HomeMy WebLinkAbout1935 ANAHEIM AVE - Building Permits Ciiy of Costa Mesa
Development Services Department
CERTIFICATE O F OCCUPANCY No. O U 2 J 7 2
Building Safety Division
P.0.Box 1200
Costa Mesa,California
The Building located at 1935 Anaheim Avenue. B & C
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
fora Group rya Occupancy.
Use of Building nr.-4.1-r„„d-a
Legal Description 499_1A9-15
(See reverse side for Metes and Bounds/
MP 30153
Building Permit NORMcSS.R952D4 Electrical Permit No. PE 27056 Plumbing Permit No. PE 27056
Mechanical Permit No. MP 30153 Number of apartments 2 and/or guest rooms
ISSUED TO: Building Official William T. Howard
anhnrh Paster
1935 Anaheim Avenue by 7 /r -•
rnar„ rasa, CA 92627
Date Jult1 14, 1988
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 lel U.B.C.
CMF 1015.46 rev. 1/83 White-Owner;Canary-Numerical File;Pink-Bldg.Permit File
___ — '- due —I L./.1.) IC iL
+ Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. `r .�„i•.
1L • r#.
A� CITY.OF COSTA MESA\ -CgNt��S/TaRUCTION PERNJIT PE3&IT O. TRACT NO. LOT NO. UNIT -
-.�IProlect Address ( gi J r f r Y/f q4=iu'f A'VL � I 3066 I S.On
AppliCant's'Mailippng Address TYPE OF CONSTRUCTION U NEW U ADD U ALTERATION p REPAIR '
Applies Name toe. r O-fir[L 4- Phon ' t2W� ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# - I Zone '
r DESCRIPTION OF WORK/USE OF BLDG.
Address S Main Building: Accessory Building:
• E Z
Arch/Eng. License No. TYPE OF PERMIT.�ry U GRADING U FOUNDATION U STRUCTURAL T Front - O
Address / ❑ TENANT YJ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear. N
Contractor's Nam A 7t• "c. lC LC C Phont3 ❑ OTHER /` A
N —I PROJECT DESCRIPTION SQ. FT. OCCUPANCY K Right -
N
Address(mailing)/ f. 7LO • abs NGE ic. I /. s' K G
1 ^ CONSTRUCTION TYPE VALUATION$ _ S Left
_City License No. I J ./ �'7 - R
ZONE GRADING CU.UOS. ACRESE
LICENSED CONTRACTOR DECLARATION Ping. Ref.4 Parking Req./Provided .
O
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: M
with'section 7000)'of Division 3 of •• Business and Professions Code, and
my license is in f911 forcend effectL $
Li censeClass I `� "ten e �� O •
Date -(CF.' Signature. r e. PLUMBING FEES
A
•WORKERS'COMPENSATION D LARATIO '
' c 1 hereby affirm that I have a certificate of consent to se f-incur ora certificate •
Bar Sink • Showers ELECTRICAL FEES
of Workers' Compensation Insurance, or a certified copy thereof (Section •
..' 3800,Lab.-CJ Backflow Preventer- Service Sink- :r Automatic Washer Transformer.❑ 15-50 KW
Policy No. Company• - Backflow Irrigation ' Sewer Cap Construction Pole Sub. • 0 50+KW
Certified copy is hereby furnished. ,
rr�p//
Certified copy is filed with the city Building Division. • -- Bathtubs • Sewer Connection -r_ Cooking Unit I Meter I;glp to 100 amps ' S Ex
Date Applicant - F
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION ,•1 Clarifiers Solar Collectors , l" Dishwasher Meter Dover 100 amps
(This section need not be completed if the permit is for one hundred($100)"or .
less). Dishwasher Solar Piping -- Dryers ❑Gas ❑Electric Sub Panel
I certifythat in the performance of the w rk r whit th p y�n is issued, I ,
shall not employ any person in any m ne so as t b /(�s�j ct to the " Drinking Fountains Solar Tank .11 Fan Motors❑61 HP ❑1'h-8
9
Workers.' Compen Laws of Califorvy� Y _
. Date I E- Signature Floor Drains Swimming Pool w/Spa F.A.U. I I Ina Solar 09-15 HP 016-15+
NOT E: If,after making this declaration,you should become sutijfet to the
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures - - -
( (�C
comply with such provisions or this permit shall_ Microwave - -
be deemed revoked. -
CONSTRUCTION LENDING AGENCY Device Boxes
Gas Service Outlets Water Closet
I hereby affirm that there is a construction lending agency for the performance a Pole Light •
oft he work for which this permit is Issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets / / Range gra
Lenders Name - Outlets
AddressKitchen Sink Water Service Switches (�j Sign (�;
• OWNER BUILDER DECLARATION a
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories . Auto-Wash , Garbage Disposal ;Standing Sections
following reason (Section 7031.5 Business and Professional Code: Any city-or '
county which requires a permit to construct,alter,improve,demolish or repair P-Trap i Laundr Trays
. any structure, prior to Its Issuance, also requires the applicant for such permit y Generator ❑0.5 KW ❑5.15 KW Trash Compactor
to file a signed statement that he/she is licensed pursuant to the provisions of '• Roof Drains
the Contractor's License Law(Chapter 9(commencing with Section 7000)of
Division 3.of the Business and Professions Code) or that he/she is exempt
-
therefrom and the basisfor the alleged exemption. Any violation of Section • -
7031.5 by any applicant for a permit subjects the applicant to a civil ' • i
penalty of not more than five hundred dollars($500).
Ll I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ 3
compensation, will do the work,and the structure Is not,intended or offered Reinspection Fee $15 Issue Fee 3
-
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL f FEES ,
License Law does not apply to an Owner of a property who builds or improves _
• thereon, and who does such work himself/herself or through his or her own - DEVELOPMENT SERVICES REQUIREMENTS: •
employees, provided that such Improvements are not intended or offered for BoilerHood or Type I ❑ � �
sale. If, however, the building or Improvement Is sold within one year of com- Canopy Type II 0 Zoning Approved By •
Date
pletlon, the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground' Building Approved By Date
prove for the purpose of sale). • -
0 1,as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Dat
tractors to construct the project (Section 7044,Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who Duct- Ventilating 00-100,000 BTU 0100,000 BTU SUMMARY OF FEES
--builds or improves thereon, and who contracts for such projects with a con- -
tractor(s) license pursuaht to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ _ SMIP $
proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT
• ❑ lam exempt under Section ' B.8 P.C.for this reason Firepl/Fact.Blt. ICBG 4 Fire Dampers PLUMBING $ ISSUANCE $
Date Owner Heating System& Ducting Registers - PLAN CHECK 25% $ ENERGY P.C. $
I hereby certify'that-I have read this application and state that the above ❑0-100,000 BTU D100,000 BT - ELECTRICAL $ �S •l7 t`.�i GRADING $
information,is correct. I agree to co r•ly with all city and county ordinances
' and state laws Iating to build' g -• [ruction,and hereby authorize repre-
sentatives o t s city to e - ...n M.: .bove-mentioned^prop%lty £qs�
inspection rises. -I [ o-I MECHANICAL $ TOTAL FEE I $ IS'on
Signature • Date/ V
Drivers' License or 55 4 ( Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ ,
_ __
CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant; Pink - Accounting; Goldenrod - Assessor
I
(CONSTRUCTION AND PLANNING .. POurL& SPA
'APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
C I 1
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
1
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd. -
8. Foundation I 59. Gas Pipe, 0 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
1.2. Sewer•Cap . - i 63. Heater & Vent-Final
13. Roof Drains 1 64. Plumbing System - Final
14. Rough Plumbing1
9 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring y� fr( e 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 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas ❑Oil
25. Roof Sheathing 74. Overhead Hydro
•
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT .
31. ,Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final / / 80. FOOD CERTIFICATE ISSUED
33. Final Electric (131 Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test '
i36. Hood or Canopy
I37. Final Factory Fireplace
38. Final Plumbing •
39. Water Service-Final
I . .
40. Gas Service-Final
41. Solar Domestic-Final
. 42. Backflow Preventer .
' 43. Backflow Irrigation •
44. Landscape Irrigation System ,
45. Sound Attenuation
46. Handicap Regulations •
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed, '
49. Electric,Release to Edison
50. Gas Release to Southern California Gas Co .
51. 'CERTIFICATE OF OCCUPANCY 1 ,
1
No, Date - - .
1
• - - - Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. •
�' _
CITY OF COSTA MESA CONSTRUCTIONsALLPERMIT PERMIT NO. ..x . ; 7-MAt,TRU. LOT NO. UNIT NO. 30611-1'2/27/07 14708 ''
'Project Address /9".3.� T'[ F/ /h , ,..i......6.: C,.q ..' #. ,
Applicant's Mailing Address S'A M a. , ., TYPE OF CONSTRUCTION NEW ADD LI ALTERATION LI REPAIR -
Q S3'8o/zp/ I ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A,P,./k . I Zone
Owners Name f A d b��i- ,e r • .=os rat,hor. ] DESCRIPTION OF WORK/USE OF BLDG.
Address /f3} /t/1//✓11E-4 M CoS 'r.4.-nese s Main Building: Accessory Building:
Arch/En . 80 ' 'L/ sem License No. ` 7-L 7. , TYPE OF PERMIT�gI ❑ GRADING Iii FOUNDATION U STRUCTURAL E Front Z0
Addressg S`e '/ Re ie.
a�+w1O/ZT 'F/KIi i ❑ TENANT xi ELECTRICAL tea PLUMBING,. t4ECHANICAL B Rear r N
Contractor's Name Re 4€ r- ire S T=2 Phone _0 OTHER A I
p 3 'PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right' N
Addrezcenss(mailing)—L7 JS ��� A !�(L-D a_
CON ST RUCTION TYPE VApPATION$ S Left • R
•City License No. u� 4/ �/� /lJl (/ t ZONE T GRADING CU.YDS. ACRES
LICENSED CONTRACTOR DECLARATION //�/ '` Ping. Ref. Parking Req./Provided E
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: A / 7 S� Planning Notes: Q
with section 7000) of Division 3 of the Business and Professions Code,and M
• my license is In full force and effect. - T
icense Class License No. . _ - - - S
PLUMBING FEES
' ice Signature - - -
WORKERS'COMPENSATION DECLARATION Bar Sink Showers
I hereby affirm that I have a certificate of consent to self-Insure or a certificate . • - ELECTRICAL FEES
of Workers' Compensation Insurance, or a certified copy thereof (Section 4" ackflow Preventer , . Service Sink --
3800, Lab. C.) ' BZ Automatic'Washer Transformer ❑ 15-50 KW ''1 +'7�'s7
Policy No. Company J,F, Backflow Irrigation Sewer Cap0 50+KW O(�J`�
• Construction Pole Sub.
U Certified copy is hereby furnished. _ /'�
Certified copy is filed with the city Building Division. 3 Bathtubs \ Sewer Connection '_ 62S~ -,'L Cooking Unit Meter yup to 100 amps 'i` ��
Date Applicant _ - . - �l II�
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION , Clarifiers s - Solar Collectors• • .Dishwasher Meter Dover 100 amps 0
(This section need not be completed if the permit Is for one hundred ($100)or ..,,,,
less). - • 'Dishwasher Solar Piping Z Q0 ,. Dryers Dias ❑Electric 2- Sub Panel la-0U
I certify that in the performance of the work for which this permit is Issued,.l, - -
shall not employ any person in any manner so as t become su ject to the. -• Drinking Fountains Solar Tank Fan
Workers' Compensation Laws of Californ ! - Motors❑0.1 HP 011/2-8
Date �0 7 g'7 Signature (/�� Floor Drains Swimming Pool w/Spa � F.A.U. ' Inc.Solar 09-15 HP ❑16-15+ 7�
NJOTIC If,after mak ng this declaration, you should b come subject to the — — - �a
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks 'Urinal /6 Fixtures 2 Microwave r
comply with such provisions or this permit shall be deemed revoked. -
CONSTRVCTION LENDING AGENCY _'• Gas Service 6 Outlets 3Water Closet /oL CO Device Boxes
I hereby affirm that there Is a construction lending agency for the performance _ Pole Light
of the work for which this permit Is issued (Section 3097 Civ. C.) Interceptors Z Water Heater 06 ,Outlets. - ,` Range Lender's Name y+— 9
Lender's Address '- `1 Kitchen Sink - - Water Service `Qt,�y Switches
OWNER BUILDER DECLARATION Sign
I hereby affirm that I am exempt from the Contractor's_License low for the .3 Lavatories.. . IthAuto-Wash U/'� CO—
Garbe et bs Osal
following reason (Section 7031.5 Business and Professional Code: Any city or Up, W<! 9 P Standing Sections
county which requires a permit to construct,alter,improve,demolish or repair s- P—Trap rap Laundry Trays '. Generator 0.5 KW❑5-15 KW
any structure, prior to its issuance, also requires the applicant-for such permit ❑ Trash Compactor •
to file a signed statement that he/she is licensed pursuant to the provisions of d• Roof brains • ✓
the Contractor's License Law(Chapter 9(commencing with Section 7000) of '^ '
Division 3 of the Business.and Professions Code) or that he/she is exempt •- -
•
therefrom and the basis for the alleged exemption. Any violation of Section
7031.5 by any applicant for a permit subjects the applicant to a civil _ -
.pepalty of not more than five hundred dollars($500).
^y . •AQ I, as owner of the property e�wur. e r solo Reinspection Fee I $15 Issue Fee $ 3 —
I` 3t+ will tlo the work,and the structure Is not Intended or offered
Reinspection Fee $15 Issue Fee $ 3
for. sae I coon 7044, Business and Professional Code: The Contractor's MECHANICAL FEES
•
License Law does not apply to an owner of a property who builds or improves
thereon, and who does such work himself/herself or through his or her ownDEVELOPMENT SERVICES REQUIREMENTS: -
employees, provided that such improvements are not Intended or offered for Boiler .•-] I Hood or Type I '� ZoningApproved If, however, the building or Improvement is sold within one year of com- /-- Canopy Type 11 ❑ pP roved B y ' nate
pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground -
Building Approved By Date
prove for owthener
r of the pof ope). . el lu
❑ I, az owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System - Application Issued By Dat. L7, -
tractors to construct the project (Section 7044,Business and Professions Code: _ -
The Contractor's License Law does not apply to an owner of.property who • 'Duct-Ventilating ❑0.100,000 BTU ❑100,000 BTU - SUMMARY OF FEES -
builds or Improves thereon,and who contracts for such projects with a con- _ -
tractor(s license pursuant to the Contractor's License Law). lam aware that - BUILDING PERMIT $ - - SMIP $
Exhaust System 0 Multiple 0 System Repair/Alteration
proof of their Worker's Compensation Insurance should be provided reasonto me. I PLAN CHECK $ ' PERMIT
❑ I am exempt under Section 1e.6 P.C.for this . Firepl/Fact.BIL ICBG 5k Fire Dampers• PLUMBING $ -• - ISSUANCE $ - - •
Date /owner �6��,r � ��- r Heating System& Ducting Registers PLAN CHECK 25% $ J ENERGY P.C. $
I hereby c rtify that I have read this application and state that the above . t' V0.100,000 BTU 0100,00067E ale I GRADING $ - ,.• information is correct. I agree to comply with all city and county ordinances ELECTRICAL $ r
and state laws relating to building construction,and hereby authorize repre- -MICROFILM $
sentatives of this city to.enter upon the above-mentioned property for PLAN CHECK 50% $ ��
i n gnatuompurposes. 2�2 7A7
, Signature Date MECHANICAL $ TOTAL FEE $
"'Drivers' License or SS j ' _ Reinspection Fee I $15 , . Issue Fee • $ 3 PLAN CHECK 25% $-
IS
CMF 0865-46,rev.10/84 White - Building: Canary - Applicant; Pink -Accounting; Goldenrod ;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. ?44/J2f 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 UF ER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. 60. Backwash'Lines,P-Trap, 0 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line& House Connection ..r/47c7 Arc 62. Backwash & Receptor-Final
12. Sewer Cap ( 63. Heater & Vent-Final •
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing q.(/.e7 LUSO 65. Electrical-Final
15. Rough Electrical-Conduit �/7' v66. Solar System-Final I
16. Rough Electric Wiring 6/20-i t W, ,,.►� 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, Ventilating71. Product Piping 0Gas 0Oil 4 i
23. Gas Pipe-Rough& Test 72. Underground Flush • (jl
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil I
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 ,1;'
31. Plaster Brown Coat79. FINAL INSPECTION
32. Electrical Power Meter-Final /1eri,G 6-348
{!JJJ� 80. FOOD CERTIFICATE ISSUED ! .
33. Final Electric -3 JJ/I Notes:7 r�0, aX 75 !M", .z „d &H r
34. Final.Heating & Air Conditioning 6 /j�
.o onirmy ,'...rr tjaZ 1.... arta 7.-A
35. Final Gas Pipe-Tes ® / . 7zii� r. i -yam�•--
j/�7 r6 air 7//o y7 w /r�G/(Y �riY /O!/
36. Hood or Canopy V iii triad unT fear viols ' a
37. Final Factory Fireplace
38. Final Plumbing ,•
39. Water Service-Final 141.4/7 GOD
40. Gas Service-Final g447 tri) ..
41. Solar Domestic-Final
42. Backflow Preventer
•
43. Backflow Irrigation
44. Landscape Irrigation System
•
45. Sound Attenuation •
_ •
f
46. Handicap Regulations .
47. FINAL STRUCTURE & BUILDING .
48. Special Requirements Completed
t
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co •
51. CERTIFICATE OF OCCUPANCY •' . ••
No Date . -
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
-. CITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT NOM P30/53 TRACT NO. LOT NO. UNIT NO. 495
Project Address 9/10/87 41 p�'1 Ti
�g35`ANA4a/ H A1v/2 R�C', - ' •
• fT1� r 1 U
Applicant's Mailin(R7Address f I t1 TYPE OF CONSTRUCTION Ue NEW L I ADD U ALTERATION REPAIR I '
Mo o h/�� r �OST�� �-OYO/ ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P..#6 Zone
Owner's Name 2 Phone DESCRIPTION OF WORK/USE OF BLDG.
Address /935—An AA e/ n S Main Building: Accessory Building:
Arch/Eng. License No. TYPE OF PERMIT LI GRADING FOUNDATION E - O
�--1 r�yU STRUCTURAL Front
Address PAP
LJ TENANT ❑ ELECTRICAL PLUMBING I(�J MECHANICAL B Rear - N
Contractor's Name OWN 45 4. {SAY 154 Phone 8-0w/ ❑ OTHER
PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right N
Address(mailing) K • G
CONSTRUCTION TYPE VALUATIONS S Left
City License No. ZONE GRADING CU.YDS. ACRESR
LICENSED CONTRACTOR DECLARATION arQ A/ p s Ping. Ref.# Parking Req./Provided E
I hereby affirm that I am licensed under provisions of Charter 9(commencing Remks: R E�• B z L l._ Planning Notes: M
with section 7000) of Division 3 of the Business and Professions Code,and J T
^ty license is In full force and effect. •
f sense Class License No. S
_date Signature PLUMBING FEES
WORKERS'COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL FEES
I hereby affirm that I have a certificate of consent to self-insure or a certificate - -
of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink
3800, Lab. C.) Automatic Washer Transformer 0 15-50 KW -
Policy No. - Company Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+KW
BCertified copy Is hereby furnished. .
Certified copy is filed with the city Building Division. Bathtubs • `j` Sewer Connection 5 00 Cooking Unit Meter Cup to 100 amps
Date Applicant
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps
(This section need not be Completed if the permit is for one hundred($100) or
less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric ,Sub Panel
I certify that in the performance of the work for which this permit is issued, 1
shall not employ any person in any manner so j s to eco a sub' ct to the Drinking Fountains Solar Tank Fan Motors 00.1 HP 015 -8
Workers' cpn pe satiQ n Laws of Californ}'��y ��� ,
Date Yr/(J -57 Signature % !�w'"` ' Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP 016.15+
NOTICE:If,after making this declaration,you shou d become subject to the —! -
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal •- Fixtures v
comply with such provisions or this permit shall be deemed revoked. _ 1 Microwave
•
CONSTRUCTION LENDING AGENCY • / GIs Service Outlets Water Closet �' Device Boxes v Light
I hereby affirm that there is a construction lending agency for the performance '/7 /. . Pole g
of the work for which this permit is issued (Section 3097 Civ. C.) Interce tors Water Heater
Lender's Name p Outlets Range
Lender's Address ' Kitchen Sink Water Service - Switches Sign
OWNER BUILDER DECLARATION '
I hereby affirm that I am exempt from the Contractor's License Law for the /. Lavatories Auto-Wash .ta'
following reason (Section 7031.5 Business and Professional Code: Any city or - Garbage Disposal %A.", Standing Sections
county which requires a permit to construct,alter,improve,demolish or repair 4 Pr Trap Laundry Trays - - '%t Generator 00.5 KW 0' 5.15 KW Trash Compactor
any structure, prior to its issuance, also requires the applicant for such permit i.
to file a signed statement that he/she Is licensed pursuant to the provisions of -1 Roof Drains
the Contractor's License Law (Chapter 9 (commencing with Section 7000)of 1 - -! •f
Division 3 of the Business and Professions Code) or that he/she Is exempt
therefrom and the basis for the alleged exemption. Any violation of Section
7031.5 by any applicant for a permit subjects the applicant to a civil •
enalty of not more than five hundred dollars($500). I $ 3
as owner of the property or my employees with wages as their sole Reinspection Foe $15 Issue Fee
compensation, will do the work,and the structure is not intended or offered - Reinspection Fee I $15 Issue Fee - $ 3
for sale (Section 7044, Business and Piofesslonal Code: The Contractor's MECHANICAL FEES
License Law does not apply to an owner of a property who builds or improves
thereon, and who does such work himself/herself of through his or her own - - - - - DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such Improvements are not Intended or offered for Boiler a Hood or Type I I�—
sale. If, however, the building or Improvement is sold within one year of com- Canopy Type II 0 1O! on Zoning Approved By Date /!
pletion, the owner will have the burden Of proving he/she did not build or im- Duct-Under Ground
prove for the purpose of sale). {/LO
Building Approved By Date c /g 7
0 I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date
tractors to construct the project (Section 7044,Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00.100,000 BTU 0100,000 BTU SUMMARY OF FEES
builds or improves thereon,and who contracts for such projects with a con- _
tractor(s) licenseExhaust System 0 pursuant to the Contractor's License Law). I am aware thatBUILDING PERMIT $ SMIP $
proof of heir Worker's Compensation insurance should be provided to me. Multiple 0 System Repair/Alteration PLAN CHECK $ PERMIT
Tam exempt under Section B. : P.C.for this reason Firepl/Fact,Bit. ICBG# Fire Dampers PLUMBING $ B .00 ISSUANCE $
Date -___7_1.6_1:_r4 I- OwneY rad---.. •r� . _ Heating System& Ducting C� RegistersENERGY P.C. $
2 100,000 BTU 0100,00067 / 7 O PLAN CHECK 25% $ • a s
I hereby certify that I have read this y p pitta ln and state that the above ELECTRICAL $ GRADING $
information is correct. I agree tocomply with all dy and y countyh ordinances
and state laws relating to building construction,and hereby authorize y for - MICROFILM $
inspection
fives of this city t• en upon the above-mentioned property for PLAN CHECK 50% $ I
inspection purpose ] / / q�0_I7 MECHANICAL $ Z-6 �0 TOTAL FEE $ �-( • CI 13
Signature y.a�. s_a. Date /
drivers' License or 55# •
•
MF 0865-46,rev.10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - 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-Undrgrnd. 55. Electrical Bonding •
5. Steel Reinforcement f 56. Rough Plumbing& Pressure Test
6. Electrical UF ER 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
11. Property Sewer Line & House Connection , /.7 . 62. Backwash & Receptor-Final
12. Sewer Cap �//' !D 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
Electric Wirin
9 $'
16. Rough67. 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 /d/0,�jy FIRE DEPT. REQUIREMENT ,
20. Rough Factory Fireplace %� C APPROVALS Permit# - •
f
21. Ducts, in Structure 70. Underground Hydro - , .
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil •
23. Gas Pipe-Rough & Test • ' 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank OGas ❑Oil '
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical - . -
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL I
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 ,
i
35. Final Gas Pipe-Test /Mgr 2re'
36. Hood or Canopy '
37. Final Factory Fireplace
38. Final Plumbing - ,
.
39. Water Service-Final ,
40. Gas Service-Final -
41. Solar Domestic-Final
•i
742. Backf low Preventer
;43. Backflow Irrigation l
t 44. Landscape Irrigation System
45. Sound Attenuation - .
• 46. Handicap Regulations .
47. FINAL STRUCTURE & BUILDING - '
48. Special Requirements Completed k
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co - I "
51. CERTIFICATE OF OCCUPANCY, • ..
No. Date
I -
- - _ - - - ._- -. Applicant to fill in all spaces except,those within heavy border lines and sign all appropriate declarations. _
CITY OF COSTA MESACONSTRUCTION eERMIT PERMIT NO.52C.-Y-1
TRA N1'YK1 •
O. LOT NO. UNIT NO. l 4 • __ ) ,
Project Address ,�� ,JSP' iT1T,, Me g ��1C h��a,'(t �I'�• r -- •
Applicant's Mailing 'ddress (I TYPE OFCONSTRUC. 0 U NEW IJ ADD LI ALTERATION LI REPAIR 012628 9'/os/aI IR.nn 'T1
J i - ❑ CONVERSION DEMOLISH ❑ OTHER \ � — /�2 _ /5 Ra.
Owner's NameO ► ®,(�' �'nS " phone -� d DES RIPTION OF We RK/USE OF BLDG'. cam• A.P-dk Zone
Address / 73C'AW46 ti;t1 ` 'eS - AO IR �r svtOLh Sj • 40 e. LZ -• - iU/i���.,,[ Gi- S Main Building: 'Accessory Building:
E Z
' Arch/Eng. License No. TYPE OF PERMIT N GRADING J FOUND -TION STRUCTURAL T Front - O
Address �.{ ,C�[s 0 TENANT ELECTRICAL 0 PLUMBING ❑ MECHANICAL B Rear N
Contractor's Name l/�-6 J Phone ❑ OTHER _ _ - I A - _ , 1.
PROJECT DESCRIPTION SQ OCCUPANCY C Right N
Address l mailing) .F K G
CONSTRUCTION TYPE �16K-.� VALUATION'S !i OC a' s Left , .
• City License No. - R
ZONE GRADING CU.YDS. ACRES Ping. Ref. # Parking Req./Provided E
LICENSED CONTRACTOR DECLARATION /__� •
I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: ,1/ AC�` - Planning Nater. r A�7 L LSP J" M
CI
with section 7000) of Division 3 of the Business and Professions Code, and /✓� /• "••e Q Gf/r �^'"/"e"'� N� - ,_ `vV
my license is in full force and effect. S �•Let?
/ECE-5947E T
S
cense Class License No.
1120,ate Signature PLUMBING FEES
'
WORKERS' COMPENSATION DECLARATION Bar Sink Showers
I hereby affirm that I have a certificate of consent to self-Insure or a certificate • ELECTRICAL FEES
of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer - Service Sink
_ Automatic Washer Transformer 0 15-50 KW
3800, Lab. C.)
Policy No. Company ' Backflow Irrigation - Sewer Cap Construction Pole Sub. '❑ 50+KW• -
8 Certified copy is hereby furnished. - P„:..-Certified copy is filed with the city Building Division. Bathtubs, Sewer Connection Cook ing'Unit Meter ❑up to 100 amps •/•
Date Applicant
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers - Solar Collectors • Dishwasher - Meter Dover 100 amps / •
(This section need not be completed if the permit is for one hundred ($100)or - -
less), Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel / . '
I certify that In the performance of the work for which this permit is issued I -
-
shall not employ any person In any manner s as to beta a ubject t the Drinking Fountains, Solar Tank Fan Motors❑0-1,HP X-8 -
Workers' om Rgnspi Laws of Califorof /g/, {��^� _ : '
Date �x _y 4 Signature [�{,�jB� �/`CI Floor Drains Swim g Pool w/Spa F.A.U. Inc.Solar�5 HP ❑16-15+ .
NOTIC If,Si ter-Fn airing this declarat76n, ydG sh Wd b come subject to 11 he- - - - --�- -
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks ' al Fixtures
comply with such provisions or this permit shall be deemed revoked. Micro ve •
,
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes '
I hereby affirm that there is a construction lending agency for the performance - ole Light
of the work for which this permit is issued (Section 3097 Clv. C.)
Interceptors Water Heater Outlets /
Lender's Name Range
Lender's Address - - - - Kitchen Sink - • -Water Service - Switches Sign ' _
OWNER BUILDER DECLARATION '
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal
following reason (Section 7031.5 Business and Professional Code: Any city or 9 Sp Standing Sections l i
county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays Generator ❑0-5 ❑5.15 KW
any structure, prior to its Issuance, also requires the applicant for such permit Trash Compactor
to file a signed statement that he/she Is licensed pursuant to the provisions of Roof Dra'
' the Contractor's License Law(Chapter 9(commencing with Section 7000) of - -
Division 3 of the Business and Professions Code) or that he/she is exempt" -'--- .
therefrom and the basis for the alleged exemption. Any violation of Section / ,
7031.5 by any applicant for a permit subjects the applicant to a civil - /`
VP:of not more of thanthe five hundredor dollars($500). `II
I, as owner property my employees with wages as their sole Reinspection Fee i f $15 Issue Fee $ 3
compensation, will do the work,and the structure Is not intended or offered 1 -. .Reinspection Fee-1 $15 Issue Fee ' $ 3
for sale (Section 7044, Business and Professional Code: The Contractor's • - MECHANICAL FES..^
License Law does not apply to an owner of a property who builds or improves _ _ ,_ _-
thereon, and who does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQU EM N S: . p•
employees, provided that such improvements are not intended or offered for Boiler -- Hood or Type I 0 / / - a / - _a/
sale, If, however, the building or Improvement Is Sold within one year of com- Canopy Type II ❑ Zoning Approved By r� ' ' 0- Date 5 fO
tion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground f Building Approved By Ig/Ls - Date —8C •
rove for the purpose of sale). 'IE�J-, f �p`'
LJ I,as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration Sy Application Issued By ws �� a Date ?S-SG
tractors to construct the project (Section 7044,Business and Professions Code: �� t
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑0.100,1•ITU ❑100,000 BTU - SUMMARY OF FEES - '
•
builds or improves thereon, and who contracts for such projects with a con- - - _
tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 em Repair/Alteration - BUILDING PERMIT $ /7t s--e, 470SMIP $ / �
• proof of their Worker's Compensation insurance should be provided to me. - PLAN CHECK $ PERMIT -- '
0 I am exempt under Section B.& P,C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers PLUMBING $ ISSUANCE $
Date 5 � G Owner /e ,- ._ ^ Heating System&Duct' Registers PLAN CHECK 25% $ • ENERGY P.C. $
I hereby certify that I have read this application and state that the above ❑a-100,000 BTU 100,000 BTL— GRADING $
information is correct. I agree to comply with all city and county ordinances ELECTRICAL $
and state laws relating to building construction, antl hereby authorize repre- PLAN CHECK 50% MICROFILM $
sentatives of this city • en •r up,. ave-me•tioned -property for $
inspection purposes. //�� �iy�yp' /,, `p•
Signature /�.6.i�_ w' 61'e ' Date' /�s-1v MECHANICAL $ TOTAL FEE $ ! Of 062
Drivers' License or 55# - .'- - einspection Fee $15 • Issue Fee $ 3 PLAN CHECK 25% $
CMF 0865-46,rev.10/84 White - Building; Canary - Applicant: Pink -Accounting; Goldenrod -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-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, 0 Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval •
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit# . •
_
21. Ducts, in.Structure 70. Underground Hydro '
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 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 .;,j
29. Insulation 78. FIRE PREY. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION I - •
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED If
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 Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations `
47. FINAL STRUCTURE & BUILDING Wet tar . •
48. Special Requirements Completed ,t v
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co /
51. CERTIFICATE OF OCCUPANCY!
No. Date
• Applicant to fill in all spaces except those within a dal!app,oV n.._uecla ration•- —__._____ _____ .
CITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. �� TRACT NO. „Ls UN ., ju n '
ProjectAddress /93•S �/�iD'ffj�'/!vr 107JTL ' ' - //J as 1 '�� Q� V M0748 I /?r3/87
���jjj U REPAIR I� y • p n' I _
Applica 5 Mailing'Address w , TYPE OF CONSTRUCTION NEW Aoo J ALTERATION (�a of ��a — J _ I - NOCK
�j ry�O / [f- A ❑ CONVERSION ❑ DEMOLISH OTHER AP*# Zone
Ovyd s Name vogue"
CZ/4" -r e5' V - Phone, % QY�� 1 DESC'IPTION F WORK/USE OF BLDG. `� - - i
Address g¢.jJ,� •6:141:.(4;7„.#0/�� _COM?
ry /' _fit h i.. _ • S - Main-Building: Accessory Building:
•
Arch/Eng. D4n 4- 95-
1•• L•LLIcense No. _ .2/� ? frf •TYPE OF PERMIT M GRADING 6 OUNDATIO ` STRUCTURAL T Front / 7/ 0
Address/ 5 T 95 Si J' /foe nr[!•�'•C-!'f • ❑ TENANT ELECTRICAL P. PLUMBING MECHANICAL R Rear /�I ' N
ki
C6rrtractor'S Name >V ^� I- Phone ❑ OTHER A V
��"' I PROJECT DESCRIPTION Set. T, Z�!-¢�I S OCCUPANCY C' Right 5) ......„/"(....-
N
Address(mailing) J�„�-' ”, - v?3�17D� CONST CTION TYPE VALUATIONS /55170.-C.0 •$ Left ///4// G
0171 R
City License No. " ZONE irC yZ GRADING CU.YDS. . ACRES
PIng. Ref.# video
LICENSED CONTRACTOR DEC LA RATIO Ni f��1 iCi fr' ( D C!• 1 Tppl'9Ery 13 I E
I hereby affirm that I em licensed urider provisions of Charter 9 (commencing /�' .0‘,6,9°,53‘" •/� - Planning u0� f�n yy�Z _ M
Remarks: Y [�.R Notes:
•vith section 7000) of Division 3 of; the,Busines5 and Proiesslonz Code, and - -
license is in full force.and effect.._, 4' -r , I - _V V /!l3/ A i.+ h., _ S
T
• .ense Class License No. - • - 7! _/pito/"17 1(rM7 IX n N F
Date Signature - : ' PLUMBING , _ FEES — rim • p( (17 oven) Lsi tot, *(,onus 2.
WORKERS' COMPENSATION DECLARATION Bar Sink Showers
I hereby affirm that I have a certificate of consent to-self-insure or a certificate . • - - ELECTRICAL FEES
of Workers' Compensation Insurance, or a certified copy thereof (Section • I
3800, Lab. C.) _ Backflow Preventer Service Sink - Automatic Washer • Transformer 0 15-50 KWi
Policy No. -Company / - • Backflow Irrigation Sewer Ca • 0 50+KW
❑ Certified copy - p - Construction Pole Sub.
❑ is hereby with
thehed. f• 1 r
Certified copy Is filed with the city Builtling'Division. - • Bathtubs Sewer Connection -,Cooking Unit • Meter ❑up to 100 amps
Date - i.ant
• EXEMPTION FROM WORKERS'COMPE permit
�D EC LA RATION ' Clarifiers • Solar Collectors - Dishwasher Meter Dover 100 amps
permit
(This section need not be Completed If-the is for one'hundred ($100) or ' Dishwasher - ' •
less). - - - Solar Piping • - , - Dryers ❑Gas Electric Sub Panel '
I certify that in the performance of the work for which this permit is Issued:I _ -
shall not employ any person in any manner as.to •e • - subject • the , Drinking Fountains Solar Tank I Fan • .
' Worker Co p at ws of Califo a " , Motors 00-1 HP 01%-8 '
' Date Signature It1 / `/� • y Floor Drains - SwimmingPool w/Spa - �t�l
` � �`-%•a. j w!i - - - p F.A.U. ' Inc.Solar ❑9-15 HP ❑16-15+' (rte
NOTI E:If,of r m in this declaration, s'ou d beco e b e t
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures
comply with such provisions or this permit shall be deemed revoked. Microwave
CONSTRUCTION LENDING AGENCY Gas Service - 'Outlets Water Closet Device Boxes
I hereby affirm that there 1s a construction lending agency for the performance Pole Light
of the work for 'which this permit is Issued (Section 3097 Civ. C.) Interceptors A Water Heater Outlets •
Lender's Name , Range;
Lender's Address - Kitchen Sink r Water Service - - • - - ' .
OWNER BUILDER DECLARATION I — Switches Sign
I hereby affirm that-(/am exempt from the Contractor's License Law,for the Lavatories . - Auto-Wash Garbage Disposal - Standing Sections ,I
following reason (Section 7031.5 Business and Professional Code: Any city or - 1 '
county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays - Generator ❑0-5 KW ❑545 KW
' any structure, prior to,it4 issuance, also requires the applicant for such permit Trash Compactor
. to file a signed Statement that he/she is licensed pursuant to the provisions of Roof Drains
the Contractor's License-Law(Chapter 9(commencing with Section 7000)of _ r
Division 3 of the Business and Professions Code) or that he/she is exempt — . . .-
therefrom and the basis for the alleged exemption. Any violation of Section ^
• 7031.5 by any applicant for a permit subjects the applicant to a civil
p aity of not more than five hundred dollars($500). t
IRI" ' I. as owner of the property ' Reinspection Fee, a I $15 Issue Fee $ 3 ' •
I enaaYnn, will do the work,and the structure is not intended or Offered •
__ - 1
' for sale (Section 7044, Business and Professional Code: The Contractor's Reinspection Fee I $15 Issue Fee $ 3
License Law does not apply to an owner of a-property who builds or improves ti MECHANICAL FEES
thereon, and who does such work himself/herself or through his or her own v, DEVELOPMENT SERVICES REQUIREMENTS: "/��
•
employees, provided that such improvements are not intended or offered for Boiler Hood or Type I ❑ /b '//�tt. / tet, 2 �y
sale. If, however, the building or Improvement is sold within one year of com-
pletion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground
Ufor the purpose of sale). - Building Approved By Date
UI, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By ' •
tractors to construct the pfofect (Section 7044,Business and Professions Code: - • Date
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating - 00-100,000 BTU 0100,000 BTU •
SUMMA Y OF FEES
builds or improvesicense thereon,and who contracts for such projects with a con- •
�.,g UI LD ING PERMIT $ SMIP $ • 1
tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple❑ System Repair/Alteration -tilt/ 2 c�
proof ftheir Worker's Compensation insurance should-be provided to me. _ astir" CHECK $ • PERMIT
0 lam exempt under Section ' /J B.& P.C.for this reason Firepl/Fact.BIt. ICBO 4 'Fire Dampers , PLUMBING $ ISSUANCE $
Date /--2.3_47wner —4ra/���✓-w��-�r�— plJ w. Heating System& Ducting ' . Registers • '\PLAN CHECK .25% $ ENERGY P.C. $ - '-
•• i hereby certify.that I have read thismyap¢f aaon and staco that the above- ❑0.100,000 BTU 0100,0006T I�`� . GRADING $
information is correct. I agree'to comply with all city and county ordinances- I (ELECTRICAL '$
and state laws relating to building construction, and hereby authorize repre- MICROFILM
•
sentatives of this city to enter u on the abo e-mentioned property for 'PLAN CHECK 50% $ $ /p \rj1'�•�
inspection pure s. /{/y • MECHANICAL $ �' ! •�9
Signature �I / _.;w Date �_Z� 7 Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ TOTAL FEE $
Drivers'-License or SS# . �'��' J
CMF 0865-46,rev.10/84 White Building;Canary - Replicon t: Pink -Accounting; Goldenrod - Assessor
0
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-Undrgrnd. 55. Electrical Bonding -
5. Steel Reinforcement 56. Rough Plumbing& Pressure Test
6. Electrical UF ER Grnd. 3/9 1 Pe 57. APPROVAL TO COVE R-GUNITE
7. Footings '. I 58. Electrical Conduit-Undrgrnd.
8. Foundation • s 59. Gas Pipe, O Undrgrnd.,Test
i 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, ❑.Undrgrnd. ,
10. Structural Floor System 3/9/1 Die 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final : .
12. Sewer Cap 63. Heater & Vent-Final '
13. Roof Drains 64. Plumbing System -Final
14. Rough Plumbing 65. Electrical-Final ! - ,
15. Rough Electrical-Conduit 66. Solar System-Final -
16. Rough Electric Wiring 67. Fencing&Access Approval.
-
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL .
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace '-' APPROVALS Permit# -
21. Ducts,in Structure 70. Underground Hydro
-
22. Ducts, Ventilating - 71. Product Piping 0 Gas ❑Oil
23. Gas Pipe-Rough &Test s, - 72. Underground Flush •
-C
M 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25: Roof Sheathing , - GtaIr? .90' 74. Overhead Hydro
( 1111
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical '
27. Frame and Flashing .-, ,:/A//Jy rr1 76. Dry Standpipe • I
28. Lathing & Siding zWeg art '- 77. FIXED SYSTEM FINAL
29. Insulation 10 in 0 a 78. FIRE PREV. FINAL •
30. Drywall Nailing LSki& (4\,-Q'(1, / HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat www"'`"' •
71 kn. 79. FINAL INSPECTION • . .
. \
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED"
33. Final Electric Notes:
34. Final Heating &Air Conditioning � L IM
MMUS
RE
Final Gas Pipe-Test 37 in FQCTA45 L/« ern 4 stmat 8w+s
36.:Hood or Canopy Q +grew 4 core
,
a - ,` w-
37. Final Factory Fireplace , ire, ctc _ I /Ntf inns-iSc1kP•' Vinv.it,5 S
38.' Final Plumbing '
nr. ffe n t Ca 614-d 44 044 •
39.'Water Service-Final
‘.,.-
1(34/0 C/4 //A/ufVir
40. Gas Service-Final FA...a_ apt _ ', ax, oF.04i-.
'41. Solar Domestic-Final i 01): erZV 4
N
I427 ilackf kivv Preventer I al 1 A_ iL
Or
' 43. Backflow.lrrigation 6 /a/ [', '.�j�oitt t 4" g
44. Landscape Irrigation System l' , r U�'IC Cf1 fi�00 �,
'45. Sound Attenuation
46. Handicap Regulations
47: FINAL STRUCTURE & BUILDING 6 z. lt 0_0- - -
48. Special`Requirements Completed $e icAakt, ri
49. Electric.Release to Edison !-'' ,
'
50. Gas Release to Southern California Gas Co .. . ..
51. CERTIFICATE OF OCCUPANCY - ,
•
No. Date
FEE RECEIVED
14C 1 . MAR 7 1951
COSTA MESA BUILDING-SAFETY DEPARTMENT `,�' FINANCE DEPT.
P. O. BOX 317 COSTA MESA. CALIFORNIA CITY OF COSTA MESA
For applicant to Fill In Completely APPLICATION FOR PERMIT
'/, TYPE OR PRINT BUILDING
BUILDING ADDRESS(73S/{AMile'/I'AVQ
"' COSTA MESA. CALIFORNIA For Office Use Only '♦
f //'wA pe-,27/e4
^7 4 I RECEIPT NO. I �BA*I ,02
OWNER,Ii!/O// .l ////___--o.L yG/
MAIL ,,L RECEI D BY DATERECEIVED TE ISSU
ADDRESS'S 4#STA Mete AW�-. - 7- o/ �`7 -(O/
TEL. BUILDING
CITY (_, es'TA /-/F«- NO.L1 9-BSOE ADDRESS
ARCHITECT TEL. COSTA MESA. CALIFORNIA
OR ENGINEER NO. / N t17
" FIRE // 7 E.
ADDRESS ,�,/ f�Jq ,,// ZONE TYPE VVV GROO/U/F, / W
CONTRACTOR �%L11�//'G� /[J F♦ I�' BYAPPROVEO `.r�/JS/���'J' QATE//l a 7 I
ADDRESS ZONING
ZONE 9 I / I NO. I USE OF N ' `v . Li j
a
CITY X11 1C 1 PLANSO.OUSEDINOLLa<.-[9 !N`�t/. lY•
STATE TEL. LEGALq�f L/� O7�
LIC.NO. NO. DESCRI PTI o4Y c.>1�4" .y<7. Ii ItYlAA,(.L-0 :2
SIZE So/, 12O 4/ I NO. OF SLOGS. / —
OF LOT �,/ NOW ON LOT A.P.NO. II S-- 3� - S
USE OF RES? YARDS EVES VL
EXISTING BLDG. APPROVED ALLOWED
SETBACK LINE FROM q��JJjj �y/ ICBMER LINE BTd /� ,,
CENTER OF STREET ii lir
REAR YARD /C FRONT / 1-- FT. "✓�'Y'� IN. OI'C 4
a.SIDE YARD I LEFT Ry j I RIGHT q ' R.SIDE SFT. +:- IN. C\=:ct
DESCRIPTION OF WORK FT. t I IN. t
�/ L.SIDE
NEW I /I II ALTERATION I V ADDITION I RFAR / S 'Fr (cA ,,,.) .IN.-_..1
REPAIR I II MOVING II DEMOLISH I 6YI'ROT�,�f� it F D €-_ L-' /
BUILDING .y/�/ / NO. OF (fjF'�f, dga
Y 4
SIZE J'K.,/t 7./. ROOMS ' STORIES / py �q ^p ggg q yyy---���' �'�,
EXTERIORWALL y. _I COVE U� p� � " U 1 Il1� + r p
COVERING/E /� e,„,„_ma RCO(_VE/RINGgPARPTIER//yam 3dY� 1Ri',. �S`tl 6J 1YI"NY y
U/.f�f/'PI 'Vc WOtRK1Z-1/ , S 'DL/ 4g / 0 `.--e.�,1e46rts ,,tL,./.
— vil� ;bap DATE
Q:�A .PM 0 v�J APPROVED _.3"�'6/
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION d”`THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT PEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING ^� /
BUILDING
81GNATURE OF CONSTRUCTION. VALUATION
"1'1
PERMIT FEE $ p�`—
N
PERMITTEE $ /D 7'3 PLAN CHECK $ /3 w
AUTHORIZED AGENT
TOTAL FEE -