STRUCNRAL PERMIT " PERM� ' 1io -51372�� PI 7' / � '�-C� J i __ ��/ II ///r .�.� LOT R L� [J�V APPROVED f CONTRACTOR � e� � AODRESS � " � CITV � NOL�' � � � STATE CITY AFFROVEDSETBACKS LIC. NO. LIC. NO. � SIZE NO.OF BLDGS. (FROM GL STREET) L OF LOT NOW ON LOT ROM FT a USE OF '�' EXISTINGBLDG. �� g / y FSeparate permits are required for L. SIDE r� Q electric, plumbing and heating work. REAR F,W. USE OF BVILDING AND WORK TO 8E PERFORMED PLANNING ACTIO Q ° l I� T�r2l�— p�lc�� Pdl�i'tT1�1 a a � l i! � APPROVED �, v�� .� � m aa 1 hereby acknowledpe ihat I hava reatl this appllcation and atata that tha ebova In7ormation ia carreci antl aprea to comply wlth a all laws reBuletln8 buildinp conattuctlon, antl I shall not amploy Z any perwn In violation of the workman's eompanseilon laws of � the Stete of Celitornia. �T. 3 I �ereby certify ihat I om properly Ilcensetl ef a coniracior untlar SQ. FT. t�e Scate af Celifornia Buainesa entl Protesslona Coda, Olvlsion 3, THE AMOUNT SH01 C�apter 9, anG thet s h licensas are in full force antl effect, or I THE PURPpSE OF ES am exempt from th p i iona ot tha Siate of Cellfornla Boslneas VALUATION entl Professions Co vi I� , Chepter 9. Signatura ot � /� Permlttea $ 3 2W �, 2— 1�- �3 l � Authorizatl ABent Date pEMOLI VALUES rJ/' �� fO - DATE Z�� DATE APPROVED ti �TL C i v � VN UNDER VALUATION IS FOR m 'ABLISHING A PERMR FEE ONLV: � PERMIT FEE S 2 `� pv �qL, PLAN CHECK § � 2o Q TAX : Z. S3 � TOTAL PAID s 34�_ � 2 . ' COSTA MESA BUILDING-SAFETV DEPARTMENT ' P,O.BOx 1200 COSTA MESA,CALIFORNIA 92626 ' For Applicant to Fill in Completely — Use Ink Only BUI�OING �'� ADDRESS OWNER OR TENANT MAILING C ADDRESS �J /��,y�� TEL. CITV C�j� /p�y NO. BRANCM ADDRESS ARCHITECT CONTfl<.CTOR ADDRESS I � GTV ,� .� � STATE LIC. N�. {y SIZE � OF LOT a USE Of „�. EXISTING BLDG. y �� 962 4/01 /81 APPLICATION FOR STRUCTURAL PERMIT 2ECE1 i P RMIT �0 � � � � A.P. No. a- i 9� - a� BUILDING'?/� rj ri�/ � � ADDRE55 �� 6 G`j VNIT OR SPACE NO. �� LOT � BLK. NEW ADD LTE REPAIR MOVING DEMOLI51 / )WNER A� ! ir R �� c7dNlJiYfLNOL/'T.Y��I ••'•-�r � lmn s .h 20NE L, APPROVEC BV 2.l � � I-1 �` 1UGCKLlJS LJ NOLQ ��4, CITV FiPPROVED LIC. NO. NO. OF 8LD(i5. ( F RO M C/L NOW ON LOT ROM � Separate permits are required for � electric, plumbing and heating work: F USE OF BUILDING AND WORK TO BE PERFOPMED Q a % �'� ; O l ti� .� � W a PLANNING ACTION DATE DATE 0 I herabV acknowletl8a that I hava reatl this application entl steta y� that the ebova informeNon is correct and epree to comply with �: all IawS rapuleting builtlin8 consttuction, and 1 shell not employ z eny pelson �� violation of iha workmen's compensation laws of � Me State of Californta. 3 I herebV cartify that I am properly licenaetl as a conttacior unAer SQ. FT. the State of California Businass end Professlonz Cotle, Division 3, THE AMOUNT SHOWN UNDER VALU Chapte� 9, and that such licenses are in full torce antl effect, or I TNE PURPOSE OF ESTAHIISHING A PERI am xxempt from tha provi� ns of thaStete of Calitornia Business VALUATION PERMIT FEE S anC PrOtassions Cotle, '� I n 3, Chaptar 9. PLAN CHECK § Signature of �n� ^ Permiriee g �7�J TAX E or Auihor�satl Apant Data TOTAL PAID $ � 5.50 Tl:' m � a' J i m _ n 4 m n 0 LL F U ,� .-. , • � � ��87 . CQSTA MESA BUILDING-SAFETY DEPARTMENT . ' P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only qDIDRESS �i '^�� OWNER /j�j� �� /(JfjLE /LODS CITY BRANCH AR OR AO 1 TEL. 4609 9/07/78 . APPLICATION FOR STRUCTURAL PERMIT RECEIV D E CEIV D '[ ISSUE^C ,.o .�.. Q%%� %S�L�)/ PERMITNO. BUIL�ING ADDRESS FIRE 20NE APPROVED VALUE �A ADORE55 TEL. ZONE NO.OF USE OF NEW CITY NO. PLAN$ BUILDING F STATE CITV YARDSAPPROVED VARDSAPPROVED �IC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING � SIZE NO.OFBLDGS. IFROMCJLSTREET) �. OF LOT NOW ON LOT ROM' FT� ¢ USE OF � EX15�'ING BLOG. I .�. 1 FSepara[e permi[s are required for L SIDE FT � electric, plumbing and heating work. REAR FT � USE OF BUILDING AND WORK TO BE PERFORMED F DISTANCE BET. BET. MAIN & �Q MAIN BLDGS. ACCESS. BLIX �-7 �'�I c /"r•�- 1' I�O�S C URP. gW APPROVED Q � APPROV , r' a m v� � I hereby acknowlatlga that I have rantl This applieoiion antl state y� thnt the abova Intormetion is cortect antl epree to comply with a ell laws regulating buildinp construction, and I shall not employ Weny person In vlolatlon of the workman's compenution lews of S the 5tate af Calitornle. 3 I hefeby cartity thai I am praperly Ilcensetl as e contractor untler SQ. FT. tha Stata of Celifornie Businesa antl P�otessions Cotla, Divislon 3, THE AMOUNT SHOWN UNDER VALU Chepter 9, entl thot such 1(canses ere in }ull force untl atfaci, or I THE PURPOSE OF ESTABLISHING A PEFI am exempt }rom Ma pYovisions ot thaStata of Calitornia Business VALVATION pERMIT FEE entl Professlons Cade, O��' on 3, Chnpt $ Od PLAN CHECK $ Slpnatura of /�O O .— Perr.�lttee S TAX $ AutPorizetlAgent TOTALPAID $ `- 21.95 T , � n m i m � IS FOF m ONLY: � ,OU[ � . \ m 0 .. � � . �aso5 COSTA MESA BUIIDING-SAFETY DEPARTMENT ' P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely BUILDING r�.�nr : i A. n. .. , A.. .� Z . d U Z 2Q ON am J7 J U7 Q W ¢I J J m a �Q Z � aW wZ J Q m Z J � w W � Z � w° � � � z Q U J a a Q O � N z O F- U � � H N Z OWNER KULLS/IRy,ISI MAIL 3190 A Air AODRESS CI7v COStd ME53 CONSTRUCT�ON . _ BRANCH ADDPESS NPG1[YlY : ARCHI`TECT �.1SOn �� rt Ioop Drive No`929-9205 N�`639-5541 CONTRACTOR � gpll �[rcaanv. Tnr ADDRESS 19�1 �i� S'�i2�t TEL. arr Newt�ort Beach No.833-3031 LIC. No. 221764 LICyNO. 1QHQ SIZE NO.OF BLOGi. OF lOT NOW ON LOT O. USE OF E%ISTING BLpG. SIZE OF NO. OF NEW BLDG. 8 QOO ROOMS 3 STORIES EXTERIOR WA4�_ __, ROOF COVEfiING WliC �� COVERING BIl]`It-4jEj_ USE OF BVIIDING AND WORK TO 8E PERFORMED I heraby ecknowletlga that I have reatl this application antl state thet the above intormotion is correc[ antl aBree to comply with all laws regulatinB builtlln8 �onstruction, antl I shall not employ any person ln violation ot the workman's compensztion laws of t�e State ot Celifornia. I hereby certify thet I am proparly licnnsetl as a contractor under the State of Celitornia Businoss antl Professions Cotle, Divisicn 3, Chapter 9, and that such licanses ere in tull force end effect, or I am exempt from the pr � isians ot tha 5[e[e ot Calitornia Business and Protessions Cotle, vision 3 ptar . Sipnatur of Parmittee / Authorizetl Agent BUILDING ADDRESS ED PAIU �:, -2-7U�..—..p0 ?ny<, :::�a:263.�3 FOR BUILDING PERMIT 'aTE RECEIV D DATE ISSUED i �� D�i/• / PEHA�I� !O � /� A.�',ewr�, /�v� R co i 3 lOT /,3 BLOCK r��,,�E s �/ I . VALU$ % �d v (.s � . PE GROUP ! .,�r� �e .2i.[.[ ZONE INO.OF I USE OF NEW mP P�� 2 BUILDING f VARDS APPROVED VAROS AF R6VED BVILDING REAR `7 / FT. � �� FT. DISTANCE BET. BEf. MAIN & MAIN BLDCS. ACCE�. BLDGS. c u`�'r # ZE- 72-/� / qPPROVED �� I��7 �APPFOVED�,�n p� ��r� 7-3o-7�f MOLD FOR THE AMOUNT SF THE PURPOSE OF VALUATION � � $ V�� V m �e �y o (� 'OAJ N IS FOR j ` 0 fiM1T FEE ONLY: m Q �. � ry V � ] �� m �.5�' ' ,� �' 1PPLICATION FOR A BUILDING PEpM1T BUILDING PERMIT NO. Ei°<t'i`ai �° Tract Bbck Lot . Permi[ No. . . Plumbin a BUIItlin9 � I 1 � j�/ � �� 9 Atltlress }� �( Parmit No. fp Cross � v �� Mechanital a Area Street a Q Permit No. m Owner Type of Prajett: ❑ New ❑ Alter Atltlition � ACtlress ❑ Repair ❑ Convert ❑ Demo ❑ Occupancy Pmt. A P Sup. Dist./ ��y Zip Phone Insp. Area Archltect/ Zone SP�. Pmt. No. Daslgnet nsB No. Setbacks P/L Front C/L 5t. Stree[ Witlth Atltlress Vartls eft g t ear CItY � 21p Phone ave ol. e 9 . . Engineer l.icanse No. ,� _ ,/� f Og SP2f95 Bq IB lOV1 d uvBle p, Atltlress � W Struct No. of No. of m CIIY � ? Phone Helght Stories Family � LICENSED CONTRACTOR'S DECLARATION Park Fees Ycs Fee m I hereby affirm that 1 em licensad unCer provisions of Chepter 9 Requlretl No T• Recalpt (commancing wiih Section 7000 of Dlvision 3 of tha Business entl .t. Protassions Code, y licensa is in full foroe antl c Zoning A�P�ovetl BY: Date � Licam CI s L' n � ber T Dete� Convac r_ Mlsc. � Atltlrass Proposetl Use jy City antl Zip Phone Of 5[ructure « CONSTRUCTION LENDING AGENCY � � I heroby attirm that thero is a construction IentlinB agency for the a pertormenr.e of the work for which thie permit is issued (Sec. 3097, ��' Typa Cotle ' Civ. C.1. Class Const. vear C Landar's Mame �� USE/OCCUPAN V SIZE SQ. FT. Lender's Address _ ,i '� OWNER-BUILDER DECLARATION r I hereby atfirm that I am exempt from the Conhactor's Licenea �aw �� for tho follouving roason: ` ' � ❑ I, as owner of [he property, or my employea5 with wages as their , 2� C sole componsation, will do tha work, end the sbucture is not �L„ intentled or oifarutl /er se1e. 3. � ❑ I, as o�vnar ot tha property, em exclusively conbocting wit� lieensatl contractorsto cons[ruct [ha prolect. �.d. ❑ I em exempt under Sec. , B&PC tor ihis reaeon 4' m Q �ata Owner E WORKERS' COMPENSATION DECLARATION Tota� vaivation �j I hereby nftirm that I heve a certlficata of consent to self-insure, � No or a cortificate of Workeri Compensation Insuran[e, or a cartitietl EnC�oathm¢nl Pe�mi[ Fepui�etl Yes C copy th¢reoJ„ ._,�/�� .—,I,Yy� � ��y H./�' w, Gra01n9 Pmt. Gratling .� Pol(cYNo.v{3�:J.QYLL'CIi*PanV-!�'?Jurivh wRz�ic.�� aoaw.aa ❑ves 'CI ❑ No Pmt. No. � ❑ Ce�[ified copy is haraby furnishe a❑ ca. �ri pppp �s r�iea w�tn C/7J� af C•M • Rou9h Gratling � a fx y' ' qpprovetl by: Date Deca � � Applican . 3 CERTIFICA EMPT . FROM WORKERS'COMPENSATIONINSURANCE Z (This aectiun neetl not be completetl if parmit is for $100 or less). � I wrtify that in tho parformance of the work tor which this permit is Q fisuod, 1 shell not employ eny perwn in eny manner so as to Cecome 1 s�bject to the Workarz' Compensetion Laws of Calitornia. PERMIT FEES Dat Applicant NOTICE TO APPLICANT: If, after making this Cortifieete of' Structural E Plan Check § Exemption, you shoultl bacome subject to the Workers' Componsation ' p.ovisions of tha Labor Cotle, you must forthwith comply wixh such SPecial provisions or this pormtt sholl be tleemetl ravoked. ElecVical 5 InvesL s I CERTIFV THAT I HAVE READ THIS APPLICATION ANO STATE plumbing S THAT THE ABOVE INFORMATION IS CORRECT. I AGREE TO COMFLV W H A�L COUNTV ORDINANCES AND STATE LAWS RELAT T ING CONSTRUCTION, AND HEREBV AUTH- Methaniwl E ORI2 P E ENTA ES OF THIS COUNTV TO ENTEF UPON TME V ENTION PROPERTV FOR �NSPECTION PUR- pre•GraGe Pos �I—I—BI ��=oe«�o� s Pre-Gratle Pormit SIOna ure o��Apjp�licent o. ABen2 Date Rec. No. § Issue E P�L��Iiwnt's A98 Ys Neme � � �� All spaces within this hox must be com0�eted to proceu Plan Issuance Cneck By: APProvetl: cmr uaoo<o �n�-eo� rev. oiao �� 1 PXOJECT RODflE55: 3 Z H H AI RWAY �it� OWNEH'S NFME: ROGER SCHUNEk aooRess: 3188 AIRWAY AV COS'TP. MESA CA 92626 PNCHIENGINEEH: RUOflESS: flEG.NU.: �N�T: aLn x UNIT: PEHMITTEE: SDBW ELECTRONICS ( 719 ) 291-8252 aooxess: 3496 WIMBELDON WY C,M. CA 92626 IICENSEO CONTFACTOB OECIABATION: I hereby aifirm iha� I am licensetl under pmvisions of Chap�er 9(commencing wi�� Section 7000) o� �ivisian 3 of Ihe Business and Pmlessions Code, an0 my license is in full �orce anA effec�. ciTvuc.: 031155 araTeuc.:626779 c as: C10 �� ,�� % Daie: —� ( � � Z� � SignaNre' Ic�/.I�KA�/�--/ WOBKEXS' COMPENSNTION DECIAHATION: I hereby aflir a� I have a certificate of consen� �o self-insure or a cerlificate o� Workers' Compensaiion I wt e ob c�j(tifieQ� c y �hereof (Sectio 360q Lab C. POLICY NO.: �� 3'-`� v— J� E%P. DATE: � 7 I O S/ S 4 COMPANV: -�+TATE ,i ❑ Cetlified copy is hereby tumi5he0. L'Y Certi�ietl copy is �iled wi�h h city Builtling Oivision. ♦ �Jate: ��Z'�3 Applicant: E%EMPTION FBOM WOflNEHS' COMPENSRTION OECLAflFTION: ( is sec�ion neetl not be campleted i�the De�mi� is fo� one hunAreO ($100) or less�. I cetlify that in Ihe pedormance of the woB far which Ihis per it is issuetl, I shall no� employ any person in any manner so as �0 6ecome sublect �o the Workers' Compensaiion Laws oi Califomia. �ate: Signature: NaTICE: tl. afler making Ihis tleclaration, you should become subied to ihe workers' Compensation Orovisions of the Labor Coee. you mu5i forihwi�h comply wi�h such pmvisions or Ihis permi� shall he deemed revokeU. CONSTPIICTION LENUINC pGENCY: I hereby affirm ihat ihere is a consimction lentling agency tor the De�o�mance of ihe work for whlch this permi� is issoed (Secilon 3097, Civ. C�. LENDEH: aoonEss: OWNEX BUILOEfl DECIANRTION: I hereby aftirm tha� I am exemp� irom the ConVacmrs' S�a�e License Law for �he following reason (Section 7031.5 eusiness antl Pmiessional CoOe'. Nny tiry a� counry which requires a permi� to constmc�, alter, impmve, Uemolish, or repair any stmcNre. prior to its issuance, also require5 ihe applican� for such permit to file a signed statemen� Ihat he/she is licensetl pursuam m �he provislons of �he Comractors' S�a�e Lmense Lew (Chap�er 9(commencing wlth Section 7000) of �ivision 3 of �he Buslness ane Professians Code) or ��a� helshe is exempi �herefrom antl Ue basis �ar �he allegetl exemp�ion. Nny violation of Section 7031.5 hy any applican�for a permit sublects �he applicani �o a civil penalty o� not more �han �ive hundretl tlollars ($500�. I, as owner ot [he D�opehy or my employees wi�h wages as ��eir sole comDensation, will do �he work, anA �he ❑ slmcNre is na� imende� or oHered for sale (Section 7044, Business antl Pm�essional Cotle: The Con�rac�ors' State License Law Uoes no� appry to an owner o� a pmDerty who builds or improves thereon, and who does such work himself/herself or �hmugh his or her awn emplayees, pmvitletl tha� such improvemenls are not intentletl or oflered for sale. If, however �he �uiltling or impwvement is soltl within one year of cample�ioq Ihe owner will �ave �he burtlen o� pmving he/she Uid no� build or impwve for�he purposa of sale). I, as owner oi ihe pmDetly. am exclusively coniracting with licensed coniractors to consimct ihe prolect (Section 704d, Business � and Pmiessions Code: The Contractors' Slate License Law tloes not apDly to an owner of propeny who hutlAs or improves thereon antl who comracts �or suc� pmjec�s with a conVactor(s�license pursuam to the Contractors State License Law�.l am aware �hat proo� o� iheu Warker's Compensa�ion insu�ance shoultl be pmvided �o me. � I am exemp� untler Sec�ion: B. 8 P. C. for �his reason. Date'. Owner I tla here6y cenity Ihat I am aware of an0 un0ersiantl the requirements of Cali�omia,Heal�h and Safery Code Sec�ions 25505, 25533, antl 25534 and iha� I or any fmure huiltling occupam willlwill not (circle one) neetl �o comply wi�h saiA s�a�e cotles antl �he requirements for a permit for constmction or moditica�ion fmm �he Air Oualiry Managemem �is[ric�. flesitlemial cons�mction applica�ions are exempt irom �h¢5¢ pf0VI510n5. Dale Npplicant: I hereby cetliry �hai I have reatl �his appl¢ation and s�a�e iha� �he above intorma�ion is correcL I agree �o comply wilh all ciry antl county ortlinances and s�atelawsrela�ingio buildinq cons�mction antl hereby aNhorizerepresen�atives o��his cityto en�eruponthe above�mentionetl pmpeny lor inspection purposes. (�I oate. II—IZ.'�I�J SignaNre: Qry�41��+11L�/��,✓y oriver's �icense or Socia� Securiiy a: � 16n1.q6 WM1ite—Building-, Green—Cotle Eniorcement; Canary—ApplicanC, Pink—Revenue; GOltlenroC—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO; E 064$7A FERMIT NO: E 064878 PLAN CHECK NO; N GOVT: N SUF�P: N CONSTRUCTION TYPE: PERMIT TYF�E: ELE PURPOSE: ALT JOB DESCRIPTION ; 22QV PLUG, 220V QUICK DISCONNECT SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: B-2 / CODIMENT5: NO STRUCT PERMIT ON FILE, NO OTHER WORK AUTHORIZED HY THIS PERMIT #;�***�**�*�r*** �**�r*�*�� *� �r+�� ****�r�***�r#*x #****�**� �**�r�x��*�r*� �#*�**+�+�� **** ��c** Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ----- ---- --------- 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 PARY.ING REQ • PROV: PARCEL: 42719332 ZNE; REF N0: PLANNING NdT'ESa � iF iE �lE �lE if !E #�%�lE �lE iF if iE ic # iE 1E if ik iFlE 1F if �lE �7E iF 3E ff ik iE 3f 1E iE # 1f-iE if iE iF iE if # �E 1E �E if ?F 1E if iF if iF 1F # iE �E �E iE # iE �fE �)F?f'lE iE iE iE if iF iE # jE # iE �1f iElE �E iE P E V E L O P M E N T S E-RiV I C E S R E Q U I R E M E N T S ZONING AFPRC�G'ED BY DATE: BUILDING APPROVEII BY ; 0 ISSUED BY L�ATE : DATE iE iE i4 jf iE iE iE i(� iE iE iE iE iE if �E fE jE iE jf jE iF if iE �lf iE jE iE if 1ElF iE iE iE if iE iE 1� iE iE iE �E iE if iE 9E iE if iE iF iE iF if iF if iE if % iE iE iF if if iE jE if �F iE 9E iE if jE 1E iE jF iF �f �3E jE iE LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N f BLDG PMT FLUMBING ELECTRLC MECHANIC FIRE SMIP/RES GRADING PERMIT 14,00 SOR SMIP/NON—RES PLAN ISSUE FEE 15.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECY, TOTAL PAID pUE TOTALS----> 14,00 15.00 0,00 29,00 29,00 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 29.00 OVER/SHORT: ,00 HLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GP,ADING PLAN—CHECK 29.00 iE # iE iF if if if iE iF iF iE iF iE iF it if iF if iE 3E # if i4 i@ 3F fF iE iE ic iE iE'k iE ie iF if iE iF # iE ik iE iE it ik iE iE fE if iE fE iE if if iF iE �)f iE �f-9E+E 1f iE # i'r iE if if'IF. # iF iE �7E iE if if if �4 iE 2 N D I V I D U A�L F E E B R E A K D O W N TYPE QTY D E S C R I F T I O N UNIT COST TOTAL COST ELE 1 NON—RES APPLIANCE NOT QVER 1,0 HP 3.00 ELE 1 P9ISC APFARATUS NOT,LI5TED REQ PERMIT 11.00 ^END OF FEES A Vi i�1�17iJ?�r7—��!ii]�+�t$% T1�� CArF.� ivt"r/?3 'f717E: xi: iC 3.00 11.00 ?.V. �'iri � CONSTRUC7ION AND PLANNING POOI & . APPROVALS Permit q"'r Date laspector APPROVALS Permit � �ate inspector 1. Ternporary Electrical Service"br Pole 52. Pooi & Equipmenc Location � '" 2. Soi! ?ipe�Undrgmd. 53. Stee4 Relnforcement � 3. Electrical Conduit Ut4iity-Undrgmd. �� 54. Forms �� 4. Efectrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Stee! Reinfoicement 56. Rough Piumbing & Pressure T2st 6. Electrical UFER Gmd. 57. APPROVfll7Q COVER�GUN7TE 7. Footings 58, Electrical Conduit-Undrgrnd. 8. Foundation °��"'"' 59. Gas Pipe, 1� Undrymd., Test � 9. Nlater PIpe�Undrgrnd. r 60. Backwash Lines, P-TraP, � Undrymd. a� 10. Structurai Floor Svstem � �-� 61. APPROVAL TO DcCK �� t t. Proper:y Sewer Line & Hous�nnection �-� 62. Backwash & Recepter-Final • > 12. Sewer Cap ^,} _-'� 63. Heater & Veot�Finai -"' 13. Roof Drains _� = 64. Pium6ing System � Pi�a! " 'j 5 74. flough Plumbing � � 65. Electrical-Finai t5. fiough Electrical�Conduit 66. Solar SYstem-Final 76. Rough Electric 4t�iring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTEfliNG 78. Rough Electricai�T Bar Cei�ing 69. POOL,'SPA SYSTE^:15 FINAL 19. Rough Heating & Air Conditioning FIRE �EPT. REQUIREMENT 20. Rough Pactory Fireplace APPROVALS Permit = 21 . Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oii 23. Gas Pipe�Rou9h & Test 72. Underground Flush 24. Roof Framin9 73. Underyrnd. Storag� Tank i� Gas ❑ Cil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling IStructurai) & Monocoat 75. Dry Chemical 27. Frame and F�ashing 76. Dry Standpipe 28. La,hing & Siding , 77. FIXED SYSTEM FINAL � 29. Insulztion � � 7$. FIRE PREV. FINAI 30. Drywali Naiting NEALTH DEPT. REQUlREMENT 31. Piaster Brown Coat J9. FINAL INSPEC'fION ^ 32. Electn � � , . . . . . , , �, FOOD CERTIFICATE ISSilEO _____��- ' J� 33. Finai Electric Z� 9 Q� No s_�2.-$-� � �� o � - _-_._-_._ _-------- 34. Finai eaun � � � 35. Final Gas PiDe-Test 36. Hood or Canopy 37. Final Factory Fireplace I 38. Final Plumbing 39. Water Service�Final 40. Gas Service-Final 41. Solar pomesiirFinal 42, Backflow Preventer 43. Backfiow �rrigation 44. Landscape irrigation System 45'. Sound Aitenuation A6. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINALP�ANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIfICATE OF OCCUPANCY No. Date �� / AOV��ant ta fill in all ipaces excep� those within heavy EorOer Iines antl sign all apOrop�iate tleclarations. CITY OF COSTA MESA COII��ST UCTION PER/(�� IT PER IT NO. TRACT NO. LOT NO. UNIT N6 . Project Address � � �� " N � l QI.U��i I't Ll � � � � ' ApplicanYs Mziling Addre/s�sn � -1�=�_S P_ U T H ST . TYPE OF CONSTRUCTION � NEw AD� ALTERATION REPAIR VATL�\'�IJ�F ' SV�'%I� '❑ CONVERSION ❑ DEMOLISH OTHER p�p # Owner'sName - Phone DESCRIPTIONOFWORK/USEOFBLDG. � Address I �SS C• TFi�� ST� �NTh-�'N+� � s Main Building: Arch/Eng. ' License No. ' � �� Address � —� n^� � ' ' Contracror's Name��1w« Phone ' 1'7�35 Address (mailing) � �S''�'� �'� �� Ciry License No. � � y�2 LICENSEO CONTRACTOR DECLARATION I hereby affirm Ma[ 1 am �Icensetl untlei provisions o( Char[e� 9(commenCing with 5ection �000) of Divlsion 3 of tha Business antl Professions Cotle, antl I my license is in lull / c�an^tl efiect. � tJcen 9C a{� � �✓ -i ��$ns No. �� % Date�`I�l �O 5'9 [ �11A �Jdl9-%t�-f� WORKERS'COMPENSAY�ON DECLAHATION I hereby afflrm tnat I have a certHicate of consent to self-Insure or a cortiflcate ' of Worker5' CampenSalion InGsu�IanGe, or a certifietl Copy the�eol (Se<tion 3800, Lab. C.�pG I�S- i�b STATe f�'�'� � olicy No. � I Company �Oe�titietl caOY is he�eby furnlshetl. !.� ertif' qcopy s filea w�th Ihe clty tlin9 Divisims�� _� 1/ �Ma` ' Date � 1\a- l,� �^ . APPlitant��j 4-- V� ��" �T� MV y EXEMPTION FROM WOHKERS' COMPENSATION OECLARqT10N (This section need not be Eompletetl if [ha p¢rmit is to� On¢ hundretl (5300) or IC55) I certify that in the pertofmance Of th0 work to� which [h15 Perm�t ISlssuetl I shall nof employ any pOrSon In any manner so as to become zubj¢ct to t�e Workers' Compensation LAws of California. '� Date � Signalure � NOTICE: It, after making this tleclaration, you shoul0 Decome 5ubject to the Workers' COmpensation provlsions ot N¢ Labo�.Cotle, you mu5t �ortnwien comply with such provislons or this permlt shall be tleemetl revoketl. CONSTRUCTION LENDING AGENCV I hereby affirm that [nere Is a construtUon lentling agency tor the performance ot tn¢ wOrk fOr whitb Inis permlt iz issuetl (Sectlon 309] Clv. C.) Lenaer's Name Lentler's:ACtlress. ' ' OWNER BUILDER DEC4P.AATION � I hereby affirm that I am oxampt trom tM1e Cont�acto�'s Lic¢n5e Law for the following. reason (SecHon 7031.5 Busine5s antl Professional CoOe: Any tlty m wunty which require5 a p¢rmit to'ConS[ruct, alter, imprave, tlemolish or repair any structure, prior to Its Issuance, also requires the applicant for such permit to tile a signetl statemenl that he/she Is Iicensetl pursuant to the provlsions of the Con[ractor's License I,aw (Chapter 9(commencing wi[h Section ]000) ot • DiviSion' 3 Of lhe Bu5ine55 antl ProfesSions Cotle) or lhat he/she i5 exempt therefrom antl the�basls for t�e allegetl exemption. Any violation of Soc[ion '+031.5 by any applican< <or a permit subjects the applican[ to a civil �nalty of not mare than f��e huntlretl dollarz (E500). � � I, as owner of the property or my employees with wa9es,as their sole ompensation, will tlo tne work, ana the structure is not intentlea or oHeretl for'sale (Settion� ]044, Business antl•Protezsional Cotle: The'Contractor's License ldw tloe5 not apply to an owner of a p�ope�ty who builCs o� Imp�oves thereon, antl wpo does such'work hlmselt/herselt or throu9h his or her own employ¢e5, PrOvltletl that such improvements ate not IntenGetl Or o�toretl for sale: It, however, the build�ng o� im0�ovement i5 Soltl wlthin one yea� of com- . pletion, the-owner will hTve the burtlen of orovin9 he/sne tlltl not builtl or im- � rove for Ihe purpose al snle). . ��' I, as owner ot [he proPerly, am extlusively tontracting with Iicensetl mn- tractorst0 cOnst�uctthe p/o�ect ($ection ]044, B�sine55 antl Profession5 Cotla: The ConVactor'S' litense ldw dOes.not aOPly to an owne� o� prOPe�ly who builtls or improves there0�, antl who contracts for such projects with a con- tracior(s) ucense pursuant m the Contractor's Lirense �aw). I am awaro that proof �o( their Worker's Compensatlon' insurance ShoulB be ProvlOetl to me: ❑ I'am exemo� untler Section '8. & P. C. for this reason Date � Owner ' I hereby certiry tha[ I nave�reatl lhis application antl ztate that the anove information is correct. 1 a9ree to comoly with all city antl touniy ortllnances antl ztate laws relating to bullCing conitruction antl hereby authorize r¢pre- sen[atives of Ihis city t0 enter up [hG above-mentlOn¢tl p�operty for Inspectionpnp ses. 9I�—Ll� (� Signahre � . Date Drivers' License or SS � � ` . 3ui� yiie�e . i ' Accessory Building: TYPEOFPEFMIT GRADING ❑FOUNDATIO STRUCTURAL T Front ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING�ECHANICAL ' g , Rear ❑ �OTHER . ' � ; A PROJECT DESCRIPTION SQ. FT, OCCUPPNCV C Right "' CONSTRUCTION TYPE VALUATION $ S left � ZONE � GRADING CU. VDS. ACRES Ping, Ref. dk Remarks: � � � , , Planning Notes: ackflow Irrigation athtubs larifiers . , ishwa5her - - rinking Fountains loor Drains loor Sinks as Service ! OuUets itercep�ors � ' itthen Sink � . . avatories ' -7rap �oof Drains ' � . Fee. � $15 Duct - Under Ground Duct - Struchral Duct - Ventilating Exhaust System ❑ Multiple � FirepVFact Blt. ICBO # Heating System &' Ducting ❑ ai oo,oao aTu O i oo,000 si ' v�1J� F�f�sil� Reinspection Fee $15 CMF 0865-46, r¢v. 10(04 Whlte - Buil4ing; Canary - Appllwnp Plnk - Accounting: Goltlenrotl - AssaSsor 0 Showers Service Sink Sewer Cap Sewer Connection � SOI81 COIIQLLOYS Solar Piping Solar Tank Swimming Pool w/Spa � Urinal � Water Closet � Water Heater � � Water Service - . . . AUtO-W85I1 ' � LaundryTreys ' laue Fae Hood or Type I ❑ �CanoPY TVPe I I '❑ � Refrigeration System ❑0-100,000 BT U � O 100,000 System Repair Fire Dampers Registers Issue Fee FEES m� � Automatic Washer ' ConslruttionPoleSub: ' Cooking Unit ' Dishwasher � ` � Dryers"OGas �Electric Fan F.A.U. , Fixtures ' Device Boxes Outlets Switches �. Garbage Dispoul Generator �0.5 KW �5-' ing ELECTRICAL � Transformer ❑ 15-50 KW ' ❑ 50+KW _ Meter ❑up ro 100 amps - , Meter ❑over100amps � Sub Panel ' � - Momrs �61 HP 01 X- 8 Inc.�Solar �9-15 HP �16�15+ Microwave ' � � Pole Light , 5KW $ 3 ' Reinspection Fee 515 FEES^ �DEVELOPMENTSERVICESREQI Zoning Approved By Buildin9'ApPraved BY � $ 3 31.00 7L 0 2 O N I N G R E Q M T S FEES ' .,..�.y� Sign . . _ . Standing Sectio�s Trash Compactor . t . � � � � 1 , Ittue�Fee . $ 3 JTS: _ � • - SUMMARV OF FEES � � ' BUILDING PEfiM1T $ SMIP' - $ ; PLAN CHECK � $ PERMIT � , , PLUMBING . $� ISSUANCE'.• $. _ PLAN`CHECK 25% $ ENERGY P.C. $ � ' ELECTRICAL • � '$ GRADING $ �D�LAN CHECK 50% $ �� MICROFILM $ �� /�/1� � MECHANICAL •$ �" �� TOTAL FEE $ � PLAN CHECK 25% $ � CONSTRUCTION AND PLANNING POOL & SPA � ' � APPROVALS Permit # Date Inspector qppROVALS Permit # Date� Inspector 1. Temporary Electrical Service or Pole � 52. Pool & Equipment Location . � 2. Soil pipe-Undrgrntl. _ 53. Steel Reinforcement ' � 3. Electrical Conduit Utility-Undrgrnd. 54. Forms � � 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding � 5. Steel_Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVALTO COVER-GUNIT6 7. Footings 58. Electrical Conduit-Undrgrnd. � 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. � � 60. Backwash Lines, P-Trap, O Undrgrnd. 70. Structural Floor System 61. APPROVAL TO DECK 11. Pro�erty Sewer Line & House Connec[ion 62. Backwash & Receptor-Final . 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing SYstem - Final � � � 14. Rough Plumbing , 65. Electrical-Final ' ' 15. Rough Electrical-Conduit . . 66. Solar System-Final �� 16. Rough Electric Wiring 67. Fencing 8c Access Approva� . 77. �Rough Wiring Sign 68. APPROVED FOA PLASTERING 18. Ro4gh 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. Underg�ound Hydro � 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oii " 23. Gas Pipe-Rough & Test 72. Underground Flush - 24. Roof Framing � 73. Undergrnd.StorageTankOGas ❑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. REQl11REMENT 31. Plaster Brown Coat � 79. FINAL INSPECTION � � 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Finaf Heating & Air Conditioning � t� ��7 L�O 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. Solgr pomesticFinal 42. Backflow Preventer � 43. Backflow Irrigation 44. Landscape Irrigation System . � 45. Sound Attenuation . 46. Handicap Regulations - 47. FINAL STRUCTURE & BUILDING - 48. S{ieclal Requirements Completed ' 49. Eleccric Release to Edison � 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date \. City of Costa Mesa ' Development Services Department Building Safety Division P. O. Box 1200 Cosia Mesa, Californfa CERTIFICATE OF OCCUPANCY No. The Building located at 3188 Airway Avenue, Suite J has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group B2 Occupancy. � Use of Building OffiCe Legal Description 427-193-24 . (See reverse side for Metes and Bounds) Building Permit No B 45922 Electrical Permit No.E 46188 Plumbing Permit No.P 46456 Mechanical Permit No. Number of apartments and/or guest rooms ISSUED T0: Building Official 'Ponv C'Da Baca John Howenstine' . _ ,--; 3188 Airway Ave.,, Unit J by �-� .?"l �-<:-"ir`>, � Costa Mesa, CA 92626 " Date Aoril 9: 1990 This Certificate of Occupancy SHALL BE posted in.a conspicuous place on the premises and SHALI: NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. ' . . � CMF 1015-46 rev. 1/83 ' White�� Owner, Canary -,Numerical.Fiie; Pink - Bldg. Permit File � ' �:4e;�7� . � • .CO: • ' P. + � For Applicant to Fill in Completely — Use Ink Only IIDRESSJ�/1!/ �/ ��/I��, OWNER MAIL ADDRE' CITV � BRANCH ADDRESS ARCMITECT BUILDING f ADDRESS /f/f /.► TRACT OWNEfl TEI, FIRE ZONE �— � � � . PROVED 1�76 5/2�/78 FORSTRUCTURALPERMIT �OT i ZO NO.OF USE OF NEW CITV LL � �� NO P�� BUILDING F STATE q �� CITY VAflDSAPPROVED VARDSAPPROVED � LIC. NOj� � �� LIC. NO. MAIN BUILDING ACCESSOR {,y SI2E NO.OFBLDGS. / (fFOMGLSTqEET) C. OF LOT NOW ON LOT f ONT FT. a USE Of �/ ` � E%ISTING BLDG. I�/f/'� \ � H FSeparate permits are required for L SIDE . F � electric, plumbing and heating work. REAR W USE OF BUILDING AND WOFK TO BE PERFOflMED F DISTANCE e BET. MAIN & QMAIN BLDGS. ACC6S BLD( � � _' /��, VAR.�+ DATE Q % C.V.P.� APPROVED } � �/ /''� fi . (/ I� APPROV U1—� � i .� a w - � I harebV acknowletlBe ihat I have reatl Miz application antl sinte � fX that tha ebove information is correct antl epree to comply with a all ie.,�+ .oe��a��e bulltlinp const�uction, entl I shall not employ Wany pafson in violation of the workmen'a compensation lews of � Me Sta�e o/ Celifomla. 3 I herabY certify that 1 am ptoperly Iicansetl es e contractor �ndar SQ. FT. tha Sta�e of Californie Business antl Professions Cotla, Division 3, THE AMOUNT SNOWN UNDER VALU ChapteY 9, entl that such Iicenses ara In tull force antl atfect, or I THE PURPpSE OF ESTABLISNING A PERI em exemPt from i�e provisions of theState of Califprnle Businass VALVATION PERMIT FEE E nntl Professlons Cotla, Division 3, Chapter 9. �� Q e Sipnetura of PLAN CHECK S Pa�mlttee TAX E Author(zatl peni TOTALPAID E t � 4Col" TL n m i e m 7 m e a n m LL F V -.,',:.� : : 4�1604 ' ' � COSTA MESA BUILDING-SAFETY DEPARTMENT " P.O. 80X 1200 COSTA MESA, CALIFORNIA 92626 For Applicant ro Fill in Completely �BUILDING -2 � �A 'ST�� . _ . _ OWNER MAIL ADDFE: pTV BRANCH ADDFESS CONTRACTOR ADDRESS CITV STATE LIC. NO. SI2E OF LOT USE OF EXISTING BLOG. SIZE OF �/ NEW BLDG. 7 EMERIOR WALL NO. OF � ROOMS FOOF COVERING AND WORK TO BE PE TEL. NO. TEL. NO. pTY LIC. NO. INO.OF LB�DfiS. NOW ON LOT RMED c�P ?�-75P=-iLOOi?_59`:� **'r*UO.�O I «« APPLfCAT10N FOR BUILDING PERMIT EI DAYE RECEIVED E IS I �7 � FIRE ZONE APPROVED 1VV.Vr /� PLAN$ � YARDSAPPROVED MAIN BUILDING IOM Gl STREET) D4STANCE BET MAIN BLOGS. VAR. �i'+ I haroby a<knowlatlpe thet I have reatl thls apP�Ication e�tl stata that the abova information is correct nnd eB�� to comply wkh all lews reguleting builtlinp constructian, antl I ahall not employ eny person In violation ot the workmen'e compansation laws of the Stexe of Celifornia. I hereby cmNfy that I am properly licen6etl as a contractor untler Sn' � the Stare ot Califo�nle Bucinass end Proteasions Code, Dlvisicn 3, THE AMOUNT Chaptar 9, antl Nat such Iicenses era in full force anG effact, or 1 THE PURPOSE ( am axampi from tha provisfons ot th mta o4 CeliSo�nla B�zinecs VALUATION antl Professions Code, Div sion 3iCH ter 9. Signatvra of /) _ �D Permkta � $ 0"V�i�� Authori2e AOeni I.Ce71 �� J�I �� VAWE �I1� c OF NE� LDING YARDS APPROV ED OET. MAIN & ACCEY.8LOG5. DATE APPAOVED �� STA7E i T. TAX SHOWN UNDER VALUATION IS iF ESTABLISHING A PERMR FEE I e�e.... «< e � • � � � O � \i FOR ' n' �LV: Q \ ' \ '� ro u N 1 7 I 1 Q @ � ^ n LL/� i� ; -:: � . � 38806 COSTA MESA BUILDING-SAFETY DEPARTMENT � P.O. BOX 1200 COSTA MESA, CALIFORNIA 926Z6 For Applican[ to Fill in Completely BUILOING ^J�Nri � n� .., i .� . ✓I . 2 . aU �- Z Z � � N am J � J N mJ m J Q U N Za W � d W J Q m z J Q W W � 2 F W � 70 F Z Q U J a a a 0 H N 2 O f- U � � F N Z vir, _ i,Pntc�� 205te f:,:� z-7 �,.� 1R8.69 ON FOR BUILDING PERMIT R OWNER KOLL�IRVII�I}' G�� A.P. NO• �`_O MAI L BUIID�NG d ADDRE55 3190 A Airport Loop Drive ADDRESS 3� p, arv Costa Mesa No 929-9205 .Fi2UT A� 6u� CONSiRUCfION !�.�r...�.. W A LENDEF In%I.Re uJs�4�u•Y ,/ BRANCN ADDRESS NEWPOii ARCHITECT ��n (]R FNGINFFR CONTRACTOR jX] ADDRESS L9O1 CITV N�•jjJ�Y' LIC. NO. 2Z1% SIZE OF LOT USE OF EXISTING BLDG. SIZE OF NEW BLDG. 4 � 800 E%TEflIOR W COVEFING �• VSE OF BUI�DING P TE Na� 833-30 �ic�No. 1484 INO.OF BLOGS. NOW ON LOT O NO. OF ROOMS 3 STOF {P• COV�EPING �lt' WORKTOBEPERFORMEO I haraby acknowled8e that I have reatl t�is appllcation entl ste[e thet tha above informaiion is correct and aBree to comply wlth all laws regulatin8 buildin8 consttuction, end I shall not employ any parson in violation of the workman's compensation lews Of tha State of California. 1 he�eby cartity Nat I am properly licensed as e conhactor under the Steta of Californta Business antl Professions Cotle, Divisicn 3, Cheptar 9, antl that svch licenses ere in tull force and affect, or I em exempt from the pr visions ot tha Smta of Celifornta Business antl Protasslons Cotle, ivizion 3, Chapter . ' Sipneara Parmlttee� Authorizatl ABent � �OWNER KOLL y�/�/N� � �Lt`J /'1� Ol VAIU$�U � � FIRE �_ �J ZONE T E GFiOVP v APPROVED gy G DATE ' �� ZONE NO.OF USE OF NEW,z"'n/ ,�/+� �f f% PLANS � BUILDING � YARDSAPPROVED YApDSAPPROVED VAR. # DATE C.U.P.$ZE •7,Z—%�ZI qPPROVED APPROVED • ' THEAMOUNTSM THE PURP06E OF E VALUATION $3�y� �' �J�%Z. �7y Y �O � ( py�,�[ 0 m �� 0 VAIUATION IS FOR m �(� A PERMIT FEE ONLV: Q \y � � m E $ r' B� � m :K S — E � � � LL : $ rxaccr�poxeas: �1IIII ATRWAY AF .. uxn:,� ' CITY O� GOaTA M�SA - HUII.AIPIG PLRMIT PEI2M NO: E 4461a8 _.. OV7NER'BpMtE; a'QI�IN H(?WGNSTTN� ' � � � . . ' , . . ,.^ . - . • .maa�as: 91£SII AIRWAY AC� #:! P�.I2MIT NQ: E 04b10fl " PLIsN CFIECK Nt?: N � GO��Te N SUPP: N CO:,Th MECA • . ' • = CA 9262f CONSTRU,CTiON TkPE; 5-N FFRMI7 TXPL: �LE PUftP05E; ALT � t71.4)557�4D6�! , . , �NGHtEN61NEEfl: MACtT� ,70HN50N � nec.xo.:NQNG JC�kt A�5CRTPTION : COMMGRCIAL T.I,. (c�FFIC�S} � 5'�7 FT: -- �� . � AOQBE&6: ] �l B �S ASRWAY AC� . , � uxrc: � � � . � . , . . . - � . CUSTA M85A CA 92626 ` CLAiM VALUE;� . CALC-VALUE: GRODP UCC:'B-7.' ! �E�xrtr�e: JOAN IiOWGNSTTNE • t 714 ) SS7 �4064 . . . � . aooxesa:. 37.IIa ATRWAY AV J CC�MMEN'i'S; RE:84592?. PRTMFtRY pLi?G. P�'RMZ'T. • COSTA MESA <;A 92Fi26 ��r*x-�*+c�e�t��*�r�*��*�r�xxat*�x�t�*a��r�*��r��r��tt*�taer�at*��*at��ea��at*a�x�+t��c�*�**�***;�*�� , i 410EX8EU COMiMGtOP DECtAM7�pN: 1 hereEy �rm tAat i am 4cerrsea �Mer amvsim�s of Ctizpter 9(cpmmenGnq with SeMron �• %. O N 7 Dt G R E' Q U T R E: M E N T 5 - � _ �� ' 7o�tl) M avivon 5 01 tYB 9usines5 and hategsions Cada, antl my Nce�na Is in tuP tarce aiW etlect. � � ' $ E: 'X' j3 A C K,�i � ' � ' � GRY UC.: StATE U&: � � CU38: � ' � ' . oate: siwwtwe: __�________ • - MAIN FiUTLD7NG -_._.._____� ____.____ ACCEarSQRY BLIZLI?TNG = � ; WORKENS'cubpEpSnnONUEc�IRAnoN: iherebyanirmtnatlnaveacertititazeoiwnsentwseH-MsureoracenMcata'arWansrs' FRNT: ^4^4P9' 'IN ilEAft; FT IN F'RN'1': ' �F1' ZN REA'R:. EFT~' �IN� . fmmpmutionin5urance.otacertitiedcopythereofl��W.4aD.C�. � r+��Tl C''T IN fiGH'P: ti>'Z' IN LEFT: ,fiTr IN RGI�IT; � . F'T , IN �cmaPAr: tacv.onTe: . . PARKING REp: E'ROV: • Pl�RC�I,: 97719324 ZNF: RL:F Nt?: - r�n�n:a coor �s ne«nr rum�snen. ❑ c�nn�a cnvr a r�i�a w��n ma �rcr �a�orna rnaswn: P LANN C NG NOT E5 > - . ' s re: ADDikant: • • . '• - , '. 1(�3F?E#k3E�M0FiF��E�YE1�iFir#kiFk�lE1EiF3F3'edFiFiFiE�Fit##iE1FiFdiiFlFiFN�dfiE?EaE#iEft�fEaE3EltkiflEftifiEitlE##!(�?FBF�it9F9fdE9fiFiE#it?tit}e�iEkaE9F . ae��wonce�s�caar�xsurox��uuunox: p�: V� G O P M E N T 5F E'R C� I�C E S R�' U I• R E td E N T S (T�+s sGGlion neea rmt ne camPkt� it Ne uermd is ar are hurarN ($�001 a kss1. . � 1 ceNry Inat in the peMormar�Ga ot the vmrk tw whkh U1is permit iS isSuep. I shaN npt empby AM oe�mn m any manr�er w aS to beGpmO ' � ; , . supi�c��ottrewaners comernsation�awsmcainomo. , � ?.(?NZNG� A1�PROlrE17 t�i'� ��,�,�_____ � DATE: OMe: � SiSMature: � - . ' ' � � ,�,+�,�, . NotwB: u. aner mat;nu �n5 dena�at�on, rou snauw tuwma sueiect ro me Wan�ers Comeenu�iun wo�iswM ot �lia laoor � U z LD T NG Ati P RO VET? 5 Y :� �,��_,___, _____� . , p AT E e � �`. Code. Y� must IonlrMtn wmqy wit� sucn CmNsare ar tlris oermft snae aa deemed reaoked. � �„ . , .'��. � . CAN5TqUGtION l€NOING �CENCY: i hereby attirm tl�at Nera rs a wnstNttbn ien�n4 atlency tor the permrman6e N'ina wurk tor An P L T CAT I ON I 55 U E.D B Y: j � DATE :� r�' . whah mIs oermn is �sS�ceo (senion aWy, CH. C!. � � *�!� ** 1�?E * iE ie iE �E if iE x• iE st }f it� iE *�7E"?�'R�#F'R��i .-x'i�?t �.... .- .: ir- �?�'3F3FfF'�tl-"�'�� iE k�E 1� aF�F fF tt iE# �'k�% 3t'_ ��t`r iF�e IFNpFH; . . / ,� 3EkirOtiriF�iF#iF3E#3FititiEiEiE##iFit�.h�ititi6ltNitieki[�k,dE,�tt�7tdFiedtif�}t bkiE � :itft�lttt�ttrt#itxiEit�k#t3tlFit�dtif3f9E?F#ititiFlf'!P#�x:tit?E �� ; � I,EGALTZA'TIpN:r1 ' ' F U E S t7 •M M R Y STRUCTURAL -SEGMENT:N ' owaEAeu��oexueti�iunox: �nemoyarraminatiame�emptimmmecontrattms'stateticensetawmri�touon+npreasmi �BLDG PM'I' PLIJMBING Eii�F.C'LRIC MF'CHANTC C�TItE 5M'IPlRF.S GRAUtNG ' tsaction 10.9tS susioess aria Prolesson�l cade: nnr chy ot counN ��h requtrae a permit to cansvuct,�tnar,-Improve, oemohsn, a. p�Rt�i z'� � - � ... . . $ 2.`.i 5 , � ' � repau am strnctwe, prim ro as asuance, atso reqwres me aoWica�t ror woh permn ro ti�a a sipoea swtement tna� he+sne ta ikensed �. -. 5 0 3 ' a M 1 P/ NQN -R Ear purwant ro me arovisansat �he Contractm' stare Lkense Law (Chapter 9 tcammeuinp witA Section 7�01 ot Oivisjan a ot tnt sus��ss p j,AN '•� � � - � � � 8M Pt01lSSiats Code� uf t1�21 AUSne i5 e%2mpt (�er¢irom 2na fAe bd5is (M t�E 2Aeped G%Blnpt�M. My vroWtion o� SBGGM 7031.5 6y any app��cant tw a oemrot sutiects tne apphwnt w e ct,� penattr ot imt mma tnan rrre nmarea do�ars i55Po1. I a 3I) li FE F � ' 15 . 0 0 � i as ownar ot me aaaeM or my e byees rmn waues as meir so�e comvansatwn, wiii ao cne war�. ana ma �UTT,A LNG�UI'V-% ' PEI2M2'I' "� IS�UE'; !'L�N-CHGCiC TO"1'AL ' . Pi1Ii1 � Dt1E [1 structure is �wt mte�weo w oHerea la uta i�ectiori 7naa. @usirress ana pmtass�ona� Code: itie Cantractors' State Lkrense taw T��iAI+k"t -"-' -? .£� 2. 5�� 1 S. Q U.. d. Q d 9 7.`.i 5, . ! 9 7. 5 S � �. 0 0 , dces twt eppty ro en ownet a( a O�aperty who Oollps �g Improves thareon, and xro0 daes $ucb �wrfc himuNJh¢rseti w t�iouqA � .�. � ' , � ,hk w ner own empbyees, p�m�eea ma� such �mprovomemx are noe mtenpee or orcered �or sz�a. A. twwever me twiWinp or HEVk:NU,E: D IC'XS ION TOTAL•5-� i � CQLL6CTEA : 9? , 55 (JVER JSHCIRT i� 00 � ' �improvemem is sda witNn one �year ot wmpktion, tAe uwner �.+li have the nurden oi prarinp neisne aid na� butlp rn improva y immeoum�emu�s�. • ftLDG PMT YT,UhiB:tNG ELECTfiTC MEC2iANiC b'TAE .BMIF�ITOT ,GRAt�ING PLt1i+1-�HECIi i, es awna� of tne properry, am excwsrvan eomreotirq wnn �icensea wmrepars ia wnstruct tna proieq (Seciiun 10ee, eusiness . 9 7. 5 5 , , se � andProlBSS�quCadE. TheC0�t2[IOrs'$UtBLKEnSelawticeSt�tOPD�YWan�wmtol wMEWI05almptm'&4i�ieaon itiPdFitk-iE##3E3SiE:#�lklfif�i-7EiFiE#k##'kiFiFlh#ip4fiE�f,iklF#iFlf#itiF#it3f�kit##}f'#%)ki4#4liF�)kit!tdEit#EiF3[34�k#3f3t3tiF7NiEitii�it3tiffE�?E � wm 3nU Wtla tOMtaCiY im 5uCi1 pfqECts N1fi a COnttaCtor(5) IiCEMe OurSW�lt t0 @0 COnpdCiotS' [4te LiCen59 lawJ; I dm SwNa ��w� omu� ot thei� wonm's Comce�sacian �.cwance snouW be uroiaCea'ro me. '. . T t�t L7 T' Lr I 7j U A L [' r C 9[i F: A K i7 O W N � p 1 am exsmpt wmer 5ecibn�. , B. 8 F. C, " i . . .. , torrtdsreawn: . .(�,,�� ' : TYPE � �'I'Y •TJ Ti a C R T. F T' S O N ONIT C051'' 1'UTAL COST ' �� " �'- t'�'. `� a ?""e` -'-�-'f1°�-�-��'��'�------ ELG: 2U FTXTt1RES T.�ICHTIhIG 1 ST 20 LA. . 75 15 _ OQ � i do nereoy cen�ry �rtat i am aware m an0 unasrstana me requnemenu oi caetan�� t+eauh ana saie� cade sec�hns 2s5os, 25533, ane , Ey �' � 9 (L' I X'T'UR ES � 4 T GI[ T I NG ADA T T I ONAI:. EA . . 4 5 � f3 . 5 5 z553datwtnattwuyhrtureDuUainpoccupantwiiwnwnm+circ�amce)neeotocomo7wunsawstatewdesanathateQuiremenulma ��,�� 2� REC.EPT/qfJ'i'LL•;T-- ` ' 1 aT 2Q �A. .7S . 15.00 permit �ar conswnion or rcautticatwn rwm Gne arc Watm hiana�mant oismct. Pesiaentai comtnrcron appucatanz are axemp� irum �� , 3 5 ' R EC'r. P`I' IOU T I, F: T' ADD I T I UNA li F A, . 9 5 . l S. 7 S mesec�a�sans. . • �1,[ ' 1'1 , FtEEETPTtSWITCH 1 ST 20 6A, .75 9,75 �m: `�-"�L,-'�I � acmicanr. � a• . _._-•- ELB 1 SERVTCES BELQW .60a V 6 l3EI,OW 241: AMP iF3.SQ 1FS.50 i hereQy certiry Mat i nave read tMs apWicatian and atateihat ��E abave inrormEtion is corra . � a4ree to canply wittl an city ar�d county ' � �N1) Q[' FF F.$ • � . oNinancesaiaetaza�awsreaN�wteMnwa�aeonstnictiaiao0trereWamrot¢erepresenlamcsm�Nsscrt!'�nemerupmitreaPavamemmned . . .. . .. . . CmpehY tor i�Pection Oumous. . . ' . . . . ' oa�e: � �-�a s�Bnaiure: � � ' � . tll 00054522-OC3Q54`�22 1"t7T 47.55 , unvqrstkmuorsaaa�secudry;r: , ORTE: Q2/2l190 TIME� 10=4Q 16at-ng Wnda--8uiiditw: Gr¢¢�—�p� �nMcameM: Canary—ApWkam: Pink-•RevenuY. GOId9nro0--Asseasw . . , � . " �_ '�, G,ONSTRUCTION AND PLANNING " ` � PO01 PA � �� APPROVALS Permit# Date Inspector qpPROVALS Permit# Date Inspector 't ..� 7� Temporary Electrical Service or Pole � 52. Pool & Equipment Location ' , 2. Soil Pipe-Undrgrnd. � 53. Steel Reinforcement � �' . 3. Electrical Conduit Utility-Undrgrnd. 54.- Forms. - ,r � � 4. Electrical Conduit�Undrgmd. 55. Electrical Bonding �� .5. Steel Reinforcement 56. Rough Plumbing & Pressure Test ,! . � 6. Electrical UFER Gmd. 57. APPROVAL TO COVER�GUNITE � - 7. Footings � 58. Electrical Conduit-Undrgrnd. '8. Foundation 59. Gas Pipe, � Undrgrnd., Test ` �' 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd. ` 10. Structural Floor System 61. APPROVAL�TO DECK _ ' 11. Property Sewer line & House Connection - 62. Backwash & Receptor�Final . �' ' . 12. Sewer C2p - . 63. Heater & Vent-Final - ' i 13. Roof Drains . 64. Plumbing System - Final ' _ � � 14. Rough Plumbing � � 65. Electrical-Final '. , • � 15. Rough Elecc�ical-Conduit .$olar System-final j ( 16. Rough Electric Wiring- . Fencing & Access ApP�oval � �� 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING ' �� 18. Rough Electrical•T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL � � � 19. Rough Neaung & Air Coridi[ioning �� . FIRE DEPT. REQUIREMENT ' � 20. Rough Factory Fireplace - : APPROVALS' Permit # � � 21. Ducts, in Stiucture ' 70. Underground Hydro � 22. Ducts, Ventilatin9. - 71. Product Piping OGas OOiI 23. Gas Pipe-Rough & Test . 72. Underground Flush � 24. floof Framing _ �� . 73. Undergmd.StorageTank OGas OOiI 25. Roof Sheathing 74. Overhead Hydro ' 26. T�Bar Cei�ing (Structural) & Monocoat � 75. Dry Chemical � � 27. Frame and F�ashing � 76. Dry Standpipe 28. Lathing & Siding , 77. FIXED SYSTEM.FINAL -- � 29. Insulation � . - 78. FIRE PREV. F�NAL ' 30. Drywall Nailing _ ' . � �a .HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat � ��,� � � 79. FINAL INSPECTION � ' I . _ 32. Electrical Power Meter-Final 80�. FOOD CERTIFICATE ISSUED 33. Final Eiactric � y6 Notes: � . 34. Final Heating & Air Conditioning . _ �� '' � � ' , 35. Final Gas Pipe•Test �_�` - . � 36. Hood or Canopy : ; / j , _ , � � � 37. Final Factory Fireplace U'/.t � 38. Final Plumbing �L''� � _' 39. Water Service-Final �' . .. 40. Gas Service-Final � �� ' •� ' � 41. Solar pomesticFinal . � � 42. 8ackflow Preventer � � - � 43. Backflow Irrigation , � � 44. Landscape Irripation System � �, 45. Sound Atrenuation � , � - 46. Handicap Regulations � �, � � ' - 47. FINALSTRUCTURE&BUILDING . �. ; � . 48: FINALF'LANNING j- - � � . 49. �Electric Release to.Edison �� _ . � � 50_ Gas Release to Southern California Gas Co • �" • �� 51. CERTIFICATF Of OCCUPANCY � . � � � No. Date a I, PP0.IECT �UOqES3: � i ES S AIRWAY AV •- UNR: J i owNea•sxune: JOHN HOWENSTINE � I "DCpE� 3188 AIRWAY AV ttJ • � ' , COSTA MESA ` CA.92626 . ' (714)557-4064 ' RRCN/ENGINEEfl: MAR I E JOHNSUN xeo.xo.: NONE �� nooeess: 3188' AIRWAY AV • uxir: J COSTA MESA CA 92626 PEPMITTEE: JOHN HOWENSTINE ( 714 ) SS'1-4064 "o°",Ess: 3188 AIRWAY AV J . COSTA MF.SA • CA 9262G 11CFNSEO CONTIUCTON OFCLAMTION: I �ereEy allirm W[ I am ticense0 untler DroNsions al Chapter 9(commencinp with Section 7000� of �ivision 3 olf�e Business anG Professions CoOe, an0 my license I�'in �ulllorce anG etlecL ' - CITY LIC.: ST1TE IIC.: � LU55: Date: ' SipnaWre: WOPI(EPS' COMPENS�TION OEClAN1TI0N: I here0y attirm Ihat I Iwve a ceNlicate af consent to ul��insure ar a certificata al Workers' Compensation Insurance, or a certifieE wDY ��e�eof (SecUon 3800; Lab. C�. ' POl1CY NO.: � F%P. O�TE: ' ' COMP�NY: ❑ Ceriilie0 coOY is Aereby fumished. ❑ CerlAied copy is filed wi[h �he cHy Building Uvision. ete: ApDlicant: EIIEMPfION FflOM WOHKENS' COMPENSITION OEGAMTION: (Ih's settim neeG rot he compktM il Ihe permt's fw wre hurdr¢A (E700� or kss). I cetliry itwt in t�e Dertarmance of the work for wNc� ihis permit is issuM, I stWl not empby any persan in any manner m as to beiome subieci to tha workers' fAmpensation Laws oi Calilomia. , , Date: Sipnamre: NOTICE: tl, atler makinq tAis Oeclaration, you S�ouIC Oecome SUEject ro t�e Workers Compensation pmvisions of Ihe Labar COOe, you must IortlrMtA comDH �th such Dmvisions �or this permit s�all 6e EeemeG revokeE. � - CONSiBUtT10N 1FN01NU �GFNCY: I �ere0y aKrm Itwt t�ere is a canslructiari lentlinp a0ency far t�e pertormance of t�e work tar which I�is Oermfl i5 i5sued (Secuon 3097, Civ. C). , , � ' ' IENOEfl: , . . -ROOPESB: . . .. - . ., - . � .. OWNEp BULLOEB UECLANITION: I hereDy attirm that I am exempt imm t�e Contrac[ors State License Law br t�e followinp reason (Section 7031.5 Business antl Pmtessional CoEe: Any ciry oi counry wliich aQuires a Dermi(ta consimct, alter, imDrove, tlemalis�, or mpair any stmcwra, pdor to ns asuance, also,requires t�e appfunt far such permn io lile'a siOneG statement 11u� he/she is IlcenseE pureuant to iha D�sians af tne Contactors' State Licenu Law (Chapter 9lcommencin0 �+�� ction 7000) ol �ivision 3 0l Ina Business anA Pmhssions CoOe) or ihat Ire/sAa is exempt ihemfrom an0 tAe basis tar the alleOeA exemDtion. My vialation ol Sectian 7031.5 hy any applicant for a permit sutl�cis the applicant ro a civY penalry ol not more ttwn INe �unEreE Uollars (5500�. , , I, az owner al Iha DroDerty �ar my emyloyees wit� wapes az t�eir wle fAmpenSaGun, � will Oo tAe wolk, an0 [he ❑ simcWre is not inten0ed ar atlere0lar sale (SecUon 701d, Business an0 Professional Cotle: • Ttle Contractars' State License Law Aaes not aDPly ta an awner of a pmpeM �o �uilUs or ImDroves thereon, anA w�o Ooes suc� xrork himselt/hersell or Nmuph Ais or her own em0loyees, D�� such im0��ement5 am not intenAed ar otleaE br sale. Ii, however the huilUinp ar im0�ovement Is SOIC xitNn one year ol completbn. tM owner will�tave the EUNen of proWnp Ae/sna ai0 not build or impmve for the Duryose of ule�. . ' - . � ' I, as awner of the pm0erty, am exclusively canlracGnO �� Iicense0 contractors to consimct the D�ajecl (Section 7047, Business � an0 Prolessions COAe: The Contactors' State Licensa Law Oces not aDGH �o an ovmer of Drope�y who �utlAs or im0��s Ihereon and w�o contraci5 for suc� project5 wii� a COntattoqs) litense pursuani to ehe Controctor5' State License Law).' am awam Ihat prooi n/ t�eir Warker's CompeiKaUon insu2nce s�oWO De prwiGaO Io me. � I am e�empt un0er Sectian: B. 8 P. C. � , for this reason: � � oate: 3 ^ � � � a � I do �ereEy cenity thai I am aware of antl uMerslanU the requiremenis of lifomia eatlh and Safery CoOe Sect ns 25505, 25533, antl 25534 an0 ihat 1 nr any iNure buil0inq ottupant xilVwill not (drtle one) nee0lo co ON ��n uiC stat coaes a the reQuiamems lor a Dermit for mnstmction or moEilication from t�e N'r 8ua4ty Mana ent Ustrici. e ntial c- 'on app ions are exempt irom �hese Olovi5i0n5. �ate: ..3 '�'� q"' p � MPlicant: � I hereby certiry l�at I �ave rtad t�is application and state I�at t�e a ove intarmation is w ce I a0�ea camply h all ciry anE counry orUinances anA sute laxs relatin0lo buil0ing constnnlion anG Ae N� apresen of his ' o emer up tne abovamentioneA property lorinspectian Durpases. Oate: 3 �`9�( � SiAnatu : oriver's License ar Saciai Security x: � 1841-G6 White—Builtli�g; Green—Code Eniwcemenp Cennry—Ayplirant; Pink—Revenue; Gobenrotl—q55esaor ' CITY OP COSTA MESA — BUILDING PERMIT PERMIT NO: P 046456 PLAN CHECK NO: N PERM, NO: P; 046456 �� GOVT: N SUPP: N 'CODISTRUCTION 1YPE: 5—N' � ' PERMIT TYPE; PI�U PURPOSH: OTH JOD DESCRIPTIOTI : REPLACE 6 RELOCATE PLMB. FIXTURES SQ FT: � CLAIM VALUE: CALC—VAI,UE: , GROUP OCC: A-2 / � COMMF.NTu:'RE: H45922 PRIMARY HLDG. PERMIT. - �*****�e��r�r****�r�*�e�e*t��ex�*�****��r**�*��r�***�*�**�**��***+r�*�r****�-xx�*�x�*�� - Z O N I N GS FRTEBQ�UCIKRSE� M E N't S • '' � . ------------- MAIN DUILDING ---------- •---------.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 I�t PARKING REQ: pROV:° PARCEL: 4271932,4 ZNE: REF �10:. � PLANNING NOTES> . , � . . . . . . . � .. . .. '__S. ... k it �k it it it iE 1E iE iE iE iE iE iE aE � iE 3E if if iF if iE iE iE iE �f iE if iE jE 1E it it 3f �k Ik jE iE iE iE 1E iE 3E if �)E �)E iE k j! �IE �E ff iE iE iE fE IE iE 1k af iE iF iF iE 3E iE IE iE IE iF iE iE.k if ik if iF 3E D,E V E L O:P M E M T 'S E R V I C E S`";. R E Q U 2 R.E M E N T S' � � ZONING APPROVED BY' ____ =� DATE: . , BUILDING APPROVED HY : " DATE: ' ' � APPLICATION ISSUED.BYc ' • DATE: �9 �v fEiEfElfiElEifiElElElEiE141FiEiE1EiFlFiflFiF �E vFiF ik ��{F�� IE�1E1FiE3E1FiEikiEif SF1F ifiEif ifiFikiEifiEifiEiEif�%1FiElElfIFlEifiE9ElfiEiEififiFifiEiElEiEiEiE3fiEiFikiEiliF11-itiEifiE3E iE9EiEiEiEif�EiElfiE3EfEiElEiEitiEiFlFlfiElElF1E1f1i(iEifiEifjF LEGALIZATION:N "� F E E 'S U M M A R Y STRUCTURAL SCGMENT:D1 BI.DG YMT PLUMBZNG ELECTRIC MECIiANIC � FIRE SMIP/RES GRAL�ING PERMIT , 0.00 � ' • 253 SMIP/NON—RES PLAN • ' ' ' • � ISSUE FEE 3.00 . BUILDING—DIV—> PERMIT ISSUE PLADI—CHECK TOTAL PAID ' DUE 'TOTALS----> 8.00 , 3':00 0.00 11.00 11.00 .00 REVENUE DIVISION TOTALS--> COLLECTED: 11.00 UC�ER/SHORTi .00 � BLDG PMT FI�UMBING GLECTRIC MECHANIC FIRE SM'.IP/TOT GRADING PLAN—CHECK - , 1 1 . Q � , . . ' ik 1f #E if iE iE iE iE if if iE iE if iF K-if k ik iE 3f iE iE If 3E iE iE If if iE iE 3E if iE 3f aE iE k ik k�E iE k� iE �f 1E If iF if if 1E iE iE it M if jf if iE iE iE iF �t iE iE 7E iF iF i(� if if i(-�%iE M 3E �k 3f jE ' I M D I V I D 0 A I, F G F. B R E A K D O W N TYPE PLU PI,U QT'Y D E S C R iI P T I 0 N. 2 WASH BASIN 2 WATER CLQSET (TOILET? � _. En�D or• r• eEs 0 UNIT COST, TOTAL COST . 2.00 . 4.00 7..00 ' 4.00 i � i ' 01 000`5773-00055773 T U T i1.0a DATE: 03l04I90 TItfE: 15:11 ' CUNSTRUCTION ANDPLANNING . P�� A APPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector � l.�Temporary Electrical Service or Pole _ 52. Pool & Equipment Location • " 2. Soil Pipe,-Undrgr,nd.- . ... 53. Steel Reinforcement L-� /'� y -'3.Y�Electric5l'Conduit'lltility-Undrgsnd. � 54. Forms - � � 4.Elect�;cal'Conduit,Undrgrnd. 55. Electrical Bonding � :, -�'5 `Steel Reinforcement . 56. Rough Plumbing & Pressure Test , � �M �r6.'OElectrical,UFER'Gmd. - 57. APPROVALTOCOVER�GUNITE�� ,7.. ;Footings= � � 58. Electrical Conduit�Undrgrnd. � ' ='8. Foundation �= 59. Gas Pipe, � Undrgmd., Test i• �- 9. Water Pipe�Undrgrnd. � 60. Backwash Lines, P�Trap, O Undrgrnd. � • � 10. Structural Floor System 61. APPROVAL TO DECK � 17. Property Sewer Line & House Connection 62. Backwash & Receptor�Final " � � 12. Sewer Cap : 63. Heater & Vent-Final '', �� . 13. floof Droins� ;_ " 64. Plumbing SYstem � Final ' , .� 74. Rough Plumbing l y0 y�%' 65. Electrical�Final � �'� - 75. Rough Electrical-Conduit 66. Solar System�Final .. . � ' --r � • 16. Rough Electric,W�ring - - 67.' Fencing & Access Approval . � 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough ElectrirabT Bar Ceiling . 69. POOL/SPA SYSTEMS FINAL 19. Rough Heat�ng &�,?xr Conditioning� y,�_ , ,. �_ ,�,FIRE DEPT. REQUIREMENT _ 20.-Rou h Factor Fire lace _, '2' ' �` ' _ -'' " �'� � ' - 9 . Y _ P rx . �<1PFROVALS �_._Permit # 21 f �Ducts, i�Struc[u�ei � - - i , ' ` � ; �70. Undergiound Hydro 22.� Ducts, Ventilating� �, i - , - r: �� ..�77, Product-Rping O Gas � Oil 23. Gas-Pipe-Ro�gh & Test "�- '. �� d; •_�'� ' -7y, Underground Flu'sfi' � ' 24'�Roof Fr'aming �.. _ ��r.' r = c� � -73 � Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing "' �-`. * �' : ; " ' 7q;�Overhead Hydro,- �. , 26._T�Bar Cei�ing (Structural) & Moriocoat - - �; � � 75�Dry Chemical ' _ " 27c�.Frame and Flashing: �. - - =' 76. Dry Standpipe - � - `28' lathing,& Siding- ,' ' �=;:', ' " ' `,', ' 77 fIXED SYSTEM FINAL _ �� 29. Insulation - `-� • ' � 7$ =FIRE PREV. FINA'L ' " �30. Drywall.Nailing •�,� /', �' ' � HEALTH DEPT,. REQUIREMENT 31. Plaster Brown Coat- = ^- y�•� � 79. FINAL INSPECTION � �,32�:�Electrical Power Meter-Final ' .` ;�� ; J80. FOOD CERTIFICATE ISSUED z _ :.33:,Final Electric � . � . ° Notes: - �-- � • � T . �!34_..:Final Heating & Air Conditioning � _ �� ' � � � = , - - �_ , � 35� Final Gas Pipe-Te"st. - . - , . ' �� , "'36._Hood oFCanoPY t = - : ; - ' , ' j;. i - - �. - .. - �37. Final Factory Pireplace: � •, � � "i' � � � i ^ � �;38. Final Plumbing " - Qd ,[�J�`� ` _ �. �� t ' 39. Water Service�Final. -- ` , _ � �]40. Gas Ser"vice�Fina1 , " � " ' � - t �� ' ' � ,_ :�,41. Solar pomestioFinal ' � i .,• - � - - . � 42.�Backtlow Preventer � r = - , - . 43. Backflow Irrigat�on � � ; � � • . � '�44._ Landscape Irrigation System" � � - �' ' ' '. - ' - - y � ' . z45..�Sound ,Attenuation : .. � � ` .-. ,- --� . , - - �� ', _ a . �46: •Ha�dicap Regulacions � + � _ ' - ` •- � - _.47i'FINAL STRUC'�U.PE & BUILDING � ' ` - _ 48.yFINALPLANNING -� • ' ,�• � ' _ - „-, 49: ,Electric Release to Edison � ' ' :. ;, _ � _ / ��50.. Gas Release to 5outhern California Gas Co ' �. �- - _ � " '51. CERTIFICATE OF OCCUPANCY = • - ' No. Date . _ Pfl0.1ECTR00flE5S: 31�� ATRWAY AV �ux�T:J �� CITY OF COSTA MESA = DUILD'ING�PERMIT �YERM NO: �B 045922� OWNEB'EN�MF: JOFiN HOWENSTINE � � ' �' � � ' ' � ` � ' � � �oaxesa: 91�8 AIRWAY AV #J PEf2MIT NO: B� 045922 L'LAN CHCCK NO: N GOVT;. N SUPP: N • COSTA MESA ` ' - • • CA 9?.626 'CONSTRUCTION 'CYPE: 5-N YERMIT`TYPEo STR . PURPO:iE: ALT (71q)557-4064 � ' • RBCH/ENGINEEfl: MARjE JOHNSON • �pEa.No.:NONE � JO� �DESCRIPTION : COMMERCIAL� T.I. (OFFZCES) ' � �� . SQ FT; 22,�4J9 • ►DOBEBS: ] 1 S H AIRWAY AV uxR: ,7 ' . � ' - . COSTA MESA CA 92626 CLAIM VALUE: 2?.,439.00 CALC-VALUE:' 7.2,439.00 �GROUP.00C: B-2 / PEflMIfTEE: JOHN HOWENSTINE ( 714 ) 557-4064 - � ' ' �� DOflE33: ]'LQQ AIRWAY AV J COMMENTS: RG: PClk 251-895 PC FEES PAID ON 5-9-09.'' � ' � COSTA MESA CA.92626 ir�r*�t�r��r�-**��**�**��e*�t*ir*x�x�**+r��t�c�*x�**�t��*�t*�ei�****�r�t�t�r*+t*�t�r�-�c*��r*��***�t*f�*�r*r�*�t� uCENSEo cox7MCTOB OFCIAMTION: I nere0y anirm'that I am licmaea uneer prmicians of Clupter 9(commencinp witn Seition � � 7 O N I N G R �� Q U'Z li E M� N T S - ' - �� 700010l Division 3 al t�e Business ana Prohwions CoOe, ana my Ikenu is in full force anU etlect. . � . . .S E T H A C K S' �� ' � �' � cm uc.: sr�re uc.: cuss: ' , ' ------------ MAIN BUTLDING ---------- --------- ACCESSURY BUTLDTNG --=------ oate: S�pnamie: FRNT: FT . IN REAR: FT IN FRNT: FT IN REAR: FT ' IN' WORI(Efl5'COMPENSIITIONOp�p�7�ON: I�er¢ arermtnaunaveaaniruateaiansenuoseu�insureoracertiticareo�woncers' I�EFT: FT IN RGHT: FT IN� ' LEFT; FT IN RGHT: �= FT� IN._ Compensation Insurance, or a certife0 copy t�ereol�Seciian 3800. 1a0. 6ry. . . , POLICY NO.: �� IXP. O�TE: ' - �QMP�Ny, — PARKING REQ• PROV: PARCEL: 42719J24 ZNE: MP REE' NO: , CertifieOcopyi5here0yfymLSheE..❑ art�neeworaruea�wmurecMewanouiv�ston. � . PLANNING NOTF.S> POR TENANT IMPROVEMGNTS, •ONLY.. CREAT.ION OF ADDITIONAL' � PA E ' %� � oate: - npplicant: [x�vnaxmoMwoauxs�Wxr[xs�iroxo[cuuuTrox: f�uamnxaro�oemnde�eanmeo�sroraremmaroo(sioal«ias1. I certity t�a[ in the perlarmance of tAe wuB for wNc� Nis'Demtit is iuuea, I 51W1 no[ employ any person in any manner m as ta become su�lect to tAe Workers' Compynsation Laws ol Calitorrua. Date: Siqmturo: - ' � NOTILE: If, after maldn0 ws Oeclaration, you SMiEE'Eewme su01M to Ne WOAeers' Compensation proviUorts of Ne LaOor CaOe, you must fortMlit� �mDN �+�h wc� Drovisions or Uus permit sAall Ee GeemeC revokeE. CONSTI1UCf10N LENOINO �GEXCY: I.Aeaby affum tlu� thea is a constmciion IeMiiry aO��Y �or IAe peAarmance of t�e work tar wnicn mis cemm� u iswea (secuon 30s7. civ. c). , � IENDEH: noosess: , - � � OWNEB BUILOEB OECIAMTION: I �ereUy alfirm �Aat 1 am exempt imm Ne ConVaRors' State Lkema Law tar t�e IWlowinp�reason �Section 7031.5 Business anG Pmlessional Catle: , My ciry ol iounry wNU repuires a permit to cansiruct, alter, impmve, tlemolis0. or reDair airy rtruciure. D�or to ilz issuaxe, ysp repuires tlu appGcam tm zWi permit ro ide a sipne0 statement Wt��/slie b Ilunse0 pursuanl to Ue D�ovisions al tk Caitnctors' SUte lkense law (C�tVter 9(commexin0 wIN Section 7000) ot Divislon 3 of Ne Business anE Pralessions COCe) or Nat tre/stie 5 eaempt Uertfrom anE tM EasB ta IM allepe0 exempUon. rVry violation of Secuan 7031.5 Ey any applicant Ior a permit wEjMs tne applkant to a clvil penalry ol nol rtqre tAan /ive MmCreO dolWrs (5500�: I, as owner of iM prop��ty or my emyloyeas with wape5 u theU mle compenutbn, will Oo tAe wark. anE t�a �❑ slmcture is not intentlatl or aHered for sala (Setllon 7044. Busmass an0 Professional CoAe: T�e Contractars' S�ate Licensa Law Aces not apDN �o an owner of a property who OuilQs or Imprwq tlrcrron, ariG wM tlaas wcl� work Nmself/lierself or Ihraup� Als or Irer ovm emDloyees, Dmvi0e0 tlw� sucA improvements am naDmlen0e0 or otleaC lor ule. II, Iwwever I�e huiltlin0 or ImO�ment B wW witlun me year of wmpletion. Ne owner wm luve IM OurEen ol prwinp IMJ50e AiA not OWW or improve Ior me o��W�a oi sa�el. � � . �'� I, as awner ol �ne O�ope�y, am exclu5lveN comrac6np wii� Ilcense0 comractors ro cansirucl the Dmject {Secuon 70/d, Business aM Pmlessioirs CoOe: The Cantr+aors' SYate Lkense Law das mt apdy to an owner ot vrocer1y � eNIOs or Improves ttureon an0 who cOnIr2CIS Iot SUC� D�alecis wli� 8 mntraclar�s) li[¢nse Dursuant Io t�e CAntfaClofs' Siate License Law�. 1 am aware Ihat praal oi t�elr Wo�er's Compenu�lan insurence sAoulC Oe proviGeE to�me: � � I am exemD� under $hyWn: B. E P. C. ' � . lor tAts reasan: ' �(� � Uata: �! � � � Owner. � �,y.L_ I Oo MreUy cenity ttut I am �wug of antl uMersianC Ue re7uirement5 0l Calitomu Healih anE Salery Ce Sectwns 25505, 25533, an0 25534 ana t�at I or any fuwro huilEinp acupant xill/vnll not (cirUe one) nma Io compry witn sai0 slaia coEes an0lha repuiramems for a permit far construction ar moryiliption irom t�e Nr ualiry Manaqement Ustrict. HeSiAentlal miructbn aDW��ons am ezemD� �rom IhesB pfOviSions. , oate: 2--' r— 9 O ppp�: �cL._w u I nere7y ceniry ttwt I liave «atl tlds apD�� statt that ihe a0ove intwmation a wne I apree to mmpty wit� ap ctty an0 counry ortlinances aiM state Im relati�p to budGinp mnstnctim a�7 �ereM ��e reD�� a��Y �o emer upon Itre aUwa�memroneO propeM Iorinspeclun Durpo;es. Data: � —� �O �O�ture: x�+� Dnver's License ar Soclal Securiry x: ' 18Cl.dfi W�ite--BuiWUg: Rrean—Cotle EnlOrcemenl: Canary—Ap0licant: Pink—Ravenue: Gabanrod=Asaesaar > OFFICE S C . - _ _ _ _ .. ,.,. ., ��**�*��*�***�;��x��***x�+��*�*+r�r�*��**�x��x�*****��rt�r***�*x�*�**�*�+t��*�x*�*�� 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�;C S ' ZONING APPRUVEll BY :_�J__.��EZ�_�__ DATE,c ��p • DUILDING A RR� OVED DY :_ � llATf;; �= ( �O APPLICATION ISSUED BY: � DATL: ��F�'��'3Fi� **atatit*at****x�*3aitio-+tat�itatit FiF�� F� r �e�F iFiF3F7F'iF -*��**+t*it�tie c �� **��r+�*��r*�**x�*x*�r�t�tx��r*x*x�#�t*�t*�r�t**�t*��r*x��*�* �r**rt�t+t�r*�r*�r*�t�r**�r�**+rk��7�+r�r�t*+t*�+�* LEGALIZATION:N F E E S UrM M A R Y,., , STRUCTURAL',SL:GMENT:Y , !:• � ' BLDG PMT PLUMBING ELECTRIC.¢fECHAN'IC, FIRE SMIP/RES' GRADING PERMIT 234.00 ' , . . : � • -Sihi�-i'idO1V-RES PLAN • , • i ' . 3�.37 ISSUE F'EE • . � ' "�' ' HUILDING-DIV-> PERMIT ISSUE PLF�N-CHECK, "TOTAI, PAID DUE TOTALS----> 277.37 0.00 !• ,. 0'.00� 2•77.]7 237.77 � .00 REVENUE DIVISION TOTALS-->� COLLECTEID:�= 237.J7 OVER/SHORT: .00 DLD34PM��1�' PLUMIIING ELECTRIC MECHANIC� P.LRE: SMIP�'TO,T� GRADlNG PLAN--CPIECK, .!(� �lf iF ik 1E iE iE iE 1E fk ik X� k if lE if it iE iF ik 1E iF iE it it k iF iE 7h if if 36 iElt it i( if iP 1k �E af IE� W.If # iE i6 it fk i! iF iF iF iFlk IP 1E iE fk IE 1E ft IF 3t 1E iE k if 3E iE iE �IE IF �IF IF iE �1P 1E X� i N D I V I D U A I;: ' F E E H R�iE A K D O W N' TYPE QTY D E S C R I P T I O N,:, , �� UNIT COST , TOTAL C051' SFC ?2439 ALTER IIY VALUE COMMERCIAL� NOZC?N� 1.00 '12,439.00 - Er�� oF r• ees • � �, � / .r ' . , . . - l. ,f a . .. . , ' . .� ` 'y �' • i � '' d f n 0100053163-000531b4 TOT 237.57 �"�/1 ' (��7�r(�, ;' DATE:•02/Ql/90 TII1E. 15:39 , � . CONSTRUCTION AND PLANNING� � PO� arA � .�'i AFPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector � 1: Temporery Elenrical Service or Po1e . 52.� Pool & Equipment Location •- 2., Soil,P,ipe-Undrgrnd: 53. S[eel Reinforcement r' '- 3. Electrical Conduit Otility-Undrgrnd. . 54. Forms ' . ' -_4. Electrical Conduit-Undrgrnd. � 55. Electrical Bonding . ',� -�.5: Steel•Reinfoicement _ 56. Rough Plumbing & Pressure Test ' ' � 6.,Electncal�UFER;Gmd. 57. APPROVALTOCOVER�GUNtTE� �7:.Footingi�. �, Sjof L y� 6 58. Electrical Conduit-Undrgrnd. - � 4 ., ��B.�Foundation 59. Gas Pipe, O Undrgmd., Test � � 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd. • 10. Structural Floor Svstem 67. APPROVAL TO DECK -•• � ° 17. Property Sewer Line & House Connection 62. Backwash & Receptor�Final ' � :� 12. Sewer CaP :- 63. Heater & Vent-Final 1' � `�-_ 13. Roof prains . . 64. Plumbing System - Final 1� �� 14. RougN Plumbing 65. Electrical•Final '��r `, i 15. Rough Electrical-Conduit 66. Solar System-Final `�� ' � 16. RougM 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.-'RougN Factory Fireplace � ,� � � _ . � APPROVALS'�.. Permit # � 21: Ducts, �� St�ucture �'�''`� _ - "� F' 70. Undergro�nd Hydro r. 22 Ducts, Ventilating �, - _ � ,.' ��. �, 7�, p�oduci P ping O Gas ❑ Oil 23. �GarPiPe-Rough & �Tesc ' � ° ; ` �, � 7y, Underground Flush - � 24. Roof Framin9 ' � . � - - � • •73r.Undergrnd.StorageTank �Gas OOiI 25. Roof 6heathing ' • � • ' ' " •� � 7q, p�erhead Hydro 26: T-Bar Ceiling (SlrLctural) & Monocoat. `• ,,, . `- . � 75c Dry Chemical . � 27. Frame a�d F.lashing _ ' :; i; 76. Dry Standpipe ^ . ' 28. L.athing & Siding. ' ' � ' " ' "y. „; 77,_ FIXED SYSTEM'FINAL �. . 29. Insulation � - '� ' �� ''�+ 78-FIREPREV.FIN�AL � - r �30. Dryw011,Naiiing.= ` �, +. .. �. "' ' � � " HEALTH-DEPT. REQUIREMENT . 31. Plaster Brown Coat _ ` . '�!• �: � •�79. FINAL INSPECTION - "32..Electrical Power;Metei;Final �'.;�. .�� 80.. FOOD CERTIFICATE ISSUED_ � �-•� � 33-Final Electric c*� !� - � � �� Notes: R;,�� ' '��_� -Lo 0 � �� 34.. Final Heatirig &;Ai� Conditioning � � - ' ' ° � �� `- �, 0 �: i . - 35. Final Gas Pipe-Test � �. • ; � � , i: •. . 0:•,• - , 36. Hood oi;Canopy ' - � " " � " :, �/�l ` - - -' • _ � � �. �� 1 - a r,. '�. 1 r� - 3T: Final Factory Fireplace•: ,��. � -';' � � _ 1 l -LC- e - 38. Final Plumbing =, �' _ - . � . .�' S � � �•� a' � -� 39. Water Service-Final� � - � - � '.� 'p .. � ' 40. Gas Service•Final -• - = � - � �;, + „ � '.41. Solar Pomestic�Firial- - - , i ;, .,. _ -- �� - 42. Backflow Preventer • � ' � + ' ' . . . �. i-'• - 43. Backflow Irrigation � "" � , � : � . �44. Landscape Irrigation System ; �. '• - � y' � _ . ' • �45.�Sound Attenuation . l _ - r� , -� !r <, - - - � -,, y 4 • p egulations - , ,47, FINAL STRUCTURE & BUILDING � ' " _ _ ��,- -� z,. - ' . r. . 49: Electric Release to Edison � � '` - .. . . �."'n .. .: _� 50. Gas:Releate to Southem California Gas C4 • � f � ^ � ' � - � � �51. GERTIFICATEOFOCCUPANCY + � • - -- ' - No. Date , Aoolleant to flll in all spatts exttpt lhose within neavy.boreer limt antl sign al1 appropriate aeelareUonz. CiTY OF COST MtE�SA /�CONSTRUCTION P.1E�RMtT ProjectAddress ��CJS /-i-l✓Z1AiliM L�E "�"�T ApplicanYsMailin�gpAd�dTres�s� ��L �('~S"% � OAiner's Name �� 1"�O�J�%$T71'� E Phone Address 3�8%� %112wA"7 '4VU.'w� Arch/Eng. Licenu No. Address Contractor's Nam � � � hon�/�� G'13`�P4s Addresslmailingl-�'O��L q �� S��NO�+Po.t,TS2pGM 9z�/rJ Ciry License No. �47 / LICENSED CONTRACTOF DECLARATION Lhereby affirm [hat I am Iicensetl untler provisions of Charter 9(commencing with seccion ]000) o( Division 3 of the Business antl Professions Cotle, antl my license is in full � ce a etiect. /L` Llcense Cla �� L en5e No.T•,�� ate �e-1 ^Q 5'g t �' w^�—� WORKERS'COMPENSATION DECLARATION I hereby aitirm Ihat I have a certificate of consent to seH-insure or a certifitate �t Workers' Comoensatfon Insurance, or a certi(ietl cooY thereof,(Section �- 3800, Lab. CJ ' � Policy No. Company 8 Certifietl coOY Is �ereby furnishetl. � Certifiea cooY is filetl with the city Builtling Division. . Date Ap0licant ' EXEMPTiON FROM WORKERS' COMPENSATION DECLARATION (Tbls section neetl not be completetl it the permif is fOr One huntlretl (E700) or less). 1 certity lhat in [he performant¢ Of th¢ work tOi whith thi5 perm�t i5155uetl, I shall not employ any person in any manner so as t0 become sub�ect to the , Workers' Co pe a ion Laws o( Cali /� �ate 7 —�Si9nature �c� 'NOTIC : If, after making this tleclarat on, you shoultl b come subject to lhe Workers' Compensacion provisions ot Ihe Labor Cotle, you must•forthwith ' comply with such provislons o� [nis permit' shall be tleeme� �woked. CONSTRUCTION LENDING_AGENCY � I her¢by affitm tnat �nere i5 a con5tructlon 1¢ntling agency fo� the petfo�mance of the work tOr which (his permll is'i55u¢tl (SettiOn'309� Clv.'C:J �enGer's Name � Lontler's Atltlress - OWNER BUILOEN DECLARATION � - � � I hereby a/flrm thal 1 am oxempt trom the Con[�actot'S Llcense Law �or [he � followin9 reason (Sectlon ]031.5 Business antl ProfeSsional Cotle: Any cl[y or county whlch requires a permit to construct, alter, improve, tlemollsn or repair any strutture, prbr [o9[s issuance, also requires [ne applicant for suth p¢rmit �to lil¢ a slgnetl stalement lhat he/Sh¢ V5 Iicensetl pu�suant to the provisiOns of . the Contractor's License Law (Chapter 9(commenting with Sectlon 7000) ot OiviiiOn 3 of lhe Bu5ine55 antl Plofessions Cotle) or that he/she is exempt hereirom antl Ih! basis ior lhe allegetl ex¢mptlon. Any vlolation of SnctlOn )031.5 by any applicanl for a permit subjects the apP��ant to a civll �endlty of n0[ more [hdn five huntlretl tlollars (5500). I; as owner ot lha property or my employees with wages as their solo compensation, will Co the work, antl the structwe Is not Intentletl or offeretl lor sale (Section 7044, Busine55 antl Protessional Cotle: The Contractor'S' License�Law tloes nol apD�Y �o an owne� of a pro0arty who builtl5 or improves thereon', antl wno tloes such work himself/nerselr or throuqn nis or' ner own em0�oyee5, Provitletl titat such improvemenl5 are nOl intentl¢tl or offeretl for sHle. 11, hOwever, t�a builtling or improv¢ment is soltl within one year ot com- pletlOn, the Owner will have the burtlen ot proving hC/sh¢ tlitl not builtl or Irn- proveforthe purpose of sale). � � ❑ I,�as owner ot the property, am exUuzively contracting wi[M1 licensetl con- t�actOR td mnst�ucl the project (5¢<tion 7044, Businazz antl Profe55ions Cotla: _The Contractor's.,Llcense.Law tloes not apply to an owner of property who builtls or ImOroves thereon, antl.who conVacts for such projec[5 with a con- tractor(s1 Ilcense pursuant�to tne ConVa<for's �icense Law). I am aware thaf proof o( their WO�keYs COmpenzatlon insu�ance ShOultl ba O�ovitletl to me. ❑ 1 am exempt untler 5¢ction B. & P. C, tor this reason ' Date Owner I-nereby certity ihat'I have7ea Information I5 correcL'I a9ree to antl state laws relating to buildir upon Si9nature ��?M✓'I Drivers' License or 55 � Dace %-7 -i % 0 TYPE OF CONSTRUCTION � LJ NEW LJ ADD LJ ALTERATION �REPAIR. — ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A p #, � DESCRIPTIONOFWORK/USEOFBLDG. C16 5L/OP ' ' S Main Building: E TVPE OF PERMIT GRADING 'FOUNDATION STRUCTURAL T Front ❑ TENANT �ELECTRICAI ❑ PLVMBING ❑ MECHANICAL B Rear . ❑ �OTHER - %� . PROJECT DESCRIPTION Sq. FT. � oCCuvA Cv C Right CONSTRVCTIONTYPE VALUATION$� g L2ft � - . ZONE � GRADING CV. VOS. ACRES p�ng. Ref. # Rema'rks: • � Planninq NotCs: 0 Bar Sink Backflow Preventer Backflow Irrigation A °loor Orains =1oor SinkS � - ' ad5$ElVICE DUI�CIS I nrerceptors Kitchen Sink ' Lavatories � •� � ?-Trap � ' " � ROOf.Drains ,_� ' Reinspection'Fea $15 Boilcr � ' � .• Duct - Under Ground ' Duct-Ventilating - Exhaust System ❑ Multiple Firepl/Fact. Blt. ICBO # � Heating System & Ducting ' ❑6100,000 BTU �700,000 Rainspection Fee � $15 CMF 0865-46, rev. 10/84 White - Builtling: Canary - Applicant; Pink � Accountin9: Goltlenrotl - Assesso� -Service Sink Sewer Cap Sewer Connectiori Solar Collectors Solar Tank $wimming Pool w/Spa Urinal Water Ciout � Water Heater Water$ervice� ' . -AuIO�WBSh �- Laundry Treys ' ' Issue Fae ' � $ 3 IANICAL � FEES Hood or Typel ❑ �. � I Canopy � Type I I � � i , Refrigeration System ' .00-100,000 BTU tO100,000 BTU . System fiepair/Alteration Fire Damperi Registers Issue Fee $ 3 Auromatic Washer Cooking Unit' Dishwasher . . . -_ Dryers �Gas ❑Electric Fan � F,A.U. Fixtures Device Boxes � � Outlets 6547 6%02/86 .4.60 'fL �� Zone AcceSsory Building: 2 O N I � N � G R . Parking Req./Provided E� Q ' M T _ _ S ELECTRICAL �� Transformer ❑ 75-50 KW� ' ❑ 50+KW . Meter ❑up to 100amps � . Meter ❑over 100 amps - Gar6age Disposal Generator DO-5 KW �5-15 KW Sub Panel � � MotorsO0.1HPO1X=8 � Inc. Solar �9-15 HP 016-15+ Microwave � Pole Light , � SigO ; Standing Sections Trash Compactor � Rainspection Fee �$15 � �� luue Fee DEVELOPMENT SERVICES REQUIREMENTS: Zoning APProved By ' Building Approvad By � Application laued BY 6/I 1' FEES $ 3 � SUMMARV OF FEES BUILDINGPERMIT' $ � SMIP � �, $ � PLAN CHECK � $ � � PERMIT ' ' � PLUMBING ' ' $ ' � ,ISSUANCE $ PLAN CHECK ,25% $� ENERGV P.C. S , � ELECTRICAL � $ � GRADING S PLANCHECK ,50% $ ' MICROFILM � $ �� MECHANICAL , $ � �TOTAI FEE $ D PLAN CHECK ;25%� $ � � CONS�RUC710N AND PLANNING POO. .SPA , APPROVALS Permit# Date Inspector qppROVALS Permit# Date Inspector 1 t Tem�oorary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. ' . 53. Steel Reinforcement 3.- Electrical Conduit Utility-Undrgmd. 54. Forms 4. �Electrical.Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement - 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. ' 57. APPROVAL�TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, � Undrgrnd. 10. Structural Floor System 61: APPROVAL TO DECK � 11. Property Sewer Line & House Connection 62. Backwash & Receptor•Final 12. Sewer Cap . 63. Heater & Vent-Final 13. Roof Drains . , 64. Plumbing System - Final 14. RoughPlumbing�� 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final . 16: ,Rough Electric Wiring - 67. Fencing & Access Approval 17. Rough Wiring Sign , 68. APPROVED FOR PLASTERING 18. Rough Etectr+cal-T Bar Ceilirg 69. POOUSPA 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 Framin9 73. Undergrnd.StorageTank �Gas ❑Oil 25. Roof Sheathing 74. Overhead HYdro 26. T-Bar Ceiling (Structurall & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry S4andpipe 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 60. FOOD CERTIFICATE ISSUED 33. Final Electric a� 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-Fina1 40. Gas Service-Final 41. Solar pomestic-Fina� . . 42. Backflow Preventer 43.,Backflow Irrigation , ' � .,. 44. �La�dscape Irfigation System 45. �Sound Attenuation 46: Handicap Requlations , 47. �FINAL STRUCTURE & BUI LDING 48. Special Requirements Completed ' i . _ . _ ... ._ . .. i 49. ElectridReleaseto Edison � � . ._- _. ;. !_ ._i__ __��._' �r I 7__� , , � � � (-� T�1 � 1� '�, � � � �1 � . , 50. _Gai�Release to Southern California Gas Co � ' � ' t � i I � ��, i ' 57.oERTIFICA7E OF OCCUPANCY _ _ __ ' _ _ �__ _ _ _ No. �' Date " - , � ! � . _L_ l._l. J. . .. (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 3188 AIRWAY AV Suite No Vicinity: UNIT L(PIN POINT MEDIA) Parcel Nunmber: 42719329 Applicant HOFMANN, CHUCK Address: 3188 AIRWAY AV UNIT A COSTA MESA, CA Owner: PINPOINT MEDIA LLC Address 3�88 AIRWAY AVE C.M, CA PLUMBING PERMIT Phone: (949)515.8822 Zip: 92626 Phone: Zip: 92626 ConYractor. HOFMANN FINN DEV COMPANY WC Address: 3188 AIRWAY AV Arch / Eng : Address: UNIT A COSTA MESA, CA Phone: (949)515.8822 Zip: 92626 License: 731034 Phone: Zip: License: ISSUED BY: Status: ISSUED Applied: 09/26/2002 Issued: 09/26/2002 SCOPE OF PERMIT 4097 SQ Ff TENANT IMPROVEMENT FOR OFFICE AND WAREHOUSE SPACE. UPGRADE RESTROOM FACILITIES FOR ACCESSIBILITY RE�UIREMENTS. TENANT: "PIN POINT MEDIA) 1 SHOWER, 1 KITCHEN SINK, 2 WASH BASINS, 2 WATER CLOSETS, t WATER HEATERNENT. REF: B02-01005 ISSUE FEE Backflow irrigation Backflow Preventer Bathtub Clarifier System Connect Qce,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve Gas (1-4 ouUets) Gas (Over 4 outleLs) Gas Repipe Gas Service Interceptors (Grease, Oil) Interceptors (Sand Auto ) AMT $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 QTY FEE SUMMARY AMT Laundry Tub / Washer $0.00 Landscape Irtigation $0.00 P-Trap $0.00 Pressure Regulator $0.00 Process Piping (per 10 ft) $0.00 Receptors $0.00 Septic Tank $0.00 Sewer Cap for Demo $0.00 Sewer Connect $0.00 Sewer Pnvate Line 50.00 Shower $9.80 Sink, bar $0.00 Sink, commercial $0.00 Sink, Floor $0.00 Sink, kitchen $9.80 Sink, service/mop $0.00 Spa (private) $0.00 Spa (public) 50.00 �TY 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 SumpPump Swimming Pool Trap Primer Urinal Vacuum Brkr Bkflow(t-0) Vacuum Brkr Bkflow(5+) Wash Basin Wash Basin Set Waste and Vent System Water Closet (Toileq Water Heater / vent Water Piping Qnst or Rep.) Water Re-pipe Water Service Water SoNener OTHER VIOLATION PLAN CHECK REINSPECTION AMT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $19.60 $0.00 so.00 $19.50 $72.30 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES: 594.60 QTY 0 0 0 0 0 0 2 0 0 2 1 0 0 0 0 NOTICE: The work authonzed by this permit sFQ� pl$�,I(p�p�l@ ly'�Jf��$ requirements under California statutes antl related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for �he work euthorized under �his permi� �o be considered legal, such work mus� comply with all applicable codes, and all required Inapeetiona and fi�al approval musi be obtained. Failure to obtain inspections and final approval will result in the expiratlon of ihis permit. FOR INSPECTIONS CALL: (714) 7545628 � zaarwe Ierool WORKERS' COMPENSATION DECLARATION: _ I hereby aHirm under penelty of perjury one of lhe �ollowing declaratlons: ❑ I have and will maintain e certiticete ot wnsent to self-Insure for workers' wmpensetlon, es provitle0 for by section 3700 ot the Labor Gode, tor Ihe peAortnanca of ihe 1� work for which this pertnit Is 155ued. Q�Lhave antl will maintain workers' wmpensation insurence, es required by section 3700 of the Lebor Cotle, tor t�a pertortnance oF t�e work for whkh this pertnit is issuetl. ( My workers' compen n Insurance wrtler entl p�cy number are: v6S 3 y� ^G L Carrier. %� Tf` br5/I�t 4G �-.�u.� PolicyNumber. (This section need nat be complet d i� the permit ig velued ef one hundretl0ollars ($100) or Iess.J ❑ I certity that in iha peAormanca of ihe work fpr w' h this p rtnit is issued, I shall not employ any person in any manner so es to become subject to iha woMere' wmpensetion laws of liternie, end agree Ihat sh � ecome sub�ect m the workers' compensetion provislons of Section 3700 of Ihe Labor Code, I shell forthwlth comply wit� lhese pro isiqrlc y/L /� Applicant Signature: Date: � � 7 WARNINO: FAILURE TO SECURE WORKERS' COAIPENSATION COVEPAGE IS WFUL AND SHPLL SUBJECT AN EMPLOVER TO CRIMINAL PENALTI AND CIVIL FINES UP TOONE MUNDRED THOUSrW D DO�LAFE (5100,000). IN AODITION TO THE Cp$T OF COMPENSATI , AMAGES AS PROVIDED WR IN SECTIqJ 31080F THE LABOR CODE, IMEREST, AND ATTORNEI"S FEES. LICENSED CON7RAC70RS DECLAFiATION: t here6yaffirm that 1 am license er pro �io%�s ofF Aapf¢r 9(commencing with Saclion 7000) ol Division 3 01 the Busineu e d Pro(essions Code, and my license is in full force end eflect. Lic. N �� G�-I .M ./ /1 Cless a � . � ContrectorsSignaWre: ��_ D — Date: 2f %i/ ' I � CONSTRUCTON LENDING AGENCY: ❑ I hereby aNirtn that ihere is a consiruMion lending egency for the pertormence oi ��e work for which this permit is issued. (Sec. 3097, CiNI Code). Lendefs Name: Lender's Address: Signeture: Date: OWNER-BUILDER DECLARATIONS: . I hereby e%irm that under penelry ot perjury ihet I am E%EMGT FBOM THE CON7RAC70R5 LICENSE LAW for the tollowing reason (Sec. 703L5, Business and Professions Code: Any ciry or counry which requires e permit t0 construct, alter, improve, tlemolish, or repair any structure, prior to its issuance, also requires the applicent tor such permit ro file a signed statement that he or she Is license� pursuam to the provisions of the Comractors License Lew (Chapter 9(commencing with Section 7000) of Division 3 of the Busineu end Professions Code) or Nel he or she is e:empt thereirom and the basis for the ellega0 exemption. Any violetlon af Section 7031.5 by eny epplicent for e permit su�jecis the applicant to e civil penalry of not more than live huntlred dollars ($500).): , ❑ I, es owner ot the pmperty, or my employees with wages es their sole compensation, WILL DO THE WORK, antl Ihe siructure Is noI Inientled or oftered for sale (Sec. 7044, Business antl Professions Cotle: The Coniractors License Law does not apply to an owner oi property who builds or improves thereon, antl w�o tloes such work himself or herself or Ihrou9h hls or her own employees, provided ihet such improvemenis ere not intendetl or oNeretl for sale. H, however, ihe bulltling or improvement is sold wi��in one year ot completion, the owner-builder will have the burden ot proving ihat he or sha tlitl not builtl or improve for purpose ot sale.). ❑ I, as owner of Ihe property, em E%CWSIVE�y CONTRACTING WITH LICENSED CONTRACTORS ro Conslruct the project (SecJ044, Business and Protessions Gode: The coniractors License Lew does not epply to an owner ol proparty who builOs a Improves thareon, antl who contracis lor suc� project wlt� a contractor(s) license pursuent to Ihe Coniractors License Laws.). ❑ I am ezempl under sec. Business end Prolassions Code for this reeson: Signature: Date: ' Owner ID verified by driver's license. ❑ Ves ❑ No Driver's License No. Expires: ' Verification of Ownership by (type of tlocument, i.e, - property tex bill ar deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CEpTIFICA710N: �' ❑ I hereby certify ihat no excavetion five (5) or more feet in depth into which a person is required to descend, will be mede in connection with work authorizetl by this permit, end that no building siructure, scaffoltling, talsework, or demolition or dismantling ihereof, wlil be more than thirty-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Tltle B, Califomia Administrative Cotla). ❑ As owner-bullder, I will not employ enyone to do work which would require e pertnit from the Division of Indusirial SeFery, as notetl aDove, unless such person hes a pertnil lo do such work irom Ihe division. SignaNre: Division of Intlustdal Satery Permil Number: 3 Date: AFi00US MATERIALS AND EMISSIONS CEpTIFICATION: WiU the applicant or present w future building octupant naed to file and certity a Business Plan lw emergency response 10 release wlhreetened release of a hezardous meterial9 ❑ Yes ❑ No (Section 25505 of ihe Califomla Health and Sefery Code requires, wi�h some exceptions, thet e Business Plan be fileA with the Coste Mesa Fire Depanment �y every business which hes at any one time during a reported year a quantiry ot hazardous matenals eQual to or greater than e weight o1500 pountls, or e volume oF 55 gallons, or 200 cubic feet of compressed gas at stantldrtl temperaWre and pressure). .................................................................................................... .................................................................................................................................................................................... ....................... ................................................... Does or will ihe epplicant or present or future builtling occupant need to file e registration torm for ecutety hezardous meterials7 ❑ Ves ❑ No (Saction 25533 ot the Celifomia Health and Sefery Code, with some exceptlons, requires registretion with the Costa Mesa Fire Department by eech business which et any one time has on hend e quantity of acutaly �azerdous materials equal to or greater than e weight of 500 pounds, or e volume oi 55 gellons, or 200 cubic feet ot compreuetl gas at stantlertl tempereture end preuure). ....................................................................................................................................................................................................................................................................................................................................._....................................... Does or will the applicant or present or future builtling occupant neetl to prapare an RMPP (Risk Manegement antl Prevention Program for ewtely hazardous mflterials)7 ❑ Yes ❑ No (Section 25534 of tha Califomle Heel�h and Safety Cotle D�ovides that the Costa Mesa Fire Deparlment may require the preperation, certlticatlon and filing with the Flre Depenment of en RMPP by businesses which ere requiretl to register acutey hezartlous matenals wlt� the Fire Department. .............................................................................................................................................................................................................................................................................................................................................................................. If en RMPP is presenity requireQ �as Section p5534 of Ihe Califomia Heelth and Safaty Code been fully wmplietl withl ❑ Ves ❑ No ................................................................_...................................................................................................................._..........................._........................................................................._.............................._...:....................................... Does or will the applicant or present or future builtling wcupant require for the work which is Ihe sublect oi this a plication e gertnit for such construction or modification imm lhe South Coest Air �uality Menagemen� DlsMct or from eny other eir pallution cont�ol tliSMct o� egencyt � Ves LJ No (Section 658502 of the Celifomia Govemmen� Cotle requires �hai Ihe requested iniormation be furnished on epplicatlons tor nomresitlentiel builtling permits). ............................................................................................................................................................................................................................................................................. ..................................................:......................................... Will any part ot Ihe feciliry to 6e constructetl untler ihis pertnit ba witNn 1000 feet from tha outer boundaries oi e school7 ❑ Ves ❑ No Qf'yes", Ihe facility must meet ihe requiremen� ot Sedions 25534 end 42303 of the Celitomia Heelt� end Sefety Code). i ......................................................................................................................................................................................................................................................................................... _................................................................................... If a permit from the South Coast Alr Oueliry Menagement District or olher elr pollution control disMct or agency is requiretl for the wark which is the subject ot this epplicatlon, have ell ot the disclosures prescdhed by Celitornia Heaith and Satety Code Section 42303 been mada7 ❑ Ves ❑ No � ................... _.......................................................................................................................................................................................................................................................................... _............................................... _........................... (If yes', anach certiliwte of compliance from the appropriate air pollution control oBicer). � CERTIFICATE OF COMPLIANCE: I certiy thet under penelry of perjury Ihe informetion given above is correct. I agrae to comply with all state laws and ciry ortlinances regarding Hazardous Matenais antl Emission9. Signature: Data: CERi1FlCATE OF COMPLIANCE AND AUTHORIZp710N OF ENTHY: I cenity under penalry of perjury Ihat I have read ihis appliwtion and state that the intortnation given is wrrect I flgree ro comply with ell stete lews and ciry ordinances relating to building consimction, an0 authonza representatives oi the Clty of Costa Mesa to enter upon ��e above-tlescribed property tor inspeclion pury�es. I egree not to occupy or ellow occupancy oi eny building authonzed by this permit until linal inspection. � CODE t. 1616 1266 200 201 202 203 204 INSPECTION TYPE Fizetl System Final Fire Prevention Pool Spa Final Final Re-Foot Final BIxWReteining Well Final Factory Fire Place Final Sign Finel Demolition PdLf I[l7P1A4S cooe� 206 20B 210 212 220 INSPECTIONTYVE Final Mechanical Final Plumbing Final ElecMcal Finel Fire Prevention Final Ptanni�g Approval 222 FinalSite 250 Final euilding/Occupflncy PAg'� It�EL$ ►�-�6-�a � � ' � , r . . � ♦ 1, i . i '' , r (714) 754-5273 • fan (714) 754-4856 • www.cl.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 3188 AIRWAY AV Suite: L Viciniry: BIDG L Parcel Number: 42719329 Applicant: HOFMANN, CHUCK Address: AS OF 8/30/02 Owner: BERG INVESTMENTS Address 38 HARCOURT NEWPORTCOAST Zoning: Phone: 949-5158822 2ip: Phone: Zip: 92657-2110 Conuactor: HOFMANN FINN DEV COMPANY INC Address: 3188 AIRWAY AV UNIT A Phone: (949)515.8822 ISSUED BY: Status: ISSUED Applied: 07l03/2002 Issued: 09/03/2002 COSTA MESA, CA Zip: 92626 License: 731034 Arch : SCHEER, TANAKA, DENNEHY, RILEY ARCHITECTS Eng: SHIMAJI LASCOLA STRUCTURAL ENGINEERS Address: 3190 AIRPORT IOOP BLDG K Address: 23862 BIRTCHER DRIVE Phone: 714-444-1960 Phone: 949-770.9967 COSTA MESA, CA Zip: 92626 License: C7465 LAKE FOREST, CA 92630 License: 3088 SCOPE OF PERMIT 4097 S� FT TENANT IMPROVEMENT FOR OFFICE AND WAREHOUSE SPACE. UPGRADE RESTROOM FACILITIES FOR ACCESSIBILITY REQUIREMENTS. Plan Check: $577.69 Permit: $888.75 SMIP Res: $0.00 SMIP Com: $17.85 Other: $0.00 Inspection: $0.00 Total: $1,484.29 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0-0 PARKING NOTES: Existin : 0 Rear 0- 0 Rear 0- 0 Required: 0 FEE SUMMARY CaIC ValuatiOn: 585,000.00 Claim Valuation: Sas,000.00 PLANNING & ZONING Lek 0- 0 Right Left 0- 0 Right Pr000sed: 0 0- 0 NOTICE: The work aulhorized by this permit shall compty with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permlt shall automatically ezpire and become void it work is not commenced wlthin 180 days, or if work is suspended or abantloned for a period of 180 days. INSPECTIONS: In order for the work eulhorized under this permit to be considered legal, such work must comply wlih all epplicable codes, end ell requlrod Inspectiona end flnal epprovel must be obtained. Failure to obtein Inspectlons and Iinal approval will result in the expiration of thts permit. FOR INSPECTIONS CALL: (714) 7545826 � 2aa&d8 (flN0) � DECLAR/ITi10NS WORKERS' COMPENSATION DECLAFiATON: ' `i� I hereby etfirm untler penelry of pe�ury one of the tollowing tleclaratlons: ❑ I have entl will malntain e ceNilcale of cqnsent to setl-Insure br workers' compan5ation, es pmvided Por by section 3700 of tha Lebor Code, far Ne petlortnence ot the work for whith ihis permit I5 i55ued. �I have and wlll mainteln workers' compenge�on Insurance, as requlretl Dy secUon 3700 ot Iha Labor Gode, tor the pertortnence of the work fw whkh Nis permit Is Lswed. J" My worker`s' wmpensation surence caMer and policy number ere: ! Carrier. N tr�� fT��SA'rj�„` ��K�y�..�.�� 1� PolicyNumber: 067 9 ZI�i � �_/ (This sectlon neetl not be coinp/eted il e pemut is veluetl et one huntlred dollers ($100) o� IessJ - ❑ I certily Ihet In the peAormance of lhe work r w�l t�is permit is issued, I shall not employ eny person In eny manner so es to 6ecome suhjact to the workers' compensatlon laws at Calif le, and egrg¢ et if �hould hecome suhject to the workers' compensetlon pmvislons of Section 700 ot the Lebor Code, I shell larthwlth comply wi�h these pro � io . Applicant Signature: Da�e: Q g 6 Z WARNINO: FAILURE TO SECURE WORKERS' OdAPENSATION COVERn�E UWFVL AND SHALL SUBIECT AN EMPLOVER TO CRIMINAL PE LT1E5 AND CML FlNES UP Tp pNE HUNDRED TFIOUSANO DOLURE (5100,000), IN ADDITION TO TNE CQST OF OOMPENSATION, UAMAGES A$ PROVIOED F-0R IN SECfION 3'1O80F THE UBOR COOE, IMEREST, AND ATTORNENS FEES. LICENSEU CONTRACTORS DECLARATION; I hereby affirm ihat I em Ilcensetl untler provisions ol Chapter 8(commencinp with Section 7000) of Divislon 3 oi Ihe Business antl rofessions COCe, entl my license Is In full force entl eflect. Lic. p % i O, Cless N Gontrector'sSignatura: �Q _ �/-� �_ Date: Q aj,l Q L v CONSTRUCTION LENDINO AGENCY: ❑ I hereby eHirtn t�et t�ere is e consiruction lending egency lor ihe pedormance oi Ihe work br which this permit is Issued. (Sac. 3097, Civil Cotle). Lentler's Neme: Lentlers Addrass: SlgnaWre: Date: OWNER-BUILDER DECLARATONS: I hereby aNirm that under penalry o1 per�ury th9t I flm El(EMP7 FROM TXE CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Buslness enC Prolassions Cotle: Any city or counry whic� requires a pertnit to construct, alter, impmve, demolis�, or repeir eny atructure, prior to ils issuance, elso requires the epplicaM tor such pertnit to file e signed statement �het he or she is licensed pursuant to t�e provisions at t�e Contrectore License Lew (Chepter 9(commencing with Section 7000) of D'Msion 3 of ihe Business and Professions Code) or that he or she is ezempt Iheretrom and the basis ior Ihe elleged exemption. Any violatlon oi Sectlon 7031.5 by any epplicant for e pertnit subjects Ihe epplicant to e civil penalry of not more then live hundretl Collars ($500)J: ❑ I, es owner of Ihe properry, or my employees with wages as their sole compensa�lon, WILL DO THE WORK, and Ihe siructure Is not intended or otteratl tor sale (Sec. 7044, Business entl Professions Code: The Coniractors U'cense Law does not appiy fo en owner o! property who bullds or improves ihereon, and who does such work himsetl or hersell or ihrough his or her own employees, provided ihet such imprwements ere not intentled or oHereC br sele. If, however, the bullding or improvement Is sold within one year of wmpletion, ihe oWner-builder will heve Ihe burden of proving that he or she tlitl not �uiltl or improve for purpose ot sale.). ❑ I, as owner ot Ihe property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, BuSiness and Professions Cotle: Tha cromrectors Llcense Law doeg not apply to an owner ot properry who bulltls or Improves thereon, entl who contracts tor such pmjen wlth e contrador(s) license pursuent to the Contractors License Laws.). ❑ I am exempt untler sec. Business entl Professions Code for this reason: Signature: Date: Owner ID venfietl by driver9 licen5e. � Ye5 ❑ No Drivers Licen50 No. Expires: Verificatlon ol Ownership by (rype of tlocument, I.e. - property tex bill or deed): UIVISION OF INDUS7RIAL SAFEfY PERMIT CER7IFICATION: ❑ I hereby certily tha� no excevaiion Ove (5) or more leet In depih Into which a Derson is requireG to tlescend, will be mede in connection with work euthorized by Ihis pertnit, entl that no builtling sirucwre, scaHolding, talsework, or tlemolition or dismemling thereof, will be more t0en Ihirty-sl: (38) feet high, (C�ap. 32, Grp 2, Art 2, Sec. 341, Ttle 8, Calitomia Administrative Cotle). ❑ As owner-builder, I wlll not employ anyqne to da work which would requlre e permit irom the Divislon of Industriel Sefety, es noted ebove, unless such person hes e permit to tlo such work irom the divlsion. Signature: Olvision ol Indusirial Safery Pertnit Number: Date: HAZAFiDOUS MATERIALS AND EMISSION9 CER7IFILATION: 1 W III t�e epplicent or present or futura Culitling occupant neetl to tile entl cenity a Business Plan for emergency response to release or Ihreatened releese ot e hezerdous matedal7 ❑ Ves ❑ No (Seclion 25505 of the Celifomia Health antl Sefety Code requires, wilh some exceptions, thet e Buslness Plen De illeA wlih the Casta Mesa Fire Department by every business which �es at eny one time during e reportetl yeer a quantiry ol hezerdous materials equal to or greater than e welght ol 500 pountls, or e volume ot 55 gallons, ,or 200 cubic feet at compressed gas et stpnCaM temperaNre entl pressure). .. .. ................................................................................................."_..................................................................................................................................................................... . ........................ ............................... _.. _.............. 2 Does or will the epplicam or present or tuture building occupant neetl to file e registratlon tortn br ecutely hazerdous metedalsl ❑ Ves ❑ No (Sectian 25533 of ihe Celllomia Heallh end Sefery COCe, with same eaceptlons, requires registretlon with Ihe Costa Mesa Fire Oepertment Cy eacl� buslness which at any one time has on hend e quentiry ot ec4tety hezerdous metedals equel to or preater then e welght ol 500 pounds, or e volume ol 55 gellons, or 200 wbic feet of compressetl gas et stenderd tampereture entl pressure). ....................................................................................................................................................................................................................................................................................................................................._.................._......................._ 3 Does or will the eppllcant or Oresent or fuWre building occupant neetl to prepare en RMPP (Risk Management and PrevenNon Progrem tor ecutely hazertlous materials)7 (Section 25534 ot the Califomie Healih antl Safery Code provides thal the Coste Mesa Fire Department may require �he preparatlan, certilicatlon end filing with the Fire Deperiment ot en RMPP by businesses which ere requiretl to register ecutely hazerdous materlals with �he Fire Department. 4 If an RMPP is presently required, has SeCtion 25534 of ihe Celilomia Heelth entl Sefery Code been fully complletl with7 �❑�Yes � ��No �� ........................................."'�..............._....._................._._._........._.............................__..................................._....................................................................................................................................................._....................._'_ 5 Ooes or will the eppiicent or present or fuNre huilding occupant raquire tor tha work wNch I5 ihe suGject of this e plication a Permit for such cons[ruqlon or motliflcatlon from �he Sou�h CoaSt Alr �uallry Manegemem Olsttict or from eny other eir pollution contml distdd or agenc)? � Ye5 �J NO (Section 658502 01 the Calitomia Govemment Code requires t�at the requestetl informa�lon be fumishetl on epplicatlons tor non-resitlentiel building pertnits). ....................................................................._......................_..............._._.......................__._.............................__........................................................................................ ....................... ......................_.._................_.._............ 8 Will eny pert of tne feciliry to be constructatl under this pertnit Oe within 70001eet from the outer boundedes oi e school? ❑ Ves ❑ No (If yes", Ihe faciliry must meet lhe requirement of Seclions 25534 ena 42303 ot tha Calitomie Health end Safery Code). ............................._.......—_..............._..........._......_..._...._.._._.._._.. __._....__ '..........."'__._..................._....__......................................"_._..........."'_'"""_�._...—_' 7 If e permit from the SouN Coast Air �ualiry Manegement District or other alr polNtion control disidct or egency Is requirad for Ihe work which is the subjecf o1 this epplication, heve ell of the tlisclosures D�45cnhetl by Celifomia Health antl Satery Code Section 42303 6een matle9 ❑ Ves ❑ No . .........................._.__.__.........._....__.....—_....._.....___..."'_—__'....._....__'_"'................... ...................................._............_..""_'—_.........._�__.._.......__�.._..._...___ B Qt "yes", atlach certificate of compliance ham ihe appropnate air polWtion control otticer). CERTIPICATE OF COMPLIANCE: I ceniy that under penalry oi perjury the intortnetion given above is correct. I agree m comply with ell state laws entl ciry ordinances regarding Hazertlous Matanals and Emisgions. SignaWre: Date: CERTIFlCA7E OF COMPLIANCE AND AUTMOROATON OF ENTRV: I cenify under penelry of perjury that I have read this application end state Ihat the iniortnation given is correct. I egree to comply with all stele laws gnd ciry ortlinences rela�ing to building construction, end euthodze representetives of Ihe Ciry ot Costa Mesa to enter upon t�e ebove-described properry lor Inspection purposes. I agree no) lo occupy or ellow acupency of eny builtlin9 euthorized by this permit until final inspadlon. CQOE �. INSYECTION TYPE 1616 Fixetl System Finel Fire Preventlon 1266 POoI Spa Finel 200 Finel Re-Rooi 201 202 203 204 Finel BIocWRetelning Well Final Fectory Fire Place Final Sign Final Demolilion � � / Date � a �y � oeie COOEI INSPECTONTYVE 206 Final Mechanical 20B 210 272 220 222 250 Flnal PIum6ing Flnal Eledrlcal Flnel Fire Preventlon Finel Planning Appravel finel Site Finel Building/Occupan< � 1-ia�-�5�� Job Address: Suite No Viciniry: 3188 AIRWAY AV L UNIT L (PIN POINT MEDIA) Parcel Number: 42719329 Applicant: Address: Owner: Addtess: HOFMANN,CHUCK 3188 AIRWAY AV UNIT A COSTA MESA, CA PINPOINT MEDIA LLC 3188 AIRWAY AVE C.M, CA MECHANICAL PERMIT Phone: (949)515.8822 Zip: 92626 Phone: Zip: 92626 Contrador: HOFMANN FINN DEV COMPANY INC Address: 3188 AIRWAY AV UNIT A COSTA MESA, CA Phone: (949)515.8822 2ip: 92626 License: 731034 ISSUED BY: Status: ISSUED Applied: 09/26/2002 Issued: 09/26/2002 SCOPE OF PERMIT 4097 SQ FT TENANT IMPROVEMENT FOR OFFICE AND WAREHOUSE SPACE. UPGRADE RESTROOM FACILITIES FOR ACCESSIBILITY REQUIREMENTS. TENANT: "PIN POINT MEDIA" 4 INST FAU < 100K BTU, 4 COMPRESSORS UP TO 3 HP/100K BTU (A/C UNITS), 1 GAS PIPING, 3 VENT FANS/SINGLE DUCT. REF: 802-01005 ISSUE FEE Inst FAU <700 k BTU Inst FAU >100 k BTU Repair / Alt Cooling/Heat Inst / Rep. Recess Wall HV Refig Sys <100 k BTU Refrig Sys >100 k BTU Gas Piping Factory Fireplace Hood w/Mech Exhausl VAV Box Vent Fan / Single Duct Appliance Fire Dampers Smoke Dampers Inst or Relocate Appl Vent Air Handlers < 10000cfm Air Handlers > 10000cfm Floor Fumace Floor or Suspend Heater $23.50 $5920 $0.00 $0.00 $0.00 $0.00 $0.00 $6.15 $0.00 $0.00 $0.00 $21.75 so.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity 4 0 0 0 0 0 1 0 0 0 3 0 0 0 0 0 0 0 0 FEESUMMARY Repair / Alt Absorbtlon Unit Repair / Alt Refrigeration Unit Ventillation System Evaporative Cooler Commercial I ncineraror Domestic Incinerator Compressors / Absorption Svstems Upto3hp/100kBTU 3To15hp/500kBTU 15 To 30 hp / 1,000 k BTU 30 To 50 hp / 1,750 k BTU Over 50 hp / Over 1,750 BTU Boilers Up to 3 hp 3Tot5hp 15to30hp 30 to 50 hp Over 50 hp Other Mechanical Fee � Inves6galion Fee Plan Check Fee Reinspection Fee Quantity $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $58.80 4 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 50.00 0 $0.00 0 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES $169.40 COMMENTS / SPECIAL CONDITIONS NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period o( 1 BO days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, antl all requlred inspeetiona and final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (774) 7545626 � 2M8�8 (8�00) WORKERS' COMPENSATION DEC�pqq7�ON: _ � nereby anirm unaer pene�ry or per��ry or,a or the ta�owinp aeuaratiau: ❑ I �ave enE wiil malntain e ceNO�¢te ol consent ta self-Insure br workeB' compensation, es provltletl tor by seclion 3700 ot the Lebor CoOe, tor the pertormence of ihe work for which �his permi� I5 I55Vetl. � I have end vn� maintain workers' �pmpensetlon Insurance, az requiretl by sectbn 3700 ot Ne LeCor Cotle, tor Na peRormence at Ne wark lor whkh IhL9 pertNl is lswed. 7'My work rs compen% �tl�o�n In�surence carder end,yo��uc,v� number ere: C ! �, �j -6 7i Carrier ��YJlnt$iG('( j,... .W'o-S(�k/j..[fc-r-u.-D PoliryNumber: _��7 3 �/b (IhlS secf/on neetl not be canpl ted I! the permlt Is velued ef one hunCretl tld/ars (5100) w less.) ❑ I certity Ihat in the peAormance ol the work for hlch thi, permit is Issued, I shall not employ eny person In eny manner so es to become sub�ect to the workere' compensatlon laws ai CgIIt5ynle, enC epree th sho bec e suD�ect to the worken' compensetlan provisions oi Sectlon 3700 01 t�e Lebor Cotle, I a�all lonhwilh comply with Ihese prov 41oM. (� Applicent Signature: Date: -1 /z6 / a -Y WARNlN3: FAILURE TO SECURE WORI(Ep$' CpMAENSATIQY COVERAQE I NLM L AND SHALL SUHIEGT AN EMPLOYER TOCRIM! PENALTI S AND CNIL FINES UP TOOkE HUNINtE� TMOUSAND OOIJ.ARE (510U,000�, IN ADDITION TO THE CO^uT OF CAMPENSATI , MMGES tiS PROVIDED FOR IN SECTION 37080F TME UBOR COOE, IMEREST, AND ATTORNENS FEES. LICENSED CONTFiACTORS DECLqRATION: I here6y aNirm that I am licensed undpr provislons of Chapter 9(�omm ncin with Seclian 7000) of Dlvision 3 0l the Business nd Professions Cotle, entl my license is in tull force and etted. Lic. A�O `[� Class p — Contrectofs SlgnaNre: � Date: L O Z CONSTRUC710N IENDINO AGENCY: ❑ I hereby aKrtn Nat Nere is e constructlon lendlnp epency for ihe peAormance ol the work lor w�lch Ihis permit is issuetl. (Sec. 3097, Civil CoAe). Lentlera Name: LenCefs AtlCress: Slgnature: � Date: OWNER•BUILDER DECLARAT10N3; I hereby eHirtn thet under penelry oi per�ury Ihat I em EXEMPT FROM THE CONTRAC70RS LICENSE LAW lar the following reason (Sec. 7031.5, Buslness end Protessions Cotle: Any clty or counry which raqulres e permit lo conSlmct, elier, improve, tlemalish, or repelr eny structure, prlor to it5 issuence, 015o requires Ihe eppllcaN for such pertnit to ille e signetl stetement Ihat he or she Is Ilcensed purauant to Ne provlslans of the CoNractoro Ucense Lew (Chepter 9(commendnp with Sectlon 7000) 01 Divlslon 3 of the Business end Professlons Code) or �het he or she Is exempt iherelrom end the besls tor the elleped eaemption. Any Nolatlon W Section 7031.5 Dy eny epplicent for e pertnit sub�ecis Ihe aOD�� a e civil penelty ol not more then five hundreC tlallars (5500).): ❑ I, es owner of the praperry• or my employees wi�h wages es Iheir sole companse6on, WILL DO THE WORK, and t�e sWcture Is not intended or otterad for sele (Sec. 7044, Business and Protessiong Code: The Contradore License Lew does not epDN �o en owner of property wha builds or improves thereon, end who does such work himselt or harself or lhrauph his or her ov.•n employees, provided ihat such improvements ere not intended or oflered tor sale. If, however, the bulltling or imprwement is sdd within one year ol complelion, t�e owner-builtler will have Ihe burtlen ot proving that he or she did not build or improve tor purpose ot sale.). ❑ I, as owner of the Oroperry, am EXCLUSIVELV CONTRACTING WRH LICENSED CONTRACTORS ro conswct the pmjed (Sec. 7044, Business end Professions GOCe: TTe contrectors License Lew tloes not epply ro en owner of pmperty who bulltls or Improves thereon, end who contracis tor such project wit� e conirector(s) license purwant to the Contrac(ors Liceree Lews.). ❑ I am exempt under sec. Business and Prolassions Code for I�Is reeson: Slgnature: Date: Owner ID veAfietl by tlrivers Iicense. ❑ Ves ❑ No Drivele Ucense No. Er,plres: Vedflcetlan of Ownership hy (type ol tlocumem, i.o. - property tex bill or deetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no exceveHbn flve (5) or mora feet in depth imo which e person is required to descend, will be made in conneclion wlth work eut�odzetl by this permit, en0 thet no buildinp siructura, scaHoltling, telsework, ar demolitlon or tlismantling thereof, wlll ba more then Nirry-siz (38) feet high. (Chep, 32, Grp 2, An 2, Sec. 341, T111e e, Calllomla Atlministretive Catle). ❑ As owner-builder, I wlll not employ enyana to do work which would require e pertnit trom t�e DlWsion oi IndusiAal Safery, es noted ebove, unless such perean has e permit to tlo such wark trom t�e division. SignaWre: Division oi InAusirial Sefery Pertnit N�mber: Date: Will Ihe epplicant or Oresent or t�ture bullding accupent neetl to tile antl cenity e Business Plen tor emergenty response to releese w threatenetl release oi a harartlous material7 ❑ Yes ❑ No (Sectlon 25505 ot ihe Calitomie HeaIN and Setery Code requires, with some e:ceptions, Ihat e Business Plen ba filed with the Coste Mesa Fire Depenment by every business whkh has at eny one time tlunng a reportetl yoar a quantlry at ha¢ardous matedels equal to or greater than e weighi oi 500 pounds, or e volume o155 gallons, or 200 cubic feet of compressed gas et stenCartl tempereture,anO pressure). _..........._._ .....................................__............_.... __._�......................................_............____.._.__.._......... _............__...................._..... Does or will Ihe applicant or present or fuWre Duiltling occupant need to file e registration fortn lor ecutely hezerdous melerials7 ❑ Ves ❑ No (Sectlon 25533 oi the Cellfomia Healt� entl Setety Code, with some ezceptlans, reQuires registretlon wlth t�e Coste Mesa Fire Depenment by eech business whlc� et eny ono time hes on hend e quently of ncutely hezerdous meterials equel to or graeter then e weigM ol 500 paunds, or e vdume ot 55 gallons, or 200 cublc feet oi comDressetl gas et stentlartl tenlpereture en0 Oroseure). 3 Does or will Ihe eppliwnt ar present or luture builtling occupant neetl to prepare en HMPP (Fisk ManeBement antl Prevemlon Proprem br ecutery OazerCous malenels�7 ❑ Ves ❑ No (Sectlon 25534 at the Califomie Health end Salery Code provides ihat the Coste Mesa Fire Department mey require ihe preparatlon, cetllfication and filing wlih ihe Fire Oeperiment ot en RMPP Dy Dusinesses whlch ere reqWreC lo register ecutety hazertlws metedeLs with the Fire Department. _.___...'_"�—..,._._._._......__.-.-.. ....._....__...._ __ ..._. 4 If en RMPP is presently required, hes SecYlon 25534 0l the Galitamla Heallh end Sefery CoOe been fully complied with7 ❑ Ves ❑ No .__ ..__...._ ............... _....__ ................._ 5 Doas or wlll the epplicanf or prege�� or tuture Dullding accupflnt require tor the work which Is Ihe subiect ol this e.pplication e ertnil for 6uch construqlon or modiiicetlrn trom the South Coest Air Oualiry Managemam Distda w from eny oNer eir polWm mnlyd dlstdcl or egencyt u Yes � No (SecNon 658502 of t�e Caiitomle Govemment Code requires Ihat Ihe requested inlortnetlon Oe tumisnea on epv��enons tor non-residentlal bulidlnp pertnits). ......._..__ .._.....—.._.........._ .................._ _....__-.._....._ _.... ..... _'_'_................_ 8 W ill eny pan of Ne tadliry to be Cpnstruaed under Ihis permit be wiNin 1000 feat trom t�e outer poundades ot a schod? ❑ Yes ❑ No (tl'yes , Ue tatlliry must meet the requirement of Sectlons 25534 entl 42303 of Ne Cfllifomia Heelth end Satery Cotle). .. ___"._...._'_'_"""._�_._ ....................................__._.._........................._..'__..................._................................................................_.._._.............._...__...._................_...................................... 7 It a pertnit irom the South Caasl Alr Queliry Menagement Distrid or oNer air pollulion control distdct or egency is require0 for lhe wwk whlc� Is Ihe subject of ihis aoWication. have ail of the discbsures orescrlEeC bv Calitomla Health a� Sa�eN Code Sactlon 42303 been made7 ❑ Yes ❑ No Slpnature: I certify Ihet under penely at perjury Ihe infortnelion gNen abovo is wrrect. I egree to comply with ell stete laws end ciry ordinences Emluions. Date: CERTIFlCATE OF COMPLIANCE AND AllTHORIZA710N OF ENTTiV: I certity under penalry ot perjury thet I have reaa this epplicalion and state Ihet the inlormatlon given is wnect I egree to compy vrith ell stete lews anC clty ordinances relating to building construcNon, end euthodze represenletives ot Ihe Ciry oi Costa Mese �o entar upon the ebove-tlescribed D�operty lar Inspeclionpurposes. I egree not to accupy w ellow occupenty of eny bullding euthorizetl by Ihis pertnit until linal Inspection. CODE �. INSPECfiONTYPE 1616 Ffxetl System Final fire Preventfon 1266 Paol Spe Final 200 Final Re-Roof 201 Finel BIocWRetaining Wall 202 Final Factory Fire Place 203 Finel Sign 204 Final Demdi6on �g � �F,( INSPECTIONTYPE 206 Finel Mechenical 208 Flnel Plumbing 210 Flnel Electrlcal 212 Flnal Fire Prevention 220 Flnal Planning Approval 222 Final Slte 250 Finel Building/Occupancy (714) 754-5273 • Faz (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT �ob Address: 3188 AIRWAY AV Status: ISSUED Suite No L Applied: 09/O6I2002 Vicinity: L Issued: 09/O6/2002 Parcel Nunmber: �x�:xY�:� Applicant: HOFMANN FINN DEV COMPANY INC Address: 3188 AIRWAY AV UNIT A Phone: (949)515.8822 COSTA MESA, CA " . Zip: 92626 Owner: PINPOINT MEDIA LLC Address 3188AIRWAYAVE C.M, CA Phone: Zip: 92626 Convactor: HOFMANN FINN DEV COMPANY INC. Address: 3188 AIRWAY AV UNIT A Phone: (949)515.8822 COSTA MESA, CA �. Zip: 92626 ,� ' License: 731034 ISSUE FEE Temp service test Res, a/c package New Res (1-2 units) New Res (3+units) Pool I Spa LighUng Fixts Recept Outlets Switches Non Res Appl , Res Appl Service to 200a Service W 1000a Service over t000a Motors to 1hp Motors to 10hp Motors to SOhp Motors to t00hp Motors over t00hp ISSUED BY: SCOPE OF PERMIT REF B02-01005 BUILDING. FOOR PINPOINT MEDIA. 40 LIGHTS, 50 OUTLETS AND 26 SWITCHES. - . 10I70/02: PC REVISION 40 LIGHT FIXTURES Duantiry 323.50 $0.00 - $0.00 so.00 0 50.00 0 $0.00 0 $65.80 80 , , $43.90 � 50 . $26.38 . 26 30.00 � _� o ao.00 ��; ;�o-�_ $0.00 , � �0 � � 30.00 �. 0 - - ' $0.00 , .0� � $0.00-�- �0 � - so.00 . o $0.00 - 0 50.00 0 $0.00 0 5 FEE SUMMARY Temp Dist System / Lighting Busway/100 k Standing Section Misc ElecVical Equipment ' Transfortners up to 1 kva/kw ................up to 10 kva/kw .................up to 50 kva/kw ......:..........up to 100 kva/kw ..................Over 100 kva/kw ' Low Voltage EQuipment � Low Volt Wiring System / Ckl � Misc. Conduit . Misc. Conducror Circus ( gen or ride) Circus (mech ride or lights) � Christrnas Tree Sfand _ FirewoAcs Stand ' Other ElecVical Fee Quantity $0.00 0 $0.00 0 $0.00 0 ao.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 ao.00 0 ao.00 0 $0.00 0 so.00 0 $0.00 0 $0.00 0 $0.00 0 so.00 0 $0.00 0 a�.so NOTICE: The work authorized by this permit shall comply with all applicable handicap access raquirements under Califomia statutes and related regulations. (OM. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void Ii work is not commenced within 180 days, or if work is suspended or abandoned for a period oi 180 days. . INSPEC710NS: In order for the work euthorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inapectione and Iinal epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 �', zsa6�a le�oo) t� WORKERS'COMPENSAnON DECLARATON: — I hereby atlirtn under penelry ot perjury one of Ihe fWlowing declarations: ❑ I have and will meiNain e cenificate of consent to aelbinsure for workers' compensatlon, es D��ded for by section 3700 ot the Lebor Cade, tar 1he pedortnance of the work br which Ihis permit is issuetl. I have and will meintein workers' campensatlon Insurflrke, es requlretl by sectlon 3700 0l Ihe Lahar Cotle, for Ihe peAormance ol the work tor whlch Ihlv perrNt Ls Issuetl. My worke Oensatloy nsurence cerder end poli mber ere: ca��e�: �/�� C..v.�r �'`S�l T....- s L� WP Polity Number: O bi 3 i' �'C — Q 2/ (rnls secUon need not be completed d fhe permit ls velued e( one hun�retl dW/ers (S I00J or IessJ ❑ I cenify Ihat in the perfortnance ol the work lor ich this ertnit Is issued, I shell not employ eny peraon in any manner so as to become subjed to the workers' compensetion laws of Celll i ntl egree tha 1 s1�pu eco ub�ect lo the workere' compensatlon provisions ol Section 3700 0l Ihe Lebor Cotle, I ahall forthwith II campl9with Ihese pmvis' ns ,� / � / App�cantSi neture: Dete: 0 �6 Q�" WMNINQ:FAILUPETOSECUREWOHKERS'COMPENS4TONCOVERAGEIS �LA fIILANDSNALL5UB1ECfANEMPLOYERTOCRIMIWILPENALTIESANDdVILFlNESUPTOONEMUNDREO THOUSAND OOLLRRE (5100,000), IN r1DqTION TO THE W5T OF COMPENS�iION�A��OES hS PROVIUED FOR IN SECfION 3]OB OF THE IABOR OODE, IMEREST, AND ATTORNEYS FEES. LICENSED CONTRACTORS DECIARATION: I hereby aHirm ihat I am licensetl unOer provislc lorce end eMect. Llc. a 3( O � CONractofs SlgnaNre: Chepter 9(commencinp wilh Section 7000) ol Divlslon 3 oi Ihe Buslnesrs_a�ntl Prolessions Code, entl my Iicense is In full � Class a � � Da�e: /6 /n / ... _ _ _ _ CONSTRUCTION LENOING AGENCV: � I �ereby effirtn Ihat there Is e canstruction lentling epency lor the peAormanco ol t�e work lor which Ihis permil Is i55uoO. (Sec. 3097, Civil Cotlej. Lentlera Neme: Slgnature: _ OWNER-BUILDER DECLARATIONS: Lendels Address: Data: I hereby elfirm Ihat under penalry ol per�ury thet I em E%EMPT FROM T1E CONTRACTORS LICENSE LAW tor I�e I011owing reason (Sec. 7031.5, euslness end Professiau Cotle: Any ciry or counry whic� requires e pertnit b conswct, elter, Improve, Aemdis�, or ropair eny swcwre, prior to its lasuance, also requires Ihe epplicent lor such pertnit to tile a signetl stetemant thet he w she is licensetl pursuant to Ihe provisions of Ihe Contrectore License Lew (C�apter 9(commendng with Secllon 7000) ol Division 3 of Ne Buslneu antl Protessions Cotle) or t�at he or she is exempt therelrom antl the besis for tha ellege0 exemptlon. Any violatlon of SecUon 7031.5 by eny epplicent lor e pertnit subjeas Iha ep0�icant to e civil penalry oi not mare ihan frve �untlretl dallers (5500).): ❑ I, as owner oi Ihe properry, or my employees with wages as their sole compensetlon, WILL DO 7ME WORK, end the structure Is not IntenAetl or offerad for sele (Sec. 7044, Business and Professions Cade: The Cantraclws License Lew doas not apPN �o en owner of property who builds or improves thereon, aM who tloes such work himselt or harself or Ihrough hls or her own employees, provided Ihat such Improvements are not IntentleC or ottered lor sele. If, however, the builtling w Improvement is sold within one year o1 completion, ihe ov.•ner-6uiltler will hava the burden ol proving thet he or she ditl not builtl or improve lor purpose o1 sele.j. ❑ I, as owner of the property, am E%CLUSIVELY CON7RACTING WI7H LICENSED CONTRACTORS to construct tha proJect (Sec. 7044, Business and Professions Cotle: The contractars License Lew tloes not eppy ro en owner ol proparry w�a builAs or improves thereon, end who contracts far such projecl with a contractor(s) licen5e pursuan� �o �he Contretlors Licen58 LewS.�. ❑ I em exempt under sec. Business antl Prolessions Code for this reason: Siqnature: Dete: Owner ID venfea by OriveYs Iicense. ❑ Yes ❑ No Onvef9 LJCen9a No. Verifica0on oi Ownership 6y (type ot Cocument, i.e. - property tav bill or Caetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICA710N: Ezpires: ❑ I hereby cenHy Ihat no excevetion tNe (5) ar more feet In depih Into which e person Is required Io descenU, will be metle In connectlon wlih work authorizetl by NIs pertnit, antl that no builtling siructure, scalloltlinp, falsework, or tlemolition or dismentling thereot, wlll be more Ihen thirty-siz (38) leet high. (C�ep. 3.2, Carp 2, Ah 2, Sec. 341, Titla 8, Celilamia Atlministretive Cada). ❑ As owner-bulltler, 1 will not emplay enyane ta do work which woula require e parmit trom the DlWsion oi Intlustnel Sefery, es noteA aDove, unless such person �as a pertnit to do such work Irom the division. SignaNre: Dete: Division ol Indusidal Sefery Permit Number. CERTIFlCATE OF COMPLIANCE AND AUTHORIZATON OF ENTRV: I certify untler penelry of perjury thet I have read this epplication en0 state Ihet t�e Inlorma0on gNen Is conect. I agree to compty wilh ell state laws and ciry ortlinances relating to building construction, en0 euthodze representatives of the Clry of Coste Mesa to enter upon the ebove-0escnbetl properry tor inspectioqpurpaaes. I egree not to acupy or ellow accupanry of eny builtling euthodzed by ihi9 permil until linel inspeclion. •. . ' tll.�. \I'� 1616 Fixetl System Final Fire Prevention 1268 Pool Spe Final 200 Final Re-Roof 201 Finel Block/Fleteining Wall 202 Final Fectory Fire Place 203 Finel Sign 204 Finel Demditlon /d/�0/ �a`i/ Date pd¢, �� COpE1 INSPECTIONTYPE 208 Flnal Mechanlcal 208 Flnal Plumbing 210 Flnal Electdcal 212 Flnal Fire Preventlon 220 Final Plenning Approvel 222 Final Slte 250 Final Building�Occupency �� • �� F � W S Q y y S F G W F Q 0 � Q 7 } .] � W a O � G. z W S 3 ' , _ _,�.�.:L6..43 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only WILDING � fe�`"1 / A._ A. _ OWNER � MAIL � ADDRESS CITV CO_ CONSTHUCTION LENOEF BRANCH � ADDRESS ARCNITECT _ TEL. ^ NO. TE CONTRACTOR ,l Jni� � (1.j_4 C� ADDFESS `,9 O 1 Q rE J TEL. CITV �� Y�/ (t't+ GA� NO. a;' STATE CITV IIC. NO. IIC. NO. SIZE NO.OF BLC OF LOT NOW ON L( USE OF EXISTING BLDG. . Separa[e permits are required for electric, plumbing and heating work. USE OF BUILDING �+ND WORK TO BE PERFOflMED I heroby ecknowlad9e thet I have reotl thls appllcatlon ontl smta that tho ebove Info�matlon la corract antl apree to comply with ell lews repulating bulltling conetructlon, ontl I shall not amploy eny porson In vlolot�on of tho workmnn'e componeatlon Iawe of che State of Calitor��n, I heroby cartify thai I am proparly Iicensatl ea a cantrector untlar the Stete of Coliforn�o Businosa entl Professione Cotla, Dlvialon 3, Chapter 9, antl that such Iicansos nre In full forca entl effect, or 1 em oxempt from Sh0 Provislons of tha Steta ot Cnlifornle Business end Professione Cotll, Dlvislon 3, Chepter 9. Sipnat • Permlttae � � �� ^� Auiharized Apent .� :PB i9-7FF=:°00 902� :_,:** �„.. 79.RU FORSTRUCTURALPERMIT BVILOING ADDFESS FIRE ZONE N NO.OF , PLAN$ VAFDSAPPROVED �L�GT' � 111 VALUE �O) $ 0 / ROUP ^ DATE � � VSE OF N BUILDIN L VARDS APPROVED DISTANCE BET. - BET. MAIN & MAIN BLDGS. ACCE�. BLD VAR.� DATE C.U.P.qW APPROVED� / APPROVED / /ID T L/ � : m i : m SQ. FT. N THE AMOUNTSHOWN UNDER VALUATION IS FOR m THE PUflP06E OF ESTABLISHING A PERMR FEE ONLY: � VALUATION PERMIT FEE E a � m 7LAN CHECK E ^� o � o S /{� �� TAX S E (%��•��.� u TOTALPAID E � ; �; . . �a�c� � COSTA MESA BUILOING-SAFETY DEPARTMENT �� P.O.BOX1200 COSTAMESA.CALIFOflNIA92626 For Applicant [o Fill in Completely BUIIDING �/�/�/ / /l�n`��A� /Ju� ADDRESS p p L. /7 /c /7` OWNER KpIS,/I�I�I�IF (�NPER ADDRESS 3190 A Au-port Ioop Drive cirv Costa Mes� No�'929-9205 COKSTHVCTION I�l� �Y 1 FNfIFF BRANCH ADDiiESS Newport Beach� Cd11f�YTLld ADDRE55 44 Plaza �2� DidT1Qe CONTRACTOR A7R K011 C�11Z1� IT1C. ADORESS 1901 [�VP �C�(�r2Pt CITV N Na��833-3030 ewr�ort Beach iic No. 221764 uc�No. 1484 SI2E I NO.OF BLDC'tS. OF LOT NOW ON LOT O USE OF EXISTING BIDG. NWe � 4,15Q qOOMS 3 STORIES 1 EXTERIOR W L ROOF COVERING�IIC. E�CFJ. COVERING BU11t`�UD VSE QF 6uI�DI�f+ND WORK TO BE PERFORMED lmi srs 1 I hereby acknowledge thet I have reatl this application antl state that ihe above information is correct antl agrae to comply with all lews ragulating builtlin8 consttuction, antl I shall not amploy any person in viole[ion of the workman's compensation laws of ihe Stete of California. I hereby cartify that I am properly licensetl as a contractor untler the State ot Calitornia Business antl Professions Cotle, Oivisicn 3, Chapter 9, antl that such licenses are In futl forca and effect, or 1 em exempt from the prov(siOns of the Stat¢ of Calitornla Business antl Protassions Cotle ivision 3, Cha r 9. SiB�etuKe of � Permltte9� Authorizatl ABant R BUILDING ADDRESS OWNER FIFE ZONE "'�C-2-��Pa[c�� 207:s ,:t,*+. �,:� � 69.57 FOR BUILDING PERMIT SR vi.✓� - � 7%% VALUE OF USE OF NEW NS � BUILDING YARDS APPFOVED MAIN BUILDING ,l` DISTANCE BEf BET. MA�N & ACCESS. BLDGS. DATE r APPROVEO/�i—/Q � �oTF � �o -ay THE AMOUNTSHOWN UNDER V THE PURPpSE OF ESTABLISHING A VALUATION . � $�� •J, TOTAI � mr b o I ON IS POR - � U FEE ONLV: m ¢ i s� � G % ] m � ��tsLL\ r .�