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HomeMy WebLinkAbout1912 HARBOR BLVD - Building Permits CITY OF COSTA MESA• fl BUILDING DIVISION Fre ____ DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER 4�00.y� PERMIT er-� ' 03-00698 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.usING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDJob Address: 1912 HARBOR BL Status: ISSUED Suite: Applied: 04/28/2003 Vicinity: Issued: 04/28/2003 Parcel Number: 41920513 Zoning: Applicant: YOUNG, MIKE ISSUED BY: Address: 1015 E CHESTNUT Phone: (714)953-5444 SANTA ANA,CA Zip: 92701 Owner: RUFFELL, DAVID ATR Address 307 E BAYFRONT Phone: BALBOA ISLAND,CA - Zip: 92662 4:1\1.°1:700:11.111:0000, Contractor: YOUNGS ROOFING CO, INC Address: 1015 E CHESTNUT Phone: (714)953-5444 SANTA ANA,CA Zip: 92701 , License:. 568560 Arch : • Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF.INSTALL NEW 30 YEAR CLASS A FIBERGLASS SHINGLES.B.U.R.ON FLAT SECTION OF ROOF. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $6,000.00 Permit: $125.25 Claim Valuation: $6,000.00 • SMIP Res: $0.00 SMIP Com: $1.26 Other: $0.00 Inspection: $0.00 Total: $126.51 • PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: 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: 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 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 all required Inspections 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)754-5626 2446-46 WOO ' • DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit Is issued. ❑ I have and will maintain workers'compensation insurance,as required by:Action 370Q of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carder and policy number are: Carrier: Policy Number: (This section need not be completed IY the permit is valued at one hundred dollars($100)or loss.) ❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Californ ,a d agree that If I should become subject to the workers'compensation provisions of Section 33700 of the Labor Code,I shall forthwith comply with these p v Bions. tL_,J` 3 Applicant Signature: Date: ( WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL P NALTIES AND CML FINES UP TOONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDmON TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION roe OF THE LABOR CO0E.INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is In full force and effect.Uc.4 Class q Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,CMI Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its Issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or 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 Uvil penalty of not more Stan live hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not Intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner 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 owner-builder will have the burden 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 project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2.Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I wit not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: • Division of Industrial Safety Permit Number. HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: • I WIII the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feel of compressed gas at standard temperature and pressure). __ 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Ves 0 No (Section 25533 of the California Health and Safely Code,with some exceptions,requires registration with the 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 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes u No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes ❑No (If yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If'yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPUANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with ell state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described properly for Inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature Of Legal Owner(s) / a Lit/ - ae An uthorized Applicant Da e ;ODE r, i$5PECTIONTYPF PATE IBIMALE CODE! INSPECTION TYPE PATE gETI11SL5 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing / 200 Final Re-Roof `//its/'" 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. • CITY OF COSTA MESA - - PERMI,,ii..NO- / TRACT NO. LOT NO. - •BLDG:NO. -- . - • --- - . CONSTRUCTION PERMIT L(.77C.S ',.6921 4/08/83, • 13.00 TL Project Addressf t• ', .(y(2 (-};d/LQt9/Z� - TYPE OF CONSTRUCTION • , Owner ' J3j4 (,(•p,-a/ S7 ,gj; PhoneSli r..115.4 �Q,❑/NEW ❑ ADD ❑ ALTERATION Address SA:r•,ra - - -• - - REPAIR 0 CONVERSION ODEMOLISH ZONING REGULATIONS Arch/Eng. - -- • License No. -• ❑'OTHER •-. - DESCRIPTION OF WORK gspca c2 (3.•RNttf1 • A'P'B • Address -. , . • - .. _ - • - - . . • _ •u ZONE PLNG. REF.9F- Contractor (sRCGU3 - `St-c c ' - Phone-1 TYPE OF PERMIT - - BUILbING To gill LplNC Address / SETBACK C/L ST. PROPERTY LINE M /(o 46,Z. M I GLlfctr. / A.,15._... 0 GRADING,,,,..�//❑• FOUNDATION- 0 STRUCTURAL .- L DET YARD LICENSED-CONTRACTOR DECLARATION 0 TENANT-TENANT ❑PLUMBING ❑MECHANICAL SIEDEE YARD I hereby affirm that I am licensed under provisions of Charter 9 (corn- RIGHT mencing with section- 7000)- of Division- 3 -of the Business and 0 OTHER REAR YARD(TO P/L)' ' ( Professions Code, and my license is In full force and effect. PROJECT DESCRIPTION License Class ' 0 -Zyry ` icense'N - ' PKG.SPACE REQ. " _PROVIDED- 1 ROVIDED- 1 Date 9-r in - Signature !"... T. - - _ - 6 - STREET-WIDTH PARK FEE S OWORKERS'COMPENSATION DECLA AT-ION ..00CUPANCY_CONSTRUCTION TYPE I hereby affirm that I have a certificate of consent to self-insultor a VALUATION ZONE ZONING APPROVED BY - DATE- certificate of Perflation Insurance, or a certified copy _ \ thereof(Se�r�^.� ). GRADING CU.YDS. ACRES - SPECIAL CONDITIONS: • - nlicy No.M e4 Company/Mat •e_ �Mif w _ _ _ . . - — -• - - y.3 Certified copy-is hereby furnished._ _ - " , ~ REMARKS: -'t ` • ,_, - - • - - Si Certified copy Is filed with the city Building Division. • - • -' • 'EXEMPTION'FROM WORKERS' COMPENSATION DECLARATION - - - ' - - . (This section need not be completed If the permit is for one hundred • - - .. ' . ' ($100) or less). - - - - . -. .. _ . ... . . certify that in the performance'of the work for which this permit is Issued, I shall not employ any person In any manner so as to become PLUMBING-- ,,,'PLAN CHECK - - - - ELECTRICAL- ^ - P CHECK, - .subject to the Workers'Compensation Laws of California. _ - _ .UW tLLINu, _ _ bE • Date Signature -BATHTUBS " SHOWERS - ' . - SO FT FT - • NOTICE: If after making this declaration, you should become-subject TOILET$ URINALS--• - . -- . GENERATOR 0 KW-1-10 - - - to the Workers' Compensation provisions of the Labor Code,you must TRANSFORMER forthwith comply with Such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS • - • - - APPLIANCE• -10- KW_ W ' _ . _revoked. -�... !-_ , _ _ CONSTRUCTION LENDING AGENCY - KIT.SINKS - ' - DISHWASHERS - - - - MOTORS - 0-1 P • 1-30 HP I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS • SUMPS' - -•' ' (INC.SOLAR) 10-5 P 50+•HP . formance of the work for which this permit Is issued (Section 3097 - Civ. - - - - - ' ' -FLOOR SINKS - - - FLOOR DRAINS- - - FIXTURES- OUTL 5-- SWITCHES • -- "- - _Lender's Name - Lender's Address -- '- DRINKING FOUNTAINS •- - - - - GAS TUBE SIGNS- - -- . - - 'OWNER BUILDER DECLARATION - -- ---• --INTERCEPTORS` CLARIFIERS ' - - - POLE LIGHTS • - - - I hereby affirm that 1 am exempt from the Contractor's License Law for - the_following-reason-(Section 7031.5 Business and Professions-Code: SWIMMING POOL • - P-TRAP - - . - LUNSI HUL I ruiN Any city or county which requires a permit to construct, alter, ' POLES METERED -SUB ' -/ Improve,demolish or repair any structure, prior to its issuance,also re- WATER SERVICE-' '-'ALTERATION - PANELS MAIN - SUB -/ 7-. 00. quires the applicant for such permit to file a signed statement that he " is"licensedpursuant to the provisions of the Contractor's License Law GAS SERVICE - " -OUTLETS - - - - SERVICE /20/2q0 ti. /AVAMR /-- l QO (Chapter 9 (commencing with Section 7000) of Division 3 of the - Business and-Professions Code) orthat he is exempt therefrom-and the- WATERHEATERS - BTU OUTPUT •• - - - •- - - - • ' . - . •sis for the alleged exemption. Any violation of Section 7031.5 by - y-applicant- for a permit subjects the-applicant to-a civil penalty- -SEWER'CONNECTIONS.. -- - - - not more than five hundred dollars ($500). ' • ' 121;as-owner of-the property, or my employees with-wages as their - SOLAR TANK COLLECTORS- -- - - - • - - ' -. -sale compensation, will do the work, and the structure is not intended - .. or offered for sale. (Section 7044; Business and'Professions Code:The SOLAR PIPING SYS. .. - ISSUE FEE - -- • - Contractor's License Law does not apply to an owner of a property - APPLICATION APPROVED BY .. DATE who builds or improves thereon, and who does such work himself or - ISSUE FEE • ._ - - - through his own employees, provided that such improvements are not intended or offered for sale. If, - - however, the building or improvement MECHANICAL PLAN CHECK ' • .. SUMMARY OF FEES is sold within one year of completion, the owner will have the burden r ' of proving he did not build or improve for the purpose of-sale). -' - - - BUILDING - . .. __. HEATING SYSTEM 0-100,000 BTU PERMIT $ ,.r SMTP S 0-1,-as-owner of -the property,-am exclusively contracting with - AND DUCTING - + licensed contractors to construct the project (Section 7044, Business lo0,000 BTU PLAN CHECK $ PERMIT and Professions Code: The Contractor's License Law does notappiy.to - _ _. - _. ISSUANCE..S' an owner of property who builds or improves thereon,and who con- REFRIGERATION 0-100,000 BTU -' - PLUMBING $ •tracts from such projects with a contractor(s) licesned pursuant to SYSTEM ,$_ _ GRADING $ the Contractor's License Law). 100,000 +BTU - PLAN CHECK- . : - _ _ _ __ _ ;.S ❑ I am exempt'untler Section' • - - '- •B.& P.C.for this BOILERS BTU ELECTRICAL $ r 3 O� -' reason - - - - - --- - PLANCHECK S MICROFILM S' SYSTEM REPAIR,ALTERATION - - Date Owner TOTAL FEE_E I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE - -' MECHANICAL E - - ,LESS AD- information is correct. I 'agree to co ith air city and county .PLAN CHECK? S• - VANCE PC -$ - -- ordinances and state laws relating to co truct on,and hereby authorize representatives of t•'s 'city to en - upo the above-mentioned` - - - ' - / r� property ion purposes a Z ! 3 ` �� CGl/ FINAL FEE $ Signature I� - Pink-Accounting:Goldenrod-Assessor • CONSTRUCTION AND PLANNING _ POOL&SPA • APPROVALS Permit# 6- /I �J Date Inspector APPROVALS Permit# , Date • . Inspector `•c 1. - Temporary-Electrical Service or Pole43. Pool & Equipment Location - 2. Soil Pipe-Undrgrn - - 44. Steel Reinforcement - -=`"' " •' 3. Electrical Conduit Utility-Undrgrn .-, . . - 45. Forms - - - - 4. - .Electrical Conduit-Undrgrn . - - .. • ' - ' -46. - "Electrical Bonding . - ,_ . .. , 5. . Steel.Reinforce . . .. . 47. Rough Plumbing& PreS3ure'Te;t 6. Electrical UFER Grn - 48. -APPROVAL TO COVER-GUNITE ` - ' ' t'' ' 7.. . Footings.. - _ • 49. Electrical,Conduit-Undrgrn ' 8. Foundation . -. 50. Gas Pipe, 0 Undrgrn,Test 9. Water Pipe-Undrgrn 51. Backwash Lines, P�Trap 0.0.ndrgrn ' 10. Structural Floor System -• - 52. -APPROVAL TO DECK. :. • ` ` 11. - Property Sewer Line & House Connection _. 53. Backwash& Receptor-Final • _ '- 12. Street Sewer Connection .. . - 54. Heater & Vent-Final., , , • , ..y 4 .•,\ c IC L ZI ,t` .13. Rough.Plumbing. . _ 55 Plumbina System -Final ' 14. Rough Electric-Conduit _. - -56. Electrical-Final -)..- 15. }15. Rough Electgc-Wiring + ___ �v, '- 57. Solar System-Final - • -16. Rough Heating& Air Conditioning • - , _ 58. Fencing&Access Approval . • 17. Ducts, in Structure . . - - . . 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating ! - - _ . - 19. GasPipe-Rough,&Test i 60. POOL/SPA SYSTEMS FINAL 20.- Roof Framing 21. Roof Sheathing 's....,• . - . _ -- • ' ' • ' 22. - Frame and Flashing / - NOTES: 23: Insulation - I • - - - - 24. Lathing &Siding 7 - • • - 25. Drywall Nailing - r - • ' - - - 26. Plaster Brown Coat - - - 27. -Electrical Power Meter-Final -- !J/f 3 .tot-- - 28. Final Ele"cmc- N . • 1.. 4/ , del - 29. Final Heating-& Air Conditioning - ' , 30. Final Gas Pipe-Test - 31. Final Plumbing . • 32. Water Service-Final - - - - . ' 33. Gas Service-Final 34. Solar Domestic-Final - 35. Landscape Sprinkling System - . ' . - 36. Sound Attenuation _ -- • 37. Handicap Regulations ' 38, FI NAL STRUCTURE & BUILDING . 39. Special Requirements Completed 40. Electric Release to Edison ' 41. Gas Release to Southern California Gas Co. • • 42. CERTIFICATE OF OCCUPANCY - - . " No ' • Date _ -. • ; • r Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. • CITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NU. 5922 3/01 /BB 93000 TL , Project Address 11 f-2- uA7% R �Q- t-V p E 323"1 Z Applicant's Mailing Address q to Oe' .S-r TYPE OF CONSTRUCTION U NEW ❑ ADD MiALTERATION U REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A,P.4 I Zone Owner's Name Phone DESCRIPTION OF WORK/USE OF BLDG. bAddress S Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMIT U GRADING U FOUNDATION E o �/I U STRUCTURAL Front Address 1s�� ❑ TENANT LTy ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear • N Contractor's Namp•✓IGY SCNVt_'- M q/d Phone(422u33 ❑ OTHER A 1 PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right N Address(mailing) i.tO oak �T COW% MEQ - K Left G 0 25041 CONST RUCTION TYPE VALUATIONS R City License No. ZONE 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: C E Zc54 og T5-PE 3i zi01 Planning Notes: M with section 7000) of Division 3 of the Business and Professions Code, and T M my license is in f J fore-aOtl effect. Z- 'Q� Jo (? �,Q��c S Ucense Class V ic" - ��+G Date / - . +S ignature in - - +� - PLUMBING FEES WORKERS'COMPENSATION DECLARATION . Bar Sink Showers ELECTRICAL FEES t 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 - ❑ 50+ KW 8 Certified copy is hereby furnished. Certified copy Is filed with the city Building Division. Bathtubs Sewer Connection Cooki Meter pup to 100 amps . Date Applicant EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwas Meter Over JecsmosS (This section need not be completed if the permit is for one hundred ($100)or — — ht,AT I B SC less). Dishwasher Solar Piping Dryers as ❑Elects 4$1, Sub Panel I certify that in the performance of the work for which this permit Is issued I — — shall not employ any person in an manner so s to eyvl eub jeect to the Drinking Fountains Solar Tank Fan - ! Motors 00-1 HP al%-8 75b WorkeiWicss_rna nsa� ws of Cal nn. \,,t�t Date `1�lNxlj- en Signature s U Floor Drains ' Swimming Pool w/Spa F.A.U. Inc.Solar ❑g-15 HP 016-15+ NOTICE:If,after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks ' Urinal Fixtures Microwave comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Gas Service' Outlets Water Closet - 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 Water Heater 2C Outlets Range S ire Lender's Name - — i `� 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 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 : Laundry Trays Generator 00-5 KW 05.15 KW Trash Compactor any structure, prior to Its Issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains y the Contractor's License Law(Chapter 9(commencing with Section 7000)of 1 ^-� MQ,=(�ts„Q I ' 00 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 JJ 7031.5 by any applicant for a permit subjects the applicant to a civil 1.]�-+ if f T penalty of not more than five hundred dollars(S500). ❑ I, as owner of the property or my employees with wages as their solo Reinspection Fee I $15 Issue Fee $ 3 1c r compensation, will do the work,and the structure is not intended or offered - Reinspection Fee $15 Issue Fee 5-3- for sale (Section 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 own Boiler Hood or Type I 0 DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered foryP sale. If, however, the building or improvement is sold within one year of com- Canopy Type it ❑ Zoning Approved By Date 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 the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By fi7k Date 3(I Be, tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's Ucense Law does not apply to an owner of property who Duct-Ventilating 00.100,000 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). I am aware that Exhaust System 0 Multiple❑ System Repair/Alteration BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation insurance should be provided to me. O I am exempt under Section B.& P.C.for this reason 7 Firepl/Fact.Blt. ICBG# _ I Fire Dampers PLAN CHECK $ PERMIT ISSUANCE $ - PLUMBING $ 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 ❑o-100,000 BTU ❑100,000BT ' ELECTRICAL $ �D7 W- GRADING $ information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize repro- PLAN CHECK 50% $ Z(p00 MICROFILM $ Sig at ure of this city to enter IfpOry the above-mentioned Property `for �q0 inspection D ses,- ....0 to C�l'm"1 MECHANICAL $ - TOTAL FEE $ 9 Drivers' Date MW Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ Drivers' License or 55 — 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. 1 54. Forms 4. Electrical Conduit-Undrgrnd. '1 . 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test • 6. Electrical OF ER Grrid. i 57. APPROVAL TO COVER-GUNITE � 7. Fgotings , 58. Electrical Conduit-Undrgrnd. 8. Foundation - 1..:\ 59. Gas Pipe, El Undrgrnd.,Test • 4• 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 8/Receptor-Final 12. Sewer Cap 631 Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrica'I-final 15. Rough Electrical-Conduit 66.,Solar System-Final 16. Rough Electric Wiring 67 .'yencing & Acc9ss 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 t i 22. Ducts, Ventilating 71. Product Piping O Gas 0 Oil t 23. Gas Pipe-Rough & Test 72. Underground Flush ‘._ 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas O Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical ' • 27. Frame and Flashing 76. Dry Standpipe i 28. Lathing & Siding 77. FIXED SYSTEM FINAL ~ • - 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat . FINAL INSPECTION N. • '1 ^, I . 32. Electrical Power Meter-Final 41 FOOD CERTIFICATE ISSUED if.l 33. Final Electric 17 s'317/€8 no/. 2t�dyalet6 For ,ieSryla al, 34. Final Heating& Air Conditioning II( 35. Final Gas Pipe-Test 36. Hood or Canopy '" 3?: Final Factory Fireplace 38. Final Plumbing 1 . 39. Water Service-Final .. 40. Gas Service-Final J , i 41. Solar Domestic-Final ' 42. Backflow Preventer - ' 'N- ` 43. Backflow Irrigation s.,. t • ' N. . ,44. Landscape Irrigation System , ,x,45. Sound Attenuation -. 46.Handicap Regulations 1 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed - 491•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. • / PE M T NO. TRACT NO. LOT NO. UNIT NO. 4324 1/29/88 E6025 TL, • CITY'OF COSTA MESAp CONS/T/RUCC!TION PERRJM,IIT 3'2aaS . Project Address //�2 ,4 rsi�or - //L_- /1 Applicant's Mailing Address � .SYS//‘ 7/!/Or,6.f,- 274 Gam' ,t' TYPE OF CONSTRUCTION - LJ.NEW LI ADD L I ALTERAT1IPM Li REPAIR /4/K39,754-es�i,.i[�i r14 ❑ CONVERSION ❑ DEMOLISH ® OTHER Ad Ain Ler?r / elAr d A.P.# r Zone • Owner's Name p 'J • �Bpone DESCRIPTION OF WORK/USE OF BLDG. (/ Address /7�2 Ak.217r - - S Main Building: Accessory Building: •Arch/Eng. License No. TYPE OF PERMIT El GRADING CI FOUNDATION U STRUCTURAL T Front 0 Address• �^ ( /J ❑.TENANT ❑ ELECTRICAL ❑ PLUMBING L� MECHANICAL B Rear. N Contractor's Name �/lFn.-t v//fcf 5 ,a1+(fhoneit1>�6^/ ❑ OTHER - - . ✓� // // PROJECT DESCRIPTION. SQ.'FT. OCCUPANCY C Right N Address(mailing) �y9/� ©YP-r/c e In r7 Xia K Left G � CONSTRUCTION TYPE VALUATION $ S City License No. 3/5ZONE GRADING CU.YDS. ACRES R LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E hereby affirm that I am licensed.under provisions of Charter 9 (commencing Remarks: rM Planning Notes: Q with section 7000) of Division 3 of the Business and Professions Code, and 'L !F-..�- -f �dt ' - M my license is in full force and effect. O r I License Class // - e, o. ..-/ G PE3/- lot ' , deal. eleaoyof s Signature _fgf, _ �/_ ii -� PLUMBING I FEES . OR KERS'COMPENSATION •ECLARATION Bar Sink Showers ELECTRICAL FEES tereby affirm that I have a certificate of consent to self-insure or a certificate I 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 - . 0 50+ KW 8 Construction Pole Sub. - Certified copy is hereby furnished.cit Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Cooking Unit Meter Oup to 100 amps Date Applicant , EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Clover 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 r for which this permit is issued, I shall not employ any person in any r so as to b some subject to the Drinking Fountains Solar Tank Fan Motors❑O-1 HP 01'14-8 Workers' C era, s'on Laws of Califo - - Date �C 7�rl'/1 Signature V4�//' �q/+��f�T.A ' Floor Drains Swimming Pool w/Spa F.A.U. NOTICE: If,after making this decl ation, you should become subject to the - - _ - Inc.Solar ❑9-15 HP Di 6-15+ Workers' Compensation,provisions of the Labor Code, you must forthwith Floor Sinks , Urinal Fixtures Microwave comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet 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 • Water Heater Outlets Lender's Name ___- _ Range Lender's Address Kitchen Sink Water Service Switches i- , - Sign - , OWNER BUILDER DECLARATION - I hereby affirm that I am exempt from the Contractor's License Law for the 'Lavatories Auto-Wash • following reason (Section 7031.5 Business and Professional Code: Any city or Garbage Disposal Standing Sections county which requires a permit to construct,alter,Improve,demolish or repair •R—Trap Laundry Trays Generator 00-5 KW 05-15 KW Trash Com actor ' any structure, prior to its issuance, also requires the applicant for such permit P 'a file a signed statement that he/she is licensed pursuant to the provisions of -Roof Drains e Contractor's License Law(Chapter 9(commencing with Section 7000) of • _ vision 3 of the Business and Professions Code) or that he/she is exempt ..lerefrom 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 , og.nalty of not more than five hundred dollars ($500). . LI I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 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 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 own DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such Improvements are not intended or offered for Boiler Hood or Type I sale. If, however, the building or improvement is sold within one year of com- Canopy Type I Zoning APPlOved 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). - �I7 0 I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural / Refrig System Application Issued By ' Oat: ,7 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 IN0-100, OBTU ❑10 BTU SUMMARY OF FEES builds or improves thereon, and who contracts for such projects with a con- tractors license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System R it/A tion BUILDING PERMIT $ SMIP ' $ 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 Damp 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 0D100,000 BTU 0100,000 BT ELECTRICAL $ GRADING $ information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize repre- - - PLAN CHECK 50% $ MICROFILM $ sentatives of th�'q'yity to enter upon the above-mentioned property or inspection burpQgJ¢9yyay /yamp qp C� �7,( / Signature�!J(L11..E/k/ %/'(�� pe IS $ i PLAN CHECK 25% •ys CMF 0865-46,rev.10/84 white - Building; Canary - pplicant; Pink -Accounting; Goldenrod - Assessor CONSTRUCTION ANDYPLANNING POOL&SPA APPROVALS Permit # Date Inspector APPROVALS 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 Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE ' 7f Footings 58. Electrical Conduit-Undrgrnd. a }--8:rFoundation f' 59. Gas Pipe, O Undrgrnd.,Test 9.I 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 08. Rough Electrical-T•Bar Ceiling 69. POOL/SPA SYSTEMS ANAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# ' t ::21. Ducts, in Structure' 70. Underground Hydro O 22: Ducts, Ventilating 71. Product Piping 0 Gas O Oil 's 23. Gas Pipe-Rough & Test 72. Underground Flush i 24. Roof Framing ' 73. Undergrnd.Storage Tank O Oas ❑Oil 25. Roof Sheathing 't'' 74. Overhead Hydro ` 1 l 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical �r ' • 27. Frame and Flashings 76. Dry Standpipe ✓(. 28. Lathing& Siding 77. FIXED SYSTEM FINAL^ 29. Insulation 78. FIRE PREV. FINAL • • 1 30. Drywall Nailing HEALTH DEPT.REQUIREMENT t 31. Plaster Brown Coat 79. FINAL INSPECTION t;. , . i- , 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 1' 33. Final Electric Notes: 34. Final Heating & Air Conditioning '?71rre - •_. 35. Final Gas Pipe-Test 36. Hood or Canopy . 37,. Final Factory Fireplace , 'i 38. Final Plumbing / , ; ' .: 39. Water Service-Final • i5- ,. 2 • 40. Gas Service-Final - e' . `, 41. Solar Domestic-Final - ' i 4. r . 42. Backflow Preventer / ' - �, t. 43. Backflow Irrigation V • . , 1 ' , 44. Landscape Irrigation System . >; e'• f t r 45. Sound Attenuation i, ;i - 46. Handicap Regulations ' 47. FINAL STRUCTURE & BUILDING - 48Y Special Requirements Completed i 11 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 7 ' _ 51. CERTIFICATE OF OCCUPANCY No. - _ Date . Applicant to fill in all spaces except those within heavy border lines and.sign all appropriate declarations.• .Z-'7� • - .• GiT• 'OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO. - Project Address 1912 T1 erbrat- uo . CAA RPE3d0030 I I /EO/87 189,90 7L Applicant's Mailing Address 249% ^" es 71 TYPE OF CONSTRUCTION U NEW U ADD *ALTERATION Li REPAIR -wr. sco-IWO eat 1_11'1,'1151 ❑ CONVERSION ❑ DEMOLISH 0,OTHER ill q.p-q(6 // - )47- Q� _ 0 7 \ I Zone �'t / Owner's Name Ws W[ iL honesY�I DESCRIPTION qF WORK/USE OF BLDG. V eftna H'OS s, )47- Address 20$1� Qot tG3f-e1r- St (as4vt. WIest( (JZE(./Et...JAL —rt BLDG., 5. r a D i S Main Building: Accessory Bui4ding: Arch/Eng. jilt _Lavas I dense No. -01 1 TYPE OF PE RMITr�pS' GRADING UNDATION STRUCTURAL E Front G 3 f / \ O Address 5%5I 65)(�t1-nci& �tr Ave. t Ste. ❑ TENANT 16,1 ELECTRICAL k PLUMBING ❑ MECHANICAL B Rear g / r N OB1e4,-..“ &V2-71 ❑ OTHER A Contractor's Name LMer ! Phone O0 C Right / / / N Address(mailing) �$ epCteaJ'kr 94' CpSta- WI"°(- PROJECT DESCRIPTION 50. FT 3 OCCUPANCYMK V G //�� CON STRUCTIONT PE �� VALUATION$ ZDIpup ' $ Left 0 City License No. Q/(� ZONE GI CUT -GAGRADING CU.YDS. ACRES - Ping. P✓1 CI 5t. gReq./ProvidedR LICENSED CONTRACTOR DECLARATION 1 ^ Ref. /-T A J T Parkin E hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: \ r` (LI TEA- �� g la Anipg Notes:, M -Thy 0 / v(Z ALLs CIM with section 7000) of Division 3 of the Business and Professions Code,and ' \ /'' (� (� I -�s--I ,/ 1 T my license is In full force and effect. ` V ��� �_,/) C ZDS -1 - G 2_1IL 4 1 Racibi jVVV'11111122 -E ��(�1/�,{///J/O�J'� License Class License No. `\lam �l I "' �Y/tjyyJ1 F p SPECT K� - S Date Signature PLUMBING 4 C! I, OR AL r1��� 4444, YORKERS'COMPENSATION DECLARATION Bar Sink I Showers ELECTRICAL - - / S hereby affirm that I have a certificate of consent to self+nsure or a certificate - as J6C - of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow PreventerService Sink 3800, Lab. C.) 2- 9 pa Automatic Washer Transformer 0 15-50 KW Policy No. . Company Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+KW 8 Certified copy is hereby furnished. ,!}{{ Certified copy is filed with the city Building Division. I Bathtubs Sewer Connection 10 C I Cooking Unit Meter ❑up to 100 amps J OC Date Applicant EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collector _ Dishwasher Meter Dover 100 amps (This section need not be completed if the permit is for one hundred ($100) or less). I Dishwasher S lar ,AQP I Dryers ❑Gas {Electric Sub Panel �oC I certify that in the performance of the work for which this permit is Issued I ! • shall not employ any person In any manner so as to become subject to the Drinking Fountains So Tank (a Fan Motors 00-1 HP ❑1'h-8 b Workers' Co�p en Lion Laws of California.o Date II '20� '1 Signature P rr1�U Floor•Drains Swi ing Pool w/Spa F.A.U.— Ina Solar 09-15 HP 016-15+ • NOTICE: If,after-making thii declaration,you should become subject to the 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 .f Gas Service / Outlets I Water Cl e QD • Device Boxes Light - I hereby affirm that there is a construction lending agency for the performance _ Pole of the work for Which this permit is issued (Section 3097,Civ. C.) Interceptors I Water Hea r BOG AOutlets Range Lender's Name -- -�s Lender's Address I Kitchen Sink Water Servi p-4°L - Switches Sign OWNER BUILDER DECLARATION ' I hereby affirm that.l 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 Laundry Trays ' Generator 00.5 KW 05-15 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 Drains - 1e Contractor's License Law (Chapter 9(commencing with Section 7000)of fivision 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 — • ganalty of not more than five hundred dollars ($500). - - LJ I, as owner of the property or my employees with wages as their sole Reinspection Fee I $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 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 SERVICER=QUIRE y TS: ���+++ employees, provided that such improvements are not Intended or offered for Boiler Hood or Type I ❑ _ �/ ) ^ _.. sale- If, however, the building or Improvement Is sold within one year of com- Canopy Type II ❑ Zoning Approved By `y���p. fi Date /f-eiC2 pletlon, the owner will have the burden of proving he/She did not build or Im- Duct-Under Ground Building Approved By "� - Date ao ,tyre for the purpose of sale). r/�S� . 1 //meq--. LW I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By AJC 1 ! s' - Date -IC tractorsto 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 0o-100,000 BTU 0100,000 BTU $ MARY OF FE: builds or improves thereon, and who contracts for such projects with a con- /t1 ,yam - • y tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust SystemMultipleSystemBUILDING PERMIT $ / `10•_5t SMIP $ /. 0 0 Rglleration proof of their Worker's Compen5atlon Insurance should be provided to me. PLAN CHECK $ PERMIT ❑ I am exempt under Section rt B.& P.C.for this reason Firepl/Fact.BIt. ICBG# Fir ampers LI- PLUMBING $ ISSUANCE $ —Date J.0 ' 1 Owner fpm M Heating System& Ducting /Registers PLAN CHECK 25% $ ENERGY P.C. $- I herebymacertify that haverread thismapplication all and state that the above ❑0-100,000 BTU ❑700,000 BT ELECTRICAL $ y��V GRADING $ Information Is correct. I agree to comply with all city and county ordinances • .0 and state laws relating to building construction, and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ Inspection fives of this cit to enter upon the above-mentioned propert for Inspection purposes, MECHANICAL $ D Signature 1/I u. ac Date ///�rg7 TOTAL FEE $ ' Drivers' License or SS# ' Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ - 1 CMF 0865-46,rev. 10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor T - dONSTRUCTION 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. - i 53. Steel Reinforcement,i . . 3. Electrical Conduit Utility-Undrgrnd. 54. Forms r: I 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding tI , I--• • 5. Steel Reinforcement', - 2 ' 56. Rough Plumbing & Piessure Test 6. Electrical UFER Grnd 57. APPROVAL TO COVER-GUNITE 7. Footings ' , j . 58. Electrical Conduit-Un`drggnd. 8. Foundation ! 59. Gas Pipe, 0 Undrgrnth Test 9. Water Pipe-Undrgrnd( " 60. Backwash Lines,P-Trip, 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 X i • _ 13. Roof Drains 64. Plumbing System - FinalJ' 14. Rough Plumbing 65. Electrical-Final • -ff, , . 15. Rough Electrical-Conduit 66. Solar System-Final ' 16. Rough Electric Wiring • -Y/,L /" 67. Fencing & Access Approval • 17. Rough Wiring Sign • 68. APPROVED FOR•PLASTERING 18. Rough Electrical-T Bar Ceiling i . , 69. POOL/SPA SYSTEMS FINAL ! , -:? 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT L`1 20. Rough Factory Fireplace APPROVALS Permit#_ _ T . 21. Ducts, in Structure 70. Underground Hydro - 22. Ducts, Ventilating .7 71. Product Piping 0Gas 0Oil.) 1 23. Gas Pipe-Rough & Test 72. Underground Flush I. ; 24. Roof Framing -. 73. Undergrnd.Storage Tank 0 Gas 0 Oil - ' 25. Roof Sheathing - -• ; ..74. Overhead Hydro y 26. T-Bar Ceiling (Structural) & Monocoat 75.ddry Chemical - 27. Frame and Flashing - - 76. Dry Standpipe • - - 28. Lathing& Siding 77. FIXED SYSTEM FINAL , 29. Insulation 78. FIRE PREV. FINAL • 2 30. Drywall Nailing HEALTH DEPT. REQUIREMENT - 31. Plaster Brown Coat 79. FINAL INSPECTION . 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED i 33. Final Electric 3-ffe Notes: • 34. Final Heating & Air Conditioning - 35. Final Gas Pipe-Test "- - • - • - ; 36. Hood or Canopy 37. Final Factory Fireplace • ,(� 38. Final Plumbing ,-'/q�/,f`' Y�� 'J' 39. Water Service-Final i i (•40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer - -- 43. Backf low Irrigation - • - ' - _ 44. Landscape Irrigation System " 45. Sound Attenuation 46. Handicap Regulations /' ,_47. FINAL STRUCTURE &.BUILDING /et Or 48. Special Requirements Completed - 49. Electric'Release to Edison I _ - . 50. Gas Release to Southern California Gas Co • 51. CERTIFICATE OF OCCUPANCY - I No. Date 4 - • 31 199 PAIR COSTA MESA BUILDING-SAFETY DEPARTMENT DEC 26-690—EA-CO 992 ***=30.00 P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely RECEIVFD BY DATE RECEIVED DATE ISSUED ADDRESS/1/ v/4jK46 - ilea./• lm . - ,/on-) . 42-0,74-6%� 1a fl-6 ADDRESS/` /J PERMIT 8 OWNER r lrk'Q Ii.. C A.P.NO//� ✓4�"D I T MAIL2¢¢�I p J� /7 BUILDING do _ // V Z ADDRESS 3% / CO '`i/v IPV/ 0/7 / ADDRESS /� �1 Z Q CITY /5evV tj �1 //� e /NOLU zu L 4,47 TRACT���( LOT BLOCK •/CY ( TTT 2C' O NEW ADD ALTER (REPAIR MOVINf: DEMf111SH --No- op LENDER QW14 C `^ /X/\ J In BRANCH �� O72Lt S / �. \ J N CO -I �/O�W-(N�E-IRA�.u�(G',� �/Lf/r^/_-- /f]/�'/E7U// ‘W- -I s.�t� Q-CO ARCHITECT W ARCHESS ) TEL.$ To ; `� U'SY �f"LC-fI.�- /U/I'/ ' A S� vl�YIftst �� UN OR ENGINEER. �f /• WA-nous`n1 NO/.��//�_A/ FIRE dW ADDRESS / J� AL / J 7' I l f I'Y/' f ZONE—‘,...7 TYPE_ GROUP?�/" ✓�/ L APPROVED ♦T DATE ` �(! . , J O CONTRACTOR `W//�e r BY coZ J Q ADDRESS • W W TEL Z/979 NO.OF USE OF NEW 0= CITY NO. ( j , PLANS BUILDING ZF W-O STATE CITY YARDS APPROVED YARDS APPROVED fn CC LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING DO (FROM C TREET)— SIZE I NO.OF BLOCS. >/;C` (p eyfnzvi OF LOT NOW ON LOT FRONT T. FT. USE OF EXISTING BLDG. R SIDE 464 ET. FT. • I- SIZE OF / C 1 NO.OF Z NEW BLDG. V�S L— ROOMS /yST(/O��RIES L SIDE /OA FT, FT. ✓ EXTERIOR WALL4100 J I ROOF COVERING -t / O ,� REAR l(/ FT. — FT. COVERING N J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& 1MAIN BLOCS. ACCESS. BLDGS. a VAR.# DATE .1ER/�� � , C��/oQ � C.U.P.# APPROVED VED I- � ROVED4tf/) ATOe�nFX7.004, P 'HATE �o2 --X41 Z S .j . U I hereby acknowledge that I have read this application and state ✓ that the above Information is correct and agree to comply with tr all laws regulating building construction, and I shell not employ i_ any person in violation of the workman's compensation laws of y the State of California. 25-819 ? I hereby certify that I am properly licensed as a contractor under SD. FT. o the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: CC am exempt from he provisions of the State of California Business VALUATION and Professions de, Division 3,Cha ter 9. co �� 9PERMIT FEE $ .20 Signature of L }�j //)I oU D Permittee / / / ��G``Q_ $ L0OO PLAN CHECK $ Al er E OV 16LL - Authorized Agent TOTAL FEE $ O _,► 29402NAV 22-68u- 5°7001078 F.4*****5.0C COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 - APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely t� /� RECEIVED BY DATE RECEIVED DAT SU ADDRESS /9/ 7. fm a. 131.V.O / q 7 �✓p��� 02 q 4 , lefwritn1CL est C3c ri4C- A.P. NO. /is` ,n4— P..Lterr yQ/ OWNER J v�� /// MAIL C BUILDING /'/ot S/ / Z . ADDRESS S R PA E. ADDRESS G A.,_-.30,_ 4 d U CITY G6$ frA r•z ESA NOL6f 2-317 7 TRACT f/M I LOT 4-i BLOCK Z I !!! Z < CONSTRUCTION NONE`^' NEW ADD ALTER REPAIR MOVING DFMOI ISH 0-CO 03 �Y 'V L� Y ✓/ J 0 BRANCH tt� _ De JN OWNER L` Der/co J ADDRESS /J VALUE CO• ARCHITECT TEL. USE C�'s'1'LMVDA IiIO $ J'a OR ENGINEER NO. N y/ Z Q FINE T PE " GROUP 7.-.--- y U FIRE s Lu Ir ADDRESS '/J o_ Ly APPROVED / ///� //12_ (/J • W Z CONTRACTOR 0 W N E � BY /J DATE �0 J Q ' - m ^ J Q ADDRESS �R /N E r- W w TEL. ZONE > NO.OF ,, USE OF NEW • 0= CITY NO. _ C` PLANS (/ BUILDING do 41- ZH W STATE CITY YARDS APPROVED YARDS APPROVED j O LIC. NO. LIC.NO. MAIN BUILDING ICCESSORY BUILDING SIZE NO.OF BLDGS. (FROM /L STREET) OF LOT NOW ON LOT FRONT 'I g'jri F Gr XI IP FT. USE OF ffiir(r(('J(J(j EXISTING BLDG. R SIDE — FT. FT. I— SIZE OF NO.OF • Z NEW BLDG. ROOMS STORIES L.SIDE FT.EXJ S FT. VEXTERIOR WALL ROOF COVERING COVERING REAR IEio FT. FT. Ja USE�F BUILDING AND WORK TO BE PERFORMED DISTANCE BET.`— BET.MAIN& O_ na t R `) ems' MAIN BLDGS. ACCESS. BLDGS. Q /�� /t,R E O 1 o QCM 1 a VAR.+ DATE 0 �J�7 V ,{� / C.U.P.# APPROVED I— Co rh M.aaC-/R G IJ L D CrW A�ROVE /�9 AP—ELY Si DATE /`o,D—(`Id� p HOLD FOR SPECIAL REQUIREMENTS ~ I hereby acknowledge that I have read this application and state / _ zol �� / � _:JJ that the above information is correct and agree to comply with �'�/^ /Ylfi( rYA+y1 ( -T( cc all laws regulating building construction, and I shall not employ H any person in violation of the workman's compensation laws of a�At0/M.t t//'I, ifj' m the State of California. co (� m Z I hereby certify that I am properly licensed as a contractor under SO.FT. 6 the State of California Business and Professions Code, Dlvision'3, THE AMOUNT SHOWN UNDER VALUATION IS FOR 5 Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: a CC am exempt from the provisions of the State of California Business VALUATION m and Professions Code, Division 3,Chapter 9. PERMIT FEE $ N D Signature of ^ �{+ m Permittee !t(i�w!l_ENGfi yOU 1 LAS �:CN C $ 0� PLAN CHECK $ E 1 `o �-ri �J LL Authorized Agent / / ! GL�'t/j� ` TOTAL FEE $