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Home My WebLink About245 FISCHER AVE - Building PermitsPERMIT TYPE B_MISC APN: 93898027 Zoning: , JOB ADDRESS: 245 A006 FISCHER AV CM Vicinity: UNIT A006 Primary Occ SO. FT: 0 Valuation: PERMIT NUMBER: BX15-00243 STATUS: ISSUED DATE ISSUED: 04/16/2015 ISSUED BY: CK $0.00 Suite/Unit: A006 Const Type: ?? SCOPE OF WORK: INTERIOR TENANT IMPROVEMENT TO REMOVE AND REPLACE EXISTING INTERIOR STAIR, RELOCATE STOREFRONT ENTRY AND GLAZING. NO MECHANICAL, ELECTRICAL, OR PLUMBING WORK TO BE DONE AS PART OF THIS PROJECT, PER APPLICANT. 12/18/2014. ELECTRICAL PLANS APPROVED. 25 FIXTURES. 5 OUTLETS. 20 SWITCHES. REF: BX14-00141, PS14-00352 CHANGE OF CONTRACTOR PAID ON OLD PERMITS NOTE: FINAL APPROVAL OF PERMIT SHALL NOT BE GRANTED UNTIL ACCESS TO DWELLING UNIT(S) IS PROVIDED FOR VERIFICATION OF SMOKE AND CARBON MONOXIDE ALARMS BY THE CITY INSPECTOR. SEE ATTACHMENT W/INSPECTION CARD _ OWNER: MARUSICH, ROBERT B TR UnitMISSION VIEJO, CA City/State: 27031 SANTA SUSANA CIR Zip Code:92691-6235 Phone: APPLICANT: STEVEN FOSTER City/State: Zip Code: Phone: 714-330-2240 CONTRACTOR: STEVEN FOSTER CONST $0.00 License No.398318 Address: 26939 CAMINO DE ESTRELLAUnit: City/State: CAPISTRANO BEACH, CAZip Code: 92624 Phone (949)443-5104 Cell: ARCHITECT: Phone ENGINEER: Phone FEE SUMMARY Building Plan Check: $0.00 Building Permit: $0.00 Electrical Permit: $0.00 SMIP Residential $0.00 SMIP Commercial $0.00 Bldg Std Admin Fund $0.00 Address::MARGARET CLOUGHERTY TRUST License No. License No. Address: Unit: TOTAL FEES $0.00 HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/18/2010 - PER CMMC Sec. 13-279 Monday thru Friday - 7:00 am thru 7:00 pm. Saturdays -9:00 am thru 6:00 pm. Prohibited all hours - Sundays and the following Federal Holidays: New Years Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day and Christmas Day PERMIT TYPE: B_COMBO Sub Type: COM—ALT PERMIT NUMBER: BC15-00509 STATUS: FINALED DATE ISSUED: 08/05/2015 ISSUED BY: BH JOB ADDRESS: 245 C003 FISCHER AV CM Suite/Unit: C003 APN: 93898031 Zoning: Vicinity: Primary Occ: Const Type: V -B SQ. FT: 2400 Valuation: $53,000.00 SCOPE OF WORK: T.I FOR "NEXIO-LAW" TO INCLUDE FIRST FLOOR 1,920 SQ FT T.I AND NEW 480 SQ FT MEZZANINE. ELECTRICAL: 10 FIXTURES. 10 OUTLETS. 5 SWITCHES. NET 300 SQFT ADDITION OWNER: VAKIL IMRAN F & SIDHRA K AVE C3, Unit: Phone: APPLICANT: AARON HAMMINS ST SUITE A-208 Phone: 949-354-3405 CONTRACTOR: OWNER -BUILDER Phone: Cell: ARCHITECT: ENGINEER: SHUCRI YAGHI PHONE: 714-997-9120 COMBINATION PERMIT FEE SUMMARY City/State/Zip: COSTA MESA, CA Unit: : City/State/zZip: COSTA MESA, CA Address: Unit: City/State: License No. Building Plan Check: $108.02 Building Fees: $664.75 Electrical Fees: $51.00 Mechanical Fees: $0.00 Plumbing Fees: $33.30 SMIP Residential: $0.00 SMIP Commercial: $14.84 Bldg Std Admin Fund $3.00 TOTAL FEES: $1,049.91 —Refer to fee receipts for all fees paid for project License No. 000000 Address: 245 FISCHER Address: 1041 W. 18TH ZipCode PHONE: License No.C43205 HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/18/2010 - PER CMMC Sec. 13-279 Monday thru Friday - 7:00 am thru 7:00 pm. Saturdays- 9:00 am thru 6:00 pm. Prohibited all hours - Sundays and the following Federal holidays: New Years Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day and Christmas Day CITY OF COSTA MESA f BUILDING DIVISION F 77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us �•"�� FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER: BX07-00095 PERMIT TYPE B_MISC STATUS: ISSUED DATE ISSUED: 08/28/2007 ISSUED BY: RMD JOB ADDRESS: 245 FISCHER AV CM Suite/.Unit: Vicinity: ROOFTOP PrimaryOcc: Const Type :?? SQ. FT: 0 Valuation: $5,500.00 SCOPE OF WORK: PLASTER AND, LATH TO REPAIR AN (E) PARAPET'ON'THE ROOFTOP OF A COMMERCIAL BUILDING (SOUTHMIEST SIDE) BLDG C. OWNER: ZONTA CLUB OF NEWPORT Address-: HARBOR FOUNDATION Unit COSTA MESA, CA City/State: 245 FISCHER AVE`A #8-C `- Zip Code:, 92626 Phone: APPLICANT: WICKERSON, RICK 'Address:- 201W. CARLETON AVENUE :: Unit: City/State: ORANGE,CA Zip Code: 92867 Phone: 714-865-5945 CONTRACTOR: RICK HAMM CONSTRUCTION; -INC License No. 495184 Address: 201 W.'CARLETON AVENUE Unit: City/State: ORANGE CA Zip Code: 92867 Phone 714 532-0815 Cell: ARCHITECT: License No. " Phone ENGINEER: License No.�,' Phone FEE SUMMARY Building Plan Check: $0.00, Building Permit: '-$125.25= Electrical Permit: $0.00 SMIP Residential $0.00 SMIP Commercial $0.00 $O.00TOTAL FEES $125.25 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. ODE r. INSPECTION TYPE 1616 Fixed System Final Fire Prevention 1266 Pool Spa Final _ 200 Final Re -Roof 201 Final Block/Retaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition DATE INTI_ AL CODER INSPECnON TYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy DATE INTITIAL 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 section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Insurance carrier and policy number are: R ' I-c�) I o f f� tl• 1 1 � ^Game. (This sedan neer) rico �5�e w••pp,,��pMeneth penn4k valuetl at one hVntVetl ibllars (St00)wless) Folic Number: �� nX11ep �'� ❑ 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 California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these provisions. V_ plica "S'ionaWre Date- J s� WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES, LICENSED CONTRACTORS 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. uD..#-' I4 Cli ass a> 7 Contractor's Signature DatJ CONSTRUCTION LENDING AGENCY: EJ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: Signature = .tel Data IE OWNER -BUILDER DECLARATIONS: I hereby affirm that under jienalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW-foic'tlle following reason (Sec. 7031.5, Business and Professions Code: Any Gly 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 civil penalty of not more than five 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 ovmer of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of Completion, the 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 contractus 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 305746(N07) Owner ID verified by driver, se. ❑ Yes ❑ 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: ❑ 1 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, a 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 will 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. Applicant's Signature Division of Industrial Safety Permit Number: _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will 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? ❑ Yes ❑ 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 feet 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? ❑ Yes ❑ No (Section 25533 of the California Health and Safety 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 fling 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? ❑ Yes ❑ 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? ❑ Yes ❑ 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? ❑ 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? ❑ Yes ❑ 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 COMPLIANCE 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 all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. ,Si n - Ovm Dale 2-5,�P_ -a7 `And/.rAuthonzed Appy. (__Date___ . (714) 754-5273 • Fax (714) 754-4856 www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 245 FISCHER AV Suite: A001 Vicinity: Parcel Number: 93898001 Zoning: 07/06/2004 Applicant: SHEPHERD, C J SMIP Com: $2.86 Address: 2750 SIGNAL PARKWAY Inspection: $0.00 - Phone: 562-528-8000 SIGNAL HILL, CA Zip: 90755 Owner: HITTNER, GLENN W Address 245 FISCHER AVE #A-1 , Phone: -. COSTA MESA, CA' Zip: 92626 Contractor: , HAR-BRO INC ' .Address: 2750 SIGNAL PARKWAY Phone: 562-528-8000 BY: Status: ISSUED Applied: 07/06/2004 Issued: 07/06/2004 SIGNAL HILL, CA Zip: 90755 License: 258441 Arch Eng: Address: - - Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT VEHICLE DAMAGE TO STORE FRONT DAMAGE. SCOPE OF WORK TO INCLUDE: REPAIR STOREFRONG, FRAMING, DRYWALL, MISC. ELECTRICAL WORK. I - - I . - - - Plan Check: $154.21 Permit: $237.25 SMIP Res: $0.00 SMIP Com: $2.86 Other: $0.00 Inspection: $0.00 Total: $394.32 SETBACKS MAIN STRUCTURE Front 0-0 ACCESSORY Front 0-0 PARKING Existing: 0 FEE SUMMARY PLANNING & ZONING Rear 0-0 Left 0-0 Rear 0-0 Left 0-0 Required: 0 Proposed: 0 Calc Valuation: $13,600.00 Claim Valuation: $13,600.00 Right 0-0 Right 0-0 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 t"646 (6/00) DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 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 section 3700 of the L•3bor Cade, 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 if the permit Is valued at one hundred dollars ($100) or less.) ❑ 1 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 lawsId eg a that it hould become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with t �- W �, p Applicant Signature Date: WARNING: FAILURE TO SECU WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE (5700,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3106 OF THE LABOR CODE, INTEREST, OND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am license pr isions Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license Is in full force and effect. Lic. 4 Class k Contractor's Signature: Date: fZ CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agen*,Jor the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: Signature: Date: .r OWNER-BUILDER DECLARATIONS: 1 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 civil penalty of not more thAn five 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.). ❑ 1, 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.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Data: Owner ID verified by drivers license. ❑ Yes ❑ No Drivers License No. Expires: Verification of Ownership by (type of document, Le. - 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 will 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: 1 Will 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? ❑ Yes ❑ 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 feet 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? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Cade, 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 ...4..........I.t...e...n....R...epartment. ...............................................................................................................................................................................................................:..................................................................... ............................................................... .MPis presently required, has Section 25534 of the CaliforniaCalifomia Health and Safety Coda been fully complied with? ❑Yes ❑ No ....................................................................................................................ildi.............................................................................................................................................................................................-....co ....difi................ 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication appermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agent/! � Yes LJ 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 pad of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (it "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? ❑ Yes ❑ No .......................................................................................................................ap-l................................11ut................trol..............r)......................................... ............................................................... -.................................................................. 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 COMPLIANCE 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 all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to Occupy or allow occupancy of any building authorized by this permit until final inspection. n lure Legal Owner(s) / _ Date And/Or Authorized Applicant Date CODE N. INSPECTIONTYPE DATE, INTITIAL CODE INSPECTION TYPE 20ku IHSS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 206 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Well 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site ,H 204 Final Demolition 250 Final Building/Occupancy z'i-'ivr'IAS"/' (714) 754-5273 • Fax (714) 754-4856 www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: 245 FISCHER AV Suite No A001 Vicinity: Parcel Nunmber: 93898001 Applicant: SHEPHERD, C J Address: 2750 SIGNAL PARKWAY Phone: 562-528-8000 SIGNAL HILL, CA Zip: 90755 owner: ' HITTNER, GLENN W Address 245 FISCHER AVE #A-1 Phone: COSTA MESA, CA Zip: 92626 CdR>rmS .w/_1Ea.]09112[�1• Address: 2750 SIGNAL PARKWAY Phone: 562-528-8000 SIGNAL HILL, CA Zip: 90755 License: 258441 Status: ISSUED Applied: 07/06/2004 Issued: 07/06/2004 ISSUED BY: SCOPE OF PERMIT VEHICLE DAMAGE TO STORE FRONT DAMAGE: SCOPE OF WORK TO INCLUDE: REPAIR STOREFRONG, FRAMING, DRYWALL, MISC. ELECTRICAL WORK. - .. Quantity ISSUE FEE $23.50 Temp service test $0.00 Res. a/c package $0.00 New Res (1-2 units) $0.00 New Res (3+units) $0.00 Pool / Spa $0.00 Lighting Fixts $0.00 Recept Outlets $0.00 Switches $0.00 Non Res Appl $0.00 Res Appl $0.00 Service to 200a $0.00 Service to 1000a $0.00 Service over 1000a $0.00 Motors to 1 hp $0.00 Motors to 10hp $0.00 Motors to 50hp $0.00 Motors to 100hp $0.00 Motors over 100hp $0.00 Communication drops $0.00 Sub panel to 200a $0.00 FEE SUMMARY Temp Dist System / Lighting Busway /100 It Standing Section Misc Electrical Equipment Transformers up to 1 kva/kw .:..............up to 10 kva/kw .................up to 50 kva/kw .................up to 100 kva/kw ..................over 100 kva/kw Low Voltage Equipment Low Volt Wiring System / Ckt . Misc. Conduit Misc. Conductor Circus ( gen or ride) , Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand Other Electrical Fee Investigation Fee - Plan Check Fee Quantity $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $18.20 1 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 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 244646 (6100) DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereb attiml under penalty of perjury one of the following declarations: ❑ 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 section 3700 of the Labor Code, for the pedomlance of the work for which this permit Is Issued. My workers' compensatlon Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed if the permit Is valued at one hundred dollars ($100) or less.) ❑ 1 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 a gre that it I ould become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with thea Applicant Signature: Date: WARNING: FAILURE TO SECURE ORKERS' PENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND hVIL FINES UP TOONE HUNDRED THOUSAND DOLLARE (5100,0001, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37060E THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: hereby affirm that I am licensed under revisions 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. LIC. 0 Class a Contractors Signature: . r Date: CONSTRUCTION LENDING AGENCY: ❑ 1 hereby attire that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lenders Name: c' Lender's Address: Signature: ""� Date: OWNER-BUILDER DECLARATIONS; _ I hereby affirm that under penalty of perjti�hal 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 civil penalty of,not more than five hundred dollars ($500).): ❑ I, as owner of the property, or mAmployees 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 contractods) license pursuant to the Contractors License Laws.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑ Yes ❑ No Drivers License No. Expires: Verification of Ownership by (type of document, Le. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 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. 32, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner-builder, I will 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: 1 Will 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? ❑ Yes ❑ 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 feet of compressed gas atstandard temperature and pressure). ..........._................................................................................................................................................................................................................................. ......................... .................I.......................................................... 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Ves ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mese 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 theappplicant 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? ❑ Yes ❑ No ............__—_.._.................___.....................____.._......._.................__..._.._......._...._...........___......._.._..__._......................_.._... _... _... _...... _.......... _.._...................... _._._.. 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this a plication aygermil for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes LJ 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 pert of the leciliry to be constructed under this permit be within 1000 teat Iron the outer boundaries of a school? ❑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 applicatlon, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ 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 COMPLIANCE AND AUTHORIZATION OF ENTRY: I cenity under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection, Date � Sign ure Of L al Owners) AndtOr Authorized Applicant Date CODE/. INSPECTION TYPE (ZB INTMAlS CODES INSPECTION TYPE ILLS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical q ZR-BY 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 City of Costa Mesa Development Services Department Building Safety Division CERTIFICATE OF OCCUPANCY No. P. O. Box 1200 Costa Mesa, California v /� The Building located at 01313 Fisch?X Ave. Unit A-1. has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group B-2 Occupancy. Use of Building OffiCiV. Legal Description 427-033-07. (See reverse side for Metes and Bounds) Building Permit NoB-8099 electrical Permit No.R-9017 Plumbing Permit Noy—p7nn Mechanical Permit No. M—A7S1 An o7pn Number of apartments ISSUED TO: Building 01 E= PU ] i M. by=/ 1517 N. Fairview, Santa Ana, CA, Date J Zi This Certificate of Occupancy SHALL BE posted in a conspicuous place on the p 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 and/or guest rooms 0 and SHALL NOT BE removed except by the COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely —Use Ink Only MAA BUILDING INN GG eI ADDRESS G H OWNER OR TENANT ULL r� , - 1 Es ADDRESS Iry l`] {�], P&412V1EW CONSTRUCTION LENDER BRANCH ADDRESS ARCHITECT 1 A & Ate.... L s. rt- _ TELy. . o_A, USE OF 4 EXISTING BLDG. FSeparate permits are required for G electric, plumbing and heating work. (w. USE OF BUILDING AND WORK TO BE PERFORh Q 1 _ > w Iz w APPLICATION FOR STRUCTURAL PERMIT RECEI V EAY A.P. NO .Z U BUILDING ADDRESS24,15 UNIT OR �.: _ U[ COSTA Illtv.^I SPACE NO. TR NO LOT - &f e> BILK. NEW -1 ADD 1ALTER IREPAIR IMOVINGIDEMOLISH I n /VALUE USE p ��, CoTS j fw.aJ C.oA.rNo S. $ Em 1 :rl,09 _!� 1 APPROVED PLANNING ACTION FOR 0 1 hereby acknowledge that I have read this application and stat.' 1 1:11 that the above Information is correct and agree to comply with 6. 0 all laws reguiatir;g building construction, and I shall not employ j I a Z[and CONTRACTOR (fJ Nej C.. .1VI L' G L - wate of California. .ADDRESS _ �/ 3y TEL. SO. FT. •/ ^— N CITY NO. F STATE CITY THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: LIC. NO. LIC. NO. w SIZE NO OF BLDGS. w sL OF LOT OF PERMIT FEE S %—�ure NOW ON LOT A- USE OF 4 EXISTING BLDG. FSeparate permits are required for G electric, plumbing and heating work. (w. USE OF BUILDING AND WORK TO BE PERFORh Q 1 _ > w Iz w APPLICATION FOR STRUCTURAL PERMIT RECEI V EAY A.P. NO .Z U BUILDING ADDRESS24,15 UNIT OR �.: _ U[ COSTA Illtv.^I SPACE NO. TR NO LOT - &f e> BILK. NEW -1 ADD 1ALTER IREPAIR IMOVINGIDEMOLISH I n /VALUE USE p ��, CoTS j fw.aJ C.oA.rNo S. $ Em 1 :rl,09 _!� 1 APPROVED PLANNING ACTION FOR 0 1 hereby acknowledge that I have read this application and stat.' 1 1:11 that the above Information is correct and agree to comply with 6. 0 all laws reguiatir;g building construction, and I shall not employ j I a Z[and rson in violation of the workman's compensation laws of a wate of California. _ �/ 3y certify that I am properly licensed as a contractor under SO. FT. •/ ^— N te of California Business and Professions Coda, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m r 9, and that such licenses are In full force and effect, or 1 THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: empt from the provisions of the State of California Business e ofessions Co e, Division 3, Chapter 9. VALUATION PERMIT FEE S %—�ure of ��PLAN CHECK S��c g ytiq LLeerN4 TAX Srized Agent a[e TOTAL PAID $ 9 75'. % 7 F F3 COST MEAILDIIBUILDING-SAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT B COSTA MESACALIFORNIA 9 For Applicant to Fill in Completely — Use Ink Only72�/F/ BUILDING ADDRESS A,ir= RECEIVED PERMIT y F A.P. NO. OWNER OR�^ �I TENANT BUILDING ADDRESS 2 /S e Ave_., UNIT N SPACE NO. -� MAILING ADDRESS'EY7 I r. 1 I GW TR.NO. LOT BLK. r� TEL. CITY �jl._lA NO. 5574- NEW qDD ALTER IREPAIR I MOV INGI DEMOLISH CONSTRUCTION CONSTRUCTION LENDER BRANCH OWNER Q Q r T/C.S ADDRESS/ VALUE / USE G`rU &i X oco/ E (f(7r%�- ARCHITECT TEL.�1 ORE GINEER C_0. ZONE TYPE GROUP - 2 - ADDRESS CONTRACTOR APPROVED APPROVED BY DATE -,?.- ADDRESS TEL. CITY NO. STATE CITY LIC. NO. LIC. NO. APPROVED SETBACKS ' SIZE OF LOT OF BLDGS. NOW ON LOT (FROM C/L ST ET) NT USE OF EXISTING BLDG. Separate permits are required for electric, plumbing and heating work. L SIDE FT REAR FT. USE OF BUILDING ND WORK TOB PERFORMED PLANNING ACTION If %✓�t l O —O� TE APPROVED / APPRO D -- I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all laws regulating building construction, and I shell not employ any person In violation of the workmen's compensation laws of the State of California. I hereby certify that I am properly licensed as a contractor uno" the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are in full force and effect, or 1 am exempt from the provisions of the State of California Business and Professions Code, Division 3, Chapter 9. Signature of Permittee / ` 600 Bier. FT. OC70 •� THE AMOUNT SHOWN UNDER VALUATION IS FOR THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: VALUATION $ /(J/O ��`�" PERMIT FEE E PLAN CHECK E/ . 0 TAX E 2 Or -e Authtlrizad Bent at TOTAL PAID E 6 Z 52 T lv e 7609 6/29/81 560x81 TL COSTA MESA BUILDING -SAFETY DEPARTMENT APPLITION FOR STRUCTURAL PERMIT P.O. BOX 7200 COSTA MESA, CALIFORNIA 92626 N V 3 RECE PERMIT S , Q / L For Applicant to Fill in Completely-- Use Ink Only -� { ' ADDREBUILDiNG ��// A.'p' NO. _ SS TTENANTOWNEROR /�J� /' A/�j�r/�`z`—^ 7/tom✓�✓ ADDRESS /(/.L(-, AMAILINGDDRESS /�/� / �� SPACE NO. TEL. TR. LOT R BILK. v CITY NO. NEW ADD LTERREPAIR MOVING DEMOLISH CONSTRUCTION LENDER BRANCH OWNER ADDRESS ,t' T VALUE ode ARCHITECT TEL. USE 7 �7.../ OR ENGINE R NO._ ZONE � TYPE v'/NQGROUP g_2- ADDRESS /tom/ / �.f� APPROVED CONTRACTOR 't'1/1// 'rte By DATE (P p%/� �j''� ADDRESS/5/ �V/ (! 26 U ' TEL. CITY CITY J• NO. .2 STATE CITY APPROVED SETBACKS LIC. NO. LIC. NO. SIZE NO. OF BLDGS, IF ROM C/L STREET) OF LOT NOW ON LOT ONT FT USE OF EXISTING BLDG. R Sint; Separate permits are required for L SIDE electric, plumbing and heating work. REAR FT. USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION DATE APPROVED APPROVED /Q.TF C1 LL• // I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all laws regulating building construction, and 1 shall not employ any person in violation of the workman's compensation laws of the State of California. I hereby certify that I am properly licensed as a contractor under SQ. FT. the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses ar fuil force antl eft act, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: em exempt from the provisions of i Stam of California Business VALUATION PERMIT FEE E 3 37. and Professi0 Division 3, C ter 9. �Q PLAN CHECK $ �• .Q Signature of Permittee fJ ^If S�X ,[ 0a TAX 5 q, 76 VV VV or L r Authorized Agent Date TOTAL PAID y Sb D. N V 3 a r C_ COSTA MESA BUILDING -SAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT P.O.BOX 1200 COSTA MESA, CALIFORNIA 92626 40 TL RECqeltax PERMIT Srj f LL V For Applicant to Fill in Completely — Use Ink Only BUILDING �[�rj/�� /II"%�/ � A.P. NO. Z ^ J �D ADDRESS A s/'^• OR !J (^ �C �^/J ADDRESS L��•i / 1T✓ AVE-.OWNER TENANT�`� f VC/�' + N UNIT OR �U« SPACE NO. AMAILING DDRESS /tom �./J�__ t CITY �' //i A -"A NO.. TR.N LOT .� BLK. NEW ADD ALTE REPAIR MOVING DEMOLISH CONSTRUCTION LENDER BRANCH s ' ,t Q �rrM �Ju OWNER ( (/�L `�D • ADDRESS VALUE 1.UT ARCHITECT TEL. USE TLT E�2t$Do OR ENGINEERNO- l�♦� �( V-/ff"y S-2 ADDRESS ZONE TYPE GROUP vV BVPROVED DATE 6 ^� Z f7I CONTRACTOR ADDRESS TEL. CITY NO. STATE CITY APPROVED SETBACKS LIC. NO. LIC. NO. SIZE NO. OF BLDGS. (FROM C/L STREET) OF LOT NOW ON LOT RONT T. USE OF EXISTING BLDG. R -SIDE T. Separate permits are required for L. SIDE F1. electric, plumbing and heating work. REAR FT. USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION OrGb %✓"r/ i►� DATE APPROVED ZZK/�/ D APPROVED �f.{.� �c.I 8 I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with ' all laws regulating building construction, and 1 shall not employ any person In violation of the workman's compensation laws of the State of California. I hereby certify that I am properly licensed as a contractor under SQ. FT. the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such license re In full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions f he State of California Business VALUATION PERMIT FEE E and Professions e, Division 4, C apter 9. •--o PLAN CHECK S 6C.{ • O Z Signature of Permftt $ 121 S'oo TAX E 0, 1pg o Authorized Agent Date Z TOTAL PAID E 16 t7 TL Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA - PERMIT O. ' CONSTRUCTION PERMIT 91160110 ., TRACT NO. - LOT NO. BL G. NO. 1 1' TYPE OF CONSTRUCTION " "" - '❑NEw ADD- OALTERATION ' ❑.REPAIR�CONVERSIONI�DEMOLISH 'CI OTHER 1' t ! •'`•�- -5099- 9/02/63 .. 83:8•, _ - - - - - - -ZONING REGULATIONS •Project Address S �!- S cH.C�/t, !Owner- Vf�' �ltOPt?rlaihbde -- •Address _ - - Arch/Eng. f License No. - - - - DE SC RIPTION OF• WORK '') A.P. `d -� -• -"' A)5;r,AiZ-- ( jfr?f Sfrt/%U�'L�yss ,ZONE - - 'P NTG.. REF. pW - TYPEOFPERMIT- - ""1� "' '-" pgOBP EIfiTVNLINE. Imo' - .SETBACK C ST. O�GRADING-- ❑'FOUNDATION ❑STRUCTURAL - - 'SID -VA RD _� J1 "I s'� LE I C -TENANT 0 ELECTRICAL' PLUMBING ❑MECHANICA _, WII HTA RD - ❑ OTHER 11'-" ( R G r i ; REAR YARD(TOPILI PROJECT DESCRIPTION ' _" _ _ _ _ - __ - Z " fPKG. SPACE REO PROVIDED' $Q. FT. �.. _'- _ _ - -_ OCCUPANCY' CONST C_TION TVPE_ 'STREET WIDTH _ 'PARK FEE $ ' p '- - iZONING APPROVED BY—-, - DATE VAL`UATIOCO ae "20NE - n �/ i� - - .SPECIAL CONDITIONS: -- GRADING CU. O5. _+1 ACRE$ t • -. F -. - -. - r- REMARKS: , AUt7 - ,Address- - -- - --- --.•• -COntractol -L{ /nom _- OT, PhonrjSQ•(./ Address AV71 L.u1 C.$AADW LICENSED-CONTRACTOR-DECLARATION _ - '" 1 hereby affirm thLt I am licensed Under provisions of Charter 9 (com• mencing with section 7000) of Division -3 of the .Business and Professions Code, and my license is in full force and effect, License Class 4z. License N -3IIL.B1 y p �{ gnature` ,WORKER .COM ENSATION DECLARATION _ ,I hereby affirm that I have a certificate of Consent to self -Insure ora ,certificate of Workers' Compensation- Insurance,,or. a certifiedl copy.. the- tion 3800, Lab CJ. C PolisenTt - -Z=11-%�%• MAR Ye.ana0 lAl5. Y f -' �e mpany '¢rtlfietl Copy-ISh¢reby furpish¢d-L Artified copy is filed with the city Building Division. eAEMPTION^FROM WORKERS' -COMPENSATION DECLARATION (This section need not be complet etl if the permit is for one hundretl ($100) Lr -less).- ". _ - - i r •IL'.;:•,,' - ,•; _S I certify that in the, performance of the work for which this permit is Iss uetl" I'shall 'not employ any person -1n any ma nne r'so as-to.become subject to the Workers' Compensation Laws of California. •' r _." - •. •-- "- i Date SignatureSO.FT PLUMBING'-,.; :�-"" PLAN CHECK"" -- - - - „'SHOWER$ .. _ 'ELECTRICAL '" "'- `- PLAN CHECK' - - - - "BATHTUBS •'_--.". .- _ _ _ _ -_ ..-_ _ __ ___ qQ FT__ NOTICE: If after making this declaration, you Should become subject to to the Workers' Compensation provisions of the tabor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. I _ _ _ _ __ _ _ ___ ^` - - I- CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the per- formance of the work for which lnls permit is issuetl (Section 3097 anc f t w or TOILETS.-.. 1."� �. -,,URINALS-- - - - -' - - LAVATORIES DOUBLE LAYS-^- -i' --- -- GENERATOR-- -' 0 -1 -KW' -"'1=10-KW - ;TRANSFORMER —i.. :- ; 'I: •a -APPLIANCE-' "-10-50 KW- -50 +�KW - - -- _ KIT. SINKS -- DISHWASHERS - - 's SERVICE SINKS y-li f -- -- • - 1l SUMPS- MOTORS - ---'0-1 HP_T-30 HP' - - - '(IND. SOLAR)_ 10 -50 -HP 50+HP _ ^ Civ. - . .- Lender's Name _ - .- �_y-. FLOOR SINKS' FLOOR -DRAINS' __ FIXTURES- OUTLETS ---SWITCHES .. _ -' -" -'" - -' - "' Lentler's Atltlress DRINKING FOUNTAINS-- ,' ' '- - -- -- - -- -- - GAS TUBE SIGNS''-'--- - - OWNER BUILDER DECLARATION---- - -- -- 1 hereby affirm that I am exempt froro.the Contractor's License Law for '• INTERCEPTO RSx - CLARIFIERS '- -- - " '- - POLE LIGHTS - -- the following -reason (Section 7031;5 -Business antl+Professions-Cotle: Any city or -county- which-requlres a permit to 'construct; alters Improve, tlemolish.or repair -any -structure,-Prior to its issuance, also -re - quires the ap, licent for such permit to file a signed.statemenl that he - SWIMMING POOL - -\ �PTRAP - - - ' - i POLES - METERED -SUB. - - -WATER SERVICE - "''t-ACT.ERATtON' '^ -- - - - - -PANELS - -- -MAIN - -SUB - 7 - -GAS SERVICE- -'"OUTLETS -" I - -,SERVICE -'- - --- - -- AMP istIcensed-pursuant-to the•provisionS of the Contractors.License-Law (Chapter 9 (commencing with Section 7000) of Division 3 of the e- usines5-and•Prolessions Code) or that he is exempt-therefroMLand the - basis basis for the alleged exemption. Any violation of Section 7031.5 by -WATER HEATERS. - -BTU OUTPUT -- - - _ - - - - - - - - SEWER' CONNECTIONS - -- -----f- - ' ------ - --- --- --- - _ a ---:-applicant -fora permit -subject$ the.applicant to a civll..penalty 'eat more than five hundred dollars (S500). -a s'owner-of the property, or'my employees with wages as their sli e•com pen sat ion, will property, the work, and the structure is not as their SOLARTANK-' - --COL'LECTORS- -- t - - - - --- -- -- - - - n Bupiness and an owner ons Code: The or Contractor's for sale. ($Law does Contractor's License Law tloes not apply to an owner of a property and who tloes such work are not who but hi br n employees, through his own employees, prohowe that such Improvements are not intendetl or offered -for sale."If[ however, the 'building or Improvement Is sold within one year of completion, the owner will have the burden of proving he did not -build or improve -for 'the purpose 'of- sale). ❑ I, .as -owner_. of the property, am exclusively "contracting with licensed contractors to construct the project (Section 7044, Business and. Professions -Code: The.Contractor's License Law does not apply.to an owner of properly who builds or improves thereon, andwhocon- tracts from.suth.projects with a_contractor(s) Ilcesned pursuant to- the Contractor's License Law). ❑-I-am exempt under -Section• - B -&-P: C. for "SOLAR PIPING 'SYS- �i "' `---- i-' -- --ISSUE FEE'- --' - - -- -- -- -- -'ISSU E'FEE _-- - -' - I "' - -` --� --- ' - APPLICATION APPROVED—By- �- - - -- DATE - _ ___ _ ryIECHANICAL PLAN CHECK° ' ---- - - -- - -0-1-0-0,060' HEATING SYSTEM0 BTU _ AND DUCTING - - S- ' 100,000,+BTU j _ REFRIGERATION 0-100,000 BTU .SYSTEM._. _ _: 100,000;+ BTU - I - BTU -- ----� - -" - - ( SUMMARY OF F.EES:. , - -;BUILDING- SPE PERMIT E '$MIP, $- -_ PLAN CHECK E 3Z^ 8Z• PERMIT.0 ,; 11 -`PLV MBING ISSUANCE=-$ S_ GRADING.'$' �� `• PLAN CHECK 6 �'- 'ELECTRICAL .$ - $ reason _ _ _ _ _ _ SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE p 11 , -- - - - - 1 - -ISSUE FEE MICROFILMS- PLAN CHECK--$ , TOTAL FEE $ "' +- 'MECHANICAL- E - - - -- - PLAN CHECK=-$ - = - ' -LESS AD- .. •, ,"VANCE PC-'$-" 8Z i _ FINAL FEE $83. - Date Owner 1 hereby certify that 1 have read this application and state that the above informatlon-is correct. I -agree -to comply with all city antl county ordinances and state laws relating to construction, and hereby authorize re presentativ is• City o. ter upon- the above ntur etl property for �-in pec n po Signature ♦ D t ZZf�� Drivers' License or " CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor RM CONSTRUCTION AND PLANNING Date # -�� b APPROVALS Permit D ._ POOL & SPA 'Inspedtor Date .Inspector APPROVALS, Permit # _ _ 1. Temporary Electrical_ Service or Pole _ 43.' Pool & Equipment Location- ocation_ -2. Soil.Pipe-Undrgrn - . _ 44. Steel Reinforcement - - - - 3. Electrical Conduit.Utility-Undrgrn_ _ _ 45: Forms • - . . 4... Electrical Conduit-Undrgrn . 46. Electrical Bonding _ - - -- - - b. Steel em orce_ 47. Rough Plumbing&Pressure Test - - - - - 6. Electrical UFER Grn - 48. APPROVAL TO COVER-GUNITE- - - - - 7 Ffootings,_ 49. Electrical Conduit-Undr rn -8. Foundation 50. -Gas Pi e, [:)•Undr rn, Test 9.... Water. Pipe-Undrgrn. _ 51. Backwash Lines P-Trap.1:1 Undrgirn - 10. ,Structural Floor System- 52. .APPROVAL TO DECK - - - - -- ' 1.1. _ Property Sewer Line & House Connection. " 53. Backwash & Receptor -Final" " 12. Street Sewer Connection - ' ` 54. Heater & Vent -Final 13. --Rough Plumbing ._._ _ _ _ - 55. Plumbong Svstem�: Final - 14. Rough Electric -Conduit - - - - - - - 56. Electrical -Final' 15. Rough Electric -Wiring --- - -- - - 57. 'Solar System -Final - -,- 16. Rough Heating & Air Conditioning= - - encing & Access Approval ' 17. Ducts in -Structure APPROVED FOR PLASTERING' " , - 18. 19. 20. - Ducts; Ventilating Gas Pipe -Rough & Test - ..__._ Roof Framing• ,. ' 60. POOL/SPA'.SYSTEMS FINAL••', 21. 22.- Roof Sheathing-- "_ ' - - Frame and Flashing- -- - - - _ _ --- - -- - - - •'a. ., •i- n� - NOTES: 23. Insulation - - - - - - - - - - 24: Lathing & Siding - - - - - - - - 25. Drywall Nailing- 26r- Plaster Brown Coat = 1 - 27. Electrical Power Meter -Final _ .t _ 1 ' 28. Final Electric -- - -- - - - - - - -- - - •' 29: Final Heating & Air Conditioning _ 30:- Final Gas Pipe -Test 31: Final Plumbing 32: rWater Service-Final-- 33. Gas-Service-Final -- -- -• - _- - - -' i 34.- _- Solar DomesticNFirial ' �' ` �'��' i- _ 35. Landscape Sprinkling S stem 36. Sound Attenuation - 37. Handicap Regulations ••' -- - 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. • CERTIFICATE OF OCCUPANCY No Date Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA- - PERMIT NO. TRACT ILO. SLOT NO. BLDG. NO. CONSTRUCTION PERMIT M - �`7S� Pnlicy No. _ Com any :ertified copy is hereby furnished. n ..REMARKS: ertified copy is filed with the city Building Division. GXEMPTION'FROM WORKERS' COMPENSATION DECLARATION' - - -- - _ - --•-- f---- " (This section need not be completed if the permit Is for one hundred - - 24b ]-ISCner Ave. JLe. A-1 TYPE OF CONSTRUCTION Owner -p. Phone fj -62 TOILETS - URINALS- RINALS-to Ely sNEW LA�1DD El ALTERATION NOTICE: If after making this declaration, you should become subject- Address --1517 N. FairviewSanta Ana ❑ REPAIR ❑ CONVERSION ❑DEMOLISH LAVATORIES - DOUBLE LAYS Arch/Eng. - - - - - - License No. - - ❑ OTHER 1 hereby affirm that there is a construction lending agency for the per- �formance of the work for which this Permit is issued (Section 3097 DESCRIPTION -OF WORK Address- -- - - _. _ .. PLUMBING Contractor - Phone _ TYPE OF. PERMIT--`" -- Address - - - - DRIIVKING,FOUNTA_ INS ''-i- -- ❑ GRADING _ ❑ FOUNDATION ❑ STRUUCCTURAL \ -.❑'TENANT 1:1ELECTR•ICAL ❑PLUMBING UMECHAI 'LICENSED CONTRACTOR DECLARATION._ '. �". WATER HEATERS- — 'BTU'OUTPVT' ' 1 hereby affirm th:.t I am licensed under provisions of Charter 9 (com- Business antl Professions Code) or that he is exempt therefrom and the Business basis for the alleged exemption. Any violation of Section 7031.5 by SEWERCONNECTIONS-- 'mencing with -section 7000) of Division. 3- of- the Business =and ' ❑ OTHER' - 61) Professions Code, !and my license Is in full force and effect. - ( I-__ - __ - Ucense Clapss - � 'ceRy p-- _PROJECT DESCRIPTION--_ i J-" - Signature'" SQ. FT. \Date {WORKERS` COMPENSATION DECLARATION _f7_ ...,_ I OCCUPANCY_ CONSTRUCTION TYPE _ \I hereby affirm that I have a certificate of consent to self -Insure ora VALUATION ZONE ❑ 1 am'exempt under Section' - ' r" 'B)& P:-C7for'this reason certificate of Workers' Compensation- Insurance, -or a -certified .copy _ W Date. Owner !thereof (Se , Lab, C.I. Goodman Ins GRADING'CU. YDS. ACRES Pnlicy No. _ Com any :ertified copy is hereby furnished. n ..REMARKS: ertified copy is filed with the city Building Division. GXEMPTION'FROM WORKERS' COMPENSATION DECLARATION' - - -- - _ - --•-- f---- " (This section need not be completed if the permit Is for one hundred - - wo,,,:�M�F 0865-46 White -Building; Canary-APplicant; Pink -Accounting; Goldenrod -Assessor A.P. ZON �ICHT..'nu REAR YARD (TO PKG. SPACE REQ STREET WIDTH 5085- 9/20/B3 21.OQ TL NTNG REGULATIONS PCNTTGp.. ggR UtE�F.,�. PROPEi RTVNLINE PROVIDED PARK FEES TUNING APPROVED BY 'UAIL - c - SPECIAL CONDITIONS - i lV 'ELECTRICAL -'PLANCHECK: - ! GAR 50. FT. UWLILL.NU_ ,GENERATOR- '0:1 KW 1.10 KW - '- .TRANSFORMER - ,APPLIANCE" 10-50 KW__50+KW - - - —' MOTORS '-04'HP^_�1=30 HID—-^ ,- '(INC. SOLAR)___ to -50 HIP - 50+-HP'I� i ,FIXTURES- OUTLETS- -SWITCHES- GAS TUBE SIGNS -^ - •- - - --- !POLE LIGHTS' - i 'POLES METERED SUB - .PANELS -` MAIN"- - ,SUB - - SERVICE- ---- AMP' I. ISSUE'FEE '- -- -- -- - - - - -' J ,APPLICATION APPROVED BY - DATES .✓ '2 $100) or less). 1 1 certify that in the performance of the work for which this permit is issuetl, I shall not employ any person in any manner so as,t0 become subject to the Workers'. Compensation -Laws of California. _ Date Signature -PLUMBING •-}, �' p;, PLAN CHECK' " .. __ _ 'BATHTUBS _ "SHOWERS - - TOILETS - URINALS- RINALS-to -- - - - - - NOTICE: If after making this declaration, you should become subject- $ tothe Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked._ _ _ 1 -, __ _— _ __ CONSTRUCTION LENDING AGENCY -' LAVATORIES - DOUBLE LAYS KIT. SINKS- DISHWASHERS PERMIT ! -• t •I 1 hereby affirm that there is a construction lending agency for the per- �formance of the work for which this Permit is issued (Section 3097 SERVICE SINKS..- .,'SUMPS '--+r FLOOR SINKS' FLOOR DRAINS-" _ - �- PLUMBING Civ, C:). - - - -'- - Name ,Lender's, _ {Lender's`Adoress - OWNER-BUIL'DER'DECLARATION'--' Iherebyaffirmthat lam exemptfrom(the` Contractor's License' Law for the following reason (Section 7031t5`Business,anci-Professions Code: 'Any city or county which requires a permit to construct, alter, Improve, demolish orrepair any structure, prior to its issuante,-also re- quires the api- icant for such permit to file a signed statement that he Is -licensed pursuant to the -provisions of the Contractor's License Law (Chapter' 9 (commencing with Section 7000) of Division 3. of the - DRIIVKING,FOUNTA_ INS ''-i- -- -- - --CLARIFIERS INTERCEPTORS,�< , -SWIMMING POOL - ""' P -TRAP- `- -"- - , I WATER`SERVICE "ALTERATION-' -"'- GAS -SERVICE- - OUTLETS—- "- ! WATER HEATERS- — 'BTU'OUTPVT' ' Business antl Professions Code) or that he is exempt therefrom and the Business basis for the alleged exemption. Any violation of Section 7031.5 by SEWERCONNECTIONS-- -:V applicant for a permit -subjects the applicant -to -a civil -penalty- ',,,,ot more than five hundred dollars ($500). SOLAR TANK- T „"COLLECTORS"` - SOLAR PIPING SYS $-�,,,j,JCgd��OTAL .as -owner of the'property,'or my employees with wages'aS'thelr' Sole compensation, will do the work, and the structure is not intended or offered -tor sa le.'(SectioF]044,-Business and -Professions -Code: The Contractor's License Law does not_apply . to an owner of a property who builds or improves thereon, and who does such work himself or _ EE --- "' - -- - ISSUE FEE- $ through his own employees, provided that such improvements are not through Intended or offered for sale. If, however, thee -building or improvement- is sold within one year of completion, the owner will have the burden of proving: he did not build or improve' for-th¢'purpose-of'-sale)- !❑-I, as- owner -of the -property, -.am-exclusively contracting witht licensed contractors to construct the Project (Section 7044, Business MECHANICAL PLAN CHECK I HEATING SYSTEM 0-100 ,000 BTU AND DUCTING 100 -- , IO.( 100,000+ BTU and Professions Code: The. Contractor's LicenseLawdoes noapply to REFRIGERATION 0-100,000 STV -SYSTEM - - -- - -- _ 100,000 +BTU an owner of property who builds or improves thereon, and who con- tracts -from such projects with. a-contractor(s). Iicesned-pursuant -to the Contractor's License Law). . , �'�` ❑ 1 am'exempt under Section' - ' r" 'B)& P:-C7for'this reason BOILERS BTU Date. Owner SYSTEM REPAIR, ALTERATION I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE - Information 'is 'correct.'1-agree to connPly With all city -'and' county i) ordinances and state laws relating to construction, and hereby authorize representativesofWis.-city t ter -upon' the -above mentioned Property for ink I -pur o Signature Date -9 -I9 -83 - Drivers' License or SS a¢ -- - ISSUE FEE -- - 3.0 wo,,,:�M�F 0865-46 White -Building; Canary-APplicant; Pink -Accounting; Goldenrod -Assessor A.P. ZON �ICHT..'nu REAR YARD (TO PKG. SPACE REQ STREET WIDTH 5085- 9/20/B3 21.OQ TL NTNG REGULATIONS PCNTTGp.. ggR UtE�F.,�. PROPEi RTVNLINE PROVIDED PARK FEES TUNING APPROVED BY 'UAIL - c - SPECIAL CONDITIONS - i lV 'ELECTRICAL -'PLANCHECK: - ! GAR 50. FT. UWLILL.NU_ ,GENERATOR- '0:1 KW 1.10 KW - '- .TRANSFORMER - ,APPLIANCE" 10-50 KW__50+KW - - - —' MOTORS '-04'HP^_�1=30 HID—-^ ,- '(INC. SOLAR)___ to -50 HIP - 50+-HP'I� i ,FIXTURES- OUTLETS- -SWITCHES- GAS TUBE SIGNS -^ - •- - - --- !POLE LIGHTS' - i 'POLES METERED SUB - .PANELS -` MAIN"- - ,SUB - - SERVICE- ---- AMP' I. ISSUE'FEE '- -- -- -- - - - - -' J ,APPLICATION APPROVED BY - DATES .✓ '2 JUMMHKY Vt; YttJ t Y , I •..SMIP:- - BUILDING -- -- - - - - - PERMIT $ I PLAN CHECK $ PERMIT ! -• t •I - - - - -ISSUANCE- $ - PLUMBING $' 'PLANCFiECK $ - - - GRADING $ 2 ELECTRICAL $ - MICROFILM*$ -� '. PLAN CHECK -$ FEE $LESS MECHANICAL• $-�,,,j,JCgd��OTAL PLAN CHECK_ $ AD' - VANCE'PC --$ - S _' a _, 1 O • FINAL FEE $ CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & SPA _. APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole - 43. 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 em orce 47. Rough Plumbing & Pressure Test - -6. Electrical LIFER Grn _ - 48. APPROVACTO COVER-GUNITE - 7. Footings _ - 49. Electrical Conduit-Undr rn B. Foundation 50., Gas Pipe, ❑ Undr rn, Test 9. Water.Pipe-Undrgrn 51. Backwash Lines P-Trap,❑ndr rn' 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 13. _Rough Plumbing 55- Plumbina System - Final 14. Rough Electric-Conduit `- 56. Electrical-Final '- 15. Rough Electric-Wirin -' -- 57.- Solar System-Final t 16. Rough Heating & Air Conditioning _Fencing & Access Approval 17. Ducts in Structure ' '' - _ "_ _9. APPROVED FOR PLASTERING - ' 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe-Rough & Test - - . - 20: Roof Framing 211 Roof Sheathin NOTES: 22.- Frame and Flashing _ _ 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26: Plaster Brown Coat 27. Electrical Power Meter-Final" - 28. - Final Electric - - 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 SprinklinQ System 36. Sound Attenuation 37. Handicap, Regulations - - 38. FINAL STRUCTURE&BUILDING - 39. Special Requirements Completed _ 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY -No Date AODAMOF6NLOm0: 245 FISCHER AV owNEBSI"ElvaaYDRAIRPORT WEST BUSINESS PAR ADDREs9:245 FISCHER AV COSTA MESA, CA 92626 556-4990 APDL. MINDlG ADDRESS: ARCHITECT OR ENGINEER: ARCH. OR ENG.'S ADDRE53: UC. No.: UNIT: A CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO: B 077541 PLAN CHECK NO: N UNIT. CONTRACTORSNAl P ETRON ELLA ROOFING (714)548-1645 CONTRACMITSMMLDM 2626 NEWPORT ADDRESS:COSTA MESA CA mm, 00460707 92627 uNIT: 201 LICENSED CONTRACTORS DECLARATION: I hereby affirm Yoder piously of perjury Nd I em licmaed under provisos of Chapter 9 ,(commencing with Ramon TOW) of Division 3 of the Business; end Pmlmaiom Cade, And my license is in full face old whites. CrTYLIC. N000032605uC.Cu3S:C 39 uc.NO. 00460707 EXP: 07/96 Doe: . "S __1 q l �o c raaa: OWNER BUILDER DECLARATION: I hmal affirm und r penalty of perjury had I am exempt from the Contractors License Law for IM PERM NO: B 07"1541 GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: OTH SOB DESCRIPTION : T/OFF BUR 6 REROOF W/SAME SQ FT: 27,000 CLAIM VALUE: 27,000.00 CALC—VALUE: 27,000.00 GROUP OCC: B / COMMENTS: REROOF 20000SF COMMERCIAL BUILDING W/BUILT—UP Z 0 N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT:, FT IN LEFT: FT IN RGHT: FT IN fdbwrt, reeson(Beabn)Wts Business end Prd Coda: Any Cly county which Muhm a permit to comwd, after, imprme. PARKING REQ: PROV: PARCEL: 00000000 ZNE: REF NO: demdoh, a repair any structure, prior M ns neuance, requires oho t for such perms to Rb a v9rhad ebtemant that he a she licensed um am to the proverms, d the Commissars License Law (C ler 9 (commeram, with Swum 7(00) d Ovation 3 d iM PLANNING NOTES > riness and Probsscna Cade) a that M a aM is axe pt therahom d the bean for the eloped exemption. My viounim d Section 31.5by.yapplirantlaepermilsubie tlappl'can oaanl ally d not more than love hundred colors r4MI). 1EiElE1F)E iE iE dE iE SE iE iF iE lEiF if iE lE)E iE lE lFiF if -If if if if iF iE lE lEiE lEif 9E lE lEiE SE iE lE lE lE lF iE lEif iE 9E iE lid iF iElE iE lEfEdE 1(-iE iE1E iE 1E 1E lFi(ff 3E SE fE 3E iE 1F IF iE ❑ I, as owner of the prepmy or my employees with wages ..to cora action, will do Ne work, and the almclura n mol intended Code: D E V E L. O P M E N T S E R V I C E S R EU Q _1E I R E M E N T,T S or offered for rola (Section 7060, Business and Professions The Contractors Lineme Lew does not appy to an owner of profprofanitya hereel X' who buids m improves thereon, and who does such work pmsell or or through he or her own employees, provided Nd such f improvements we rot inleMed or offered for seta. ff, however, the Wildm,, or inpmvemam is sok within act year of completion, the ZONING APPROVED"BY DATE : ow en4it ilder will have the burden d pa virq he or she did net build a improve for the urpose of ode). ❑ I, m owner of the property, am exclusively conlradip with Iicemed conumtore to construct the pmject (Section 7004, Business and BUILDING APPROVED BY : DATE Pmfeasions Coda: The Contractors License Law nom mol appy b son owner of Property who Wilds or improv« thereon and who : convince for such Prgecta with a moral licensed pwauenl to the Contractors License Law). / = ❑ Iammemptunder Semon: B.AP.C..for this reason: APPLICATION ISSUED BY: DATE: Data: Ownec - dE dE iE iE jE dE iE SE iE iE dE if sElv'1E fE*1E df 1E it if�F3F3f�fTFiF�f�F'3F3F'iFiF�FiF3F'1F iF3F 3F3f �F;E3F i'F�F3fiE iE 3E lE 1E lE iE if 3E if a iE aE J LEGALIZATION "N F E E S [7 M M A R Y STRUCTURAoL SEGMENT:Y I do hereby ceniy Net I am aware of and understand the requirements of Ceiomb Health and Sal Code Senium 25505. 25533, and 25530, end mat I or any future Wikirq ocarpat will /oil net (nrcb one) need to comply with said dde miles and the requirement, or apemdt«mnsvucoim«moeir elionfranthenr rely anagemam Dmrid.mid«dalcondr Rmappicoiomve mpfmm Nate BLDG PMT PLUMBING 1: ELECTRIC. /MECHANIC FIRE SMIP/RES GRADING amaeons. PERMIT 367 75 i f". i' ' Cuts Applicant: WORKER'S COMPENSATION DECLARATION: I hereby affirm under pertly of perjury ane of the following dectddior: ❑ I have and will mention a cenlcale dismissal to saN-imure for woruma comnematkn, m pwovidetl for by Section 37W of the Lebow Coda, for the mdo.. of the wale for which this permit is issued. ❑ have and oil memaih wonders' ed. My or,e insurance, m required by Section 3]W d Ne Lebo Code, kxtM pedwmuhce d the oak /a xlhkA this permA b mooed. MY wakens Compensatkn insurance mrrbr ere policy numbw ma: canner: 7ARG NAUT EXPIRES Policy Number. 1 5�O 1 54 95 01/01/97 iris section need not ba completed l the perm0 is lar one hundred dollars /SIX/ or local j I cony that in the performance of IM work for which this Permit t, i i a l I shall net employ my person in my manner so m to femme subject to the workers' compmeation levee d Cdifanie, spree thiol ff shook become subject to the wodea' coatp�9\Bion provianns d�aSectJion 37W d the lf,t:�� II fc t iN campy M e provisions. Dole 'V �� \(� - WaminD: F+Dure ro+ecure wodnen'rompsnsetlan b d+Nll dd/eci en +mpoym ro edMowl pmeMu eMcivil flow+ W to one hundred thousand ddbn ($1l/on me coat of con0osow+t ch ple po m provdM for In Sacdon 3706 of me Labor Cod, Interestend emmCONSTRUCTION LENDING AGENCY: I hereby affiy perjury that there is a condruction brdirp agency for the performance d the work Iso which this perms is issued . CI. LENDER'S NAME: LENDER'S ADDRESS: I candy this I have reed this mplicdion end dine final the shove Information is correct. I spree to comply with all city well county adirhehcee and sone burs relating to WiMing construction end hereby authorize apro ntdivee d this city to enter upon the above-mentioned property for irpedion p^urposes. l\ LOID WATTS Dim. 5-_1-9L Whit"uildr, ASddy; GrewFle: Ganery-Appliram; Pink -Revenue; OoldenmakAssesaor „; ' iJ•i SMIP/NON—RES PLAN ISSUE FEE 4— ep 5.67 - BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 373.42 0.00 0.00 373.42 373,42 .00 REVENUE DIVISION TOTALS--> COLLECTED':% 373.42 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 367,75 5.67 dF dE dE RE sE dE dE dE df * * dE RE lb fE dE dE dE dE sE dE * iE fE dE * dE * iE * iE iE dE lE fE,df dE irk * 1E * RE ib s9 * dE ♦E 1E ♦E!E dE AE * 9E 1f k iF df iE dE 3E iE dE * * * dE dE ♦E dE 1E * dE iE iE sE dE dE ie I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST SFC 27000 REROOF BY VALUE COMMERCI/AL NOZONE 1.00 27,000.00 END OF .FEES w CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL A APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Po,e -_ 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 S. Steel Reinforcement '. 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings '" 58. Electrical Concluit.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-- i 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 APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71, Product Piping 0Gas 0Oil 23. Gas Pipe-Rough & Test 72, Underground Flush 24. Roof Framing 25, Roof. Sheathing /ZC/rCl ' 73. Undergrnd.Storage Tank 0Gas 0Oil 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 PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79, FINAL INSPECTION 32, Electrical Power Meter-Final 33. Final Electric 34. Final Heating & Air Conditioning - 80. FOOD CERTIFICATE ISSUED Notes:s'/Q6 N 35. Final Gas Pipe-Test 36. Hood or Canopy; - ,S� 9- 63.W ?� 1 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 'ft/y.6 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Cc 51. CERTIFICATE OF OCCUPANCY No. Date ADDRESSOi BO1LDIN0: 245 FISCHER IAV UNIT, C-1 OANEII'SNAMEIPKNDWN: CLOUGHERTY, MARGARET M ADDRESS: %ROBERT B MARUSCIH 27031 SANTA SUSANA CIR MISSION VIEJO,CA 92691 MR. AWUNO ADDRESS: ARCHITECT OR EIATIHEER: UC. NO.: ARCH. OR ENO.'b ADDRESS: UNIT: CWMACTORSMW DEL MAR HEATING 6 AIR (714)499-2805 CONTRACTORS MAR➢, 15 MONARCH BAY PLAZA AOfism MONARCH BEACH CA uDNo.: 477331 92629 uNIT: 384 LICENSED CONTRACTORS DECLARATION: 1 hereby Nim Under partially of perjury that I wm Streamed under Provision. of Chapter B (commenonO with Section 70001 of Division 3 of the Bowem and Prolasiaru Code. red MY lieenn is In lull Iotm and aNact. CITY UC. NO, 038177 UC. CLASS: C-20 LIC. NO.; 477331 EXP; 00/00 OWNER BUILDER DECLARATION: I hereby alfim+ under "nay d mrjury that I am nempt Iran the Contradon Umma Law for the idkrw'v, mean (Section 7031.5 Iha nm, all prdessloas Code: Any city a county, enrich rectum a pamH to eonstrua, Mer. improye, demd'dh, or tepee am sauckov, prim to V awanm, abo requires Me Applicant for such permit to file a.gnad "whand that he «she cma!rsed N opuuIP e pa , d Ne idorCaprOaA dLimme Lew [Chaphe B (.at&* anth Swam 7000) of Oiyebn 3 d the Area and professions Code) or IM be or Aro b azempl nhreham and the beds for to Metnd Wamqun. Any vNation of SediOn at.S by arty aMApa t for a perms subpW Ihe apprcam to a me pemAy of nor more Ther fere hundred do. )SSOOD. ❑ I. n oaer of the papal or my waploaea web wapn as their Ade oompamatnn, wM do the work, end Me armvwe b not intendnd or Mere! for cab (Section 701,1. Busirwsa and Pmimsiom Cab: The Conlredars Lioena Lew does not apply to en bean« of property whe panda or wpova Thereon, ern wfio does each work himself or herself or tlrouph h0 or her own employes. provided! That such improve nem are M indended or offered for see. 1. howwer, the buildW or inpoament is went within one year Of completion. Ne owrw.bdker wit hem The burden of pram, he or she did not bud or impoya for The purpMa, of ew). ❑ I. n carer of the property ro1peMam ndmivdy oarirV cosh tamed Corarwaas w [ma W the pr i d (Section 70M. &wines, all pmlaadons Code: The DWradOre tserue Vw dose ata appy to en owner of popany arm bride or ioprwm thereon and who [untrecN he suM propria yah a corprmoNal licamed pu luso to the Contractors Lioness Lew). ❑ 1 am enmpi under Section: B. 8 P.C., for this remora Date: I do hereby [Wdy that I ern ea.. of end undenbrd Ire naamnante of CeNomia 11eeDh and Slay Code Seotipm 25505. ,5533. ell p553a, end that I or any Mute WIMN ocwpam wit I" r,t (Arcs ore) road a campy wih elect dale cotes And the readnmerus for e armH forosrwouctionamndifimlianhom the Ai v Y erapement Cannot. Reeidenlidoongrudion wPloetionswe ezampinm lMee Date: Applicant: WORKER'S COMPENSATION DECLARATION: I hereby elEvm under PaaDy of Partwy ane of Ne NtowinO dawr V WA: ❑ I hese, end coil whwn ama d IM wa as am d carat to eMimaa iss workers' commmatlon, m provided la by 6ermrr 370o d the leba Code, lathe pacamork for wNch this pennN is iaund. TI I have and MI meinten workers' mmParualon imuranm. m tauired by Sectbn 3700 of Ne labor Cade, W the pedamvwe d am ]� work la xlridr Nie Pam! b bared. kite' wake+,' mmpamaten imurarrpa cerci« end pury comber era: Cener:FUND EXPIRES Policy Namba: 9 ST R 7 — 01/01/97 ata wrction need Mor per compered a rhe P«me or Abr are hoothad ddlva )Sto01 or leu.) J I cart%% that in the pedormerrca d the, want Ip which Ne perms ie ®rind, I shill ml employ coy paean in any mnmr a n to modynee saffpct to the atelvel' compenea✓+n in" of CUEani/etaatW at/me Net ! 1 aheuM o rY own Code ' Dole: / O' sV •d ( G70o d the Apps t: l //0 Al Wame,: Fa Run At .ecus w«ken' corzpematlan wwrape is un4wNl, and shall aubpcran aro,I oyer to pars . pPwaltle. all Sect Dm. W awe hundred tMuurd dollen (lnneve f lo aW/tlon ro Ns ems of rompamefbn, Wmspu m provMM for In Section 37(16 0l chis Labor COW, /nferul, and allomeY a Iwe. CONSTRUCTION LENDING AGENCY: I hereby affirmnd uw penalty y portio%mdion that there is a cormTending cowry for fa to perforan. of the work for which Ibis perms is bared Boom 3097. Cb. C). LENDER'S NAME: LENDER'S ADDRESS: I Comity That I have read Nb wpicatico earl Ane Ihd the above inlamatbn ie coned. I cam to [apply with M dry and county o dinwrme and wane ba reWn9 to butch, construction all hereby authorize noweenlaliVe, of this dry.enter upon the M MwaionM Iaop«ty for impaction arpmm. WALTER M KI Pnn 1 am Signature of OvmeHApa A hrContrecta (5151-46.WP) Win!"uildv, 8 Sd«y: Gran-Flle; Cam,%- ppimm; Pink -Revenue; Gddenrod-Aeaap CITY OF COSTA MESA — BUILDING PERMIT PERM NO: M 078386 PERMIT NO: M 078386 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: MEC PURPOSE: ADD JOB DESCRIPTION CHANGE OUT A/C UNIT 6 TON SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: B / COMMENTS: CHANGE OUT EXISTING ROOF MOUNTED A/C UNIT �uE+r�EiE�E�r*�E� �E+H�rurSe�Ex+E��E�H+E*�E��Hx��E��xiE�Eit�E�HRr*�E��E��Ex��*+E SE�E+t�E�EiE�r�E�Hx **ur+r�E�E�r�x�E�H�E*iE�k�H�E Z 0 N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 42729206 ZNE: REF NO: PLANNING NOTES> eE♦E*1ElE♦E iE 1E*******SE*iE*♦f♦E**♦E♦E♦Ek*1f 1E if 1F eE 1E 161E*eE**eE***eE*1E 161E if 1f iF 1E 1E 1f*1E*1f*1E♦E♦E 161E 9E eE1E1E 1E 1E ♦E ♦E *iE eE of lE iE D E V E L O P M E N T S E R/V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY APPLICATION ISSUED BY *1E 1E 1E 1E 1E 9E 1E*41E 1E*1Ek ♦E *♦E 1E 1E ♦E LEGALIZATION:N F E E S U M M A R Y BLDG PMT PLUMBING ELECTRIC MECHANIC PERMIT 25.50 25% PLAN IN ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTALS ---- > 25.50 22.00 0.00 REVENUE DIVISION TOTALS--> COLLECTED: BLDG PMT PLUMBING ELECTRIC MECHANIC 47.50 22.00 STRUCTURAL SEGMENT:N FIRE SMIP/RES GRADING SMIP/NON—RES TOTAL PAID DUE 47.50 47.50 ,00 47.50 OVER/SHORT: 00 FIRE SMIP/TOT GRADING PLAN—CHECK * M ♦E 1E * ♦f ♦F 1E elf 1E iE of * iF elf 1E elf 1f lE elf * iE lE 1i lE1E ♦E 9E elf 1E ♦E ♦F * * 1E 1E iE ♦E ♦E elf 1E 1E 1E ♦E 41E * * 1f elf lE if 9E if 9E iE * * 1E * * 1E * * iE * ♦E 1E elf * 1E 1E 1E 1E * 9E iF iF iE I N D I V I D U A L. F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST MEC 1 REPAIR/ALT COOLING UNIT/SYS W/CNTLS 12.25 12.25 MEC 1 REFRIGERATION SYSTEMS <= 100 K BTU/H 13.25 13.25 END OF FEES h CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL A APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd, 53. Steel Reinforcement t -34 Electrical Conduh Utility-Undrgrnd, 54. Forms - :4: Electrical Conduit-Unprgrnd. 55. Electrical Bonding - 51 Steel Reinforcertieetx 56. Rough Plumbing & Pressure Test _ Electrical UFE 57. APPROVAL TO COVER-GUNITE `- 7; :Footings 58. Electrical CondulpUndrgrnd. 8: Foundation = - 59. Gas Pipe, 0 UnOnd., Test r :.9;_Nrater Pipe-Undrgrnd. .. 60. Backwash Lines, -P -Trap, C1 Undrgrnd. 10. Structural Floor'System 61. APPROVAL TO.OECK 11. Property Sewer House`Connection 62, Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final s 13. Roof Drains _, - 64. Plumbing System - Final 14. Rough Plumbing -. 65. Electrical -Final - 15. Rough Electrical:Cohduit 66. Solar System-FiQal. 16. Rough Electric Wiring„-,, _ 67. Fencing & Accen Approval 17. Rough Wiring Sign -- 68. APPROVED FGR PLASTERING 18. Rough Electrical T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air. Conditioning _ * r ',�,• a, _ �• FI-REr•D.,_ T. REQUIREMENT "APPF{pVAlS- Permit#� 20. Fbu h Factor Fireplace •S`! 21. Bucts,in-Structure'^ •• -'` - ^ ^"' 1-:70. 70. Under round Hydro g t 22. Ducts; Ventilating e - ti ; �,; 77, Product- Piping _0 _Gas boil 23. Gas Ripe -Rough & Test r ,. ": 72. Underground FlusR 24. Roof Framin9 ' -'.. _ r _ • '� +�-•_• 73: Undergrrid. StoraW, Tank. 0 Gas 00il 25. Root Sheathing - v+, r .� -.> 74: Overhead Hydro_ _ r 26. T-Bal,Ceiling (Structtral) & Monocoat x .- cr75�- Dry Chemical , - J - r 27. Frame and Flashing -+ •- !: :�• t 76. Dry Stand'oilbe7. 28. Lathing &Siding Z- J i ' 77-r FIXED SV$TEM.FINAL -- 29. Insulation 7 =FIRE PREY. FINAL 30. Drywall NailingAE-A LT14DEPT. REQUIREMENT 31. Plaster Brown(Coat 7 a' 79. FINAL INSPECTION ,_ 32. Electrical.Power M te,}'Figal.x` a 80.: FOOD CERTIFICATE ISSUEDo. - 33. Fjnal Electric- r34. �:inaCNe iingo Ai� Condttioning- 35. Final Gas PipelTest= .. ; c -. •x - - 36. Hood•or Canopy " " C - y37. Fnal.Factory Firep_7ace r ,a _38. Final Plumbing 39. Watei Service -Final_ -40. Gas Service -Final -41. Solar Domestic -Final - 42. Backflow Preventer +' Y ..1-. h.. 4 43. Backflow Irrigation ;; t_ ' "' -• - 44. Landscape" IrrigationSystem ^ •T"- " "' C r r, v - - �. 45. Sound Attenuation - ' . - -• 46. Handicap Regulations c - - 47. FINAL STRUCTURE & BUILDING- ta 48. F1NA1 PLANNING 49. Electric Release to Edison 50. Gas Release to Southern CaliforniaGas Cio _ 51. CERTIFICATE OF OCCUPANCY No. Date ADDRESS OF BUILDING:.245 FISCHER AV OWNERS NAME IF 11114( : LOUGHERTY, MARGARET M AGDBEss 8ROBERT B MARUSCIH 27031 SANTA SUSANA CIR MISSION VIEJO,CA 92691 ADPL. MAILNG ADORES - ARCHITECT OR ENGINEER ARCH OR ENQ'S ADOREsS: uc NO.: UNIT: C-3 UNIT: COMNACTOWSNAIIE: DEL MAR HEATING 6 AIR (714)499-2805 CONTIACTOWSMMUNG 15 MONARCH BAY PLAZA AooREss MONARCH BEACH CA mw.: 477331 92629 UNIT: 384 LICENSED CONTRACTORS DECLARATION: I hereby Mrm order penally of perjury that I am licensed under Womiti r of Chapter 9 (mmmenap with Section 7000) of Dbisb 3 of the Busir a and Pmteasbm Code, and my license bin lull McSebOidi. CITY LIC. NO, 038/ n 1�77 uc/.cuss: C-20 uC/ryp 47 33/7IE /00 Dae: �� ? y} , ] iO Comredor: OWNER BUILDER DECLARATION: I hereby affirm under PerW y of prjmy Ira I am ezempt fir n the Comma. Limme law to the ldbmp recon (Sedim 7031.5 Bhnrros. and Pwfaeiom Code: Arty city a county which repu4aa a puma to mnalmd, Mer, improve, demd'eh, or repair any structure, prior to to bauerrm, abo hicuiree IM mplimnt for such Famh to fib a signed ew&hmm that he or aha 'bared purwat to the provisions d the Commaro s Li mm few jChaper 9 (opnmenap with Section 7o W) of DMbion 3 of the 'new and Prdear. Cods) or that the or are b exempt therefrom and the berm for as albped aaraption. Amy violmion of Sec in .1.5 by err, appEmw for a permit armpda the epPliuN to a Civil Perby of M mea Iha We thumbed do0ara )5500)). ❑ I,wowmr d the property or my emppmes with wepea w ther.Dle mmpuhtohon. will do the work, ad Me seudum b am Werdad unpmvarnreda are M warmed a offered to vale. a. hPmmu,. IM buff, or inpoanant Is sold withhh ton Year d opnpbtion. Me a..f,ul der ON have IM Wrdaa d ppaq he or sha did nct build or i npro m for the propose of tout). I, w owner of the Property. em exduahoty mntrMbg with licensed mnlredan to mnetwd IM project (Sedron 7014. Batm.. aha Pi,u, tom Coda: TM Contmdon Limn. Lew does tot apply b an Curer of pommy who Wilda or improve the. and who contracts for such pnojeds with a oantrador(s) Iben.ad Wwtum to the Contractpre Lioerue Lew). I an aempt um. Section: B. A P.C., for this moron: Data: I do thereby caddy that I am aware of and mdwelend tbe mcukemenb of Caf9mhi. Neabh and safety Code Sedi,m 25505.25533. ad 2553e, and that 1 or arty Mum Wilding codtprom will I Oil not (arcb aw) need to canpy with sad dee codes and the recuiremerw for e pem it for conswabn a modi&wion ran the A'v�0ue tTi yI�toapemeM gdrid. Rseitlemiacondtudbn eppirabneam wsmpt Irom 1Mee prov None. Dae: Applimm: WORKER'S COMPENSATION DECLARATION: I he" affim udu penallyd perjay err of the Idlowip dedaelbn.: I have end OB mafmab a ced'drele of convent to aaBwrure for wokam' mmpemaipn, as provided far by Section 3700 of the Labor Code. fa IM Iledpmance d the work for which the permb b Iwhad. 1 lum a f W mafmab eodham' mmpemation imureme,. mgdmd by Swbn 3700 of the Labor Code, ror the pdam.nae of IM wok la which Mie permit b wsmd. MY waken' compasalbn imurapa wrier end po0ry number ere: Carrier; STATE FUND EXPIRES Pony Number 01/01/97 is vection need tot be rompfered I Me part b M ens huMrM dMen (4100/ a Am.l LJ mdly titer in tM podamerra d tM work Ip which This Permit ut iauad, I shell vert empty ay mrem n>•lnletm a to me becowbjed to IM waken' comparear on laws d fpnut. end Calierne chat N I should berme ubjq to IM A torp/ayiaorh provbbm d Seth o 37W d the Leber Cods, I shall nhwhh m with Mo. 'ons. Dae: V � yy . h — Applicenh: W.m/n$: Falun 0 aacum wo&ws'ro mm,dadon rovarpm Is unutwM, -d hall atbHct en am d-Yor M todrNm .naMu aha 1helf Ona up to oto hatdmof thou u rat Acle. ($104000X, In eddidbn M M. put of roltpMNIPM1 d raper. a p,a ddad ler In S.H. 3706 of fM Lebo, Code, Ire est. era aft ,My'a rata. +� CONSTRUCTION LENDING AGENCY: I herby affim under PMd mmrmtudn ut My rPay that then he e iordirp agency ler the Md.. d the wok to Ouch M Ipaint b owed (Seam 3087, Cl'. C). LENDER'S NAME LENDER'S ADDRESS: 1 caddy that I haw red Mb Application ad date Ihed the above idameiion is coned. I pass to comply with M ray a l county artluhame ad ewe Ian Maiq to buildkp canmwiph aha hereby autharca mpraaewativa of this city W ewer upon the abosmewbnad popsy for irpeaicn Wrporoe. �W�ALTER MARETZ ,M 1DCare:m NenK L Signature of er/AgenUAppican mr a (51514 wp) Whms BuAdip A Safety; Or.a-File; Cemry-Appfum; Pink -Reamer Goldenrod-Aaav CITY OF COSTA MESA — BUILDING PERMIT ERM NO: M 078387 PERMIT NO: M 078387 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: MEC PURPOSE: ADD JOB DESCRIPTION : CHANGE OUT A/C UNIT 2 TON SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: B / COMMENTS: CHANGE OUT EXISTING ROOF MOUNTED A/C UNIT Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RIGHT: FT IN PARKING REQ: PROV: PARCEL: 42729206 ZNE: REF NO: PLANNING NOTES> > jY dE♦fiE*RE dEdE iE*iE irk**BE 9E**kE 9E iE***if iE lE dE dF iE*iE****iF*Bk iE kF*dE irk 9E*****iF irkrt SE iE 9E*kE NE**iE N'BE 1E iE**4*iE iE BE'N'***iE*iE D E V E L O P M E N T S E RV I C E S R E Q U I R E M E N T S +n ZONING APPROVED BY DATE: BUILDING APPROVED BY DATE: APPLICATION PPLICATIONk 9E ISSUED B*;E3f�F��FSF'�F3F'i�� F�F7F'i�TFiF� LEGALIZATION:N F E E S U M M A R Y BLDG PMT PLUMBING ELECTRIC MECHANIC PERMIT 25.50 25Y PLAN ISSUE FEE (h 22.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTALS ---- > 25.50 22.00 0.00 REVENUE DIVISION TOTALS--> COLLECTED: 4 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE 47.50 I STRUCTURAL SEGMENT:N FIRE SMIP/RES GRADING SMIP/NON—RES TOTAL PAID DUE 47.50 47.50 .00 7.50 OVER/SHORT: .00 SMIP/TOT GRADING PLAN—CHECK 'lE***fE*iE*MiE SE iE*******iE*SE*dEM***dF kk 9f SE 9E 1E 9f*♦ESE**dF dE*if**iE 9E 1E iF 1E♦E 1E SE*BE kE**SE 9E iEiE**IE dE BE BE 9E *lE Sk iE iEk*1E iE I N D I V I D U A L, F E E B R E A K D O W N TYPE QTY D E S C R I P T I O"N UNIT COST TOTAL COST MEC 1 REPAIR/ALT COOLING "'UNIT/SYS W/CNTLS 12.25 12.25 MEC 1 REFRIGERATION SYSTEM <= 100 K BTU/H 13.25 13.25 END OF FEES CONSTRUCTION AND PLANNING POOL 'A `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 Condutt Ufility-Undrgrnd. 54. Forms �_:4.E,lectrical Conduit-Undrgrnd. 55. Electrical Bonding - 5: Stee! Reinforcement:' 56. Rough Plumbing & Pressure Test �6. Elggtrical UFERiGp'd. 57. APPROVAL TO COVER-GUNITE % 7�,0`ootings - t 58. Electrical Conduit-Undrgrnd. :- <8-:- Koundation - rt 59. Gas Pipe, O U0 grnd., Test t;g.�Water Pipe-Undrgrnd. -• 60. Backwash Linesr B -Trap, 0 Undrgrnd. -_0. Structural Floor�system 61. APPROVAL TQ;@ECK ' ,1-1. Property Sewer'LipgII& HouseConnection, 62. Backwash & Receptor -Find ' 12. Sewer Cap - 63. Heater & Vent -Final 13. Roof Drains 64, Plumbing System - Final - 14. Rough Plumbing-, T. 65. Electrical -Final t - 15. Rough Electrical=Conduit 66. Solar System -Final ' 16. Rough Electric LViring 67. Fencing & Acce'sg:Approyal - 17. Rough Wiring Sign 68. APPROVED F€,49 PLASTERING 18, Rough Electrica.l;T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating &Air Conditioning Fi_RE;DEpT: REOUIfjEMENT J t OVAtS-•F Permit # 20. Iou9h Faptory Firegtace t- f., _ I, C. 21. Ducts;, in'StruLturi, n 70. Underground Hydro 22. Ou4ss, Vegtil6 ing`• r -; 71. Product Riping Q -Gas 00i1 23. Gas Frpe-Rough &Test - ^ t-; T �' = ` 72. Underground Fausti A _ 24. Roof Fra in9' > Q 737 Undergrnd. Stora4a Tank ❑ Gas ❑ Oil 25. Roof_SheSthing :,r < V ' '' `l' 76:' Overhead Hydrt�:` .K 7 k t, -, rr, Z, A. 26. T=Ba ;Ceiljpg 1Struci} ral) & 6fon6coat j 73 75r. Dry Chemical i -G _ 27. Prame and Flashing h --' c = >+� 76. Dry Starsbpipe 28. Lathing &?Siding?4r! -� C Z w 77-4 FIXED.S4STEhYFINAL- C 29. InsulatiorTn'* 78-. FIRE PREV. FINAL _ e 7; ,:, 30. Drywall Nailing ^-, F.. { _ f* =' -HEALTH DEPT. REQUIREMENT -'31. Plaster BrowriCoatJy y, j [ 79. FINAL INSPECTYbN ,-32. Electrical'Pov er Meter -Final , j _ 80., FOOD CE RTIFfCATE I5SMED- _ .33. E.inabElectric:, - r tY 1 " Y'34. r Nutes. FinaP-Heating:BiArCgntiRioning'r- !; 35. Final Gas -.Pipe -Test, s = N2; d i .r rn r ' 36. Hood or Canopy - -, a .y- C, * ' <rn 37. Final FactoryFireplace >; i -;-r' k•"• • x�' u t - 38. Final Plumbing r� " 39. Water Service -Final' -40. Gas Service -Final ' " a' r 11 -41. Solar Domestic.Final; - - -_ �+ - ,_ ^ - 42. Backflow Preventer 43. Backflow Irrigation ><__ -- r. ` - -• 44. I1'r; :,j rT, Landscape Irrigation' System 4, ;rt i rT r] y N - r '�<*S 45. Sound Attenuation,, -, •� _ .. rna. 46. Handicap Regulation's + t• r 47. FINgt STRUCTURE & BUILDING r F .i -� •' F -- r t - 48. FINAL PLANNING T t `M t r. c t v 49. Electric Release to Edison , - - ---, 50. Gas Release to Southern Californla'.Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date ADDREssa9MLMxD: 245 FISCHER.AV UNIT. D B OWNERS NAYEIF KNOMN: AIRPORT WEST USINESS PAR AgDREss: 245 FISCHER AV ,. COSTA MESA, CA 92626 556-4990 APPL. MARDIS ADDREss: ARCHITECT OR ENGINEER: MC. NO.: UICIL OR ENO.'s ADDRESS: UNIT: CONmacers NAME PETRONELLA ROOFING (714)548-1645 CONRACTORS MAJURIG 2626 NEWPORT ADDREss COSTA MESA CA uGNo, 00460707 92627 u8: 201 LICENSED CONTRACTORS DECLARATION: I Mreby affirm uMer prely of perjury Net I em fcanaed uMer proneian of Chow 9 Nommendsg with Section 7000) of DMaon 3 of N. Etna. a PM Cade, arld my Iicerme o in NO lero end allot. CITyuC.NO,032605 uONG. CLASS: C 39 � 00 07 EXP: 07/96 Q_MER BUILDER DECLARATION: I hereby dfirtn uMer d prju that 1 am eaempl front tM Contractors Lim me few lar One Idnwklp reeson (S ion 7031.5 Bsnms end Prolmeion6 e: Arty crY county white repuiree a penmr to eoneeuct, after. Improve, duh, or repair w structure, prior to ra Muewe, eL I ins tM apl for such pons to fib a signed Malemerr Net M or aM esad pnuart to IM Provisions d the Cwrrwon Lew �C or 9 (oommeneng voth Section 7000) d Ovuion 3 d IM -.Zmem ed Pro.. code) or IMI M or efts b uempl I M hum for Na allepd memplon. Any vmWon d Section ;31.5 by e" ePpGunt fpr a perms sbi" tM aplie I to a d nal mare then W. hlmdred ddbn [3500D. ❑ I, as owner dtM popery or on, employes wfh wapam their ads compnrmtim, will do the wok, err Ne dnicm. a not intaMed or Mend for sb (Section 70ae, Busitws aM Prolmsbns Code: TM Comrwan License Lew dos not applytom ownerd papery wM bolds or inprovma thereon, ed who does such wok h'rnaes or MnN or Nro h Im c Mr own am to am, prowiml that each improvements are not intended or Bleed for b. H. Mweter, tM Wrdin or knpronlned u sold witN n one Yee of oompleun. the owmrb lder will Mve the When of ponnp M or she d'd not build or impwe In tM p of sale). ❑ 1, as owner of tM prop". em ud..v*.nmog wan [ironed contraclon ro oonmud IM pmjed (Seeion 7011. Bu"veaa and Prolaeaiarn Code: TM Cptrwon Liens Lew does not apply to an owner of property wM Wlda or hnprovm toren and w1to aonswa for a projects with a mrarwor(s) hoonawl pmsM to IM Contrmas Linea Lew). ❑ 1 em a empl under Semon: B. 8 P.C. lar Nu rmsn: Dme: Owner: I m he.by assay Nd I em aware of end andenlud the reiuirommb of California w h em Sale, cod. Swone p5505. zs533, .m 2553x, and ret I or any Mut bolding cooupent mill 1 w8 w (circle one) need 1. carriply wIh maid stale coca a IM nauaemarga ler Dwe: Applicant: WORKER'S COMPENSATION DECLARATION: I hw by alfirm Inde prwhy of penury one d the folowhq dadawone: ❑ I Mvs eM W maintan a ceniTicets d oawd Ip aetlirmva ler worker' canpemtlon, m ProvWad tar Ery SadvI 3)00 d tM leba Cade, lar 1M pelamence d Ne work la which Nu pmts u Muer. I have end wil mainlan Iwrkere' compneetun isunnre, as roauirod by Swion 3700 of IM Labor Code, bane prlormanoa d 1M work for which Nu parmr is ueued. MY waken' rompnmation ineurewe owner ed pricy numbs aro: Carnw. ARGONAUT EXPIRES Poky manor: 01/01/97 is sdnn reedw Meanpbud yfM Pant/u fa on huMred ddbn 1001abs.) LI I oenly NM n Ne promwrwe d tM work for which thin pens u I andl w employ any preset In a" manner oro as to lessens won to IM wo Swi c WOO of tbn ewe d C. I wlav, that'=M w1 baronw rbjw to IM wadws' becxwe min ct to I ne d Swion 3700 d tM lobar Cade. I 1 cenpy wrh W np: F.N. b aacun wodrei rot fln. W b oro hrndn i fhooaand B.S. 3706 of dw Labor Cab, Idem CONSTRUCTION LENDING AGENCY: I prwmance d tM way ler wh this pan LENDER'S NAME LENDER'S ADDRESS: eDnlawmLp d"!a jwf an wnplayn to almrml p«wDu em add/tbn MN. cut of conpamauon deramm u pnvMM ler In that ton is e cunpvYion kinclirlp etlamc, for the certiN the I have raM Nu m v coor and data ne eb above bdamaian u parted. I . cit tt comply wrh eecryand ionordkwes Wiq conNudin mad Mraby authorize Iepneaerltativm d IM dry to we upon IM ebow-menlionM pmpary OID WATTS Dab: (5151) .vvp) rwAuldkp A Safety. Gn Rfl.; C.,to"pploed; PinkJiserwe: G.W..d-Aamaaaor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 078453 PERMIT NO: B 078453 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: OTH JOB DESCRIPTION T/OFF BUR 6 REROOF W/SAME SQ FT: 45,000 CLAIM VALUE: 45,000.00 CALL—VALUE: 45,000.00 GROUP OCC: B / COMMENTS: REROOF 17000SF COMMERCIAL BUILDING W/BUILT—UP Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RIGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING RE& PROV: PARCEL: 00000000 ZNE: REF NO: PLANNING N TES> > k kkk kitk k kk kkkkk k kk k k kkk kkkk k k kkkkkk k k kkkk kkkkkk kk kkk kkk kk kkkk kk k k kkk kkk k k k kk kk k D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY DATE: / APPLICATION ISSUED BY:� DATE: 6 k kkkkkkkk kkkkkkkkkkkkk3F3F�iFif;f�� iFiiiFTFiFTF3FiFiF�Fkk kkkkk kkk k ' LEGALIZATION N F E E S U M M A R Y STRUCTURAL SAGM BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 529.75 4.50 SMIP/NON—RES PLAN ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 534.25 0.00 0.00 534.25 534.25 .00 REVENUE DIVISION TOTALS--> COLLECTED: 534.25 OVER/SHORT:00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 529.75 4.50 kkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkk I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST SFR 45000 REROOF BY VALUE RESIDENTIAL NOZONE 1,00 45,000.00 END OF FEES CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL 'OA APPROVALS ^ Permit # Date Inspector 1. Temporary Electrical Service or.2nle J 52. Pool & Equipment LocatioA 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 "est \ 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7, Footings - 58. Electrical Conduit• Undrgrnd. '+ 8. Foundation _ 59. Gas Pipe, O Undrgrnd., Test - - - 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P•Trap, ❑ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO gECK-- 11. Property Sewer Line & House Connection 62. Backwash & Receptor•F inal ' 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 APPROVALS Permit # 20. Rough Factory Fireplace -r , 1 21. Ducts, in Structure _ .- r - - t 70.' Underground Hydro , 22. Ducts, Ventilating _ : i 71. Product Piping O Gas El Oil 23. Gas Pipe -Rough & Test _ - 72. Underground Flush 24. Roof Framing. - - 73. Undergrnd. Storage Tank OGas OOil 25. Roof Sheathing ?/�/�6 (• 74. Overhead Hydro" " 26. T -Bat Ceiling (Structural) & Monocoat - 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe r 28. Lathing &Siding 77• FIXED SYSTEM FINAL 29. Insulation 7$. 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 - V - Notes:2. 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 �7 __.'' - • - > 48. FINAL PLANNING -• 49. Electric Release to Edison- - 50. Gas Release to Southern California Gas Co ' 51. CERTIFICATE OF OCCUPANCY No. Date Applicant to till in all spaces except those within heavy border lines and sign all appropriate declarations . I CITY OF COSTAMESA . -- -. - PER IT NO. - - - TRACT NO. - LOT NO. - BLDG. NO. 7 121 10/12/[37 • 511.9:r _ Ti CONSTRUCTION PERMIT Piojact Addres TYPE OF CONSTRUCTION. NE D L1 ALTERATION LJ REPAIR, Applicant's Mail: Addr 55 ' - /�� ❑ CONVERSION ❑ DEMOLISH TIER A.P. # ° Zone - Owner's Name_ - hon -DESCRIPTION OF WORK Q S Main Building: - Accessory Building: Z Address C - ,i TYPE OF RMIT GRADING- FOUNDATION• -STRUCTURAL T Front N Arch/Eng. License No.� ❑ TENANT ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B - - Address. - - ❑ OTHER ` _ A Reef N �-'I'' � ff�� -..//' or's Nam! ,Q_'4&& 6?Cf1'1e1C honeE Contracte PROJECT DESCRIPTION SQ. FT. 'OCCUPANCY C K Right - G Address(mailing) CONSTRUCTION TYPE VALUATION$ $ Left R E City License No' '� ' ZONE GRADING ; - CU. YDS. ACRES - - Ping. Ref. # - Park. Fees $ Q LICENSED CONTRACTOR DECLARATION Remarks: - Parking Req./Provided - - - U 1'gereby;affirm that I am licensed under provisions oYCharter 9 (commencing - with section 7000) of Division 3 of the Business and Professions Code, and - O Use of Building: 1 R my license is in full f e an effect. - E _ pr License CiSss' - '> LI elS4e No.'�, ,,�f'+� eL ' PLUMBING FEES Planning Notes: M OO ''� _ Date /�)L�a� Signature - - I E WORKERS' COMPENSATION - RATION= I Bar Sink Showers - N hereby affirm that I have a c t" Cate of consent to self -Insure Or a certificate ¢� Backflow Preventer Se_rvice_Sink 1 ' I S I Workers' Compensation "I Rsurance; or a•certified -copythereof-(Section I ` - - - ,e00, Lab. CJ I I � Backflow Irrigation ! - 9 Sewer Cap I � � ELECTRICAL I ! 'FEES Policy No. ComPanY � { B Certified copy is hereby furnished. ; Bathtubs I ' a Sewer Connection Automatic Washer I Transformer El 1550 KW i Certified copy is filed with the city Building Division. l Date Applicant larifiers Solar Collectors j Construction Pole Sub. 50'+KW E%EMPTION'FROM WORKERS^COMPENSATION DECLARATION (This sectlon need not be completed if the permit is for one hundred (E100) or Dishwasher - - - $oiar Piping'-- - ". - -'- -- - -Cooking Unit - - - - ' - Meter'Dup to 100 amps - i .. less) I I certify that 'in the performance of tha v/o�k for'which is permit Is issued I in t Drinking Fountains Solar Tank & Dishwasher Meter Over 100 amps shall. not employ any person any n er so as come subject to,tke Worke:eTPC atr lis on Laws of Calif r Floor Drains' ! Swimming Pool w/S a ' 9 p Dryers ❑Gas ❑Electric Sub Panel '00 Date (�!! �� Z - o Signature 1 NOTICE: If, after making this decI n, you should become su ect to the Floor Sinks Urinal I Fan. ' Motors 00-1 HP 1_t' -S j Workers' Compensation' PrOVI5l0 f in Labor Code, you must'f )rthwith comply ,with' such ,provisions, -this permit) shall be, deemed revoketl.. I CONSTRUCTION LENDING, -AGENCY.: ` 1. Gas Service Outlets i - ' .. Water•Closet I ,, i ,- I.. ,,. _ _ . F.A:U. Inc. Solar'09-15 HP 01615+ ' - I hereby affirm that there 1i a construction lending agency for the pertorman<o' Of the work for 'which- this, permit -0s issuetl:,(Sechon': 3097 Civ. C.) I' I Interco tots' 1 - p _ Water Heater I j Fixtures ! , �MiCroWave I s Lender's Name. - - ' _l ' I , i 1 - Lender's Atltlress - -- '- -_ - - `' Kitchen Sink i = 1 - - Water Service - - Device Boxes 'Pole, Light ' I OWNER BUILDER DECLARATION I - .. - j I-avatories - - ., , ; Outlets j Range ' I hereby affirm'that 1 am: exempt from the Contractor'd.License Law forme T - following reason' (Section 7031:5IBusiness and Professional. Code: Any city or F, Trap ) ' , t - I T Switches, ' ,Sign county which requires a permit to construct, alter, Improve, demolish or repair - _ l ;any structure, prior to Its issuance, also requires the applicant for such permit to file he/she is II<ensed*pursuant _ ` Roof Drains' - ' i�' { - _ l I - Garbage Disposal l Standing Sections ' ' a signed stalementlthat to the provisions of Cthe Contractor's -License Law (Chapter 9 (commencing with, Section 7000) of 1 1 , I "Olvisioni 3� of the, Business and Professions Code), or that he/she is exempt j I I T i i `. j -j Generator ❑D5 KW ❑5-15 KW 1Trash Compactor •erefrom-and the basis for,the alleged exemptionAny violation.of Section ! 131.5 by,; any- applicant for; a, permit' subjects the, applicant to 'a civil enalty bf no[ more than five hundred dollars ($500). ! f ' ! '=Reinspection Fee ' l ' $25 ; Issue Fee_:, $'3 _ •! ' I a� I, as owner of they property tor,' my employee's.with wages as their solo Reinspection Fee $25 Issue Feed I $' 3 , dompensation, will do the work, antl the structure is not Intended or offered - ' - i (MECHANICAL FEES for sale (Section '7044, Business and Professional Code: - The! Contractor's I License Law does not apply to an'owner of a property who builds or Improves - Boiler - Hood or Type I ❑ ' '; PUBLIC SERVICES REQUIREMENTS: , 1 thereon, and who does such work himself/herself or through his Or her own employees, Provided that such improvements are riot Intended or offered for - - I Canopy : Type 11! ❑ I I •. Zoning ApprOv¢d By Date sale. If, however, the building or Improvement is sold within one year of com- Duct - Under Ground Application Approved By Dateor pletion, the owner will have the burden of proving he/she did not build or im- - - �roveifor the purpose of sale). - , Duct - Structural Refrigeration System - Application Issued:By Dat LJ 1, as owner of the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044, Business and Professions Code: Duct - Ventilating❑0-100,000 ' BTU ❑100,000 BTU SUMMARY OF FEES The Contractor's License Law -does -not apply- to an owner of property who - builds or improves thereon, and who contracts for such projects with a con- Exhaust System ❑ Multiple El System Repair/Alteration - BUILDING PERMIT $ I SMIP $ tractor(s) license pursuant tothe Contractor's License Law). ❑•bam exempt under Section B. & P. C. for this reason Firepl/Fact. Bit. ICBO # PLAN CHECK $ -PERMIT ' } ' PLUMBING $ ISSUANCE $ Date Owner. Heating System & Ducting L I ! PLAN CHECK— I $ ' ENERGYIP.C. $ ' I hereby certify that have read this application and state that 'comply antes - ❑0-100,000 BTU (]100,0006 y(J, J� GRADING $ ' information is ecL'1 agree rdi wlth'ali city and county ordinances ;' and.state la r ating:to b ing construction and hereby authorize repro- sentatives t s city: to ter. upon the above-mentioned property '.for - -. - - ELECTRICAL PLAN CHECK : $ .p �•- $ �Q .6d MICROFILM $ 'p I - inspection ur b5C5. 5�gnature I Date .112 , ! MECHANICAL $ TOTAL FEE $ Sd? •4S Drivers'' arise - Applicant;Pink - Accounting; Goldenrod - Assessor- -- CONSTRUCTION AND°PLANNING - APPROVALS Permit # Date Inspector POOL ,PA 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 Grndr,,i 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 t 16. Rough Electric Wiring ,y 8Ce 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 i FIRE DEPT. REQUIREMENT APPROVALS Permit# '20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts; Ventilating? i 71. Product Piping 0 Gas 0Oil 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 ll a Notes: 34. Final Heating & Air Conditioning - 35. Final Gas Pipe -Test - 36. Hood or Canopy 37. Final Factory Fireplace - 38. Final Plumbing 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer 43. Backflow Irrigation - -�• '; ..i � r 44. Landscape Irrigation System r ' 45. Sound Attenuation - 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed - 49. Electric Release to Edison '- - - 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Dale • CITY OF COSTA MESA -- CONSTRUCTION PERMIT Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. PERMIT NO. I I TRACT NO. I LOT NO. I BLD project Address 2115 171'se If e r STsc - A -1 Applicant's Mailing Address 336E- vrl rr0. Lot" Owner's Name f I I I A M -E �n*Phone Address 11517 N. 'C4irL)i e (J 5• Arch/Eng. —N7�f} License No. Address Contractor's Name 2 / CL A "S hone 52 -&OC Address (mailing) ,!3-6S- C� iiaA L1J41/.9 Ave A� %�.tP� City License No. 32 y - -L% LICENSED CONTRACTOR DECLARATION I hereby affirm that i' am licensed under provisloes of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my,ll'cense is in f I f ce and -effect. p z,� Ll cense lass �-' n LI c se No. Wr Date Signature WORKERS' COMPENSATION DE RATION or hereby affirm that I have a certificate of consent to selfinsufe or a certificate I Workers' Compensation Insurance, or a certified copy thereof -(Section Policy Lab. C.)�..,/ rm Company x004 MAN/ Policy No./{� LIY/[y-/-u— eCertified copy is he eby furnished. , Certified copy is filed with the city Building Division. Date Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - (This section need not be completed if the permit Is for one hundred ($100) or less). 1 certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner spies to become subject to Lite Workers' Compensation' Laws of California. Date Signature NOTICE: If, after making this declaration, you should become subject to the -Workers( Compensation provisions of the Labor Code, you must forthwith I comply with such provisions or this -permit I shall be deemed revoked., CONSTRUCTION'LENDING AGENCY- - ' 1 hereby affirm that there is a construction lending agency for the performance of the work for 'which_ this' permit Is, issued (Section ,3097 Civ. C.) Lender's Name - Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the , following reason. (Section 7031.5 Business and Professional 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/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of 0ivislon 3 of the Business and Professions Code) or that he/she is exempt aerefrom and the basis for the alleged exemption. Any violation:of Section 031.5 by any applicant for a permit subjects the applicant -to a civil LJpenalty of not more than five 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 (Section 7044, Business and' Professional Code: The Contractor's Llcense 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 employees, provided that such Improvements are not Intended or offered for 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 lm- Eveefor the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con. 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 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 exempt under Section B. & P. C. for this reason Date Owner - hereby certify that I have read this application and state that the above Information Is correct: I agree to comply with all city and county ordinances and -state laws relating to building construction, and hereby authorize repre- sentatives of thja7city/Jtq/ entV upon the, above-mentioned ,property for Signature 0— Drivers' License or SS V -/yo BUILDING PERMIT $ SUMMARY OF FEES SMIP $ TYPE OFCONSTRUCTION NEW DD ALTERATION .REPAIR ❑ CONVERSION -❑ DEMOLISH THER DESCRIPTION OF WORK ' A.P•.h6 S E T B A C KLeft $ Main Building: TYPE OF PERMIT LlGRADING 0 FOUNDATjfjIG\ STRVCTU RAL El TENANT E]ELECTRICAL ❑ PLUMBING �71�LY�j/v /t•,�ECHANICAL El -OTHER ,Front Rear ' PROJECT DESCRIPTION SOFT. OCCUPANCY % CONST RUCTION TYPE 'V ALUATIONS ZONE GRADING CU.YDS. ACRES Right Ping. Ref. # Remarks:Parking , Req./Provided 1 of g: UseBoildin PLUMBING - FFFC Planning Notes: Sink Preventer Irrigation Drains Sinks , Lavatories ` P -Trap Roof Drains -Reinspection.Fee $25 Boiler Duct-- Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact. Bit. ICBO # Heating System & Ducting 00-100,000 BTU 0100,000 f s 4 Plus roil r Reinspection Fee 1 $25. 0865-46 rev. 7/83- White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Water Closet Water Service f. Issue Fee Hood or Type ❑ Canopy Type I I ❑ Refrigeration System ❑0100,000 BTU 0100,000B1 System Repair/Alteration Issue Fee a Automatic Washer Construction Pole Sub. , Cooking Unit - Dishwasher Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generator 005 KW F764 O N 1 N G E Park. Fees $.. c D U R E N E N T S ELECTRICAL FEES 5 KW Transformer ❑ 15-50 KW 0 50+KW Meter ❑up to 100 amps Meter Dover 100 amps : Sub Panel Motors E10-1 HP❑1h-8 _ Inc.Solar 1:19.15 HP 1:116-15+ Microwave Pole Light Range Sign Stariding'Sections Trash Compactor $ 3 I Reinspection Fee : $25 -Issue Fee ' $ 3 FEES PUBLIC SERVICES REQUIREMENTS: Zoning Approved By Date Application Approved By Date APPlication Issued By L 1 r �� y I Date BUILDING PERMIT $ SUMMARY OF FEES SMIP $ PLAN CHECK $ PERMIT PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK $ $ $ $ ISSUANCE $ ENERGY P.C. $ GRADING $ MICROFILM $ - MECHANICAL $ — TOTALFEE $ $ 3 PLAN CHECK $ r CSNSTRUCTION AND PLAIgNt APPROVALS, Permit# q 8a Data JInspector POOL SPA APPROVALS Permit# Date Inspector •11. 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-Unprgr.nd. 55. Electrical Bonding 5. Steel Reinforcement ` 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd.\ 57. APPROVAL TO COVER-GUNITE 7. Footings' - 58. Electrical Conduit-Undrgrnd. 8. Foundation _ 59. Gas Pipe, ❑ Undrgrnd., Test 9., Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash &Receptor -Final 12. Sewer Cap - Final 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 APPROVALS Permit #_ - 20. Rough Factory Fireplace, 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0Gas ❑Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing - 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV, FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final 40. Gas Service -Final 41. Solar 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 No. 'Date _ Applicant to fill in all spaces except those within - heavy border lines and sign all appropriate declaratlons. ,FP/6'TY OF COSTA MESA 1 PER MI TRACT NO. LOT NO.. I BLD ; ' CONSTRUCTION PE I p n p�p '1 ' R ' I aeFO .6 . I 304 6/70/0a Ti - Applicant's Mailing Address TYPE OF CONSTRUCTION (NEW ADD ALTERATION ' REPAIR - - • :. =� 1. ' �� Ss.fn Ems ❑ CONVERSION ❑ DEMOLISH ❑OTHER. - Project Address ,e- Owner's f AM's 0' gRL4 `P -S �_JI Owner s Name _(F Phone DESCRIPTION OF WORK , ' ZONING EGU •ATI S .- ` Address' TYPE OF PERMIT GRA FOUNDATION RAL' - A. P. +M• ' -- 'ZONE _: Asch/En License No.i _', I ❑•TENANT ❑ ELECT R IC7gPLUM B_ ING; ❑ MECHANICAL PLNG. REF. 9h- I : BUILDING r ., , Address ' - { i 0, -OTHER +. _^ - ` - .TO BUILDING -- PROPERTY I E _ - REAR YARD (TO P/U • H `^' Contractor's Nem ' hon PROJECT DESCRIPTION' SG. FT. OCCUPANCY •: Address (,ailing) S( �••+ C O N STRUCTION TYPE - VALUATION . LEFT SIDE YARD RIGHT SIDE YARD j - I t/� ��3i�•�--ZQ ZONJ= i GRADING CU. YDS. ACRES PKG. SPACE REQ. PROVIDED ; ! License No _'-._-.. LICENSED CONTRACTOR DECLARATION I i ' ._ - Remarks: 1 f - STREET WIDTH i - .PARK FEE $ ' .• I�herebylaffirm that'ham Iicensed•under provisions of Charter 9 (commencing with section 7000) of Division 3, of the Business and Professions Coda and -y r ( • • c (% 7 1 SPECIAL CONDITIONS: 1\ m license Is lit fu for, a;nd eftgG't. / 1 ' ; i7, $�Q' - Ucen la C •�Za/� Uc ,}yo - • ° `D/ ' i > PLUMBING ' - ' I t -• j 1 Date- ( 3 Signat„r,.- Bar Sink , SeWer Cap i lQ I ELECTRICAL �� I WORK RS'E COMPENSATION DEC LA RATIO I ' -areby aftirm. tha, 1 have a cerliti cate. of -consent to self -Insure or a. certificate - - -. : Backflowv Preventer - - - Sewer Connection' - -r- -. _ -_ �I !_ Automatic Washer,: ' -..- , ' (Meter ❑over 100_amps_' .{ _ -r- ”, - - ' Workers' Compensation Insurance,'or a cert a py th reof (Section;. + - - -_ - - - Construction Pole',— rs, l Sub Pahall •'"sk Lab. C,)sO I /' - 1 } Backflow Irrigation Soler Collectors ! ; • •1 ' ! Policy No. ii �.� 1 ompany ertifletl copy is hereby furnished I r-- Bathtub - , Solar Piping - Cooking Unit • ?-� Sub Pole i Certlfi tl co y I5 tl with the cit Iltling iv it ♦ - i5-Gby.1V Ipa f Clarifiers i - Solar Tank Dishwasher +� T i rr !M010rS 00-11 HP O1%-8 i I Date Applicant - EXEMPTION''FROM WORKERS' CO ENSA ON DECLARATION _Clarifiers Dryersv❑G&5' ❑E{eetr is : ' .Ina Solar ❑9-15 HP ❑ 16-15+ - Dishwasher Swimming POO( W/$pe 1 (Thissection need not be completed If the permit is for one hundred ($100) or-, - - . ! r Fan • I 1 1 less). I certify that In the performance of the work for which this perm It Is Issuetl I ;. ; Drinking Fountains I Urinal r- ^; j - Microwave l • shall' not employ any person in any manner so as to become subject to the ; Workers' Compensatiom Lawn California. { I - Floor Orainsi - F.A.U. �n� ` /1. Pole Light ! I I 1 I of I 1 I 1 nature Date. .NOTICE: Water Closet) , -- - _ Fixture / ' i '• ` - .,Flange,- _, _ _,f,_,--_ �, - { --.-'•a ' 1 1 + ' -'1' Floor Sinks �- - -� -- Water Heater - --i -f- -- -- -, declaration,- If, after maklI his on, -You should become subject -to -the Workers', Compensation provisions of the Labor. Code,. you must forthwith comply ,with such .provisions . or this permit shall. tie deemed revoked: I - Gas Servite� :Outlets' Q v ." Water,Service , i I "' +r.17 00 • Device Boxes 1 j Sign, ' CONST R UCTION-LENDING AGENCY' ! ' I hereby affirm that there is a'construetion landing agency for the performance i� - Interceptors '4-.) i _V •% i ! •' Outlets r• - 'r t f Standing Sections t of the work for which: this, permit is Issued (Section 3097 Civ C+ Lender's- Name ' - ' •'- ' - i * - .-v - Kitchen Sink - - Switches f" ;Trash Com actor i P r 'Lender's' Address' Garbage Disposal I Lavatories -• T ' r ' ' { d -+ f - OWNER BUILDER DECLARATION = - , ' •. 't ,o i -- „f• Ihereby affirm that I am "exempt from Me,Contractor•S-License Law for me following 7031.5 Business ProfesslonaljCotle: Any ° J P , , i - I "- ; Generator '❑0;5 KW ❑5-15 KW ' reason -(Section' and city or county which requires apermit to construct, alter Reprove, demolish orrepair { to Its Issuance, tate (Trap; ; = ; tr ( ' ; f ' I -_ I Transformer ❑ 15-50 KW ' I any structure;' prior also requires applicant -for such permit to file a signed statement that he/she Is licensed pursuant to tha'provl4on5 of I Roof'Orains 1 L - -- ' - - r I _' •' u - ' r .: ❑50+ KW • ! ++a ! •� Reinspection Fee i $15' the Contractor's License Law, (Chapter 9 (commencinglwith!Section 7000) of p�vision 3'of the 'Business antl: Professions' Code or that. he/she as;exem t ° -of '- + 1 +-- Showers 0' j�,1 - - •- _ I ReinSpeetion,Fee ? r - " ' _ ' , $ 3 ,y Meter ❑up to 100 I I 'Issue I efrom and the basis for the alleged exemption. Any. violation Section "applicant 'a•permit { 1 amps Fee i , •y'T.5 Dy any for subjects the •aDDlicant to a=civil ' lty of not more than five hundred dollars ($500).. i• I ,. - Service Sink 1 s_f i = Issue Feer$ 3� ZpHing Approved By _. Date 1 ❑ 1;'as .owner of, the:property Or my employees. -with wages -as their sole i •- rFs S 1• j compensation will do the work; and the structure is not Intended or offered Professional I MECHANICAL Application Approved By 1 ate for sale.(Sec�lon 7044, Business' and; Code: The Contractor's License Law does not apply to'an owner of a property who builtls or Improves _ Boiler _i Refrigeration System , r +" 1 1' { f�� y• D thereon, and who does such work himself/herself or through his or her own , employees, provided that such improvements are not Intended or offered for - 1 -: + ❑0-100,000 BTU ❑100,000 BT U' , n - p Application Issued By : " ata !' Duct =Under Ground ' - - - I 'SUMMARY sale. If, however, the building or Improvement Is sold within one•yeanof com- J Im- pletlon, the owner,wlll have the burden of proving he/she did not builtl or Im- prove for the purpose of sale). •. i 1' as 4lcensetl I i ,f _-; -, -• ";"BUILDING PERMIT $� OF FEES 1 SMTP '. $ ' I' Duct - Structural ; System Repair/AlteratioA. +'t.' I, owner of the property, am exclusively contracting •wlth con- tractorsto construct the project.` Section 7044, Business and Professions Code:..-_}. Duct: Ventil2ting- 1._ -- _ 1 , - 1 _ �� R:PLAN CHECK' $ •PERMIT t I The Contractor's License Law does not apply to an owner of property who 1 bullds or Improves thereon, and who contracts for such projects with a con- f Exhaust System 13 Multiple ❑• ( i i ISSUANCE $ PLUMBING ;$ 1 I - tractor(s) license pursuant to the Contractor's License Law)• , I 1 '7 PLAN CHECK. $ .:C� ' GRADING I $ i ❑ I am exempt unser Section B. a P. C. for this reason Firepl/Fact. Bit. ICBG iF , i 1 •• �� t $ ' V 1 Dace ' Owner' 1 I - - Heatin stem g,Sy em &Ducting j .'. ELECTRICAL. $ ' .1 i ',' PLAN CHECK! $ - MICROFILM '$ ' t I hereby cert) that-Irhave'read this application and state that ttie,above- 00100,000:BTU-❑100,0008 - ' r - TOTAL FEE, $ Information is rrect. 1 agre to comply with all city and county ordinances ply , - I - ". - 1 MECHANICAL $ antlstate law elating to b Il',Ipy c s ruction, antl hereby autho ize repro- sentative his kcity� to he above-mantlo ned pr ty r 1IPOII�r__ Inspectl0 av/ t I �{ v Q 3 Hood or Type 1 ❑ i Cena T - e II ❑i - 1 , Reinspection Fee r 1 r ` PLAN CHECK' $ I 1 i j I ; LESS i i - , ADVANCED PC $ { Signatur Drivers' License orYSS # 'eF'.up —L Data 1 Registers r ! t' I 1 Issue Fee , , , - $ 3 i ' I FINAL FEE 1 $ l '..fid �. CMF 0865-46 rev. 12/82 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod -Assessor • t., CONSTRUCTIOWAND PLANI Gp ?- T -Inspector )� ''POOL 7 4 - - • _-; , , -��-Oo .Date -i APPROVALS ', Permit:# .APPROVALS - Permit# Date • Inspectors 1: Temporary Electrical Service or -Pole- S' ' '52. Pool &EquipmenCLocation t •- 2: Soil Pipe-Undrgrnd. : i 53: Steel Reinforcement-- ' ., 3: Electrical Conduit -Utility=Undrgrnd: - 54. Forms - - -` Electrical Conduit-Undrgrnd:- :- j %'_ - `� . Electrical Bonding ' ,55: 5' Steel Reinforcement--.� • - ' - •; -- -_ - -•" :" _ ' 56. Rough Plumbing'& Pressure Test - ' 6. Electrical LIFER Grnd. 'i �' - - ° -� ` "'' 57. APPROVAL TO COVER-GUNITE . 7. Footingsz 58. Electrical-Conduit-Undrer�d. r: 8. Foundation 59. Gas -Pipe, O Undrgrnd.; Test - - 9. Water Pipe-Undrgrnd. Backwash: Lines, P -Trap, O Undrgrnd. ` 10. Structural Floor System ! '. .� ! ��, •,• 61. APPROVAL TO DECK - - 11. Property Sewer Line & House Connection 62. Backwash &Receptor -Final 12. Sewer Cap - o 63. Heater &'Vent• -Final •• - 13. Roof. Drains I = 64. BlumbingBystem.:Final' ' 14. Rough Plumbing, a;r1amI 65. Electrical -Final" 15:Rough Electfical•-Conduit : r �___, - - - -;'-,'--;' '66 Solar System -Final " 16. ,Rough Electric Wiring: ! ';: r• ` w' E ; • _- r -i' "6TI !-Fencing &Access Approval 17. 'Rough Wiring Sign; S -' - `-` '' 1, 68.APPROVED FOR PLASTERING 18: Rough Electrical-T.BarCeiling_�;69. POOL/SPA SYSTEMS FINAL - 19.:Rotigti Heating &'Air Conditioning FIRE DEPT.:REQUIREMENT APPROVALS• Permit# , 20. 'Rough Factory Fireplace. ' ?�. Ducts, in Structure i �; , ' .70. Undeiground Hydro ` .22. 'Ducts, Ventilatingf ' 71.' Product Piping 0 Gas ❑Oil _- 2'3. Gas -Pipe-Rough &Test' I I 72.- Underground Flush; ' 24. -Root Framing 73. Undergrnd. Storage Tank ❑ Gas -0 Oil _25. Roof Sheatl ing > - c; :,.74. Overhead Hydro ' 26. "T -Bar Ceiling �(Structural)i & Mon ocoat, �'-.. ;'- 1'' 75.' Dry Chemical 27. Frame and Flashing•- •. ,76. Dry Standpipe 28.'Lathing&Siding!A i i !77: FIXED SYSTEM FINAL _ 29. �lnsulation r" - " c i j j ! I 78' FIRE PREV. FINAL :30..Drywall-Nailing I •Notes9 31. -,Plaster 'Brown Coat �i i ' ' 32.'Electrical, Power Meter -Final • .I, I i i(•' , 33. Final Electric 34. Final Heating &Air Conditioning 35. Final Gas Pipe -Test � �• 36. Hood or CanOPV:.' 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service.Final i 40. Gas Service -Final 41. Solar Domestic-Fin,al 42. Backflow Pre venter 43. Backflow Irrigation el L, 44. Landscape Irrigation;System;- J- 45. Sound, Attenuation 46. Handicap Regulations! 47. FINAL STRUCTURE & BUILDING !; ! 48. Special Requirements Completed '' i 1 _ I °" 49. Electric Release'to Edison 50. Gas Release to Southern California Gas Co I 51. CERT,IFICATEOF, OCCUPANCY - _ _ '_ _:_ _' - _ '.- No. Date I I ! ! Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. Sewer Cap -CITY-OP COSTA -MESA ' - - CONSTRUCTION PERMIT T PERMIT NO. J TRACT NO. " • -LOT NO. ' BLDG.�NO. Project Address. Applicant's Mailing A ��,ep��7. � �� "� Owner's Name4._ll.l r one 7,r/_�j TYPE OF CDNSTRUCTION- ' LJ, NEW ADD ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH '❑ OTHER- DESCRIPTION OF WORK _ - A;P, # S: Main Building: _ Address: '/n TYPE OF PERMIT -GRADING LJ FOUNDATION ❑ STRUCTURAL - + ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ."❑,BOTHER - , - t - - - ROJECT DESCRIPTION SQ. FT. OCCUPANCY CONSTRUCTION TYPE 'VALUATION$ T. Front• _ fy Arch/Eng.: - ense No.' - - ' B A Rear _ - Address Contractor's Nam / hone /-'17 'Address,(maihOgl —�isd. C _ Right ' K S Left - 1 ping. Ref. " City ;License No. - - ZONE GRADING CU.VDS. ACRES 1 _ Remarks: Parking Req./Provided - - ' LICENSED CONTRACTOR DECLARATION I 1 hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and '_ I Use of Building: my license is in full force and effect. License Class " License No. PLUMBING t FEES I Planning Notes: Date ' Signature, WORKERS' COMPENSATION DECLARATION, ,Bar Sink Showers ' . Floor Drains ' Swimming Pool w/Spa - Backflow Preventer 1 Service Sink' - - - - ' ' hereby affirm that I have a certificate of consent to self-insuie or a certificate Workers' Compensation Insurance,. or "a certified. copy thereof (Section Zone , Accessory Building: _ Z Or N I N G E Park. Fees $ f ` j " _ �r Q U' R E E N T S .00, Lab. C_) I Policy No. Company - 8 Certified copy is hereby furnished. . Backflow Irrigation I Sewer Cap ' ELECTRICAL FEES Bathtub -s Sewer Connection Automatic Washer Transformer 11 15.50,KW Certified copy is filed with the city Building Division. Date Applicant ConstructionPole Sub. I " r X50+KW I Clarifiers I I I Solar Collectors ' •EXEMPTIONFROM WORKERS' COMPENSATION DECLARATION- (Th section need not be completed if the permit is for one hundred ($100) or } ' Dishwasher-- - '. -Solar Piping - -`- 1 I 'Cooking Unit- - -- Meter ❑up: to 100 amps" , less): I certify 4hat in the performance of the work for which this permit Is Issued Drinkin Fountains I 9 Solar Tank I" - Dishwasher - :Meter ❑over 100 amps ' shall not employ any person In any manner sofas to become subject to the f Workers' Compensation Laws of California.; i 1 Date Signature I e NOTICE: If, after making this declaration, you should become subjecttot�I . Workers' Compensation provisions' of'the-Labor Code, you 'must forthwith "` complywith such provisions or this • permit 'shall be ideemed revoked., CONSTRUCTION -LENDING .AGENCY.' . Floor Drains ' Swimming Pool w/Spa - 1 I Dryers ❑Gas ❑Electric - ,Sub Panel FIOdf Sinks Urinal - j - j Fan. _ - - Motors �Od HP 01 %"- 8 1 - - -- - Gas Service, 'Outlets ° t Water Closet! r• "' - U F.A.U.-'Inc Solar 09-15 HP ❑i6-15+ - Interceptors - f? • - Water Heater l r ' Fixtures (Microwave I t I hereby affirm that there is a construction lending agency for the performance of the work for which this. permit• is' issuedc(Section 3097 Clv. 'CJI Kitchen Sink .,- > ' Water Service I - Device Boxes ! 'PoleLighY j f I Lender's Name.- - _ - -'r - Lentler's Address OWNERBUILDER DECLARATION - - - Lavatories ' - - - Outlets Range t I hereby. affirm that I am exempt from the'Contractor's.License Law for the following reason -(Section 7031.5 Business and Professional' Code: Any city or county which requires a permittoconstruct, alter, improve, demolish or repairany - _ - - P -Trap - - Switches , Sign 1 Roof Drains. - - Garbage Disposal - ' Standing Sections 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 _ ' ". - - Generator ❑0.5 KW ❑5-15 KW 'Trash Compactor - p (the Contractor's License Law (Chapter 9 (commencing wlthl Sectlon 7000) of 'Division 3 -of the Business and Professions Code)_on that he/she:is exempt orefrom and the basis for the alleged exemption. Any,vlola ion of Section 31.5 bg:any-applicant for a' permit subjects"the applicant -to a civil realty of not more than five hundred dollars ($500). 1 1 ', 'El 1, 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 - - Reinspection -Fee _ $25 Issue Fee ' $,3 Reinspection Fee $25 Issue Fee $-3 1 { - _' MECHANICAL - •- FEES PUBLIC. SERVICES REQUIREMENTS: Zoning Approved B g pp y Application Approved By Application Issued By v Date 1 Date - ��7�' 3� r Date/_ for sale' (Section 7044, Business and; Professional Code:; The Contractor's 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 employees, provided that such -Improvements are not Intended or offered for I sale. If, however, the building or Improvement is sold within one year,of conn- plet' n, the owner' will have the burden of proving he/she did not build or Im- pryvyeo for the purpose of sale). c I 'L� 1 as owner of the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to anownerof property who builds or improves thereon, and who contracts for such projects with a con- _ Boiler- - , Hood or Type ❑ t Canopy Type II ❑ ( ,. Duct'- Under Ground. s Duct -Structural Refrigeration System '" ❑0-100,000 BTU ❑lOO,000 RTU Duct - Ventilating I ' BUILDING PERMIT -SUM ARV O FEES ' $ � � �� SMIP ' $ - Exhaust System ❑ Multiple ❑. e- - - System Repair/Alteration - tractor(s) licens ursuaof to a Contractor's License Law). ❑,I•am exem nder Sect' n B. & P. C. for this reason PLAN CHECK P.LUMBING PLAN CHECK ELECTRICAL PLAN CHECK MECHANICAL 1 PLAN CHECK ' $ $ ' $ $ ' $ $ l $ PERMIT ISSUANCE $ ENERGY P.C. $ GRADING $ MICROFILM $ , TOTAL FEE $ I Firepl/Fact. Bit. ICBO # Date er 1 I hereby er ty at } h r¢ad t Is app c� Irtl-_ztate that the above . informati n co ect.rl to'c I'city and -county ordinances and stat la r ating t nstr o and hereby authorize rept sent al iv s tr s. city enter n ove-mentionetl per y r inspect on to Qa. Signa re . Dat 1 Heating System & Ducting 1 ❑0.100,000 BTU 0100,0008 - - - - -- I - Reinspection Fee $25 Issue Fee $ 3 Driv rs' cense 0r.5 CMF 686546 rev. 7/81 ' White - BuI lAng; Canary - Applicant; Pink -'Accounting; Goldenrod -Assessor " CONSTRUCTION AND PLANNING - ' APPROVALS Permit # Date Inspector _ ,POOL 'A - 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-Undrgfnd. " 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'Cond uit-Undrgrnd. B. Foundation 59. Gas Pipe, O-Undrgrnd.,'Test - 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 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. Rdugh 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 APPROVALS Permit # 20.- Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts; Ventilating 71. Product Piping O Gas []Oil 23. Gas Pipe -Rough &,Test l 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing i HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION ' 32. Electrical Power Meter -Final 1• 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: ' 34. Final Heating & Air Conditioning - 35. Final Gas Pipe -Test 36. Hood or, Canopy - 37. Final Factory Fireplace 38. Final Plumbing - - 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer 43. Backflow Irrigation - + 44. Laridscape Irrigation System - 45. Sound Attenuation 46. Handicap Regulations ' 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison - - - - 50. Gas Release to'Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. 'Date + CMF 0865-46 rev. 12/82 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod -Assessor Applicant to Till In all spaees except thole within heavy border lines and sign all appropriate declarations. ' CIf �a lt,��a OSTA MESA I — 1 a^c6kdrHUCTIOFJPERMIT�c/ PERMIT NO. p TRACT NO. LOT NO. BLD /l/•Fi9t �� 7� 3��3 4-1- ,' _2831 .77271;3 r7c> Ti Applicant's Mailing Addresssy- TYPE OF CONSTRUCTION NE ADO- ALTERATION' REPAIR Project Address.��? �r ��'/�� J�� - ❑ CONVERSION ❑ DEMOLISH OTHER _ �s - gv— (.8Z 771-'15-7; c r? �� O \ . t �-y/ 'Owner's Name ' Z ' Phone SJ T'�n� DESCRIPTION OF WORKn=� ". - 99NIN9 REGULATIONS -, Address 15:121 /lf/niQV/ I <AA 7a �r��'� License No. Z-(i7ELECTRICAL H ' GRADING FOUNDATIOSTRUCTURAL - ❑'PLUMBING❑MECHANICAL I =ION A. P.+ v-7 • C -•O ZONE'IArch/Eng. . PLNG. REF.9W`\ BUILDING Address ��j�,Q X. - O TO UILDING -PROPERTY Contractor's Nama dLT�illeA �i41777�e�..- PhooB SO.FT OCCUPANCY E HEAR YARD (TOP ) - Addresslmailing) CONSTRUCTIONTYP Jf VALUATION$"Zs QOv7- 1 LEFT SIDE YARD -RI TSID AFib - Ihl ZONE X'�P GRADING CU. YDS.. ACRES PKG. SPACE, REO. P O EO - I' •' License No. __ LICENSED CONTRACTOR DECLARATION Remarks: PC 41 PARK FEE $ '. I. hereby affirm that I am Ilcensed'undar provisions of Charter.9 (commencing with: section 7000) of Division 3 of the Business and Professions Code, and I SPECIAL CONDITION my license Is in full force and effect. 'I s 1�IC ` Ucense Class License No. I - PLUMBING Lb d 1) nAm , ' Date Signature , I 1. - , Bar Sink Sewer Cap- ! I ELECTRICAL )IJ WORKERS' COMPENSATION DECLARATION I ' `ereby affirm that I have a certificate of consent to self-Insureor a certificate.. Automatic Washer_ _ 1Meter over 100 amps i - Backflow Preventer'- -' - Sewer DOOOeCiIOd-^ - - -- -•- _ Yorkers' Compensation I.n ura.nce,jor a certified copy thereof (Section Construction Pole Sub Panel, .0, Lab. C-) P30 3(o 1Y Fh( �"� Backflow Irrigation Solar Collectors _ Policy No. Y Company G r,i v1�-s1I•f certified copy Is hereby furnished. Bathtubs - - - Solar Piping ! Cooking Unit Sub Pole r C�tilJe oyy s tiled with the city ildinx•��(I•vis n (/�) " Z�-X �_ Clarifiers j I Slicer Tankv �. Dishwasher ' ' Motors ❑0-1 HP O1 /a$ - pat••1a• Applicantp"o�- -+�C(�=� EKEMPTION FROM WORKERS' COMPENSATION DECLARATION - Dryers ❑Electric" -- - InQ Soler'�9-15 HP ❑16-15+ I :r4 ` Dishwasher ! - Swimming Pqdl w/SPal (This section need not be wmDleteO If the permit I5 for.One hundred ($300) or less). I - 1 certify !that in the per/urman<e of the work for which [hid permit 15 I55uetl I Drinking Fountains ! - ... Urinal ',� - ; Fan' I I Microwave J t ' shall not employ any person in any manner so as to become subject to the - _ •�i' F.A.U. Pole Light ' Workers' Compensat Ion Laws of California. r , Floor Drains 1 Water Go5_at''- 1 '� I _ Data Signature 1 NOTICE: If,'aft<r making this declaration you stiould' become subject to the Floor Sinks. -- --: -- - —Water Heater - - - +_ _ _ _ Fixtures—' Range Workers' Compensation provisions of the labor Code,.you must.forthwith -or Device Boxes C" Sign_` comply ,with such provisions this permit ishall be deemed revoked. Gas Service • •Outlets - ,Water Service y. CONSTRUCTION' LENDING AGENCY' ' - 1 that there IS for the : - - _ Outlets '- " Sections ' • a construction issue agency f the affirm of the work for. which' this Is issued (Section :307 Civ. C) 7 CIv.a C.) Interceptors - - ,� I - U, , .Standing i permit 'Lender's1 Hamer Kitchen'Sink'- -- , Switches - - 1 .iTras- h Compactor , � ' l_ -' - � - � LBVatorle5 ! - _ Garbage Disposal r.a '. t OWNER. UILDAddress . OW NE R.BUILDER DECLARATION' ! , .' � � ,. ( !. 1 hereby.atfirm that I am exempt from the ContractoYs.License Law for the - •' Generator 1:1.0-5 KW 135-15 KW i following reason -(Section 7031.5 Business and Professional Code: Any city or P—Trap - - F county which requires a permit to, construct, alter Improve, demolish oCrepair ' any structure, prior to Its Issuance,'also requires the applicant for such permit Roof Drains r _ r r Transformer 0115.50KW (• 7,' :t0 SIs a signed statement that he/she Is licensed pursuant to the provlsl ons Of the Contractor's License Law (Chapter 9 (commencing -with Section 7000) of vision 3'0f the Business antl Professions Code or, that he/she is'exem t - - Showers - _ - ` r Reinspection Fee `$15 - ❑SU+ KW - _ 'Reinspection Fee I " $15 efrom and the basis for the alleged exemption. Any violation -oft Section - - _ Meter ❑up to 100 amps 1 ' ' Issue Fee 1:5 by.any applicant for a permit- subjects the'applicant to a civil alty of not more than five hundred dollars ($500). - Sl _ ' I 1 I Issue Fee - $� 3. - Zoning"Approved By � - _ Date U I, as owner of; the property of my employees with viages as their sola . . I _ 5 compensation' will -do the work, and the structure is not Intended or offered for sale Business . and; Professional Code: The- Contractor's , I _ - ! MECHANICAL ' Application Approved By - . ate S 1 Law doe of al- to an owner if a property ,who builds or Improves I License Law does not t who 'thereon, himself/herself through _ Bailer - t Refrigeration System l Applimtign lauod'By '—LL ! , - 'net and who does such work or his or her own s such employees, provided that such Improvements are.not Intentletl or offered for �� Duct - Under�Grou round I 00100,000BTU ❑100,000 BTU - - v'. _ sale. II however, the building or Improvement Is sold within one yeanof com• i .. • •,BUILDING SUMMARY OF FEES r pletion, the owner.will have the burden of proving he/she did not build or im- I rove for the purpose of sale). 1 Duct -Structural i System Repair/Alteration _ ,. , �I PERMIT $ �•S�L� SMTP $ I, as owner of the property, am exclusively contractinglwith licensed con- tractors to construct the'Droject..fSection.7044, Business. and Professions Code: Res Duct_Ventilating __ ;. - _ _ __ _ �, �' ,`PLAN CHECK ' $ , PERMIT The Contractor's License Law not apply to an owner of property who builds or Improves thereon, and who contracts for such Projects with a con- Exhaust System 0 Multiple 0 , I - PLUMBING $ _} ISSUANCE $ ' . tractor(s) license pursuant to the Contractor's License Law): 0 1 Section B. & P. C. for this Firepi/Fact. PLAN CHECK $ "s - v .. GRADING $ am exempt under reason r Bit. ICBO # _ 1 I ELECTRICAL' $.� j'; $ l Date Owner) r Heating System&Ducting ! •$- - MICROFILM $ -certify that I have read this appllcatio'n-and state that the above- — � 00700;000 BTU' 0100;000 - _ _ _ _ _ '. PLAN CHECK t9 ' itherebyy nformation incorrect. I agree to comply with all city, and county ordinances building hereby - MECHANICAL y '$ %.I TOTAL FEE $ and state laws relatin .to construction .antl authorize repre- 'sentatives this; to n n the for Hood or TYPei 0. ', • ( Y j' LESS ' 1 ! r up a ve-mentioned property Inspection r , Cant) T e II ❑. Reinspectioh Feel i ; I $15 PLAN CHECK' $ ores. , i, Signature Dat ' Registersi Issue Fee .' $ 3' • ? i ~•i ADVANCED PC ! $ Drivers' License or'SS # I , FINAL FEE $ I,LJiJ CMF 0865-46 rev. 12/82 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod -Assessor •00I4STRUCTION,ANO.PLANNING; `,� b --'I ;r.,. -- -Permit•# 'Date ^ . ' ,� gQ90 z .,nate i --TTAPPROVALS Permit# ;Inspector - - 'APPROVALSI. inspector. , Temporary Electrical Service or. Role '52: Applicant to fill in all spaces within heavy border lines and. sign all appropriate declarations. CITY -OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. BLDG. N I ,�CO�TRUCTIONPERMIT / //[ 4084 B/27/BI 41p95 Profen Address f'` y S h$ h TYPE OF CONSTRUCTION ❑ NEW ❑ ADD ❑ ALTERATION ❑REPAIR ❑CONVERSION ❑DEMOLISH ❑ OTHER ZONING REGULATIONS - Owner UULbi Al, /(p06- T, -S Phone Address' 1`4 T'A12CV)C--Lsi ArchlEng. License No. DESCRIPTION OF WORK A.P.# Address ' ZONE PLNTG. REF`. ^ Contractor C- tC /C4.7 SfG NCUBSrS Phone 731-( TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL BUILDING SETBAS IO YARD p� PRpOBP IRTV LINE Address 13 0. P VIL C s '-- 0 LICENSED CONTRACTOR DECLARATION ❑ TENANT ❑ ELECTRICAL ❑PLUMBINJG ❑MECHANICA SIDE A I hereby affirm that 1 am licensed under provisions of Charter 9 (Com- RIGHT Tenting with section 7000) of Division 3 of the Business and OTHER.,!2�0'11:1 ' Professions Code, and my license Is In full force and effect. REAR YARD (TO P/L) PROJECT DESCRIPTION License Class.—License No. Sq. FT,' PKG, SPACE REO. PROVIDED -PARK Date Signature WORKERS' COMPENSATION DECLARATION - ' ' OCCUPANCY --CONSTRUCTION TYPE STREET WIDTH FEE § I hereby affirm that I have a Certificate of consent to self -insure or a �, l` C' - VALUATIONy� ZONE ZONING APPROVED BY DATE Certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C.I. - - GRADING CU. ✓D5. ACRES SPECIAL CONDITIONS: Policy No. Company REMARKS: - - - - 'ertified copy is hereby furnished. -' ertifled copy is filed with the city Building Division. . b-EMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit is for one hundred Or less). , Sb1001 tatt(((y that In the performance of the work for which this permit is PLUMBING. PLAN CHECK ELECTRICAL PLAN CHECK' issued, 1 shall not employ any person In any manner so as to become subject to the Workers' Compensation laws of California. - ' BATHTUBS SHOWERS Date Signature NOTICE: If after making this declaration, You should become subject TOILETS _ URINALS GENERATOR 0-1 KW -1 O.KVJ ' t0 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 10-50 KW_50+KW revoked. KIT. SINKS DISHWASHERS MOTORS 0-1 HP -1-10 HP CONSTRUCTION LENDING AGENCY 11hereby affirm that there is a constructloh.lending agency for the per- SERVICE SINKS SUMPS (INC. 50 LAR) 10-50 HP 50 + HP formenee of the work for which this perms t'is Issued (Section, 3097 - FLOOR SINKS - FLOOR DRAINS - - - YDRINKING FIXTURES OUTLETS SWITCHES CIV. C.). _ L'ender's Name Lender's Address FOUNTAINS -GAS TUBE SIGNS OWNER BUILDER DECLARATION 1 hereby affirm that I am exempt from.the Contractor's License Law for INTERCEPTORSCLARIFIERS - - POLE LIGHTS " POOL PTRAP POLES METERED SUB the following reason (Section 7031.5 Business and. Professions Cotle:SWIMMING 'Or 'requires 'a' Any City -county which -permit t04 construct, alter, improve, demolish or repair any structure, prior to its issuance, also re- W .,ATER SERVICE ALTERATION 'PANELS MAIN SUB - quires the applicant for such permit to file a. Signed Statement that he - GAS SERVICE OUTLETS SERVICE AMP is licensed Pursuant to the Provisions of the Contractor's License Law (Chapter 9 (commencing with- Sectlon>7000) of -Division 3 of the WATER HEATERS BTU OUTPUT - - Business and Professions Code) or that he Is exempt therefrom and the basls.forthe alleged exemption. Any violation of Section -7031-.5 by SEWER CONNECTIONS applicant for apermit Subjects the,applicant to a civil penalty 4 more than five hundred dollars ($500). , _ SOLAR TANK COLLECTORS „I 1,- as owner of the property, or my employees with wages as their sple Compansatlon, will do the work, and the structure Is not Intended or offered for Sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SVS. ISSUE FEE Contractor's License Law does not apply to an owner of a property ISSUE FEEMCHECK APPLICATION APPROVED BY DATE who builds or Improves thereon, and who does Such work himself or through his own employees, provided that such improvements are not - MECHANICAL CK SUMMARY OF FEES intended or offered for sale. it, however, the building or improvement is sold within one Year of completion, the Owner will have the burden of Proving he did not build or improve for the purpose of sale).BUILDING Z1 r So ❑ 1, as owner of the property, am exclusively contracting with HEATING SYSTEM 0PERMIT AND DUCTINGlicensed $ • — SMIP Ee). contractors to construct the project (Section 7044, Business 1PLAN CHECK PERMITantl Professions Code: The Contractor's License Law tloes not apply to .E ISSUANCE $ an owner Of property who builds or Improves thereon, and who con- REFRIGERATION 0 PLUMBING $ tracts from such projects with a contractor(s) licesned pursuant to SYSTEM GRADINGthe Contractor's License Law). - 1PLAN CHECK $1 am exempt under Section B. & P. C. for this BOILERS ELECTRICAL § § reason PLAN CHECK E MICROFILM $ Date , Owner - SYSTEM REPAIR, ALTERATION _ MECHANICAL E TOTAL FEE E - I hereby cert llythot 1 have read lois application and state that the above EXHAUST SYSTEM MULTIPLE - LESS AD- - information is correct. I agree to comply with all city and county PLAN CHECK $ VANCE PC E ordinances and state laws relating to construction, and hereby authorize representatl of this city to ter upon the. above Q�entip0ad �t property f ins ectl n purpo �� / � Signature ate FINAL FEE E 1./. -sl_ .— Drivers' Lcense $ ISSUE FEE CMF 0116546 White -Building; Canary -Applicant; Pink -Accounting: Goldenrod -Assessor TL R CONSTRUCTION AND PLANNIN r7 Date APPROVALS Permit #)_LJ-.� Date POOL & SPA ,, Inspector.' -APPROVALS .. Permit # Date ;InspeL:-- 1. Temporary Electrical Service or Pole - " 43- Pool & Equipment Location. 2.- SoilPipe-Undrgrn - -, -- - 44: `Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn - - - " -45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding5. - Steel ein orce _ 47. Rough Plumbing & Pressure.Test.. f 6.- Electrical UFER Gro _r '48. APPROVAL TO COVER-GUNI.TE 7. Footings - - �,- -- 49. Electrical'Conduit-Undr rn B. Foundation -- - ---- - -"- -- - -- - -- - - - - 50. 'Gas Pipe; ❑Undr rn, Test 9. Water Pipe-Undrgrn - - �- 51. Backwash Lines P -Trap- EJ Undrarn 10:- Structural Floor System -- - -- - - -- -527-APPROVAL TC DECK---- - - - - - - - ---- - - - 11 Property Sewer Line & House- Connection _ 53.. Backwash & Rece for -Final . 12. Street SewerConnection: ;, .. 54. Heater & Vent -Final - 13. Rough Plumbingy Plumb no System _- nal 14. 'Rough'Ele&ric-Conduit _ _'56. ElectricalFirial-- -15.--flough Electric -Wiring- --57.- Solar System-Final.-'�%�<- �•- -16. . Rough Heating &-Air Conditioning- _ _ _ __ _ __ encing &_Access Approval-- + 17. _ Ducts, in Structure. APPROVED FOR PLASTERING - I 18l 19. 20'. Ducts, Ventilating Gas Pipe-Rough&Test_ - - = Roof Framing 60. POOL/SPA SYSTEMSFIN'AL " 21'. 22'. Roof,Sheathin Frame and FlasNin- -- - I NOTES:: 23. Insulation 241. Lathing & Siding ' 25'. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final + -•+ a 28. Final Electric ' f A 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 i •' - 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING '7_ _- .c - 39. Special Requirements Completed 40. Electric,Release to Edison_ - 41. Gas Release to Southern California Gas Co: 42. I CERTIFICATE OF OCCUPANCY . No - Date ---- I " - - - --- - - - - - A Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. —S OF,COSTA MESA PERMIT O. TRACT NO. LOT NO. BLDG. NO. ,C[TY PERMIT %/S .CONSTRUCTION TVP F CONSTRUCTION NEW ❑ ADD ❑ ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER ' 33.? /"r/SI 6e C` ZONING REGULATIONS Project Address Z`iT F15CAk%6% Owner QJ `�.yl'ss,W vQS Phone SSV-LLZ Address \S\Z 1.1 . 'hps1.4d\tiJ I *Wiii lLA w Arch/Eng. License No. DESCRIPTION DESCRIPTION OF WORK TYPE OF PERMIT ❑ GRADING ❑ FOUNOATIO ❑ STRUCTURAL ❑ TENANT ❑ ELECTRICAL PLUMBING ❑MECHANICA N E BUILDING SETBACK ST. S SID VAgD LS IEpE VA PLNG. REF.:f �RoEp.0kJPYI LI NE Address Contractor "-'e`%dshWV l4Phone Address �i(Olq I,TM\Cq f \ •�.. LICENSED CONTRACTOR DECLARATION that licensed Charter 9 1 hereby affirm I am under provisions of (com- men ting with section 7000) of Division 3 of the Business and ❑ OTHER' RIGHT Professions Code, and my license is in ful force and effect. REAR YARD (TO P/L) *�,� PROJECT DESCRIPTION _ License lass Z"1 Licens No. 50. FT. 'PKC. SPACE -REQ. STREET WIDTH PROVIDED PARK FEE $ - Date 7' 8\ Sign WORKERS' COMPENSATION DECLARA ION OCCUPANCY_ CONST R UCT ION TYPE I hereby affirm that I have a certificate of conse'n'tto self -Insure or a VALUATION ZONE ZONING APPROVED BV DATE Insurance, a g¢rt copy SPECIAL therCertificate eof (Sect ggWorekpp9j LLIpih,}¢�n5ation £r 7 a% LrM P GRADING CU. YDS. ACRES GRADING _ CONDITIONS: P-';cY No. Cp mosey artified Copy is hereby furnished. REMARKS: .ertified copy is filed with the city Building Division. - EXEMPTION FROM WORKERS' COMPENSATION DECLARATION/ -Y/ (SAI CAI (This section need not be Completed if the permit Is for one hundred I$100) or certtify that 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 PLAN CHECK subject to the Workers Compensation Laws of California. BATHTUBS SHOWERS INGc0,FT - Date Signature SO- FT - NOTICE: If after making this declaration, you should become subject TOILETS URINALS GENERATOR 0-1 KW_ 1-30 KW to the Workers' Compensation provisions of the Labor Code, you must _ TRANSFORMER forthwith comply with such provisions or this permit shall be deemed 1 LAVATORIES DOUBLE LAVS 0 APPLIANCE 30.50 KW -50 + KW revoked. KIT. SINKS DISHWASHERS MOTORS - 0.1 HP -1-10 HP - CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the per. SERVICE SINKS SUMPS (INC. SOLAR) 10-50 HP 50 + HP formance of lthe-workfor which this permit i5 issued (Section 3097 FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES 1M ` entl er). Name Lender) Lender's Address 11`01:11,85 ��\7aM G '� DRINKING FOUNTAINS GAS TUBE SIGNS "- - OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS POLE LIGHTS - 1 hereby affirm that 1 am exempt from the Contractor's License Law for SWIMMING POOL PTRAP - - ' the following reason (Section 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, POLES METERED SUB WATER SERVICE ALTERATION PANELS MAIN "SUB - improve, demolish or repair any structure, prior to its issuance, also re- quires the applicant for such permit to file a signed statement that he GAS SERVICE OUTLETS SERVICE - AMP Is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT Business and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS applicant for a permit subjects the applicant to a civil penally )t more than five hundred dollars ($500). SOLAR TANK l� ., as owner of the property, or my employees with wages as their Tole compensation, will do the work, and the structure Is not intended - or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SVS. oe ISSUE FEE Contractor's License Law does not apply to an owner of a property -- ISSUE FEE APPLICATION APPROVED ED BV DATE -' who builds or improves thereon, and who tloes such work himself or through his own employees, provided that such Improvements are not MECHANICAL PLAN CHECK SUMMARY OF FEES Intended or offered for sale. If, however, the building or Improvement is sold within one year of completion, the owner will have the burden of proving he did not build or improve for the purpose of Sale). HEATING SYSTEM 0-100,000 BTU PERMIT UILDING $ SMIP $ El 1, as owner of the property, am exclusively contracting with AND DUCTING - licensed contractors to construct the project (Section 7044, Business 100,000+BTU PLAN CHECK $�/—� PERMIT and Professions Code; The -Contractor's License Law does not apply to _ ISSUANCE $ an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $—(r._ —¢.r•— tracts from such projects with a contractor(s) Ilcesned pursuant to SYSTEM - GRADING $ the Contractor's license Law). 100,000 + BTU PLAN CHECK $1 ❑ I am exempt under Section B. & P. C. for this BOILERS BTU ELECTRICAL $ $ reasonPLAN SYSTEM REPAIR, ALTERATION - CHECK g MECHANICAL $ - MICROFILM $ TOTAL FEE $ Dale Owner 1 hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE LESS AD- Information is correct. ILagrise to comply with all city and county PLAN CHECK '$ _ VANCE PC $ _ ordinances and state laws �tlA, at ing to onStr.ction, antl hereby authorize ' representatives of this c to ter upon the abov me Iionetl pro PertY f �lZiWi / v, _ FINAL FEE $ SIq ure Dale Drivers' License or SS f- ISSUE FEE- - CMF 0865-46 White-Buliding; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor fit: CONSTRUCTION AND PLANNING APPROVALS Permit # Date POOL & SPA •s Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment'Location' 2. SoilPipe-Undrgrn 44. Steel Reinforcement.. -� 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel Reinforce 47. Rough Plumbin &'Pressure Test -' 6. Electrical UFER Grn - 48. APPROVAL TO COVER=GUNITE' 7. Footings 49. Electrical Conduit-Undr rn - - 8. Foundation - 50. Gas Pipe, ❑Undr rn; Test r 9. Water Pipe•Undrgrn 51. Backwash Lines P-Tra' �_ bd"r rn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash &.Rece for -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing -- - - 14. Rough Electric -Conduit - _ - - 56. ` Electrical -Final 15. Rough Electric -Wiring - 57. Solar System -Final 16. Rough Heating & Air Conditioning - - - encing & Access Approval 17. Ducts in Structure. 9. APPROVED FOR PLASTERING 18. 19. 20: Ducts, Ventilating Gas Pipe -Rough &Test Roof Framing ' 60. . POOL/SPA SYSTEMS FINAL 21. 22. Roof Sheathing Frame and Flashing NOTES: 23. Insulation:' •-'-`-'- 24. Lathing & Siding 25. Drywall Nailing - -- 26. Plaster Brown Coat - - 27. Electrical Power Meter -Final 28. Final Electric - 29. Final Heating & Air Conditioning 30. Final Gas pipe -Test 31. Final Plumbing - 32. Water Service -Final , t 33. Gas Service -Final 34. Solar Domestic -Final 35. Landsca22 Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE&BUILDING 39. Special Requirements Completed 40. Electric Release to Edison ' 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No. Date Applicant to fill In all spaces within heavy border lines and sign -III appropriate declarations.- _. '{ �✓ - CITY QF COSTA MESA - PERMIT NO. TRACT NO. LOT NO. BLDG. NO. ' CONSTRUCTION PERMIT 2TYPE OF CONSTRUCTION ❑ NEW ❑ ADD 11ALTERATION ❑REPAIR ❑CONVERSION ❑DEMOLISH ❑ OTHER " :7\ , :-, 8094 ]/02/81 16.64 ZONING REGULATIONS Project Address t (( o2T' EST-,uf XWe/2 --OwnertC ir��Q% Phone Z Address S(7 Fa IK ✓(F Ni SA.AAW. 19A1.4 Arch/En -=E} $feC, License No. DESCRIPTION OF WORK A.P. g. ti0 i Address' 7% el//� CA 9L7� T ZONE PLNG. REF. $ Contfactor Y CSTXIC_ - Phone 65-L. 347 TYPE OF PERMIT - ❑GRADING - El FOUNDATION El STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHANICA BUILDING SETBACK ST. SIDE VARD LS IEDFS VA To el�ILpING PROPS RTV LINE ' — - Address d L LICENSED CONTRACTOR DECLARATION 1 hereby affirm that I am licensed under provisions of Charter 9 (com- 3 ❑ mencing with section 7000) of Division of the Business and Professions Code, and my license is In full force and effect. OTHER REAR YARD (TO P/L) - 68,21 26 PROJECT DESCRIPTION _ - License Class C2 --/o LICs e N PKG. SPACE REQ. PROVIDED 2 SQ. FT. Date Signature � =�� Ml STREET WIDTH PARK FEE E WORK RS' COMPENSATION DECLARATION - OCCUPANCY— CONST RUCTION TYPE ZONING APPROVED BY GATE I hereby affirm that I have a certificate of consent to self -Insure or a VALUATION ZONE certificate of Workers' Compensation Insurance, or a certified copy - thereof (Section 3800, Lab. C.). GRADING CU. YDS. ACRES SPECIAL CONDITIONS: ^,licy No. Company - Certified copy is hereby furnished. REMARKS: 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 1 \\ or idol. S$300) cert((fy that n 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 PLAN CHECK subject to the Workers Compensation Laws of California. UWLLLING GAH,UL Date Signature BATHTUBS SHOWERS 5Q NOTICE: If after making this declaration, you Should become subject TOILETS URINALS - GENERATOR 0-1 KW_ 1-30 KW 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 LAYS- APPLIANCE - 10-50 KW_50'+ KW revoked. _ KIT. SINKS DISHWASHERS - MOTORS 0-1' HP HP CONSTRUCTION LENDING AGENCY -1-10 I hereby affirm that there is a construction lending agency for the per. SERVICE SINKS -' SUMPS - '(INC. SOLAR) 30-50 HP 50 + HP formance of the work for which this permit is Issued (Section 3097 FLOOR SINKS FLOOR DRAINS- - FIXTURES OUTLETS' SWITCHES 1-7 Civ. C.). Lender's Name _ Lender's Address DRINKING FOUNTAINS - GASTUBESIGNS ' INTERCEPTORS CLARIFIERS POLE LIGHTS " OWNER BUILDER DECLARATION - 1 hereby affirm that I am exempt from the Contractor's License Law for SWIMMING POOL PTRAP ' POLES METERED SUB the followingreason (Section 7031.5 Business and Professions- Code: Any city or county which requires a permit to construct, alter, WATER SERVICE ALTERATION - PANELS MAIN - SUB improve, demolish or repair any structure, prior to its issuance, also re- quires the applicant for such permit to file a signed statement that he GAS SERVICE OUTLETS SERVICE - AMP Is licensed pursuant to the provisions of the Contractor's License taw (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT- - - Business and Professions Code) or that he is exempt therefrom and the hasis for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS - -' y applicant for a permit subjects the applicant to a civil penalty not more than five hundred dollars ($500). SOLAR TANK COLLECTORS ...j 1, 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. (Section 7044, Business and Professions Code: The SOLAR PIPING SVS. ISSUE FEE - Contractor's License Law does not apply to an owner of a property -APPLICATION who builds or Improves thereon, and who does such work himself or ISSUE FEE APPROVED BY DATE through his own employees, provided that such Improvements, are not MECHANICAL PLAN CHECK _ SUMMARY OF FEES Intended or offered for sale. If, however, the building or Improvement is.sold within one year of completion, the owner will have [he burden BUILDING of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU PERMIT $ SMIP $ ❑ as owner of exclusively contractingwith AND DUCTING n t p n7044, licensed contractors to construct the project (Section o construct 100,000 +BTU PLAN CHECK E PERMIT not apply to es not apply and The Contractor's License Law does ISSUANCE- $ a owner of property who builds or improves thereon, and who ton- owner of property REFRIGERATION 0-100,000 BTU PLUMBING $ batt from such projects with a contractor(s) Ilcesnetl pursuant to tracts SYSTEM - - GRADING $ the Contractor's license Law). 100,000 +BTU PLAN CHECK $ ❑ I am exempt under section - B. & P. C. for this BOILERS BTU ELECTRICAL $-IJ-O� �(L�7-Cfj—. $ reason' SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE PIAN CHECK g MECHANICAL' $ MICROFILM $ TOTAL FEE $ - LESS AD - Date Owner I hereby certify that I have read this application and state that the above Information is correct. I agree to comply with all city and county PLAN CHECK $ VANCEPC $_ and State laws relalin to const ruction, and hereby authorize representatives f this city [ enter upon [M1e above a ion¢tl represtnta property for sp [i ra FINAL FEE $ Ila Signature Date/S1ISI�Ell Drivers' License or 55 � ISSUE FEE - .. CMF 0865-46 White -Budding; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor V\ CONSTRUCTION AND PLANNING APPROVALS 1 Permit # - Date POOL & SPA ',•• , - Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - . SoilPipe-Undrgrn 44. Steel Reinforcement - 3. Electrical Conduit Utility-Undrgrn 45. Forms T. Electrical Conduit-Undrgrn 46. Electrical Bonding ' 5. Steel ein orce 47. Rough Plumbing & Pressure Test - 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Trap. ❑ Undrgrn 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 13. . Rough Plumbing - 14. Rough Electric-Conduit . ,56. Electrical-Final 15. Rough Electric-Wiring 57. Solar System-Final 16. Rough Heating & Air Conditioning W. Fencing & Access Approval 17. Ducts in Structure APPROVED FOR PLASTERING 18. 19. 20. Ducts, Ventilating Gas Pipe-Rough &Test Roof Framing- 60. POOL/SPA SYSTEMS FINAL • 21. 22. Roof Sheathing Frame and FlashingNOTES: '23. 'Insulation _ 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter-Final 28. Final Electric 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. FINAL STRUCTURE & BUILDING 39. Special Requirements Comprei d 40. Electric Release to Edison - ' 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY 'No Date Applicant to fill In all spaces within heavy border lines and sign all appy detlaratlo nf. 11 r•ey OF COSTA MESA PER IT NO. TRACT NO. LOT O. BLDG. NO. CONSTRUCTION PERMIT % / j 2 ,'3s fl S TYPE OF CONSTRUCTIO' ❑ NEW ❑ ADD ALTERATION ❑ REPAIR 13 CONVERSION ❑DEMOLISH ❑ OTHER- 663j; 4:010®%®Ilei 253_A6_ - ZONING REGULATIONS Prajeet Address Own Or Phone wf Address - AI` - �j Arch/Eng. License No. DESCRIP ION OF WORK r A.P. # '- Address ��EE �a>, ZONE PLNTGpp. RttE//FLL. ` ContractorJLY P Phone �'T TYPE OF PER �� ❑GRADING ❑ FOUNDATION Ili STRVCTU RAL ❑ TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHANICA SETBACK I YARD 51 E Y pp 4ROPElW'Tl NE Address LICENSED CONTRACTOR DECLARATION I hereby affirm that 1 am licensed under provisions of Charter 9 (Com.RIGHT mencing 7000) 2-06T % with section of Division 3 of the Business and Professions Code, and my license Is In lull force and effect. HER REAR YARD (TO P/L) PROJECT DESCRIPTION License Class License No. PKG. SPACE REO. PROVIDED Date Signature - T._ SO. FT. --- STREET WIDTH PARK FEE $ WORKERS' COMPENSATION DECLARATION OCCUPANCY ONSTRUCTION TYPE 1 hereby affirm that I have a certificate Of consent to self -Insure or a O VALUATIO ZONE ZONING APPROVE GATE cert)fleate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C.). GRADING CU. YDS. C��ICRES SPECIAL CONDITIONS: POIIPI?"Ko. Company HOLD_ FOR MCI" 'riffled copy Is hereby furnished. -- REMARKS: mm artifled Copy Is filed with the city Building Division. V L-EMPTION FROM WORKERS' COMPENSATION DECLARATION (This Section need not be completedif the permit is for one hundred r ° - S$3001 or Iat tnat n the performance the work for which this card, PLUMBING - PLAN CHECK ELECTRICAL PLAN CHECK I ploy person I shall not employ any person in any manner so as to become barn e subject [o the Workers Compensation Laws of California. - . BATHTUBS SHOWERS .subject Date Signature NOTICE: If after making this declaration, you should become subject TOILETS URINALS - GENERATOR 0-1 KW_ 1-30 KW to the Workers' Compensation provisions Of the Labor Cotle, you must TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE 10.50 KW -50 + KW - revoked. KIT. SINKS DISHWASHERS MOTORS 0-1 HP_1-30 HP CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS- (INC. SOLAR) 10-50 HP 50 . HP - fOrmance'of the work for which. this. permit Is Issued (Section 3097- FLOOR,SINK,S - ,FLOORDRAINS FIXTURES OUTLETS SWITCHES LenCIv. Cq. - Lender's Name Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS OWNER BUILDER DECLARATION I hereby affirm that I am exempt from. the Contractor's License Law,for 'the following reason (Section 7031.5 Business and Professions Cotle: INTERCEPTORS CLARIFIERS - - - POLE LIGHTS - SWIMMING POOL PTRAP POLES METERED SUB Any City or county which reeulres'-a permih to .construct, alter. ImF,rovo, demolish or repair any structure, prior to Its Issuance, also re- WATER SERVICE ALTERATION PANELS MAIN SUB qu res the applicant for such permit to file a signed statement that he Is licensed pursuant to the provisions of the Contraptor's License Law GAS SERVICE 1 OUTLETS SERVICE - - AMP ' (Chapter 9 (commencing with Section 7000) of Division 3,of the Business and, professions Code) or that he Is exgmpt,therefrom and the WgTER HEATERS �, BTU OUTPUT basis -for the alleged exemption: Any violation of. Section -7031.5 by, - - SEWER CONNECTIONS ' 'a� abplicant' for a permit subjects *the applicant to -a civil penalty t more than,five hundred dollars ($500). wages ' SOLAR TANK COLLECTORS - es owner of [he property, or my employees with as their Sold Ccnrdensation, will do the work, and the structure Is not intended, f or offeretl for Sale. (Section 7044, Business and Professions Code: Tho ' SOL`AR:PIPIN_G-SVS ISSUE FEE ' Contractor's License Law does not apply to an owner of a property - ISSUE FEE APPLICATION APPROVED BY DATE 0- Who builds or Improves thereon, and who does such work himself or ihroUgh his own employees, provided that such Improvements are not -' MECHANICAL PLAN CHECK SUMMARY OF FEES Intended or offered for sale. If, however, the building or Improvement IS Sold Within one year of completion, the owner will have the burden of proving he did not build improve for the purpose of sale). HEATING SYSTEM 0.100,000 BTV PERMIT G �0� rt exclusively contracting with ❑ 1.n as owner of the property, to construct the (Section Business AND DUCTING SMIP IS i5s S contractors project p and antl es not Contractor's Law does not apply t0 Code: The Contra Cor 100,000,+ BTU PIAN CHECK $ PERMIT ISSUANCE $ wn r of pr I provLicenso an owner of properly who or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING b tracts from such projects with a contractor(s) Iicasnetl pursuant to With a SYSTEM - ? GRADING E the Contractor's License Law). 100,000 +.BTV =-� �_ t �7 -� 1 \_t� 1 PLAN CHECK S ❑ I am exempt undo, Section B. & P. C. for this J$ BOILERS BTUV ELECTRICAL § reason PLAN CHECK E MICROFILM $� Date Owner SYSTEM REPAIR, ALTERATION MECHANICAL § TOTAL FEE $--259d6 I hereby cert ly that I have roa0 his ap plicatlon and state that the above EXHAUST SYSTEM MULTIPLE LESS AD- inlocmation is act. 1 dg to comply with all ttty dnd cqunty - PLAN CHECK § VANCE PC $ tl rtes a e relatln construction, OO'b UCLIOd, and hereby dUfhprla0 _ 'aprea hws Pro Party vas f this dlY"' r Upon o eve Lrlen red property for Io Dur s _ - •` El rp ) `Pie �,/S �J FINAL FEE SI na to 9 e Jul Drivers' License or SS # ISSUE FEE - - CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting: Goldenrod -Assessor s// -CONSTRUCTIONfANDF�ANNI APPROVALS Permit 2 Date Ins Inspector POOL & SPA APPROVALS Permit Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Soil Pipe-Undrgrn -74 -Steel Reinforcement 3. -Electrical Conduit Utility: Undrgrn, .45. Forms 4., Electrical Conduit-Undrgrn 460 Electrical Bonding b. Steel Reinforce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undrgrn 8. Foundation 50. Gas Pipe, 0 Undrgrn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines. P -Trap. 1:1 Undrarn 10. Structural Floor System 52. 'APPROVAL TO DECK 11. Property Sewer Line,& House Connection :':53.' Ba & Receptor -Final 12. Street Sewer Connection .54. Heater & Vent -Final 13. Rough Plumbing 55. Plumbona System - Final 14. RougH.Electric-Conduit 56. Electrical -Final 15. Rough Electric -Wiring 57. 'Solar System -Final 16. Rough Heating & Air C6ndifibAiog --5K�ancing & Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough &Test 20. Roof Framing 21. Roof Sheathing NOTES: ,,o Aeore . 0" ,ed.,e OW.O 22. Frame and.6mWng 23. InsulationJr/ -r. eE. 00rO4,14 B AVAWW~ 47-4"' AEOLV� 24. Lathing & Siding 10 25. Drywall Nailing Aep 6, /t0.1 aAA14*0,;� 14fZZIW-. , 30 26. Plaster Brown Coat Cu #7 27. Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning Zeg. 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. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No batg 0 ni ;,Fj F/ - Applicant to tilt in all swcef within heavy border Tines and sign all appropriate declarations. C& OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. -BL G. N CONSTRUCTION PERMIT M - 561 TYPE OF CONSTRUCTION CXNEW ❑ADD ❑ALTERATION i. / h - l e)#123 -' ,t•� 2899.; 1 #i233 8/06/81 I leOC Project Address 245 Fisher Ste.D-5' Owner Phone Addre a Ana El REPAIR ❑ CONVERSION ❑DEMOLISH ❑OTHER ZONING REGULATIONS Arch/Eng. License No. DESCRIPTION OF WORK TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL ❑TENANT ❑ELECTRICAL ❑PLUMBING MECHANIC _ A.P. # r ZONE PLNTG.. RVEF. pY LINE14 SETBACK T. G0.0BP EI�i'i SIDE VA Address Conlr t COnd • Phone 5288200 Addr Anaheim 92806 LICENSED CONTRACTOR DECLARATION -- 1 hereby of /ince that I am licensed Charter 9 under provisions of (com- ,pricing with section 7000) of Division - 3 of the Business and ❑ OTHER _ RIGHT - Professions Code, and my license is In full force and effect. REAR YARD (TO P/L) PROJECT. DESCRIPTION License Class — Llgppae No. iii 9988 PKG. SPACE REQ. PROVIDED Date 2-7-21 Signature kazdal SQ. FT. - WORKERS' COMPENSATION DECLARATION - OCCUPANCY_ CONSTRUCTION TYPE STREET WIDTH PARK FEE E 1 hereby affirm that I have a certificate of consent to 5 If -Insure or a VALUATION I ZONE ZONING APPROVED BY DATE certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C.). GRADING CU'. YDS. ACRES SPECIAL CONDITIONS: - Pa1ICyNo.C.7GAAQ /• J,� ,,, �Company 6eedman ins. •. edified copy is hereby furnished. REMARKS: -entified copy is filed with the city Building Division. ' EXEMPTION FROM WORKERS' COMPENSATION DECLARATION -' This section need not be completed it 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 --- PLAN CHECK subject to the Workers Compensation Laws of California. BATHTUBS SHOWERS Date Signature NOTICE: If after making this declaration, you should become subject TOILETS URINALS - GENERATOR' 0.1 Kim— 140 KW to the Workers' Compensation provisions of the Labor Code, you must TRANSFORMER forthwith comply with such provisions or this permit shallbe deemed LAVATORIES DOUBLE LAVS APPLIANCE 10-50 KW_50 + KW revoked. KIT. SINKS DISHWASHERS MOTORS 0-1 HP -1-10 HP CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS SUMPS (INC. SOLAR) 10-50 HP 50 + HP formance of the work for which this permit Is Issued (Section 3097 - FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES Civ. C.). Lender's Name Under 'S Address DRINKING FOUNTAINS GAS TUBE SIGNS OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS POLE LIGHTS 1 hereby affirm that I am exempt from the Contractor's License Law for SWIMMING POOL P TRAP - the following reason (Section 7031.5 Business and Professions Code: Any City or county which req ulres a permit to construct, alter, POLES METERED SVB WATER SERVICE ALTERATION PANELS MAIN SUB Improve, demolish or repair any structure, prior to Its issuance, also re- quires the applicant for such permit to file a Signed statement that he GAS SERVICE OUTLETS SERVICE AMP Is licensed Pursuant to the provisions of the Contractor's License Law 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT. 8(Chapter usiness and Professions Code) or thal'he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS - - applicant for a permit subjects the applicant to a civil penalty .t more than five hundred dollars ($500). SOLAR TANK COLLECTORS ., 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. (Section 7044, Business and Professions Code: The SOLAR PIPING SVS ISSUE FEE - Contractor's License Law does not apply to an owner of a.property - - ISSUE FEE APPLICATION APPROVED BY DATE who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvementsarenot MECHANICAL PLAN CHECK SUMMARY OF FEES Intended or offered for sale. If, however, the building or Improvement Is sold within one year of completion, the owner will have the burden of Proving he did not build or Improve for the purpose of Sale).BUILDING HEATING SYSTEM 0-100,000 BTU PERMIT ' SMTP $ El 1, a5 owner of the property, am exclusively contracting with AND DUCTING n 4 4.)0 E licensed contractors to construct the Project (Section 7044, Business 100,000 +BTU PLAN CHECK E PERMIT and Professions The Contractor's License Law dq, not aDPIY to - - ISSUANCE E pert or I an owner of property who builds or improves thereon, and who Con- a REFRIGERATION 0-100,000 BTU PLUMBING E tracts from such projects with a contractor(s) licesned pursuant to SYSTEM - GRADING $ the Contractor's License Law). 100,000 +BTU 4. D PLAN CHECK E ❑ I am exempt under Section B. & P. C. for this BOILERS BTU - ELECTRICAL $ - - E reason SYSTEM REPAIR, ALTERATION PLAN CHECK E MECHANICAL $-1/• MICROFILM $ _ t I1�1 TOTAL FEE $ ' i •TLII� Date Owner' I hereby Certify that I have This application and slate that the abate EXHAUST SYSTEM MULTIPLE LESS AD- ' agree Information is correct. I agree to comply with all city and county PLAN CHECK 'E VANCE PC E_ ordinances antls[ate laws relating to construction, and hereby authorize representatives f this city to enter .,on the above mentioned property for j n C5. - Signature Date 6-J-9/ ISSUE FEE - 100 - FINAL FEE E 11 .00 Drivers' License or CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor - TL CONSTRUCTION AND PLANNING APPROVALS Permit # ' S0 Date Inspector POOL & SPA I APPROVALS Permit # Date Inspector 4- 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - _2. SoilPipe-Un rgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. tee m eorce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVALTO COVER-GUNITE - 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, .0 Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Trao, ❑ Undrarn 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 13. Rough Plumbing 55- Plumbina System - Final 14. Rough Electric-Conduit - 56. Electrical-Final 15. Rough Electric-Wiring 57. Solar System-Final _ 16. Rough Heating & Air Conditioning b8. Fencing & Access Approval 17. Ducts in Structure b9. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe-Rough &Test 20. Roof Framing 21. Roof Sheathing NOTES: �+ S tp J � d �d h, t' 22. Frame and Flashin 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter-Final 28. Final Electric 29. Final Heating & Air Conditioning Y(l 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. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Soutfie'rn California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date - - .. Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. Ct�'Y OF COSTA MESA PER' h�T NO. TRACT NO. LOT NO. Bl-aG�NO CONSTRUCT vPERMIT rV Project Ad •S Ak TYPE OF CONSTRUCTION Phone ❑ NEW ADD ❑ALTERATION OJS__ w.r. a r n ., 9096 12107/81 Se00 Tl r•.......w V_- _.. __,••�,.�,��• uv�•V ��I ❑ OTHER I ZONING REGULATIONS Arch/Eng, License No. DES T N WORK A P OF - Address ZONE PLNTGp. _ Contractor • Ph TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL ❑ TENANT ❑ ELECTRICAL PLUMBING ❑MECHANIC SETBA T. YARD 1RE, pE Y gREF�. p# PROPEIRT FYI Na V LINE Address LICENSED CONTRACTOR DECLARATION men[in9 awit� 9eCtlohat In 7000) licensed untlg v IOOns Ca IGHT ton Ines9 G `ids ❑OTHER Professions Co d my icon In f Ce nd effect. REAR YARD (TO P/L) PROJECT DESCRIPTION License Class Ce s0 o SQ' FT' PKG. SPACE REG, PROVIDED Date Signature WORKERS' COMPENSATION DECLARATION - OCCUPANCY_ CONSTRUCTION TYPE STREET WIDTH PARK FEE E 1 hereby affirm that I have a certificate of consent to self -Insure or a VALUATION ZONE ZONING APPROVED BY DATE certificate of Workers' Compensation Insurance-, or a certified copy thereat (Sat') -GRADING CU. YDS. ACRES SPECIAL CONDITIONS: Macy No. Company. •ttified copy Is hereby turnished. REMARKS: 7. rt)fied copy Is filed with the city Building inion. , _MPTION FROM WORKERS' MPENS 10 DECL TION ,r his section need not be tompl if (tie r Is n on.,. or less). • - (E100) 1 certify that n the performan of th r T whit his Permit is PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK issued, 1 shall not employ any rson, n n nor as to become subject o= Workers CompenSa s f Cal or a. BATHTUBS SHOWERS Date Signature 'r NOTICE: If a ter making this deo ation, you d become subject TOILETS' URINALS GENERATOR 0-1 KW_ 1-10 KW 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 LAYS APPLIANCE 10-50 KW -50 + KW revoked. KIT. SINKS DISHWASHERS MOTORS 0-1 HP -1.10 HP CONSTRUCTION LENDING AGENCY 1 hereby affirm that tnere is a construction lending agency for the per. SERVICE SINKS SUMPS ZINC. SOLAR) 30-50 HP 50 + HP forman Ce of the work for which this permit Is issued (Section 3097 FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES Civ. Lender'sName Under's Address DRINKING FOUNTAINS GASTUBE SIGNS OWNER BUILDER DECLARATION 1 hereby affirm that 1 am exempt from the Contractor's License taw for the following reason (Section 7031.5 Business and Professions Code: INTERCEPTORS CLARIFIERS POLE LIGHTS SWIMMING POOL PTRAP POLES METERED SU Any city or county which requiresa permit to construct, alter, WATER SERVICE ALTERATION 'PANELS MAIN SUB Improve, demoish or repair any structure, prior to its issuance, also re- quires the applicant for such permit to file a signed statement that he GAS SERVICE OUTLETS SERVICE AMP Is Ilcensed Pursuant to the provisions of the Contractor's License Law Chapter 9 (Commencing with Section 7000) of Division 3 Of the Eusiness ' WATER HEATERS BTU OUTPUT and Aofessions Code) or that he Is exempt therefrom and the basis for the alleged exemption. Any violation of -Section 7031.5 by SEWER CONNECTIONS a^" applicant for a Permit subjects the applicant to a civil Penalty I more than five hundred dollars ($500), SOLAR TANK COLLECTORS as owner Of the property, Or my employees with wages as their nom Compensation, will do the work, and the structure is not Intent" or offered for safe. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE Contractor's License Law tloes not apply to an owner Of a property ISSUE FEE - 1 - _ �I APPLICATION APPROVED BY DATE who builds or improves thereon, and who tloes such work himself or through his own employees, provided that such improvements are not MECHANICAL PLAN CHECK Intended or offered for sale. If, however, the building Or Improvement Is sold within One Year of completion, the owner will have the burden SUMMARY OF FEES of proving he did not build or Improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU BUILDING , ❑ 1, as owner of the property, am exclusively contracting with AND DUCTING PERMIT $ SHIP $ licensed contractors to construct the project (Section 7044, Business _ 100,000,+BTU PLAN CHECK $ PERMIT and Professions Code: The Contractor's License Law does not ply to ISSUANCE $ an owner of property who builds or Improve hereon, a ' con- REFRIGERATION 0-100,000 BTU PLUMBING E tracts from such projects with a contract ecesn uant to SYSTEM GRADING $ Contractor's License Law). 100,000 +BTU PLAN CHECK $ 1 am exempt r t io B, P. C. for this BOILERS BTU ELECTRICAL E $ reason SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MVLTIPLE PLAN CHECK $ MECHANICAL E - MICROFILM $ TOTAL FEE S LESS AD. Date Own certify to 1 M1av d this antl state loaf the above information information is ect. gree t om with all city and county PLAN CHECK E VANCE PC $ ordinances and ate la elan o co ruction, antl hereby authorize _ representatives t City o e upon th0 dpOye m¢pfipn¢d • property for Insp n pur nes, �, �- Sign CMF d8ECr-41i White -Building; Canary -Applicant; Pink -Accounting; Gotdenrod-Assessor CONSTRUCTION AND PLANNING APPROVALS r Permit:#A__Z!ZyZ Date Inspector POOL & SPA. APPROVALS Permit # - Date Inspector-----------' 1. Temporary Electrical Service or Pole Po Y - 43. - Pool &Equipment Location � 2. SodPipe-Undrgrn -47 --Steel Reinforcement , 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn , 46. Electrical Bonding 5. Steel ein orce - 47. Rough Plumbing & Pressure Test 6. Electrical LIFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn Test 9. Water Pipe-Undrgrn 51. Backwash Lines P -Trap. C3 Undrqrn 10. Structural Floor System 52- APPROVALTO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing 55 Plumbing System - Finn( 14. Rough Electric -Conduit - 56. Electrical -Final - 15. Rough Electric -Wiring 57. --Solar System -Final 16. Rough Heating & Air Conditioning W, Fencing & Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. _ .. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough &Test 20. Roof Framing 21. Roof Sheathing NOTES: 22. Frame and Flashing 23, Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27, Electrical Power Meter -Final 28. Final Electric 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. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. - 42. CERTIFICATE OF OCCUPANCY No Date - P APPLICATION FOR A BUILDING PERMIT CMF 0335.46 (BU -28) rev. 6180 to c n b d a r BUILDING PERMIT NO. Elect ri" Tract Block Lot I -7 Ll - 7 / / Permil NBuildo. Atldress r` Address -x'.41; F1 SCOcn Plumbing Permit No. Cross Mechanical Area Street Permit No. Owner U L -W AP-1,F_5J Type o1 Project: ❑ New ❑ Alter ADOition Address t�1� �1 I ❑ Repair Cl Convert ❑ Demo ❑ Occupancy Pmt. City J�N� Lo'woj e PhonyZ2"L A.P. •so. Area/ \�l1.1 Architect/ Ggipner � L License NO. Zone ' Sol. Pmt. No. 11 Agtlreu 4+ e; Setbacks P/L Front C/L St. Street Width ! a `i ` eras Let rent ear LP /L70 1 PhoneRO City y-�'A �A eve ol. a l9 Engineer License No. rk.r, _lace% .quire ow a overs Address Struct No. of No. of City Zip Phone Height Stories Family LICENSED CONTRACTOR'S DECLARATION Park FeesYes C.T. Fee I hereby affirm tthat1 am licensed antler Provisions of Ch.,t., 9 Reaulred NO Receiot Zoning Approved By: Date (commencing with Section 7000 o1 Division 3 of the Business a" Professions Code. and my Iiesn" is in full force and affecO. License Clefs License Number Date COntrecior Misc. Ptoposeo Use of Structure Address City no Zip PDOna CONSTRUCTION LENDING AGENCY ' hereby affirm ?Mt %neve is a construction landing agency for the Occ Ty Oe Coo, Performance of the work for which this permit is issued (Sac. 3097. Class CortsT. Year Civ. C.), USE/OCCUPANCY SIZE SO. FT. Lenders Name Lender's Address OWNER43UILDER DECLARATION I herebyl that 1 em exempt from The Cemnctor's License Law 1. for rite following reason: w Q 1, as owner of the p,costly. or my employees With wages as Thai, 2. sole cpmPensatien, will d0 the work, and the structure is not intended or offered lot sale, 3 I, as owner of the Prooerts, em eaciusivtly contracting with licansed contractors to construct the project. ❑ 1 em exempt under Sec. B&PC for this reason 4. Del, Owner Total Valuation WORKERS' COMPENSATION DECLARATION ��ll Encroachment Rermll Reoulred ❑ yes lJ No I hereby affirm that I have a certificate of consent to setf.insu,e, C,5cc fllicate of Werkni Ce mcemeGCn tnw"r,ce, o' • cart ifisd copy thereof. GCin9 Pml. Grading Policy NO Company R.&.'n❑Yes ❑No Pmt. NO. Certified COPY is hereby iurnishatl. Certified COPY is filed With O ge EMA, ding Rouyn eO by: Approved Y: Date A Data Af�'� Apo ilcant CERTIFI 7E F E%EMPTI FROM WORKERS' CO ENSAT ION INSURA E (This section need not be completed if permit is for S1DO or least. I certify that In the perfe,nlsnca of the Werk for which this permit is issued, 1 shell not employ any person in env rMnner so as to become subject t0 the Workers' Con pensarion Laws of California. PERMIT FEES Oet. Applicant NOTICE TO APPLICANT: If, alar nuking this Certificate o1 Structural f Plan Check 3 Exemption, you should become subject t0 the Workers' Compensation Electrical s Special a Provisions 01 the Labor Cotler you must forthwith comply with such Provisions or this permit shall be deemed revoked. Invest. I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. I AGREE TO Numbing 3 - COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS Mechanical f RELATING TO BUILDING CONSTRUCTION, AND HEREBY AUTH. ORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE. ABOVE MENTIONEn PROPERTY FOR INSPECTION PUR- Pie-Graoe Inspection o ( ' a -Z1 - O Pre -Code RaG. No. f Perms Issue a ipNf r of APPIi nr or A ant Date jztLL"{ MnRO �R Print Applicaca ntNas/Agent's Nsma � All spades within this box must be wintploted to proyeu Plan Check By: Issuance Approved: CMF 0335.46 (BU -28) rev. 6180 to c n b d a r /Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. CITY -9,L COSTA MESA PERMIT NO. - TRACT NO. LOT NO. BLjNO.CONSTRUCTION PERMIT I A.Project TYPE OF CONSTRUCTION ❑ NEW ❑ ADD ❑ ALTERATIAddress REPAIR ❑CONVERSION ❑DE 1:1 OTHER 3 ;,_,6093 7/02/61 15416 ZONING REGULATIONS AddressAWOAT WErii Zi(r Sc}/fJ2 ,Tut 7E- /(} Owner (� pT/� Phones - LZ $'/% �/ �-W AN1A AICA Arch/Eng. S /4S�o(.License No. DESCRIPTION OF WORK A.P. # Address _ ^ 1U r- 'W/AlE' `A / ZONE PLN-rGp. Contractor F - 6L.EZTYLIG Phdne6 -j 72 TYPE OF PERMIT. ❑ GRADING ❑' FOUNDATION ❑ STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHANICA SBUILD ETBACK SIDE YARD LEFT WIIpE YARD gRlE1FL.p9rf.j GRO PEIRTL LGNE - . Address t O Z - LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under of Charter 9 provisions (com- men ting with section 7000) of Division 3 of the Business and ❑ OTHER RIGHT Professions Code, and my license is in full force and effect.- - REAR YARD (TO P/L) C-/ 3g�=Z-G' PROJECT DESCRIPTION License la i�i%�nse o. SQ. FT. - PKG. SPACE REQ. _ STREET WIDTH PROVIDED PARK FEE $ y7� Date 7 1/ /N/ Signature ,�1•/U- .A[ %��GtsA.Mi WORKER C MPENSATION DECLARATION ' OCCUPANCY—CONSTRUCTION TYPE I hereby affirm that I have a certificate of consent to self -Insure or a VALUATION ZONE ZONING APPROVED BY DATE certificate of Workers' Compensation Insurance, or a certified copy _ _ thereof (Section 3800, lab. C.). GRADING CU. YOS. ACRES SPECIAL CONDITIONS: P^qcy No. Company - 'ertified copy Is hereby furnished. REMARKS: :ertified 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 1$300) 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 PLAN CHECK subject to the Workers Compensation Laws of California. BATHTUBS SHOWERSUWI LLINU 3(p d cQ FT - Date Signature NOTICE: If after making this declaration, You should become subject TOILETS URINALS GENERATOR 0-1 KW_ 1-10 KW 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 - 10-50 KW -50 + KIN revoked. KIT. SINKS -DISHWASHERS MOTORS 0-1 HP -1-10 HP CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the per. SERVICE SINKS SUMPS - (INC. SOLAR) 10-50 HP 50 + HP formance of the work for which this permit Is Issued (Section 3097 FLOOR SINKS, FLOOR DRAINS - .. FIXTURES z OUTLETS j/ SWITCHES lea_ Civ. C.). - Lender's Name �- Lender's Address DRINKING FOUNTAINS -. - GAS TUBE SIGNS OWNER BUILDER DECLARATION - 1 hereby affirm that I am exempt from the Contractor's License Law for INTERCEPTORS CLARIFIERS POLE LIGHTS SWIMMING POOL "P"TRAP - - the following reason (Section 7031.5 Business and ProfesSlons Code: Any city or county which requires a permit to construct, alter, POLES METERED SUB WATER SERVICE ALTERATION PANELS MAIN SUB improve, demolish or repair any'structure, prior to Its issuance, also re- quires the applicant for such permit to file a signed statement that he GAS SERVICE OUTLETS SERVICE - AMP '- is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT- and Professions Cotle) or that he is exempt therefrom and the hasis for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS v applicant for a permit subjects the -applicant to a civil penalty not more than five hundred dollars ($500). SOLAR TANK COLLECTORS 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 Salo. (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 ISSUE FEE APPLICATION APPROVED BY DATE who builds or improves thereon, and who does such work himself or through his own employees,.provided that such Improvements are not MECHANICAL PLAN CHECK SUMMARY OF FEES ' intended or offered for sale. If, however, the building or Improvement is sold within one year of completion, the owner will have the burden of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU BUILDING PERMIT $ SMIP $ El 1, as owner of the property, am exclusively contractingwithAND DUCTING licensed contractors to construct the project (Section 7044, Business 100,000+BTU 'PLAN CHECK $ PERMIT and Professions Code: The Contractor's License Law does not apply to - ISSUANCE $ 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 $ ❑ I am exempt under Section B. & P. C. for this BOILERS BTUELECTRICAL $ / $ reason SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE PLANCHECK$ MECHANICAL $ - _ MICROFILM.$ TOTAL FEE $ LESS AD - Dale Owner I hereby certify that I have read this application and state that the above_ Information Is correct. I agree to comply with all cit and count 9 PY Y Y 'PLAN CHECK $ VANCEPC $_ and State laws relating to construction, and horeby authorize a representative p this City t9 enter upon the above mentioned Si rtyf r property for pro o /r/�9 ses. Y/ Signature ,a A/��AG/- CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor TL CONSTRUCTION AND PLANNING APPROVALS Permit # -sLG� Date Inspector POOL & SPA APPROVALS ,� Permit # Date Inspector ' 1. Temporary Electrical Service or Pole - 43. Pool & Equipment Location 2. Soil Pipe-Undrgrn 44. - Steel Reinforcement AY 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical'Bonding 5. Steel ein orce 47. Rough Plumbing & Pressure -Test 6. Electrical UFER Grn 48. APPROVALTO COVER-GUNITE 7. - Footings 49. Electrical Conduit-Undr rn - 8. Foundation _ 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P -Trap.❑ Undrorn 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 13. Rough Plumbing 55 Plumbina System - Final 14. Rough Electric -Conduit :56. Electrical -Final 15. Rough Electric -Wiring 57:" Solar System -Final 16. Rough Heating & Air Conditioning 58. Fencing & Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING 18. 19. 20. Ducts, Ventilating Gas Pipe -Rough & Test Roof Framing . '. 60. POOL/SPA SYSTEMS FINAL 21. 22. Roof Sheathing Frame and Flashing NOTES: --23. -Insulation - 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final' - 28. Final Electric 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 Sorinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE &BUILDING 39. Special Requirements Completed 40. Electric Release to Edison - 41. Gas Release to Southern California Gas Co. 42. ' �' _ CERTIFICATE OF OCCUPANCY No Date Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PERMI NO. ,TRACT NO. LOT NO. BLDG. NO. COVSTRUCTION PERMIT L TYPE OF CONSTRUCTION ❑ NEW ❑ ADD ❑ ALTERATION 4REPAIR ❑CONVERSION ❑DEMOLISH fe-[1�'_THER DESCRIPTION OF WORK 4080 8/27/81 17eC' - - ZONING REGULATIONS A.P.$ .Project Address �y� F/ 1/6 Owner Phone,5 Address' Arch/Eng. - License No. Address ZONE PLNG. REF. Contractor J($ TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHANIC SETBACK T. IDE YARD SIEpEE V ARD �O BUI LDING ROPERTY UNE Address �[� LICENSED CONTRACTOR DECLARATION - 1 hereby affirm that I am licensed of Charter 9 under provisions (cam- mencing with section 7000) of Division 3 of the Business and ElOTHER RIGHT - Professions Cotle, and my license is in full force and affect. REAR YARD (TO P/L) PROJECTDESCRIPTION - - License Class License No. PKG. SPACE REQ. PROVIDED Sq. FT. Dale Signature OCCUPANCV_CONSTRUCTION TYPE - STREET WIDTH PARK FEE $' WORKERS' COMPENSATION DECLARATION 1 hereby affirm that I have a certificate of consent to self -Insure or a 'VALUATION I S^CJ �' OZONE ZONING APPROVED BY - - DATE, certificate of Workers' Compensation Insurance, or a certified copy t' eof (Section 3800, Lab. C.). GRADING CU. YDS. ACRES SPECIAL CONDITIONS: I No. Company -ertifled copy Is hereby furnished. REMARKS: ' Certified copy is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - Thls section need not be completed if the permit Is for one hundred - 100cart(l) or lesat �$ - - ns. fy ththe performance of the work for which this permit Is PLUMBING- - .PLAN CHECK ELECTRICAL PLAN CHECK Issued, I shall not employ any person in any manner so as to become subject to the Workers Compensation Laws of California. Date Signature BATHTUBS SHOWERSFT_ FT - NOTICE: If after making this declaration, You should become subject TOILETS URINALS GENERATOR 0-1 KW_ 1-30 KW 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 30-50 KW -50 + KW revoked. KIT. SINKS DISHWASHERS MOTORS 0-1 HP -1-10 HP CONSTRUCTION LENDING AGENCY I hereby affirm that there is a' construction lending agency for the per- SERVICESINKS SUMPS (INC. SOLAR) 30-50HP 50+HR, formence of the -work for .which this permit is Issuetl (Section 3097 FLOORSINKS', - FLOOR DRAINS FIXTURES OUTLETS SWITCHES Civ. C.). - \ *_ Lender's Name Lender's AddressDRINKING FOUNTAINS GAS TUBE SIGNS _ OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS POLE LIGHTS I here%, affirm that I am axe m pt.fro m.t he Contractor's License Law for POOL P TRAP the following reason (Section 7031.5 Business and Professions Cotle:SWIMMING Anyrocity or county which requires a permit to construct, alter, POLES METERED SUB WATER SERVICE ALTERATION PANELS MAIN SUB impve, demolish or repair any structure, Prior to Its issuance, also re- quires the applicant for such permit to file a signed statement that he GAS SERVICE OUTLETS SERVICE AMP Is licensed pursuant to the provisions of the Contractor's License Law Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTV OUTPUT 'Iness and Professions Code) or that he is exempt therefrom and the for the alleged exemption. Any violation Of Section 7031.5 by SEWER CONNECTIONS applicant for a permit subjects the applicant to a civil penalty not more than five hundred dollars ($500). - SOLAR TANK COLLECTORS ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will d0 the work, and the structure Is not Intended or offered for sale. (Section 7044, Business and Professions Cotle: The SOLAR PIPING SVS. ISSUE FEE Contractor's License Law does not apply to an owner of a property ISSUE FEE APPLICATION APPROVED BY DATE who builds or Improves thereon, and who does such work himself or through his own employees, provided that such improvements are not MECHANICAL PLAN CHECK SUMMARY OF FEES_ Intended or Offered for sale. If, however, toe building or improvement is sold within one year of completion, the owner will have the burden - - - of proving he tllnot Do improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU G ''n� PERMIT Sh SMIP E—..�L•.}� ❑ I, as owner of the propertrty,am exclusively contracting with o AND DUCTING - e licensed contractors to construct the project (Section 7044, Business 100,000+BTU +l "PLAN CHECK $� PERMIT and Professions Code: The Contractor's License Law does not apply to - ISSUANCE $ an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU- I 'PLUMBINGS - tracts from such projects with a contractors) Iicesned pursuant to SYSTEM r • GRADING E Li the Contractor's cense Law). 100,000 + BTU - PLAN CHECK E - ❑ 1 am exempt under Section B. & P. C. for thisBOILERS BTU I ELECTRICAL $_ $ reasonMICROFILM SYSTEM REPAIR, ALTERATION PLAN CHECK $ MECHANICAL $ S TOTAL FEE $ Date Owner I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE - LESS AD - AD - LESS A - Information is correct. I agree to comply with all city and county ,PLAN CHECK $ E ordinances and state laws relating to construction, and hereby authorize s , representative of this city to enter upon the above anti nad Q0 property f action ur lases y S; / Signature �Yc Date FINAL FEE $ Drivers' License or ISSUE FEE CMF 0865-46 White -Building; Cana ry-APPI!cant; Pink -Accounting; Goldenrod -Assessor TL CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & SPA APPROVALS Permit # • - Date Inspect 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. iPipe-Undrgrn - - - 44: Steel Reinforcement ' 3. lectrical Conduit Utility-Undrgrn -' 45. Forms - 4. Electrical Conduit-Undrgrn 46. Electrical Bonding5. Steel ein orce - 47. Rough Plumbing & Pressure Test - 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE - 7. Footings - 49. Electrical Conduit-Undr rn ' 8. Foundation - 50. Gas Pipe, ❑ Undr rn, Test . 9. Water Pipe-Undrgrn 51. Backwash Lines P -Trap,❑ Undrqrn 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 13. Rough Plumbing - - - - -- -- 14. Rough Electric -Conduit- -' '56.- Electrical -Final 15. -Rough Electric -Wiring -- -- -- -- i- -57. Solar System-Finalc- 16. Rough Heating & Air Conditioning bb. Fencing & Access Approval , 17. Ducts in Structure I APPROVED FOR PLASTERING - - - 18. Ducts, Ventilating -` - - i _ 60. - - POOL/SPA SYSTEMS FINAL - 19. Gas Pipe -Rough & Test 20. Roof Framing 21. Roof 'Sheathing .- NOTES: 2(g- 22. Frame and Flashing 23. Insulation 24i Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27: Electrical Power Meter -Final 28. Final Electric" `• 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 a, - 35.. Landsca e Sprinkling System - - 36. Sound Attenuation ' 37. 38. Handicap Regulations FINAL STRUCTURE & BUILDING - - 39. Special Requirements Completed - - - 40. Electric Release to Edison - -, - -- - - -- -- -- - '41. Gas Release to Southern California Gas Co. -'- 42. - CERTIFICATE OF OCCUPANCY No Date Applicint to fill in all spaces within beaby aoraer lines and sign all appropriate declarations. .IT.Y OF WSTA MESA PER ITN TRACT NO. LOT NO. BLDG. NO. CONSTRUCTION PERMIT . TYPE OF CONSTRUCTION ❑ NEW ❑ ADD gALTERATION El REPAIR ❑CON\ ON M., 11.11 ❑ OTHER a - `+ , �I 4G Ir�`^•I /EI ZONING REGULATIONS Project Address T iz Owner Phone Address Arch/Eng. License No. If DESCRIPTION OF WORKS A.P. $YA 7 -o -33—Q ZONE PLNG. REF. Address ContractorAW Ioledet. fzu/jje Phone — _ TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHANIC BUILDING�ROBP�JI�'PI SETBACKYARD SIDE Y - �G Y INE Addfess LICENSE CONTRACTOR DEC LARA ON I hereby affirm that I am licensed under provisions of Charter 9 (Com. RIGHT mancing with section 7000) of Division 3 of the Business and ❑ OTHER Professions Code-- and m license is In force and effect. REAR YARD (TO P/L) `4 PROJECT DESCRIPTION �ffull �j SD. FT. - OCCUPANC CONSTRUCTION TYPE PKG. SPACE RED. STREET WIDTH PROVIDED - PARK FEE E DlatenS z Gt at 1 /.,K1NZSS41, �/— �� WORK ERS COMPENSATION DECLARATIBN • I hereby affirm that 1 have a Of consent t0 self -Insure appy ` VALUATIO A 00t) — ZONE ZONING APPROVED BY DATE Compensation certificate of Workers' Compensation Insurance, or certified copy (Sectipn1 0 xLa -), �^s GRADING CU. YDS. ACRES SPECIAL CONDITIONS: - Policythereof Ei% PplicY No. C� DOmpanY F� rnii..�s �V/ REMARKS: - Certified copy IS hereby furnished. Certified copy is filed with the city Building Division. - eX'EMPTION FROM WORKERS' COMPENSATION DECLARATION - - Section need not be completed if -the permit. Is for one hundred ' Nhis 00) or less . 1n - ertify that 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 - PLAN CHECK subject to the Workers Compensation Laws of California. BATHTUBS SHOWERSFT- DWELLING E " Date Signature NOTICE: If after making this declaration, you should become subject TOILETS URINALS GENERATOR 0-1 KW 1-10 KW 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 LAYS APPLIANCE 10-50 KW ---:50 + KW revoked. KIT. SINKS - DISHWASHERS MOTORS 0-1 HP_3-10 HP CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS SUMPS (INC. SOLAR) 10-50 HP_ 50 + HP formance Of the work for which this permit is Issued (Section 3097 ' FLOOR SINKS FLOOR DRAINS FI%TURES OVTLETS SWITCHES CIV. C.)._ - Lender's Nam¢ ` Lender's Address DRINKING FOUNTAINS__ GAS TUBE SIGNS OWNER BUILDERq DECLARATION - INTERCEPTORS— CLARIFIERS POLE LIGHTS I hereby affirm that`Sanf exempt from the Contractor's License law for SWIMMING POOL PTRAP POLES METERED SUB tha following reason (Section 7031.5 Business and Professions Coda: Any city or county which requires a permit to construct, alter, WATER SERV ICE ALTERATION PANELS MAIN SUB Imrove, demolish or repair any 5tructur e, prior to Its Issuance, also re. the applicant for Such permit to file a signed statement that he GAS SERVICE. OUTLETS SERVICE AMP auPres licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT ' Business and Professions Code) or that he I5 exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS - v applicant for a permit subjects the applicant to a civil penalty not more than five hundred dollars ($500). SOLAR TANK COLLECTORS - 1, as owner Of the property, or my employees with wages a5 their SOIe Compensation, will do the work, and the structure IS not Intended or offered for Sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SVS. ISSUE FEE ' Contractor's License Saw does not apply to an Owner Of a property ISSUE FEE APPLICATION APPROVED BY DATE who builds or Improves thereon, and who does Such work himself or through his Own employees, provided that such Improvements are not MECHANICAL PLAN CHECK SUMMARY OF FEES intended or offered for sale. If, however, the building or Improvement IS sold within One year of Completion, the owner will have the burden of proving he did not build or Improve for the purpose of Sale). BUILDING f HEATING SYSTEM 0-100,000 BTU PERMIT $ �_SD SMTP E r J� ❑ as owner of the property, exclusivelyesti contracting with AND DUCTING _�.��q�vc__y�_ - IlcenSetl contractors IO the project (Section n p 100,000+BTU PLAN CHECK $ � PERMIT es not applyBusiness he Coutt and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ a owner of property who builds or Improves thereon, and who Con- REFRIGERATION 0-100,000 BTU—PLUMBING E tr Ira from such e<with d contractor(S) IICeSnetl pursuant to SYSTEM GRADING E C the Contractor's License Law). 100,000+BTU PLAN CHECK $ ❑ 1 am exempt under Section B. & P. C. for this BOILERS BTU$ ELECTRICAL $ reason SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE PLAN CHECK S MECHANICAL E MICROFILM S TOTAL FEE S LESS AD - Date Owner I hereby certify that I have read this application and state that the above Informatlon is correct. I agree to comply with all cit and count 9 DY Y PLAN CHECK $ VANCE PC $_ and state laws fe ling to Construction, and hereby authorize e represent nt represent 5 of this <i o enter upon the abo e m tionetl property Ins echo r oses. Slgnat ur Date t FINAL FEE $ `' •� Drivers' License ISSUE FEE CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING h -1 APPROVALS Permit # Date k i POOL & SPA - Inspector APPROVALS Permit # - Date Inspector 1. Temporary Electrical Service or Pole 43.- Pool & Equipment Location i ' • �' 2. SoilPipe-Un rgrn _ 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn - - 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding5. , Steel em orce 47. Rough Plumbing & Pressure,Test 6. Electrical LIFER Grn 48. APPROVAL TO COVER-GUNITE ` • ' �•' - "� 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Trap.C1 Undrqrn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection -53:i..Backvvash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing - ' 14. Rough Electric -Conduit 56. Electrical -Final 15. Rough Electric -Wiring 57, Solar System -Final 16. Rough Heating & Air Conditioning encing & Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING • 18. 19. 20. Ducts, Ventilating Gas Pipe -Rough & Test Roof Framing 60. POOL/SPA SYSTEMS FINAL 21. 22. Roof Sheathing Frame and Flashing NOTES: 23. Insulation „ 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 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. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date .. r r Applicant to all spaces within heavy border lines and sign all appropriate declarations. C)TV OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. B G.N --.{-: O�FJ I_��I�EI ..^o_.. CONSTRUCTION PERMIT 3 I A Gam_ TYPE OF CONSTRUCT NN - ❑ NEW ❑ ADD 'I��`(i_" LTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER t� ZONING REGULATIONS Project Address F' 37 Owner Phone Address - Arch/Eng. y, . License No. DESCij)PTIp OF IpL0 A P � 423 Address - S ZONE PLNG. REF. -h' Contracto ( Phone _ TYPE OF PERMIT ❑GRADING [I FOUNDATION ❑STRUCTURAL ❑TENANT ❑ ELECTRI ❑PLU-Nfg NG (ECHANICA n BUILDINGrp SETBACK YARD LS IEpE Y 'WILDING PRSID - _ Address F LICENSED CONTRACTOR DECLARATION 1 hereby'aiflrm that I licensed Charter 9 am antler provisions of (com- mencing:.;with section 7000) of Division 3 of the Business and /''� MOTHER ICL% J�11L) O(L (�( RIGHT Professlons Code, and my license Is In full force and Ifgct. REAR YARD (TO P/L) ^ ••••��ee�� 'Z3 PROJECT DESCRIPTION % j Li�gSQ NN �I( SQ. FT. PKG. SPACE REQ. PROVIDED ate day to ,``"` Z� WORKERS' COMPENSATION DEC LAR ATI N- OCCUPAN��1��sCr�ONSTR UCTION TYPE STREET WIDTH PARK FEE E I hereby affirm that I have a Certificate of consent to self -Insure or a VALUATIO C1. qn -"=ZONE ZONING APPROVED BY DATE certificate of Workers' Compensation Insurance, or a certified copy thereof (Stion 3yp0, Lab. C.). GRADING CU. YDS. ACRES SPECIAL CONDITIONS: policy oOf 7 -3010V Company ��r-a/nsQsr-eS l`e car l N - - 'ertiffed copy is hereby furnished. REMARKS: ,ertlfied copy Is filed with the city Building Division. bAEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed If the permit Is for one hundred (E100) or less). - -- - I certlify that n the performance of the work for which this permit Is issued, 1 shall not employ any person in any manner so as to become PLUMBING PLAN CHECK - ELECTRICAL PLAN CHECK subject to the Workers Compensation Laws. of California. BATHTUBS SHOWERS Date Signature NOTICE: If after making this declaration, you should become subject TOILETS URINALS GENERATOR 0-1 KW -10 KW - 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 LAYS APPLIANCE 10-50 KW -50 + KW revoked. KIT. SINKS DISHWASHERS MOTORS 0-1 HP -1-10 HP .- CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the per. SERVICE SINKS SUMPS - (INC. SOLAR) 10-50 HP 50 + HP formance of the work for which this permit Is. issued (Section 3097 FLOOR SINKS, FLOOR DRAINS FIXTURESOUTLETS-- SWITCHES Cy.,C.). �; - ` -\ - �s - Lender's Name Lender's -Address DRINKING FOUNTAINS - GAS TUBE SIGNS - OWNER BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for INTERCEPTORS CLARIFIERS POLE LIGHTS - the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP 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 quires the applicant for such permit to file a signed statement that he Is licensed pursuant to the'provisions of the Contractor's License Law GAS SERVICE OUTLETS SERVICE AMP Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT - - B uSlness and Professions Code)'or that he Is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by -SEWER CONNECTIONS - - - applicant for a permit subjects the applicant to a civil penalty of more than five hundred dollars ($500). SOLAR TANK - - COLLECTORS - - - ., 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. (Section 7044, Business and Professions Code: The SOLAR PIPING SVS. ISSUE FEE Contractor's License Law does not apply .to an owner of a property ISSUE FEE APPLICATION APPROVED BY DATE who builds or Improves thereon, and who does such work himself or through.his own employees, provided that Such improvements are not MECHANICAL PLAN CHECK SUMMARY OF FEES intended or offered for sale. If, however, the building or Improvement Is .sold within one year of completion, the owner will have the burden of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU BUILDING SQ S�. , rn •.]� Cl I, as owner of the property, am exclusively contracting with AND DUCTING PERMIT $ SMIP $ - licensed contractors construct the project (Section Business 100,000 +BTU PLAN CHECK E PERMIT : es not and Professions Code: The Contractor's License Law does not apply to ISSUANCE E owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts tracts from such projects with a contractorsHa pursuant to SYSTEM GRADING $ the Contractor's License Law). 100,000 + BTU PLAN CHECK E - ❑ 1 am exempt under Section - B. 3 P. C. for this BOILERS BTV$ ELECTRICAL E ieason PLAN CHECK E MICROFILM $ Date Owner- SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE MECHANICAL E TOTAL FEE $ LESS 1 hereby certify that I have read this application and state that the above information is correct. 1 agree to comply with all city and county - PLAN CHECK $ E P VANCE PC $ ordinanc d state Is s yL�atin9 to construction, and hereby authorize _ represen t s of thl{ djfy to enter upon the above Rlen coed property ins"i n oses. 4/�nrT/ �3.� `p1u Signatu Date FINAL FEE $ Drivers' License or - ISSUE FEE - - - - CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit 4A Z-� Date ', --• to Inspector POOL & SPA - _. Date, Inspector APPROVALS Permit 4- 1. 1 - Temporary Electrical Service or Pole 43: Pool & Equipment Location - 2. Soil Pipe-Undrgrn 44. Steel Reinforcement 3.. Electrical nduit Utility-Undrgrn 45. _ Forms 4. Electrical Conduit-Undrgrn 46.' Electrical Bonding 5. Steel ein orce 47. Rough Plumbing & Pre's"sure Test +' 6. Electrical UFER Grn 48. APPROVALTO COVER-GUNITE " 7. Footings _ 49. •Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn _ 51. Backwash Lines P-Tra =O•Undr-'n / •. - �- >• 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 13. Rough Plumbing _ 14. Rough Electric -Conduit - - 56. Electrical -Final 15. Rough Electric -Wiring 57. Solar System -Final 16. Rough Heating & Air Conditioning encing & Access Approval 17. Ducts in Structure b9. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test 20. Roof Framing 21. Roof Sheathing- NOTES: 22. Frame and Flashing 23. Insulation 5 h I 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final ' 28. Final Electric 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 r' 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison ' 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date •aAr. •�.,,� E LL APPLICATION FOR A BUILDING PERMIT Tract Block Lo[ BUILDING PERMIT NO. Electrical Permit No. Bung lltling /l>n Atl dress 16 'j i� PermiPi um t No. q` - C� - Street �f`,� �l�G Area /V/ Crosst��T�1//' / Mechanical No. Owner ULL(�NC F+�Ory—// n //j�. s./`f�//�— Type o1 Pr Olech ❑ New ,Mecha L=1 Alter ❑ Addition / �J� T,MII/O/�/ Address l��IV rt'I LV f t/��✓77V ❑ Repair ❑ Convert ❑Damp ❑ Occupancy Pmt./ //�1// City J'A Cf! ZIp0L70/ horu 2 A.P. sup-DIrea / Insp. Area Architect/ 7p10 Designer (�L� ytensa-No. 20oC Sol. Pmt. No. / Address /77%� �T ` // Front C/LSL Stet Width �//^MA,-� CITY 14VIIVt� C'K . Zip Phone ¢let ffa Le gh ear Engineer License No.eou a ig / re Provide Covera Address / City Zip Phone St, uct Height No. of Stories No. of - Family LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000 of Division 3 Of the Business and ProfessionCotle, antl license is in }ull force antl a t) License Cl:.a��c n/��e �N�uumber �4 r.c Date G 67'Contract��v�""�_. Park Faes Yps Required No C.T. r /Fee Receipt Zoning Approved By: / Date Misc. / �'�"A-`� Address �5�� %d- """'y �w A Proposed Use Pt structure / —V'if.4A. �270�22� City end Zip Phone CONSTRUCTION LENDING AGENCY / 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097', Civ. C.). Occ. Class Type Const. / Cotle Year USE/OCCUPANCY / SIZE SO. FT. Lender's Name Lender's Address OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law I / for the following reason: ❑ I, as owner of the property, or my employees with wages as their 2. / sole compensation, will do the work, and the structure is not intended or offered for sale. ❑I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ I am exempt under Sec. , B$PC for this reason 3 / 4 / Total Valuation Data Owner WORKERS' COMPENSATION DECLARATION Encroachment Permit R pulrod ❑ Yes ❑ No 1 hereby affirm that I have a certificate of consent to salt -insure, or a certificate of Workers' Compensation Insurance, or a certified Grading Pmt. Required Ye No ❑ ❑ Grading Pmt. No. copy thereof, Policy No Company ❑ Certified copy Is hereby furnished. Certified copy is App with.Lange Coytrl�y, EA�A� /- ,rte �rJJ t�y/(Oy(d(Q 16Lt ✓ Date Applicant c -i, Rough Grading APP roved di Oate CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if permit is for $100 or less). I certify that in the performance Of the work for which this permit is PERMIT FEES issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Dat, Applicant NOTICE TO APPLICANT: It, after making this Certificate of Structural $ Plan Check $ Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, y04 must forthwith comply with such rovisions or this permit shall be de P P erred revoked. Electrical $ Special Invest. $ PlumDi g $ 1 CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS Mac nical $ RELATING TO BUILDING CONSTRUCTION, AND HEREBY AUTH. ORIZE REPRESENYATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE M ZONED PROPERTY FOR INSPECTION PUR. / -n� ,a/ Signature of Applicant or Agent -C Date •L C/ Pr Gratle Irtl Pachon $ 1 Rec. o. $ get. No. I Permit Issue $ �,t'J�,-tom TQ�1 WLLSL[/r_/ Print Applicant's/Agent's Name All s aces within this box must be completed to process P P Plan Check BY: Issuance Apo ,ved: GMF 0335-46 (BU -28) rev. 6/80 >v v TO WHOM IT MAY CONC I 7 G • This Permit N 245 Fischer Ave., Costa Mesa Street Addrers ' . AP Number I, r_ Norman P n 1 1 i am , as Owner in Title of the above referenced property, do hereby authorize: Diane Filppi „' 731-Ne6901 eme phone No. American Sign & Design 1'382.-rvalencia Avenue- . troot Address Tustin, CA. 92680 City State Zip to obtain permits in my behalf, as owner/builder, for the construction, alteration, moving, demolition or repair of the above referenced property. Should any person become an employee engaged in -the Improvement of the property, I shall immediately provide Worker's Compensation Insurance coverage and cause a certificate of that coverage to be filed with the Building Division of the City of Costa Mesa, as required by State of California laws. As owner/builder in foci, I understand and accept that my 'responsibilities do not transfer to any other person, company or corporation. I agree to indemnify and hold the City of Costa Mesa and Its employees or officers harmless from any claim resulting in damage or personal injury to myself or any other parties. August�'26, 1981 Date ANftCp11WpM 1 Notary's Statement: PRINCIPAL•_OFF .N4 ],�� teY CoeeMsabn Eeplme Nw.16,' la STATE OF CALIFORNIA ORANGE COUNTW COUNTY OF ORANCE On June 11., 1981, before me, the undersigned, a Notary Public in and for said County and State, personally appeared C. Norman Pullia know to me to be the person whose name is subscribed to the within instrument, and acknowledged.that.he executed the same. Witness my hand and official seal. c CMF 0779-4: B d ng f Costa 49esa uN aSaf P.O. BoY OePartment T CO 00 Mes,. 10 C SBO e E C has been lnsPe.catedat FiTI FfCArE OF for a Gro sPecled and fOund�4 JI.. nhr OCC(/PA NC U up d to co Ply With >♦v'r�t:� V jOle of Building O°cupa1 the Pro�ision �c'r- s egal Description }Aj.�`�''nr 7�n of °f all City Of COsla^Mesa" �' J Jf buil I)-,It nb7_ OrdinancesaPpli ding Permit NO ,�?Z^'n� cayle thereto ea r u Electrical _ e"erbe si ISSU ED TO. N mberofaPartmentsPerm it NO t' e.orAletesandeounosl `r7 .. and/or guest _Plumbing Permit ThisCLrti -',",�•,., a oOms No• Building Oftoate Of ancp Occp ' T', uildi�9 Official- `' PO eu s4 ReV.a Inohe �pty of Costa McBE Posted fn �Y /,.`,� Oat % Q under Sec, 30 6 (e) spiU B C P/ eO�h 8 L,O'D t B�SN4ILNO7.BErm�._On except by the (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: 245 FISCHER AV Suite No A002 Vicinity: LOBBY Status: ISSUED Applied: 11/27/2002 Issued: 11/27/2002 Parcel Nunmber: Quantity 93898002 Quantity '. ISSUE FEE."' $23.50 Applicant: FABREGAS, JACK - Busway /100 ft _ ISSUED BY: Address: %UNIVERSAL MERCHANT SVCS'-'_- New Res (1-2 units) $0.00 - New Res (3+units) COSTA MESA, -CA % �., - - " Phone: 949-394-9100 c - 0 Lighting Fixts - $0.00 0 Recept Outlets, -x$5.50 ;$0.00-" -''_ 0 245 FISCHER-AVE #AU Zip: 92626-4535 �0 _-% Non Res Appl "I $0100 0 ' \ Res Appl $0.00 " 0 Service to 200a �� $0.00-, " Fireworks Stand Service to 1000a �" - $0.00 =" - 0 - Service over 1000a _ $0.00,' , - , 0, Owner:' -, MOORE, JASON W�."- 0 Motors to 10hp - A 0 ' //%UNIVERSAL $0.00' 0 Motors to 100hp Address MERCHANT -SVCS Motors over 100hp $0.00 - 0 Communication drops COSTA MESA,.CA - Phone: Sub panel to 200a $0.00 0 245 FISCHER AVE #AU Zip: 926264535 Contractor: OWNER -BUILDER Address: , 'Phone: \ Zip: - \ License: 000000 / i-: - 1 j/ SCOPE.OF-PERMIT I •-,, rT .-; ', - ELECTRICAL TO INCLUDE: 5 OUTLETS LOCATED IN THE LOBBY_ : REF.r802-01456 "UNIVERSAL ` ERVICES" MERCHANT SERVICES,- FEE SUMMARY Quantity '. ISSUE FEE."' $23.50 Quantity . Temp service testi. $0.00 Busway /100 ft Res. a/c package - $0.00 $0.00 0." - New Res (1-2 units) $0.00 0 New Res (3+units) $0.00 0 Pool / Spa \,. \ $0.00 0 Lighting Fixts - $0.00 0 Recept Outlets, -x$5.50 ;$0.00-" -''_ 0 5 Switches ' $0.00, �0 _-% Non Res Appl "I $0100 0 ' \ Res Appl $0.00 " 0 Service to 200a �� $0.00-, " Fireworks Stand Service to 1000a �" - $0.00 =" - 0 - Service over 1000a _ $0.00,' , - , 0, Motors to 1hp $0.00 _ 0 Motors to 10hp ., $0.00 0 ' Motors to 50hp $0.00' 0 Motors to 100hp $0.00. _ 0 Motors over 100hp $0.00 - 0 Communication drops $0.00 0 -" Sub panel to 200a $0.00 0 Pole Light Pkg $0.00 0 FEE SUMMARY " - - - Quantity . Temp Dist System / Lighting $0.00 0"' Busway /100 ft . $0.00 0 ; Standing Section $0.00 0." - Misc Electrical Equipment $0.00 . /0/� .= �. 'Transformers up to 1 kva/kw -$0.00„� �0 ",-- -, .............up to 10 kva/kw $0.00. -;, /0 ' ..............:..up to 50 kva/kw $o.00i ! 0 - - .....:........:..up to t00:kva/kw--"....$0.00 .., , 01, = ,' ..................Over 100 kva/kw ' $0.00 0 - - 'Lowyoltage Equipment' -.� ;$0.00-" -''_ 0 - - Low Voll Wiring System I Ckf�, ' $0.00 0 -- - Misc. Conduit _ - $0.00 ""0 ! Misc. Conductor i 0 - - Circus ( gen or ride' ) $0.$0.00 00 �'0/ Circus (mech ride or lights) , ,;$0.00 -�O " ,Christmas Tree Stand $0.00 .' 0 " Fireworks Stand -' $0.00' 0 _ Other Electrical Fee - �j" :, $0.00 - "-_ Investigation Fees" $0.00 Plan Check Fee $0.00 Reinspection Fee $0.00 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 2"646 (&100) DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Cade, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers' compensation Insurance, as required by section 3700 of the Labor Cade, for the performance of the work for which this permit is Issued. My workers' compensation Insurance carrier and policy number are: Cartier: Policy Number: (This section need not be completed it the permit Is valued at one hundred dollars ($100) or less.) 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 lawa oJ,California, and agree that If l should become subject to the workers' compensation provisions at Section 3700 of the Labor Code, I shall forthwith comply with thew o}' ion (APpriZFFSlgnat: l..�C�1 �TiVMrh 'tDa J �— Z%—OZ WARNING FAILURE—TO SE RE WORKERS' COMP rSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS 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. Lic. M Class n Contractors 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, Civil Code). Lenders Name: Lenders Address: Signature: Date: OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I arAXEMPT 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 civil penalty of not more than five hundred dollars ($500).): I as owner of the property, or my employdbs 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.). Cl I am axe de se Business and Professions Code for this reason: Signature: F�cplres: 1-7 -23-(ac. Verification of Ownership by (type of docu an , 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 will 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 pennit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will 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? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Cade 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 feet 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? []Yes ❑ No (Section 25533 of the California Health and Safety 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 aection 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 partment of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. ..._................__.........................._........... ........................................................................ ....................... .................................................................................................................................................................................................................. I.......... 4 II en RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No 5 Does or will the applicant Air or present or future building occupant require for the work ontch is she subject of this a plication a19 No tort such construction or modification from the South Coast Air Quality Management District or from any other air pollution control tlisirict or agency? � Yes {� 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 feel from the outer boundaries of a school? ❑ 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? ❑ Yes ❑ No ............._.._..................... ............ __................ .............................................................. __.......................... _.._.._.......................... ___......................................................... __........................................................ _.................. _.._............... B (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 COMPLIANCE AND AUTHORIZATION OF ENTRY: I certity under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. „ _ Q Si nature Of Legal Owner(s) Date V�� l i 27'07 Af n r; Authorized Applicant) Date:. CODE P. INSPECTION TYPE RM SAL$ CODE INSPECTIONTYPE gd¢. INTITIAL�y 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 210 Final Electrical 201 Final BlocktRetaining 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 I (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: 245 FISCHER AV Suite No A002 Vicinity: LOBBY Parcel Nunmber: 93898002 Applicant: FABREGAS, JACK Address: 14 MESSANDRIA Phone: 949-497-0147 NEWPORT COAST, CA Zip: 92657 Owner: MOORE, JASON W Address, %UNIVERSAL MERCHANT SVCS COSTA MESA, CA Phone: 245 FISCHER AVE #AU Zip: 926264535 Contractor: OWNER -BUILDER Address: Phone: Zip: License: 0 Status: ISSUED Applied: 09/11/2002 Issued: 09/11/2002 SCOPE OF PERMIT ELECTRICAL TO INCLUDE: ADD 81 TING FIXTURES TO LOBBY IN BLDG. A002, REF.: B02-01457 "UNIVERSAL MERCHANT SERVICES". COMMENTS / SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) 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) 7545626 FEE SUMMARY Quantity - - Quantity ISSUE FEE $23.50 Temp Dist System / Lighting $0.00 0 Temp service test $0.00 Busway /100 it $0.00 0 Res. a/c package $0.00 Standing Section $0.00 0 New Res (1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0 New Res (3+units) $0.00 0 Transformers up to 1 kva/kw $0.00 0 Pool / Spa $0.00 0 ................up to 10 kva/kw $0.00 0 Lighting Fixts $8.80 8 . .................up to 50 kva/kw $0.00 0 Recept Outlets $0.00 0 .................up to 100 kva/kw $0.00 0 Switches $0.00 0 ..................over 100 kva/kw $0.00 0 Non Res Appl $0.00 0 Low Voltage Equipment $0.00 0 Res Appl $0.00 0 Low Volt Wiring System / Ckt $0.00 0 Service to 200a $0.00 0 Misc. Conduit $0.00 0 Service to 1000a $0.00 0 Misc. Conductor $0.00. 0 Service over 1000a $0.00 0 - Circus ( gen or ride) $0.00 0 Motors to the $0.00 0 Circus (mech ride or lights) $0.00 0 Motors to 10hp $0.00 0 Christmas Tree Stand $0.00 0 Motors to 50hp $0.00 0 Fireworks Stand $0.00 0 Motors to 100hp $0.00 0 Other Electrical Fee $0.00 Motors over 100hp $0.00 0 Communication drops $0.00 0 Investigation Fee $0.00 Sub panel to 200a $0.00 0 Plan Check Fee $0.00 Pole Light Pkg $0.00 0 Reinspection Fee $0.00 Sign Circuits $0.00 0 Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $32.30 Intermed Pole $0.00 0 COMMENTS / SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) 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) 7545626 DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 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. ❑ 1 have and will maintain workers' compensation insurance, as required by section 3700 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 if the permit /s valued of one hundred dollars ($100) or less.) I certity 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' compensatbn law Califomi9 nd agree that it I should become subject to the workers' compensatlon provisions of Section 3700 of the Labor Code, I shall forthwith If comply with ihesAPr isi s! Applicant Signature: � _�e�L''�_' Date: �� // �Z- WARNING: FAILURE TO SE RE WO NSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TOC MIRIN PENALTES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE ()100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: 1 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. Llc. N Class It Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is issued. (Sec. 3097, Civil Code). Lenders Name: Lenders 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 far a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): 1, 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. It, 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.). ❑ 1 am GXQQ under s°e�� Business and Professions Code for this reason: Signature: %L�nY �.klYil/4Gp '1 Expires: IZ-23' . Verification of Ownership by (type of document, i.e. - property tax bill or dead): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 hereby certify that no excavation Me (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 will 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 Persil Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certity a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ 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 ❑ No (Section 25533 of the California Health and Safety 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 aVppals)? iicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materi ❑ Yes ❑ IJ0 SSection 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 apartment o1 an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. ................................__........................................................................._.................._......................................._.............................._._........................................ ................. ......._._..................._............... _.................._. 4 If an RMPP is presently required, has Seclbn 25534 of the Califomia Health and Satery Cotle been fully complied wlih7 ❑Yes ❑ No ............................."w"'.................................................................................. ildi............................................................................................................................................................................................................................................difi............... 5 Does or will the applicant u present or future building occupant require for the work which is the subject c this a�ppplication a1�97 Not for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Ll Yes LJ 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? ❑ Yes ❑ No (II 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 Quell 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? ❑ Yes ❑ 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. 1 agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and slate that the information given is correct. I agr a to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the ahove-ce ri d prop for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. /(^%1(J Signature Of Legal Owner(s) (''j Date And/Or Authorized Applicant Date OJI L INSPECTION TYPE PATE INTITA CODE INSPECTION TYPE 2ATE MMIAbj 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 210 Final Electrical 201 Final Block/Retaining Well 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 (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 245 FISCHERAV Suite: A002 Vicinity: LOBBY Parcel Number: 93898002 Zoning: Applicant: FABREGAS, JACK $0.00 Address: 14 MESSANDRIA Permit: $23.50 Phone: 949-497-0147 SMIP Res: NEWPORT COAST, CA Zip: 92657 Owner: MOORE, JASON W $0.50 Address %UNIVERSAL MERCHANT SVCS Other: $0.00 COSTA MESA, CA Phone: Inspection: 245 FISCHER AVE #AU Zip: 92626-4535 Contractor: OWNER -BUILDER $24.00 Address: PLANNING & ZONING Phone: Zip: License: 0 Arch : Address: Eng: Address: Status: ISSUED Applied: 09/11/2002 Issued: 09/11/2002 ISSUED BY: Phone: Phone: Zip: License: License: SCOPE OF PERMIT REMOVE EXISTING T -BAR ONLY FROM LOBBY'S CEILING IN BLDG A002, "UNIVERSAL MERCHANT SERVICES-. 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 11 FEE SUMMARY Plan Check: $0.00 Calc Valuation: $400.00 Permit: $23.50 Claim Valuation: $400.00 SMIP Res: $0.00 SMIP Com: $0.50 Other: $0.00 Inspection: $0.00 Total: $24.00 PLANNING & ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92.28, § 1, 12.21-92) EXPIRATION: This permit shall automatically expire and become void If work Is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 11 DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to sell -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the perfgfmance of the work for which this permit is Issued. ❑ I have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit Is Issued. My workerscompensation Insurance tamer and policy number are: Camey. Policy Number. (This section need not be completed if the permit Is valued at one hundred dollars ($IDO) or fess.) r�vm'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 to fwith th�Cy�allifo la, end agree that If I should become subject to the workers' compensation provisions of Section 3700 of me Labor Code, I shell forthwith ING: tant liygnature�4�/L��1 FNLURE TO ECURE WORKERS WMPENSATION COVERAGE IS UNLAWFUL AND SHALLSUEUECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($100.000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3106 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Sectlon 7000) of Division 3 of the Business and Professions Code, and my license Is In full force and effect. Lic. M Class e Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ 1 hereby Shinn that there Is a construction lending agency for the performance of the work for which this permit Is Issued. (Sec. 3097, Civil Code). Lenders Name: Lenders 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 Cade: 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 OMslon 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 s jects the applicant to a civil penalty of not more than five hundred dollars ($500).): al, as owner o1 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 Use cenLaw 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.). ❑ 1 am exemptyyg9der sec. Business and Professions Code for this reason: -Slgpature: <,/Y.(& ..• AJ� � Fr�Ci.',ilas, 12-Z3-�3 Verification of Ownership by (type of ent. Le. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation Trve (5) or more feet In depth Into which a person is required to descond, 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, Ttle B, California Administrative Code). ❑ As owner -builder, I will 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: 1 Will the applicant or present or future building occupant need to Ills and con fy a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ NO (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mese 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 feet 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? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with some excep0oru, 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 9r will he applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? (Section 25534 of the California Health and Safety Code provides that the Costa Mass Fire Department may require the preparation, urfifica0on and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. _...........................—__._...... _. ._......._............____._._.._................................._._........_...__...._ 4 Ii en RMPP Is presently required, has Section 25534 of the California Health and Safety Code bean fully complied with? L) Yes ❑ No .........................................__-..................... ..... _.... _................................ __............. _.__.......................... __......................... _................................................................. __............ __...._.._._.__....__..."'—" 5 Goes Or will the applicant or Present or future building occupant require for the work which is the subject of this application aPe"ll for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 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 en art of the facili to be co islmcted under this y p ry pertnil be within 1000 feet Irom the outer boundaries o1 a school? ❑Ves ❑ No (If yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Coda), ..........................._.__............._—._ .___.—_..... _............... _.._............................... _........ _..... _.._............................ ._............ 7 It a ppeermit 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 epplicatlon, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ yes ❑ No ...............................................__..._...............___..._...__....___...__.._.............._.._..........................__............................................... ............................. _....................... __........ _........ ___ e (If yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certity, that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordlnances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE 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 all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow Occupancy of any building authorized by this permit until final inspection. ature Of Legal Owner(s) Date 9 -r/ -.oz a `afiIgndlDr Authorized Appiitaht \ Dale .) CODE I. INSPECTION TYPE gNTIRALS CODE INSPECTION TYPE gam, 2MnAL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Root 210 Final Electrical 201 Final BlocWRetalning Wall 212 Final Fire Prevention 202 Final Factory Fire Place f 220 Final Planning Approval 203 Final Sign 222 Final Site ry 204 Final Demolition 250 Final Buliding/Occupency L/ (714) 764-5273 • Fax (714) 754.4856 • www.ci.costa-mesagUtTRICAL PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 245 FISCHER AV Suite No A002 Vicinity: Parcel Nunmber: 93898002 Applicant: LEW GARY KNOX Address: 23482 PERALTA E Phone: 949-859-5924 LAGUNA HILLS, CA Zip 92653 Owner: MOORE, JASON W Address %UNIVERSAL MERCHANT SVCS . COSTA MESA, CA Phone: 245 FISCHER AVE #AU . Zip: 92626-4535 Contractor. KNOX CONTRACTING INC Address: 23482 PERALTA E LAGUNA HILLS, CA Phone: 949-859-5924 Zip: 92653 License: 726573 ISSUED BY: Status: ISSUED Applied: 06232005 Issued: 06232005 SI:UYt OF YtKIVII1 5,743 S.F. INTERIOR TENANT IMPROVEMENT FOR "UNITED AGENCIES" SPACE A002. WORK TO INCLUDE: NEW WALLS, CEILING, RESTROOM UPGRADES, AND DEMOLITION EXISTING WALLS. REF.: B05-00757 ELECTRICAL TO INCLUDE: 70 LIGHT FIXTURES, 12 OUTLETS, 10 SWTICHES, 5 MOTORS TO 10 HP, AND 13 COMMUNICATION DROPS. -- - - -. SUPPLEMENTAL PERMIT TO ADD: 44 LIGHT FIXTURES, 1 SUB PANEL TO 200A FEE SUMMARY Quantity Temp Dist System / Lighting $0.00 Quantity ISSUE FEE $23.50 0 Temp service test $0.00 0 Res. a/c package $0.00 0 New Res (1-2 units) $0.00 0 New Res (3+units) $0.00 0 Pool / Spa $0.00 0 Lighting Fixts $90.62 114 Recept Outlets $13.20 12 Switches $11.00" 10. Non Res Appl $0.00 0 Res Appl $0.00 0 Service to 200a $0.00 0 Service to 1000a $0.00 0 . Service over 1000a $O.od 0 . Motors to 1hp $0.00 0. Motors to 10hp $61.50 - '5 Motors to 50hp $0.00 0 Motors to 1 00h $0.00 - 0 - Motors over 100hp $0.00 , 0 Communication drops $14.30 ' 13 " Sub panel to 200a $30.50 1 Pole Light Pkg $0.00 0 Sign Circuits $0.00 0 Temp Pwr Pole $0.00 0 FEE SUMMARY Quantity Temp Dist System / Lighting $0.00 0 Busway /100 it $0.00 0 Standing Section $0.00 0 Misc Electrical Equipment $0.00 0 Transformers up to 1 kvalkw $0.00 0 ................up to 10 kva/kw $0.00 0 .................up to 50 kvalkw $0.00 0 ..:..............up to,100 kvalkw $0.00 0 - ..................over 100 kva/kw - $0.00 0 Low Voltage Equipment - $0.00 0 ' tow Volt Wiring System I Ckt $0.00 0 Misc. Conduit - ,- $0.00 0 Misc. Conductor $0.00 0 • • Circus ( gen or ride) $0.00 0 Circus (meth ride or lights) $0.00 0 Christmas Tree Stand $0.00 0 Fireworks Stand , 0 Other Electrical Fee' ,$0.00 $7.50 Investigation Fee $0.00 . - Plan Check Fee - $0.00 Reinspection Fee $0.00 TOTAL CALCULATED FEES $252.12 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, 1241-92) EXPIRATION: This permit shall automatically expire and become vold 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) 754-5628 2448-46 (SM) DECLARA 710N5 WORKERS' COMPENSATION DECLARATION: - I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 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 section 3700 of the Labor Code, for the performance of the work for which this permit "issued. My wo mm nsatlon josuranoe carnia nd policy number are- Policy �� Policy Number. 6 / Y 1 (This sec said not be comp/ led if the permit is valued at one hundred dollars ($100) or less.) -- ❑ I certify that In the performance o1 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 C fomla, and agree that i I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply With these pro" ens. �},Srgpasue: (Date.` rte' �17 D WARNING: FAILURE TO SE WORKERS' COMPEL &TION COVERAGE IS UNLAWFUL AND SHALL SUBJECT' AN EMPLOYER CRIMINAL PE TIE AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($1 . IN ADDITION T07 COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37060F THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am ficonsedoder provislons o1 Chapter 9 (commencing with Section 7000) of DMslon 3 of the Business and Professions Code and my license is in full form �and e_ffecL Uc.,# Class p Con` trJctgjs.Signeture: D1 efe: CONSTRUCTION LENDINGE CY: �— ❑ 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). Lenders 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 the a signed statement that he or she Is licensed pursuant to the provisions of the Contractors Lloense Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or Ihal,he V 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 penalty of not more than five 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, thre 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.). ❑ 1 am exempt under sec. Business and Professions Coda for this reason: Signature: Date: Owner ID verified by driver's license. ❑ Yes ❑ No Drivers License No. Expires: Verification of Ownership by (type of document, i.e. - property talc bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 hereby certify that no excavation live (5) or more feet in depth into which a person is required to descend, will be made In connection with work authorized by this per ill, 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 will 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: 1 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? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Masa Fire Department by every business which has at any one time during a reponed 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 a1 standard temperature and pressure). ...............................w.................._.............__.__._.__.._.. .__......... t need t........._....................._............................................................teri................... .................. .._._...........__....__..__ 2 Does or will the applicant or present or future building occupant need to lite a registration forth for acutely hazardous materials? ❑Ves ❑ No (Section 25533 of the California Health and Safety 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 maledals 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 ;Tppllcant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ ND (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 antl Safety Code been fully complied with? ❑ Yes ❑ No ................_.................___................_._........_....._.._._...._._.._____._.—._.............._....................._...................................._.....__.__...................__..............—.__._.__._—_ 5 Does or will the applicant or present or future bulltling occupant requlre for the work which is the subject of this a plication appermil for such constructlon or modification genc from the South Coast Air Quality Management District or from any other air pollution control district or ay? Ves 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 oe COnstmctetl untler this permit be within 1000 feet from the outer boundaries of a school? ❑Ves ❑ No (It yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). a __............__.._...... _...__.._.........___...__............................._.__...""—_ — 7 If a permit from the South Coast Air Quality Management Dismal or other eir_._pollution control district 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? 13 Yes ❑ No e (If 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 COMPLIANCE AND AUTHORIZATION OF ENTRY: I cenity, under penalty of perjury that I have read this application and state that the Information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for Inspection purposes. I agree not to occupy or allow Occupancy of any building authorized by this permit until final inspection. Signalur ILog her le�/7 S t, nd/Or AUT4adAppligent ,-,. +' 1._Dalp_::0 CODE If. ge¢, Ifs CODE I INSPECTION TYPE gdjE II✓TITIALS 1616 Fixed S em Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Ra-Root 210 Final Electrical .S 201 Final Block/Retaining Well 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 (714) 754-5273 • Fax (714) 754-4856 • www.ci.cosla-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 245 FISCHER AV Status: ISSUED Suite: A002 Applied: 05/112005 Vicinity: Issued: 06/23/2005 Primary Occ: B Eat<50/ Office/ Bar<50 Type of Construction: V -N Parcel Number: 93898001 Zoning: Applicant: LEW GARY KNOX ISSUED BY: Address: 23482 PERALTA E _ Phone: 949-859-5924 LAGUNA HILLS, CA Zip: 92653 i Owner: HITTNER,_GLENN W Address 245 FISCHER AVE #A+1- Phone: . /',-COSTA MESA, CA%'� Zip: 92626 - Contractor: KNOX CONTRACTING INC Address: 23482 PERALTA E - -� � � ;Phone: 949.859-5924 LAGUNA HILLS, CA - Zip: 92653 Licenser 726573 Arch : 'DATUM ARCHITECTS '-Eng: Address: 6 MORGAN - Address: , Phone: 949-7224910 _ - - - -Phone: IRVINE, CA Zip: 92718 - -`✓ License: C19769 ` License: SCOPE OF PERMIT ; 5,743 S.F. INTERIOR TENANT IMPROVEMENT FOR "UNITED AGENCIES' SPACE A002. WORK TO INCLUDE: NEW WALLS, CEILING, RESTROOM UPGRADES, AND DEMOLITION EXISTING WALLS. FEE SUMMARY Plan Check: $252.49 Calc Valuation: $200,000.00 Permit: $1,553.75 % Claim Valuation: $200,000.00 SMTP Res: $0.00 SMIP Com: $42.00 Other: Inspection: $0.00 .Total: $1,848:24` ,� PLANNING & ZONING �� SETBACKS '✓ �� ..�_ A MAIN STRUCTURE,Fronl, 0- 0� , / Rear -0- 0 ` Left 0- 0� Right "0- 0 ACCESSORY Frontes 0. 0 Rear 0-0 - Left 0-0 Right -0-'o " PARKING Existing: o' -.° \--,Required: p \ Proposed: 0 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 cod nd all required Inspections and final approval must be obtained. Failure to obtain Inspections and final approval will result in the expiration oft ermit. FOR INSPECTIONS CALL: (714) 7545626 244&46 IBM) DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by sectlon 3700 of the Labor Code, for the performance of the M for which this permit is Issued. I have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is Issued. • ..'- ikers' compensation ct7nInsurance carder end policy number are: -2 rnemer.S y rc �r� is seon n e ot be competed if the permit Is valued atone hundred dotlers (SIOO) or /ass.) ❑ 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 California, and agree that If l should become subject to the workers' compensatlon provisions of Section 3700 of the Labor Code, I shall forthwith comply vi Ions. ate: _� �7 3 / t�J S� A n ` Ts6 FAILURE TO SECURE�ORI4=R8' COMPENSATION RAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL P TIES CML FINES UP TO ONE HUNDRED TkUSAND DOLLARE ($100,00D), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3/06 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: he ebq afflrthtfieYliamilkensed:unAer,provisions tom o1 Chapter 9 (commencing with Section 7000) of Division If gpQ Professions Code, and my license Is In full �!j tractor's riaf�. ilitil- Date:. CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is Issued. (Sec. 3097, Civil Code). Lender's Name: 4 • Lender's Address: Signature: Date: OWNER -BUILDER DECLARATION$; I hereby affirn that under penalty of perjury that I Aril 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 (commenting 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 civil penalty of not more than five 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: Tj)e 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 appy to an Owner of property who builds or Improves thereon, and who contracts for such project with a contractors) license pursuant to the Contractors License Laws.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑ Yes ❑ No Drivers 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 6, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Solely, 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: 1 Will 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? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mese 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 feet o1 compressed gas at standartl temperature and pressure). .......................................................................................................__._......._.......................__.........................................................................................................................................._......................__.................._................_..._. 2 Does or will the applicant or present or future building Occupant need to file a registration forth for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety 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 o1 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 end Prevention Program for acutely hazardous materiels)? ❑ 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 bapartment of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. ................................................._....................._.._.........................._._....._._.__...._............_..._...........full.........._._YeY._ .._..........__.. _..__ 4 If en RMPP is presentty required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes ❑ No 5 Does or w0 South applicant or lily M f or future building occupant require for the work which Is the subject c this ,application a Permit for such construction or modiflcatlon from the South CoBSI Air Quality Management District or from any other air pollution control district or agency! LJ Yes LJ No (Sectiin 65850.2 of the California Government Code requires that the requested Information be furnished on appllcatIons for non-residential building permits). B Will any pan of the facility to be constructed under this permit be within 1000 feat from the outer boundaries of a school? ❑Vas ❑ No (If 'yes, the facility must meet the requirement of Sectors 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? ❑ Yes ❑ No ..........._.__.....................____......._—.______._..._..__._...................._....................._._..........................__..............................................................._.............._......_._._......._ 8 (it yes', attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certity that under penalty of perjury the information given above Is coram. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I cony under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, 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, Signal 11ate 'Inc CODE I. INSPECTION TYPE QdTE INTRIA CODE r INSPECTION TYPE PATE IM I@ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pod Spa Final 208 Final Plumbing 200 Final Re -Rolf 210 Final Electrical 201 Final BlockfRetalning Well 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final BuildingrOccupancy, (714) 754-5273 • Fax (714) 754.4856 • www.cl.coste-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 MECHANICAL PERMIT Job Address: 245 FISCHER AV Suite No A002 Vicinity: A002 Parcel Number: 93898002 Applicant: STEVE PAQUIN Address: 2221 E WINSTON RD #P ANAHEIM, CA Owner: MOORE, JASON W Address: %UNIVERSAL MERCHANT SVCS COSTA MESA, CA 245 FISCHER AVE #AU Contractor: A/C PLUS Address: 2221 E WINSTON RD #P ANAHEIM, CA Phone: (714)774-9707 Zip: 92806 Phone: Zip: 92626-4535 Phone: (714)774-9707 Zip: 92806 License: 616420 Status: ISSUED Applied: 07/05/2005 Issued: 07/05/2005 ISSUED BY: 1p W0111111000 SCOPE OF PERMIT MECHANICAL PERMIT FOR 5,743 S.F. INTERIOR TENANT IMPROVEMENT FOR "UNITED AGENCIES" SPACE A002. WORK TO INCLUDE: 1 INST FAU TO 100 K BTU, 7 REPAIR/ALT COOLING/HEAT, 1 GAS PIPING, 2 VENT FAN/SINGLE DUCT AND 5 3 TO 15 HP/500 K BTU. 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.P FOR INSPECTIONS CALL: (714) 7545626 244546 (600) FEESUMMARY Quantity Quantity ISSUE FEE $23.50 Repair/ Alt Absorbtion Unit $0.00 0 Inst FAU <100 k BTU $14.80 1 Repair / Alt Refrigeration Unit $0.00 0 Inst FAU >100 k BTU $0.00 0 .Ventillation System $0.00 0 Repair / Alt Cooling/Heat $95.90 7 Evaporative Cooler $0.00 0 Inst / Rep. Recess Wall His $0.00 0 Commercial Incinerator $0.00 0 Refrig Sys <100 k BTU $0.00 0 - Domestic Incinerator $0.00 0 Refrig Sys >100 k BTU $0.00 0 Compressors / Absorption Systems Gas Piping $6.15 1 - Up to 3 hp / 100 k BTU $0.00 0 Factory Fireplace $0.00: 0 3 To 15 hp / 500 k BTU $135.75 5 Hood w/Meth Exhaust $0.00. 0 15 To 30 hp / 1,000 k BTU X30 $0.00 0 VAV Box $0.00 0 - To 50 hp / 1,750 k BTU $0.00 0 Vent Fan / Single Duct $14.50 2 Over 50 hp / Over 1,750 BTU $0.00 0 Appliance $0.00 0 Boilers - Fire Dampers $0.00 0 - Up to 3 hp $0.00 0 Smoke Dampers $0.00 0 3 To 15 hp $0.00 0 Inst or Relocate Appl Vent $0.00 0 15 to 30 hp $0.00 0 Air Handlers < 1 0000c $0.00 0 30 to 50 hp $0.00 0 Air Handlers > 10000cfm $0.00 0 Over 50 hp $0.00 0 Floor Furnace $0.00 0 Other Mechanical Fee Floor or Suspend Heater $0.00 0 Investigation Fee $0.00 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.P FOR INSPECTIONS CALL: (714) 7545626 244546 (600) DECLARATiONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 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 o1 the wo for which this permit is Issued. I ' e and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Cade, for the performance of the work for which this permit is Issued. y workers' compensation ijpsurance carrier and policy number are: rr mer. - F r_11AAJ PQlgy jyll0lherw`h"i�D�y�r��iL17}— P(!M�s `soman need not be completed if the permit is valued atone hundred dollars ($100) or less.) ❑ 1 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' compensatlon laws of Calif la, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shell forthwith comply with ese p VISI / A�plf",(,Slgne�7 —Zx L(. Date: a,_, 7-5-0"C WARNING: FAILURE TO SECURE WORKERS' ODMPENSATI COVERAGE IS UNLAWFUL MND SHALL SUBJECT AN EMPLOYtwKYCRILLWIL PENALTIES MID CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37060E THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I em 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 forces d dffecti:3p % (es'slg, C— 20 �ppyllctpna signator Deti '� —.7/— 0 7 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, Civil Code). Lender's Name: Lenders Address: Signature: Date: b OWNER-BUILDER DECLARATIONS: I hereby afflrn that under penalty of perjury that I ann EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a perrtyI 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 IIca ad 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 civil penalty of not more than five 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, thAwner-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 appy to an owner of property who builds or Improves thereon, and who contracts for such project with a contractors) 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. ❑ Yes ❑ No Drivels 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 pernil, 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-bullder, 1 will 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: Dale: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 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? ❑ Yes ❑ No (Section 25505 o1 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 feet of compressed gas at standartl temperature and pressure). ..........................................................................................................................................................__...................................................................................................................................... ......................................................._................... 2 Dass or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety 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 2DO cubic lest of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepreaen MP RP (Risk Management end Prevention Program for acutely hazardous materials)? 13 Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department me y 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 fln RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No ......................................_........................... _......... ...... _.._......... _.__... __...................... __........................ __................................................................................... ...................................................................................... _............ ___..... 5 Does or well the applicant or present or future building occupant require for the work which is the subject of this as (cation aemit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or egencyt LI Yes 8 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 pert of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (If yes', the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ...................................._................................._.._................................................. _... _................ ____._._................................ ..................................... ... .................................................................................................... __............... .Y...... 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? ❑ Yes ❑ 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 stele laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the infornadon given is correct. 1 agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mess to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. nature Of Legal Owner(s) Date A 7ABtlmdzed.M,PPccan�_ I,yDete__ if CODE 1. INSPECTIONTYPE Qct$ IHTITIA CODES INSPECTIONTYPE 10 S 1616 Fixed System Final Fire Prevention 206 Final Mechanical T 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final BlockfRetaining Well 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Bullding/Occupancy (714) 754.5273 • Fax (714) 764-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 PLUMBING PERMIT Job Address: 245 FISCHER AV Suite No A002 Vicinity: Parcel Nunmber: 93898002 Contractor: KNOX CONTRACTING -INC Address:. 23482 PERALTA E Phone: 9498595924 LAGUNA HILLS, CA �, Zip: 92653 License: 726573 Status: ISSUED Applied: 06/23/2005 Issued: 06/23/2005 ISSUED BY: SCOPE OF PERMIT 5,743 S.F. INTERIOR TENANT IMPROVEMENT FOR -UNITED AGENCIES' SPACE A002. WORK TO INCLUDE: NEW WALLS, CEILING, RESTROOM UPGRADES, AND DEMOLITION EXISTING WALLS. REF.: B05-00757 - - - - PLUMBING TO INCLUDE: 1 SEWER CAP, 4 COMMERCIAL SINKS, 1 URINAL AND 3 WATER CLOSETS. - i AMT Applicant: LEW GARY KNOX- Sump Pump % QTY, 0 11 AMT Address: 23482 PERACTA E , 0 / Washer - -_Phone: -949859-5924 $0.00, j LAGUNA HILLS, CA - -�_ Zip: 92653 ., $0.00 • Backflow Preventer $0.00y\� 0 -P-Trap �' $0.00" Bathtub "JASON'W 0 Owner: MOORE, Clarifier System'A- /$0.00 "" 0 ��,Process Piping (per, R)' ;Address %,UNIVERSAL MERCHANT SVCS ',- $0.00/ , Receptors _." $0.00 Dental Units COSTA MESA. CA Phone:"£ - < Septic Tank d: Dishwasher\,$0.00" C 245 FISCHER AVE #AU i Zip: 92626-4535 Contractor: KNOX CONTRACTING -INC Address:. 23482 PERALTA E Phone: 9498595924 LAGUNA HILLS, CA �, Zip: 92653 License: 726573 Status: ISSUED Applied: 06/23/2005 Issued: 06/23/2005 ISSUED BY: SCOPE OF PERMIT 5,743 S.F. INTERIOR TENANT IMPROVEMENT FOR -UNITED AGENCIES' SPACE A002. WORK TO INCLUDE: NEW WALLS, CEILING, RESTROOM UPGRADES, AND DEMOLITION EXISTING WALLS. REF.: B05-00757 - - - - PLUMBING TO INCLUDE: 1 SEWER CAP, 4 COMMERCIAL SINKS, 1 URINAL AND 3 WATER CLOSETS. QTY - i AMT FEE SUMMARY --AMT Sump Pump % QTY, 0 11 AMT ISSUE FEE,, $23.50Laundry,Tub 0 / Washer $0.00 Backflow irrigation $0.00, 0 Landscape Irrigation $0.00 • Backflow Preventer $0.00y\� 0 -P-Trap �' $0.00" Bathtub $0.00 0 Pressure Regulator . $0.00 Clarifier System'A- /$0.00 "" 0 ��,Process Piping (per, R)' $0.00 Connect (Ice,Soda:etc) ',- $0.00/ 0 ":, Receptors _." $0.00 Dental Units io.00 ,� 0� - < Septic Tank $0.00 Dishwasher\,$0.00" C 0�� Sewer Cap for. Demo _ $9.80 Drain, Floor $0.00 '�> 0 '0� _ Sewer Connect - $0.00 Drain, Rainwater \-$0.00, 0 Sewer Private Line $0.00 Drain, Roof $0.00 0 .. Shower • - $0.00. Drinking Fountain $0.00` 0--,_ Sink; bar $0.00 Expansion Tank $0.00 -0 '' Sink, commercial \ $39.20 - Gas Earthquake Valve $0.00 0 Sink, Floor_ $_0.00 Gas (1-4 outlets) $0.00 0 Sink, kitchen • ," , $0.00' Gas (Over 4 outlets) $0.00 0 , Sink, service/mop -$0.00 Gas Repipe $0.00 0 Spa (private) $0.00 QTY - i AMT CITY 0 Sump Pump % $0.00 0 --0 Swimming Pool $0.00 0 '0 . - s;'. •; : _ Trap Primer - $0.00 0 O'.Urinal $9.80 1 -0- Vacuum Brkr Bkflow(1-4) $0.00 0 0"- - �Vacuunl Brkr,Bkflow(5+), $0.00 0 0 Wash Basin - $0.00 0 - 1`-'" .Wash Basin Set- $0.00 0 0 -Waste and Vent System $0.00 0 0 Water Closet (Toilet) $29.40 3 .0 Water Heater / vent $0.00 0 0 "- Water Piping (Inst or Rep.) $0.00 0 4 Water Re -pipe $0.00 0 0 . - - Water Service $0.00 0 '0 Water Softener $0.00 0 0 OTHER $0.00 0 VIOLATION $0.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void It work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and' -' required Inspections and final approval must be obtained. Failure to obtain Inspections and final approval will result in the expiration of this pe FOR INSPECTIONS CALL: (714) 7545626 2"6-46 ISM) P DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a cortiscme of consent to self-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the tork for which this permit Is Issued. freve and will maintain workers' oonpensatlon insurance. as required by section 3700 of the tabor Code, for the performance of the work for which this Permit Is Issued. My workers' compenssaytion Insurances Mer and policy number are: Sii%T �^t/Ny S Po icyNumbor`-�6�—a(%O� Nssection need net be Completed if the pannif is valued at me hundred dollars ($ 100) or less.) ❑ 1 certify that in the performance o1 the work for which this permit is issued, I shall not employ any person in any manner so as to became subject to the workers' compensation laws of Calif and agree that If I shout became subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comp) with these ovisto Y P 6/% 3�D pficwt Slgrtetume - - "4 6b�'�t� 7 " Date:` W AILURE TO 5 RE W RS' COMPENSATION CODE GE IS UNLAW FIA. MID SHALL SUBJECT AN EM YETI TO CRINONAL PE TIES AN CML FINES UP TO ONE HUNDRED r"USAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 8106 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I he by atllrm(list I am Ilc_en a oder provl3Lo f Chapter 9 (commencing with Section 7000) 01 Division 3 of the Business and Professlons Code, and my license is in full forol and effect. I M' r- _ LL Class Contractor's Signature. CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is issued. (Sec. 3097, Civil Cade). Lender's Name: Lendoes Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjuryl�al I am EXEIZI/T FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Profassims Code: Any city or county which requires a permit to co nstru6MIter, 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 U 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 civil penalty of not more than Me hundred dollars (5500).): ❑ 1, as owner of the property, or my employees mini 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, dm EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Seo. 7044, Business and Professions Code: The contractors License Law does not appy 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.). ❑ 1 am exempt under sec. 4 Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑ Yes ❑ No Driver's License No. Expires: Verification of Ownership by (type of document, i.e. - property lax bill or dead): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation two (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 otructure, Scaffolding, faisework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 6, California Administrative Code). ❑ As owner-builder, I will 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: 1 Will the applicant or present or future bustling occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 01 the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mase 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 o1 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standartl temperature and pressure). .......___ wi_.._.......ratio.f._................._....._._........................._______........_�_....�_ 2 Does or will the applicant or present or future building axarpent need to file a registration form for acutely hazartlous materials? ❑ Ves ❑ No (Section 25533 of the Callfomla Health and Safety Code, with sone exoipUons, requires registration with the Costa Mesa Fire Department by each business which at any we 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 aappplicant or present o future building Occupant need to prepare an RMPP re(Risk Management antl Prevention Program for acutely hazardous metertab)? ❑ Yes ❑ No (Section 25534 01 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? ❑ Yes ❑ No ..........................__................_..___.........._----- _—._.................. __....................... ___................................................................. __............. __.......... __....... _._..._._ 5 Does or will the applicant or present or future building oxupant require for the work which Is the subject of this application eggermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 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). 8 W III any Part of the facility to pe constructed under this permit be within 1000 toot from the outer boundaries of a school? ❑ 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? ❑ Yes ❑ No ...............__........................._.._................_.__................._.._.................._._...__._—_...................._....._............................._._......................__.____.._._......_.—__..._—___—_ 8 (If yes', attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certity that under penalty of perjury the Information given above is correct. I agree to comply with all state taws and city ordinances regarding Hazardous Materials and Emissions. Signature: Dale: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: 1 certify under penalty of perjury that I have read this application and state that the Information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree net to oxxlpy or allow occupancy of any building authorized by this permit until final inspection. S hatu o��e� � Date ai oX,:ffyJ- 6�7 3 /0-S Ahtl/Qr A ifludzed mom--.` - WAta�' CODE I. INSPECTION TYPE 011IE ISL$ CODE INSPEC11ON TYPE 21111 ggjBSLS 1616 Fixed System Final Fire Prevention 206 Final Mechanical p 7S 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Root 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 v,Final Factory Fire Place 220 Final Planning Approval d. 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Bultding/Occupancy (714) 754.5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us Job Address: 245 FISCHERAV Suite: A002 Vicinity: UNITED AGENCIES, A002 Parcel Number: 93898002 Applicant: STEVE HELLMICH Address: 1170 E FRUIT ST SANTA ANA, CA Owner: MOORE, JASON W Address %UNIVERSAL MERCHANT SVCS COSTA MESA, CA 245 FISCHER AVE #AU Contractor: FIRE SAFETY FIRST Address: 1170E FRUIT ST ' SANTA ANA, CA 77 FAIR DRIVE, COSTA MESA, CA 92626 Zoning: Phone: 714-329-7110 ISSUED BY: Zip: 92701 Phone: Zip: 92626-4535 Phone: (714) 836-4800 Zip: 92701 License: 599761 Status: ISSUED Applied: 08/03/2005 Issued: 08/042005 IMF'KUVtMtN I t -UN "UNI I tU Alit NUIL=b JYAUt AUUZ. REF #B05-0757 FEE SUMMARY Plan Check: $54.11 Calc Valuation: , 53,000.00, ?, Permit: ' $83.25 " ° ', .Claimed Valuation: $3.000.00 Other: - "$0:00 Total: $137.36 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 / 2"646(6=) DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 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 issue(J. \ I have and wm maintain workers' compensation Insurance, as required by section 3700 of the labor Code, for the peftmumce of the work for which this permit Is Issued. My workers' tion Insurancecarter and policy number are: _ P`liryNumberI LUs n )alSl C%l b' v(Thls section need not be completed lithe permit Is valued at one hundred dollars ($100) or less.) ❑ 1 comity that inme pe ante 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 f C Ilomle, end agree that If I should become subject to the workers' compensation provisions of Section 370D of the Labor Code, I shall forthwith comp) with mese ovis' ns. Appl�lca_ fit Signet tu_r�e:.----^� Date: [� ^ �i O WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SMALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE (SIOBO00L IN ADDITION TO THE COSTOF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm mat,l.am licensed under,g�ovisio sof Chapter 9 (commencing with Section 70DO) of Division 3 oLthe.Business and Professions Coda, and my license is in full Toros and effea. _cLl ..ffi �5,�9 /(,n -Contraao� cote: CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is Issued. (Sec. 3097, Civil Code). Lender's Name: Lenders 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 Ilcense6pursuant 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 civil penalty of not more than live hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sola 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 appy to an owner of property who builds or improves thereon, and who does such work himself or herself of 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 appy 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: Data: Owner ID verified by driver's license. ❑ Yes ❑ No Driver's License No. Expires: Verification of Ownership by (type of document, Le. - 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 B, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has e permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 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? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Masa Fire Department by every business which hes 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 feet of compressed gas at slander A temperewre and pressure). 2 Does of will the applicant or present or future building occupant need to file a registration form for acutely hezeMous materiels? ❑Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exoetions, requires registration with the Costs Mese Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equarto or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas of 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 en RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No ......._...................._.____.__.....___._......................................................._......................_..._......__—___.........._............................._....._...._.............._..__.__........... ._..................... _................... 5 Does or will the applicant or present or future building Occupant require for the work which is the subject of this a pllcatlon aemit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Es Yes 8 No (Section 65050.2 of the California (3ovemment Code requires that the requested information be furnished on applications for non-residential building permits). .............................__._............._.....cilit............................................................._....__................_.._........._.........._..._................_.................................... drool? ._.. ...___..__............._................._...............................__ 6 WIII any pan of the facility to be constructed untler this permit be within 101X) feet tram the outer boundaries of a school? ❑ 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? ❑ Yes ❑ No 6 (II 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: Data: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I cortity under penalty of perjury that I have read this application and state that the Information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for Inspection purposes. I agree not to occupy or allow Occupancy of any building authorized by this permit until final Inspection. SignatureO ga r(s) Date -�loS ,-ArMJOr Authodzetl Applicant CDaate CODE It INSPECTION TYPE gejE 1111ITTIELi CODE INSPECTION TYPE 2AU 1NTITIAL5 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pod Spa Final 206 Final Plumbing 200 Final Re -Roof 210 Final Electrical �( � j n 201 Final Block/Relalning Wall 212 Final Fire Prevention r r /v I� cis- L�civ 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy Is (714) 754-5273 • Fax (714) 754.4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 245 FISCHER AV Suite: A002 Vicinity: LOBBY Parcel Number: 93898002 Zoning: Applicant: FABREGAS, JACK Address: 14 MESSADRIS - i Phone: 949-497-014 NEWPORT COAST, CA Zip: 92657 Owner: MOORE -JASON W - i Address ,"%UNIVERSAL MERCHANT SVCS - COSTA MESA, CA - - Phone: ./,245 FISCHER AVE #AU Zip: 92626-4535 Contractor: Address: Phone: Zig ' License•` Status: ISSUED Applied: 09/11/2002 Issued: 11/27/2002 - p 4'/ \ PLANNING & ZONING Arch - Eng: Address: - .' - `_ - - _ Address: - " Phone: _ <" V , , % `; Phone: MAIN STRUCTURE Front 0-0 - Rear `Zip: ,� " License: 0'0- '0-ACCESSORY C License: ACCESSORY SCOPE OF PERMIT-,, Rear - 844'S. F. INTERIOR T.I., LOBBY AREA ONLY OF BUILDING,"A002"., WORK TO INCLUDE ADD 80'-4"\ LF OF COSMETIC WALLS WITH (6) 110 VOLT OUTLETS AND SAFETY GLASS. , :7 PARKING Existing: 0 -' Required: �. FEE SUMMARY. Plan Check: $145.11 — - Calc Valuation: $12,150.00 Permit: $223.25 Claim Valuation: $10,000.00 SMIPRes: $0.00 SMIP Com: $2.55 Other: . $223.25 4n action: $0.00 Total:' . $594.16- 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 it 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 pertniL-� FOR INSPECTIONS CALL: (714) 7545626 11� - 2"6.46(6=) 4'/ \ PLANNING & ZONING " /'�` i SETBACKS_ MAIN STRUCTURE Front 0-0 - Rear 0-0 '_ 'Left 0-0 - - Right' ;., 0'0- '0-ACCESSORY ACCESSORY Front` 0-0 Rear - 0-0 Left. 0-0- �� Right -0=0%� , i . PARKING Existing: 0 -' Required: -0 Proposed:-- 0 - 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 it 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 pertniL-� FOR INSPECTIONS CALL: (714) 7545626 11� - 2"6.46(6=) DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to sell -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 section 3700 of the Labor Code, for the performance of the work for which this permit is Issued. My workers' compensation insurance carrier and policy number are: Carder: Policy Number: (This section need not be completed if the permit is valued at one hundred dollen (8100) or less.) 21 cenity that in the performance of the work for which this pem it is issued, I shall not employ any person In any manner so as to become subject to the workers' compensation lawrtff California, and agree that if I should become subject to the workers' compensatlon provisions o1 Section 3700 of the Labor Code, I shall forthwith comply with 99 j �1 ,Applicantcant 8lgnall re: the � Dat, 1 / _ L T -DZ WARNING: FAILURE TO SECURE W RKERS' &MPENSATION COVERAGE IS UNLAWFUL AND SMALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I em 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. a Class # Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is Issued. (Sec. 3097, Civil Code). Lenders Name: . Lender's Address: Signature: ' Date: OWNER -BUILDER DECLARATIONS: 1 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 DNlsion '3;f 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 rmit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): � 1, 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 propertywho 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 sate. 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, em 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.). ❑ [am e t and r c. Business and Professions Code for this reason: Signature: = [ F�,m_ ,A Verification of Ownership by (type of docu NI, i.e. - property lex 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) feel high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person hes a permit to do such work from the division. Signature: Data: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 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? ❑ Yes ❑ 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 feet of compressed gas at standard temperature and pressure). .........._..............._.............__•......................W._._..............._...___.........._____..__.._....._........................._............................................................................................. __.......... _............ __...... ___. 2 Does or will the applicant or present or future building occupant need to lila a registration form for acutely hazardous materials? [3 Yes ❑ No (Section 25533 of the California Health and Safety 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 aqua 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 thepllcant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ h0 (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 It an RMPP is presently required, has Section 25534 of the Califomla Health and Safety Code been fully complied with? ❑ Yes ❑ No 5 Does or will the applicant or present or future building occupant require for the work which Is the subject c this plication eermil for such construction Or modification from the South Coastst Air lr Quality Management District or from any other air pollution control district or e9ency'7 Byes 8 No (Section 65850.2 of the California Government Code requires that the requested Information be furnished on applications for non-residential building permits). .............._........................__...................... _.__.....................__....—........_._._..........__.........................__........................_...................... ............................................... ._......................_................_............ _._.................. _.... 8 Will any pert of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑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 emit 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 applPcation, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No ..................................................................... .......................................................................... ._................................................................................................................ ................................ .................... __............ __.......... _................. B (If yes', attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certity 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 COMPLIANCE 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 all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permil until final inspection. Signature Of Legal Owners) Date 0 -27 -o -z I OK aE,Or Authorized -Applicant [Date CODE If. INSPECTIONTYPE DAIS IKOAL$ CODE# INSPECTION TYPE DAM IIS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Root 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 I -- r —� 4gppneanrm;...--- les wlthm heavy border lines and sign an appropriate declarations. QF COSTA MESA RMITO. � C iJSTRUCTION PERMIT Ef =�� TRACT NO. LOT NO. BLDG. NO. rJ�/ 35 7 A - 2-- - TYPE OF CONSTRUCTION NEW ❑ ADD ❑ ALTERATION ❑REPAIR ❑CONVERSION ❑DEMOLISH ❑ OTHER 5_203_ 4_/28/82 557.00 ZONING REGULATIONS Project Address Owner Ph Z Address I Arch/Eng. License No. DESCRIPTION OF WORK - A'P' Z -O ' Address - - - ' ZONE PLNG. REF. - -I Contractor (,�JP,r2.� Phone - TYPE OF PERMIT ❑ GRADING ❑ FOUNDATI N ❑ STRUCTURAL �./. TENANT al ELECTRICAL LV MBING ❑MECHANICA B �� BPM ING SETBACKC /LST. O LINE SID YARD F SIDE Tq , RIGH Address LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (com- mencIng with section 7000) of Division 3 of the -Business and I/ - ❑ OTHER It Professions Code, and my license is In full force and effect. REAR YARD (TO P/L _ License Class License No. PROJECT DESCRIPTION r ✓1�/f CAS ^7 SO. FT. �{/CJ'�� L i /,/ _ PKG. SPACE REO. PROVIDED •Date Signature WORKERS' COMPENSATION DECLARATION OCCU PANC CONSTRUCTION TYPE Ir STREET WIDTH PARK FEE $ _ I hereby affirm that I have a certificate of consent to self -Insure or a Workers' Compensation Insurance, VALUATIOZONE ZONING APPROVED BY - G . DATE certificate of or a certified copy thereof (Section 3g 00, Lab. C.). GRADING CU. YDS. SPECIAL CONDITIO IAL RE N Policy No. u7%`% A'%�G7SY. ompany EMEAAONT /NL1�1•l.(JCN ACRES - ,nE - ' . ❑ Certified copy is hereby furnished. - REMARKS: - - KCertlfied copy is filed with the city Building Division. n -O� EMPTION FROM WORKERS' COMPENSATION DECLARATION / u - Is section need not be completed if the permit Is for one hundred less). . ` I ea I• „le Gam. .DO) or 1 Certify that n the performance of the work for which this permit is CiJ .i-•� Issued, I shall not employ any person in any manner so as to become PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK - - subject to the Workers' Compensation Laws of California. BATHTUBS SHOWERS - - Date Signature NOTICE: If after making this declaration, you should become subject TOILETS y URINALS GENERATOR 0-1 KW_ 1-10 KW. to the Workers' Compensation provisions ofthe Labor Code, you must - TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES 7r DOUBLE LAVS 60 APPLIANCE 10-50 KW -50 + KW revoked. CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS - MOTORS - 0-1 HP -1-10 HP 1 hereby affirm that there is a construction lending agency for the per. SERVICE SINKS 'SUMPS (INC. SOLAR) 30-5 0 + HP - formance of the work for which this permit is issued (Section 3097 j11'c ,FLOOR SINKS FLOOR DRAINS C?' U . ,DRINKING -FOUNTAINS FIXTURES OU T SWITCHES GAS TUBE SIGNS r 1j Civ. C.). :t Lender's Name i .. s •a.9.-, t \ , \, Lender's Address•`- ` •` '� - '\ OWNER BUILDER DECLA RATION \ I hereby affirm -that I am exempt from. the.Contractor's License Law for fINTE RCEPTO RS CLARIFIERS - • -`t POLE LIGHTS the --following reason*(Section 7031.5 Business and ,Professions Code: .SWIMMING POOL P,J RAP- Any city or. county -which. requires a permit. lb. construct, alter, .\� POLES METERED SUB - Improve, demolish or, repair any structure, prior to its issuance, also re- WgTER SERVICE ALTERATION Q PANELS -MAIN SUB ' quires the applicant for -such permit to file a signed statement that he , 'ALTERATION is licensed pursuant to the provisions of the Contractor's License Law GAS SERVICE, SERVICE AMP - (Chapter 9'(commencing with Section 7000), of. Division 3 of the i - - - - 0 HEATERS ' -BTU OUTPUT - ' Business and Processions Cotle) or'that he is exempt therefrom and,the basis for the alleged exemption. Any violation -of .Section 7031.5 by `WATER SEWER CONNECTIONS - any applicant for a permit subjects the applicant to a civll.penalty of not more than fivelhundred dollars)($500): ,. ._ . I•` )',• I _I ` SOLAR YANKS COLLECTORS .- - Osl, as.ownenof the'property,\or. my'employees with Wages. as their "iompensation, will do the work; antl the strucjure is not intended ' - ♦ .'"'.'fered for sale,.(Section 7044r -Business and Professions Code: The., SO_ LAR PIPING SYS. ' ISSUE FEE tractor's License L'aw'does not apply to'an'owner-of'a property• ISSUE FEE ) i APPLICATION APPROVED BY - DATE wike builds or improves thereon, and who does such work himself or through his own employees; provided -that such improvements are not • I MECHANICAL PLAN CHECK - •• - SUMMARY OF FEES BUILDING /� 9 intended or offeretl for sale..If, howevor, the builtling or improvement Is sold wilhln one year of compl¢tionth¢ owner will'ha ve.t h¢ burden. of proving he did not buile or Improve\tor the purpose of sale). I r4 ❑ I,_as' owner of'the property, am exclusively'contrac[ih g with -HEATING SYSTEM 0-100,000 BTU PERMIT $ I% SMTP $ s / - Ilcensed.<ontractorslto construct :[he_projec[ (Section 7044; Busines„ AND DUCTING .- 100,000 + BTU PLAN CHECK $ PERMIT and Professions Code: The Contractor's License -Law does not apply to �• ISSUANCE $ an'owner of property who builds,oclmprovos,thereon, and.who con- -REFRIGERATION;- 0.100,000 BTU PLUMBING $ , tracts from such projects with ticootractor(5) liceshed' pursuant to SYSTEM _ x'51 GRADING $ the Contractor's License Law).:'_ - ,, , - .L ,. . �''100,000+BTUw � _ t PLAN CHECK $ ❑ I am exempt under Section B. & P. C. for this BOILERS BTU -- %\ \ $ ELECTRICAL $ _ reason ,'. ' MICROFILM $ PLAN CHECK $ Date Owner SYSTEM REPAIR, ALTERATION _ TOTAL FEE $ MECHANICAL $ �. I hereby certify that I ve t s app) cati nd.state that the above EXHAUST SYSTEM MULTIPLE LESS AD - information is co, ct. agre I co p1 with all city and county 'PLAN CHECK $ VANCE PC 8_ ortlina nca antl st ala tat 9 td eqn r ctio I and hereby authorize 'e representatives f t ci toer Ton he above mentioned property f r i spe on p ses. J/ Signatu,eX ISSUE FEE FINAL FEE $ - - Drivers' icanse or SS ] yCMF 0865.46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # -. Date Inspector POOL & SPA. APPROVALS - - Permit # - Date Inspect 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Soil ipe-Undrgrn ,-, �. • -44.. _ Steel Reinforcement' •;' 3. Electrical Conduit Utility-Undrgrn' 45. Forms 4. Electrical Conduit-Undrgrn _ 46. Electrical Bonding 5. Steel ein orce _ 47. Rough Plumbing & Pressure Test ' 6. Electrical UFER Grn - 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation - 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn ` - `5 --Backwash Lines P -Trap,❑ Undr rn 10. Structural Floor System 'at . 52. APPROVAL TO DECK 11: Pro erty Sewer Line & House Connection 53. Backwash & Receptor -Final :'.12!'•.i5freet Sev'ver(;onnec io'n 1•I %-"'- 54. Heater & Vent -Final - 13. Rough Plumbing 55 Plumb6na System - Final ' - 14. Rough Electric -Conduit -56. Electrical -Final 15. Rough Electric -Wiring 2 57. Solar System -Final 16. Rough Heating & Air Conditioning b8. Fencing &Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test _ 20. Roof Framing 21. Roof Sheathing - + NOTES: 22. -Frame and Flashing„ 23. InsulationCo4R•ir%/o...,1•- 24. Lathing & Siding d / - o✓ • rr ..a... •. c7 . r.r 25. Drywall Nailing rri M r iev . 26. Plaster Brown Coat _ V 27. Electrical Power Meter -Final 28. Final Electric '%_ - C �, 29. Final Heating & Air Conditioning 17 30. Final Gas Pipe -Test 31. _ Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35.' Landsca e SDrinkling System 36. Sound Attenuation _ _ ' 37. Handicap Regulations - AIA -ed 38. FINAL STRUCTURE &BUILDING -7 -/f -t 39. Special Requirements Completed QL L. i !�✓{/ 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42., CERTIFICATE OF OCCUPANCY NaDate - ' - - ApDliG nl to fill in all spaces colleen heavy border lines and sign all appropriate eeclantloro. CITY OF.COSTA MESA PERMIT NO. - TRACT NO. "' LOT NO. !BLDG. NO.-- CO•NSTrRi•iCTION PERMIT f % '. 41 "7'7 =:� � `. r :` : A .7 ..%•- TYPE OF CONSTRUCTION NEW ❑ ADD`y, 0 ALTERATION ❑ REPAIR C) CONVERSION ❑DEMOLISH - O OTHER 7EA444,T �' ZONING REGULATIONS " Protect Address •Y� ,._.' Owner' , - rvi "' _ - Ph Z' Addressao Al• Y "' Arch/Eng. License No. DESCRIPTION OF WORK - - - - - __ A P. - 'L nG L7 - AddrrA -'-- ° ZONE PLNG. REF. is -'•i.• �)( Contractor -SUPS. Phone TYPE OF PERMIT- ': _ _ 'Q GRADING ` ❑ FOUNDATIQN ❑ STRUCTURAL' EhECTRICAL LUMPING ❑MECHANIC T._ - - o 111 I t ✓ R• E E -- Address '� LICENSED CONTRACTOR DECLARATION —TENANT I hereby affirm that 1 am licensed linear provisions of Charter 9 (com- menting with section 700q` 01 �DlNslon 3 0l the Business and (] OTHER - Professions Code, land my�:llfanee'Is' In full force antl effect REAR YARD (TO P/L) •, - .r•--•.••sw-+-• .• • License Class - Ucan" No. • PROJECT'DESCRIPTI N - ;Q FT. I + s ad(�r 5 ACJ', _ -PKG. SPACE REQ. - ` ' PROVID �'•�" _ . ...� Date Slgdet ure !i• N '..00CUPANC CONSTRUCTION TYPE STREET WIDTH 'PARKFEE E WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a cartfflcate of consent to se 114nsure or a .07 , IryAL:UATIQN � ZONE 'ZONING APPROVED BV f - - ^)}f -� I, L DATE + certificate of Workers- Compensatlon'lnsuranG, or a'certilled copy .._.. _ _._ _ ( J :}•weot seGtbn aro '•'AOs•Y• "u. AVAlj(,(Jr'jY ra••� GRADING CU VDS ACRES SPECIAL CONDITIONS 'Y No. pnlpanY _ - I I 1; 7 L..:artiflecl copy Is hereby furnished. "-i • •pHMARKSsuv i' - r J y�ar Certified copy Is filed with the city Building Division. 1 - .I' , 'EXE 'eTION RRObI WORKpRS'`COMPENSATION DECLARATION v """" ..)f - „ it ( T ctlon need not be ccmDletld,ILlhe permit Is for one hundred -, ::: - . .I, .. .. ..7 r' ^'aJ •�!, .. �:" +-'•'+ 1'r ;• - it or IOU hn }s- r.., , . -...-1 .13 v •a: r . . G...ry that the work for which this permit a the ploy any person -In I shall not employ aey `In any manner so as to become .'PLUMWNG7TT- C l� i�' "''y'•p LAN CHECK - 'v' "' "' ' 'ELECTRICAL PLAN CHE K;! L-'— sulaja anon mDject.to the Workers Compensation Laws of. California. _ BATHTUBS' S SHOWER - -UW1 Date l Signature 1 NOTICE: If after rtie king this tleclgratlon. You should becom4 su0)ect rTOILET$i?,. ,. ,( (,;URINALS "'- GENERATOR 0-1 Kw_110,1<W to the Workers' Corripensallon'proV�fislons of the Leber Code, you must - TRANSFORMER forthwith comply with Such provlsbm or this permit shall ba deemetl LAVATORIES DOUBLE L•AVS"''`•APPLIANCE ! 10-50 KW 50 - revoked.'. ... 1 . _....- U ...• ._-...,_ . .. - , CONSTRUCTION LHNDINO AGENCY - ' KIT: SINKS'' "DISHWASHERS' - (L MOTORS:""' '• 0-1 HP�l'-30 HP - I hereby affirm that there Is a Construction lending agenty for the per. formance, of the,work for which 'this Is Issuatl 3097•Y ICE SINKS , Yz "" - 'DNC: SOLAR)- 103 0 *HPI • • -•-•� y per mit. (Section v "„”- -_ 'FIXTURES LsndeCs Name LOOK S FLOOR DRAINS OU T WITCHESCIVr Lender's Address + DRINKIN OUNT INS_` 1 "" Q GAS TUBE SIGNS '•^ •- -• •• =•_^•�:«a ¢.,.•ia:,>....-. .. OWNER BUILDER DEC LA RATIO N'r'-' f I hereby affirm that I am exempt from the Contractor's License Law f INTERCEPTORS - ^- CLARIFIERS it ,ppCE'CIGHTS-"' the following reason (Section 7031:5 Business and Professions Cod '•'S 1 POOL' -•r' -'"'P TRAP'"•""r'"`-" """""""" a •_ - `-'•'• -r• s•�M•+-.• POLES METE U ..-•�u ,,...0 - Any city or county which requires a permit to construct, alter, -""-� - - --c" •• -+•••--^�;. •uPANELS;.•-._..-. WATER SER I ALTERATION'•• .-. • { ` '' "" MAIN:`;"'-'-"'; '.SUB �, •.+. _ LL �. •.+�-' Im role, demolish or repair'anystructurs, prior to Its Issuance, also!re- the for to file tffa< he TQ4 res applicant .in permit a signed statement pursuant to the provisions of'lhe Contractor's'Llcanse`Lnw _ _ GAS SERVIC !_OU;Fl.ETS� 'j' �- �` SERVICE'" ""' ' ' AMP -7 ':'�! G1- �C'�llcansatl wlth Section 7000) of Division 3 of the WgTER HEATERS• BTU OUTPUT �"'•"'�T'-'""c,- rr ^•, '�,t�w:?�• `� t F-'jloesiene(commenci Coda)'or that he Is exempt therefrom and the for the allegata exemption. Any violation of Section 7031.5 by `for "a -SEWER CONNECTIONS_`•-"''�'"•""""`_�^'•" `;' •.. _„r.._,. ..... ,,,�,� - :5 applicant Permit subjects the applicant t0-8' Civil penalty •e not than five hundred dollars (5500)_ mgre ❑ I, as owner of the property, or my empployees with wages as'their ' -eensallon, ' SOLTANK ”' —'--COLLECTORS _-"" "�'•" A.R '- ' '- " ' '• -" ' •;�� ,i: � '- .; r sola will do the work, and the.structure Is not Intended or c 1 for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE Con, is Licanse Law doea-not apply to -an owner of a property ., .. ._._.._.._.., _.._.._......... ,-._, ;, ISSUE FEE APPLICATION APPROVED BY - DATE w who ulds or Improves thereon,•and who does such work himself or througyh his own employees, provided that such Improvements are not PI. MECHANICAL PLAN CHECK ) - HEATING SYSTEM 0-100,000 BTU i '- - �_A..� SU RY OF FEES .wf I ,'Iyi,^„ BUILDING t'• - PERMIT 5 •' 'SMIP ` intended or offered for sale. however, the building or Improvement Is sold within one year of completion, the owner will have the burden of proving he did -not build or Improve for the purpose of sale). I,' as ,owner' of- the Property, am axclusivel contracting with �' to construct the stoical (Sec Ion AND DUCTING ... r. BT_ - ]00,000+BTU .5 .... ,�'•. 'irC.__ and Prtl ssionttod and The Law does not apply to es not apply for •PLANCHECK E PERMIT ,: ig • - ISSUANCE -4 - owner of p pert build I provese ar owner o1 property who ith"a or Improves thereon, and who con- to REFRIGERATION 0-100,000 BTU Y !PLUMBING E : '• slj,tp}j '- Netractor%LiceneeLaw)tn"a'contraetor(s)'dlcesnetl•'punuant the Contractors License Law). SYSTEM -- - 100,000+BT6 GRADING` d' 'PLAN CHECK8 �• -;•;I; ' ' ❑ 1 am exempt under Section B. 6 P. C. for this BOILERS BTU .Il E ELECTRICAL 3' ' !"son ' SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE _ _ 1 _ - -.'.MICROFILM E •PLAN CHECK' E ,,,,2.' TOTAL FEE E IMEC MECHANICAL E - ••' • LESS AD• PLAN CHECK E VANCE PC S_ _ Date Owner L hereby cartlf That 1 vred t s a IjCa Y pp tl� antl state that the above Information Is car ct.\I(egre isI with all city and county la ordinances and Site a r tat 9 to con r ctlon and hereby authorize representatives O'1 I cl[y to' enter Pon ��a above mentioned f r i, per�lon p oses.i I / properly FINAL FEE Signature -;, Ing; Goldenrod -Assessor •� , CONSTRUCTION AND PLANNING APPROVALS Permit# Date Inspector POOL & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Soil ipe-Un rgrn 44. Steel Reinforcement 3. Uectrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. �;teel Reinforce 47. Rough Plumbing & Pressure Test 6. Electrical LIFER Grn 48. APPROVAL TO COVER-GUNITE 7. Pootings 3 $:Lc1l 49. Electrical Conduit-Undr rn B. Foundation 50. Gas Pipe ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P -Trap. El Undrarn tructural Floor System 52. APPROVAL TO DECK Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing 14, Rough Electric -Conduit 56. Electrical -Final 15. Rough Electric -Wiring 57. Solar System -Final 16. Rough Heating & Air Conditioning bU. Fencing & Access Approval 17. Ducts in Structure APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough &Test 20. Roof Framing 21. Roof Sheathing NOTES: 22. Frame and Flashing ?3 /j2 23. Insulation 24. Lathing & Siding r / 25. Drywall Nailing 16. Plaster Brown Coat C /1 c v2C LL Bsc Electrical Power Meter -Final 26. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 1- 31. Final Plumbing 'L.o 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape. Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. E2. CERTIFICATE OF OCCUPANCY No Date Applicant to fill in all spaces within heavy border lines and si n all appropriate declarations. • . CITY OF COSTA MESA N� TRACT NO. LOT NO. LOT BLDG. NO. -- -- - •` - CONSTROCTION PERMIT FT C ^ Project Address : z-/51,46/ZZ Z TYPE OF CONSTRUCTI N - _ 52Q4 4/28/82 ,- TIX0 TL Owner j>Qey Ph/o�nes Ce U LL U/ -A4,- ❑ NEW ❑ ADD ALTERATION w/7 ,Address - +� S'A /VTT /4 + - 0 REPAIR 0 CONVERSION ❑DEMOLISH _- ', - r -" - - - - O'OTHER - - + ZONING�REGULATIONS , Arch/Eng. License No. Pr CYEK.• +A.P:.S¢,',_:. I _- Address DESCRIPTION OF WORK ., I,.. .'. ZONE'i:,'-I7LNG.REF.-9F - \ �, — Contractor 2'T/NS ir`�,EC]t�/�Phon �� TYPE OF PERMIT + B TToo ggVVILLppING- !PROPERTY _ , _• Address ,W , (f� NI,1 J 4Z4,At E ,. ❑ GRADING -.0 FOUNDATION ❑ STRUCTV RAL SETBACK`C C T.. LINE .. 1 WF`a'yARD �( LICENSED CONTRACTOR DECLARATION--' --- - - ", 0 TENANT I��/ELECTRICAL`CPCUMBING 'C MECHANIC L � - v I hereby alfirm that I am licensed under provisions of Charter 9 (com- / - RIIG LA' '.. ' ''.. •• WIN + men c Ing with section 7000) of Division 3 of the Business and 0 OTHER '' — t Professions Code, 'antl my license is i I forte ntl effe'' I REAR YARD RD LTO P/L)'' ' - - - - C � / � '•— - - PROJECT DESCRIPTION- 't 8lcense CIa55 coos No ,' . - � PKG[SPACE.R EQ:. . - • PROVIDED 2. Signature - .C" La SQ. FT.' STREET -WIDTH . 's:PARK FEE E, WORKERS' -COMP ENSATION E ARATION -' —CONSTRUCTION TYPE .. ZONING:APPROVED DATE I herebyaffirm that I have a certificate of consent to self -Insure or a VALUATION ZONE By '+ ^.ertificate of Workers' Compensation Insurance, or a- certified copy l,"ereof (Section 3800, Lab. C.). _ CU.,YOS. 1 ACRES i 'SPECI:AE:C O NDITIO t• :.%licy No. Company . GRADING - 'El -certified copy is hereby furnished.-- REMARKS:- Certlfied copy Is.filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - (This -section need not be completed �If the s.fon one huntlretl _ _.._- �' (5300) or less,1 d; �• ^• - Issued, 1 -certify thabin the performance -of the rk f whit ermit is shall not employ any person I a o as becomePLUMBING '' PLAN CHECK - ELECTRICAL PLAN CHECK -11 subje�t T ('1(vor,$s' Compens of. f rn BATHTUBS SHOWERS _ Date J ,��'` Slg fi.r. NOTICE: If atter making t de 'ration, you should become subject TOILETS f; , URINALS ' - -,GENERATOR''. p-1KWT•�1-S OIKW' TRANSFORMER,' + I the Workers' Compensat ovlslons of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed ,__,_ - LAVATORIES DOUBLE LAYS- .1. APPLIANCE'. 10Sb ILW_50'l'KW" revoketl: — -- --- - - - - --- '� "' - CONSTRUCTION LENDING AGENCY KIT. SINKS -DISHWASHERS - I 'MOTORS - '.OY ,Hp '-50'NpT-50 1+l0 HP -' I hereby affirm that there is a construction lending agency for the per- ...-- SERVICE SINKS ' f .p. SUMPS -'- 7 _ .-(fNC:SOLAR) �:• 1 .. -'HP' formance of the work for which this permit is issued (Section 3097 i Civ. C.). s - _ _ _ ,FLOOR SINKS FLOOR DRAINS + FIXTURES '.'OU TLET$ ', 'SWITCHES Lender(S.Name-• - - _ r� -. Lender's�Atldress • w _ _I DRINKING FOUNTAINS F - - .GAS TUBE SIGNS' - - I OWNER BUILDER DECLARATION- -- INTERCEPTORS CLARIFIERS ) *-POLE LIGHTS i I hereby. affirmIthat.l•am exempt from the Contractor's.License Law dor - " 1 the following reason (Section 7031.5 Business.antl-Prolessions Code: SWIMMING POOL PTRAP - - POLES ' METERED - �.• �_ SUB Any city or county, which requires a Permit to construct, alter, improve, demolish or repair any structure, prior to its Issuance, also re- -+ WATER SERVICE ALTERATION t, MAIN, - SVB - jl quirestheapplicant for such, permit tofilea signed statement that he ,PANELS• - - ^ CAMP Is licensed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS j$ERVICE `"' '- "" --- -(Chapter 9 (commencing with Section7000)of Division 3 of the ' - ,.;`3.�usiness and Professions Code) or that he is exempt therefrom and the _.__ WATER HEATERS BTU OUTPUT 'z -,basis for the alleged exemption. Any violation of Section 7031.5 by -any appli Pant fora permit subjects the -applicant Co a civil penalty SEWER CONNECTIONS -- - - I- onot more than five hundred dollars ($500). - _ 0 I, as owner of the property, or my employees with wages as their _ _ SOLAR TANK COLLECTORS - _ 7. ''`' Sole Compensation, -will do,the.work, and the structure is not Intended 1 or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SVS. ISSUE FEE . Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself or - ISSUE FEE 'APPLICATION APPROVED ED BV" ""' P"--- DATE through -his own employees,.provided that such Improvements are not 1 intentletl or offered for sale, If, however, the building or Improvement MECHANICAL PLAN CHEJCKis-sold -.. -.• - SUMMARY OF FEESof within -one year of completion, the owner will have the burden proving he did not build or Improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTUBUIbDING .,PERMIT._E SMIP:' .�$ 0"I, -as aowner-of the -property; am exclusively contracting -with -- AND DUCTING licensed contractors to Construct the project (Section 7044, Business 100,000+BTUPLAN tCHECK E' 'PERMITantl Professions Code: The Contractor's-Clcense Lawdoes nota I to PP Y - ISSUANCE- Ean owner of property who builtls or improves thereon, and who con- REFRIGERATION 0-100,000 BTU•PLVMBIfJG $tracts from'such-projects with a contractor(s) Ilcesned' pursuant to'SYSTEMGRADING -Ethe Contractor's License Law). 100,000 + BTU- PLAN -CHECK- E0 I am exempt under Section B. & P.C. Por this BOILERS BTU E'reason ' $ELECTRICP.L CHECK E MICROFILM $- _ - - Owner- - — - -- SYSTEM REPAIR, ALTERATION'PLAN _ TOTAL FEE EI -Date .E'--.--_ hereby certify that 1 have read.this application antl state that the above EXHAUST SYSTEM MULTIPLMECHANICAL LESS information is correc I agree to comply with all city and county PLAN CHECK $ VANCEIC PC E_ ortl ina nces,a ntl s a relatin construction, and hereby authorize .' representative of q enc er,,y9on [h¢ above mentionedprop ertY f 6 Puri/// s T FINAL FEE 1 Sign ISSUE FEE- -' - se 'rF 0=65-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole -/ 43. Pool & Equipment Location 2. SoilPipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. _Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel em orce 47. Rough Plumbing & Pressure Test"_ 6. ^7. Electrical UFER Grn - 48. APPROVAL TO COVER-GUNITE Footings - 49. Electrical Conduit-Undr rn _ 8. _ Foundation _ _ 50. Gas Pipe," ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Trap,❑ ndr rn 10. Structural Floor "System 52. APPROVAL TO DECK - - - 11. Property Sewer Line & House Connection 53. Backwash & Receptor-Final 12. _ Street Sewer Connection 1 54. Heater & Vent-Final 13. Rough Plumbing - - - -- 14. Rough Electric-Conduit - .56. Electrical-Final - 15. Rough ElectricWiring- -- -" -- - - - -57. Solar.System-Final- - 16: Rough Heating & Air Conditioning - _ - - - - Fencing &Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING• �- 18.. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe-Rough &-Test _ 20. Roof Framing _ 21. Roof Sheathing-� NOTES: 22. Frame and Flashing ` 23: Insulation 24. .Lathing & Siding 70- 25. Drywall Nailingf 7- 26; 26: _-.Plaster Brown Coat i Wd P45;aok I 27. Electrical Power Meter-Final 28: Final Electric" ` 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 j 36. Sound Attenuation - 37. Handicap Regulations - 38. FINAL STRUCTURE & BUILDING ` 39. Special Requirements Completed 40. Electric Release to Edison - - ' 41. Gas Release to Southern California Gas Co. - 42. CERTIFICATE OF OCCUPANCY No. Date Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. ,CITY OF COSTA MESA - PEF!nIT NO. TRACT NO. LOT NO. BL'DG'.-N9. - I - _ % I,9% GI I OIB�L- - ]*OO ,CONSTRUCTION PERMIT /�— TYPE OF CONSTRUCTION N NEW [-]ADD ❑ ALTERATION - - ❑ REPAIR ❑ CONVERSION-ODEMOLISH C1 OTHER 1 - : 1 , - - -- - ZONING REGULATIONS . 1'.• - Project Address 245 Fischer- A -Z. . Owner Pulliam PropertTeb Phone ,'Address 1517- -N. Fairview -'Santa Ana- Arch/Eng. - - - - License No. DESCRIPTION OF WORK + - - A.P. � ZONE PILING. REF. 41 Address - - '- r - - - -' "' -' 'Contractor Villa Htg'. & Air -Ph6ne 5?$-$ pE OF PERMIT- D - a'O BI�I L.DIrvG- ! SET ACK LST. ROP RTYLINE' O,. GRADING,1, ❑ FOUNDATION' []STRUCTURAL i IDE YARD `1 1 E TENANT ❑ ELECTRICAL- EIPLUMBING- NMECHANICA IEDPE VA + 5 _ Address *, Miraloma Anaheim _ LICENSED CONTRACTOR -DECLARATION- -- affirm Charter ( 7000 licensed mencing uDivision 95-of5 -and , ii -0 -OTHER• f RIGHT "'n') ' v s with sections of the Business Professions Code, 'and my license is In full force and effect: "' + REAR YARD (TO P/LJ .,. gn --' 2,319 PROJECT DESCRIPTION.-_ _ '�. _ - - _ 'PKG. License Class _SC. Lice • .a SPACE REO. -;PROVIDED, ,p 'f-' Dad 6-()-22 -"Si rioture - �SO. FT. __ _ _-. - �� sp STREET WIDTH ' ,i PARK'FEE,$,-.�,' WORKERS' COMPENSATION.DECLARATION - - - : OCCUPANCY_CONSTRUCTION TYPE. I hereby affirm that have a certificate of consent to set -Insure or a '+ , VALUATION""' ZONE ,ZONING APPROVED BV certificate of Workers"Compensation-Insurance,,^or a certified copy 'roof (Section 380 t.ab. C.). 'GRADING CU; YDS. ACRES SPECIAL CONDITIONS: �• Ey No. 5764'0 Company Goodman' -Ins-. - - - -- - - - - - - - - - .Certifietl copy is hereby furnisheU.-- -. _ _ TI REMARKS: I certified copy is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (Thisn_neetl_nOL.be completed it the permit is -for one hundred _ $3 or or less) -.t. fy in thel for this PLUMBING%'r�' 1'„ "PLAN CHECK _ ELECTRICAL ~PLAN CHECK,. t '._ certify that i work which permit e ploy mance pof erson 1 shall not employ any person in any manner so as to become subjeIssued, subject.to.the Workers' Compensation. Laws of -California. "_ - _._ BATHTUBS SHOWERSFT- DWELLING___ _ _ _ Date Signature NOTICE: If after making this declaration, you should becomwsubject TOILETS. ; 1', I :. URINALS , - .GENERATOR` --0-1KW_1,-1 O.KW r to the Workers' Compensation provisions of the Labor Code, you must - _ __ -,TRANSFORMER _ -50 ` forthwith comply with such provisions or this. permit shall be deemed LAVATORIES DOUBLE CAVS APPLIANCE 10-50 KW_ + KW' CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS I - MOTORS 0-1 HP_1-30 HIP I hereby affirm that there is a construction lending agency for the per- l _ - SERVICE SINKS (`/SDMPS - `"" '-' - _50+ - "'" -' (INC: SOLAR) 10=50 HP' HP formance of the work for which this permit is Issued (Section 3097 _ t t _ - FLOOR SINKS FLOOR DRAINS i �- .FIXTURES-' OUTLETS -SWITCHES'-,., Civ: C.)t--'---`" - -" -" - Lender's Name Lender's Address DRINKING FOUNTAINS-,—!, - - -' `I ' GAS TUBE SIGNS- - INTERCEPTORS CLI CLARIFIERS S POLE•LIGHTS�"` T `+ OWNER BUILDERDECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for r •r<. .y the following reason -(Section ' 7031-.5 Business -and' Professions Cotle: SWIMMING POOL " P TRAP - " j ' Y•r Any city or county which requires a permit to construct, alter, - POLES METERED SUB -WATER SERVICE ALTERATION- 'PANELS MAIN -� , SUB improve, demolish or -repair any structure, -prior to Its Issuance; also re- quires the apt Iicant for Such permit to file a signed statement that he - - -"--'-' -- -'-'� ---- -" GAS SERVICE OUTLETS - ''SERVICE" -'--, `-- -AMP- - - -- - -- is'licensed'pursuantto' the provisions of'the'Contractor's-License-Caw- (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT._, ` t � - - " --" - - - - - --- - - .•-�" -' -siness and Professions Code) orthathe IS exempt :therefrom and the- is for the alleged exemption. Any violation of Section 7031.5 by " SEWER CONNECTIONS - -' — _ -�'- - "' - -- --` /-applicant' fora 'permit subjects the 'applicant to -a civll-penalty" o1 not more than five hundred dollars ($500). - _ SOLAR 'TANK COLLECTORS ' ' - - - .__-�.. - .. _ ..__- ___-_ _e _ __ _ _ ❑ I, as owner of the property, or employees with wages their , a t will do the work, and Profess Is not de: _,+, • 1 n; , ti or offered for sale.n. ons Code: The s and The or offered for sale- (Section 7044, Business SOLAR PIPING SVS. -;{ �' _ } ISSUE-FEEwho o an owner .r Law tloe5 not apply -to Owner of a property. ISSUE FEE ^f -- - -APPLICATION APPROVED BV- -- -� - DATE - " builds es who builtls or improves thereon, and who does such work himself or impe his own employees, such improvements are not through -his MECHANICAL PLAN CHECK SUMMARY OF FEESa<,1' 'BUILDING'- Iprovided-that intended th offered for sale. If, however, the building lq or improvement tended is-soldwitnin_one,year of completion, the owner will have the burden of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU t _ _ ,PERMIT $ ,SMTP. �' owner -of the property, am exclusively contracting with AND DUCTING y-. ___ - _ .—. _ -_ __ is licensed contractors toconstructthe project Section 7044, Business P I ( 100,000'+BTU !PLANCHECK $ [PERMIT. and Professions Coder The Conoractor'S^Licen5e•Law doesnotapply to I - -- -- -- -- -- -- ISSUANCE-$- f an owner oproperty who builds or Improves thereon, and who con- REFRIGERATION 0-100,060 BTU ,PLUMBING ' - $ tracts-from-such-prolects with a contractor(s) Iicesned_ pursuant -to -SYSTEM - - - - -- -- --- - - - --'- _ -- - - - GRADING---$- - - �t:i the Contractor's License law). 100,000+BTU 'PLANCHECK $. - ' ., .. 'r1 ;, o ;�i 1$ El am exempt undei Section - -- - �B.-& P. C. for this BOILERS BTU ELECTRICAL $ - - - reason - - - - - - -- - - - 1 SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM . _ PLAN CHECK- $ MEC HANIGAL $ O� 77: Q TOTAL.FEE'$ 7 'OO' Date Owner - this application and state that the above _ hereby certify that I have readagree _ _MULTIPL_E _ ( - LESS AD- ' 'PLANCHECK - information is correct, I to comply with all city and county $ VANCE PC $_ later ortl inantesontl statG�laws relate g to construction, and hereby authorise representatives f t i can enter -pon the above en ionetl • - � ', ,• r. J property fo e I n ur r _ - r a vents ea. • 70.0 , FINAL FEE $� S l gnat ure //i/,. Date Ir Drivers' License or 55 # -'ISSUE FEE - - - - 3 OO -- - - - - - - - - - CMF 0865-36 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor .enw t n6lo,bOr. no! on. x^nd sbrcc tv4an Plelfw za-lgz 0r ni 110 011n coit 4q CONSTRUCTION AND PLANNING APPROVALS Permit # _L.:LSIL� L� Date •..�:v�u:� 1 Inspector•,•5• .uta u:J .,,,.. .uN ll�n a'I�I } 2+a JIv, r :c J•r '.,.. 1,L.2 V POOL!& SPA T,=Dat -.L, ----I Spector, tAPPROVQL•S; "`-""'�""" ^""'Uate=� Inspector=--, L 9Y'T Permit # .. ,:vv . •,0.4 �I ---------- 1. Temporary Electrical Service or Pole P Y - "�" "" J' J""" "`"=`'' "location---- Merit""'r" 43. Pool,& Equip ---- _ SoilPipe-Un rgrnlJU0�3t10u,1•nus fl -- 44.- - SfeelReinforcement ' i 3- Electrical Conduit rn _ 'a G. --Utilit---yUndr- 9 --- A -------�_- .. _ 45. oYForms�Irnw]z ac ' 4. Electrical Conduit=Untlrgrn- _ _ _ 3nos q i 6. Electrical 8onding_r--- {5. Steelern orce('4�;yF, ,-,`>i;;aai�z fl 47. Roiigh- 1LIKiI i"n`"_& Pressure Test ' 1ec6. Electrical UFER Grn ��"• i _ .,-- TJreJ J�.n„ _ria re .r,,, I 'u' „ - _ _ 48" APP,ROVA'L TO COVER-GUNITE - 7. Footings-ftrols+. 49: --Electric il'Conduii-Undr me 19r,r.na to moizlvolq ,9bin hotne_i1 ros I all mitts �du,otl 8 Foundation _ _ rJ''. ^ • r•v nA3sz — — - - bnc to, of 1'111 ni z1 0. ran:)' Y; tnc ,9bz.] xnorxzY.oY 50.,, -Gas P.ipe,.,❑,Undr m; Test v I .9.__Water Pipe-U,ndrgrn- 51. Backwash Lines-.P-Tra--❑-tndr rn `z?"'J I 10. Structural iFloor'System__VIT,:'Vt 1,3AT2 G - ., 52., , APPROVALTODECK 11. Property Sewer Line &House •Connection --_-_- - _ - -,tar - 53. Backwash)&IRece tor-FinaU?n'•Thx of tr:2•ob 10 91wr rryJ ' 12. - Street Sewer Connection -zn01TI0MC] JAI'3v2 _ ,� --e:1fc]A _--54-_,Heater:&'Vent-Final �' ' -• e '•,, .t].r1G 1,0'ar ngltavy)tn9v" 13. Rough Plumbing g^^^••-�--• ._ -••�-_._.�, •.-.- -- - �vr,� ,lo-, .___.___.o"I t:, 14. Rough Electric -Conduit {--- ---_-_--- - 56 -Electrical -Final—$ .I1oai"10 nnibrue v :, ad? nrl'.Y bnl, 21 Ninon benit„i 1— -^ -g — r 15. Rough Elecfrl0-Wirin} -- ' - L'IVIIHHHJJ�U VI VIIi,CVIJ-YIVIV� iH�!r>I V1N Ii UH -1 Out I YM.7J:: --57,-Solar_System-Final{ „,,,„1111,, 1111,• ,,, _ _ 6.16.. �Rough.Heating:&.Air-Conditioning-_ --- ( __ - _ 6= - -- - .encing:&_Access-Approval O (0U L3 I I ”' ._17. -Ducts .in Structure-'- ' v r Jn 31;I,JdJm -- --- -- - - I-- NJtlHJ I :_r 9, APPROVED'FOR PLASTERING oz ,9nnem •(n4 In nr ,pq w,. volgn , ;on usn2 I ,b1uz2 ,, _� .- ._I.,_..- 1 C__18! -Ducts! Ventilating_--i-I rL-_ �_ I I _j_=H_IO )_'z 28UTrl,AH p `_ 19! Gas Pi a-Rou h'&'Test- -''N r C ”' "" '"' " P 9 HJ , fl C]9: -1AAT {-�_ _) eJ'a` Nc60. POOL/SPATSYSTEMS%F INA'L'nmao blumu uoY ."00 L, )q90 x1!11 eriHr n ,1te 11 :3]ITOL +:n rcr „UY ,Ob Url ,od LJ 901 t0 xrlol2 'OlR nOil Gxn94 10J 2,O,aOVJ Oflt O o0 231rlornvAJ b,rnoab va uLnz 11m,nc ztr.) ,o znc xivo,q dauz nt n Ngn,a9 01w1+110 _20!-Roof_Framing:"'' - H,- ,-1/1 i -�= bHJ nJa r -,u r .- „�),. I 21! Roof $heathiri' �a+ncHvn aU ev,n,e.vs l - 1'3143DA u4I0:13J NOITOUHTZN O: 'u:NOTES: itNWz J]1Vnd2 -`9q ,nt ?ot ya Mob pnibnal nOfbu •hno, r, ei 9refd len: m,itiL ,I'tle,9n _ e0E n .),9at b,uui J r,;n`9c •a: noid, rot An,ie, aur to oanwmn L_22i-Frame.and:Flashin " "` I ( I ` 1 •r.J, rY.r :r',JIUU <e)r,Lxly 23�--Insulation_____-__ __ I { eNrAq(J NC )J3 dNWe ApCUR E --� r ernr. ciebna L 241__Lathing.&.Siding---_--'---=.J____{_-- J—, ev„Atr1�Jo+unlN•r11No�--—z:9mbA;"nn9. L_ 25!-- Drywall -Nailing ----------- _- - --_ ,0r ,J JtPO]:J III' moiQ ?da m4 1 ISM, ol,i::6109,911 I .26!_. Plaster Brown..Coat -_-=1=r_}.�� -_-- LiJo` vIA ,lyn4 ,}Jll. 1?nm of brm9q L >v`:rno, rUiri v.' v]Lu„a .o VS,. vn: - i _27L_ Electrical v.'H� I I Nu 11H1r JH 3JI VSi-da AJ rAW 9-' •••••..•'•,""`�. `•• I" 1"-,• —1- 1. 1"- I'_' �.•n. �,-•., _,,,.r •v" -_JI 9n ,,.rt !rsm JW: oanniz r. 9111 ,J rim.,o n>ue ,o: mwrl .ae :•n) it"'. _ 1__28!-Final.Electric., •.-•.,r f Pr31 J._.� � UQ 3:,,va3i?AO......:............................................:....r,,.,,, ,,..,. ..,,.,.. . _� nor .0 E nol2rvlu to MOM null x_ rU,,N pr.ion,rnmoj)` e�,9lqun] L29!_ -FinalrHeating &Air Conditioning__ t UU ! _ .�. ria CH Ji YyM NiI HI'J -J vd t. 1LM `Ioltlte -0 nolic'oiv't�p ..11euamix'u ^5eelir. art 10 z: L30.,_FinalGas_PiPe-Test-_ j t —1 --- GL'IUIiJJu'i'v1U!Hi'NJC .......• ••••- -•6'"`oe8100W>,tinDFi9Vil �0i�10'fo, L31) Final Plumbing, _�___{,_ -{_ -, �•+�, J f_ ,JJ ,+'!IH 13J,JUC 11 ,Iv�J %. xupaw ri sw 2 oyc nwa vrn 'm ,V; squr5 9nJ In "nwo z6 ,1 t 1.111....., ..I, ,.,.r .�_ ...... + fti tivee' i 321-WaterlSecvice:Final_____.__- _._� { I -1 .aV2 aVl lglq RA.J02 9nl :Lho]:fmlPmlg K1 brit xx9n�2uH ,ACOA 'o... I i .tltl4.... I b•,mt10 ,,,,.,n,..n,>,,.n..,.... ,nrl• . n vu vvn ,ire 11 11 L_33._.Gas_Secvice=Final_—. - ---- -----� -E-{-- -1-- -------- n Y3i JU[-Lel lU 119GnTn Nlow rUU2 x_:+b nd. bpe ,n0"OfI1 .'.9Vnlgfi„ 10 >bllUtl -------------.�,., .1.�n,,...,rn.,.:�• ,�,.,.-I..,..,. ,........r I 34. Solar Domestic Final YnA'iA01J2 { { N -13H] V '•Jq JADIMAH33M f 1^>14,Voluln„0 enn,]lua u01 ,uvewon ,tl .9tre ,n, u9,ettn m bonn9r7 Nv.� , ,L. ntl, n„n,n , ,n �bli 35._ Landscape Sprinkling System iir:.a`�%1 I L u rH 10.00:-n roil l2vz ovn rA3N 1 'PIS, 10 D?Oq'�f: °nT lot W01g„ 11 ,o oo ton•_bj. onl,niVo;q 1 36.- Sound Attenuation >-„'I". VIA Iq { I L ---_U re 000,001 u),IDhfiJnpro '13x1;9, I 37: Handicap Regulations _ __ t + Nldi. v IR UTH 30,00:-0 NOrrAH 371H'13A no-, �u'iw tine ,i(oo�isG (zvvo;grni +o ztiiL]� ori .J �t�i94 ��fi"ro �9nwoii {38. FINAL STRUCTURE & BUILDING N 11H]idln lq { I � uTa 000,001 "'�"" Y - -" - -' -- -- '-' --- -- - - .... - --" N -I nC.1 ;A:99iJ :'rn Ut,lnO] 9n �'�t�"t 1 39. Special .Requirements Completed' { � � I,u ro, .J ." a.a uun,9c m,nu ulm9x9 nm l , PH eA3J1GflB ` 140. Electric. Release to Edison” " "' — { I I Lti 111413 TJA ,fl tA93R fA3Te Y: V _ "- 141. Gas Release to Southern�Califor Ia Gas'Cd: '• { i I U41i' U61 .3leVz TZUHIixJ Y V pp ^v,.n-. In, I.," U aril. 111101 unu Z, r. -,t nsnr 9.cq 11etlf v`rtu� an.4 ,uu'nuw ....� 42. CERTIFICATE OF OCCUPANCY No - Date -- ---- - - ----- — _11 •1Jnoc. onn •U,a plq:noo o: ss,i.n 1 JX"' nn xr nun Ln�y M1 t •'I..: •,n•„ -•r' bne.n.-ri, a,n+ann: n: orurw,a ,, no-.,: brie'.,nlr,:,.. .rl (I L��• VY,rU6 r:Vq'J ,..mJ ��l ,IIJ crnr r0 Z:.Vlrr ln4xJ`4:r ----------- - _ - - ------ _ _ 1 - 1._ -_ L_. - - - -------- e,••*.v Applicant to fill in all spaces within heavy border lines and sign all appropriate b& lations. FgaL A/nl/RO 21.00 TL CITY OF COSTA MESA P R IT NO. TRACT NO. LOT NO. BLD . fJD. - .. -' - _ ' CONSTRUCTfON'P�RMIT 3 % TYPE OF CONSTRUCTION 0I NEW 0 ADO '❑ ALTERATION 0 REPAIR 0 CONVERSION ❑DEMOLISH ❑ OTHER ��jf•� y/�� t+ `. .t .. - ZONING REGULATIONS .Project Address 245 Fischer Ste.A-2 ,Owner Pull •am Pr Phone 'Address 1517 N.• Fairview Santa Ana -- Arch/Eng. License No.- DESCRIPTION OF WORK TYPE OF, PERMIT,• 'L '❑ GRADING •❑ FOUNDATION' 0 STRUCTURAL 'O 'O ELECTRICAL OPL'UMBING-C� MECHANICA A.P. - ZONE PLNTTGpp. gRg ILE��FLL. p� SETBACK PROPEIRTVNLINE• I Address "- - - I 'Contractor Villa Htq. & Air Cond. Phone, 528 -H2O Address3369 E Mi aloma Anaheim LICENSED' CONTRACTOR DECLARATION - - 1 hereby affirm that 1 am licensed under provisions Of Charter 9�(com• 7000) 'Olvlslon -3 -of the TENANT I - = 0 - - - - - -- poggYARD RIIGHT mencing with Section of Business and Profession5 Code, and my license IS in full force and effect. - - OTHER- - "PROJECT DESCRIPTION •REAR YARD (TO P/L) - - - License Class - LI No. - - � .. - __ _ !PKC. SPACE REQ. PROVIDED Date C,_9F_R9 Signature ._ - ' .SQ. FTAM I : TYPE ;STREET WIDTH ,PARK FEE $1 WORKERS' COMPENSATION DECLARATION- - OC CUPANCV_COIVSTRUCTION - 1 ZONING APPROVEO.BY _ -DATE 1 hereby affirm that 1 have a certificate of consent to self -Insure of a -copy ,p r VALUATION ZONE - certificate of Workers' Compensation Insurance, or a certified thereof ( 00, Lab. C.). �➢KW4t9, Goodman Ins. 1. GRADING CU. YOS. ACRES I SPECIAL CONDITIONS: - - -- _. cY No. Company Artified copy IS hereby furnished. - - - - ---+ REMARKS: - --.----- _ ]� Certified copy Is flied with the city Building Division. 'EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - - - -`- - -'- - - -- - - ((This.section need -not be -completed if.the permit IS for one hundred - 1E100) or less). ... II cart iffy that -in lhe'performince 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 -' - -•PLAN CHECK -- subject to the Workers -Compensation Laws of California. .-_- . BATHTUBS SHOWERS _ - - - - Date Signature NOTICE: If after making this declaration, you should becomefsubject TOILETS •` t URINALS GENERATOR ' - 0-1 KW_ 1-1O:KW ' to the Workers' Compensation provisions of the Labor Code, you must _ TRANSFORMER - 1 forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE'LAVS _ 'APPLIANCE - 10-50 KW_50'+'KW - revoked. CONSTRUCTION LENDING AGENCY _ KIT. SINKS DISHWASHERS - ', - -- MOTORS" '0-1 HP_1-10 HIP I hereby affirm that there is a construction lending agency for the'per- SERVICE SINKS f''-• .SUMPS -UNC_ SOLAR) - 10-50 HP_50 + HIP - -- formance_of the work_for which this permit is issued (Section 3.09] FLOOR SINKS FLOOR DRAIf•IS FIXTURES` OUTLETS SWITCHES-- - - - Civ. C.). Lender's Name Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS- OWNER'BUILDER DECLARATION -`- - "'- --' - - INTERCEPTORS CLARIFIERS POLE LIGHTS- 1 hereby affirm that I am exempt from the Contractor's License Law for SWIMMING POOL - PTRAP- -'POLES METERED - SUB .. - the folio wing reason (Section 7031.5 Business and Professions- Code: Any city or county which requires a permit to construct, alter, improve, demolish or repair ahy-structure, prior to its issuance, also re= WATER SERVICE - ALTERATION PANELS - MAIN - SUB quires the ap, Iicant for such permit to file a signed statement that he _ GAS SERVICE OUTLETS "SERVICE' -' - '� - AMP -- - is licensed Pursuant to the provisions of the"Contractor's License Law 1Chapter_ 9 (commencing with Section ]_000) of Division 3 of the _ _ WATER HEATERS BTU OUTPUT - - -' " " -' ' - - ...... Business and Professions Code) or thatheis exempt therefrom and the Is for the alleged exemption. Any violation of Section 7031.5 by _ _ _ --"- ' SEWER CONNECTIONS applitant for a permit -subjects the 'applicant to a civil -penalty" of more than five hundred dollars (E500). /r SOLAR TANK - �`- COLLECTORS LI I, as owner of the property, or my employees with wages as their Sola Compensation, will do.the work,.and the structure Is not.intendedJ- or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SVS. P I ISSUE -FEE !APPLICATION-APPROV Contractor's License Law does not -apply to an owner of a property. ISSUE FEE u - ED'BY - �' DATE' - who builds or improves thereon, and who does such work himself or through his -own employees,,provided that such.improvements are -not MECHANICAL PLAN CHECK SUMMARY OF FEES •, intended or offered for sale. It, however, the building or Improvement Is sold -within -ono year of. completion, the owner will have the burden_ of proving he did not build or improve for the purpose of sale). HEATING SVST_E M_ 0-100:000 BTU •BVIL'DING - 'PERMIT S SMTP., Es- O'ned owner os the exclusively -contracting -with the ]044, Business 'ANDDUCTING 2-100,0001a _ _ 10.0 'PLAN to project (Section licensed contractors to construct p BTU j CHECK E 'PERMIT. . and Professions The Contractor's License Law tl and - P- - - - - - ISSUANCE E' IItT or who owner of properly who builds or Improves thereon, and who con- property , coo REFRIGERATION 0-100,000 BTU PLUMBING E - f tracts from such'iprojects with -a contractor(s) Ilcesnetl pursuant -to tracts the Contractor's License Law). SYSTEM - 2-100,000+ BTV $, O -- - ,PLAN CHECK E GRADING- E , � ' ❑ I am exempt untler Section - B. & P. C. for tti i5 BOILERS BTU 'ELECTRICAL E $ reason — - -' -' -- - SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MVLTIPLE !PLAN CHECK S - MECHANICAL - �Q MICROFILM E-+s'�—/�/� TOTAL FEE E iLy-, UU'. - AD- 1 1 Date -- - Owner- - - - - - certify that 1 have.read this application information tit hat the above ts agre Information is correct. agree to comply with all city and county with all _ _.11LESS PLAN CHECK E - - VANCE PC $_ - - ordinances and state laws relating to construction, and hereby authorize representatives of Is Ply to a ter upon the above mentioned ' properly for insA b ur pos,17" _ { 'Z1 00 �Z - FINAL FEE E Signature _ Date SL Drivers' License or SS > ISSUE FEE' _ -' 3.10 . CMF 0865.46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor 06, 11 , +bn., w.-tl„:,. a -'q'Wr nr,e+ine+,: i^A CONSTRUCTION AND PLANNING,{ Date APPROVALS Permit # `' �T '_ I ` ,� Inspectoi 1 .^ ', -.' ••. - I �- Fie Jut GJJ �u I POO LI SPA.• 17 {14i� , i. a,Jr,TB!f,C70 -- - ,- -% - -= Date - - _= Inspector APPROVAL$.,; zC . qyT f _Permit # 1 ..-vll, • ,".0 1 1. Temporary Electrical Service or Pole y "''" ""' '''43." pool & EquipinenS Location--��-----�- �-=------------------ `2. Soil ipe-Undrgrm,t'+:. ,cjV1i cY'n _ ;{ -- 44. Steel Reinf6 cement',--- ---- ,.,..3..-Elec1rical Conduit Utility,-Undrgm_., _9_ 45: -,,Forms,,, •,!v ---- j-4._ Electrical_Conduit-Undrgrn _ _ '•''" _II _ 46. Electrical Bonding -�-_ --- I 5. Steelein Orcea'�ii%YS4 •.'�Test=-`----- M1D Yn •r}�„ � =-` •o:vnmo,i 47. Roiigh'PlumLiiri""& Pressure -Test------__ "" - Electrical UFERGrn __ r'it; k "'"APPROVAL� `48` 48" TO`COVER-GUNITE -- L7_ Footm s _ "Y?s,q f(' g-- 49. Electrical-Conduit-Uhdr rn� u!,;r!� to znoiv,o,a ,.0 t hxrt9JL !r,6 1 1 •+1 m.•ti6 `�,'-nn ! -B.-Foundation (J T -r.Ay.,r]>; ------ _ , _ _ ...-., .,.. .. ....... .. ........ 60Gas.P.i��Undr rn; Test ,.,, n,ol ;, .I 9•r,>n vm c„`. .c`,co L 9.,_Water_P-iPe Uird!: i' n •.w _ _ G w •.z 9-, 1�:. _--zclo ,-r .. 51. Backwash Lines P-Tra -� ndr rn - 10.__Structural Floor System ! r311, - - ,.52., . APPROVALTO.DECK-'-"'-`*�•- """"''P" - - -"' L11,. -Property Sewer_Line & House Connection 53. Backwash Rece tor -Finals^ "9z + !+1^zr:4> ro nmol r,o, r, , ,n 1 :.ru :.,+hr6 PAO' r i,Z"01.uuana ;_12._Street-Se.wer_Connection d ---==- , 3q,;,A ._ .__ ._......... ... ..-..., ....... .:.. ,.,: :,4,:�.... ..,� ::, -54._ .Heater, &_Ventm melt -13._- Rough Plumbing ----- --__ -- - - ' 14. Rough Electric -Conduit - ---- _ --56--Electrical-Final---4 .no,zwlO e,:w„•o 1 o "li m. - bol• --1 „nn, n9..r,» 15 Rough Electric-Wiiing -57-Solar_System-Final_,4"`,"A TAMAJ;>3o VIOIT.9aMr 9NIO '183AHOW I IUfii NOIT9V,:YX' f--16-Rough-Heating-&-Air-Conditioning=-_-= - -----,-�-- 4.42--=- - __T8 -_-_F-e_ncing_&.Access_Approval • - •, -_, -,• . „- .iz?9+,-. (pu'° I n., nl �rnr.lua F� I --17..L-Ducts!in.Stiucture_-.�-__ _ -.1- AJ -HJ 1 ,.,'59 APPROVED''FOR' PLASTER ING o -nnern vrG ni ne non m. volgn n n+.:v i ,bsdz: -••-- • - ��- -� � � -18.--Ducts,-Ventilatin -.I_.-1.a-__'-- -- gc60_ POOL/SPATSYSTEMS=FINAL^r• , ' o•wn> ,, •.y ,nc U. b9 z nt :nnr ,. •„rb v .3JITo7 - -q Ru n:,c•; ,'.boo ,onw oM ru znre: mo c,U ZAIROTAVAu 4 r,9 r•'.0 bu qb^.e fi••nxr z,nt ,n e•.:.z Po• q r.-..- tl :. va:mo> , n a-" + 19. Gas Pipe -Rough &'Test--' -I ..'•. p. =.'A.1 "ff -+-- -20t-Roof_Framing_•. - .: ".-.. ' ;`',. I { _ f c.,..� , ,1, -- I 21! Roof Sheathing"_ -{----1.- "O= . =_-_-- t,+v�IH iIN p YONd OA 3YIOM9u ViCtrzUHTPOO- -c •NOTES: eNvlz ]_,I Vri32 „y 'ar - i. r> �,ab emboo, no �u-rxnuo c -- 9rt ,..n nnn+L �„o,9,t _ .._' , I'•91:'-: )Ir, It-, n. + �-.•o,J ,„: tr. L22:- 1 -Frame-and Flashln ._-�_-_[- , -1- {- 23! --Insulation --` - (_... F _I -V -__ --vuA 24i--Lathing.&-Siding--_ - - __ - - J --.f- -I l w..c.� „v;:vm:sra�', --.-- --- --- -Z..bhA-,.Ibnl 1257--- Drywall Nalhng._. '•"'' 'T�-�- 1 tNt,uc_) ,1!„g3-rvr✓, rlvlinan»auwnw.+�arlevtwc ,1 ,_l :,,r.,:uc0 .,.,. nm�.: ,:Jr nrl: It. ! ^ i' I,p Z I ,O� 1_2W ---Plaster Brown Coat___ --------- _ _ - -._. _ -._ -1__-1-_- •.n -(------ :.: J,lc 1v awn[¢ ; :.n.� ��. .., a, -_._.----------- -.q .:ii= .._.,,!.,1,�, ,.) nr.,,,o 1; •:,..,:oi, „r„,n v.u..'u, 27,1 - Electrical_Power_Meter.-Final_'-Meter.- �_.1.--- J_. ----'•, JH .J')tVPlL F19TA^, •: '::u ,u. ..,uur [ne ,000,, .or^or .ev. ..,r _!I -+•, i ----_-e�IVn 28: -Final Electric- - ---b_` ' :.r+. Ur' rA� •� -' .. ,o..,,,,,a :,.., .., ..: `� ,.,., 4-29i--F.inal.iHeating-&.Air_Conditioning m,, .v,�.•r,vA•r: -:. .:. It, >�: .. .•, ": ,9:, -nom:; ._11. J !EW, ..'IT It, ,o nu.-inn•"v ",r. oiJ,a, - w911a sdl 301-FinalGasPipe<Test f- ,- C4,U, _17MM 7: :1 "motzl_ .n,• xZ.,f,'"roI . oJl.)_9-eC., .D„n2 -. =0- 1-.31�__Final!Plumbing-_ "'_, 1. ,o.o._Ab o,1,r)q+D? ,: .A4e+ ,, rnl+l s,.'uue 29e61 n,w 1 .,I„JJI r :.p on.gn t1 132.-WaterService=Fina 9,4 8n_, O�':'nI,[ t� qA 102 pY 3'hnno in2.,9e..9n-. C1 u : . ._..- � .. _.. .. ... .. . ....G. . ... i-33.-GasServlce,Final------- - --- - - - i-_L� _L. --- -- I:t- 3 i , 3U m,•t u w dpn) 2rob O•Iv. Lw 27 -2-1 -- _..-- {I ,-. ' ... .. . ,,,o�,.,n: ,•._�",.�.,-r„ .,, m:.:;n ,•14 . -• Ff -r9u2 4 I 34. Solar Domestic -Final '° 1 I >+>>r,- . 1 „.vo,hrnl �r mm ad 9,y .,.a,,.., `3A01tnF.�+a31v, � ;° _ _ _ _ f 35.- Landscape Sprinkling System_ .;.+, I L---,rl& ,o,Oe c -o a+iravz nn,�.a�l-, p he _-,rn..o 11. ,n* >„ .1:11 .1 u.l.n "I :,r, 10 „n," t I 36. _Sound Attenuation c �• i I• (- --uIv ""� "° cw,.uor N z "ve;u:o.`�,:1��;'r'! i��io.ri ,,}'.=r;,i)l„o' ,;a r:!,o>' :zn3 i 37. Handicap, Regulations uru ,o,Orro HO,T„s,3urgr3r, .'._ �dUo00,�TI_Y;'v`:-;i;a.:;1;is�>i;ir��ic,iw1i';a'":q1,`„�,i,o�r� �- 38. FINAL STRUCTURE & BUILDING ,_• it+a r ), t re eoa,,;;. .,.� I ---..- I 39. Special -Requirements Completed i111 ' f I I - "jlot, U -.1. '.'-' 11 "� "�_;'s, n"!`In'"• " i 40. Electric. Release to Edison ' '- 1 i i -c :.�a3T�A.sn,�.n r.ar•. --- - .I I41. Gas Release to.SOUthern California`Gai'C6. '" I D-911 1V 1, .:e z r, ,Arx ♦ ll ...,,„, „ 1.,,,..,.,, :,.., _•-,. -.. -.,:.. -.... . .. ....:..... fI 42. CERTIFICATEOFOCCUPANCY +,a ••.-_}__-- No. • .v Date {-�------ -J _...- _ __ I --- - ---- v',': . n,n 'a .. ', .. ..... tI _` - I --- - - - ---- __1'-_ "1- -- it L re Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PERMIT NO. TRACT NO. -LOT NO. BLD,9. NO: - I - - - -- - - CONSTRUCTION PERMIT 3 7 9 .2 - Project Address 2 TYPE OF CONSTRUCTION sJ.l_53f TL.I Owner [/[�(�/ Q.E'0T' one - ❑NEW XADD- 13 ALTERATION - - - -- 67.55 6/03/82 ((r1, - Address /5/7 eu. D REPAIR ❑CONVERSION ❑DEMOLISH_ •e' - _ • ' ❑ OTHER 1 _ -ZONING REGULATIONS. , _� Arch/Eng. _ . _.License No._ _ 'ST L� F/ A.P. $ ' - Address - I DESCRIPTION OF WORK - --. .._ _ _ _ . _ - .ZONE - - PLNTGo. REFI 9P- Contractoryc- / '- P & : PhoneSZ•%%jZ •TYPE;OF PERMIT- - 1 -' ^- .%BU PROP IL,pING - LINE' (-Address Q%/�/�,,,% %✓„��'j �i/9 /%� �'\IZ. 9 ❑GRADING ' ❑ FOV NDATI�Or�N- -� STRUCTURAL ERTV .• .SE VARD L - - - LL !LICENSED CONTRACTOR DECLARATION ' ❑-TENANT' ETELECTRICAL-18ILUMBING.OMECHANIC d hereby affirm thin I am licensed under provisions of Charter 9 (com- 5I DE -V RIGHT mencing with section _7000) of Division 3 of the_ Business' and t- - r -13 OTHER ?rofessions Code and my license is in full force, and fest. - - REAR YARD (TO P/L)- _ / - 'cense 'PROJECT DESCRIPTION License Cla s PKG. SPACE REO. - -- ' 'PROVIDED, Date' �A�Signature L'r.SQ: %- FT. - -_'_, _. ___ �_-_ -'� ,'-- STREET WIDTH -- ,PARK FEE '$' .WORK RS' OMPENS ATION DECLARATION J hereby affirm that I have a certificate of conse t to self -Insure or ,a- „OCCUPANCY CONSTRUCTIO_N__T V_PE__ ___ VALl1ATIONff? ZONE •_ ZONING APPROVED BY - DATE 'certificate of Worker`Ss. Compensation. Insurance, or a-certifled copy � _ _ f, _ __ _ _ - - - - - - - thereof (Sect] n 3,F0 /� 9 I 'g, sir i/ GRADING CU. Y.DS. ACRES SPECIAL' CONDITIONS:_ Poli cy' NP' -+x`• mPanY - ❑ Certified copy_is hereby furnished. _ ,., _ - - � ----- --- - - _ - - _ ,. = Certified copy is filed with the city Building Division.- -REMARKS ,.,:XEMPTION FROM WORKERS' -COMPENSATION DECLARATION - - - -r -- -- - - `'(This Section need not be completed if the permit is for one hundred ($100)'or less.- 1 certify that �n the performance of the work for which this peIrmit is _ Issued; I shall not employ -any person In -any manner so as to become PLUMBING _ F,�, r PLAN CHECK -- _I - _ ELECTRICAL - ------ PLAN -CHECK subject to the Workers_ Compensation Laws of California. • 1,1 - I - A (Date - Signature - -- - - -- 'BATHTUBS -"'-- _ SHOWERS' -- '- -qO. ^-'-'-' -' !NOTICE: If after making this decl$ratlon, you should become subject -TOILETS, ._.URINALS- - •-' - GENERATOR- - 0.1 KW -1-10 KW -- 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 -- -10-50 KW_50+'KW revoked. CONSTRUCTION LENDING AGENCY_ -KIT.. SINKS - ^' DISHWASHERS^ +-- - - (MOTORS- - - - 0.1 HP --- 1-10 HP - - '- - I hereby affirm that there IS a construction lending agency for the per- SERVICE SINKS. ,Z r , rSUMPS - - --- - (INC. SOLAR) _. 10-50.HP 50 +.HP _ formance of the work for which this permit is issued (Section 3097 - Civ. C.). •---'- - - -- - . -- -- _ ..- _ . __ _ - FLOOR SINKS' ^" -- 'FLOOR'DRAINS -- •' -I - `- '- -(FIXTURES - -OUTLETS'--SWITCHES - Lender's Name Lender's Address - ' - r • ' I -DRINKING FOUNTAINS-- •�---• - -- -- - ,GAS TUBE SIGNS OWNER BUILDER.DECLARATION- Ihereby affirm that 1 am exempt from the Contractor's License law for - INTERCEPTORS '"- CLARIFIERS '1- - - ;POLELIGHTS -- - - -- -- -- -- , the following reason ,(Section..7031.5 Business and ProfeSsionS•Code: Any city or county which requires a permit to construct; alter, -SWIMMING POOL---- -P-TRAP---------• C- ----- --- ]POLES'--- " ' METERED SUB - - Improve, demolish'or repair any structure, prior to its Issuance, also.re-. -WATER SERVICE " - -ALTERATION - - - MAIN- - - SUB- quires the ap, licant for such permit to file a signed statement that he rPANELS is licensed .Pursuant .to.the provisions of the Contractor's Llcense.Law_ (Chapter 9 (commencing with Section 7000) of Division 3 of the GAS SERVICE— -- -'OUTLETS- '-- - "- ,SERVICE --- - - AMP--- --- -- { - Business and Professions Code)-or_that.he.is exempt.therefrom and the - WATER HEATERS - BTU OUTPUT - - - - -^ - - -- - - - - -- - - - basis for for the alleged exemption. Any violation of Section 7031.5 by 1 any applicant for a permit subjects the .applicant to a Civil_penalty SEWER CONNECTIONS - .f not more than five hundred dollars ($500). I - 1,'as owner -of the -property, or employees -with wages as their SOLAR TANK - -------COLLECTORS - - - - - - - - -- - - -- -- - - - ,e compensation, will do the work, and the structure Is not intended r offered for Sale: (Section 7044,-Buslness and Professions Code; The SOLAR PIPING SYS: _ _' -'- '-' - ' -- ISSUE FEE - - - - - - - - - Contractor's License Law does not apply to an owner of a property who bulld5'or Improves thereon, and who does such work himself or ISSUE FEE"- `-'- ,,ice_ -- - - ._ _ ;APPLICATION APPROVED -BY EDGY- 1.- through his own employees, provided that such Improvements are net Intended or offered -for sale. If, however; the building or Improvement is sold within one year of completion, the owner will have the burden "MECHANICAL PLAN CHECK _ r - - SUMMARY OF FEES of proving' he tlitl not build or -improve for the purpose of sale)- ❑ I, -as -owner o1 the property, am exclusively contracting with licensed to the (Section 7044, Business - -- - - --- HEATING SYSTEM 0-100,000 BTU AND DUCTING- - + -- -.BUILDING. - - PERMIT S `� - SMIP 5-�— Q' contractors construct project 100,0(10 BTV PLAN CHECK E . PERMIT and Professions. Code: The_Contractor's .License Law does not apply to - _ .ISSUANCE. $ an owner of property who builds or improves thereon, and who con- REFRIGERATION 0400,000 BTU PLUMBING E -! tracts from such projects. with a. Contractor(s)_licesned pursuant to_ the Contractor's License Law). SYSTEM- _ _ _ _ 100,000.+ BTU` GRADING"S" 'PLAN CHECK" $ f - 13-1 am exempt under Section - B. & P. C. for -this - BOILERS BTI( } .ELECTRICAL $- reason... .. ,... SYSTEM REPAIR, ALTERATION MICROFILM $ ' PLAN CHECK $ - -- Date Owner .TOTAL FEE $ r • MECHANICALinformation I hereby certify that 1 have read this application and sta"the EXHAUST SYSTEM MULTIPLE +PLAN is correct. I agree -to comply with all ; CHECKVANCE PC Eordinances antl state laws relating to copstruction, antl representative -of this-clly to e r upon the aproperty f nspecllanp r �ISSUE FEE CMF 0865-46 W'site-Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # yb Date POOL &SPA Inspector APPROVALS Permit # Date -inspector 1._ Temporary Electrical Service or Pole 43. Pool Equipment Location 2. Soil.Pipe-.Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Uti I ity- Undrgrn'. 45� Formv, 4. Electrical,Conduit-Undrgrr)_ 46. Electrical Bonding 5. Steel Reint.orce47. Rough Fluffibin• & Pressure Test CL Electrical UFER-Grn 48. APPROVALTO COVER-GUNITE 7 Footings, 49. Electrical Conduit-Undrgrn 8.. Foundation- 50., Gas Pipe,, Q Undrgrn, Test _9_ Water Pipe-Undrgrn.. 51.- Backwash Lines, P-Tra6, _0 UndiqW' 1 -10.. -.Structural Floor System.,- 62. APPROVALTO DECK 11.- Property Sewer Line & House.Ennectioh 53. -Backwash'& Receptor -Final .12.. Street Sewer -Connection 54. Heatei & Vent -Final 13.- Rough Plumbing 55, Plumbina Sy tern- Final 14. Rough Electric -Conduit 56. Electriral-Final- 15. Rough Electric -Wiring 57. Solar System -Final • 16.-- Rough Heating & Air Conditioning - --- '- - ' - - - -_- -- - encing.& Access Approval 17. Ducts -in Structure -79T -APPRoVED,FOR PLASTERING 18: 19. 20. Ducts, Ventilating Gas Pipe -Rough &Test Roof Framing - 60. POO L/SPA SYSTEMS,F INAL 1 21.- 22- Roof Sheathing Frame and,Flashing L NOTES: 23. Insulation 7- f- 24. Lathing& Siding /V- c5r 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28' Final Electric 29. Final'Heating & Air Conditioning 30. Final Gas Pipe -Test 31, Final,Plumbing 32. Water Service -Final 33. Gas Service -Final 34. War Domestic -Final 35. Landscape Sprinkling Systery' 36- Sound Attenuation 37. Handicap Regulations_ 38. FINAL STRUCTURE& BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date I I Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITV-OP-COSTA, MESA- P RMIT NO. TRACT NO. LOT NO. BLDG. NO. CONSTRUCTION PERMIT � %7 "' l 6637 6/01/82 ' Project Address -- - ( L l .-/S'f16 e . Z TYPE OF CONNSTRUCTI N , ❑NEW. 111 ADD ALTERATION ❑-REPAI R,IL-J• CONVERSION ❑DEMOLISH ❑OTHER - _ -30.40 -- - -- '- - - ZONING REGULATIONS Owner LULL l4 eQ /�, Phone j f X12 -Address 'Arch/Eng. License No. - DESCRIPTION OF WORK A P 9P - _ Address - - -- ZONE_ ,• PLNTGp. RtE1FL.•p .. -Contractor 14Pnrl it C•(�-�KPho O/ TYPE OF PERMIT - ❑GRAOING❑FOUNDATION El STRUCTURAL - E] -TENANT IN ELECTRICAL ❑PLUMBING OMECHANICAL BUILDING - - SETBACK L ST. IDE YARD - PROOPEkPY LINE - AddressEj /LU r VAIAIV.4 D/LF%Q LICENSED CONTRACTOR DECLARATION - - - I hereby affirm that I am licensed under provisions of Charter 9 (com- SIDEYARD- mencing with section 7000) of Division 3 of the Business and El OTHER - Professions and my license Is full force nil a ect. 1 REAR YARD (TO P/L) _Code, G 0 ' 0 PROJECT DESCRIPTION � License Class Ice ._Date C i;?atur-e SQ. FT. _ PKC. SPACE REQ. - PROVIDED, WORKERS' COMPENSATION LARATION OCCUPANCY_ CONSTRUCTION. TYPE STREET WIDTH PARK FEE$ - - I hereby affirm that I have a certificate of consent to self -Insure ora VALUATION ZONE ZONING APPROVED BY DATE certificate of Workers' Compensation Insurance- or a certified copy - _ thereof (Section 3800, tab. C.). GRADING CU. YDS. ACRES SPECIAL CONDITIONS: - _ Policy No. Company - - --' - - - - • - Certified copy is hereby furnished. - - - - REMARKS: ' • I �3 b - Certified copy is filed with the city Building Division. -. .XEMPTION FROM WORKERS' COMPENSATION DECLARATION -(This section need. not becompleted if the permit is for -one hundred- - - ($100) or less(. --- _ - 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 ,IPLUMBING 1 PLAN CHECK - ELECTRICAL PLAN CHECK subject to Workers' Compensation.Laws of California. _- - ._ BATHTUBS - SHOWERS'FT, Di - -GARA FT _ _ -- Date Signature NOTICE: If after, making this declaration, you should become subject TOILETS URINALS - GENERATOR" - 0-1 KW_ 1-10 KW 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 LAYS- APPLIANCE - 10-50 KW -50 + KW -'- - - revoked.- KIT. SINKS DISHWASHERS - - -' - MOTORS' --0-1-HP - _3-10 HP. - CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for the per- SERVICE SINKS -' SUMPS - (INC. SOLAR)- -10-50 HP 50 + HP formance of the work for which this permit is issued (Section_ 3097 FLOOR SINKS FLOOR DRAINS FIXTURES44) /.f0 OUTLETS SWITCHES Lnder's Name - -- -- - - -Ler'. Lender's Address DRINKING FOUNTAINS - GAS TUBE SIGNS -- _ OWNER BUILDER DECLARATION- -' - I hereby affirm that I am exempt from the Contractor's License Law for INTERCEPTORS CLARIFIERS POLE LIGHTS " thefollowing reason`(Section`7031-.SBusiness'and Professions Code: SWIMMING POOL PTRAP - '-- - -1 Any city or county which requires a permit to construct, alter, POLESMETERE SUB WATER SERVICE ALTERATION - - PANELS -A/ MAIN C SUB - - --* improve, demolish or repair any structure, prior to its Issuance, also re- quires the apFlicant for such permit to file a signed statement that he GAS SERV ICE [.� -� SERVICE - - AMP ; XV is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the (. go HEATERS BTU OUTPUT d' - Business and Professions Code) or that he is exempt therefrom and theWgTER basis for the alleged exemption. Any violation of Section 7031.5 by CONN IO S - - �L�G - - _ -` - 'V applicant for a permit subjects the applicant to a civilpenalty-SEWER not more than five huntlretl dollars ($500). SOLAR -TANK COLLECTORS' I, as owner of the property, or my emploes with wages_ as their ye - aole.compensation,will do the.work, and the structure is not intenced. or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS _ 1; ISSUE FEE ' -- - - Contractor's License .Law does not apply to an owner of a property. _ ISSUE FEE _ (• fl APPLICATION APPROVED BY - �'OATEI. who builds or improves thereon, and who does such work himself or throughhis own employees, provided.that such improvements are not MECHANICAL PLAN CHECK _ SUMMARY OF FEES,,, intended or offered for sale. It, however, the building or improvement is sold -within one.year of completion, the owner, will have the burden_ of proving he did not build or improve for the the of sale). HEATING SYSTEM 0-100,000 BTU '-BUILDING PERMIT ' -- ---- - ❑-1- as owner of the property, -am exclusively contracting with- AND DUCTING - _ $"SMIP licensed contractors to construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK $ A, PERMIT'- I 'and -Professions - Code: The- Contractor's License Law does not apply to -- - - - ISSUANCE $1 an owner of property who builds or improves thereon, and who con- REFRIGERATION 0.100,000 BTU PLUMBING $ tracts'from-such-projec[s-with-a•contractor(s)-licesnetl -pursuant-to SYSTEM - - "• -- --- - - ---- - --- - GRADING --$ ' the Contractor's License Law). 100,000 +BTU PLAN (HECK $'' "" =' f ❑ am exempt under Section B. &-P C. for this - y $ ) BOILERS BTU ELECTRICAL $ -Fs� - ., reason"' - -- - - - SYSTEM REPAIR, ALTERATION - - - - - PLAN CHECK $ .. MECHANICAL $- ..MICROFILM $ _TOTAL FEE $ _ -Date - - Owner - - - - 1 hereby -cert ify that h eatl this application and state that the above. EXHAUST SYSTEM fvt ULTIPLE - 'I "PLAN -_L'E55°A D- ,-- information is torr gree to comply with all city and county CHECK" $ - - VANCE PC $ ordinances antl std law latin uction, antl hereby authorize ,f f ', Ire ., - , �-• representatives c' y upon �1 above mentioneC property- ctio u oses �'y�/ _ -0_ p 10, '1 ' 2 FINAL FEE �+0� Signat O C- ISSUE FEE- EE- ._ $ --- ._ •Dat ' - - Dri cense or 55 � CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector' POOL & SPA -APPROVALS Permit # ..Date Inspector 1. Temporary Electrical Service or Pole 43. Pool- & Equipment Location - - 2. SoilPipe-Undrgrn 44. Steel Reinforcement _ 3. Electrical Conduit Utility-Undrgrn . _ 45. Forms ' 4. Electrical Conduit-Undrgrn _ _ _ _ 46. Electrical Bonding - _5. SteelReinforce _ 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn _ - 48. APPROVAL TO COVER-GUNITE - 7. Footings -" - '49. Electrical Conduit-Undr rn _ B. Foundation. - _ _ _ - 50. Gas Pipe, ❑ Undr rn, Test - 9. Water Pipe-Undrgrn_ j 51. Backwash Lines P -Tray Undr rn" - 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 _ 13. Rough Plumbing - - - 14.. Rough Electric -Conduit - - - --56. --Electrical-Final 15. Rough Electric -Wiring- ' ' 57. Solar System -Final - - - - 16. 'Rough Heating & Air Conditioning _ - - - • Fencing & Access Approval . 17. Ducts, in Structure ' _ _ 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating - - -• 60. POOL/SPA SYSTEMS FINAL' 1.9. Gas Pipe -Rough &Test - 20. Roof Framing 21. Roof Sheathing- - NOTES: 22. Frame and Flashing ,23. Insulation,' 24. Lathing & Siding 25. _Drywall Nailing 26. Plaster Brown Coat . 27.- Electrical Pov�er Meter -Final - '"28: Final Electric ,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. Landsc eSprinkling System - - - 36. 'Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed - "- 40. Electric Release to Edison -- - - - - 41. Gas Release to Southern California Gas - 42. CERTIFICATE OF OCCUPANCY No. Date - - • I ,''�ilEssa eaLaNc 245 FISCHER AV UME A-2 OWNERSNAMEIFIGawNAIRP0RT WEST BUSINESS PAR 4150111151,245 FISCHER AV COSTA MESA, CA 92626 556-4990 /M. All AODRESk I ARCHITECT OR ENORYFER: UC. NO.: ARCH. OR ENG.'S ADDRESS: UNIT: 6WMACTORSNAME: SPECTRUM ENGINEERING (805)967-1173 CONTRACTORS MMLMG 217 NOGAL DR ADDHE53:SANTA BARBARA CA uCNG: 663834 93110 UMT: LICENSED lic M CONTRACTORS DECLARATION: I hereby aalux "MAY d Perjury tee am xhssd under provisios of Chapter B (om onenMhp with Section 7000) of Civeion 3 of 0w Bu.irmess am Pmleeabro Code. Y Searle n in IW fibro end effect. CITY LIC. NO.: LIC. CLASS: C-10 LIC.NO.: EXP: Oat.: Commctor. OWNER BUILDER DECLARATION: I hereby Affirm uMer d perjury thea 1 ern aaempt Isom Cotractore License Lew for the 'Mbwkq remora (Section 7031.5 Bue'sue. end Professions : A, city or oonty whits reaui a perms to mrotruct, aRx, improve, mosnh, x repair arty dmdum. Price to its beuanCe, also repuim the eppl' ant for such M and to fib a signs! statement duel he m she Bossed Tamara to the pro eons of the Contractors License Lew [Chapter B (cbrnmendrp with Section 7u00) of DYvnion 3 of the due. aM Prdembm Code) or tome M or the is mempl therehom aM the ban for the Alleged assonsion. Am oblation of Section 7031.5 by any app4om tore PxmY au sola the aPPlkxa to a deg P..1Y Of rad nam then ING hundred dollen jS500D. ❑ I. m owrm of the Property or my employees With wane m their lose omldmatbn, tiff do Ore wait. end the sMldun is sat imaMed or offered M sate (Session 7044, B.. eros Pmfesaians Code:7M Coramctore Lion" Lew dose sof apply to ar owrur of Property Who bWde or Ynpreves thereon, aM who dos cudch wank Nm.sR or herself or Mrmgh his or her own xnptoyses, pmnded that tooth 'unprawnem ere not wrestled or a0ered for ssb. E. however. the buGnp or int m ml is tosE Mahn one Year of completion. Ms owrw-0uiber MR have the urdso of Pro ng M or she did rax buDd or knpmve for the isotopes of sale). I, m center of the Property, em mduilvey onda ren, with lieeneed ootrmlon to onxrud the Project (Section 7044, Business aM Professions Cods: The Contredon License Lew dose m apply to an owner of property who Mild. or impmee Merep i most who onueds for such Pr iw. with A oomressor(e) Ikeneed Wosumt to the Colredbra Llceroe law). I am exempt urder Section: B. 8 P.C., for this reason: Ode: Owner: I de hereby cxtgy that I am... of mrd uderelend the rMpAremem of California lfeeRh end Safety Code Swicm 25505. 85593. mod 85530, W Met I or any future biON coopna, writ I wR trot (dmle os) oes l to comply with mad date codes aM the readremem for a mond lormrdlruction ornhodHrdion hanaM As u�iy vepemenl Chops. RetidentiNOMohWion appFMbm en Mompt fres lass prodsioro. WORKER'S COMPENSATION DECLARATION: I hereby alfirm under penally of perjury coo of the bI W, dedvxbm: O (have and roll manes a ortiliole d PommMl to aedemam ter waken comm Won. m provided for by Section 3700 d the Labor Cods, for the "rf. of the wait for wlich this pertnh is Issued. I hew and MR malmaih wool loy' omparW ion inssrercs, m reRused by Section 3700 of the Lobar Cods, ter the performance of the work for which this permit is issued. My waken' compensation insurance order AM polky numbr me: Croix:STATE FUND EXPIRES Ppfxy Numluc 1414994— 08/01/97 ,04 action "ed nm M oompWeJ I the peork is for em hundred dohs IS1001 or nm.) 1 onSy that le Ihe the W ce d IM work M white this pefor la larded. shed xnploy should peon su any' motor W se se' bacon ssbject b the waken' corrcemedbn lewi tl California eros ton R I thauM besot abject to IM worker' oampensdbn isoMease of `action 3700 of the labor Code. I shun forth lh M Wiens. DNe: Appliom: WmmMp: Fallon ho ssrun wo*., coolowdadon unaw4ul, a.d dell mcmir*far WloyxWp rYOW Per sss and ddl dna IW 1C ern Audred thousand do/Ws ($fWoyMQl , M addllbn W Me cost comperudlan dungm m pray ter In Seodm 3704 of Me La0ar Cods, Idxad, and a0omay'a /rex CONSTRUCTION LENDING AGENCY: I hereby aMnn under penaly of perjury Ihd taro Is a onedrudion landin nervy ter Ms mdoerarce .1 the work for Widh this permit int blued (Emotion 3087, Civ. C). LENDER'S NAME: LENDER'S ADDRESS: I unify Ihd I heva read this applks0o W dose that the above'adammion is coned. I agow to comply With all city and county, ordinances AM Rude lows reWyp to brddYq onfVddion she hereby Autlmne rePretemdhtt of this city to Wer upon the ebma numiorud propxy for inspection papesea. J03fN PEERY Ods: (515146.WP) White -Budding S Safety; Omn-Flle; Canary-APPEom; Pink -Revenue; Gddenm Asswmaor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 077581 PERMIT NO: E 077581 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE: OTH JOB DESCRIPTION ELECTRICAL SERVICE UPGRADE SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: B / COMMENTS: NOT RELATED TO BUILDING PERMITS SE SE iE iF*1E*Rf Hf Sit iE iE iF iE fE fEtF*tE IE fE St SE iE iE SEfFRE it ik iE iE*SE iE iE SElE iE dE RF*ii iE iF iE iE 1E****9E*HE*iE HE*iklE St SE SE iE if dE***1FiE 1E iE dE lE iE tF* Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RIGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 00000000 ZNE: REF NO: PLANNING NOTES> iE 1E tF )E * * * tE jE SE SE fE RE * Sf * ik 1E iF * 1E tF dE lE iF HE 3E fE tE 3E 3E iE fpdE iE * SE dE SE iE St 3E iE SE S(• * RE iE fl iE if HF iE * it iF iE SE 3S it tt RE Sf RS 1E 1E Sf * 1E iE RE Hf * il.iE 1F i51f it D E V E L O P M E N T S-E'R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY Ilk DATE: BUILDING APPROVED BY .1. _ DATE: APPLICATION ISSUED BY: DATE: 1E iE 9E RE RE tE'lE iE 1E iE**IS ik*iE*ik lE iF dE 1E 1E lEE�iE dE )F ife1 ,10 tE tE iE iE ElE RE iE tE 9E IE RES RE tai ERE lE SE iE dE RE HE SE iE iE SE*3b #jE-�3E lh LEGALIZATION:N F Ey E% S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 59.50 503 SMIP/NON—RES PLAN ISSUE FEE 15.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 59.50 15.00 0,00 74,50 74.50 .00 REVENUE DIVISION TOTALS--> COLLECTED: 74.50 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 74.50 iE tE RE SE iF dE iE iE iF fE iE * SE iF iE tE iE iE 1E iE iE IE tE iE Sf iE 1E * it 1E * * * tE dE * R5 iE RE iE iE Hf 1E SE SE RE RE tF SE SE SE dE Ht 41f k 1E lE * rfE * iF tE SE 3E lE lE 1E 1E 1E 1E * * SE tE lE iE SE it I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 1 SERVICES BELOW 600 V & 201— 1000 AMP 37.50 37,50 ELE 2 SUB—PANEL 11,00 22.00 END OF FEES 4% Oi O4TE: u::'i'.." I Ic' La:Z. 177 j (CONSTRUCTION AND PLANNING - APPROVALS Permit # Date Inspector POG SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pote 52. Pool & Equipment Location , 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms r ' 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..r 60. Backwash Lines, P-Trap, 0 Ugdrgrnd, 10. Structural Floor System Ile 61. APPROVAL TO DECK' 11. Property Sewer Line & House'Connection 62. Backwash & Receptor-Fi'nal• 12. Sewer Cap - 63. Heater & Vent-Final , 13. Roof Orains . , 64. Plumbing System - Final ' 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 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 APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 00d 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank 0Gas 0Oil 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 I 80. FOOD CERTIFICATE ISSUED 33. Final Electric .'��i _ Notes: -20 --(!,C ../ - - 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 Irriqation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING ' 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co G1f W 51. CERTIFICATE OF OCCUPANCY No Date City of Costa Mesa Development Services Department Building Safety Division CERTIFICATE OF OCCUPANCY No. 002772 P. O. Box 1200 Costa Mesa, California The Building located at 245 Fischer Avenue, A3 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group R-2 Occupancy. Use of Building Office Legal Description 427-033-09 (See reverse side for Metes and Bounds) Building Permit No B 34146 Electrical Permit No. MB 34740 Plumbing Permit No. Mechanical Permit No. MF. '447,10 Number of apartments and/or guest rooms ISSUED TO: Villanueva/Aroni 3400 Irvine Avenue, Ste. 221 NeWDOrt Beach, CA 92660 Building Official William T. Howard Date Noveber 30, 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. 1/93 White -Owner; Canary - Numerical File; Pink - Bldg. Permit File City of Costa Mesa Development Services Department Building Safety Division CERTIFICATE OF OCCUPANCY No. GC CA219k P. O. Boz 1200 Costa Mesa. California The Building located at 245 Fiaeher Avenue #A-3 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group B-2 Occupancy. Use of Building Interior Alterations — Office Legal Description 427-033-09 (See reverse side for Metes and Bounds) Building Permit No. tom --9293 Electrical Permit No, G-9293 Plumbing Permit No. P-9437 Mechanical Permit No. M-9003, F-9434 ISSUED TO: PAilliam Prnrwrt-ipc 1517 N. Fairview, Santa Ana, CA Number of apartments by guest rooms —0— 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 City of Costa Mesa Building Safety Department P.O. Box 1200 Costa Mesa, California i CERTIFICATE OF OCCUPANCY The Building located at ?dr F; c"P%� - H has,been inspected and found to comply with for a Group B-2 Occupancy Use of Buildin tie provisions of all City of Costa Mesa Ordinances applicable thereto f r Legal Description 46/—UIJ—Ul �. (See reverse side for. Metes and Bounds) - F=44b6 :50-27 Building Permit No RF.P-4603 ElectricalfPermit No. IAEP-4603 Plumbing Permit No. E-5766' Number of apartments {% —0-- and/or guest rooms —0— ISSUED TO: t Building Official s •y U,11;n„ Dmror+inrs : V. C, Newton, `B riil=g Division DikeOr Date ! % y— — 77 r_ - This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 306 lel U.B.C. Form BU 34 Rev. 11/70 :} - u M (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 245 FISCHER AV Suite: A003 Vicinity: Parcel Number: 93898001 Zoning: Applicant: SERNA, ROLAND 06/13/2002 Address: 7 CAMPANILLA ST " `i ••�_ Phone: 949-661-4668 Address: SAN CLEMENTE, CA Zip: 92673 Owner: CRELLIN TRUST (CRELLIN AND MAGDALENO) Address --1300 QUAIL ST - ." - STE 100 - - Phone: ' - , NEWPORT BEACH, CA - Zip: 92660 i Contractor: OWNER -BUILDER $1,601.89 Address: - - - Phone:' Status: ISSUED Applied: 04/29/2002 Issued: 06/13/2002 ISSUED BY: Zip: License: 0 Arch-: $623.19 Eng: MASSEY,'JOHN Calc Valuation: $95,000.00 Permit: `i ••�_ Claim Valuation: $95,000.00 Address: $0.00 - Address: 211 AVENIDA VALENCIA SMIP Com: Phone: -ne Php: 949-498-2600 Other: $0.00 SAN CLEMENTE, CA � - � Zip: License: 92672 Licenser .CO44455 Total: $1,601.89 SCOPE OF PERMIT 3,200 S.F. TENANT IMPROVEMENT FOR AN ACCOUNTING OFFICE. NO MEZANNINE/STORAGE LOFT PERMITTED. EXISTING ATTIC NOT CONSIDERED ADDITIONAL FLOOR AREA. PER MMF, NOT DESIGNED AS FLOOR SPACE. IT SHAL NOT BE REINFORCED OR MODIFIED TO BECOME MEZZANINE. 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 t«648 (6=) FEE SUMMARY Plan Check: $623.19 Calc Valuation: $95,000.00 Permit: $958.75 Claim Valuation: $95,000.00 SMIP Res: $0.00 SMIP Com: $19.95 Other: $0.00 Inspection: $0.00 Total: $1,601.89 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: 01 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 t«648 (6=) 1 WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 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 issueq. ❑ 1 have and Will maintain workers' compensation insurance, as required by section 3700 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: Cartier: Polity Number: (This section need not be completed if the permit is valued atone hundred dollars ($100) or less.) - ❑ 1 certity 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 California. and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these provisions. Applicant Signature: Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL PND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECITON 3706 OFTHE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cade, and my license Is in full force and effect. Lic. B Class a Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a Construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lenders Address: Signature: — _ Date: OWNER -BUILDER DECLARATIONS: I hereby aftirn that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professlons Code: Any city or county which requires a pornit to construct, alter, improve, demolish, or repair any structure, prior t0 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 o1 the Business and Professions Code) or that he or she isxexempt 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 penalty of not more than two 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.). 1, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Coda: The contra rs License LaW goes not apply to an owner of property who builds or Improves thereon, and who contracts for such project with a contractor(s) license p e C ractorg icense Laws.). ❑ 1 am d sec. Business and Professions Code for this reason: Signature: Date: Q Owner ID ve6fif by driver's license. ❑ Yes ❑ No Drivers License No. Expires: Q Verification of Ownership by (type of document, i.e. - property tax bill or dead): 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 will 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: 1 Will 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? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be tiled 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 then a weight of 500 pounds, or a volume of 55 gallons, ........or 200_cubic feet of compressed gas et sten........, temperature end pressure). ....................__..................___................................................................. ............................................................. _................ _ 2 Does or will the applicant or present or future building occupant need to file a registration forth for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 o1 the California Health and Safety 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 O Y or will th❑e applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? es (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 Cade been fully complied with? El Yes ❑ No ............................ ................... ............................. _... ............................. .................................................................................................. _... ........................... _................................................. ......_................. __....................................... _................ 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication a ermit for such construction or modification from the South Coast Air Quality Management District or from any other Sir pollution control district or agency? Yes Ll No (Section 65850.2 of the California Government Code requires that the requested information be fumished on applications for non-residential building permits). ..................................................................................................................................._............................................................................................................................................ .......................................................................................... ..... Y ty, pe .... ... 6 Will an Dart of the facili to be constructed under this permit be within 10001eet from the outer bountlaries of a school? ❑ Ves ❑ 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? ❑ Yes ❑ No .........._....................................................... _.._.................................................. ___....................... __..................... _.......................... ............................................................................ ___......................... _................... _...................... _ B (11 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 COMPLIANCE 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 all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. na ife0l LegalAar(s) / �L-DDate An )r Authorized Applicant Date 400E t. ASPECTION TYP DATE WTITIALS CODE INSPECTION TYPE 2AN INTRIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 210 Final Electrical 201 Final Block/Retaining Well 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 � (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 MECHANICAL PERMIT Job Address: 245 FISCHER AV Suite No A003 Vicinity: STE A003 (WILLIAMS, MAGOALENO AND CRELLI Parcel Number: 93898001 Applicant: SERNA, ROLAND ' Address: 7 CAMPANILLA ST- Issued: SAN CLEMENTE, CA , Owner: HITTNER, GLENN W Address: 245 FISCHER AVE #A-1 $0.00 COSTA MESA, CA Contractor: OWNER -BUILDER Address: Inst / Rep. Recess Wall Htr Phone: 949-275-5084 Zip: 92673-2751 Phone: Zip: 92626 _Phone: `• ` Zip: License: 0 Status: ISSUED Applied: 06/13/2002 Issued: 06/13/2002 ISSUED BY: SCOPE OF PERMIT 3200 SF TI FOR AN ACCOUNTING OFFICE (NO MEZANNINE/STORAGE PERMITTED; EXISTING ATTIC). 1 REPAIR/ALT COOLING/HEAT, 1"HOOD W/MECH EXHAUST. REF: B02-00590 FEE SUMMARY Quantity ISSUE FEE $23.50- _ Inst FAU <100 k BTU $0.00 - _ 0 Inst FAU >100 k BTU $0.00 0 Repair/ Alt Cooling/Heat $13.70 1 Inst / Rep. Recess Wall Htr $0.00 0 Refrig Sys <100 k BTU $0.00 0 Refrig Sys >100 k BTU $0.00 0 Gas Piping $0.00 0 Factory Fireplace $0.00 0 Hood w/Mech Exhaust $10.65 1 VAV Box - $0.00-: -0, - Vent Fan / Single Duct $0.00 0 Appliance $0.00 0 Fire Dampers $0.00 0 Smoke Dampers $0.00 0 Inst or Relocate Appl Vent $0.00 0 Air Handlers < 10000cfm $0.00 0 " Air Handlers > 10000cfm $0.00 0 Floor Furnace - $0.00 0 Floor or Suspend Heater ` . $0.00 0 FEE SUMMARY Quantity - Repair / Alt Absorbtion Unit $0.00 0 Repair / Alt Refrigeration Unit $0.00 0 Ventillation System $0.00 0 Evaporative Cooler $0.00 0 Commercial Incinerator $0.00 0 Domestic Incinerator $0.00 0 . Compressors / Absorption Systems Up to 3 hp / 100k BTU - $0.00 0 3 To 15 hp./500 k BTU $0.00 0 15 To 30 hp /.1,000 k BTU $0.00 0 -- 30 To 50 hp / 1,750 k -BTU $0.00 "0 Over 50 hp / Over 1,750 BTU $0.00, 0 Boilers Up to 3 hp - $0.00 0 3 To 15 hp $0.00 0 15 to 30 hp $0.00 0 _ 30 to 50 hp $0.00 0 Over 50 hp. - $0.00 0 Other Mechanical Fee Investigation Fee' - $0.00 Plan Check Fee $0.00 Reinspection Fee $0.00 TOTAL CALCULATED FEES $47.85 COMMENTS / SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92.28, § 1, 12-21-92) 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)7545626 2"6461a,00) 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. ❑ 1 have and will malntain workers' compensation insurance, as required by section 3700 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: Carder:Polity Number: (This section need not be` plated it the permit is valued at one hundred dollars ($100) or less.) ❑ 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 California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these provisions. Applicant Signature: Dale: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND GVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE (S/OD,ODD), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, 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. Lia 4 Class If 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, Civil Code). Lenders Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: 1 hereby aftirn that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the fallowing 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 civil penalty of not more,tlt jn five hundred dollars ($500).): ❑ I, as owner of the properly, 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.). 1, 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 pursu Conir CtorS C ansa Laws.). ❑ I am exe C. Business and Professions Code for this reason: Signature: &OA& Date Owner ID vedhed drivers license. ❑ Yes ❑ No Drivers License Expires Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 hereby certify that no excavation five (5) or more feet In depth Into which a person is required to demand, 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 6, California Administrative Code). ❑ As owner-builder, I will 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: 1 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? ❑ Yes ❑ 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 feet 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? ❑ Yes ❑ Na (Section 25533 of the California Health and Safety 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 en RMPP Is presently requiretl, has Section 25534 of the California Health and Safety Code been fully complietl with? []Yes ❑ No 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this a plication aggermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LJ NO (Section 65850.2 of the California Government Code requires that the requested Information be furnished on applications for non-residential building permits). ..................._......_......................................._......................................................_._.............it-h...__._.............t.1,r_._...................__..............................._.........._._...........................................__..................__............._._........... 6 Will any pan of the rattily to be constructed under this Dartoic be within 7000 feet from the outer boundaries of a school? ❑Yes ❑ No (Ii yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ...................... .................................... _....................... _........ _.._._.................................. ____.............. _................ __............... __.__......................................... _........ _............... ._.............. _._............. _.._.......... 7 If a ppemit 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 app Milan, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ 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 COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that 1 have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. at Of Legal Owner(s) - / Date AhcDVrOMall Applicant CO �J Date CODE 0. IN6ECTION TYPE Rte$ CODE ( INSPECTION TYPE 2M INTITA 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Root 210 Final Electrical 201 Final Block/Retaining Well 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Suilding/Occupancy (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: 245 FISCHER AV Suite No A003 Vicinity: STE A003 (WILLIAMS, MAGDALENO AND CRELLI Parcel Nunmber: 93898001 Applicant: SERNA, ROLAND Address: 7 CAMPANILLA ST SAN CLEMENTE, CA owner:HITTNER; GLENN W Address /-245 FISCHER AVE #A-1 COSTA MESA, CA Contractor: OWNER -BUILDER Address: - Phone: 949-275-5084 Zip: 92673-2751 Status: ISSUED Applied: 06/13/2002 Issued: 06/13/2002 ISSUED BY: ,-Phone: Zip: License: 0 SCOPE OF PERMIT 3200 SF TI FOR AN ACCOUNTING OFFICE, WILLIAMS, MAGDALENO AND CRELLIN IN STE A003 (NO MEZANNINE/STORAGE PERMITTED; EXISTING ATTIC) . 26 LIGHT FIXTURES, 54 OUTLETS, 24 SWITCHES, 5 NON RES APPL, 1 SUB PANEL TO 200A. REF: B02-00590 Quantity ISSUE FEE $23.50 Temp service test $0.00 Quantity Res. a/c package $0.00 0 New Res (1-2 units) $0.00 0 New Res (3+units) $0.00 0 Pool / Spa - $0.00 0 Lighting Fixts $26.38 - - . 26 Recept Outlets $46.82 54 Switches $24.92 24 Non Res Appl $23.75 5 Res Appl $0.00 0 Service to 200a $0.00 0 Service to 1000a $0.00 0. Service over 1000a $0.00 0 Motors to the $0.00 0 Motors to 10hp $0.00 0 Motors to 50hp $0.00 0 Motors to 100hp $0.00 0 Motors over 100hp $0.00 0 Communication drops $0.00 0 Sub panel to 200a $30.50 1 Pole Light Pkg $0.00 0 Sign Circuits $0.00 0 Temp Pwr Pole $0.00 0 Intermed Pole $0.00 0 FEE SUMMARY Quantity Temp Dist System / Lighting $0.00 0 Busway /100 ft $0.00 0 Standing Section $0.00 0 -Misc Electrical Equipment $0.00 0 Transformers up to 1 kva/kw $0.00 0 ................up to 10 kva/kw $0.00. 0 .................up to 50 kva/kw..,- $0.00 0 .................up to 100 kva/kw $0.00 0 .................. 100 kva/kw $0.00 0 Low Voltage Equipment $0.00 0 Low Volt Wiring System / Ckt $0.00 0 Misc. Conduit $0.00 0 Misc. Conductor $0.00 0 Circus ( gen or ride) $0.00 0 Circus (mech ride or lights) $0.00 0 " Christmas Tree Stand $0.00- 0 Fireworks Stand $0.00 0 Other Electrical Fee ., $0.00 -"Investigation Fee $0.00 Plan Check Fee $0.00 Reinspection Fee $0.00 TOTAL CALCULATED FEES $175.87 COMMENTS / SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void it 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) 7545626 2"6.46 IS=) DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 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 section 3700 of rite Labor Code, for the performance of the work for which this permit is Issued. My workers' compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed if the permit is valued at one hundred dollars ($100) or less.) ❑ 1 certify, that In the performance of the work for which this permit is Issued, I shall not employ any person In any manner s0 as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these provisions. Applicant Signature: Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS 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 N Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that (hare is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lenders 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 pontiff 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 appllcant to a civil penalty of.not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees withilvages as their sole compensation, WILL DO THE WORK, and the structure Is not intended or offered for sale (Sec. 7044, Business and Professions Cade: 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 UmnseLaw doVnot apply to an owner of property who builds or Improves thereon, and who contracts for such project with a contractor(s) license pursue Conir tors Li rise Lews.). ❑ I am e2�d r c. Business and Professions Code for this reason: Signature: Date: Owner ID vriver9 license. ❑ Yes ❑ No Drivers License 6cpires: Verification 01 wnership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 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, lalsework, 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 will 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: 1 Will 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? ❑ Yes ❑ 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 o1 500 pounds, or a volume of 55 gallons, .or 200 cubic feet 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? ❑ Yes ❑ No (Section 25533 has on the hand alifornia Healthsand Safety ode, mate else exuePto or requires smanistratio with the 500 Costa Mesa Fire Department by each business which at any quantity acutely eq g g pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ............................................................................................................................................................................................................................................................................................................................................................................................ 3 Yes will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ (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 II en RMPP Is presently required, has Section 25534 of the California Health and Safe __ ........................................ 5 Does or will the applicant or present or future building Occupant require for the work which is the subject of this,eppllcation a ermit for such construction or modification from the South Coast Air Quality Management District Or from any other air pollution control district or agency? LU Yes a No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). ...8..........W.....I.I.I...a..n...y....p..a...n._o..f...................... _....................................................._........................_..........................._.........................................................................................................._............................................................................ the faci.ity to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ 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? []Yes ❑ No ......_..................__.....................__.................._.___..___.____.........................state air co...................—_..................___..._.................................................___.........._..__............___.................._�...... B (II 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 COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. 1 agree to comply With all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow Occupancy of any building authorized by this pe rmit until final inspection. igna L Ow er s /i'/ ,; AndlDrAuthorized Applicant Date CODE f. INSPECTION TYPE PAIS INTMA CODE f INSPECTION TYPE gAlf. INTIDEL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing �x 200 Final Re -Roof 210 Final Electrical 201 Final Block/Retaining Well 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 (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 FIRE SUPRESSION PERMIT Job Address: 245 FISCHERAV Suite: A003 Vicinity: Parcel Number: 9389$001 Zoning: Applicant: MARTIN, DON Address: 3357 E MIRALOMA'. SUITE 157 Phone: 714 777-3477 ANAHEIM, CA Zip: 92806 Owner: HITTNER,-GLENN W" Address 245 FISCHER AVE #A-1 Phone: COSTA MESA, CA Zip: 92626 Contractor: MARTIN FIRE PROTECTION Address: 3357 E MIRALOMA SUITE 157 Phone: , 714 777-3477 - ANAHEIM, CA Zip: 92806 License: 604132 Status: ISSUED Applied: 06/12/2002 Issued: 07/18/2002 ISSUED BY: SCOPE OF PERMIT INSTALL 24 NEW OVERHEAD FIRE SPRINKLERS. "ACCOUNTING OFFICE "PROJECT" REF: B02-00590 -FEE SUMMARY _ , Plan Check: $63,21 Permit: $97.25 Other: $0.00 Total: $160.46 Calc Valuation: $3,100.00 Claimed Valuation: $3,100.00 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 orde} 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 244648 (&W) DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby all I" under penalty of perjury one of the following declarations: ❑ 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 willmaintpin workers' compensation Insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit Is issued. —My wo rs' com phsatl Insureynce carrier and policy number are: Cartier: r .� Policy Number. -(Ines section need not be comp ad " the permit is valued at one hundred dollars ($100) or less.) ❑ I certify that in the pe rma of th work for which permit Is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws Ca The, a / 11 1 Id become subject to the workers' compensation provisions of Section 3700 01 the Labor Code, I shall forthwith comply with these S. �� 'Applicant Signature: — jrDale� �? 'WARNING: FAILURE TO ECURE WORKERS' ENSA COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPL' ER TOCRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND DOLLARE (5100,000), IN ADDITION TO THE OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 303OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed andpr ' t s ter ommencing ith Section 7000) of Division 3 of.the.Business and Professions Code, and my license is in full 'force and effect. Llc. a 9 class _# Con fra`c16rfsSlgnature: - .-Date: L' 7 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, Civil Code). Lenders Name: _ Lenders Address: Signature: Date: OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that 1 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 civil penalty of not more than five 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.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Data: Owner ID vented by drivers license. ❑ Yes ❑ No Drivers Ucense No. Expires: Verification o1 Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 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 Cade). ❑ As owner -builder, I will 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 peril to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 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? ❑ Yes ❑ No (Section 25505 of the Califomia 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 repand 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 feet 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 for for acutely hazardous materials? [I Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costs Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials aqua 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 theapplicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ tP0 (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. ........................................................................._................................................................................._...................................................................................................................... I .................... ............... . ............................ _"............................... 4 II en RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully compiled with? ❑ Yes ❑ No ........................................................................................................................................................................................................................................................................................................................................................................................... 5 Does or will the eppiicant or present or future building occupant require for the work which is the subject of this �2plicatlon ayermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? U 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 WIII any pert of the facility to be Constructed under this peril be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (It yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ............................................................................................................................................................................................................................................................................................................................................................................................ 7 If a peril Irom 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 Califomlo Health and Safety Code Section 42303 been made? ❑ Yes ❑ No .................__........... ........... _............._._..__—.___..___.............._...._........____..................___.................___.......................__.................................._.__................_.____................__............... __............ 6 (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 COMPLIANCE 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 all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Sig ur I nor - Date (fAncJCYtAuthQft6dI AiIlcant� �Rr; ;Date CODE e, INSPECTIONTYPE gA¢ INTITAL�r` COPES INSPECTION TYPE I[Qj AUj 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Rcot 210 Final Electrical 201 Final Black/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/Occupanoy Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA: ' '- -- - ` - PE IT NO. , TRAOT NO., LOT NO. BLD '• 2908. CONSTRUCTION PERMIT. —/� 1/23/84 ' _ 5.00 T Project Address'4 t5 N_se61B4. 1 . TYPE OF CONSTRUCTION LJ NEW 0 ADD 'ALTERATION LJ REPAIR p fA CA c%1(. ❑ CONVERSION ❑DEMOLISH El OTHER - Zone Applicants Mail ir)g•F�.ddress a+K .3007y ,S p�qy A.P. #. ((� Owner's Name ns'r E - ��'�� Phone 7D �—jt'�C DESC RIPTION'OF WORK S Main Building: Accessory Building: t _ 2 Address -1 lSC•N LA ) 0ltd Las9A VSA eA ei�/id'L . 7 Y - � TVPE�OF PERMIT • '. GRADINGFOUNDATION STRUCTURAL' E -1• � -. � Front - _ .. .( O N . Arch/Eng., License No. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B ❑ OTHER Rear N Address; _ ' " - C Right ' '_ '�' G Contractor's Nam of Phone PROJECT DESCRIPTION SO. FT. OCCUPANCY K R Address (mailing) i - CONSTRUCTION TYPE 'VALUATION $ S Left - �- E ` _ ' ZONE GRADING CU. YOS. ,ACRES Ping. Rei. Park: Fees $ D City License No. ,� IJ LICENSED CONTRACTOR DECLARATION Remarks: _ 7 �� - Parking Req./Provided ' I hereby. affirm that I am licensed under provisionsofCharter 9 (commencing - Use of Building: - R with section 7000) of Division 3 of the Business and Professions Code, and E my license is In full force and effect. �' - PlanninglNotes: M License ss- License No. Cla "' PLUMBING FEES , Date Signature - ' Bar Sink Showers - - 'i , N N WORKERS' COMPENSATION DECLARATION ereby affirm that I have a certificate of consent to self-insure or a certificate Backflcov Preven[er Service Sink' :. t S Workers' Compensation-Insurance, or a certifiedscopy thereof '(Section •' - - ' ,800, Lab. C.) 1 I 1 Backflow In igation Sewer Cap ,` ELECTRICAL - FEES Policy No. Company BCertified copy is hereby furnished ' ! ; 1 Bathtubs I - Sewer Connection Automatic Washer I 1 I , Transformer 1115-50 KW Certified copy is filed with the'city Building Division. + I , ❑ 50+ KW , its Applicant{ Clarifiers Solar Collectors I Construction Pole Sub. i EXEMPTION-F ROM wO RKERS'COMPENSATION DECLARATION - -• ---' Dishwasher - - i Solar Piping - -- - -- -=- Cooking Unit Meter ❑up to 100 amps" - •- - - (This section need not be completed if the permit Is for one hundred ($100) or less). 1 I i I I certify:that in the performance of the work for which thii permit is issued 1 shall not employ any person in any manner so.as to become subject to rt Drinking Fountains - Solar Tank ` Dishwasher : - Meter ❑Over 160 amps t ' Workers' Compensation Laws of California. - , Floor Drains' 1 ' Swimming Pool w/Spa Dryers ❑Gas ❑Electric i Sub Panel Date NOTICE: If, after making this declaration, you should become subject to Floor Sinks : '._ Urinal _ j _ _ ,__ _ Fanl � I " - � - _Motors❑0-1 HP 01'fe-8 1 Workers' Compensationthe provisions of the Labor Code, you must forthwith - ' - — - _ comply 'With such provisions 'or this permit shall be deemed revoked. 1 _,AGENCY' - ' Gas Service .Outlets Water Closet__. \, - F.A:U, I Inc. Solar❑9-15 HP E116-15+ CONSTRUCTION; LENDING --� _ I hereby affirm that there is a'construction lending agency for the performance '3097 Interceptors ' _ ,Water°lieafer. _ I Fixtures Microwave ' of the work for which this permib is, issuetl' (Section Civ. C.) ___(Se Lenders Name-- Kitchen _ Kitchen Sink 1_'0�Water$ervice r �.?i _ `- Device Boxes. 'Pole Light Lender's Address14 OWNER BUILDER DECLARATION - OWNER LavatoriesF.''' -, );1'Q' ` Outlets 1 _ Range I hereby affirm that I am--exempt from the Contractor's License Law for the ' following 7031.5 Business Professional Code: Any P_Tra P ,.t i1 '� I ` `' ~ \�. i - $witches' reason (Section and city or county which requires a permit t0 construct, alter, improve, demolish or repair' 'any structure, to Its issuance, also requires the applicant for such permit 1 ;. Roof brains % - \t V- y t " - _ Sign - Garbage Disposal - ' Standing prior to file a signed statement•that.he/she Is licensed pursuant to the provisions of 'the 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 ' o. Sections f `' /k Generator ❑0-5 KW ❑5-15 KW Trash Compactor ^ P - refrom and the basis for the alleged exemption. Any violation of Section 31.5 by any applicant for a permit subjects the applicant to a civil ' E r `RelbSpeEtign /' ' V.r•�^' - r ' - of not mor¢ than five hUndretl t1011ars ($500). - ,Fee I,- 6e ' $ 3 - t ,pendlty fW71 their t •`, Reinspection Fee $25 Issue Fees , $' 3 I, as' owner of the property or my employeef with wages as sole compensation, will do the work, and the structure is not intended or offered ` 1 I i - ''- FEES . for sale: (Section 7044, Business and Professional Code: The Contractor's r License Law does to a who-builds or improves , "��"MEC - 1 PUBLIC SERVICES REQUIREMENTS: ) , 1i� not apply an owner of property Boiler .` odd r Type I ❑ I I thereon, and who,does such work himself herself or through his or her own / 9 Improvements intended for - Canopy Type I ❑ - Zoning Approved By ' - Date employees, provided that such are not or offered sale. If, however, the building or improvement is sold within one year of com- Duct -Under Ground - Application Approved By { Date pletion, the owner. will have the burden of proving he/she did not build or im- for the purpose of sale). Duct - Structural Ref igeration System -, , . Application Issued By at y Me I, as owner of the property, am exclusively contracting with licensed con- tra ct ors to construct the project (Section 7044, Business and Professions Cod a: Duct -Ventilating ' ❑0-100,000 RTU ❑100,000 BTU ,SUMMARY OF FEES -The Contractor's License Law—does not apply to an owner property who cts with acon- builds or improves thereon, and who contracts for such h projects - Exhaust System El Multiple ❑ - System Repair/Alteration —_ BUILDING PERMIT $ I l SMTP $ tractor(s) license pursuant to the Contractor's License law);. PLAN CHECK $ PERMIT - - ❑ I'am exempt under Section B. . C. for in reason Firepl/Fact.;Blt. ICBG # - 'ISSUANCE ( $ PLUMBING $ Date '4-3 3-,14 Owner" Heating System & Ducting ' PLAN CHECK $ ENERGY P.C. $ hereby certify that I have read this applicatioP ands a that the above `information ❑0-100,000 BTU "❑100,00087 -., -i i S ELECTRICAL $ GRADING $ is correct- I agree to'comply with all city and county ordinances' and state laws relati to builtling c struction, and hereby authorize repre- sentaLv¢s of' this, I t enter h above-mentioned •Property 'for i ' PLAN CHECK $ + , MICROFILM $ inspection purpos �¢ ` r Date �` _ MECHANICAL $ TOTAL FEE $-�' r Signature Reinspection Fee i $25 Issue Fee ' $ 3 PLAN CHECK i $ Drivers' License or SS CMF 0865-46 rev. 7/83" White - Building; Canary - Applicant; 'Pink - Accounting; Goldenrod-- Assessor - -' - - -- -" -^ - - - - ' I - - __ _.,. ,__ ,.l _�.. CONSTRUCTION AND PLANNING - APPROVALS, Permit# Date Inspector POO ;PA -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 LIFER 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 TODECK - 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 i _' - 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 APPROVALS Permit # 3f1. Rough Factory Fireplace 21: Ducts, in Structure ,' 70. Underground Hydro 22. Ducts, Ventilating' 71. Product Piping 0 Gas EJ Oil X23. Gas Pipe -Rough & Test; 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank OGas 0Oi1 25. Roof Sheathing 74. Overhead Hydra 26. T -Bar Ceiling!(Sfructural) & Monocoat • 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding. 77. FIXED SYSTEM FINAL. 29. Insulation 78. FIRE PREY. 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 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 I 42. Backflow Preventer 43. Backflow Irrigation ' 44. Landscape Irrigation System - - 45. Sound Attenuation . 46. Handicap Regulations - 47. FINAL STRUCTURE & BUILDING ' 48. Special RequirementsCompleted 49. Electric Release to Edison -- - 50. Gas Release to Southern California Gas Col, ' 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 Project Address 245 Fi SCher Ave. , Unit A-3 Applicant's Mailing Address Same��ar A�n�i��r� Owner's NameGregQxYr—�-J•1 aLlttGx u11.,]� a lttej j 1 angevay.�.__---- _,Phone 256-_1477 Address 3400_Trvi.ne Ave. Ste 221, Newport Beach Arch/Eng. Oscar Arnoni License No. 012073 Address3400 Irvine Ave., Ste 221, Newport Beach Wo7tt; Contractor's Nam Phone Address (mailing�..- City License No — LICENSED CONTRACTOR DECLARATION I hereby affirm that 1 am licensed untler provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full force pid affect.— Livens as License NO'�z Date Signature -^1�,. Lt+r WORKERS' OMPENSATION OEC�N Cfeby allirm that I have a Cerb irate of Consent to self -insure Or a cert it10te Workers' Compensation insurance, or a certified Copy thereof (Section 00, Lab. C. �/ -'f ee�q �L Policy No `��/ 0--� Company Certifietl copy is hereby furnlshed. (a Certif'e sled with the city dyjldf�g�]iwc+ Dat Applicant /_Sc, f£�24fj-af lIY•:"+� EXEMPTION P OM WORKERS' COMPENSATION DECLARATION This section need not he completed if the permit is for one hundred ($100) or ass). 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 as to DeCOma subject to t(te Workers' Compensation Laws of California. Data Signature NOTICE: If, after making this declaration, you shoUld become subject to the Workers' Compensation provisions of the Wbor Code, you must forthwith comply with such provisions or this permit shaft be deemed revoked, 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 (Section 3097 Civ, C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7033,5 Business and Professional Code: Any city or county which requires a permit to Construct, alter, improve, demolish or repalr 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 the Contractor's License taw (Chapter 9(commencing with Section 7000) of nivis'ion 3 of the Business and Professions Code) or that helshe is exempt erefrom and the basis for the alleged exemption. Any violation Of Section )31.5 by any applicant for a permit subjects Ina applicant to a civil penalty of not more than five hundred dollars ($500), 0 I, as owner of the prooertY or my employees with wages as their sole compen,atlon, will do the work, antl the structure is not Intended or of force for sale (section 7044, Business and Professional Code: The Contractor's LiCen Ss law does not apply to an Owner Of a property who builds or oflorovea thereon, and who does such work hlmseifJherseif or through his or her own employees, provided that such improvements are not intended or Offered for pl Lion, the owner withe ll have theing rburden vof prov ng he/she did nont is sold within one year build of im• Prove for tate purpose of sale). 0 1, as owner of the property, am exetuslyely contracting with licensed Com- tractors omtractors t0 construct the project(Section 7044, Busmess and Professions Code: The Contractor's License Law does not apply to an owner Of property who builds or improves thereon. antl who contracts for Such oroucts with a 'an- tractoriq hcense pursuant to toe Contractor's License taw). I am aware that proof d(( their Worker's Compensation Insurance should be provided to me, 0 1 am exempt under Section B. & P, C. for this reason Date Owner that I have read this application and state that the above rest, i agree to comply with all City and county ordinances lating to building Construction, and hereby authorize repre- i city to enter upon the above-mentioned or per for Boiler Duct, Under Ground Duct - Structural Duct - Ventilating Exhaust System 0 Multiple Firepl)Fact. Bit, ICBG # Heating System & Ducting 00-100,000 BTU 0100,000 Signature Date Drivers' License or SS 9f — Reinspection Fee $16 0865.46, rev. 5/88 1 White . Buloong; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Hood or Type Canopy Type I I Refrigeration System ' C70-100,000 BTU 0100,000 System Repair/Alteration Fire Dampers Registers Issue Fee SUMMARY Of FEES.S- .'9UILDINGPERMIT f�- A.P.# %�f�7-033- -- Zona MP $ Main Building: Accessory Building: $ ;PLAN CHECK- 25% TYIP=F-IOF CONSTRUCTION NEW ADO ALTERATION REPAIR I—.i CONVERSION 0 DEMOLISH CI OTHER DESCRIPTION OF WORKIUSE DF BLDG. ��L��t�� T Front $ GRADING $ O A ,,,,,fit Rear i N CO?'� 1d}C. 'MECHANICACr N C flight $ TOTAL FEE $ r�D�•�� N TYPE OF PERMIT GRAOtNG FOUNOATtON STRUCTURAL ® TENANT 0 ELECTRICAL 0 PLUMBING E3 MECHANICAL OTHER � S' Left G R Ping. Ref. # Parking Req./Provided E PROJECT DESCRIPTION SD. FT. 3.Ja4_ OCCUPANCY CONSTRUCTION TYPES7—N VALUATIONS 15,000 ZONE GRAOINGCU.YDS. ACRES Planning Notes: f P<h IT fCT? O FWt�Y M -1, $. Ramarks- ELECTRICAL FEES ., PLUMBING FEES Automatic Washer _ Construction Pole Sub. Transformer O 15-50 KW 0 50 + KW Bar Sink Showers Backflow Preventer Service Sink Cooking Unit Meter Quo to 100 amps Backflow Irrigation Sewer Cap _ Dishwasher Meter ❑over IODarnps_ Bathtubs Sewer Connection Dryers E7Gas OElectric Sub Panel Clarifiers Solar Collectors Fan Motors 00.1 HP 01' ", 8 Dishwasher Solar Piping F.A,U. Inc. Solar 09-15 HP 01615+ ^ Drinking Fountains _ Solar Tank Fixtures r Microwave Floor Drains Swimming Pool w1Spa Device Boxes Pole Light Floor Sinks Urinal Outlets Range " Gas Service Outlets Water Closet Switches - ! Sign Interceptors Water Heater : Garbage Diiposav� Standing Sections Kitchen Sink Water Service Generator �65.KW 05-15 KW Trash Compactor Lavatories Auto -Wash -{r P --Trap Laundry Tfays `t Roof Drains I RalnspectionFee $15 Issue Fee $ 3 MENT SERVICES REQUIREMENTS: l� D Zoning- Zoning Approved By ': AA Yt' t Date Building Approved By - �Data� Reinspection Pae $15 Issue Fee $ 3 MECHANICAL FEES .• Boiler Duct, Under Ground Duct - Structural Duct - Ventilating Exhaust System 0 Multiple Firepl)Fact. Bit, ICBG # Heating System & Ducting 00-100,000 BTU 0100,000 Signature Date Drivers' License or SS 9f — Reinspection Fee $16 0865.46, rev. 5/88 1 White . Buloong; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Hood or Type Canopy Type I I Refrigeration System ' C70-100,000 BTU 0100,000 System Repair/Alteration Fire Dampers Registers Issue Fee 0100006967-00006968 TOT 16€.25 SUMMARY Of FEES.S- .'9UILDINGPERMIT $ �.� _-r__ SMTP "PLAN CHECK- $ PERMIT _ ' PLUMBING.' $ ISSUANCE $ ;PLAN CHECK- 25% $ ENERGY P.C. $ `ELECTRICAL $ GRADING $ ' PLAN CHEM7Z 5O% $ MICROFILM $ 'MECHANICACr $ TOTAL FEE $ r�D�•�� PLAN CHECK 25% S 0100006967-00006968 TOT 16€.25 I -, CONSTRUCTION AND PLANNING 1 Date APPROVALS Permit # A [Inspector POO SPA 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. '�l 54. Forms 4. Electrical Conduit-Undrgrnd. ": "`I 55. Electrical Bonding 5. Steel'Reinforcement 56. Rough Plumbing & Pressure Test ' 6. Electrical UFER Grndl 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8: Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgmd..: 60. Backwash Lines, P -Trap, O Undrgrnd. 10. Structural Floor System yl. 61. APPROVAL TO DECK 11. Property Sewer -Line -& House Connection 62. Backwash & Receptor -Final i 12. Sewer Cap - 63. Heater & Vent -Final 13. Roof7,Drains 64. Plumbing System -Final f 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 'A7. Rough Wiring Sign ..� 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling _j 69. POOL/SPA SYSTEMS FINAL 19' Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit 46- 20. Rough Factory Fireplace ^� f` 21. Ducts, in Structure �•� �'% 21. 70. Underground Hydro 22. Ducts, Ventilating -�, 71. Product Piping OGas ❑Oil 23. Gas Pipe -Rough & Test -' 72. Underground Flush 24. Roof Framing fJ 11 73. Undergrnd. Storage Tank OGas ❑Oil 25. Roof Sheathing ' I 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing > NaT` 76. Dry Standpipe 28.- Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing (N - HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION - 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric •. Notes: 0 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test 36. Hood or Canopy /t T?3 37. Final Factory Fireplace E3DV¢� - 38. Final Plumbing 39. Water Service=Final- 40. Gas Service -Final 41.. Solar Domestic -Final 4�. 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 a '51. CERTIFICATE OF OCCUPANCY No. Date ,ter Applicant to fill in all spaces except these within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA CQNSTRUCTION PERMIT Project Address lGY. 'Applidant's Maili ddress I Owner's Namee/" � hone Address �,b ``U d �r%Ci7Tp � I Arch/Eng. 94241`d.s NJ A4`&Ix. License No.4 /2673 Address 3�&ft, Contractor's Name �� I `t'�' / Ph on 0-77-1. Address (mailing) /b Z City License No. 64� JL�4 LF— LICENSED CONTRACTOR DECLARATION 1 hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full f?sae and effect. License C ss t/ice�seLNo`�l 027T� Date P/� Signature, �� 1 �iD2= WORKERS' COMPENSATION DECLARATION ' hereby affirm that I have a certificate of consent to self -insure or a certificate Workers' Compensation Insurance, or a certified copy thereof (Section 00, Lab. C.) 16.90L 4� I Policy No. � Company Certified co y is Hereby urn ishetl. Cert if' t filed with the cityyiltlinr Date Applicant E%EM (TION ROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit is for one hundred ($100) or less). I certify that in the performance of the work for which this permit is issued, I shaWnot employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Signature NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with; such provisions or this permit shall be deemed revoked. 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 (Section 3097 Civ. C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/she is licensed pursuant to the.provisions of 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 erefrom and the basis for. the alleged exemption. Any violation of Section 31-5 by any applicant for a permit subjects the applicant to a civil ,analty of not more than five 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 intendetl or. offetetl for sale (Section 7044, Business and Professional Code: The Contractor's 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 employees, provided that Su Ch.improvements are not intended or offered for 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- prove for the purpose of Sale). ❑ 1, as owner of the property, am exclusively contracting with licensed con- 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 builds or improves thereon. and who contracts for such oroiects with a con- tractors) license pursuant to the Contractor's License Law). I am aware that Proof of their Worker's Compensation Insurance should be provided to me. ❑ 1 am exempt under Section B. & P. C. for this reason Date Owner I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize repre. sentatives of Wpis city to enter upon the above-mentioned op ty for Inspection Pu .P;es. ; � �/ DateO 7 / Signature � �!•Gtf'. ;k V' qfy� Drivers' License or SS -ff C7 n n nGi n 'JI. C 4O UlVll NV. E lt.-3 TYPE OF CONSTRUCTION LJ NEW LJ ADD M ALTERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRI (TION OF WOR K/USE OF BLDG. Ts: _ TYPE OF PERMIT - LJ GRADING LJ FOUNDATION LJ STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION SQ. FT. OCCUPANCY_ CONSTRUCTION TYPE 7:37-- _ VALUATION $ ZONE—GRAADINGCU.YDS. ACRES_ Remarks: _.X.Q14—./'- FEES Bar Sink Showers Backflow Preventer Service Sink Backflow Irrigation Sewer Cap Bathtubs Sewer Connection Clarifiers Solar Collectors Dishwasher Solar Piping Drinking Fountains Solar Tank . Floor Drains Swimming Pool w/Spa Floor Sinks Gas Service Outlets Urinal Water Closet Interceptors Water Heater Kitchen Sink Water Service ' Lavatories Auto -Wash A.P. # . S Main Building: E T Front ARear C Right K Left Ping. Ref. # Planning Notes: Zone Accessory Building: Z O N R Parking Req./Provided E D M T S. ELECTRICAL FEES Automatic Washer Construction Pole Sub. Transformer ❑ 15-50 KW ❑ 50+ KW Cooking Unit Meter ❑up to 100 amps Dishwasher Meter El over 100 amps - Dryers ❑Gas ❑Electric Sub Panel Fan Motors 00-1 HP❑1h-8 F.A.U. Inc Solar 09-15 HP ❑16-15+ �I Fixtures J •-r Microwave I Device Boxes Pole Light Outlets Switches Range Sign Garbage Disposal Standing Sections Generator 00-5 KW 05-15 KW Trash Compactor Reinspection Fee' I $151 I Issue Fee I $ 3 MECHANICAL I FEES 1 ��Boiler� Hood or Type I ❑ Duct- Under Ground Canopy Type 11 ❑ Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Bit. ICBO # Heating System & Ducting ❑ 6100,000 BTU 0100,0001311 Reinspection Fee 1 $15 0865-46, rev. 5/88 White - Building; Canary pA Canary Pink - Accounting; Goldenrod . Assessor Refrigeration System ❑0-100,000BTU ❑100,000 System Repair/Alteration Fire Dampers Registers Reinspection Fee $15 1 Issue Fee DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Building Approved By Application Issued By BUILDING PERMIT $ PLAN CHECK $ PLUMBING $ PLAN CHECK :25% $ - ELECTRICAL $ 3q.00 PLAN CHECK 50% $ 1.,3.a0(� MECHANICAL $ _2_4.00 PLAN CHECK 25% $ %. Z.S SMIP $ PERMIT ISSUANCE $ ENERGY P.C. $ GRADING $ MICROFILM $ TOTALFEE $ 01 00011170-00011173 T O T DATE: 08/03/88 TIME: 11:14 - 0 77.25 CONSTRUCTION AND PLANNING d APPROVALS Permit# Date Inspector POO SPA APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole -- - 52. Pool & Equipment Location 2.'TSoil Pipe-Undrgrnd. 53. Steel Reinforcement 67 Electrical Conduit Utility-UndrgFnd. t'� 54. Forms t.JElectrical Conduit-Undrgrnd. 55. Electrical Bonding - 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test .6 } Electrical UFER Gind. I ' 57. APPROVAL TO COVER-GUNITE 7! Footings t '. 58. Electrical Conduit-Undrgrnd. .8:- Foundation .11 , 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 1117 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 _4_Ao CCOO 66. Solar System -Final •16- Rough Electric Wiring rTf 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 Conditi ning FIRE DEPT. REQUIREMENT APPROVALS Permit # 2D. Rough Factory Fireplace `1. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating -.1 71. Product Piping 0 Gas 0Oil 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 r 75. Dry Chemical �� t 27.3rame 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'. Plaster Brown Coat 79. FINAL INSPECTION 321 Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED -: 33. Final Electric �� Notes:• - 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace r- 38. Final Plumbing 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer - '/� t•.. ' • Lf .i 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 •I .11 (j. 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date "' �•"" t�', ;J (,%•1 Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA M�{SA O STR UCTION PER,MII�T PE M 0. S O TRACT NO. LOT NO. UNIT NO. A P qW Project Address._�si 4 Applicant's Mailing Adrdrress 6 6� Owner's Namey,PhoneI54-1-�7 Address t Arch/Eng. License No, a-)�2.♦ 7h_?� Address Contractor's Nam Q o f one 722,a City License No. (14/�yT� LICENSED CONTRACTOR DECLARATION 1 hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my licensa is in lull force and e�ECLA License C_,"' SS is 7nse N Z'�Date S�r15'.�Y Sig l fill-�WORKERS' OMPENSATIONTION "ereby affirm that I have a certificate of consent to Selftinsure or a certificate Workers' Compensation Insurance, or a certifiedcopythereof (Section .lie Lab . Q " 13g Policy No.- Company rtified Copy is hereby furnished. �J Aff Cert if" tl c pY is filed with the city /Iddi g O !" Dale ApplicantI to - EXEMPTION ROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit is for one hundred ($300) or lass). 1 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 Ike Workers' Compensation Laws of California. Date Signature NOTICE: If, after making this declaration, you Should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith 'comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY 1 hereby affirm that there IS a construction lending agency for the performance of the work for which this permit is Issued (Section 3097 Cly. C.) L.ender'i Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/she Is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of - ivislon 3 of the Business and Professions Code) or that he/she Is Oxempl arefrom and the basis for the alleged exemption. Any violation of Section 131.5 by any applicant for a permit subjects the applicant to a civil anally of not more than five hundred dollars ($500). I. as owner of the property or my employees with wages a1 their sole compensation, will do the work, and the structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's 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 employees, provided that such improvements are not Intended or offered for Sale. If, however, the building or Improvement Is sold within one year of Com- platlon, the owner will have the burden of proving he/She did not build or im- Nmove for the purpose of sale). I, as owner of the property am exclusively contracting with licensed con- tractors to constr uct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or Improves thereon. and who contracts for such oroectS with a con- tractor(s) license pursuant to the Contractor's License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ 1 am exempt under Section B. & P. C. for this reason Date Owner I hereby certify that I have read this application and state that the above Information is correct. I agree to comply with all city and County ordinances and state laws relating to building construction, and hereby authorize repre- sentatives of this city to enter upon the above -me n �T Honefor aso Inspection pu6es. DateSignatureKe!7_ Drivers' License or SS # .5� // TYPE OF CONSTRUCTION LJ NEW LJ ADD LJ ALTERATION RE71R ElCONVERSION El DEMOLISH ❑ OTHER�Q-' OESCRIPJJaN OF WORK/USE TYPE OPPERMIT IJ GRADING LJ FOUNDATION,IJ STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING MECHANICAL ❑ OTHER PROJECT DESCRIPTION SQ. FT. OCCUPANCY CONSTRUCTION TYPE VALUATION S ZONE GRAOINGCU.YDS. ACRES Remarks: Bar Sink Showers Backflow Preventer _ Service Sink Backflow Irrigation - Sewer Cap Bathtubs Sewer Connection Clarifiers Solar Collectors Drinking Fountains Solar Tank Floor Drains Swimming Pool w/Spa Floor Sinks Urinal Gas Service Outlets ,ter Closet Interceptors Water Heater Kitchen Sink Water Service Lavatories Auto -Wash P—Trap Laundry Treys Roof Drains 25% Reinspection Fee 1 $15 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact Bit. ICBO # Heating System & Ducting E10-1 00,000 BTU ❑ 100,000 Reinspection Fee 1 $15 0865-46, rev. 5/88 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Issue Fee Hood or Types ❑ Canopy Type I1 ❑ Refrigeration System 110-100,000BTU 0100,000 System Repair/Alteration Fire Dampers Registers Issue Fee S Main Buildi E T Front B Rear A C Right K S Lett Ping. Ref. ah Planning Notes: Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generator ❑0.5 KW Zone ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+KW Meter ❑up to 100 amps Meter ❑over 100 amps Sub Panel Motors 00-1 HP ❑ 1 h - 8 Inc. Solar 09-15 HP ❑16-15+ Pole Light Sign Standing Sections 15 KW Trash Compactor Reinspection Fee $15 Issue Fee $ 3 •) DEVELOPMENT SERVICES REQUIREMENTS: yZoning Approved By FEES;:, Building Approved By Application Issued By 01 00012498-00012499 T O T DATE08/19/88 TIME: 13:39 7 N G R E Q M T S. FEES $ 3 15.75 SUMMAR)�OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK 25% $ ENERGY P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK 50% $ MICROFILM $ MECHANICAL $ TOTAL FEE $ PLAN CHECK 25% $ 01 00012498-00012499 T O T DATE08/19/88 TIME: 13:39 7 N G R E Q M T S. FEES $ 3 15.75 /. CONSTRUCTION AND PLANNING ` POC SPA APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector n 1. Temporary Electrical Service or Pole '-; 52. Pool & Equipment Location 2�Sail Pipe-Undrgrnd. f`•. 53. Steel Reinforcement 3.1 Electrical Conduit Utility-UncirgPnd. 54. Forms i 4.- Electrical Conduit-Uhdrgrnd. 55. Electrical Bonding ,5.•Steel,Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical OFER Grnd_. 57. APPROVAL TO COVER-GUNITE ; •7. Footings j% ) 58. Electrical Conduit-Undrgrnd. 1 8. Foundation j 59. Gas Pipe, 0 Undrgrnd., Test 9. Water. Pipe-Undrgrnd. •t' ' 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 1 I 63. Heater & Vent -Final •t. 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 (I Rough.Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Bar Ceiling 69. POOL/SPA SYSTEMS FINAL IEiectrical-T 19: Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts,in Structure 4 70. Underground Hydro 22: Ducts, -Ventilating i �•� 71. Product Piping 0 Gas 0Oil 23. Gas Pipe'Rough & Test _ _. 72. Underground Flush _ 24. Roof Framing 73Undergrnd. Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & V, onocoat 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'M6er-Final- 80. FOOD CERTIFICATE ISSUED - 33. Final Electric Notes: �� Gr1JfjGQIj,� . QQ(1Qs (,�q�/ip_(�•� 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 48. Special Requirements Completed 49. Electric Release to Edison is 50. Gas'Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date ; -' f\ I N CITW OF COSTA MESA CONSTRUCTION PE Applicant to fill in all spaces except those within heavy border Imes and sign all appropriate declarations. y PERjtQ1T�0 TRACT NO. : LOT NO. BLD . IT O Project Address !E= f—/5 Applicant's Maiaddress Owner's I_111- P,, y' i� hone�sL _yL Address fly-Dfs Arch/Eng. _ License No. Address Contractor's Nam ho Address (mailing) ) City License No. tT LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter (commencing with section 7000) of Division 3 of the Business antl Professions Code, antl my license is in 1 11 fo tl etfe License "ORI( RS' OMPENSATION DECLARATION ereby affirm that I have a certificate of consent to self -insure or a certificate Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C.) Policy No. - Comp y Ce hfie copy s her by furnished ert(fi cop O with the city B Ing Divi n. Date Applicant O EXEM IN ROM WORKERS' CO ENSAT4 N DELLA RA (Thisse tion need not be completed if the permit Is for one hundred ($100) or , certify that in the performance the work for which this permit fe' t _ t I shall not employ any person in any to y manner so as to become Subject [o file Workers' Compensation Laws California. Date Signaa ture NOTICE: If, omafter making this ions f on, you r Cod become subject to the Workers' Com sensation provisions of the Labor Code, you must forthwith comply with such • orchis permit shall be deemed revoked. 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 (Section 3097 Civ. C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/she is licensed pursuant to the provisions of he 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 erefrom and the basis for the alleged exemption. Any violation of Section 031.5 by any applicant for a permit subjects the applicant to a civil enatty of not more than five 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 (Sect Ion 7044, Business and Professional Code: The Contractor's License Law does not apply t0 an owner of a property who builds or Improves thereon, and who does such work himself/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 com- pletion, the owner will have the burden of proving he/she did not build or im- rove for the purpose of sale). I. a5 owner of the property, am exclusively contracting with Ilce nsed con- tractorsto construct the project (Section 7044, Business antl Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Law). ❑ 1 am exempt under Section B. & P. C. for this reason Date - r Owner I hereby certify tha I have reatl s application and state that the above information is corm 1 agree to ply with all city a county rdinances and state laws rela - g [o buildi 9 construction, and hereby auth rine orP.+ sen[ztives of Is sty to eryte Pon ilia abov0-mentlon0d opo �fQr inspection pu ( Signature Date TYPE OF CONSTRUCTION' LJ NEW LJ ADD ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK LJ ALTERATION L-1 REPAIR A.P. {/ S Main Building:, TYPE OF PERMIT 11 GRADING LJ FOUNDATION ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ ,OTHER ❑ STRUCTURAL ❑ MECHANICAL E T Front B A Rear C RightK PROJECT DESCRIPTION SO. FT. _ -OCCUPANCY CON STRUCTION TYPE VALUATION $ ZONE GRADING CU. YOS. ACRES .$ Left - Ping. Ref. Remarks: $ Parking Req./Provided ' Use of Building: ' PLUMBING $ FEES Planning,Notes: Sar Sink 3ackflow Preventer 3ackflow Irrigation Bathtubs Clarifiers 1 Dishwasher —' Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets Interceptors Kitchen Sink ' Lavatories - P—Trap Roof Drains Reinspection Fee I S25 Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater . Water Service Issue Fee Boiler Hood or Type I ❑ Duch Under Ground Canopy Type I I El Duct - Structural Refrigeration System Duct- Ventilating ❑0700,000 BTU ❑100,000 BTU Exhaust System ❑ Multiple ❑ System Repair/Alteration Firepl/Fact. Blt. ICBO # Heating System & Ducting ❑0100,000 BTU ❑100,0006T _ \Drivers' License or SS #1, I .I Reinspection Fee `0865-46 rev. 7/83 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor 'I '$25 Issue Fee $ 3 $ 3 Lz Automatic ng Unit Dryers UGas LJElkctric Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Disposal ' Generator 1:105 KW 1:15-15 KW 2592 1/17/B4 3.50 TL Accessory Building: - SUMMARY OF FEES Z $ SMIP O N $ PERMIT 1 N $ 6 Q ISSUANCE G $ ENERGY P.C. R E Park. Fees $ GRADING Q U $ MICROFILM I R E $ TOTALFEE N E N :CTRICAL T S FEES Transformer ❑ 15-50 KW ❑ 50+KW - Meter ❑up to 100 amps - Meter ❑over 100 amps, Sub Panel Motors 00-1 HP. ❑l% -B _ Inc.Solar 09-15 HP ❑16-15+ Microwave Pole Light Sign Standing Sections Trash Compactor Reinspection Fee I $25 I Issue Fee PUBLIC SERVICES REQUIREMENTS: Zoning Approved By Application Approved By BUILDING PERMIT PLAN CHECK PLUMBING PLAN CHECK ' ELECTRICAL PLAN CHECK MECHANICAL PLAN CHECK $'3 SUMMARY OF FEES $ SMIP $ $ PERMIT $ 6 Q ISSUANCE $ $ ENERGY P.C. $ ' $ GRADING $ $ MICROFILM $ s'`S� $ TOTALFEE $ CONSTRUCTION AND PLANNING ' APPROVALS Permit # lDZ.161'7DateInspector POG SPA - 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 APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating •71. Product Piping O Gas 00il 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O 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 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 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 48. Special Requirements Completed 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 Py -RM Project Address - Applicant's Mailing d ress tin Owner's Name I Am y1h VPho 55y lQZU Address / Arch/Eng. n �✓ License No. Address Contractor's No MITI y1 Phone Address (mailing) 3x01 / . ' n1Y 01)iGt V2 /10. Iln City License No tli� 3 LICENSED CONTRACTOR DECLARATION ' I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full for a effect. I q License �a s ' LiceeNoe Date Signature WORKERS' COMPENSATION DECLARATION lereby'affirm that I have a certificate of consent to self -Insure or a certificate -Workers' Compensation Insurance, or a-certifietl-copy thereof (Section 4800, Lab. C.) 616NuU Policy No. Company R ified copy itKts hereby furnished. bC Certif, a . filed with the city ing I Ione f Date 'Ib f7i Applicant f'+r `—me — -EXEMPTION FROM WORKERS"COMPENSATIGN DECLARATION. (This section need not be completed if the permit is for one hundred ($100) or less). 1 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 California. Date Signature - - NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Cotle, you- must forthwith comply with Such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING �AGENCV I hereby affirm that there is a constructionlending agency for the performance of the work -for which this permit is issued (Section 3097 Civ. C.) Lender's Name. - Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the and the basis for the alleged exemption. Any violati any applicant for a permit subjects the applica not more than five hundred dollars ($500). , t - wner of the orooerty or-mv employees' with wages license law noes not apply to an owner or a property wno Dusms or Improves thereon, and who does such work himself/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 com- pletion, the owner will have the burden of proving he/she did not build or Im- rove for the purpose of sale). s I, as owner of the property, am exclusively contracting with licensed con. 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 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 exempt under Section B. & P. C. for this reason Date Owner I hereby certify that I have read this application and state that the above information is correct. I agree to -comply -with all city and county ordinances and- .state laws relating to building construction, and hereby authorize repre- sentatives of this city o;enter upo the above-mentioned property for Inspection purposes. I /0's'OR Backflow Preventer Backflow Irrigation I Bathtubs Clarifiers Dishwasher - Drinking Fountains Floor Drains t•. 1 Floor Sinks ' Gas Service Outlets Interceptors Kitchen Sink Lavatories - P—Trap Roof Drains - Reinspection Fee' ,$25 Duct- Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. BIt. ICBG + LVO -100,000 System & Ducting LV 0-100,000 BTU 0100,00013T Signature _ I I Reinspection Fee I '$25 CMF 0865-46 rev. 7/83 White- Building; Canary Pink - Accounting; Goldenrod - Assessor I y$oe/ I .:i/ 7 Accessory Building: Park. Fees Showers ' - Service Sink Sewer Cap ELECTRICAL Sewer Connection ' Automatic Washer Transformer ❑ 15-50 KW Construction Pole Sub. El 50+KW Solar Collectors Garbage Disposal Solar Piping -' - Standing Sections r Cooking -Unit' - Meter- ❑up to 100 amps Solar Tank Dishwasher Meter ❑over 100 amps Swimming Pool w/Spa Trash Compactor 'n Dryers ❑Gas' ❑Electric Sub Panel I Urinal ' S 3 _Fan _ _ Motors 00.1 HP 01%-8 -Water Closet F.A.U. Inc. Solar 09-15 HP 016.15+ Water Heater ) Reinspection Fee FixturesMicrowave Water Service ' _ Device Boxes Pole Light _I Hood or Type I ❑ , Canopy - Type II ❑ , - I Outlets Rance 71 L S N G R E Q U I R E M E N T S , FEES - - - Switches Sign ' ' _ Garbage Disposal Standing Sections - Generator E10-5 KW 05-15 KW Trash Compactor �• Issue Fee S 3 Reinspection Fee $25 Issue Feb. $ 3 IANICAL FEES Hood or Type I ❑ , Canopy - Type II ❑ , - - PUBLIC SERVICES REQUIREMENTS: Zoning Approved By Application Approved By Application Issued By Date Date tefrigeration System )k0-100,000BTU ❑t00,000BTU N BUILDING•PERMIT PLAN CHECK PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK MECHANICAL PLAN CHECK SUMMARYOFFEES $ $ $ $ $ $MICROFILM $r_ $ �: SMIP PERMIT ISSUANCE ENERGY P.C. GRADING = TOTALFEE Sn $ $ $ $ $ $ System Repair/Alteration i n Issue Fee $ 3 I I - ,. CONSTRUCTION AND PLANNING APPROVALS Permit# 11-47PO Date Inspector T POG SPA '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 'S. Steel Reinforcement ' 56. Rough Plumbing & Pressure Test 6.' Electrical UFER Grnd. 57. APPROVALTO COVER-GUNITE 7; Footings - - 58. Electrical.Conduit-Undrgrnd. 8 Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60.- Backwash Lines, P -Trap, ❑ Undrgrnd. 10.,Structural Floor System . - - -61. APPROVAL TO DECK 11. Property Sewer Line & House Connection - 62. Backwash & Receptor -Final 12. Sewer Cap . ,- 63. Heater & 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 i i ` 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT, APPROVALS Permit z#- 20. Rough Factory Fireplace 21. Ducts-, in Structure 21. 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23. Gas Pipe -Rough &'Test - 72. Underground Flush 24' Roof Framing 73. Undergrnd. Storage Tank 0Gas 0OiG 25. Roof Sheathing 74. Overhead Hydro - • 26. T -Bar Ceiling. IStructurall & Monocoat - 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL _ 29. Insulation - 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. •Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 83 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 'I 43. Backflow Irrigation 44. ,Landscape jrrigation System 45. Sound Attenuation ' 46. Handicap Regulations I 47. FINAL STRUCTURE & BUILDING I 48. Special Requirements Completed ' 49. Electric Release to Edison - - 50. Gas Release to Southern California Gas Co u' 51. CERTIFICATE OF OCCUPANCY- No. Date - ' Applicant to fill In all • -City-OF COSTA MESA--- i t PEgMIZ N0� CONSTRUCTION PERMIT. ` G! / Applicant's Mailing Address Project Address w J X t7,y� r Owner's Name 111'."7 ��•L-/F�Phon.,TAA CM_Z Address _S!J•...c _. - - -- -- - - Arch/Eng. License No. Address Contractor's Nam R�4/ZXS riuTb iii. eT.phone4iv '76Z Address (mailing) License No. LICENSED CONTRACTOR DECLARATION 1 hereby, affirm that 1 am licensed under provisions of Charter 9 (commencing withsection 7000) of Division 3 of the Business and Professions Code, and my license Is In full force and effect. ucenze Class LI No _31L VF9' Date Signature `"'ORKERS' COMPENSATION DECLARATION ' reby affirm that.) have a certificate of consent to self -Insure or a certificate Norkers' Compensation Insurance, or a Certified copy thereof (Section .,aoo, Lab. C.) A POIICY No. 4, ACIE t4d BZTompany ❑ Cerlifled copy Is hereby furnished. 'rr� , rj tl'q�pp' 1194 with the AGP Icanty'Bulltll%�/ IL lzi1��.G1%�-C�.s-� Date , O �S 1 F�'Z EXEMPTION FROM WORKERS' COMPENSATION DECLARATION lessjssectlon need not be Completed If the permit Is for one hundred ($100) or 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 California.; Data I I Signature NOTICE: If, after making this declaration, You should become subject to the - Workers" Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTIONLENDING AGENCY I hereby affirm that there Is a. construction lending agency for the performance , of the work for which- this permit Is !Issued :(Section 3097 Clv, C.), Lender's Nama - - ' 'Lender's Address 'l - OWNER BUILDER DECLARATION' " I I hereby affirm that I am exempt from tne•Contractor's License Law for the ' bfl� ucense Law does not apply to an owner of a property wno punas or Improves thereon,and who does such work himself/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 com- pletlon, the owner,will have the burden of proving he/she did not build or Im. rove for the purpose of,sale). I, as owner of the property, am exclusively contracting'wlth'Ilcensed con. tractorsto construct the project(Sectlon,7044, Business and Professions Code: y The Contractor's License Law does not appy to an owner of property who but Ids or Improves thereon, and who contracts for such projects with a con- tractor(s) Ilcense pursuant to the Contractor's License law)., I am exempt under Section B. & P. C. for this reason Date: Owner ' -I.hereby certify that -I have read this application and state that the above---.- nformatlon Is correct. I agree to comply with all city, and county ordinances ; and state laws relating to building construction, and hereby authorize repre- sentatives of 11his: to enter upon the above-mentioned property for Inspection purpos % t ! Slgnatule ' � - I� Da / te �� '3� "g7 Drivers' License or SS 1P 11 CMF 066546 rev. 12/82 White- Building; Canaryi Applicant; Pink - Accounting except those within heavy border lines and sign all appropriate declarations. ' TRACT, NO. LOT NO. - BLD . TYPE OF CONSTRUCTION, 0 NEW ' ADD ALTERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISH '❑ OTHER. - ' DESCRIPTION -OF WORK /�ay>r�+r /1i<?s•' /.rt 2- c .¢E/� - TYPEOFPERMIT GRADING LJ FOUNDATION LJ STRUCTURAL_ ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ' 'BOTHER - Fl/Z,ar PROJECT DESCRIPTION SG. FT. - 'OCCUPANCY— CONSTRUCTION TYPE VALUATION$ ZON$ GRADING CU. YOS. .ACRFc I + 1 -A. P:9I6 /-a 0-73- ZONE PLNG. EF. 9W - BUILDING R- ccTnnry GL 4T BUILDING TOREAR YARD (TO P/U TO LINE ' LEFT SIDE YARD RIGHTSIDE YARD PKG. SPACE RED. PROVIDED - - STREET WIDTH - PARK FEE $ a Bar Sink Sewer Cap ! ELECTRICAL ' Backflow Preventer Sewer Connection' '-'-- - - ' - Automatic Washer - Meter C1 over 100 amps _ Backflow Irrigation Solar Collectors Construction Pole Sub Panel Bathtubs Solar Piping Cooking Unit 'Sub Pole Clarifiers Solar Tank Dishwasher -Motors 1:10-1 HP ❑1%-8 . Dishwasher Swimming Pool W/Spa. Dryers �Ges ❑Electric Inc. Solar ❑9-15 HP ❑i6-15+ • Drinking FountainFan s Urinal ,Microwave Floor Drains' - 1 - ' I Water Closet' F.A.U. - Pole Light 1 :- Floor Sinks � -� -Water Heater, - - - - � Fixtures - � -- - Range 9 - - Gas Service Outlets Water Service - - Device Boxes Sign77 I Interceptors , -- Outlets Standing Sections I ' Kitchen Sink' - _ Switches Trash Compactor I • Lavatories;., -• - _ Garbage Disposal P -Trap' . I rr _ Generator 00.5 KW 05-15 KIN ' RooYDrains - - I I Transformer ❑15-50 KW ❑5U+KW' Reinspection Fee $15 showers,; - - Reinspection Fee $15 Meter ❑up to 100 amps -issue Fee'. '$ 3 • Service Sink _ taus Fele $ 3 Zoning Approved BY Application Approved By Application Issued BY I r 'Date IL Data G r� Date 13 ! - MECHANICAL Boiler Duct - Under Ground - RefrigeratiogSystem - ❑4100,000 BTU ❑100,000 BTU - 'BUILDING PERMIT $ 'PLAN CHECK $ PLUMBING , $" !PLAN CHECK $ ELECTRICAL, $ PLAN CHECK' $' 'MECHANICAL $' PLAN CHECK- I $ I I. SUMMARY OF FEES SMTP •. '� G -- ;:Z " PERMITISSUANCE GRADING '- 1 i ' MICROFILM , TOTAL -FEE' I I 'LESS ADVANCED PC FINAL FEE $ a �� ^� $ $ $ $ $ i ' $ r ' $ ,� Duct -Structural System Repair/Alteration , ' Duct,- Ventilating ', _ , - Exhaust System C1 Multiple❑, `•t + Firepl/Fact. Bit. ICBG# _ I - • 1 Heating System & Ducting - _ - �. Hood or TYPeI Reinspection Fee ,i Cana '. .Type ll ❑: i I x"-$15 , I^.+. ; Registers I `' 1 Issue Fee, - $' 3I ,Idenrod- Assessor 1 _CONSTRUCTION AND PLANNING: '7-POOI •'APPROVALS ` '"I = Inspector+- PA'- yAPPROVALS;: '.Date -• Inspector I � Permit# . [Date ,Peirmt #- u: +' '1; Temporary, Electrical Service or.-Pole .. ' �' '52= Pool &:Equipment Location - - 2: ISoil'Pipe-Undrgrnd.`-' •- - I ;0 f i 1• ♦ J r y`�•--'• i ,53' Steel'ReinforccemenY'•� 3: Electrical ConduitUtility-Undrgrnd w�` _ - ;`. I 'S4`Forms?-�^' Yn v 4. Electrical Conduit-Undrgrnd: __; {55 Eleetrical.Bonding. 5: Steel Reinforcement ;" i t. ; s,. ` ;56: Rough ,Plumbing & Pressure Test I 6.,Electrical LIFER Grnd. - - 57' APP,ROVAL-TO COVER-GUNITE' 7. footings ' 1 .1 o ; F : z cP ��-`. I t58'`. Electrical Conduit=Undrarnd. - - 8. Foundation ; _ _, r q.. 'L59. Gbs Pipe�[;�Undrgrnd., Test. - 9. Water Pipe-Undrgrnd. - - - 1 60. Backwash "Lines, P-Trap, Undrgrnd. 10. Structural Floor System r ? ^ i 'APPIROV t! TO DECK - ,_61. 11. Property" Sewer Line &House Connection - ? 82. Backvvasti &Receptor Final 12. Sewer Cap' i 6 3-" _? 43. Heater&Vent-Final, ' 13. Roof Drains 64. Plumbing_System - Final•' 14. Rough Plumbing 1 ' ! - ` -`- •'65. Electrical-Final c - -95rRou h•Electrical=Conduit-'--- - 9 -' -i'T'766'- T- .i Solar System-Final I` -- - - - 1 I c.Y6. Rough Electric Wiring; .i 1-1 }r ';"-i. 1-'- Tt;-: T 1- 67. Fencing &AccessApp�oval _ I 17 'Rough Wiring.Sign!? j! r'. ' I { ` f 68.' APPROVED FOR,PLASTERING . 118..'Rough:Electrical;T56ar Ceiling;X69 {POOL/SPA SYSTEMS+FINAL 19' Rough Heating &'Air Conditioning I, 1 i 4 FIRE DEPT. REQUIREM APPROVALS; ', Pei mit # 20. Rough Factory Fir eplace1 i i i I 1 21. Ducts, in Structure, i ' { 1 70.E Underground Hydro 22. 'Ducts, Ventilating 171.) Product Piping ❑Gas ❑Oil 23. Gas.Pipe-Rough &Test j} I I d ='. u { I I 1 I I72'i Underground Flush; 24. Roof Framing', j i� I (� C �,1 , �� f -� 1 .-.I. 1 i f 73.1 Undergrnd. Storage Tank O Gas ❑ Oil , 25. Roof Sheathing Overhead Hydr, - �- 26. T-Bar Ceiling(Structural)k, & Monocoat'' I ;! !„' I �i ; Dry Chemical - I •, r I I i75.1 27. Frame and Flashing - i i { '' I, 1 I 1 ' I ! `76.! Dry Standpipe s 28. Lathing &Siding 177.1 FIXED SYSTEM'FINAL . 29. Insulation _ .' 1 I� I ' I 1 1 i I 178.1 FIRE PREV,. FINAL - 30. Drywall Nailing > I Not es:j 1 31. Plaster Brown Coat I, It I 32. Electrical Power MeterLFinal { i; ,, 33. Final Electric C �t-; I 1 1 I Lam..,..I I . . J.- 34. Final Heating &'Air Conditioning 35: Final Gas Pipe-Test • 2! { i - `r ; >? 1 { a - ' - i - - ' •� I'. _ 36. Hood or CaroPY 37. Final Factory Fireplace 38. Final Plumbing!- cl t I I 39. Water Service-Final! 40. Gas Service-Final { I '• i t 11 ' I I i !- I d 41. Solar Domestic-Final 42. Backflow Preventer, „ t I I f T 43. Backflow Irrigations } 1 l ~ r. - ; a f • i '� I 44. Landscape Irrigation System- --�f 1 I 45. SoundAttenuation 46. Handicap' Regulations ,;47. FINAL STRUCTURE & BUILDING ,I I =, j -• t f I I ; j ? i ' r48. Special Requirernents Completed! y � � 1 �, 1 � � ` � �� • , I 49. Electric Release to Edison _I- 50. Gas Release to Southern California Gas Co 51. CERTIFICATEOFOCCUPANCY _f__1- �_'" _T_�;_-• '-: _' +J i, No. Date_L�_ Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITW OFCOSTA MESA - PERMIT NO. TRACT NO. LOT NO.- I CONSTRUCTION PERMIT - - 6 s- '3 : Project Address TYPE OF CONSTRUCTION LJ NE D LJ ALTERATION LJ REPAIR ' Sewer Connection! Duct - Ventilating 1-1 CONVERSION El DEMOLISH 1:1 OTHER' - Certified copy is filed with the,city Building Division. ' Appl icant's Mailing ddress Flrepi/Fact.'Blt. ICBO # - A.P. hon S - owner's Namme�e'�/i�7 DESCRIPTION OF WORK _ $ Main Buildi /� Address; G ��wL� TYPE OF PERMIT GRADING �❑ FOUNDATION STRUCTURAL T Front Afch/Eng. License No.. _ ❑ TENAN-�ECTRICAL ❑ PLUMBING ❑ MECHANICAL B- Rear J ❑ A- . PLAN CHECK Address OTHER C Right - Contractor's Name -- hone PROJECT DESCRIPTION SQ. FT. OCCUPANCY K Swimming Pool w/Spa Addr¢55 lmaihn �� CONSTRUCTION TYPE VALUATION $ $ Left City License No. ,�-�� _ ZONE GRADING CU.YDS. ACRES Ping. Ref. # LICENSED CONTRACTOR DECLARATION Remarks: ! Parking Req./Pit Thereby affirm that I am licensed under provisions of Charter 9 (commencing ; $ with section 7000) of Division 3 of t e Business an Professions Code, and I Use of Building: my license is In f } (or antl effect /� ' Planning Notes: ' License ass' C of se Jvo,`�C rL�, PLUMBING FEES Dat - Signature Bar Sio nk i Showers , WORKERS' COMPENSATIO I LARATION I hereby affirm that I have a&arflflcate of consent to self -insure or a certificate 1- Backflow Preventer ' Service Sink I I of Workers' Compensation ' Insurance, or 'a ' certified, copy thereof (Section'' 3800, Lab. C.) ' i Backflow Irrigation Sewer Cap n Policy No. Company I eCertified copy is hereby furnished. I r I Bathtubs Sewer Connection! Duct - Ventilating Automatic Washer Certified copy is filed with the,city Building Division. ' rise pursuant to the Contractor.'s License Law). Flrepi/Fact.'Blt. ICBO # - rpt under Section B. & P. C. for this reason ' Owner' ' -' Date Applicant ' Clarifiers Solar Collectors c recta I agree to comply with all city and county or inances_ Construction Pole S1 - EXEMPTION FROM WORKERS"COMPENSATION DECLARATION - -r t -- Dishwasher '-' Solar Piping '+- '- - _ -' Cooking Unit (This section need not be completed if the rmit is for one hundred ($100) or rise or, 55 - Reinspection Fee $25 rev. 7/83 White- Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor •- - - . PLAN CHECK less). 1 certify that In the perfprman ce of th w k for which ermit is issued I Drinking Fountains - Solar Tank ' - 71 Dishwasher shall, not employ any person In any a r so•as to orae subject to the Workers'��.pmp sal�gn �ws of C.or a. ) Floor Drains' Swimming Pool w/Spa y Dryers ❑Gas' ❑E Date �'S` i 63 Signature y $ ; NOTICE: If, after making this decl on, you ould become subject to the Floor Sinks ! Urinal_ _ Fan Workers' Compensation provisi f,the Labor Code, you'must forthwith "'- -- comply with such •provision this permit shall be deemed revoked:, Gas Service, Outlets -Water Closet F.A.U. , CONSTRUCTION LENDING 'AGENCY. - - `• I t - ' I hereby affirm that there Is a construction lending agency for the performance of the work for which this permit •is:issued (Sechonw3097 Civ. C.) Lender's Name ' Lender's Address -' OWNER BUILDER DECLARATION -4 I hereby, affirm that I am: exempt from the Contractor's License Law for the a I, as' the � r the LJ I am Date _ I Y applicant for a permit. su Dlects the applicant to a civil more than five hundred dollars ($500). r of the property or my employees with wages as their sole will do the work, and the structure Is not intended or offered on .7044, Business and, Professional Code: The Contractor's oes not apply to an owner of a property who builds or improves vho does such work•himself/herself or ,through his or her own ivided that such improvements are not Intended or offered for BY, the building or improvement Is sold within one year of cum- I mer will have the burden of proving he/she did not build or'im- Interceptors) Kitchen Sink - Lavatories s.: P ,Trap - - Roof Drains! ReinspectionrFee • $25 ) Boiler . purpose of sale). ! I Duct - Structural :r of the property, am exclusively contracting with licensed con- nstruct the project (Section 7044, Business and Professions Code: :or's- License Law does not apply to an owner of property who Duct - Ventilating Exhaust System ❑ Multiple IJ Groves thereon, and who contracts for such projects with a con- I rise pursuant to the Contractor.'s License Law). Flrepi/Fact.'Blt. ICBO # - rpt under Section B. & P. C. for this reason ' Owner' ' -' Heating System & Ducting ti at I have read this application and state that the above. 1 ❑o-100,000BTU ❑100,000BT c recta I agree to comply with all city and county or inances_ - vs lating to builtling construction, and .hereby authorize repre- ss city to' er upon the above-mentionetl r//opert/y fopr ' �p ¢• oses. I Datr/O �G�-CJ J $ rise or, 55 - Reinspection Fee $25 rev. 7/83 White- Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor •- - - Water - - i ' Issue Fee Hood or, Type l ❑ Canopy I Type I I' ❑ Refrigeration System ❑0-100000BTU ❑100,000 System Repair/Alteration , Issue Fee $ 3 ' nEfA 12/16/8' 13.,.^;1 rl Zone Accessory Building: - Z O N 1 N G R E Park:Fees $, Q U I R E Ei N i MIN 1 mom Fixtures Device Boxes Outlets Switches Garbage Disposal Generator ❑0-5 KW ❑5-15 KW TICAL ' 'Transformer ❑ 15-50 KW 1 ❑ 56+ KV i Meter ❑up to 100 amps' Meter Dover 100 amps; Sub Panel I Motors ❑0-1 HP ❑1'h -'B .Inc.Solar ❑9-15 HP ❑1615+ Microwave ,Pole ught Range Standing Sections Trash Compactor ' I Reinspection Fee .I $25 1 Issue Fee' PUBLIC SERVICES REQUIREMENTS: Zoning Approved By Application Approved By FEES I Application Issued By L- —Date/dl!/F/ Y C ' SUMMARY OF FEES ' BUILDINGIPERMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING $ _ 'ISSUANCE $ . PLAN CHECK r $ ENERGY.P.C. $ ELECTRICAL $ D. % GRADING $ PLAN CHECK $ 3.�e d' MICROFILM $ ; - MECHANICAL $ TOTAL FEE $ PLAN CHECK $ �• CONSTRUCTION AND PLANNING 'APPROVALS Permit# E10051 Date Inspector POG_ a SPA 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 Electrical UFER Grnd. - - ' - . 57. APPROVAL:.TO COVER-GUNITE 7.� Footings '' 58. wElectrical Conduit-Undrgrnd. 8.' Foundation 59.. Gas Pipe, O Undrgrnd., Test , 9. Water Pipe-Undrgrnd. / ' - ' 60. Backwash Lines, P -Trap, ❑ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash&, Receptor -Final . 12. Sewer Cap 63.. Heater & Vent -Final ' 13.' Roof Drains -- ' 64. Plumbing System! Final 14., Rough Plumbing ,: 65. Electrical -Final - 15. Rough Electrical -Conduit - - T - -" 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 APPROVALS Permit # 20. Rough Factory Fireplace - 21. Ducts, in Structure - M. Underground Hydro - 22. Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil "23: Gas Pipe -Rough &.Test 72. Underground Flush 24. Roof Framing - 1 73. Undergrnd. Storage Tank ❑Gas ❑Oil 25. Roof Sheathing r 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 / Notes: ! 34. Final Heating & Air Conditioning ., 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace - 38. Final Plumbing i - 39. Water Service -Final i 40. Gas Service -Final I ' 41. Solar. Domestic -Final 42. Backflow Preventer ; 43. Backflow Irrigation 44. ,Landscape Irrigation System 45. Sound Attenuation - 46. Handicap Regulations I - 47.FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Rel ' ease to Edison i- - - - - - ---- - 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- PERMIT O. - - TRACT NO. LOT NO. - CO STRUCTION PERMIT - _Project Address TYPE OF CONSTRUCTION 0 NEW LJJAOO LTERATION LLJ REPAIR Applicant's Mailin Address L, ❑ CONVERSION ❑ DEMOLISH OTHER - A.P. # t Owner's Name Phone - DESCRIPTION OF WORK lerefrom and the basis for the alleged exemption. Any violation of Section S Main Buildi - _ - Address TYPE OF PERMIT GRADING' FOUNDATION El E T Front Clarifiers Solar Collectors ) Arch/Eng. License No. ❑ TENANT ❑ELECTRICAL PLUMBING ❑ MECHANICAL B. $ - Exhaust System 0 Multiple 0 System Repair/Alteration - ❑ - - . Drinking Fountains Solar Tank A Rear _ Address Contractor's Nam II'LUw a BOTHER PROJECT DESCRIPTION SO. PT. - OCCUPANCY K Right y,I `t,& Address(mailing) ��I /1✓,IS /11/6 I CONSTRUCTION TYPE VALUATION$ NOTICE: If, after making this declaration, you should become subject to the,, S Left City License No. Q /SSS �. ' ZONE—GRADING CU. YDS. ACRES PI ng. Ref. # LICENSED CONTRACTOR DECLARATION Remarks: TOTAL FEE Parking Req./Pr( I hereby affirm that I am licensed under provislons of Charter 9 (commencing , $ s Lender's Name, with section 7000) of Division 3 of the Business and Profesiions Code, and - Use of Building: my license is In f II for and effect. d - 2 3a Ucenia. Clas License Ne C PLUMBING FEES Planning Notes: Date Signature %A!hdLo `s WORKERS' COMPENSATION DEC ARATI N • Bar Sink Showers Roof Drains - ;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 Backflow Preventer Service Sink • j the Contractor's License law (Chapter 9 (commencing with Section 70 00'of livision 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 Hereby affirm that I have a certific a of co ent to self -Insure or a certificate .f Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C.) Tl/ }.¢ Policy No. 90'-.50 / to5-/ Company f� 'i 1"� ❑ Certified copyls hereby furnished. `.ry Dateert ed py' iletl with the city �p,1�iltli-ng Di�w 'a Applic the cit�r lit ildin Di r Y\JI ��I � � Backflow Irrigation Sewer Ca p - MECHANICAL ' ' for sale (Section 7044, Business and: Professional Cotler• The Contractor's 'i Bathtubs Sewer Connection Boiler I Hood or Type I ❑ ' Canopy Type II El ' I Duct - Under Ground - License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or thro wgh 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 yearof com- Clarifiers Solar Collectors ) pletion, the owner, will .have the burden of proving he/she did not build or im- prove for the purpose of sale). 0 I, as owner of the property, am exclusively contractingwith licensed con- ' 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., builds or improves thereon,iand who contracts for such projects with a con- tractor(s) license pursuant to'the Contractor's License Law)-. 0 ,I am exempt under Section B. & P. C. for this reason i , ISSUANCE EXEMPTION FROM WORKERS' COM PENSATI N DECLARATION (This section need not be completed If the permit Is for one hundred ($100) or + Dishwasher - - - - - - Solar Piping - $ - Exhaust System 0 Multiple 0 System Repair/Alteration - less). . I I 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, as to become subject to the - Workers' Compensation Laws of California. - - . Drinking Fountains Solar Tank Date Owner $ Floor Drains Swimming Pool w/Spa , I hereby certif that I have read this application and state that the above mfor mati0n is rrecL I agree to "comply with all city antl-county ordinances ,- 'a n' state laws elating to but Id ng construction, and hereby authorize repre. sentatives of is city, to en to upon the above-mentioned ,p opertyyy J, Inspection pur e 1 $ Date Signature Floor Sinks Urinal - ' GRADING NOTICE: If, after making this declaration, you should become subject to the,, Workers' Compensation provisions of the Labor Code, you must forthwith- Gas Service Outlets Water Closet _ MICROFILM comply with such provisions or this permit shall be deemed revoked., CONSTRUCTION LENDING AGENCY - , Interceptors - Water Heater TOTAL FEE I hereby affirm that there is a construction' lending agency for the performance of the work for which. this permit, is issued (Section .3097 Civ. C.)_ Kitchen Sink Water Service - , $ s Lender's Name, Lender's Address OWNER BUILDER DECLARATION. Lavatories . 1 I hereby affirm that I am exempt from the Contractor's License Law for the - 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, _ Roof Drains - ;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 '- the Contractor's License law (Chapter 9 (commencing with Section 70 00'of livision 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 Reinspection Fee Pe $25 Issue Fee 031.5 by any applicant for a permit subjects the applicant tc a civil IInof not more than five 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 - MECHANICAL ' ' for sale (Section 7044, Business and: Professional Cotler• The Contractor's PERMIT Boiler I Hood or Type I ❑ ' Canopy Type II El ' I Duct - Under Ground - License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or thro wgh 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 yearof com- pletion, the owner, will .have the burden of proving he/she did not build or im- prove for the purpose of sale). 0 I, as owner of the property, am exclusively contractingwith licensed con- ' 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., builds or improves thereon,iand who contracts for such projects with a con- tractor(s) license pursuant to'the Contractor's License Law)-. 0 ,I am exempt under Section B. & P. C. for this reason i , ISSUANCE Duct - Structural Refrigeration System l Duct- Ventilating 00-..100,000 BTU ❑100,000 BTU $ - Exhaust System 0 Multiple 0 System Repair/Alteration - Firepl/Fact. Bit. ICBO # Date Owner $ Heating System & Ducting , I hereby certif that I have read this application and state that the above mfor mati0n is rrecL I agree to "comply with all city antl-county ordinances ,- 'a n' state laws elating to but Id ng construction, and hereby authorize repre. sentatives of is city, to en to upon the above-mentioned ,p opertyyy J, Inspection pur e 1 $ ❑0700,000 BTU 0100,000 BT -- - - $ - ' Signature Drivers' Lice 5e Or .CM F.0865-46.rev. 7/83 ---..White Applicant; Pink - Reinspection Fee I $2511 I Issue Fee nrod -Assessor .. . $ 3 $ 3 Automatic Cooking Unit - - Dishwasher Dryers ❑Gas ElElectric Fan F.A.U. Fixtures - Device Boxes ' Outlets Switches Garbage Disposal Generator 065 KW 05-15 KW Zone -Accessory Building:' Park.Fees $. - Transformer 0 15.50 KW El 50.+ KIN ;Meter []up to 100 amps - Meter ❑over 100 amps ,Sub Panel Ii Motors 001 HP 01 %- 8 Inc. Solar,09-15 HP 016-15+ Microwave I Pole Light j Sign Standing Sections Trash Compactor I Z O N I N G R E I R E M E Reinspection Fee $25 .Issue Fee $'3 PUBLIC SER VICES REQUIREMENTS: ', Zoning Approved By Date Application Approved By ' Date. SUMMARY OF FEES - 13UILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING ISSUANCE $ $ —��'�0 PLAN CHECK $ 3 r (9 r/ ENERGY P.C. $ ELECTRICAL $ GRADING I $ PLAN CHECK $ I MICROFILM $ f MECHANICAL $ TOTAL FEE $ PLAN CHECK , $ s WNSTRUCTION AND PLA IN 3.. Date �✓ .APPROVALS 'Permit #` Inspector - POC . SPA •APPROVALS Permit # Date Inspector 1. Temporary E lectri ca I- 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 LIFER Grnd. - 57. APPROVAL TO COVER-GUNITE 7. Footings - 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 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 APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro ,22. Ducts, Ventilating 71. Product Piping E) Gas El Oil 23. Gas Pipe-Rough & Test 72. Underground Flush '• 24. Roof Framing 73. Undergrnd.Storage Tank ❑Gas ❑Oil 25. Roof Sheathing - 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing - 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing ' ' HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric 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 48. Special Requirements Completed . 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 1,ITY OP -COSTA MESA CICAtTRUCTION PERMIT Applicant's Mailing Address 17 s L IN [AM Fw (MN�- 1�15m�7`5�,,, M. Owner's Name 1�CdO1RM ft3u f44&4. PhoneJ�lQsee� Address Arch/Eng. DON gi711TAU10 License No. Address !'1995 Colelwl.e.Aa)�r- 3R,UIM`2.�1_�.��1 Contractor's Nam Phone.T Address lmailinq) City License No. LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class License NO. Date . Signature fORKERS' COMPENSATION DECLARATION hereby affirm that I have a certificate of consent to self -insure ora certificate - of Workers' Compensation Insurance, Or a certified copy thereof (Section 3800, Lab. C.) Policy No. Company Certified copy is hereby turn is heo. Certified copy is filed wiin tt he city Iding I n n� to - A Iian- a • K u' EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit Is for one hundred ($100) or less). . 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 California. Date Signature NOTICE: If, after making this declaration, you should become subject to the Workers'. Compensation provisions of the labor Code, you must forthwith comply with such provisions or .this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I_ I hereby affirm that there Is a construction lending agency for the performance of the work fo^avIsWR Ahis permit is Issued (Section 3097 Civ. C.) Lenders Name .VONT Lender's Address - OWNER - OWNER BUILDER DECLARATION - 1 hereby affirm that I am exempt from the Contractor's License Law for the foil owing reason. (Section 7031.5' Business and Professional Code: Any city or county which requires a permit to construct, alter, Improve, demolish or repair tiny structure, prl or to Its Issuance, also requires the applicant for such permit ' to file a sign ad itatomant that he/she (s licensed pursuant to the provisions of the Contractor's License law (Chapter 9 (comma nU ng with Section 7000) of Division 3 Of the,Business and Professions Cade) Or that It she is exempt therefrom antl the basis for the allogoo o.a mot l on. Any violatl on of Section 7031.5 by any applicant fora permit subjects the .poli-nt to a civil enalty of not rhore than five huno ad dollars ($500). I, as owner of the property or my employees with wages as their sole Compensation. will do ".work and the structure Is not intended or offered for the purpose as owner n1 the U:1 am exempt under Data and or Improvement Is sola wmmn one year or Com- . le burden of proving he/she did not build or im. am exclusively contractingwith licensed con- t (Section 7044, Business and Professions Code: does not apply to an owner of property who to who contracts for such projects with a con- na Contractor's License law). — -r--„B. &,Z. C. for Ahls reason Owner I have read I agree to r to builoinl 7 to -outer property Floor Drains Floor Sinks Gas Service Interceptors Kitchen Sink Lavatories , P -Trap Roof Drains Reinspection Fee SwimmingtPool w/Spa Urinal Water Closet 2 Water Heater •Water Service - 2 ' Issue Fee $ 3 Boiler Hood or Type 1 ❑ Duct - Under Ground Canopy Type 11 ❑ Duct - Structural Refrigeration System 1 Duct - Ventilating ❑0-100,000 BTU 0100,000BTU Exhaust System ❑ Multiple ❑ System Repair/Alteration Firepl/Fact. BIL ICBG# N Heating System & Ducting ❑ 0-100,000 BTU ❑ 100,000 8 Slgnat ure •.twrs' License or SS 11 3° - ata r+ •! c-� veReinspection Fee I $25 I I Isiue Fee Dri� - -CMF 0865-46 rev, 7/83 - White - Building: Canary - APPIi-nt; Pink - Accounting; Goldenrod - Assessor - - - - - $ 3 Dryers LJGas LJElectric Fan F.A.U. - - Fixtures Device Boxes Outlets,. Switches Garbage Disposal Generator 00-5 KW 135.15 K Reinspection Fee PUBLIC SERVICES REQUIREME Zoning Approved By Application Approved By Sub Panel Motors 110-1 HP ❑ 1 X - 8 Inc Solar 09-15 HP 016-15+ Microwave Pole Light Range Sign Standing Sections Trash Compactor $251 Issue Fee 1 $ 3 BUILDING PERMIT $ SUMMARY OF FEES _� SMIP $ PLAN CHECK $ PERMIT PLUMBING $7.00' ISSUANCE $ PLAN CHECK $ . 0. 0 ENERGY P.C. $ ELECTRICAL $ SFO GRADING $ • 'PLAN CHECK $ 77e MICROFILM $ r MECHANICAL $.S - 00 TOTAL FEE $ f"PLAN CHECK $ Ofsp 23•'I: 70 1CONSTRUCTION AND PLANNING ' APPROVALS Permit # �' 4a S3 1 Date Inspector POu_ & SPA APPROVALS Permit # Date Inspector 5 1i.Temporary 5lectrical Service or Pole - 52. Pool & Equipment Location 2. Soil PIpedlncl g?md. r• 53. Steel Reinforcement ' 3.''Electtic'uiti Utility-Undrgrnd. 54. Forms _ - 4.�Electrital•.I�6nduit:ihtdrgrnd. 55. Electrical Bonding - 5.,,Steel',R i,f+em--e ! W.7 56. Rough Plumbing & Pressure Test 6,'�IectricSRUFEll 'G"rnd. 57. APPROVAL TO COVER-GUNITE ' 7.`,•�Footinge', ;; ;�l '� "" 58. Electrical Conduit-Undrgrnd. • B. Poundauon 59. Gas Pipe, 0 Undrgrnd., Test ' 9 :'Water Pipe-Un`Wgrnd'.60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. SNucturaI Floor System 61. APPROVAL TO DECK 11. �roperty Se6ydrl Line & House Connection 62. Backwash &Receptor-Final - 12 SepvQr;Cap l 63. Heater & Vent-Final 13. Rogf•Orains 64. Plumbing System - Final 14. Rough{ Plumbingi j 65. Electrical=Final 15. Rough Electrical-Conduit 66. Solar ystem-Final ' 16. Rough Electric Wiring )a A CC 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 1i8. Rough Electrical-TBar-Cei4ng-.. /y'/ 69. POOUSPASYSTEMS FINAL 19. Rough Heating & Air Conditioning _ 8 FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace `" 21. Ducts, in Structure;..,' �• 70. Underground Hydro 22. Ducts, Ventilating I > 71. Product Piping ❑Gas ❑Oil 23. Gas Pipe-Rough &IFest !.l -7-2. Underground Flush C2A. Roof Framing ,. .. 73. Undergrnd. Storage Tank 0 Gas 0Oil 25. Roof Sheathing 'I' " 74. Overhead Hydro 26. T-Bar Ceiling (Structural) &Monocoat 75. Dry Chemical 27. Frame and Flashing �Z / 76. Dry Standpipe 28. L9thing & Siding 77. FIXED SYSTEM FINAL 29. Insulation } 78. FIRE PREV. FINAL 30: Df.4wall Nailing ' - r% k G HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat, 'i •. 79. FINAL INSPECTION 32. Erectrical Power •Meter-Final. :,8b. FOOD!CERTIFICATE ISSUED , 33. Final Electric,Notes, 34. Final Heating & Air Conditioning - 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. FipAl Plumbing 39. Water Service-Final - 40. G3s'Service-Final - 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation I , 44. Landscape Irrigation System 45. Sound Attenuation 46. HVicap Regulations 47. FINAL STRUCTURE & BUILDING S ' 48. Special Requirements Completed, 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co ' 51. CERTIFICATE QF OCCUPANCY No. Date t \ Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CIYY A,ra. COSTA- MESA PERMIT NO TRACT NO. LOT NO. 'BLDG. NO. .CONSTRUCT09PERMIT ' .11353 1 A-3 TYPE OF CONSTRUCTION ❑ NEW ❑ADD El ALTERATION ❑ REPAIR ❑.CONVERSION ❑DEMOLISH. -, - , 'j•�, '-'6764. 6/26/82 L - -. -- _ )66X0 •- .- _ Project Address 245 Fischer -Avenue. -A-3 Owner .-- -- 1' - ' Phone 55 -62 Address -' -Ave. S. A. - 517 N. Fsirvi - - _ _ : LXOTHER DESCRIPTION 2F WORK _ __ _ 'v - - ZONING REGULATIONS A'p'91' - - 'ZONE PLNTGp. REF_ -f . .. .. Arch/Eng.- - - License No. - -- - , Address - _ _ _ _ _ _ _ - Contractor- - er Ui1C�er- Phone -554-622 ,TYPE OF PERMIT, "--"- '- - " -❑GRADING ❑ FOUNDATION -0 STRUCTURAL- ^(X -TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHANICA - p��- ISET ACK C - pRpBpElg7V LINE'"" SI YARD L1 E YA Address � � - ."'-" ------ -_ --_- 'LICENSED CONTRACTOR -DECLARATION 9 p hereby affirm thut I am licensed under provisions of Charter (com- •. RIGHT mencing-with -section 7000) of ,-Division- 3 -OL the Business antl ❑ OTHER- 'REAR (Professions Code,,'and my license is in full force and effect.,. _ N- •'PROJECT. DESCRIPTIO2292 Waxeh0Use,. YARD (TO P/L) . - Ucense Class lJcense No. SO. FT. _.3nQ� t R00 Office _ PKG. SPACE RED. OVIDED - - --- - Date Sljruiture ' _ - _ _ TYPE - OCCUPANCY CONST-"- - STREET'WtOTHPARK FEE '' $ -- WORKERS' COMPENSATION DECLARATION'- -. I hereby affirm that I have a certificate of consent to self -insure or a - C�+,� 'I n. _0O r' - ZONE -'ZONING APPROVED - BV DATE ' certificate of Workers' COmbensation Insurance, or a certified copy. •'VAL`UATIONSI - - 'eof(Section 3800,Lab. C,). , GRADING CU. YDS. ACRES -SPECIAL CONDITIONS:--' "- --- -- ertified copy is hereby furnished �__...-_-_ _-,� - copy Is filed with the city Builtling Dl vi$lon. ' EECertified EMPTION FROM -WORKERS' COMPENSATIONDECLARATION -' -- - - - - (This.section-need not be completed if the permit Is for one hundred .5100) or less). '--1,:-PL'AN-CHECK -- - - certify that n the performance o the work for which this permit is Issued. I shall not employ any p¢ o in an anner stb:become - - PLUMBING- -1`11 -' ELECTRICAL - - - PLAWCHECK' -- subjgejllo ITQfJcpLs. Compensat n Laws o Caiif ATHTl1Bs -" "' "-SHOWERS' -'-- -- -- - - - _ (Dat- 0 s' )- Signature NOTICE: If after making this declaration, you shout become subject TOILETS-- .-URINALS - - - -* GENERATOR ._ 0-1 KW=1-30 KW - 'to the Workers' Compensation provisions of the labor Code; you must - TRANSFORMER KW_501-KW. 'forthwith comply with such brovisions or this permit shall be'tleemetl LAVATORIES- DOUBLE LAYS- - - ;APPLIANCE -•---_10-50 _ revoked.-_- _ _ ____ .-. _ _4-__.___ _ _ -_ .. �.. _.- KIT. SINKS --- -' --DISHWASHERS-- - -1, - +MOTORS. ,CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the per- Per- SERVICE SINKS SUMPS- _ -- - - J --- ''s� - (IfJC. SOLAR) 10-5O,HP 50 -.HP formance of the work for which this permit is issued (Section 3097 'FLOOR SINKS" "-"-FLOOR DRAINS-- v '-- - ��- FIXTURES. -OUTLETS .SWITCHES. CIv,C.)." - _"-` -^ ------------ - - - 'Lender's NSme- - ' _` :Lender's Address r- ORINKING-FOUNTAINS - - '-'---- �--- ,GAS TUBE SIGNS- - INTERCEPTORS - ""CLARIFIERS - - - - - POLE LIGHTS- 'OWNER BUILDER DECLARATION '- 'I hereby affirm that lyam exempt from.the Contractor's License Law for SWIMMING POOL-' _�PTRAP -- --- - - - cu,qb. HU _ -POLES- METERED- SUB - he following reason,;(Section 7031 -.5 -Business and -Professions Code:- Any.. city., or county which requires'a permit to construct, .alter, WATER SERVICE -1 - -ALTERATION � - -)- 'PANELS � --- MAIN. - - _ ' SUB-' improve, demolish or repaie-any' structure, prior to its Issuance, also re- ;quires the ap, licant for such permit to file a signed statement that he GAS'SERVICE L - -- -OUTLETS--' - - - SERVICE --. -- _ AMP_ Is licensed -pursuant [o the provlsions-of the -Contractor'$ LICenSe-L w- )Chapter 9 (commencing with Section 7000) of Division 3 of the - WATER -HEATERS - BTU OUTPUT -- --- - r - - ---- -- - --- _ - - - __ "ness and Prdessions-Cotle)-Or that he is exempt therefromandthe for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS_ ^I'• ^•---- - -` ` '�•' applicant for a permit subjects -t he-ap pli cant to a civil penalty 'u. not more than five hundred dollars ($500). ' SOLAR TANK-- - -'COLLECTORS` -+ - - - - •- - - - - _ _ _ _ .1-1I, as owner of tho property, -or my employees with wages as'their- sole.compensation, will EO the work, and the structure is not Intended -Professions ! ,or offered for sale. (Section 7044, Business antl Code: The SOLAR'PIPING SYS. ISSUE FEE - - - - -- 3 OO ;Contractor's -.License cense law. tloes .not apply to an owner of a property ,who builds or improves thereon, and who does such work himself or '- - ISSUE FEE- -- - { - - - 1 - + ApPLICATION.APPROVED BY_. '-d.'fJATE�'� - 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 did build improve for the "- - - ' - - - - --- BUILDING -25900 proving he not or purpose'of'sale). I, as -owner-of the Property, am exclusive) cgntractin P y. Y g -with. to 7044, Business HEATING SYSTEM 0-100,000 BTU - AND DUCTING -- - - - -- - - - - PERMIT $ - SMTP E - 16.25-- -` -.50 nsed contractors construct the project (Section Intl' Professions Cotler The-Cent,actor's License Law does not apply to_. It, 100,000+BTU _. PLANCHECK $ PERMIT - _ 'ISSUANCE E' - 16.00- - - an owner of property who builds or Improves thereon, and who con- 'tracts REFRIGERATION 0-100,000 BTU - f �'- f} PLUMBING E from Such projects with a Contractor($)-Iicesned pursuant to the Contractor's License Law). SYSTEM--- C` 100,000'+ BTU - - r : , i GRADING 5 f PLAN CHECK ❑ 15m exempt under Section - B. & P. C; for this- - I'ELECTRICA L-- $ - R- 25 .. $ 'reaso - - - -- - -- BOILERS BTU - - - . - - SYSTEM REPAIR, ALTERATION _ EXHAUST SYSTEM MULTIPLE MICROFM $ . PLAN CHECK $ IL r i TOTAL FEE $ MECHgNICAL $ __ _ �y n ' '' _ - Date S Owne her cert ify that I have read [his application a d state that the above iLESS 'nformation is correct, 1' agreetocomply" with alt city and county- - PLAN CHECK' VAN EPC- $ ordinances antl stat ¢ laws rel ating to construction, and hereby aulh Drize (' - repr¢sentat' s of lis il'G1 to e r up0 a above mentioned -- property I r insp I Of poses �-• q i' O Signature Date �� a ° r. , ` _�, _ FINAL FEE E 66.00 _ Drivers' License or SS qfL CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor TL 0 CONSTRUCTION AND PLANNING APPROVALS Permit q3- Date Inspector POOL & SPA APPROVALS Permit 4# Date Inspector 1. _Temporary Electrical Service or Pole _ - 43. Pool & Equipment Location - - - - 2. Soil Pipe -Un rgrn ." _ 44. Steel Reinforcement - - - - - 3. ElectricabConduit Utility-Undrgrn - 45. Forms -- - 4. Electrical Conduit-Undrgrn - - 46. Electrical Bonding - - -- - 5. Steel em orce - 47. Rough Plumbing & Pressure Test - - 6. Electrical LIFER Grn. _ 48.. APPROVAL TO COVER-GUNITE - - 7. -Footings 49. Electrical Conduit-Undr rn - 8. - Foundation - --- . -- _. _ 50. Gas Pipe,. ❑ Undr rn, Test 9r- Water -Pi pe-Undrgrn - - - - - - 51. Backwash Lines ❑ P -Trap, - ' ridr rn 10. Structural Floor System 52. .APPROVALTO DECK 11-. - Property Sewer- Line &-House. Connection -_ - -_ -53.- Backwash & Receptor -Final 12. Street Sewer Connection- - = -----= . - _ - - - 54. Heater & Vent -Final 13. Rough Plumbing - --- 14. Rough Electric -Conduit -' X56. Electrical -Final --" 15. Rough Electric -Wiring -,Sz 57. Solar System -Final 16. Rough Heating & Air Conditioning 5B. - Fencing & Access Approval 17. Ducts, in Structure, - - - - - APPROVED.FOR PLASTERING'(- 18. 19. 20. Ducts, Ventilating •- - - Gas Pipe -Rough & Test Roof Framing - -- - -- - - - - - - - i• - - -- - - - - 60. - - '' . _ _, _ _ ._ .. POOL/SPA SYSTEMS FINAL . - - •'' - 21. Roof Sheathin 22.Frame and Flashing - -- --- - -'�� • ' ''. NOTES: - 23. Insulation - ; - - - T. yO f 24' Lathing & Siding - - - - -- 25. Drywall Nailing 26. Plaster Brown Coat - - - 27. Electrical Power Meter -Final- - - -' 28. Final,Electric' - - -- - - -�Z• i - - - 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. FINAL STRUCTURE & BUILDING - .'2-. _gt,22 1--'- 39. Special Requirements Completed - I0 - - 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY Date PA Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PER IT NO".� --- TRACT NO. - LOT NO. BLDG. NO: CONSTRUCTION PERMIT O( -3 5502 B/D5/82' 29.37 I Project Address / 1 Z S b� ; TYPE OF CONSTRUCTION ❑ NEW ADD ' ❑ ALTERATION - 1] REPAIR ❑CONVERSION ❑DEMOLISH ❑OTHER' 1 '+ ; ' �' -- - - - - " - ZONING* REGULATIONS Owner hone - I -Address - -- - - '-Arch/Eng. License No. - DESCRIPTIONOF WORK 5 -• q s A.P. _ - -- - ZONE - PLNG. REF. 7P - -- Address - - - _ .. - • ContractorXL .F G Phones _ TVPE,OF PERMIT -' - " ' P GRADING ,- ❑ FOUNDATION ❑STRUCTURAL tA' TENANT ❑ELECTRICAL PLUMBING - SETBACKARD T. _ TTpo ggll�1I�p INC -- XRC PERTY LI NES'. Address i i t" P - LICENSED CONTRACTOR DEC RATION._-- I hereby affirm that I am licensed under provisions of Charter 9 (com- .(]MECHANICA g GHTAKU WIDE moncing-wlth-section .7000) of. Division 3 of the Business- and ❑OTHER - professions Code, 'and my license is in full force and a vett. C- PROJECT DESCRIPTION - REAR YARD (TO P/L) - - ,License l Ligeoseas 1 3 'SO- - PKG. SPACE REQ. PROVIDED 'Date �- Signature _t". '• •' FT. .. - . •-. :. _ _ _ _ _ _ - _ ,STREET WIDTH PARK FEE'S - WORKERS' COMPENSATION DECLARATION _ OCCUPANC V'' CONSTRUCTION TVP_ E I hereby affirm that I have a certificate of consent to self -Insure or a OC VALUATION ZONE- - - - ZONING APPROVED BY - - s_ DATE-- 'certificate•of-Workers'-Compensation Ins�u1r.a1nce,.or a certified copy. ",eof (Section 0 C GRADING CU. YDS. ACRES `SPECIAL CONDITIONS."- cY No.�ComdanY Aerlified copy.1s hereby furnished---- - _ _ - _- _ '� REMARKS: •. "f. �' WCertified copy is,filed with the city Building Division. _ _' _ __ __ _ _ _ __ _ 1 - _ _ _'� __ "'�+ EXEMPTION FROM WORKERS' COMPENSATION "DECLARATION - - -- - (This.seclion . need.not be completed if, the permit is.for one hundred _'__ •' ,. ,'y •,-ql p,' $$100) or less). ,'_ __;_� ., - _ _. _. _-. _ - - .- ____ - - certify thal.ln the of the -work for which this permit Is -performance issued, I shall not employ any person in any manner so as to -become -PLUMBING CHECK "- ' .0UWLLLINU - ELECTRICAL �-'-' -'PLAN ELECTRICAL- CHECK, •- subject -to the Workers Compensation_ Laws of California. - _ __ BATHTUBS - -'" 'SHOWERS- - -' -SO, -FT- - _cQ -- -- - ' Date Signature FT _ ,NOTICE: If after making this declaration, you should become,subject TOILETS- URINAL'S'---' - - - GENERATOR - 0-1 KW_ 1-30'KW--' - to the Workers' Compensation provisions of the Labor Code, you must TRANSFORMER .forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOOBLE LAVS - -- - '-APPLIANCE -- 10-50 KW_50+KW' ' revoked.. .__L__ '__.--.-___ ., CONSTRUCTION LENDING AGENCY KIT. SINKS - —DISHWASHERS - — - -:MOTORB- -0-1 HP 1-10 HP`-' I hereby affirm that there is a construction lending agency for the per. SERVICE SINKS ,SUMPS----- '•' - - - - -�(INC..SOLAR) _-]0-50.HP . 50.+HP' _ _ formance of the work for which this permit is issued (Section 3097 -'FLOOR SINKS - '--FLOOR'DRAINS FIXTURES- -- OUTLETS -SWITCHES -- . Civ. C.). - " -- - -- Name (Lender's _ _ _ _ _ Lentler's Atltlress = - - --f- -DRINKING FCIUNTAINS- -- -- - _ - - - - 'GAS TUBE -SIGNS - -- -- -• _ - _ _ _ OWNER BUILDER DECLARATION - - s" INTERCEPTORS' CLARIFIERS- - -- -' - iPOL-E LIGHTS- '-- -^-•- --- - - - I hereby affirm that I am exempt from the Contractor's License Law for SWIMMING POOL- - P'TRAP^ --- ---- — - --SUBS-'= the following reason (Section 7031.5 -Business and Professions Code: Any city or county which requires a permit for construct, alter, POL'ES-- METERED - - WATER SERVICE -ALTERATION - - (PANELS MAIN -SUB - -•- Improve, demolish or -repair any structure, prior to its issuance, also re- quires the ap, licant for such permit to file a signed statement that he _- GAS SERVICE OUTLETS- -- SERVICE-- ---- --- - AMP'= Is licensed -pursuant -to' the provisions of the Contractor's License taw- (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS --,BTU OUTPUT - - -- - - - - - --- -- ess antl Professmns-Code) or that' is exempt therefrom and -the - Por the alleged exemption. Any violation of Section 7031.5 by F'- 'SEWER CONNECTIONS --;I- - - - - - -- -- --- --- - -- - --- _ _ __ " applicant for a, per mit subjeds-the applicant -to a civil -penalty- ot more than five hundred dollars ($500). SOLAR TANK - '- - COLLECTORS - - - - - --- - -- --- - - - - -- - ❑ I, as owner of-th-e'pr-operty,-or my'employees-with wages as their 'sole.compensatior will do the work, and the structure is not intended 1 - - or offered for sale. (Section 7044, Business and Professions -Coder -The _ SOLARPIPINGSVS. - ' -- _ ISSUE FEE - - - - - - :Contractor's. License Law not apply an owner of a property _ ISSUE FEE "" '" 'APPLICATION APPROVED BY - - :-. -= . DATE -"_--. -does -to ,who builds or improves thereon, and who does -such work himself or through his own employees, -provided that such improvements arc not MECHANICAL PLAN CHECK - "SUMMARY'OF FEES intended or offered for sale. If, however, the building or improvement is sold_wlthin one year of completion, the owner will have the burden - i of proving he did not build or Improve for the purpose ofsale):' -. I, -as owner of -the property, -am exclusively contracting with - - -- HEATING SYSTEM 0-100,000 BTU - - - i BUILDING 'PERMIT S ' SMTP S ,� licensed contractors to construct lne project (Section 7044, Business AND DUCTING --- 100,000,+ BTU - - - • PLAN CHECK S1 - �. PERMIT and Professions Code: The Contractor's License Law does not apply to -a7 - _ ISSUANCE' $ ' an owner of property who builds of Improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING E - tracts -from -such projects with a Contractor(s)-licesnetl_pursuant to SYSTEM-- - - �_ •'' GRADING- '$ .the Contractor's Ucense Law). 100,000 +_ BTU , PIAN CHECK It (] I am exempt under Section - - B. &'P. C:'for this' BAILERS BTU ,ELECTRICAL S - - -' E- - - reason- - - - - - - - -PLAN SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE -`- - _ CHECK -E ! •'- 'MECHANICAL E' •' MICROFILMS' •TOTAL FEE It, " - - - - - - - LESS Date Owner I hereby certifythat I have read this application and state that the above information is correct. --I agree I with all and count 9 comply Y Y- ' 'PLANCHECK $ -VANCE PC E -r - EPC state laws relating to construction, and hereby authorize repres representatives tives bf this city -to enter-upon'the above' mentioned ) property property for i pection p pas _ _ zz QQ Signa[ur Date ISSUE FEE - s - FINAL FEES�`v Drivers� - �•- ' License or 55 CMF 0865-46 white -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor I TL CONSTRUCTION AND PLANNING APPROVALS Permit # Date � _ Inspector POOL & SPA . - - Date Inspet APPROVALS) Permit cor # � ' 1. Temporary Electrical Service-or Pole _ 43. Pool & Equipment Location -- - - 2..Soil Pipe-Undrgrn - _ 44. Steel Reinforcement --- - - - - 3.- - Electrical Conduit Utility-Undrgrn- ,. .'• 45. Forms I i - - (- A...Electrical.Cooduit-Undrgrn.. 46. _Electrical Bonding .- -5. Steel.Reintorce _ 47. Rough P16mbin- & Pressure Test- - - - _ 6. Electrical LIFER.Grn- - 48. APPROVAL TOCOVER-GUNITE - - •- - 7. _Footings _ 49. Electrical Conduit-Undr rn 8. -Foundation - - - --. 50. Gas Pipe, 0 Undr rn; Test ' - -9.-- Water_Pipe-Undrgrn _ _ 51. Backwash Lines P-Trap.-Dndr rn- 10.- Structural Floor System. _. 52.. APPROVAL TO DECK- - -1.1. .Property Sewer -Line .&.House Connection _ 53:- Backwash.&,Rece for-Final 12.- Street Sewer Connection - --- - - - 54.- Heater &-Vent-Final -13.. _ Rough. Plumbing.- _ = - ___ 14. Rough Electric-Conduit - - - -- - - - -'!56.- Electrical-Final - 15. Rough Electric-Wiring - - - ---- - - 57. -Solar System-Final - 16. '"Rough Heating &=Air Conditioning= - - - ---' -. - - - - • - Fencing & Access Approval. '- 17. Ducts, in Structure _ - - - - _ APPROVED FOR PLASTERING 18:-- Ducts, Ventilating • - - - ' _,60. -_ _ _,_ _ POOL/SPA-SYSTEMS FINAL - 19'. Gas Pipe-Rough &'Test_ 20: -Roof Framing- - - - - ------ -- -_ _ _- _ - 21'. Roof Sheathingt ----- - - - - y 22. -Frame and Flashing -NOTES: ' 23. Insulation 24. Lathing & Siding-- 25: Drywall Nailing 26. Plaster Brown Coat- - - 27. Electrical Power Meter-Final - -- - -28. Final Electric - - -•- - - , - - - - -29. Final Heating & Air Conditioning- - -• -- - -� 30: FinaltGas Pipe-Test- 31. Final'Plumbing 32. -Water Service-Final - -- -' -, 33. Gas Service-Final - - - - 34. Solar Domestic-Final' '•'•• `^' _ '`t - `- ' ' 35.'-- Landscape Sprinkling System ' • 36. Sound Attenuation ' 37. Handicap Regulations - - 38. FINAL STRUCTURE&BUILDING _ 39. Special Requirements Completed J 40. Electric Release to Edison - 41. Gas Release to Southern California Gas Co. - 42. CERTIFICATE OF OCCUPANCY No. Date Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PERjIT NO TRACT NO. LOT NO: BLDG. NO. •- - CONSTRUCTION P RMIT TYPE OF CONSTRUCTION W.pDD• ❑ALTERATION - - ❑ REPAIR ❑ CONVERSION. EDEMOLISH ❑OTHER 686L 8/27/82.. 8.00 _ •r - - f - ZONING REGULATIONS Project Address - Owner Phone rAddress - - ArchlEng. - - License No. - - DESCRIPTION OF WORK - -- - - TYPE OF PERMIT ,-' "-- -` _ A.P. _ ZONE � - PLNG: REF: � - - TQ 1 IryG - P"�V I I •Address - `Comnactor ',fivPhon x Address "' _ - -: ❑ GRADING • ❑ FOUNDATION- -❑ STR,U,��C//77U RAL SIO.SETB YARp' ACK C/L T - LINE _- LICENSE CONTRACTOR DECLARATION - I hereby that 1 am licensed Charter 9 O TENANT 0 ELECTRICAL OPL-UMBING�MECHANICA l5 (E Y - - - - - - -- affirm under provisions of (com- -section -7000) - 11 ❑OTHER. RIGHT mencing with of .Division- -3 of -the Business and Professions Cotler a y Il cense Is in full for i ' PROJECT_DESCRIP_TION' IREAfi YARD (TO P/L) License�as � Lir+f�jpsl� I _ _ _ _ _ . - .. _ __ , - PKG.SPACE REQ. - � „PROVIDED. - Date 0 SI9 t JO(r(J _ , SO FT.'S ., _ _ - _ _ STREET WIDTH - PARK FEES r - WORKERS' COMPENSATION DECLARATION 'OC CUPANCV! CONSTRUCTION TYPE ,I hereby affirm that I have a certificate of consent to selMnsure or a VALUATION- ZONE ,ZONING'APPROV ED BY "DATE certificate of Workers' Compensation Insurance, or• a ertifled copy _ -� - - ^ -�' - 1 --roof Sac! b. C.).GRADING-T ( , C Il. YDS. ACRES SPECIAL CONDITIONS: _ '.y'No. 'Company _ • . -_ _ __ -^. _ 1 - _ _ _ _ _ _ _ _ . _ - _ _ _ _ertif ietl copy is hereby_f urnisheG._ _ - - REMARKS: _: _'� 7. r' <f-prtifietl coPY is iiletl with the NtY Building Division. EXEMPTION -FROM WORKERS"COMPENSATION DECLARATIONThis section need not be completed if the Permit is for one hundred $10 0) or less). ... - __ _ .0•.- - �._ _. ____r _. _ _ ___ - _ _ •.__ .__ _ __ _ certify, that in the•performance of the work for which_this permit is PLUMPING- - 'PLAN CHECK' - - -IE LECTR ICAL PLAN CHECK Issued, I shall not employ any person in any manner so as lo•become subject.to the Workers' Compensationaws of California. - ,L BATHTUBS --� - 'SHOWERS' - - -"--- - - .. - "- ,GENERATOR ' - .- t Date Signature NOTICE: If after making this declaration, you should become subject. TOILETS- �; if., .URINALS' -- --'- - - 0-1 KW— 1=10 Kw - 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 L'AVS -' APPLIANCE- 10-50 KW_50 * KW - revoked.: r __ -- i_ - . • - - -- CONSTRUCTION LENDING AGENCY KIT'SINKS - ' DISHWASHERS' — MOTORS- '0.1 HP - - HP 1 1 hereby affirm that there Is a construction lending agency for the Per- SERVICE SINKS - ' SUMPS -^ - - - '(INC. SOLAR) .10.50 HP_-- -50 + Hp- formance of the work for which this permit Is issued (Section 3097 U I - FLOOR SINKS ^ - FLOORDRAINS- 'j'- - FIXTURES -- OUTLETS -SWITCHES' -- - - Civ. C.).-- -- '-'- --"" - - - Lender's Name Lender's Address DRINKING FOUNTAINS-- - "- "t"- -' - :GAS TUBE -SIGNS - OWNER BUILDER -DECLARATION - -' INTERCEPTORS - CLARIFIERS 'j - - 4POLE"LIGHTS'"- �... .. - 1 hereby that I am exempt from the Contractor's law for •SWIMMING'PDDL" - - PTRAP '-' _f --• - - 'POLES METERED - - - - SUB _ the -f Business and Professions Cotler ng reason (Section Lison wing which permit to construct, alter, city or county which requires city WATER SERVICE --" ALTERATION' -` '� -' `{PANELS" -" ' "MAIN SUB IAnymp r signed is Issuance, also re- Improve, en or repair any Structure, y for such permit to a signed statement that no quires the ap, li a ^- - - - - -- GAS SERVICE -OUTLETS � - -- - - - '• - 15ERVICE^" "- --' - - -AMP pursuant the provisions of the Contractors L'icanse is licensed the the ter 9 (commencing wine Suction ]000) of Division 3 of the 9 (commencing V� WATER -HEATERS- BTU OUTPUT -, - - '- -- - - - - - iness and Professions Cotla) or that he is exempt therefrom -and the for the alleged exemption. Any violation of Section 7031.5 by SEWER•CONNECTIONS- 1 applicant for a -permit subjects the applicant to a•civH'penalty ..ot more than five hundred dollars ($500). SOLAR TANK' --COL'LECTORS' - - * "-- - - --'^ �- _ •-- - '- - - '^ ❑ I, as owner of-the-proioeity, or my employees with wa os'as their sloe, will do the work, and the structure Is not inteode: ded The for sale. (Section 7044, Business and Professions ons Cotla: The or offered for or _ _ SOLAR PIPING SVS. �' - _ - _ - I-"'ISSVE FEE'- ntraced License Law does not apply to owner of a property _ _ _ ISSUE FEE _ lI' [APPLICATION APPROVED BY- --- - -' DATE------ ATE•^^ - who builds or Improves thereon, and who does such work himself or .no builds es h his.own employees, provided that such Improvements are net through MECHANICAL PLAN CHECK _ I SUMMARY OF FEES •, 1 Intend howe for sale. If, Mien, t, the building will or Improvement burden Intended within n one on, the owner will nava o burden sold one year o/ ortl vinq build e of proving he tlitl not builtl or improve for the -purpose o/ sale). o HEATING SYSTEM 0-100,000 BTU �' 1 - BUILDING' ' - - - IPERMIT b - - - -- - -- - SMIP b' �en -as- owner of the property, p exclusively contracting -with licensed contractors to construct the project (Section Business -AND 'DUCTING -' - - 100.0001- BTU - -- -- - - (PLAN CHECK $ .• PERMIT not and Professions -Cade: The Conlracsor'sLlcense•Law does esnot apply to - - - ISSUANCE $ an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ - .. tracts Irom•suCh projects with -a contractor(s) licesned pursuant -to Law). -SYSTEM- - {. -• 100,000 + BTUPLAN - —. -, CHECK _GRADING' $ the Contractor's License • ❑' I' am exempt under Section B. d P. C. for this` - - - - ' BOILERS BTO - - I - ELECTRICAL $ $ reason- - -- - - - _ SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE ___ t __ -;PLAN CHECKS - - . 'MECHANICAL- $10 MICROFILM'S' f1 n- - _ TOTAL' 'FEE E ' - - ..LESS AD- Dale Owner I herebycertify that I have read this a y application and state that the above./ information- is correct. I agree to 'comply with all city -and county -PLAN CHECK E'-- - - VANCEPC"S_ " ordinances and state lawsrelaid g to construction, and hereby authorize '�• representatives f- Ison-cit 'enter u/12"pon the above mentioned_ properly for ur a - _ _ Signature Date%%�gZ 3- ( _ FINAL FEE b_ Drivers' License or # - - ISSUE FEE --• - -- - --- - - - _ _ _ _ _ _ _ CMF 0565.46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor tl, CONSTRUCTION AND PLANNING APPROVALS Permit# :-� Date Inspector POOL & SPA - • ' ' ' ` APPROVALS t Permit# - 'Date 1 Inspector _ 1. Temporary Electrical Service or Pole _ - `' 43. PooF & Equipment Location •- - - -• - - -• -- 2. Soil._ipe-Undrgrn - - 44. Steel Reinforcement -- 3. Electrical Conduit Utility-Undrgrn 45:. Forms - - - - - • 4... Electrical,Conduit Undr_grn _ _ 46. .Electrical Bonding 5. Steel em orce _ _ _ 47. Rough Plumbing & Pressure Test - _. 6. •_Electrical UF_E_RGrn _ _ _ _ _ 48. APPROVAL TO COVER-GUNITE' - - ---�• - - ootings• _ _ _ -_ -49. Electrical Conduit-Undr rn� _7. ,. 8. _- _ Foundation50. Gas Pie ❑ Undr rn; Test - ' -_ 9.. Water Pipe.Undrgrn _ 51. -Backwash Lines P-Trap,O ndr rn ..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• 13.. Rough Plumbing. _ _ _ _-_ = -' ystem nal 14. Rough Electric -Conduit - - -- 56. ElgaricaI-Final -- - ' 15. Rough Electric -Wiring -- - - - 57. Solar System-Finab -' 16.- - Rough Heating &'Air Conditioning -- - - encing &Access Approval 17.' Ducts, in Structure _ t__ _' _ ,. � APPROVED FOR PLASTERING ` ' 18! 19. 20. Ducts, Ventilating Gas Pipe -Rough & Test Roof Framing' -21. 60.- POOL/SPA SYSTEMS FINAL - - 22: Roof Sheathing- -Frame and Flashing _ -- _ _ _ - - - - - - NOTES: - 23: - Insulation 24. Lathing &Siding -- -- _ _ --- - 25: DrywallNailing_- r ' 26.- Plaster Brown Coat i 27. Electrical Power Meter -Final 28:- Final Electric - - - - - •' 29. - Final 'Heating & Air Conditioning -- - /t�. pL,j= Z - - - 30. FinalGasPipe-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 & BUI LDING 39. Special Requirements Completed ' 40. Electric. Release to Edison - 41. Gas Release to Southern California Gas Co. ' 42. CERTIFICATE OF OCCUPANCY No Date ` A �I Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. •. CITY OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. BLDG - CONSTRUCTION PERMIT C--- `S :3,33 TYPE OF CONSTRUCTION ❑NEW ❑ADD ElALTERATION ❑ REPAIR '0 CONVERSI ❑DEMOLISH : I Project Address .--[ Owner , Phone Address - s t ZONING REGULATIONS_ 'Arch/Eng. License No. OTHER. DESCRIPTION OF WORK - - - A.P. � ZONE PLNTTG.. REF. Address - Contractor - Phone TYPE OF PERMIT - ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL ❑TENANT ❑ELECTRICAL ❑PLUMBING ❑MECHANICA ING SETBACK C L ST. SIDE YARD - LSEDFE YA pp� PROPLY YNLl NE Address - LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (com- •with 1:1 RIGHT me ruing section 7000) of Dlvision 3 of the Business and Professions Code, antl my license is in full force and effect. OTHER Ga REAR YARD (TO P/L) ._ License Class License No. PROJECT DES�BIPTIGN 1 'S / \`7 �'1 C�'�'� (�r/l.j..._-�7 SQ. FT. S PKG. SPACE REQ. _ IK'KEET WIDTH "" PROVIDED . PARK FEE $ Date - Signature WORKERS' COMPENSATION DECLARATION OCCUPANCV�CDNSTRUCTION TYPEQ� �y ZONING APPROVED BY DATE 1 hereby affirm that I have a certificate of consent to self -insure or a VALUATION ny��vE certificate of Workers' Compensation Insurance, or a certified copy 7�`.' _ thereof (Section 3800, Lab. C.). GRADING C I Y 5. ACRES SPECIAL CONDITIONS - icy No. 'Company - - Lertifled copy is hereby furnished. REMARKS: - LJ 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 onehundred S$100� or less). " cert fy that In. the performance of the work for which this permit is issued, I shall not employ any person in any an er so as to become PLUMBING PLAN CHECK ELECTRICAL "' PLAN CHECK . Pie [he ke mpensatt s f f a.DWELLING BATHTUBS SHOWERS TOILETS URINALS - GENERATOR 0-1 KW_ 1-30 KW ' Date Signature NOTICE: If ftar making this declaration, you shoultl become 5 ed [o the Workers' Corepensatlon provlslons Of the Labor Cotle, you must• forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE'LAVS TRANSFORMER 'APPLIANCE 10-50 KW ' 50+KW revoked. CONSTRUCTION LENDING AGENCY KIT. SINKSDISHWASHERS - MOTORS - 0-1 HP 1-10 HP - I hereby affirm that there Is a construction lending agency for the per. SERVICE SINKS' ', SUMPS - - (INC. SO LAR). ._g0-50 HP=- 50 +-HP - - - formance of the work for which this permit is issued (Section 3097 FLOOR SINKS FLOOR DRAINS FIXTURES' -OUTLETS SWITCHES - '- Civ. C.). ' - - ' - - - - Lender's Name _ _ _ _ Lender's Address -DRINKING FOUNTAINS - -' -- '- GAS TUBE SIGNS-• _ 'INTERCEPTORS CLARIFIERS POLE LIGHTS - -"-'-• - -- - OWNER BUILDER' DECLARATION- 1 hereby affirm that I am exempt from the Contractor's License Law for -SWIMMING POOL P TRAP - '• POLES METERED SUB the following -reason-(Section 7031-.5 Business -and Professions Code:- Any city or county which requires a permit to construct, alter, WATER SERVICE ALTERATION -- PANELS' MAIN' ---' - - -' SUB' - _ - I mprove(tlemolish or repair any structure, prior to its issuance, also re-- quires the applicant for such permit to file a Signed statement that he GAS SERVICE' - OUTLET$ - : ' SERVICE -- - - --- -AMP - is licensed Pursuant -to the provisions of the Contractor's License Law- (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS' - BTU OUTPUT' --" '- - -'- — - •-- - - Rust ness and Professions -Code) or that he is exempt therefrom and the 4 for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS- applicant -for a -permit subjects the -applicant -to a civil -penalty- .lol more than rive hundred dollars ($500). SOLAR TANK " - '-- COLLECTORS' as owner of the "property; or my employees With wages as their ole: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 License..Uw does not apply to an owner of a property, - ISSUE FEE APPLICATION APPROVED BY - -- - DATE- - - .Contractor's who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not MECHANICAL PLAN CHECK _ SUMMARY.OF,FEES intended or offered for sale. If, however, the building or Improvement Is sold.within one year of completion, the owner will have the burden of proving he did not build or improve for the purpose of sale). - - HEATING SYSTEM 0-100,000 BTU BUILDING --- - - - ^ -- PERMIT $ ., - -- - -- - -- - $MIP' 1, as- owner of- the property,-am.exclusively -contracting with ^ - AND'DUCTING'- - - licensed contractors to construct the project (Section 7044, Business 100,(;00+BTU PLAN CHECK $ PERMIT and-ProfessionscaneropCode:-The Contractor's License Law does not apply to - -. .ISSUANCE-- E or tractor( thereon, and who Con- owner Ot property who improves a REFRIGERATION 0-100,000 BTU PLUMBING $ ,� . � - with a tracts from such projects with a contractor(s) licesnetl pursuant to.. tracts 'SYSTEM - -1 - - - -- -- - - -- -•- �-- .. :.G RADING'..'$' ' the Contractor's License Law). 0 100,000 + BTU P PLAN CHECK.)$ - , ❑ I am exempt untler Section " B:& P. C. for this - BOILERS BTU ELECTRICAL_ $ • �� - '- -' $ reason - _.. _ - SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE - - PLANCHECK$ MECHANICAL .' _ MICROFILM$ _ TOTAL FEE'$ ' _ LE$$ AD- -• LESS / Da ) d.. l I hertby certify that l have read this application and.state ti t the above information is correct. 1 -agree to comply with all city and county „ PLAN CHECK $ - 'VANCEPC-$ ordinances and state laws relating to construction, and hereby authorize Y•f representatives of this citytoenter: 'upon the above mentioned property p ct ur ;es. $ ® 0 Siqnal ure ! Date •ISSUE FEE - - - - - -- •- - - - - - - - FINAL FEE $ - - -- .. - , . Drivers' License or ! #, - CMF 0865.46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit 4A Date InspedtoY .POOL &SPA -'. - - -_ �_ • - APPROVALS Permit#• -Date, _ -Inspector _ 1. Temporary Electrical Service or Pole _ 43. Pool-& Equipment'Location - - - - - 2.. SoilPipe-Undrgrn 44. Steel Reinforcement - -3.- Electrical Conduit Utility-Undrgrn 45. ' Forms - - - 4. Electrical Conduit-Undrgrn, , 46. ' Electrical Bonding - 5. Steel Reinforce,47. Rough Plumbing&'Pressure Test - ._ _ .6.- --Electrical UFER.Grn_ _ - -.-. - 48. APPROVALTO COVER-GUNITE - - - 7.- Footings _ _ _ - _ 49. Electrical Conduit-Undr rn --8. Foundation 50. Gas Pipe, ❑Undr rn, Test _"9.. Water Pipe-Undrgrn. _ 51. Backwash Lines P -Trap,❑ Undrqrn 10. Structural Floor System- 52, APPROVAL TO DECK 11. Property Sewer Line & House Connection. j, _ -53.: Backwash & Receptor -Final - _ 12. _Street Sewer Connection _ '_' _- 54. Heater & Vent -Final 13. Rough Plumbing _ - - - - " - - 14. Rough Electric -Conduit - - - 56: 'Electrical -Final 15. Rough Electric -Wiring - - 57. Solar System -Final 16. Rough Heating &-Air Conditioning 158.- Fencing & Access Approval - 17. Ducts in Structure, 59. APPROVED -FOR PLASTERING - 18. - Ducts; Ventilating 60. POOL/SPA'SYSTEMS FINAL, I- 19. Gas Pipe -Rough &Test 20. -Roof Framing 21. Roof Sheathing-- - -+- - - - - - - ' NOTES: 22: Frame and Flashing 23. -Insulation --- •- - ---- - -' 24: Lathing & Siding - 25. Drywall Nailing 26. Plaster Brown Coat - - 27.- Electrical Power Meter -Final - ANZ,- - 26:= =Final Electric - - - - - - 29. - Final Heating & Air Conditioning - - - - - - 30.- Final Gas Pipe -Test _ -31-..- Final Plumbing- Water Service -Final 33.. Gas Service -Final 34. Solar Domestic -Final J•• - ' 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap.Regulations - - - 38. FINAL STRUCTURE&.BUILDING' -- 39. Special Requirements Completed - - - 40. Electric Release to Edison - - - - - - - - 41. Gas Release to Southern California Gas -Col I' 42. CERTIFICATE OF OCCUPANCY ' ' No Date - - - City of Costa Mesa Development Services Department Building OF OCCUPANCY No. ('r' ` r Building Safety Division v �% J U P. O. Box 1200 Costa Mesa, California The Building located at nAr t,,vr o r}1tim.ntw rnrrm 6r_1 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a GroupT_O ccupancy. Use of Building ..NVXG2 Legal Description An7 nl� An (See reverse side for Metes and Bounds) Building Permit No r_1700n Electrical Permit No.r_77ROA Plumbing Permit No.17-17RQA Mechanical Permit No. r-,1 7894 Number of apartments {Y� and//or guest rooms ISSUED TO: Building Official >U, PULIJ M PROPERTIESr by 245 FMHM 6`C4, OOS'PA NtESA, CA. Date /, 0zX_1 /9�5 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 City of Costa Mesa! Building Safety Departments, , P.O. Box 1200 Costa Mesa, California CERTIFICATE OF OCCUPANCY 3390 1: The Building located at 245 Fischer Avenue. unit 4A-4 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto il for a Group n_9 Occupancy. n Use of Building Tn♦•or; nr Dli-nra4innc Legal Description d,)7—n34—n7 (See reverse side for.Metes and Bounds) ��/,r[y .. ` i/x� l X41 O Building Permit No.—LW--P--4369 Electrical Permit No. $II.' -4369 Plumbing Permit No. H-4309 Number of apartments; —0— and/or guest rooms —0— ISSUED TO: Building Official ` V. C.fl�ewt�n_Euidding Division Qirector DateThisCertificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT.BE removed except by the. Building Official of the City of Costa Mesa under Sec. 306 (e) U.B.C. -- Form BU 34 Rev. 11no Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. • CI_ F �OSTA'M ESA O. N TRACT NO. - "LOT NO. BL G. NO - 6099 8/I6/82 10.00 CO STRUCTION PERMIT [PERMIT�� oZ TYPE OF CONSTRUCTION ZD NEW ❑ ADD" ❑ ALTERATION ❑ REPAIR 'CONVERSION ❑DEMOLISH _ ❑OTHER. - r - ZONING REGULATIONS .- Project Address a Owner Phon¢ Address lS ArchlEng. License No. -- DESCRIPTION OF WORK - - _ A.P. - .ZONE PLNG.,REF. 11 Address - - - .Contractor Phone - - ' - TYPE OF PERMIT' - -- �. - - '0 - -BUILDINGTToogg SETBACK S . 1``ppING - PROPRTY-LINE' : - -- _ ;Address _ GRADING. ',� FOUNDAT,IyOfN- ❑STRUCTURAL Q TENANT Q ELECTRICAL WPLUMBING 0MECHANICA - IO YARD- - - - ,- �LICENSED CONTRACTOR DECLARATION- -- I hereby affirm that I am licensed under provisions of Charter 9 (com- r [• r- WOE-YARD 1 RIIGHT mencing with section -7000) of Division -3 of the Business and Q OTHER- - Professions Code, and my license Is In full force and effect. REAR YARD (TO P/L) PROJECT DESCRIPTION. - - License Class License No. - -' _ SQ'�'•- _ - i PKG.-SPACE REQ. - STREET WIDTH - - - PROVIDEDdate " --- PARK FEE E - Signature '- `' l - WORKERS'COMP ENI DECLARATION OCC UPq NCV_CO NSTRUCTION TYPE have a 'I hereby affirm that I have a certificate of ancient scertified ora VALUATION ZONE ZONING APPROVED BY s - DATE ' - Of Workers' Compensation - Insuranta, or -a certified copy thereof _ _ thereof (Section 3800, Lab. C.). . (S .G RADING.CU. YDS. _r ACRES ,SPECIAL CONDITIONS: _ C '.Y No. - - Company'- - _ __ ,..1 _ __ -_ i _ _ _ -. ._ _ hereby .. __. ertified copy REMARKS:' -_ _3. is filed cit. v Certified copy Is filetl with the city Building Division. the EXEMPTION FROM -WORKERS' COMPENSATION DECLARATION - - - -" - -,C, --'- -• •-- -'-- --- ----- - -- - (This.seetion need not be completed if the permit is for_one hundred I '� 1.', •'t ($100) or less). ( .,.� i •-l1, __-, ,. _ __ _ _ - _ ..__ _ _ .. _ _ - _ _ _ _____ I certify.that in the performance ofthework for which this permit Is _ Issuetl, I shall not employ any person in any manner so as•to-become' ' PLUMBING - �- ^;, PLAN CHECK- - .. s . - i -""- 'ELECTRICAL - -- - - PCAN'CHECK- - '" - subject to.the Workers' Compensation Laws oLCalif ornia.`� __ - ___ _ _ _ _ _- BATHTUBS - SHOWERSUWLLLINU _y� _ - FT ' Date Signature s ,NOTICE: If after making this declaration, you should become subject TOILETS: I „{URINALS'- GENERATOR-- -0-1 KW_ 1-1O;KW - - - to the Workers' Compensation provisions of the Labor Code, you must - TRANSFORMER forthwith comply with Such provisions or this permit shall be deemed LAVATORIES DOUBL' V j'" -- - - 'APPLIANCE 10-50 KW_50+KW- - -- - .. '. revoked._ _. _.___. ' -- - AGENCY -' LENDING KIT:SINKS'_ - -' --' ISHW S S'-"'- j - '-' 'IMOTORS - -- '0-1-HP__1'-10HP'CONSTRUCTION Thereby affirm that there ISachnstrutler lending agency for the per- SERVICE SINKS .(�. S --'- - -- -�(INO. SOLAR)_ 10-50-HPy 50+HPC - - formance of the work for which this permit is Issued (Section 3097 Civ:'C.).'- "^`-' •'---'-"'-' -- - --' - - '- 'Lender's Name FLOOR SINKS __ - OR'DRAINS-`- - -'- - 'I FIXTURES -'-OUTLETS -SWITCHES! - - - Lender's Atltlress DRINKIN OU T ",GAS TUBE SIGNS- OWNER BUILDER -DECLARATION INTE RC T C RIFIERS --- - �POCE'L'IGHTS - -- '—' - - - ---- -- I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section --7031-.5 BusinessandProfessions Cotler -SWIMMIN O "--' P'T RAP" "^^'-' ;--' ' •--- "POLES METERED - � Su6 Any city or county which requires a permit to construct, alter, improve -demolish or-repair'anystructure; prior to its -issuance, also re- -WATER-S VICE--'AL-TERATION""- "� PANELS' "MAIN - 'SUB -- -- - - quires the api-licant for Such permit tD file a Signed statement that he GAS SERVICE— •- OVTLETS }SERVICE" -'•-'- •'- -' ----AMP( •- is-licensed-pursuant'to the provisions of -the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the - WATER HEATERS - `BTU OUTPUT'- - - '- --' -' -- - - - - Business and Professions Code) - or -that he is exempt therefrom and the for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS-" 1 ' applicantfor. a permit subjects the applicant to a-clvll penalty' .n more than five hundred dollars ($500). SOLAR TANK" "-' COLLECTORS `- - - ' - - -""-' - - •- -- -- - - - - - - - - LJ I, as owner of -the -properly, or my employees witai wages'as their sole compensation, will d0 the work, and the structure is not intended ,^ r, or offered for sale. (Section 7044, Business and Professions Code: The _ SOLAR PIPING SYS. -"ISSUE FEE' - -- -' -' - - - - Contractods License .Law dDeS.not-apply to an.owner of a property_ who builds or improves thereon, and who does such work himself or ISSUE FEE L - - -- jAPPLICATION•APPROVED BY •- -- - - - DATE - - through his own employees, provided that such improvements are not MECHANICAL PLAN CHECK I _ 1 SUMMARY OF FEES, - intended -or offered for sale. If, however, the building or improvement is.sold the have the burden within one year of_completinn, Owner will Of roving he tlitl not build or improve for the purpose -of sale). - HEATING SYSTEM 0_100,000 BTU_ -j BUILDING---^- - - - -- - - - I, -as owner of the property, am ezcl usivel g- - P 0 y, -contracting- with - AND DUCTING-' s__ _ -- PERMIT $ -- - - - SMIP•. L $ - - sed contractors to construct the project (Section 7044, Business 100,000 4 BTU a jPLAN CHECK E , PERMIT. 11 and Professions Code: -The Contractor's License Law does not apply to an owner who builds or Improves thereon, and who con- REFRIGERATION 0400,000 - I—— - _ i D - - ISSUANCE{ E - - of property tracts -from such with-a-contractor(S)-licesned pursuanbto, BTU - I fp Y- C { PLUMBING E ( , t = GRADING'''E '• the Contractor's License Law). SYSTEM- - - --- -'-- I-= 100,000+ BTU n c •. - -- _ PLAN CHECK 'E'• ^� o •. Oc 011 -am exerilPf under Section --_"- '- - 'B.8-PfC'lor this BOILERS BTU - - - ECTRICALS -` .. EL--, - $ s ' reason - - --- - - SYSTEM REPAI R, ALTERATION - �PL'AN CHECK-'$ I- r' ,MECHANICAL .E - MICROFILM'S _ I ' 1 _ TOTAL FEE Date Owner I hereby certify that Icorre have read this application and state that the above EXHAUST SYSTEM MULTIPLE c information is correct. 1 to comply with al and county 'QPL•AN CHECK -$ VANCED- VANCE PC- farce and state laws relating to construction, and hereby authorize her ordinancesrepresent t represent ives'of lh'- city to enter On the above mentioned •' - - proPerlY o P tai Po h /0� Si9nat ure D •-ISSUE FEE- - FINAL FEE E Drivers' License or SS4 - CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor TL r' CONSTRUCTION AND PLANNING,POOL APPROVALS Permit 4b Date Inspector & SPA • - ' APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - - - 2. SoilPipe-Undrgrn - 44. Steel Reinforcement - - - 3. Electrical Conduit Utility:Undrgrn 45.. Forms 4. Electrical.Conduit:Undrgrn _ 46. Electrical Bonding Y -- - - -- -- - -5. Steel ein orce _ _ 47. Rougfi Plumbing & Pressure Test 6. Electrical UFER Grn _ _ _ - - 48. APPROVALTO COVER-GUNITE - - 7. Footings _ _ - 49. Electrical Conduit-Undr rn - 8. _ Foundation__ ' 50. -Gas Pipe, ❑Undr rn; Test ' 9... Water_Pipe-Undrgrn -.- 51. Backwash Lines P -Trap.❑ ' ndr rn- - 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 13.. Rough,Plumbing _ _-55, Plumbina System - Final 14. Rough Electric -Conduit - •---- 56r Electrical -Final - 15. Rough Electric -W ring - - - - - - - - - 57. Solar System -Final - 16. ,° RoughHeating& Air Conditioning = _ -- - - - - •- encing & Access Approval 17. Ducts in Structure+ _ - _ - APPROVED FOR PLASTERING • 18. 19. -20. Ducts, Ventilating _. .. -. Gas Pipe -Rough & Test Roof Framing - - 60. " -- - __ _ - POOL/SPA.SYSTEMS FINAL 21! - 22. Roof-SWathin -"- Frame and Flashing •:>;. ori. - NOTES: - 23. Insulation- -24. Lathing & Siding- - - •� - -- - _ - - 25. Drywall Nailing "- _ - 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric - - - 29. Final Heating & Air Conditioning- 30. Final Gas Pipe -Test 31. FinaFPlumbing -3D -9X 32. Water Service -Final - -- - ' 33.. -Gas Service -Final-- 34. Solar Domestic -Final - -• 35. Landscape Sprinkling System 36. Sound Attenuation - - - • - 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING P 39. Special Requirements Completed - - 40. Electric Release to Edison - - 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. II.00 TL CITY 'OF COSTA MESA FPE5 IT NO. TRACT NO. LOT NO. BLDG. 00i. u/ .!Z UC CONSTRUCTION PERMIT - S I, I TV E OFTRUCTION W O ❑ ALTERATION ❑ REPAIR.❑ CONVERSION' ❑DEMO ❑ OTHER i , ZONING REGULATIONS Project Address • Owner Phopa Addrea A -Arch/Eng. - License No. DESCRIPTION . OF' WORK• _ - 1 TYPE OF PERMIT ', - ':� - "- f ❑.GRADING ❑ FOUNDATION '--❑ ST R,U�C[7URAL - A'P: 9F ZONE SETBACK5 I YARD ' PLNG. REF. 5F s XROBPI?v LINE- . Address - - - - r - - - - _ Conlraclo - 'Phtin Addrms - j' - - LICENSED CONTRACTOR DECLARATION - 1 hereby that I am licensed under of Charter 9 ❑ TENANT ❑ ELECTRICAL ❑PLUMBING i�MiCHANICA SIpE y . affirm provisions (com. man cing with - section- 7000) of Division 3 of the Business antl--❑ �• OTHER RIGHT - Professions COfleyC y license is In is In full for p� 1/ylL, (C...��1��22jj -I PROJECTDESCRIPTION _ REAR YARD (TO P/L) Llcen�a ss License Nof�7YG— .. "- '- PKG. SPACE REG. PROVIDED-• - -' �. - -SQ_'FT. . Signature* Date - _ - OC CUPANCV_ CONSTRUCTION TYPE - - - - - (- STREET WIDTH - - PARK FEE "$ WORKERS' COMPENSATION DECLARATION _ 1 hereby affirm that 1 have a certificate of consent to self -Insure or, a 1 VALV ATION ZONE - -- iZONING APPROVED BY -" - - OP•TE - -- .•. certificate of Workers, Compensation I surance, or a-certifled copy - -- of (Se I�i Lab . C.). I GRADING CU.,YDS. 1' ACRES SPECIA I: CONDITIONS: -' ---- IS, A ertified copy.is hereby furnished. _ _REMARKS: _ _ _ - J .. led copy is filed with the city Building Division. _ - _ _ _ _ - - - -' %EMPTION 'FROM WORKERS' COMPENSATION -DECLARATION' ,- - - - - - - - .. (This section need -not be completed if the permit „is for one hundred($100) _ -7- '�n' J •i or less .- _ _ certifyPerformance work for which this permit (_certify that n the'ployany PLUMBING..--,. PLAN CHECK' -' - j•- _ 'ELECTRICAL -. - -' PLA NCH ECK'' - - -- n I Issued, 1 shall not employ any person in any 50 as Co become person a Workers California.manner subject to the Workers Compen5atlon Laws of C - - _ _ BATHTUBS SHOWERS` -'-'- -i - UWLLLING-'UARAUI� - - II Dale Signature ' NOTICE: I1 after making this declaration. you should become -subject •�TOI LETS I, , . VRINALS"- -' -'-}- -GENERATOR 0.1 KW_1=10'KW 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 10-50 KW --50 + KW - - - revoked. _ ' KIT. SINKS '" '- DISHWASHERS - -- MOTORS- 0.1 HP_1.10'HP --- -- CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the Per - SERVICE SINKS . SUMPS- '-- - -(INC.. SOLAR) 10.50 HP 50.+.HP -formance Of the work for which this permit is Issued (Section 3097 SINKS - - FLOOR DRAINS --- - FIXTURES ' - OUTLETS SWITCHES-' Civ. CJ. 'e,FLOOR en Lena a{ssNa me - _ _ Lentler't Address x "DRINKING'FOUNTAINS• - "- - -- - -' - - GAS TUBE SIGNS- - - - - - - -- --- OWNER'BUILDER DECLARATIONIN'p 1 hereby affirm that 1 amexempt from the Contractor's License Law'for -- ERCEPTO RS CLARIFIERS POLE LIGHTS - -- -- - -- - - the following reason (Section -7031.5 Business and -Professions Coca: ➢SWIMMING'POOL �--'P TRAP ^' - •POLES - - - --- - _ 'METERED -SUB An ,cit or courtly which requires a construct, alter, Y Y 0 Y permito 'WgTER'SERVICE -' ALTERATION - .PANEL'S - - - - MAIN --- SOB - - - or repair any It also a structure, -priorspe (state quiresImprove, thedemolish mit enc dulret the ap, locant for such permit to file a Contra statement that he GAS SERVICE- -- OUTLETS - --' ai'- - - SERVICE- - - - -- AMP - - - -- IC9aiter pursuant to o1 the ct icen Se•La ng with 0) of a 9 (commencing with Section ]000) of Dlerefr 3 of the �Cha Secs Division WATER HEATERS-' 'BTU OVTPUTi - • �� - - - -- --- - - - -- -- - - 'loess and' alleged ons Code) exempt- m and the ess S ction exemption. Any ve taboo Oi Section 7031.5 by m ion. Any vie a ion for the afar SEW ER'CONNECTIONS• -• •----• - - v- -- -- - - - - - -= - ---- --- a applicant fi permit subjects the applicant to•a civil penalty not more than five hundred dollars ($500). SOLAR TANK • �' - COLLECTORS 0'1, -as oviner o/ the -property, or my employees ' with'wagei as their ' sole. compensation„will do the work. and the Structure Is not intended 1. - or offered for Sale. (Section 7044, Business and Professions Code -The SOLAR PIPING SVS:- - -' --'- ”' ' "' -' -' -' - ISSUE FEE' - - Contractor's License..Law does -not apply to an owner of a property ISSUE FEE •- II - --"" - - - - - APPLICATION APPROVED BY - - �'..OATE - who builds or improves thereon, and who does Such work himself 'or through his own employees. Provided that such Improvements are not _ MECHANICAL PLAN CHECK - - SUMMA RV OF FEES Intended or offered for sale. If, however, the building -or improvement Is sold within one year Of completion, the owner will have the burden of proving h0 tlitl not -build or Improve for the purpose -df 'Sale). - - HEATING SYSTEM byp05G6f}BTU - - BUILDING ❑•I, -a5 owner - of the property, am exclusively contracting with- __ _ .-. _ PERMIT - _ _ E - SMIP,L- licensed contractors to construct the project (Section ]044, Business ]OO,000Ys BTU PLAN CHECK E PERMIT and Professions -Code: The Contractor's License Law does.net apply to - _ ..- ISSUANCE I_b (' an owner of property who builds or Improves thereon, and who con- REFRIG A ON 0-100,000 BTU PLV MBING E I tracts -from suchhicen-projects with.-a-contrador(s) Iicesnetl. pursuant to SYSTEM -- - - -_ _ _ is S the Contractor's License Law). 100,000 BTLI_ � PLAN CHECK- __ _GRADING ❑ I am exempt under Section ' - B: 6 P: C for this BOILERS BTU , EL-ECTRICAL E - reason - -- -. SYSTEM REPAIR, ALT ERATI ON -. EXHAUST SYSTEM MULTIPLE - PLAN CHECK E E _ MICROFILM E -- - 'I TOTAL FEE $- . - - - - - -- LESS AC - Date. Owner I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all city and county .PLAN CHECK $- - _ $- ordinances nces and state laws reeling to construction, and hereby authorize Zhjs 't0¢nterupon I - - repres repres¢ntatives yyJj /� I the dbOve mentlOn¢aSignatrure/or•d)(ajigQ�/on pDale ' 'I I-IECIANICAL /'(O 6 'I ISSUE FEE FINAL FEE $/-(O6 FINAL FEE $ /;C.SeSe oorr SSSS - -- CMF 0865-46 White-BUilaing; Canary -Applicant; Pink -Accounting; GOidenrod-ASSaSSor 1 I I 1 1 I CONSTRUCTION AND PLANNING Date Inspector APPROVALS Permit # �- POOL & SPA ' +- C. - Date Inspector APPROVALS ' - Permit '+. 1. Temporary Electrical Service or Pole _ 43. Pool &Equipment Location - - - - - - - SoilPipe-Un rgrn -• ' _ _ 44. Steel Reinforcement - einforcement-3.. 3. .Electrical Conduit Utility- ndrgrn 45. Forms r - - 4 -Electrical Conduit-Undrgrn 46. Electrical Bonding - --- -- - - - - -5. Steelem orce 47. Rough Plumbing & Pressure Test 6. -. Electrical UFERGrn•. y - 48. APPROVAL TO COVER-GUNITE' - - - -- -• - _ •-- 7. Footings _ 49. Electrical Conduit-Undr rn r B. Foundation 50. Gas Pipe, ❑ Undr rn, Test •. 9.- Water Pipe-Undrgrn 51. Backwash Lines P-Tra ' ❑ Undrcirn - - - - _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 13.. Rough.Plumbing. _ _ - - - -' -' - -- - 14. Rough Electric -Conduit -- - -56." Electrical -Final - • 15. Rough Electric -Wiring - - _ 57. Solar System -Final 16. " Rough Heating & Air Conditioning b8,_,Fencing & Access Approval ' 17:" Ducts in Structure - _ APPROVED FOR PLASTERING 18. 19. 20. Ducts, Ventilating Gas Pipe -Rough & Test -- Roof Framing -- - - 60._ - POOL/SPA SYSTEMS FINAL - ` - 21. '- 22. Roof Sheathing-- - - --- - Frame and Flashing _ ^• �' ' NOTES: - 23. Insulation- - -- - -" - - = - Z' 7--,Ir--- 24. Lathing& Siding-' - 25r Drywall Nailing 26. Plaster Brown Coat- ' 27. Electrical Power Meter -Final - - -" - - - 28. Final ,Electric - -- - - - '- - 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 Speinkling System ' • >• '' "- - - 36. -Sound Attenuation 1 37. Handicap Regulations - - - 38. FINAL STRUCTURE&BUILDING 39. Special Requirements Completed 40. Electric Release to Edison \ i - ' 41. Gas Release to Southern California Gas Co. ' 42. CERTIFICATE OF OCCUPANCY No- Date Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. - CITY, OF COSTAMESA "'PERMIT NO. - - TRACT NO. LOT'NOt "BLOC. NO. - '- - - - - - --- -- - - - - - CONSTRUCTION PERMIT TYPE OF CONSTRUCTION - ANEW ADD ❑ALTERATION ❑ REPAIR .E1.CONVFRgI0N ❑DEMOLISH- ❑ OTHER f t - _ R n n� I 4ZONING'R EGU LATIONS� Project Address .S— $Cili2 !t ' OWne, -' '=-Phon¢ - _ Address L /Lf _ - __ Arch/Eng. - _ License No. DESCRIPT ION OF WORK .S• - L. r _ _ A -P,:* _,Cry_ .'�Q ZONE - - PLNG. REF. .# 1 -_ 'Address - --^- -. - .. _ ., •-Contractor - Phon - XL' G/e6 ✓ 3 'TYPE OF PERMIT-, -- a - - - - - ❑ GRADING= El FOUNDATION ❑ STRUCTURAL- -' ❑ELECTRICAL'- OMECHANICA B - - -- - - - - - W BUILDING , SETBACK T. OPE RTY LINE " �g1 DE YARD - - - - •- r ; _ ) - -.� •-- -- LEF 'Address - LICENSED CONTRACTOR.DECL'ARAT N- - I hereby affirm am licensed0)of under provisions Charter 9 (cam-- -(] TENANT. PLUMBING- /� 9IDE- RIGHT intricing,fkofessio with se, on 700P) Division 3ull the._.Business and sects the-- ' El OTHER- "� ce Prof¢55ion5 Code, and my license is In full force and effect., - REAR YARD (TO P/L) - PROJECT DESCRIPTION •,- License'Class' - '- �- "License - osi - -' -- " " "`( - " v... ,--' -- - - -• -- PKC: SPACE REO. PROVIDED:,"' "-+ 1�i„/iL._ Date Signator •• - WORKERS•.COMPENSATION. DECLARATION ---'-' - '---- -' ':'OCCUPANCY - CONSTRUCTION TYPE �STREETWIbTH- •-PARK - - - FEE $ _ 'I hereby affirm that I have a certificate of consent to self -insure or ALUATION SAO. ZONE 'ZONING -APPROVED BV DATE Certificateof Workers, Compensation -insurance, or a certifietl Copy thereof (Section 3800 . GJ- ( I.V _ GRADING:CV YDS ACRES - - SPECIAL CONDITIONS ,- - yNo:�Company .//!'lyS/Oddd entified copy is hereby furnisheii. �'y - REMARKS:yt Certified copy is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION Y - - -- - - -_ -- - -� - r. - - - -- - - - (This section need not be completed if the permit is for one hundred -• - r - a :. .ro+-1 ' ($300)'or less).. -, . - .. ._ _ -._ -. _ - _ _ _ I certify that in the�periormance of the work for which this permit'W Issuetl, I'shall not -employ any person in any'manner so as'to become' , PLUMBING,,,,l �-^ �„ PLAN CHECK' +-� ' " 'ELECTRICAL --- T' --PLAN-CHECK - subject to the Workers' Compensation Laws of California. BATHTUBS- "_. --SHOWERS'' .- .-. _ - - -..-. __ - -GARAGE.. -_ SO FT ,. _- _ _ .--_ - •. .Date SignatureSO.FT NOTICE: If after making this declaration, you should become subject, ;-TOILETS-s ...r '-URINALS^'-' - -i -• -- - - - -- GENERATOR-' 0-1-KW_1-10 KW - - - •' TRANSFORMER to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such Provisions or this permit shall be deemed LAVATORIES DOUBLE L'AVS -- - - - - r• ... APPLIANCE - ---10-50 KW_ -50 + KW - _ - CONSTRUCTION LENDING AGENCY - - - - - -KIT: SINKS --- '--" -DISHWASHERS - MOTORS- -- - 03 HP -_140 HP~ - - -- '1 hereby affirm that there is a construction lending agency for the per- T SERVICE SINKS .-�-( --- -, - ,SUMPS' (INC..SO LAR ) -> 30-50 HP_-50+HP - - - - formance of the work for Which this permit is issued (Section 3097 Civ, -C:): - ---- ----- -• -- --------------.,....- - - Lender's Name -FLOOR SINKS -'"'""`- FLOOR -DRAINS"` ,- "' -"""FIXTURES -- --"OUTLETS" - SWITCHES- 'nd j - A` " ' -"- '--" --�- '"`---" Lentler's tltlress- DRINKING'FOUNTAINS'- - • e - --' -' + ^- ',. _ GAS TUBE SIGNS OWNER BUILDER DECLARATION-- --- -- -- - -- ---- - -INTERCEPTORS--"`CLARIFIERS----"�-'-- "� --POLELIGHTS- - "-' - - '--'--- - 1 hereby affirm that I am exempt from the Contractor's License Law for the -following reason -(Section 7031.5-Business.and- Professions -Code: -SWIMMINGPOOL^---'---PTRAP- --' - - - - Any city or county which requires a permit to construct, alter, ^- POLES METERED SUB - -WATER'SERVICE--- -ALTERATION--'-' - -- PANEL'S" -'- 'MAIN _.... ... improve,-demolish-orrepair anystructure, priortoits issuance, also re- quires the for such Permit to file a signed Statement that he l - nursuant is licensed ons -Gli5'SERVICE""-'"'_ '-'OUTCETS�-""'•- + - SERVICE •'-�� --- - -'- -- - - AMP 9 (commencing (Chapter 9 (commencing with Section ]000) of Division 3 of the 1 Business -antl Professions Cotle) or -that -he at exempt therefrom -WATERHEATERS '• ---BTU'OUTPUT-^--- - - - -- .. •'n -� for the alleged exemption. Any 1.5 be Section 7031,5 by SEWER CONNECTIONS - �( ----^^'--^ ^j^---• � -- 'i' ---^-•-' -'•-• -'----- '• he-ati000f tp h¢- applicant to -a -Civil penalty- for -.five idred dollarsts-t at more than five huntlretl tlollars ($500). more t hu CI [-,as owner of -the -property; or -my employees with-wages-as-their- -SOL-AR'TANK- -------- COLLECTORS ' - •'� -- - ' -r- - - -- ----- -- - -- - '� ; sole compensation, will do the work, and the structure is not intended - or offeree for sale. (Section"7044 Business and -Professions Code:'The' -SOLAR PIPING"SVSJ ISSUE FEE-- EE-`Contractor's - " Contractor'sLicense Law does not apply to an owner of a property '- ISSUE FEE-- "'-' ,1 '--^" - - 1'""> _ - 'APPL'ICATION' APPROVED BV-- -- - - - DATE- - who builds or improvesthereon, and who goes"Such work -himself -or ihrough his own employees, pprovided that such improvements are not -or - MECHANICAL PLAN CHECK r - - - - - - '- 1 SUMMARY OF FEES ntended oroffered'for-sale. If, however, the building Improvement' IS Told within one year of completion, the owner Will have the burden of proving -he didnotbuild or -improve -for -the -purpose -of -sale)..- ❑ I,..as. ownec..of .the property, am. exclusively contracting with_.. - - - - - - - HEATING SYSTEM 0-100 000 BTU` - AND DUCTING - -- -•- - �� BUILDING - iPERMtT'•, _ _ 'y, $,� _t �SM1R ..$—Y=� -[ licensed contractors to construct the project (Section 7044, Business 100 000!+ BTU '- PLAN CHECK PERMIT, 7 T and.Professions,Code:. The.Contractor's.Liceme, Law.does.00t apply to. - '- .� .ISSUANCE $ ' an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU I 'PLUMBING $- - .. = tracts, from such.. projects-with_a contractor(s) licesned pursuant to. .-SYSTEM- - - ,l -_ _ - , - - _ - -__ _ `'GRADI NGT'$• D '0• the Contractor's License Law). 100,000:, l PLAN CHECK $' - may; .i'J ❑ I•am exempt under -Section - - - B.-& P. -C. for this , ' - $ - BOILERS r BTV --- - - - - -- SYSTEM REPAI R. ALTERATION - ELECTRICAL $ .K IPL -AN CHECK- $- r -_� MICROFILM.$' reasdn. - Date Owner EXHAUST SYSTEM MULTIPLE l 'MECHANICAL $ - - TOTAL FEE $, I .LESS AD- ' hereby certify that have read this application and state that the above information -is correct: I agree to'comply with all city and county. �, 'PLAN CHECK $ - VANCE PC ordinances and state laws relating to construction, and hereby authorize --of -enter t . V• . ,l ... ,-�. .f representatives this city t0' upon the above mentioned- property for nsti pun ses. - - s' ! - ", yr% -_ Signature • - Date � - ' _ .- - FINAL FEE $ /9, -� Drivers'-Licens"e'er 55 - - - - - -ISSUE FEE CMF 0865.46 While -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING-'. - APPROVALS Permit # y 0 Date Inspector POOL & SPA - - APPROVALSPermit# Date Inspectors 1. _Temporary Electrical Service or Pole _ 43. Pool &Equipment Location - ,2. Soil ipe-Un rgrn_ 44. Steel Reinforcement - - _ 3. .Electrical Conduit Utility-Undrgrn . 45. Forms - -.4. - Electrical,ConduitUndrgrn _ _ � 46. Electrical Bonding"' -- - - - - _ tee em f orce'• _ �.. 47. Rough Plumbin &Pressure Test - -- - _ 6. _Electrical U_FER Grn 46. APPROVAL TO COVER-GUNITE' 7. ootings _ - 49. Electrical Conduit-Undr rn ' _ 8. .Foundation. - 50. Gas Pipe, ❑•Undr rn, Test ' ..-9.. Water Pipe_Undrgrn. _� _ _ 51. Backwash Line P- ra - M UndFarn- 10.. Structural'Floor System • 52. APPROVAL TO DECK -" - - -..•r - -' '. 11.- Property Sewer,Line &-House,Conriection ' 53. Backwash & Receptor-Final ' 12._ Street.Sewer.Connection _ - -54. Heater & Vent-Final. 13.._ Rough Plumbing- . _- _ - - -' 14. Rough Electric-Conduit -- - - 56. Electrical-Final - 15. Rough Electric-Wiring - - - - - - - 57. Solar System-Final "- - - 16: Rough Heating &-Air Conditioning' - - - - encing & Access. Approval - - 17:,- -.. Ducts in Structure_ - APPROVED FOR.PLASTERING.. - 18.' -Ducts, Ventilating _ POOL/SPA SYSTEMS FINAL• 19. Gas Pipe-Rough &Test..60. 20: -Roof-Framing 21. Roof Sheathing-- - - -- - -- -- '' " "'- ''•' NOTES: 22. Frame and Flashing - _ __ 23. Insulation 24. Lathing & Siding - - - - - - -- - ^ - -�-- - - --' - 25. Drywall Nailing - 26. Plaster Brown Coat - - '- 27. Electrical Power Meter-Final - - -. 28� Final Electric - - - - _ - . _ _. .. - .. __ _. - '• '.... :.• -, - 29: Final Heating & Air Conditioning- -- - - - - - 30: Final Gas Pipe-Test_ .. 31 i. .Final Plumbing 32: Water'Service-Final 33. Gas Service-Final 34. Solar Domestic-Final z - - 35. Aaadt=M Sprinkling S stem-d w 36. Sound Attenuation - - '- - - 37. Handicap Regulations - -- 38. FINAL STRUCTURE & BUILDING '- - 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. ' 42. • CERTIFICATE OF OCCUPANCY No' Date t Applicant to fill in all spaces within heavy border lines and sign ail appropriate declarations. "CITY.OP COSTA MESA P��ggMIT NO. TRACT NO. LOT NO. BLDG. NO. SO I2 8/03/82 CONSTRUCTION PERMIT77 CSEP ��35�j -Q- TYPE OF CONSTRUCTION NEW ❑ADD ❑ALTERATION ❑.REPAIR ❑ CONV RSION DEMOL SH OTHER DESCRIPTION .90.7/ ZONING REGULATIONS Project Address •Phon - Owner - u/ '!, n Address '' t tea.(.! Arch/Eng. License No. OF WORK - B A.P.Address ZONE PLNTTGp.. REF. r y 11 ^ COOPraClo( QN - UTArs/ Phon VPE.OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL y�(r TENANT ELECTRICAL LUMBING ❑MECHANICA ` X SET ACK C ST. 51D YARD LSIEpFEy pD$ PROPEI IiTVNLI NE ( Address - LICENSED CONTRACTOR DECLARATION I hereby that 1 Ilcensed Charter 9 affirm am under provisions of (com- mencing with section 7000)of Division 3 of the Business and ❑ OTHER RIGHT ' Professions Code, and my license is In full force and effect. PROJECT DESCRIPTION ((rrss�� Or�ut� REAR YARD (TO P/L) License Class License No. /')ZO _ w -Q .*.Qlyfg SQ. FT. 2"!i[O$ �qYL Wlf rs•�••�Iri e" , \ PKG. SPACE REQ. PROVIDED - Dale Signature 2 - STREET WIDTH PAFEE RK $ WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -Insure or OCC UPANCY)iZ� CONSTRUCTION TYPE VALUATIO4 ZONE ZONING APPROVED BY DATER 2 V cJ ca certifite of Workers' Compensation Insurance, or a certified copy - thereof (Section 3800, Lab. C.). GRADING CV. YDS. ACRES SPECIAL CONDITIONS: --licy No. Company Certified Copy Is hereby furnished. -. _ REMARKS: u F C Certified Copy Is filed with the city Building Division. ..�•ST EX`EMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need.not be completed if thepermit is for one hundred - - IE3001 or Ie55). f C¢rt(f that in the performance of the work for which this permit I Issuetl. I shall not employ any pe n in )ay manner so as to become e PLUMBING PLAN CHECK ELECTRICAL -PLAN CHECK sub)e��to��hgg..W,�o,r kers' Compensa o Las4 0l 1' nla. BATHTUBS SHOWERS - OatSignature NOTICE: If atter making this tleclaration, you s ou d become subject TOILETS URINALS 0 GENERATOR 0-1 KW_ 1-10 KW to the Workers' Compensation provisions of the Labor Code, you must TRANSFORMER - - forthwith comply with such provisions or this permit shall be deemed V LAVATORIES DOUBLE LAVS Q APPLIANCE 10-50 KW_50+KW revoked. KIT. SINKS -- DISHWASHERS MOTORS 0-1 HP -1-10 HP - CONSTRUCTION LENDING AGENCY Ihereby affirm that there is a construction lending agency for the per- SERVICESINKS SUMPS(INC. SOLAR) --10-50 HP 50+HP formance of the work for which this permit is Issued (Section 3097 FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS& SWITCHES Civ. CJ. - Lentl er's')Name. u A - t - •` Lender's Address JS.Ly.4 DRINKING FOUNTAINS - '- GAS TUBE SIGNS - OWNERBUILDERDECLARATION INTERCEPTORS CLARIFIERS. POLE LIGHTS - - I hereby affirm that lam exempt from.the Contractor's License,Law for q "SWIMMING POOL P TRAP - the following reason (Section 7031.5 -Business and Professions Code: Any city or County `which requires a permit to construct, alter, POLES METERED SUB WATER ERV ICE ALTERATION PANELS MAIN- SUB Improve, demolish or repair any structure, prior to its Issuance, also re-' quires the applicant for,su Ch permit to file a signed statement that he - I - GAS SERVICE OUTLETS '- SERVICE AMP Is licensed pursuant,to.the provisions of the Contractor's License law -of (Chapter, 9 (commencing with Section 7000) of Division 3 the 'WATER HEATERS BTU OUTPUT O Business and Professions Code) or that he is exempt therefrom and the —vis for the alleged exemption. Any violation of Section 7031.5 by 'SEWER CONNECTIONS 'J - - - -applicant for a -permit subjects the applicant to acivil penalty lot more than five hundred dollars ($500). -SOLAR TANK COLLECTORS .-. 1, 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. (Section 7044, Business and Professions Code: The SOLAR PIPING SVS. I ISSUE FEE Contractor's License Law does not apply to an owner of a property ISSUE FEE a APPLICATION APPROVED BY DAT who builds or improves thereon, and who does Such work himself or through his own employees, provided that such improvements are not MECHANICAL PLAN CHECK SUMMARY OF FEES intended or offered for sale. If, however, the building or Improvement Is sold within one year of completion, the owner will have the burden proving he.did not build or improve for the purpose of sale). G anI, HEATING SYSTEM 0-100,000 BTU PERMIT $ �'i vR SMIP E Xf as owner of the property, am exclusively contracting with AND DUCTING . i nsed contractors to construct the project (Section 7044, Business 100,000+BTU � PLAN CHECK $ PERMIT antl Professions Cotle: The Contractor's License Law does not apply to ISSUANCE $ an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ •�V ' tracts from such projects with a contractor(s) licesned pursuant to SYSTEM _ GRADING $ the Contractor's License Law). 100,000 + BTU I • r -- - -� t PLAN CHECK $ 1 s ❑ I am exempt under Section B. & P. C. for this BOILERS BTU$F ELECTRICAL $� reaso SYSTEM REPAIR, ALTERATION PLAN CHECK $ _ MICROFILM $ Date '�_ �Z O e - I '-' 'MECHANICAL $ TOTAL FEE $ v 1 hereby certifythat 1 have read this a and state that above EXHAUST SYSTEM MULTIPLE LESS AD - information is correct. I agree to comply with all city and county comply d PLAN CHECK $ VANCE PC $_ ordinances and laws relating to cons Pon t and hereby authorize - _state 'represenlal s this sty ente Pon the above mentionedproper - - f i CU Pur Ses. � \' x k' \" Signatty 4- Signa[ure Date � ' �� ISSUE FEE - s FINALFEE E Drivers' License or CMF 0865-46 White -Building; Canary -Applicant: Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNI-�/ 4 ✓ APPROVALS Permit # b ,= ."- Date Inspector ; ,� POOL &SQA. APPROVALS .Permit # Date,- ' Inspector- _ 1. Temporary Electrical Service or PoleIn. zl�- 43. Pool &Equipment Locatiori '- - - • - 2. Soil Pipe-Undrgrn.. - _ Z'; 44..; Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn- : 45. - Forms 4. .Electrical Conduit-Undrgrn _ 46. Electrical. Bonding - - - 5. Steel em orce _ 47. Rough Plumbing &-Pressure Test - 6.- Electrical UFER Grn _ 48. APPROVALTO COVER-GUNITE - - 7. Footings _ - 49. Electrical Conduit-Undr rn ' 8.. Foundation 50. Gas Pipe_ ❑Undr rn, Test - 9. Water Pipe-Undrgrn - 51. Backwash Lines P -Trap,❑ Undrqrn -- 10. Structural Floor System : ;`1' 52. 'AP ROVALTO DECK -- 11:. -Property Sewer Line & House Corinection 53.t_.Backwash & Receptor -Final ' 12. Street Sewer Connection _ _ - 54. Heater & Vent -Final 1.3. Rough Plumbing - - - 14. Rough Electric -Conduit - - 56. "Electrical -Final - 15. Rough Electric -Wiring - _ -_ - 57. Solar System -Final - - 16. Rough Heating & Air Conditioning _Fencing & Access Approval -17. Ducts, in Structure 5 . APPR_OVED FOR PLASTERING - 18. Ducts, Ventilating - _ -• - _ - - BO.. POOL/SPA SYSTEMS FINAL '- 19. Gas Pipe -Rough & Test - - - _ 20. Roof Framing - 21. Roof Sheathing NOTES: - v Q_ 2. ._ 22. Frame and Flashing_ 23. "Insulation 24. - Lathing & Siding - - - 25. Drywall Nailing. - _ %✓� - o •- 26. Plaster Brown Coat 27. Electrical Power Meter -Final - 28. Final Electric - - /$ 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test - -- - 31.. - Final Plumbing I / L 32. " Water,Service-Final - - 33. Gas Service -Final 34., Solar Domestic -Final ' 36: Landscape S rinklin '•S stem ' 36. Sound Attenuation - - 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed - - 40. Electric Release to Edison - 41. Gas Release to Southern California Gas Co. ' 42. `. CERTIFICATE OF OCCUPANCY No 11 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. ' D IS 7 Tim CITY OF COSTA MES/p CONSTRUION PERMIT Project Address _ 245 FCSC�FE — Cer3T14 KESA. Applicant's Mailing Address ,,�s...� MeVl —C Owner's Nam�e.T'T/Q - '`�, Ph(W � Address Arch/Eng. - License No. Address �GL�� Contractor's Name /p r fc1.7 _ 7�1T70/'f7`�T(C ho e!Q_`. '7GZZ Address(mailing)N�e ��•�-�• O �_L_�� City License No, 07 ZZ J LICENSED CONTRACTOR DECLARATION 1 hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full forte �an(tlffec[. License /1 C=iO License DateSignature WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -Insure or a certificate 1 of Workers' Compensation Insurance; or a certified copy thereof (Section .3800, Lab. C .- s. - Policy No. -O -QS 3 Company Qss C. r� ii�Ptilled copy is hereby furnished. IZI ed cop I�•liletl with the city Buieivl5iory/ �.. Date -C �l Applicant io EXEMPTION FROM WORKERS' COMPENSATION DECLARATION ,(This section need not be completed if the permit is for one hundred ($100) or less). 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 California. Date Signature NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. , 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 (Section 3097 Civ. C.) 1 Lender's ,Name Lender's Address I OWNER BUILDER DECLARATION t I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/she is licensed pursuant to the provisions of .-the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of this 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 malty of not more than five hundred dollars ($500). . 1, 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 (Section 7044, Business and Professional Code: The Contractor's License LaW'dge% 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 employees, Prpvided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of com- pletlon, the owner will have the burden of proving he/she did not build or im. prove for the purpose of sale). ❑ I, as owner of the properly, am exclusively contracting with licensed con- tractors to construct the project (Section 7044, Business and Professions Cotle:. The Contractor's License Law does not apply to an owner of property who 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 proof o their Worker's Compensation insurance should be provided to me. J❑I am exempt under Section B. & P. C. for this reason Date Owner I hereby certify that 1 have read this application and state that the above information is correct.-I'agree to comply with all city andcountyordinances and state laws relating to building construction, a horize repre- sentatives of this city to enter upon h e -me ,property for inspection purposes Signature Date Drivers' LI TYPE OF CONSTRUCTION LJ NEW L-26 ADD LJ ALTERATION LI REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHFiR DESCRIPTION OF WORK/USE.OE&i DG_ TYPE OF LI GRADING LJ FOUNDATION LI STRUCTURAL ❑ T ANT ❑ ELLEECT 1 AL "❑-. P�)JJvi,B�11YG_ S:Jr ICAL OTHER Fri€ �jQ/�•f (•CL PROJECT DESCRIPTION SO. FT. OCCUPA CY CON STRUCTION TYPE VALUATION $ ZONE GRADINGCU.YDS. ACRES Remarks: A.P. p S Main Buildi E T Front B Rear A C Right K S Left Ping. Ref. # Planning Notes: Q Zone Accessory Building: ' Z O N I N G R Parking Req./Provided - E D M T S, Bar Sink 1 Showers " Boiler Hood or Type I ❑ Canopy Type I I ❑ Duct - Under Ground ELECTRICAL FEES Backflow-Preventer Service Sink DEVELOPMENT SERVICES REQUIREMENTS: Automatic Washer - Transformer 0-15-50 KW - - Pole Sub. C150+ KW Backflow Irrigation Sewer CapConstruction Zoning Approved By Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps Clarifiers Solar Collectors Dishwasher Meter Dover 100amps Sher 1, Solar Piping Firepl/Fact. Bit. ICBO # Fire Dampers Dryers ❑Gas ❑Electric Sub Panel Drinking Fountains Solar Tank - Fan Motors ❑0-1HP❑1'A-B I Floor Drains Swimming Pool w/Spa F.A,U. Inc. Solar 09-15 HP 016-15+ Floor Sinks Urinal Fixtures Microwave -- - - - Gas Service = Outlets Water Closet T •C_ $ Device Boxes Pole Light Interceptors Water Heater PLAN CHECK Outlets Range Kitchen Sink .- - Water Service , Switches" Sign Lavatories Auto -Wash ISSUANCE Garbage Disposal ; Standing Sections P—Trap • Laundry Trays, $ Generator 005 KW ❑5-15 KW Trash Compactor Roof Drains - ELECTRICAL $ Reinspection Fee - $15 1 ssue Fee - $ 3 1 I FEES Reinspection Fee I $15 I I I Issue Fee - I $ 3 CMF 0865-46, rev. 10/84 -White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Reinspection Fee Boiler Hood or Type I ❑ Canopy Type I I ❑ Duct - Under Ground DEVELOPMENT SERVICES REQUIREMENTS: Duct -Structural Refrigeration System Duct - Ventilating ❑0.100,000 BTU 0100,000 BTU Zoning Approved By 19 Date Exhaust System ❑ Multiple ❑ System Repair/Alteration _ Date Firepl/Fact. Bit. ICBO # Fire Dampers - Heating System & Ducting Registers ' 00100,000 BTU❑100,000 BT - _ SUMMARY OF FEES Z 6 Reinspection Fee I $15 I I I Issue Fee - I $ 3 CMF 0865-46, rev. 10/84 -White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Reinspection Fee $15 I I Issue Fee DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By 19 Date Building Approved By _ Date Appligtion Issued By.�—' Dat SUMMARY OF FEES Z 6 G BUILDING PERMIT •C_ $ SMTP $ r s PLAN CHECK $ 0 PERMIT , PLUMBING $ ISSUANCE $ PLAN CHECK 25% $ ENERGY P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK 50% $ MICROFILM $! MECHANICAL $ TOTALFEE $ PLAN CHECK 25% $ CONSTRUCTION AND PLANNING APPROVALS Permit# Date Inspector POOL & SPA APPROVALS Permit # Date Inspector i. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3, Electrical Conduit Utility-Undrgrnd. 54. Forms 4, Electrical Conduit-Undrgrnd. 55. Electrical Bonding - 5, Steel Reinforcement 56. Rough Plumbing & Pressure Test 6, Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. g. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash, Lines, P -Trap, ❑ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK .11. Property Sewer Line & House Connection i 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 APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating - 71. Product, ,Piping ❑Gas ❑Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O 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 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32.' Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning v�.� / '• B'� g- i�i Oh 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. FINALSTRUCTURE & BUI LDING 48. Special Requirements Completed 49. Electric Release to Edison - 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date "VW- CITY QF COSTiA MESA, 'CONSTRUCTION PERMIT . Applicant to fill in all Project Address n f"1 -.)c -!G .rtA..-c(-- Applicant's Mailing�A7dddr�epss f,s�7.t/(CJ5&Ae�1 s�1la-&) bt'C S.R Owner's Name j��2�(�A 946% done Srf-e— Address A • Arch/Eng. License No..� /� Address 31_a/•iifl-/ 4K4V#& Contractor's Name t�ii�%�P��J�Lb «" Phone ^ -G2=2 Address (mailing) City License No. LICENSED CONTRACTOR DECLARATION I hereby affirm that 1 am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license Is in full force and effect. License Class ' License No. Date Signature 1RKERS'COMPENSATION DECLARATION sreby affirm that I have a certificate of consent to self -Insure or a certificate Workers' Compensation Insurance, or a certified copy thereof (Section, 3800, Lab. C.) Policy No. Company ~� Certified copy, is hereby furnished. Ce fl p filed with the city B Iltlu 2I Da el%s% Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This sectlon need not be completed if the permit is for one hundred ($100) or less). - ft: 1 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 California. Date Signature -NOTICE: If,after making this declaration, you should became subject to the Workers' Compensation provisions of the Labor Cotle, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for whigh \/A this^permit is Issued (Section 3097 Civ. C.) Lender's Name /1 Lender's Adoresi - OWNER BUILDER DE LARATION - I hereby affirm that I am exempt from the Contractor's License Law far the a hermit to construct. alter. Imorove. tlernclish-or reoalr ' 4 091.5 by any applicant for a permit subjects the applicant to a civil enalty of not more than five 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 (Sectlon 7044, Business and Professional Code: The Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who tloes such work himself/herself or through his or her own employees, provldetl that such Improvements are not intentletl or offered for sale. I however, the cul lding or improvement Is solo within ane year. of com- pl Ion, the owner will have the burden of proving he/she tlId not build or Im- ve for the purpose of sale). I, as owner of the property, am exclusively contracting! with licensed con. Ir tors to construct the project(Section 7044, Business and Professions Code: The Contractor's License Law Res not apply to an owner of property who 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 exempt under SectionA— this re - " Date n. A I hereby certify that'I have read this application and state -that the 'a Bove Information is correct. I agree to comply with all city and county ordinances and state laws relatAg to building construction, and herebv authorize reore- except those within heavy border lines and sign all appropriate declarations. 122-I 5/30/84, 3 3I Zone Accessory B Park.Fees $ Bar Sink Showers PUBLIC SERVICES'REQUIlpm TYPE OF CONSTRUCTION LJ NEW W ADD IJ ALTERATION REPAIR Service Sink ' Sewer Cap ❑ CONVERSION ❑ DEMOLISH OTHER �� i'r 0�1 A.P. # DESCRIPTION OF WORK Sewer Connection Automatic Washer Construction Pole Sub. S Main Buildi TY OF PERMIT U GRADING LJ FOUNDATION 4STRUCTURAL T Front TENANT N ELECTRICAL/KPLUMBINGA MECHANICAL B Meter ❑up to 100 amps ❑Rear OTHER A PROJECT DESCRIPTION SO. FT. OCCUPANCY C K Right CONSTRUCTION TV PE VALUATION$ �Z•%4A. $ Left ZONE pACRES—,�9—� GRADING CU.VDS. " Ping. Ref.# Remarks: O G Parking Req./Pr( o�U �- �•I Use of Building: • PLUMBING I FEES IPlanning Notes: 122-I 5/30/84, 3 3I Zone Accessory B Park.Fees $ Bar Sink Showers PUBLIC SERVICES'REQUIlpm Backflow Preventer Backflow Irrigation Service Sink ' Sewer Cap - ELECTRICAL Bathtubs Sewer Connection Automatic Washer Construction Pole Sub. Transformer ❑ 15-50 KW ❑ 50+KW Clarifiers Solar Collectors Dishwasher. Solar Piping Canopy Type I1 13Zoning _ Cooking Unit Meter ❑up to 100 amps Drinking Fountains Solar Tank Dishwasher Meter El over 100 amps , Floor Drains Swimming Pool w/Spa Dryers ❑Gas ❑Electric Sub Panel Floor Sinks Urinal Fan Motors 00-1 HP ❑l % - B Gas Service Outlets Water Closet F.A.U. Inc. Solar 09-15 HP ❑16-15+ Interceptors Water Heater 'i $ Fixtures Microwave Kitchen Sink - Water Service - Device Boxes - Pale Light Lavatories i I 12t�outlets Range P -Trap PERMIT A.Switches-•'t - 4_ Sign Roof Drains - - Garbage Disposal Standing Sections - $ Generator E]0-5,KW 05-15 KIN • Trash Compactor Reinspection Fee S25 Issue Fee- E - Reinspection Fee - $25 1 Issue Fee - MECHANICALFEES D c.3 . � cosier I Duct - Under Ground Duct - Structural Duct: Ventilating Exhaust System ❑ Mul Firepl/Fact. Bit. ICBO # Heating System & in E10-100,000 BTU 00 Orivers' License or, SS # s I _ I Reinspection Fee CMF 0865-46 rev. 12/83 White-Buildinr / g; Canary - pplicant; Pink -Accounting; Goldenrod -Assessor 235.29 T Z O N I N G R E Q U I R E M E N T S FEES FA $ 3 Hood ❑ PUBLIC SERVICES'REQUIlpm or Type I _ �n L Canopy Type I1 13Zoning Approved By - /1 Date - Building PProved B ' Y Application Issued a Date 3U RefrigerationIBy_n System, ' J ❑00.100,000 BTU, 100,000 BTU '• •' BUI'LDING•PERMIT 'i $ 8 MM RV OF FEES ' ,5 i0y. S D SMIP $ �. e ❑ System Repair/Alteration I PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE $ I PLAN CHECK 25% ELECTRICAL PLAN CHECK 50% $ $ $��-5 D c.3 . � ENERGY P.C. GRADING MICROFILM $ $ $ )BTL_ MECHANICAL $ /�',Uy - TOTALFEE s'2 $ -121J-5'219 $25 Issue Fee $ 3 PLAN CHECK 25% $ 12 . %5 CONSTRUCTION AND PLANNING • APPROVALS Permit Date For POO ;PA 'tiff APPROVALS Permit# - -Date Inspector Temporary Electrical Service or Pole .52. Pool &Equipment Location 2:, Soil Pipe-Undrgrnd. /ZN ( /) 53. Steel Reinforcement '3. E1ectr4l Conduif Utility-Undrgrnd. 54. Forms Edectric6l Conduit-Undrgrnd. 55. Electrical Bonding .•5. Steel Reinforceriynt' 56. Rough Plumbing &Pressure Test 6. Electrical U',FER-Grnd. _ 57. APPROVAL TO COVER-GUNITE •" . •7. Footings 58. Electrical Conduit-Undrgrnd. r -L' 8. • Fbundation_ 9. Watery Pipe Undrgrnd. 59. Gas Pipe, O Undrgrnd., Test 60. Backwash Lines, P -Trap, El Undrgrnd. - 10. StfucYural FloorSystem 61. APPROVAL TO DECK - ' *, I .a 11. Property Sewer Line & House Connection "' 62. Backwash & Receptor -Final 12. Sewer Cgp. 63. Heater & Vent -Final 13. Roof'Drains ,. ! 64. Plumbing System - Final _ --- 14. Rough Plumbing 65. Electrical -Final 15. Rough ElectrimkConduit 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 7131W /P 69. POOL/SPA SYSTEMS FINAL - 19..Rough Heating-& Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. ,Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro - - 22. -Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23..Gas Pipe -Rough &.Test= 12: Underground Flush 24. Roof,Framing - 73. Undergrnd. Storage Tank []Gas ❑ Oil 25. Roof.Sheathing -- 74. Overhead Hydro - 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27.- Fraft and Flashing -17 76. Dry Standpipe 28. Laging & Siding 77. FIXED SYSTEM FINAL ^29. Insulation 78. FIRE PREV. FINAL 30yDrywall Nailing HEALTH DEPT. REQUIREMENT 31'." -Plaster Brown Coat.` - 79. FINAL INSPECTION 32. Electrical Power ter4,Final % 80. FOOD CERTIFICATE ISSUED - 33. Final Electric �I Notes: 34. Final Heating & Air Conditioning 5W L49 - 35. Final Gas Pipe -Test 'Ok IV 36. Hood or Canopy / 37. Final-Factory•Fireplace, - 38. Final`Plumbing 39. WaterService-Final; . 40. Gas Sarvice-Final ! -. 41. Solar. Domestic -Final v 42. Backflow Preventer 43. Backflow Irrigation - 44. ,Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations - - - 47. FINAL STRUCTURE &BUI LDI.NN S 48. Special Requirements Completed 49. Electric Release t0 Edison ' 50. Gas Release fo Southern California`GasCo 51. CERTIFICATE OF OCCUPANCY No. - - Date ' 6TY OF COSTA' MESA' CONSTRUCTION s_CON-STRUiCLTIONPERMIT ProjetcAddress /riG Appl ica V9,Mai ling Address 17 6!' 5 ( L P+fI p' A Oner'Na e O(AA ppcprz,L_SPhone7ACgtG22 Addre Atl'y..'3,A, . /O)zrC L! Arch/Eng. Wu!200_�-/1l.i�l.�d License No. C' Address �jl iti"(,f-G�AAF-1 I 2,AI1 P—. CA , q'f.2..%r3 �� Contractor's Name &Xt.AQ(L Phone./�Q w 2"Yl Address (mailing) City License No. LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Busine5 anP fesslon my license is in full force and vision effect. License Class L o. Date Signature WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent t0 self -insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 1800, Lab. C.) - o Iicy No. oSB-�S /w../% /�7fompanv s/ATE Ccl-+P. /tiSb ,R yl Certified copy is hereby furnished. - Certified copy is filed with the City Build Divislon. n to -_-Applicant �{�,f1Y1 �L4. �lu.l�'1 EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit is for one hundred ($100) or s ass). I certify that in the performance of the work for which this permit is issued, Ir• shall not employ,any person in any manner so as to become subject to the Workers' Compensation Laws of California. - . Date Signature 'NOTICE: 17, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked, 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 (Section 3097 Civ. C.) Lender's Name;- Under'z Address t . OWNER BUILDER DECLARATION ' I hereby, affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/she is licensed pursuant to the provisions of 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 tensity of not more than five hundred dollars ($500). ❑ 1, 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 (Section 7044, Business and Professional Code: The Contractor's License Law does not apply to an owner of a property who builds or improves thereon, antl who tlpes such work himself/n a r self or through his or her own employees, provided that such improvemen tz are not Intended or offered for sale. If, as waver, tha building or vim Provor an Is sOltl within one yeard r g pletion, the owner Will have the burden Of proving he/she did ndt builtl or im- r ve for the pur pond of Sale). as owner of the Property, am exclusively contracting with IIcensed con- tactors td construct the project (Section 7044, Business antl Professions Code: The Contractor's Licanse Law does not apply to an owner of property who builds or improves thereon, antl who contracts for such Protects with acon- traclor(s1 license pursuant to the Contractor's License Law). I am aware that proof o// 1netr Worker's Compensation insurance should be provided tome. ❑ I am exempt under Section B. & P. C. for this reason Date Owner l hereby cattily that 1 have read this application and state that.the above Information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize repre- sentatives oJ� this'ci tY to enter upon the above-mentioned property for Inspection [fu tloose� �/l (l Signature hl ----�/ Date3 -515 Drivers' License or 55 # -- CMF 0865.46, rev. 10/84 fill inalt spaces except those within heavv border lines and sign all appropriate declarations. E7 - 1701?4- 1 //_ TYPE OF CONSTRUCTION Li NI ❑ CONVERSION ❑ DEMOLISH TYg OF PERMIT , LrJ G /`-_°'•TENANT ELECI ❑ OTHER PROJECT DESCRIPTION CONSTRUCTION TYPE ZONE' Remarks: Bar Sink Backflow Preventer Backflow Irrigation + Bathtubs Clarifiers Dishwasher ADD XSLALTERATION LJ REPAIR FOUNDATION ?1`STRUCTU LUMBING MECHANICAL VALUATION $ GRADING C J YDS. A( Floor Drains Floor Sinks - Gas Service 'Outlets Interceptors " Kitchen Sink Lavatories P -Trap Roof Drains ' - Reinspection Fee $15 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact. Bit. ICBO # Heating System & Du ting ❑0.100,000 BTUR100,000 Reinspection Fee 1 $15 Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor A.P. # S Main Build, E T Front B Rear A C Right K S Left Ping. Ref. # Planning Notes: 6925. 3[08/05 ..,1 13. La j. OF pEef /r 7-, Zone Accessory Building: O R Park i ng'Req./Provided E - Jul Q PLUMBING FEES Showers ELECTRICAL FEES Service Sink - Automatic Washer-. Pole Sub. Transformer ❑-15-50KW El 50 +'KW - - Sewer CapConstruction Sewer Connection Cooking Unit -" _ Meter ❑up to 100 amps Solar Collectors Dishwasher t Meter ❑over 100 amps 3 �S Solar Piping i+-, �� Dryers ❑Gas ❑Electric Sub Panel c� Solar Tank ' Fan Motors 00-1 HP Ell ,G Ig Swimming Pool w/Spa F.A.U. Inc. Solar 09-15 HP 016-15+ 4 ' Urinal - Fixtures -Microwave` - --" � Water Closet 4 Y Device Boxes" Pole Light ' Water Heater oi'$ Outlets Range Water Service Switches' Sign Auto -Wash Garbage Disposal Standing Sections Laundry Trays - Generator 00-5 KW ❑5.'15 KW Trash Compactor I I Issue Fee - $ 3 % I• -� Reinspectioh Fee. $15 Issue Fee $ 3 IECHANICAL -FEES' Hood or Type ❑ - Canopy Type 11 ❑ - - DEVELOPMENT SERVICES Zoning Approved By Bu Building Approveil By t�Appligtion Issued By_- REQUIREMENTS: ata Date— Date r �� / Dat -3 Refrigeration System 00-100,000 BTUIXy00,000 BTU � r .r O. - BUILDING PERMIT PLAN CHECK PLUMBING PLAN CHECK 25% e ELECTRICAL PLAN CHECK 50% MECHANICAL PLAN CHECK 25% SUMMARY F EES $ 79,� SMIP /$ $ PERMIT $ �. �' ISSUANCE I $ $•'�� ENERGY P.C. $ $ /$, vOr GRADING $ $ I MICROFILM $ $ rs'� TOTAL FEE $ $ I / —q S J / •�%4 - System Repair/Alteration •- Fire Dampers r ' Registers f • Issue Fee $ 3 r CONSTRUCTION AND PLANNING ` APPROVALS Permit # DateInspector POOL A.,r'A APPROVALS Permit # Date Inspector ' 1.•temporary. Electrical Service or Pole 52. Pool & Equipment Location - 2. Soil Pipe-Undrgrnd. y yy�y ( 53. Steel Reinforcement 3 Electrical Conduit Utility-Undrgrnd. - 54. Forms - 4. Electrical Cprtduii-Undrgrnd. 55. Electrical Bonding i g:_SteJI'leintorcement - 56. Rough Plumbing & Pressure Test 6.; Electrical UFER:Grnd. 57. APPROVAL TO COVER-GUNITE ! _ .-7,Footings. 58. Electrical Conduit-Undrgrnd. 8. 'Foundation 59. Gas Pipe, O Undrgrnd., Test ' 9.. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ Undrgrnd. '10. -Structural Floor System 61. APPROVAL TO DECK 1 Property Sower Line & House Connection 62. Backwash & Receptor -Final 12 Sewer Cap, 63. Heater & Vent -Final 13. Rpof Drains 64. Plumbing System - Final 14. Rough Plumbing•L�/2q y (grO 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final - 16. Rough Electric'Wiring 04 67. Fencing &Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 7�/ /Y(j 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning _ FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Fact pty Fireplace 21. Ducts, in Stru ture 70. Underground Hydro 22: Ducts, Ventilating 71. Product Piping 0Gas OOil 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 Fllashing //7 76. Dry Standpipe 28. Lathing &Siding ,� 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing 1 " g HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat', 79. FINAL INSPECTION 32. Electrical Power Meter -Final Re. 80. FOOD CERTIFICATE ISSUED 33. Final Electric ' Notes: , 34. Final Heating & Air Conditioning '7 (,�) 35. Final Gas Pipe -Test M. Hood orCanopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final ni 40. Gas Service -Final - 41. Solar Domestic -Final _ 42. Backflow Preventer 43. Backflow, Irrigation i .i 414. Landscape Irrigation System , 45. Sound Attenuation 46. Handicap Regulations 47: FINAL STRUCTURE & BUILDING $ i 48. Special Requirements Completed 49. Electric Release to Edison; - - 50. Gas Release to Southern California Gas Co 51. CERTIFICA OF OCCUPA Nn. ,, Date - -/ Applicant to fill in all spaces except those within heavy norder lines and sign all appropriate declarations. ' -CITY OF COSTA MESA - - "' ;" . - ' PERMIT NO. TRACT NO. LOT NO. BLD6770 I- -" - - -,--- 9 5 %Oy%86:; PERMIT Q ,6T lCONSTRUCTION 44270-85'' Project Address' 745 Fischer App -'r S}p. A-4 TYPE OF CONSTRUCTION- IU NEW LJ ADD Li LJ R PAIR' - ApplicanYsMailingAddress'77Q1 $a-tttY11--,C i- ❑CONVERSION El DEMOLISH _ALTERATION ❑ OTMERr I A.P. -7 Zone. Owner's Name Pill irate Prnnerf•i'ec Phone F Sdo9_ -6F22 2 DESCRIPTION OF WORK S Main Building:, -Accessory'Building:' - Z L Address 7S17 NT :PA 17i * . TYPE OF PERMIT- GRADING ❑FOUNDATION ,STRUCTURAL - ❑ ❑ ❑ ❑ ME HANICAL E T B Front ' - O N ,6W -r >Ana Arch/Eng N No. 1 -License TENANT ELECTRICAL PLUMBING' _C - Rear _ Address •' - ❑ ,OTHER A _ N C Right ' - G Cont'ractor's Nam."(74 1 T,r. .:u + ` • Phone5 D O -Don e.�] } �--�� j'b Ba-a}z^�•3 -zv--o-cv O ' PROJECT DESCRIPTION SG; FT. - OCCUPANCY K R ' - Address 7111 'C� C n '(mailing) Sa- urn. St.-f—area _ CONSTRUCTION TYPE CONSTRUCTION I VALUATION$ S Left I E _ *-GGDG ZONE GRADING CU.VDS. 'ACRES— Ping. Ref.# Park:Fees$' O City License No. - U LICENSED CONTRACTOR DECLARATION ' Remarks: -- - Parking Req./Provided - 1 I hereby affirm that I am licensed under provisions of Charter 9 (commencing ' R with section 7000) of Division 3 of the Business and Professions Code, and Use of Building: I I E my license is in full rf-4d, effect. �v 289588 ' -. - , Planning Notes: , __ E License Class' `- U se No. ' PLUMBING FEES Date dc o 1� / 5 Signature :� "`-- I 1 N %-"1-! RKERS' COMPENSATION DECLARATION Bar. Sink Showers - �e,ereby'affirm that I have a certificate of consent to self-insurcertificate- "Workers' Backflow, Preventer - I - , Service Sinky,_ - Y i I S Compensation Insurance; or a' certified, copy"thereof (Section-. .I - - - - X800, Lab. 85227035 ! 'Goodman' Ins. Backflow Irriga on -' Sewer Cap 1 ELECTRICAL FEES Policy No. Company nµ Certified copy is hereby turnishetl. I Bathtubs Sevne'r Connection Automatic Washer , Transformer ❑ 15=50 KW I LA Cert' i p s filed with the, ity BpildLLng Di vlsi n. - , ❑ 50�+ KW I , Date_ Applicant `%1 1 •I a IA�R S Herat-i•n r Clarifiers ''•' Solar Collectors Construction Pole Sub. -__- I ( j 'EXEMPTION 'FROM 'WORKERS' COMPENSATION DECLARATION -• •er • - - -. -• Di'shvasher - - - - - - Solar Piping!- - - CookingUnit - -"" - Meter'❑up to 100'amps - - - (This section need not be completed if the per mit Is tor, one hundred ($100) or i "' 1 ! less) certify,that in the performance of the work for,which this pert is Issued shall' not employ any person In any manner so as to become subject to,toe Drinkin Founteiris i 9 Solar Tank { ! , Dishwasher ' Meter ❑'Over 100 once I Workers'. Compensation, Laws of California., ( ` Floor Drains `" � i Swimming Pool w/Spa, Dryers ❑Gas ❑Electric ,Sub'Panei Date Signature '" ! Floor Sinks L J _ Urinal -I I ! Fan: �., �' 'Motors ❑0-1 HP ❑1 %-!B NOTICE: ICfoafter making this declaration, you should become subject to, the 'Compensation provisions of the Labor Code, you must forthwitfi _ "'"I' ' - - comply ;with such ^provisions', orr:this.. permit i shall be deemed revoked.. Gas Service ' .Outlets - 'Water Closet; -- - •' , •5 F.A'U. f - IInc. Solar ❑9-15 HP 016-15+ CONSTRUCTION, LENDING',AGENCY „ I hereby affirm that there is a'construction lending agency for the performance Interceptors) Water Heater,! w Fixtures' I Microwave ' of the '.work ,for which this permit- lsl Issued. (Section^3097 Civ. CJ _ Under's Name, ' ", Kitchen Sink r- e WatePService I _ •_ s Device Boxes _ Pole: Light ' Len Ger's Address" - •• T r, I OWNER BUILDER DECLARATION ,' - 1 •-, - - Lavatories' I' ' - `' Outlets. 1+ Range I hereby affirm that I am exempt from the Contractor's License Law for,the , following reason 7031.5 Business and Professional Code: Any city or - p-Tra - P, Switches -(Section county which requires a permit.to construct, alter, Improve, demolish or,repair _ _ _ Sign ,any structure; prior to its issuance, also requires the applicant for such permit Roof Drains ` - - ' - % .Garbage Disposal Standing -Sections .to file a signed statement that.he/she Is licensed pursuant to the provisions of ,5 Contractor's'License Caw (Chapter 9 (commencing with Section7000)'of ',.a ision 3 of the Business and Professions Code) or that he/she Is exempt Generator ❑0-5 KW ❑5-15 KW m actor Trash Compactor 1 efrom and the basis forithe alleged exemption. An violation of Section . J31.5 b9 any' applicant for. a• permit subjects. the applicant to 'a civil : ,malty of not more than five hundred dollars ($500). r , Reinspection. Fee. $25' Issue Fee' $ 3 P LI I, as owner of the property or my,employ ee.s with wages as their sola Reinspection Fee $25 Issue Fee $:3 compensation, will do the work, and the structure Is not Intended or offered - MECHANICAL FEES for sale: (Section 7044, Business and. Professional Code: The Contractor's - - PUBLIC SERVICES REQUIREMENTS: ' License Law does not apply to an owner of a property' who builds or Improves Boiler i - Hood or Type I ❑ ' thereon, and,who does such work himself/herself or through his or her own - Canopy Type II ❑ Zoning Approved By nate employees, provided that such improvements are not intended or offered for sale. If, however, the building or Improvement Is sold within one year of com- Duct - Under Ground Application Approved By Date pletion, the owner will have the burden of proving he/she did not build or im- , for the purpose of sale). LJ I, as owner of the property, am exclusively contracting with licensed con- M, Duct -Structural Refrigeration System -� • Application Issued By Dat ff-- ' tract ors to construct the proiect (Section 7044, Business antl Professions Code: Duct - Ventilating I ❑0.100,000 BTU 010.0,006BTU SUMMARY OF FEES -The Contractor's -License -Law does not apply to an owner of property who .- builds or improves thereon,.and who contracts for such projects with a con- Exhaust System El Multiple ❑ System Repair/Alteration ' vBUILDING PERMIT $ $MIP $ tractor(s) license pursuant to the Contractor's License Law): ❑ I Section B. & P. for I „ PLAN CHECK $ PERMIT am exempt untler C. this reason Firepl/Fact. Bit. ICBG # I PLUMBING $ ISSUANCE $ ` Date Owner- Heating System & Ducting 1 j Exhaust , PLAN CHECK $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above ❑0-100,000 BTU ❑100,000672 - - "' -'--I - - /'. ELECTRICAL GRADING $ $ information is correct. I agree to comply with all city and county ordinances i and state laws relatinglto building construction, and hereby authorize repre- PLAN CHECK $ MICROFILM $ ' sentatives of thi ity, to enter, upon the above-mentioned .property for inspection purp I 5�6�85 1 Cr)MPrFsC;RQr (4 ton - 7 SO s MECHANICAL $ 50 TOTAL FEE $ signature -(/ Date - - Reinspection Fee • $25 Issue Fee $ 3 PLAN CHECK $ • �j Oj, fo� DriJers'ILicense or SS -CMF 0865-46 rev. 7/83 ' White - Building; Canary =Appilcant; Pink'=Accounting; Goldenrod' -Assessor- - CONSTRUCTION AND PLANNING APPROVALS Permit# Data Inspector POC SPA - ,:,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 LIFER Grnd. 57.,,APPROVALTO.COV,ER-GUNITE 7. Footings H.- Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe;'O Undrgrnd., Test . 9. Water Pipe-Undrgrnd. 60.. Backwash Lilies, P-Trap, O Undrgrnd. 10. Structural Floor Systam 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. ElecthcaPFinal-- 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 660 FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro - 22. Ducts, Ventilating 71. Product, Piping OGas OOil 23. Gas Pipe-Rough & Test 72. Underground Flusli 24. Roof Framing 73. Undergrnd, Storage Tank OGas OOil -25 -noon-Chcethk,q - 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 Notes: 34. Final Heating & Air Conditioning a 35. Final Gas Pipe-Test - 36. Hood or Canopy - . 37. Final Factory Fireplace i 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 4. 42. Backflow Preventer i 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING - - 48. Special Requirements Completed I 49. Electric Release to Edison i I • 50. Gas Release to Southern California Gas Co ' 51. CERTIFICATE OF OCCUPANCY No, Date t City of Costa Mesa • Building Safety Department 'I� CERTI;IFICATE, OF ,OCCUPANCY P.O. Boz. 1200 _ - . Costa Mesa, California i The Building located at ;)AK LTi wn}xar 7ainn,�ca #A..4 has been inspected and found to comply with,the provisions of all City of Costa Mesa Ordinances applicable thei:eto for a Group 14-1 Occupancy. p u Use of Building nvs,,,_,.w. 'r,.,.,.,.,..•a�„•.t-�i Legal Description xt �7...it9'2_n7 NJI (See reverse side for Metes and Bounds),-+,�};t} Building Permit No BM -4887 Electrical Permit No: 1itP-4887 Plumbing Permit No. Number of apartm,ints " —fl- and/or guest roomsM- ISSUED TO: Building Official by rA 11 imn 'Orrw-7 ?*f a c II V. C. No-otm BuilgUQ Division S w D Date.l This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT.BE removed except,by the, Building Official of the City of Costa Mesa under Sec. 306 (e) U.B.C. P"d •- Form BU 34 Rev. 11/70 � � • Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. =CITYOF COSTA MESA Ng PERMIT s1f E TRACT NO. LOT NO. BI -16G. N L ' ' '- - - CONSTRUCTION PER i1 �� TYPE OF CONSTRUCTION ❑NfiW 0 -ADD ❑ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH f806 SOOu Project Address I herPhone Address E-Qj 1 J' DESCRIPTION OF WORK - ZONING REGULATIONS A. P. - ZONE PLNG. REF. # Arch/Eng. - License No. -OTHER - Address - Contractor "' Phone TYPE OF PERMIT B SETBACK L ST. ❑ GRADING ,,,��111 C1 FOUNDATION ❑ STRUCTURAL LIDE YARD ❑ TENANT tLy ELECTRICAL PLUMBING ❑MECHANICA 51E,V YA - Tp gUIRTINC - PROPEY LINE Address LICENSED CONTRACTOR DECLARATION Charter 9 1 hereby affirm that I am licensed under provisions of (com- mencing with section 7000) of Division 3 of the Business and / 1 0 OTHER - - RIGHT Professions Code, and my license is in full force and effect. REAR YARD (TO P/L) PROJECT DESCRIPTION License Class License No. -.SO. FT. _ PKG. SPACE REG. .. STREET WIDTH PROVIDED PARK FEE $ ` Date - Signature WORKERS' COMPENSATION DECLARATION - OCCUPANCY_ CONST R UCT ION TYPE ZONING APPROVED BY DATE I hereby affirm that I have a certificate of consent to self -insure or a ,VALUATION ' certificate of Workers' Compensation Insurance, or a certified copy _ZONE - -• - - thereof (Section 3800, Lab. C.). GRADING CU. YDS. ACRES - SPECIAL CONDITIONS: Policy No. Company - Certified copy is hereby furnished. REMARKS: - Certified copy is flied with the city Building Division. , EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need.not be completed, lf.the. permit is for one hundred or less). - 1$100) certify that n 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 PLAN CHECK subja to tha Workers' Compe Ion La s o Cd liforn id. - ubDat _ - BATHTUBS SHOWERSFT� .. - - - - Si9nat ur NOTICE: after 'making [his aratlon, you should become suti ct (-TOILETS, URINALS 'GENERATOR 0-1 KW_ 1-30 KW to the Workers' Compensation provisions of the Labor Code, you st - TRANSFORMER forthwith comply with such provisions or this permit shall be tleemetl LAVATORIES DOUBLE LAVS" - 'APPLIANCE - -- 10-50 KW_50+KW - - revoked.. .... _ .-._ _ .. _ _ CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS "MOTORS 04 HP"_ -_. 1-30 HP' I hereby affirm that there is a construction lending agency for the per- SERVICESINKS SUMPS " - . (INC. SOLAR).. -30-50 HPy_� 50 -+-HP• - - ..- , formance of the work for which this permit is Issued (Section 3097 FOOSINKS FLOOR ORAINS� ` "" LR I FIXTURES OUTLETS -SWITCHES " -"- TC 'CIv. C.). —. - .- -•- - . - _ _ __r.. Lender's Name Lentler's Atltlress DRINKING FOUNTAINS - GAS TUBE SIGNS RCEPTOftS CLARIFIERS POLE LIGHTS -- OWNER BUILDER DECLARATION" -"--(NTE I hereby affirm that I am exempt from the Contractor's License Law for SWIMMINGPOOL P TRAP POLES METERED. - SUB . the following -reason (Section 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, 'WATER SERVICE �- ALTERATION .. - - � PANELS' � -MAIN -' - .SUB - improve,-demolish'or repair -any structure, prior to Its issuance, also re- quires the applicant for such permit to file a signed statement that he 'GAS SERV ICE OUTLETS SERVICE" - " - �0 AMP''• is licensed pursuant'to the'provislons-of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS ' BTU OUTPUT Buslness'and Professions Code) or that he Is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS '•- applicant for a'permit sub)ects�the applicant to a civil penalty lot more than five hundred dollars ($SOO). SOLAR TANK COLLECTORS 1, ai owner of the property, or my employees with wages as their sale compensation, willdothe work, and the structure isnot intended or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. - ISSUE FEE " " "3. 920 .Contractor's .License. Lew does not apply,to an owner of a property ISSUE FEE APPLICATION APPROVED BY 'DAT /7 who builds or improves thereon, and who\Coes such work himself or through his own employees_ provided that st{ch Improvements are not MECHANICAL PLAN CHECK _ SUMMARY OF FEES,-, intended or offered for sale. If, however, the building or improvement is sold within one year of Completion, the owner will have the burden of proving he did not build Or improve for`the purpose of sale). HEATING SYSTEM 0-100,000 BTU BUILDING"-- '' PERMIT $ - -- - - SMTP% .0I, as -owner of the property, am exclusively contracting with "AND'DUCTING' - - - _•$_ - licensed contractors to construct the project (Se tion 7044, Business 100,000+gTU PLAN CHECK $ PERMIT - -and' Professions -Cotler The Contractor's LicenseLa tloes not apply to- - - - - -ISSUANCE $- an owner of property who builds or improves they on, and who con- an REFRIGERATION 0-100,000 BTU PLUMBING tracts from such .projects with a contractor(s) lice ned-pursuant to SYSTEM -- -- -- - - _,$ - - - -- •- -CHECK GRADING $.` the Contractor's License Law). 100,000+BTU PLAN ^$ - ❑ I am exempt under Section B_ & P. C. for this BOILERS BTU ELECTRICAL -; - $ reason -SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE PLAN CHECK $ - - MECHANICAL', $' 'MICROFILM $ TOTAL' FEE $ 'LESS AD - -Date Ownor 1" hereby, certify that I have read this application and state that the ab a information is Correct. I agree to comply with all city and cou y PLAN CHECK '$ VAN_ CE PC $ ordinances and state laws relating to construction, and hereby authorize representatives of t city to enter Pon' the above mentioned Proper or ins act r o } Signal _ - - ISSUE FEE- - - FINAL FEE Drivers' ense or 55 - CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor EA CONSTRUCTION AND PLANNING APPROVALS Permit Date - Inspector POOL & SON-- PA•:Date •' ._ Date _ Inspector APPROVALS Permit4# 1. Temporary Electrical Service or Pole _ - 43. 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 ein orce ., 47. Rough Plumbing & Pressure Test - 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE - - - 7. Footings 49. Electrical Conduit-Undr rn .8. Foundation 50. -Gas Pipe, ❑ Undr rn, Test - 9.. Water Pipe-Undrgrn _ 51. Backwash Lines P -Trap.❑ Undrqrn - - 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 13. Rough Plumbing _ -55 Plumbirin System Final- 14. Rough Electric -Conduit - -56.--Electrical-Final 15. Rough Electric -Wiring- - 57: Solar System -Final - 16: Rough Heating & Air Conditioning - - - - - - _ encing.& Access Approval - 17.- Ducts in.Structure 59. APPROVED FOR PLASTERING 18.. Ducts, Ventilating .. _. POOL/SPASYSTEMS•FINAL - - - •' • - 19. Gas Pipe -Rough &Test- - _ -- 20.- Roof Framing - - . -• - - •' 21. - Roof Sheathing-' 'r --- - - - " ' ' " '" NOTES:'01 - 22. Frame and -Flashing 23. Insulation -_ 24.- - Lathing & Siding ' " - - - -- -- - -• 25.. Drywall Nailing. _ - -- - - - - - 26. - Plaster Brown'Coat - 27., Electrical.Power-Meter-Final' - ;_ ,2 -:10 stj- - - '' 28. - Final Electric "- '- -- -- •- -- -;-- -- - - - -- 29. Final Heating & Air Conditioning y_ _ 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. FINAL STRUCTURE & BUILDING - 39. Special Requirements Completed - - 40. Electric Release to Edison - - - - - 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date - - Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. SITY-OF COSTA MESA- - PERMIT NO TRACT NO. LOT NO.; BLDG. NO. 5604 BIp.`�•B2 73e9B ,CONSTRUCTION PERMIT D� _ TYPE OF CONSTRUCTION ❑ NEW ADD ' ❑ ALTERATION ❑ REPAIR ❑ CONVER SION ❑DEMOLISH - - - - Project Address _2 S ¢� e, ' Owner Phoria I Address _ .S _I - ❑ OTHER - - "-- ZONING REGULATIONS ' ArchlEng. License No. DESCRIPTION OF WORK ' A'P'B "'03•x- - ZONE - PLNG. REFfs " Address Contractor,ZOPC Phones 3 TYPE OF PERMIT '•f- - -" - I - • GRADING ❑ FOUNDATION- •0 STRUCTURAL- RAL- - ❑ TENANT❑ ELECTRICAL' PLUMBING ❑MECHANIC - Tp tIf� LLpp SET ACK C T. PRO PEIRTY LINE SID -VARD- -- _- - -L51ED Yq Address - LICENSED CONTRACTOR DECLARATION "-' ' I hereby affirm that 1 am licensed under Provisions of Charter 9 (com- 3 Business and C] OTHER.Prof RIGHT mencing. with section 7000) of Division of the Isom Co a d my license Is In full force antl effect. _lr L _ 3//� LltenseClass - -License o. _ PROJECT. DESCRIPTION' --PKG: REAR YARD (TO P/L) - - - SPACE REO: -'PROVIDED" Date 7- Lx -DL Signature �� 1 s n/v/�. SQ.__FT.. '. i' 1 . _ ___ -. _ . _ (STREET WIDTH 'PARK•FEE$ WORKERS'COMPENSATION DECLARATION OCCUPANCY- CONST R UCT ION TYPE _ d hereby affirm that I have a certificate of consent to self -Insure ora - - VALUATIONS std,_ ZONE -iZONING-APPROVED•BV DATE - - certificate .of Workers' Compensation Insurance, or a certlfletl copy I' - 'SPECIAL CONDITIONS: - thereof (Se tion 00 l b ). ,-w GRA DINGCU.tY05. ACRES^ MlicY No. t 3 ComPa nY ,ry/ts/O n// _ __ - _ _ - _ _ _ - ____ _ _ -_ _ _ ertifietl copy is herebyfurnished... L i -REMARKS:! _ --_ ,ertified 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 - sc it + L+1 :-i _ ^t-' .•p. •SCI - 1 certify that in theperformance of the work for which this permit is - - - �. ., Issued hall not-emptoy"any person in any -manner so as -to become , -P.LUMBING- -- - PLAN CHECK-- -- �' ' ' t' --- - 'ELECTRICAL' ------"PLAWCHECK-- - '- subject t0 the Workers Compensation Laws of California. 1Y '. - BATHTUBS -BATHTUBS-- --SHOWERS"--__•-f-- - - - _r_. _ _ 7 - q0_ FT __ -. - ,._ .._ ._ ._ Date Signature Date NOTICE: If after making this declaration, You should become subject, TOILETS URINALS • -• ---- -, - -- -GENERATOR- - -0-1-KW - _ "10 KW-' '- - '4 to the Workers' Compensation provisions of the Labor Code, you must - - TRANSFORMER — n• '.�as.t 2. t KW' forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS --- -f-- - -'APPLIANCE--- -10-50 KW_50-+ - - revoked. _ CONSTRUCTION -LENDING AGENCY __ - _ -KIT. SINKS-- --DISHWASHERS - + _ . _ _ MOTORS -0-1-HP�1-lO HP - f I hereby affirm that there isach lending agency for the per. SERVICE SINKS - SUMPS-- --J-•----'y(INC..SOLAR)X10-50 -n HP 50.+HP --- - thisper formance of the work for which [his permit is Issued (Section 3097 a -FLOOR'SINKS'--- - FLOOR DRAINS' - "- rFIXTURES"--- OUTLETS SWITCHES--- - - Cl v. CJ---. ----r .- - -- - -- ,\ - - a _ LenCees Nalrrte, ..z..c _. . • .: _ Lender's Address - - ~ - _ _ DRINKING FOUNTAINS - 'y-• - - r- _ GAS TUBE SIGNS-- -- -- INTERCEPTORS ' `""- CLARIFIERS " - - •IPOLE-LIGHTS--- - - - - - - - - - OWNER BUILDER DECLARATION- I hereby affirm that I am exempt from the Contractor's License Law for P•TRAP ---•- - SWIMMING POOL--P-TRAP- - - -- - POLES' - METERED -- SUB-_." the following. reason -(Section, 7031.5_ Business and Professions Code:. Any City or county which requires a Permit to construct, alter, Any WATER -SERVICE--- ALTERATION - -- - -- - 'PANELS - -- - MAIN-- - - SUB - - - ,more ve,.demelish or -repair any structure,.pric,to.its.issuance, also.re> quires the an, licant for Such Permit to file a signed statement that he -GAS SERV ICE" -- "` - OUTLETS"- - - I - - _ SERVICE -- --- -- ---- - AMP- - is licensed pursuant -to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Prufessions Code) he is exempt therefrom and the. 8 usiness.and or .that basis for the alleged exemption. Any violation of Section 7031.5 by WATER HEATERS - -BTU OUTPUT -_ _ - _ - SEWER CONNECTIONS - -i --- ---- -- - - - ---^ --- --- - - - ---- - - -. - I aPPlicant. for a permit subjects. -the applicant to a_civll penalty t more than five hundred dollars ($500). - SOLAR TANK •- - - -COLLECTORS - - -- _ - --- - - - - - - - -- - -as owner -of the property, Or my employees with wages -as their Sole compensation, will do the work, and the structure is not intended _ or offered for sale. -(Section 7044, -Business and Professions Code: -The SOLAR -PIPING SYS: - - j, - -- - - - -, ' ISSUE FEE- -�- - •-- - - - - - -- Contractor's License Law does not apply to an owner of a property who builds -or'improves thereon; and -who does Such work himself or - ISSUE FEE -" - " -' '?�- -"-"'" - - - - -APPLICATION-APPROVED BV-.--. _ -. DATE -- through his own employees, provided that such Improvements are not - MECHANICAL PLAN CHECK" - - - - - -F - - ---^ - - -4U M - - - - - lMARY OF, FEES -- , ; - - BUILDING---- - SD _ - _ _ ! intended or'oitered for sale. 11, however, the building orlmprovement- is sold within one year of completion, the Owner will have the burden of -proving he did not -build Or improve -for the -purpose of sale). HEATING SYSTEM 0-I OO,000 BTU-� (PERMIT •;S• SMIP '� ❑ I, as Owner of the am exclusively contracting with licensed -contractors to construct the protect (Section 7044, Business AND DUCTING ----l• -- 100,000.+BTU - r �' `•$• - - - - --- PLAN CHECK $-0-01 and Professions, Cotle: The Contractor's License Law does not apply to. 'REFRIGERATION �; _ .PERMIT ,• __ .- _ _ ^_ISSUANCE � $ an owner of property who builds or improves thereon, and who con- 0-100,000 BTU PCUM61NG, $ • s °' tracts from such projects with, a contractor(s), Iicesned pursuant to - SYSTEM _ I. - '- ' - GRADINGi'St �E- - - the Contractor's License Caw). 100,000N BTU-- `PLAN CHECK ' J El 1 am exempt under Section•B. & P. C. for this. - - -- - - -- BOILERS '- BTl'J - - -- _ _ ... $A ELECTRICAL E- . reason_ - - - --- SYSTEM REPAIR, TIN ALTERAO EXHAUST SYSTEM MULTIPLE _ -- - -PLAN CHECK -$ _ :MICROFILM S'- _ MECHANICAL E- - - -TOTAL FEES - �� LESS AD-. •� - - Date Owner I herebY certify that I have read this application and state that the above information is -correct. I agree to comply with all -city and county PLAN CHECK -$ ---VANCEPC'$- -• ordinances antl state laws relating t0 construction, antl hereby authgriz¢ representatives .of -this-city to enter upon the above mentioned Property I/nsg5�ection pJ�J poses. it �f�p_ Signature'L�fh., I '�Z �- - - - - CMF 0065-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor TL CONSTRUCTION AND PLANNING - APPROVALS Permit # � qo8 Date Inspector' POOL & SPA -- APPROVALS Permit # Date Inspector _ _1. Temporary Electrical Service or P_ole 43. Pool & Equipment Location 2. Soil, ipe•Un rgrn' 44. Steel Reinforcement 3. Electrical Conduit,Utility-Undrgrn 45. Forms" _ 4. Electrical Conduit-Undrgrn - 46. Electrical Bonding _ 5. Steel ein orce 47. Rough Plumbing & Pressure Test 6... Electrical,UFER Grn _ _ 48. APPROVAL TO COVER-GUNITE - - - - - - 7. Footings _ 49. Electrical Conduit-Undr rn ' .8. Foundation. _ ._ 50: -,Gas Pipe,:0 Undr rn Test 9. -Water Pipe-Undrgrn _ ? 51. _ ❑ Undrqrn Backwash Lines P -Trap. 10. _ $tructural.Floor System: 52. APPROVAL TO DECK 11. Property Sewer Line.& House Connection - 53. Backwash & Receptor -Final ' . 12. - Street Sewer Connection- - 54. Heater & Vent -Final 13. Rough Plumbing._umbind Pl System - Final 14. Rough Electric -Conduit -' ' -- ' " - _ 'S6. Electrical -Final 15. Rough Electric -Wiring - -- - - - -- -57. - Solar System -Final - 16. • Rough Heating & Air Conditioning - - - •- Fencing & Access Approval - 17: Ducts in Structure'-- - - APPROVED .FOR .PLASTERING ' 18. - Ducts, Ventilating -�'- - - - -- - - - - .60. - - - - - POOL/SPA SYSTEMS FINAL - -' 19. Gas Pipe -Rough & Test - -1 - 20. Roof Framing -- -- - - - -- - - •-- - ' 21: Roof Sheathing _'NOTES:_ - 22:-- Frame and Flashing --- - - - - -i• -- - - 23. - Insulation - - -- - - - - -- - -- - 24. Lathing & Siding 25.- Drywall Nailing 26. Plaster Brown Coat- - `- - - - --- -- - _ 27. Electrical Power Meter -Final---- 28. Final•Electric - - - - - - - - - - - - - 29i Final Heating & Air Conditioning - - -• - -- 30. Final Gas Pipe -Test 31t Final Plumbing - 32.- Water Service -Final -33. Gas Service -Final 34. Solar DomesticFinal 35. 6&wkeepe Sprinkling System 36. Sound Attenuation !! 37. Handicap Regulations -- - - 38. FINAL STRUCTURE & BUILDING -' 39. Special Requirements Completed 40. Electric Release to Edison _ 41. Gas Release to Southern California Gas Co. - 42. - CERTIFICATE OF OCCUPANCY No _ Date .. 0 Aoolleant to fill in all spaces within heavy border lines and slnn all 3DDMDriale declarations. A*ITY OF COSTA MESA - PEgIMIT NO. 1 TRACT NO. -LOT NO. BLDG.% - 8091 - 9/21 /82 23.00 ,'CONSTRUCTION PERMIT /V! `' TYPE OF C NSTRUCTION D - � ALTERATION ❑ REPAIR..O CONVERSION ❑DEMOLISH ❑ OTHER ,,, - ) ZONING REGULATIONS , - Project Address - _ Owner JT1110M Phone1••�/NEW Address natAq M - - Arch/Eng.-- License No. DESCRIPTION OF WORK _ _ - t, A.P. rP •,^ ZONE _ PLNG. REF. 9F - Address 1 _ _ .. _ r Contractor - - Phone { t ypE OF PERMIT, - - - •SID TTpp ggtt�� pp PROPEIRTVNLINE: I. `. - - -� T- Addr r - GRADING --� 0 FOUNDATION ❑ STRUCTURAL- - 'El TENANT ❑-ELECTRICAL: PLUMBINCyaTIL•s..HANIC YARD - - - - LICENSED CONT ACTOR DECLARATION I hereby affirm lhLt I am licensed under provisions of Charter 9 (Com- SIMy RIGHT C mencing with section 7000) -of Division 3 of -the -Business -and ' ❑'OTHER antl my Ilnse Is In full for,gf(gt. ProfCo e, lca ". REAR YARD (TO P/L) - --- -' "- -, - -� PROJECT DESCRIPTIONesilont " License I ss. s - Ucesf, - - - -' PKC: $PRCEREO.- '- PROVIDED,., __ - - - 1Dite • " Signature - SQ' FT: .. M_ ' "_ __ __ STREET'WIDTH' _ _ - PARK'FEE E" WORKERS' COMPENSATION DECLARATION - ,thereby affirm that 1 have a certificate of consent to self -Insure ora ,I OCCUPANCY YPE CO NST RUCT ION_ TYPE- ..VALUATION ZONE 'ZONINGAPPROVED BY - - DATE ---- �certifimte of Workers' Compensation 1 urs ca, or a.Qertifletl copy: -_ thereof ( q2MLab, C. ) I GRADING YDS. 1( ACRES 1 - SPECIAL CONDITIONS:- '• kyN COmPanY _CU: ertifled copy is hereby furnished. _. - _-___ _ - •_ REMARKS:: :Oltlfled copy is•filed with the city yulltling Division. ;EXEMPTION FROM WORKERS' COMPENSATION•DECLARATION'}- (This section need not be completed if the Permit is for one huntl red , (E300) or less). r .Certify that in the _ performance of the work for which this permit is Issued, in any manner so become PLUMBING -,.,j '- -AN CHECK- -' _ - - � Ishall not employ any parson as,Co d / ,IPL ELECTRICAL -- PLAN CHECK - - subject.to the.Workers -Compensation LAWS of California .• _ -_-_ i I __ BATHTUBS------" SHOWERS -"' -' , UWLLLING-•FT. —�- ARAUL - - - ,Dale Signature NOTICE: If after making this declaration. you should become subject TOILETS ,URINALS - -' $GENERATOR- - 0 -1 -KW TRANSFORMER, 1--10-KW "- to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAV$ �- ----- - APPLIANCE- -10-SO KW_50+ KWrevoke- - --_. 'CONStl. ` KIT. SINKS' --' --- DISHWASHERS - - - - '" MOTORS--- 0-1 HP --- - - --- CONSTRUCTION UCTION LENDING AGENCY •1 hereby affirm that there Is a construction lending agency for the per. SERVICE SINKS SV MPS- -" -' - - - - -- - -- .y(INC. SOLAR) -� 10-50.HP 50!. HP:" formance of the work for whlCh this permit is Issued (Section 3097 1 - -FL"OOR'SINK$`"lam"FLOr OR-ORAINS" +"' "• - .FI%TURES -- OUTLETS ---SWITCHES --' - - �Clv.-C:). - - �' -� .-.: -- '- - - 'ry,- iLender•s Name, _• _ _ tLender'3Address` - •^jC DRINKING FOVfJTAINS'-- - -� - - .GASTUBE-SIGNS --- - -- - OWNER.BUILDER'DECLARATION •� '• -`O'-" I hereby,afflrm instil am exempt from the Contractor's License Law fol' IN CLARIFIERS"- �' ',POLE LIGHT$- ----- POLE - -- - the following- reason(Section 7031.5,0usiness-and- Professlons-Codec 'SWIMMING POOL -- -PTRAP -- - -" - ""SUB- Any city or,rcounty` which reguires a permit.to construCt,.alter, - POLES METERED'" UB- - WATER SERVICE -- ALTERATION - ) PANELS - - - -MAIN - - SUB • - - improve, demolish or repair any steuclure, piior'to•its Wuance,`also re- Improve-,demolish quires the ap, Iicant for such Permit to Nle a signed statement that he.. -GAS SERVICE- .: OUTLETS ""'-" �- - _ - SERVICE - - ----- -- • --- AMP - Is licensed pursuant totheprovisions of the -Contractor's License Law (Chapter 9 (commersol n9 with Sectlop 7000) of, Division 3 of the WATER HEATERS --'-BTU OUTPUT - 7 - - - - - — - - .Business and Aolessio Ms Code) or that he isrexempt therefrom anti the ,for ,brsius,for ine allegemviolation exeption. Any vlolaom of Section 7031.5'by -OW 'SEWER CONNECTIONS I ''• - •--- - -- - - -- --- - - - ¢,.t ppplica nt.for a permit subjects the applicant to a penalty F_*'r„-It more than five hundredWOOL .dollars t"5, as owner of the property, or my employees with wages as their" SOLAR TANK- - - - •COLLECTORS - sole compensation; will do_the work, and,the structure is not Intended nor ,offered for sale. (Section 7044, Business and Professions Code: The .Contractor's LIcense,Law'does not'applVto an -owner of a property- SOLAR PIPING SVS. ” _ 'I" --- - - --ISSUE-FEE- - - - - ^ - - - ----- - ISSUtFEE I �" -' - -- { -- -' APPLICATION APPROVED BY _ '- - .DATE.- wh0 builds or improves thereon, and who does such work himself or through -his own employees, provided that such Improvements are not -- N CHECK MECHANICAL PLA .- " SUMMARY OF FEES •r t ^ intended or offered for sale. If, however, the building or Improvement is sold within one year of completion, the owner will have the burden of proving he did not build Or 'improve for the purpose of sale). exclusively_ contracting with - - - - - - HEATING SYSTEM 0-100,000 BTU" BUILDING PERMIT -_ISMIPi s. 1 ,E -1,--as owner -of-the property, am licensed contractors to construct the Project (Section 7044, Business Professions. Code: The License Law does not apply to.ISSUANCE AND DUCTING -- - - --- _ _ 100,000 BTU_PLAN _ _a CHECK_ E ,PERMIT s• and -Contractor's an Owner of property who builds or improves thereon, and who con- from to REFRIGERATION 0.100,000 BTU ttPLUMBING E - I ° "_8)f' 1` tracts -such -projects-with a consractor(s)-licesned pursuant the Contractor's License Law). SYSTEM --- - - - - _ 100,000 +-BTU - _ _ _ PLAN CHECK" E GRADING - i-- - ,' }. ❑' I am exempt under Section - - B. & P. C. for this' - --- - --- - - -- - - BOILERS BTU ELECTRICAL E1" -- �.' _ _. _ S�- _ ' reason - - - - - t - ---- SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE ! PLAN CHECK- E 1 MECHANICAL- E _ MICROFR-M E " - TOTAL FEE Er' -• - - - -- ---_.. ,9r' LESS 1• ..� .Date Owner I hereby certify that I have read this application and state that the above Information is correct:'l agree to�corr,Pl with all Cit g y City county PLAN CHECK E - - VANCE E_ E PC - ordinances and state laws rel ting t0 construction, and hereby authorise14 'lo represents a ter" upon the mentioned representative OT his Sl property f u tion s Signature / 'Oatel�& '7f -i• - _ - FINAL FEE E0C - --- Drivers' License or 55 � - - - -- - ISSUE FEE - CMF 0865-46 White -Building; Canary-APPIICant; Pink -Accounting; Goldenrod -Assessor TL CONSTRUCTION AND PLANNING APPROVALS Permit# rn �r 9i7 Date Inspector POOL &SPA APPROVALS Permit '# Date - Inspector - 1., Temporary Electrical Service or -Pole . - ; \ 43. Pool & Equipment Location - - •-� - - . SoilPipe-Undrgrn 44. Steel Reinforcement - - - - 3. Electrical Conduit Utility-Undrgrn - 45:• Forms 4. Electrical. Conduit-Undrgrn _46. - Electrical Bonding. _ --- - - - - .5. Steel -Reinforce 47. .Rough Plumbing & Pressure Test - - -..- 6. Electrical.U,ER-Grn.._ '48. APPROVAL TO COVER-GUNITE- - - - - - �- -- 7... _ Footings 49. Electrical Conduit•Undr rri' - • •• -8. - Foundation _ .. ___ . 50:. Gas Pipe, ❑ Undr rn, Test - - 9: - Water-Pipe-Undrgrn 51. Backwash Lines P -T rap, U ❑ ndr arn. "" - - 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 A 3. Rough Plumbing 55- -Plumbi a System 14. Rough Electric -Conduit V •50 Electrical -Final --_ 15. Rough Electric -Wiring -- 57: --Solar System -Final - - 16. - Rough Heating & Air Conditioning -- - - _ - encing:&-Access Approval - 17. Ducts in Structure W, APPROVED FOR. PLASTERING'.. ' 18. 19: 20. Ducts, Ventilating Gas Pipe -Rough & Test - - - - - Roof Framing 60. _ POOL/SPA SYSTEMS FINAL • , 21. 22. Roof Sheathing- - - Frame and Flashing - -- -- - NOTES: 23. Insulation - - - Z- 24! Lathing & Siding - - - - - - - 25. Drywall Nailing --- .-� 26. Plaster Brown Coat - - - ,01 27-. Electrical Power -Meter -Final - -- - - - - - - 28. Final Electric - - - -- - - - - - - - -1 -- - - - 29. - Final'Heating &-AirConditioning 01- 30. Final Gas Pipe -Test - - - --------- - 311 Final Plumbing I 32. 33.- - Water -Service -Final - - -- - - -i - Gas Service -Final ' 34. Solar Domestic -Final'' "• 35. Landscape Sprinkling System 367-Sou-nd Attenuation 37. Handicap Regulations - -- " - 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40.. Electric Release to Edison - - - 41. Gas Release to Southern California Gas Co. 42. _CERTIFICATE OF OCCUPANCY - - - - - - No Date '' A Z Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. -- .0TY"61-- COSTA MESA PERMIT NO. TRACT NO. LOT NO. BLDG. fie"' - - CONSTRUCTION PERMIT "T7 I -,S TYPE OF CONSTRUCTI El NEW El ADD RrALTERATION ❑1REPAIR ❑�ONV ERSION ❑DEMOLISH -ip it,,, r �� Lg� ? e �'• or , - Project Address f - Owner jll Phone Addfess Address vl1 EW 14' yt VJ OTHER VG _A-' T i f4 "ZONING R GU LATIO NS Afch/Eng. �.� License No. DESCRIPTION OF WORK A.P. gP ;r n�QN ;- n•s •^PLNG. REF. 91c Address - 'Contractor C9WN Ir w Ider Phone "TYPE OF PERMIT ❑ GRADING ❑ FOVNOATIO 1 ,..,(JJ �STRUCTV RAL ❑ TENANT WJ ELECTRICAL IYJ PLUMBING ❑MECHANP. nl _, _ SETBACK C L T. ID YARD SIEpE V '�ttop gg�1/1I` pINC P0.(JPE RTY LINE Address - LICENSED CONTRACTOR DECLARATION I hereby that I licensed of Charter 9 (com- affirm am under provisions mencing with section 7000) of Division 3 of the Business and ❑ OTHER RIGHT - professions Code, and my license is in full force and effect. REAR YARD (TO P/L) PROJECT DESCRIPTION License Class License No. - PKC. SPACE REQ. - PROVIDED - FT. Date Signature .SQ. , OCCUPANCY_ CONST RUCT ION TYPE STREET WIDTH PARK FEE$ WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -Insure ora VALUATION ZONE ZONING APPROVED BY DATE Certificate of Workers'- Compensation Insurance, or a certified copy GRADING CU. YOS. ACRES SPECIAL CONDITIONS: thereof (Section 3800, Lab. C.). Policy No. Company Certified copy Is hereby furnished. - REMARKS: ' Certified copy is filed with the city Building Division: - 'CXEMPTION FROM WORKERS' COMPHNSATIONDECLARATION - - (This section need not be completed if the permit is for one hundred J$100) or less. certify that in the performance of the work for which this permit Is issuedI shall not employ any person in any manner so as to become PLUMBING - PLAN CHECK ELECTRICAL PLAN CHECK subject f0 the Workers' Compensation Laws of California. - BATHTUBS SHOWERSUwILILLIML - Date Signature NOTICE: If after making this declaration, you should become subject TOILETS URINALS GENERATOR 0-1 KW_ 1 -10 -KW 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 30-50 KW_50'* KW - revoked. KIT. SINKS - DISHWASHERS MOTORS 0-1 HP -1-10 HP ^ _ CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction fending agency for the per- SERVICE SINKS SUMPS - (INC. SOLAR) 10-50 HP_ 501'HP - - formance of the work for which this permit is issued (Section 3097 FLOOR SINKS FLOOR DRAINS - FIXTURES' OUTLETS SWITCHES Civ. .). - -- -- Lender's Lentl Name Lender's Address DRINKING FOUNTAINS' GAS TUBE SIGNS - - - - - -- - OWNERBUILDERDECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for INTERCEPTORS CLARIFIERS POLE LIGHTS - - - the following reason (Section 7031.5 Business antl-Professions Code: POOL' PTRAP - -777 - - - - Any city or county which requires a permit to construct, alter, POLES METERED SOO WATER SERVICE ALTERATION - PANELS MAIN - SUB ' improve,, demolish or repair any -structure. prior to Its issuance, also re- quires the applicant for such permit to file a signed statement that he - SERVICE OUTLETS is licensed pursuant to the provisions of the Contractor's License Law- Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS - BTU OUTPUT - - -- -- - - - iness and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of .Section 7031.5 by SEWER CONNECTIONS - '• �-^ - - -- -' applicant for a permR subjects• the applicant to a civil penally lot more than live hundred dollars ($500). SOLAR TANK COLLECTORS' 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. (Section 7044, Business and Professions Code: The _ SOLAR PIPING SVS. ISSUE FEE Contractor's License Law does not apply to an owner of a property ISSUE FEE APPLICATION APPROVED BY - -DATE ' who bullds or Improves thereon, and who does such work himself or through his own employees, provided that such Improvements are not MECHANICAL PLAN CHECK SUMMARY OF, FEES„ intended or offered for sale. If, however, the building or'Improvement Is owner will have the burden sold within one year of completion, the of probing -tie did not build or improve for the -purpose of sale).BUILDING' - ❑•I, as owner of the property, amexclusively contracting with HEATING SYSTEM 0-100,000 BTU PERMIT $ SMIP $ licensed contractors to construct the project (Section 7044, Business - AND DUCTING 100,000 +BTU PLAN CHECK E PERMIT - and Professions -Code: The Contractor's License Law does not apply to - - ISSUANCE - $ an owner of property who builds or Imploves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts from such projects with a-contradtor(s) lleesned pursuant to SYSTEM - - .. GRADING $ the Contractor's License Law). 100,000 t BTU PLAN CHECK $ 0-1 am exempt under Section- B: & P. C. for this BOILERS BTU - ELECTRICAL $- $ reason- SYSTEM REPAIR, ALTERATION - PLAN CHECK' $ MECHANICAL $'. ' • MICROFILM E - TOTAL FEE V Date Owner I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE LESS AD- ' information is correct'. I agree to comply with all city and county -PLAN CHECK E VANCE PC $ - ordinances and state laws relating to construction, antl hereby authorize 'representatives of this -city to enter' upon the above -mentioned property fo inspection pu oses. Signature ��DateI 'i -43 , - .ISSUE FEE FINAL FEE $ Drivers' License or 55 ��_ _ CMF 0865-46 White-Bullding; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING ••_ Y - Date APPROVALS Permit•# , - p •. ' ` POOL & SPAS 71, Inspector - - Date - Inspector - ',APPROVALS Permit # 1. Temporary Electrical Service or Pole - ti 43. Pool & Equipment Location - SoilPFIpe-Undrgrn 44. Steel Reinforcement - 3. Electrical Conduit Utility,-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn• 46. Electrical Bonding 5. Steel ein orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation. 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P -Trap.❑ Undrqrn 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 13.. Rough Plumbing 14. Rough Electric -Conduit '-56. - Electrical -Final 15. Rough Electric -Wiring 57: _ Solar System -Final 16. Rough Heating & Air Conditioning W. Fencing & Access Approval 17. Ducts in Structure APPROVED FOR PLASTERING 18. 19. 20. Ducts,. Vent! lating Gas Pipe -Rough &Test Roof Framing - 60. POOL/SPA SYSTEMS FINAL 21. 22. Roof Sheathing' Frameand Flashing _ _ NOTES: 23. Insulation 24. Lathing & Siding - 25. Drywall Nailing - 26. Plaster Brown Coat - - - 27. Electrical Power Meter -Final 28. Final -Electric - - - -1 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 S rinklin'S stem+ 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison - 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY Date - �__---- - l0 fill in ]IIS S �Ihl rye]V _ - b0fiber-....-eclarations. Applicant M IT NO. TRACT N0. LOT NO. BLDG. NO. j 7917 9/20182230.21 TL ,MIT 3 S Pr ' ct, ess TYPE OF CONSTRUCTION , OW of Phon ❑ NEW ❑ ADD ❑ ALTERATION - - Address 60"t - ❑REPAIR ❑CONVERSION DE L H ' ZONING REGULATIONS Arch/Eng. License No. OTHER D CRIPTIONOFWORK' A.P. •¢ — •' Address " - - - • ZONE PLNG. REF. " Contractor - - Pho r= YPE OF PERMIT' - -"BUILUING-��O GNE •- Address - ❑ GRADING. ❑ FOUNDATI0 ❑ STRUCTURAL SET ACK C T. - - - - 'LICENSED CONTRACTOR DECLARATION I hereby affirm thct 1 am licensed under of Charter 9 (com• TENANT ELECTRICAL LUMBING �- ❑MECHANICA WARD L5IEpE y provisions mencing with section 7000) of Division 3 -of the Business an 1 -. - ❑RD OTHER - - RIGMT Professions Code, and my license is in full force. and effect. REAR YARD (TO P - - " .PROJECT•DESCRIPTION _ - - License Class License No.� •SO. ` _ I PKC. SPACE RE PROVIDED = ' Date -Signature - FT.12' ��f- •'• ��S•.`- p-�� AIC7 - STREET WIDTH •,' PARK FEE S WORKERS' COMPENSATION DECLARATION _ OCCUPANCY&2t-CONSTRUCT IO N TY P I hereby affirm that I nave a certificate of consent to self -insure ora �y.y� ZONA ZONING A?PROV ED BY ATE certificateofWorkers' Compensation Insurance, or a certified copy -VALUATIONILiLGL hereof (Section 3800, Lab. C.). GRADING CU. YDS. "�� ACRES ,SPECIAL C//Os••��N�s��D1p7IONS:: - - Policy No. - -- Company - - -- S�;; Y7lJ L'Jl'OR sf (3 Certified copy is herepY furnished. - REMA0. K5: 7 77=709 Lc� iy Certified copy Is filed with the City Building Division. - 1MPTION FROM WORKERS' COMPENSATION DECLARATION •r - '�•r'�' 5, section need not be completed if the permit IS for one hundred r - .1 t..00) or less). • (.certify that.ln. the performance of the work for which thispermitIs issued, I shall not employ any per n in r mann so a 'become _ ,'PLUMBING, dr, , p , ,PLAN -CHECK - ELECTRIC PLAN CHECK ' subje to W gis'-Compensat La f C Ia. -Date Signature - _ _ BATHTUBS -SHOWERS •NOTICE: If after making this dec aration, you should become subject TOILETsn - URINALS '- - - - " "' Q'GENERATOR 0=1 KW_ 'TRANSFORMER 1-10'KW - to the Workers' Compensation Provisions of the Labor Cotle, you must � •� I i forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS _`- - Q APPLIANCE - 10.50 KW�50+KW ' revoked.-- _ KIT. SINKS - �'"- DISHWASHERS "Q MOTORS" - — 0-1 HP_1-10 HP_ - - 'CONSTRUCTION LENDING AGENCY n it hereby affirm that there is a construction lending agency for the per. SERVICE SINKS r . ,� SUMPS- - '-- -- -- - .UNC. SOLAR) a 10-50.HP_50•♦ HP formance of the work for which this permit Is issued (Section 3097 rnl..N r.. - - LenderC.�s,Nanie-. , .FLOOR SINKsy i s. F LOO R DRAINS" FIXTURES- UTLET M ITCHES _ ,Lender's Address PRINKING FOUNTAINS I GAS TUBE SIGNS -- - - - - - -- - • - - - - - - OWNER 'BUILDER"DECLARATION" I hereby affirm that I am exempt from the Contractor's License Law INTERCEPTORS •�' CLARIFIERS POLE LIGHTS' - e:- the following reason (Section 7quire Business and ' Professions Cotler .SWIMMING POOL`,- PTRAP -- '- - - - •. Any city county which a -permit to .construct, alt POLES METERED .SUB -' - WATER SERV ICE' -`ALTERATION, - ^PANELS- � MAIN SUB- - • - ;SUB- re- any structure, prior to its Issuance, also re- e;aeric demolish of repair y structure, quireslrrlpr. such the applicant for Such permit to file a signed statement that he GAS SERVICE OUTLETS - - SERVICE - -• -AMP - is -licensed pbrsuani'lo'[ne provisions of Contractor's -License Law Is Is lice 2Chapter 9 (commencing with Section 7000) of Division 3 of the usiness and Professions Code) Or that he IS exempt therefrom and the , WATER HEATERS BTU OUTPUT basis for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS - '• --- - -- - - - any applicant for a permit' subjects the appll cant to a civil' penalty of not more than live hundred dollars ($500). SOLAR TANK - - COLLECTORS- M '. as owner of the property, or my employees with wages as their' -ompensation, will do.the.work, and thestructure is not Intended fered for sale. (Section 7044, Business and Professions Code: The _ SOLAR PIPING SYS. -- ( +ISSUE'FEE - Q S, -.,tractor's. License Law does not -apply to an owner of a properly _ _ -ISSUE FEE •�;' _ - APPLICATION -APPROVED BY - DATE Who builds or improves thereon, and who does such work himself or through-his..own employees, provided that such Improvements are not MECHANICAL PLAN CHECK - SUMMARY OF FEES intended or offered for sale. If, however, the building or improvement Is Sold. within one year of completion, the owner Will have the burden of roving he did not build Or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU - BUILDING - - 49 �'. - ' I', -as - owner of the Property, am -exclusively contracting -with - AND DUCTING' -' '- '- -- - • PERMIT- § 1' SMTP . - $ c nsed contractors to construct the project (Section 7044, Business and ' Professions Code: The Contractor's License Law does not apply to 100,000+ BTU PLAN CHECK $ %� 8 +PLUMBING PERMIT ISSUANCE $ an owner of property who builds or improves thereon, and who can. REFRIGERATION 0-100,000 BTU $ •Of%� tracts from-such-prolectS with a contractor(s) Iicesned pursuant to SYSTEM _ GRADING' E- . the Contractor's License Law). 100,000 + BTU PLAN CHECK E��c/�.. - s „ El 1 am'exem& p[ under Section B. P. C. for this $ BOILERS BTU ELECTRICAL E "--"--f-- -f reasoMICROFILM SYSTEM REPAI R, ALTERATION PLAN CHECK 'S § - - Zp Date y� - TOTAL• FEE E I hereby Cethis rtify that I have read ts application and state that the a ove Information is correct. I agree to comply with all City and county EXHAUST SYSTEM MULTIPLE MECHANICAL E - PLAN CHECK _ LESS AD - VANCEP PC $ ordinances and state laws relating.to construction, and hereby authorize _ 'u _ representaC S of is c to er upon the above mentioned .,�� - property r ms o ose 1J1'� �� Signature Di „L'I�y Dare 7•'7-4 �i— S [ , _ a ,,�` +• C "-•- 23o,2r FINAL' FEE, $ ISSUE FEE :\ Drivers' License or SS # \ - - CMF 0865-46 White -Building; Canary -Applicant; Pink-ACCounting: Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector s, APPROVALS Permit # �Ua ..• or �y 1. Temporary Electrical Service or Pole- 43. Pool &Equipment Location-`��- • . t - • • --- -- - - ' 2. Soil Pipe-Undrgrn 4z44., Steel�Reinforcement - - - 3. Electrical Conduit Utility.-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn. 46. Electrical Bonding ' 5. Steel em orce 47. Rough Plumbing& Pressure Test- \ -.`• �' -' 6. _ Electrical •UFER Grnr . 48. APPROVAL TO COVER-GUNITE 7. Footings o - 4 -$�L 49. Electrical Conduit-Undr rn 8. Foundation. 50. Gas Pipe, ❑Undr rn, Test 9., Water Pipe-Undrgrn _ 51. +'Backwash Lines P -Trap. ❑ ndr rn 10. _ Structural Floor System t 52. APPROVAL TO DECK - 11. Property Sewer Line & House Connection ', "53'. '_Backwash & Receptor -Final ' .12. Street Sewer Connectiontn,_ 54. Heater & Vent -Final 13. RoughiPlum5mgl:r:i .1, !.'tel ?'ystem - 14. Rough Electric -Conduit - -56. -56. Electrical -Final 15. Rough Electric -Wiring „g 57. Solar System -Final 16. Rough Heating & Air Conditioning b8. Fencing & Access Approval 17. Ducts in Structure APPROVED FOR PLASTERING 18. 19. 20: Ducts, Ventilating Gas Pipe -Rough & Test Roof Framing- 60. POOL/SPA SYSTEMS FINAL • 21. 22. Roof Sheathing Frame.and Flashing !/- !ylt_ NOTES: - 23. Insulation- 6.2 24. Lathing & Siding _ 25. Drywall Nailing 26. -Plaster Brown Coat LWtLq,_ . .-' ' 27. Electrical Power Meter -Final 28. Final Electric - -- -- r •- 29. Final.Heating & Air Conditioning- " 30. FinalGas Pipe -Test 31. Final Plumbing 32. Water Service -Final - ' 33. Gas Service -Final -34. Solar Domestic -Final' 35. ' Landscape Sprinkling System ' 36. Sound Attehuation • - - i 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING - 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. - 42. . CERTIFICATE OF OCCUPANCY No' J 7 / Date Applicant t0 fill in all spaces withln heavy border lines and sign all appropriate declarations. *12 CITY OF COSTA MESA PERMIT N • TRACT NO. COT NO. CONSTRUCTION PERMIT �� TYPE OF CONSTRUCTION ❑ NEW ❑ ADD ElALTERATION - ❑ REPAIR ❑ CONVERSION ❑DEMOLISH 2031 12/21 /82 5.0" - Project Address Owner Phone '• Address ❑ OTHER DESCRIPTION OF WORK A P ZONING REGULATIONS ZONE PLNTGo. REF. $ ' Arch/Eng. - License No. Address Contractor �— ✓ �� Phone S— TYPE OF PERMIT ❑GRADING ❑ FOUNDATION ❑STRUCTURAL ❑ TENANT El ELECTRICAL �LUMBING ❑MECHANic B SETBACK LST. SIDE "ARD 'LSIIUL VA PROPEIRTV LANE - Address ,S/� /% Q LICENSED CONTRACTOR' DECLARATION 9 I hereby. affirm that I am licensed under provisions of Charter (com- -section 7000) Division 3 of the Business and -❑ OTHER {i1GHT mencing with of Professions Code.REAR and my license is in full force and effect. YARD (TOPL / ) � 6 PROJECT DESCRIPTION License Class License No, SO. FT. - .. _- _ PKG. SPACE REO. STREET WIDTH PROVIDED - PARK FEE E Date�cP -aV-�_ Signature 'WORKERS• COMPENSATION D AR - - - OCCUPANCY_ CO NST R UCTI ON TYPE ZONING APPROVED BY DATE I hereby affirm [hat I have a ce itiwt c ent to self -Insure or a VALUATION - ZONE Certificate of Workers' Compensation Insurance, or a certified copy - - SPECIAL CONDITIONS: thereof (Section 3800, Lab. C.). _ GRADING CU. YDS. ACRES ^^licy No. Company - .ertifier copy is hereby furnished. - - - - REMARKS: - 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 $300) Or less). - -• -certifythatthat In the performance of -the work for which this permit is Issued, I shall not employ any person in any manner so t become PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK 'subject to the Wo kers' Compensation i I n BATHTUBS SHOWERS TOILETS. URINALS - - GENERATOR 0-1 KW_1-30 - _ KW Date lg ��.�Z Signature NOTICE: If after 'making this d ati0 ould become subject' to the Workers' Compensation visio s f� Labor Cotl¢, you must forthwith comply with such provision r Hermit shall be retmer - _ _ LAVATORIES DOUBLE LAVS - - TRANSFORMER APPLIANCE - "10-50 KW_50 + KW " ..revoked.. KIT.SINKS DISHWASHERS MOTORS 0-1 HIP 1--10 HP CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the per- SUMPS formance of the work for -which [his -permit is Issuer (Section 3097 FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES - - Civ. C.). Lender's Name. Lender's Address _ _ _ DRINKING FOUNTAINS ' •- y - - GAS TUBE SIGNS - INTERCEPTORS CLARIFIERS POLE LIGHTS -- OWNER BUILDER DECLARATION- - hereby affirm that I am exempt from Contractor's License Law for SWIMMING POOL PTRAP - - POLES METERED - S' UB s 1.5 Be P the following reason (Section 7031 .e 'Business and Professions Code: Any„ City or, county which requires permit to construct, WATER SERVICE ALTERATION PANELS MAIN - .SUB r so re- Improve, demolish or repair any structure, prior to its issuance, also re= quires the applicant for such permit to file a signed statement that he _ _ GAS SERVICE OUTLETS -SERVICE - -- - - AMP - is licensed pursuant the provisions of the Contractor's License the 9 (commencing .with Section 7000) of Division 3 Of the n _ WATER HEATERS BTU OUTPUT Business and Professions Code) or Any he is exempt therefrom and the basis for exemption. Any violation of Section 7031.5 by basis for the afar SEWER CONNECTIONS -applicant for permit subjects the applicant to a civil penalty a of more more than five hundred -dollars ($500). _ SOLAR TANK COLLECTORS - - - - - - ' - . f, as owner of the property, or my employees with wages as their Sele Compensation, will -do the Work,.and the structure is not intended or offered for Sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SVS. ISSUE FEE Contractor's License law does not -apply to an owner of a property - --- - - - ' - ' who builds or improves thereon, and who does Such work himself Or ISSUE FEE ) APPLICATION APPROVED BY .GATE - - through his own employees, provided that such Improvements are not. MECHANICAL PLAN CHECK SUMMARY, OF FEES intended or offered for sale. If, however, the building or Improvement Is sold within one year Of completion, the owner will have the burden of proving he did not build or improve for the purpose of sale). - HEATING SYSTEM 0-100,000 BTU BUILDING" PERMIT E SMIP It ❑ I, "as- owner of the property, amp exclusively contracting with _ AND DUCTING _ contractors to construct the project (Section Business 100,000 +BTU PLAN CHECK $ PERMIT es not 'and pr operty The Contractor's License Law tloes not apply to, 'antl - - � ISSUANCE $ owner of property who builds or improves thereon, and who ton- owner of REFRIGERATION 0-100,000 BTU PLUMBING E tracts from such projects with a contractors) Iicesned pursuant to tracts 'SYSTEM '" —' - - �$' - GRADING E the Contra<tor's License Law). 100,000+gTV PLAN CHECK r ❑__ 1 am exempt under Section B. 6 P. C. for this BOILERS BTU ) ELECTRICAL $ $ 'reason -- - - SYSTEM REPAIR, ALTERATION - - - EXHAUST SYSTEM MULTIPLE - PLAN CHECKS MECHANICAL $ - - MICROFILM $ ' - -- TOTAL FEE $ AD - Date ' - -' Owner - - - . ' - hereby certify that I have.read this application and state that the above information is correct. I agree to comply with all City and county PLAN CHECK" $ -LESS VANCEPC S' orrinances.and,state.laws relating to construct ion,.and hereby.authorize_ representatives of thi city to t upon the above mentioned r•- properly f r inspe n purp Signal ur �2 �-� Date ISSUE FEE - ' - '- -- - - - • FINAL FEE $ o7 - -- - Driver Licen or CMFf0�8 09'46 Xhi%-Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor _ _ CONSTRUCTION AND PLANNING APPROVALS Permit # P= 7 Date Inspector POOL & SPA APPROVALS Permit # Date Inspector' 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - - - - - 2. Soil Pipe-Undrgrn - - 44. Steel Reinforcement - - - - 3. Electrical Conduit Utility-U_ndrgrn _ 45. Forms 4. Electrical Conduit-Undrgrn _ _ _ 46. Electrical Bondingl 5. Steel em orce _ - _ 47. Rough Plumbing & Pressure Test 6. Electrical, UFERGrn - - '48. APPROVALTOCOVER-GUNITE- - 7. Footings - - - 49. Electrical Conduit-Undr rn - - 8. Foundation - - _ _ 50.' .Gas Pipe, ❑ Undr rn, Test - 9._, Water Pipe-Undrgrn _ _ _ 51. Backwash Lines P - Trap - ❑-Undr rn 10. Structural FloorSystem _ '_. --- - ,- 52. APPROVALTODECK - 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection •' 54. Heater &Vent -Final 13. Rough Plumbing - - - ---- "-- -- 14. Rough Electric -Conduit -- - - - --- - 156..--Electrical-Final. _ 15. Rough Electric-Wirin'g'-'"" ' --- - --- - -- 57. Solar System -Final, `b6. --Rough Heating & Air -Conditioning: - .: _ encing.& Access.Approval r. _1.7.. -.Ducts in Structure -- "` '� APPROVED FOR PLASTERING 18. --Ducts, Ventilating.._ 60. POOL/SPA SYSTEMS FINAL - - °•' 19. Gas Pipe -Rough &Test" '''' ;• " 20.- Roof -Framing ''� _ _ -• - - 21. Roof Sheathin' ` •-__ __ .i - __ ,_ _ .. - .: .o.'. .,. ...., NOTES: .• ,, , 22.__Framearid Flashing _ _ -23. - Insulation` 24.. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27.. Electrical Power Meter -Final' 28. Final Electric 29.._ Final.Heating.& Air Conditioning. ' 4 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. Haridicap.Regulations - •• 38. FINAL STRUCTURE & BUILDING 39. Special, Requirements Completed --�• - 40. Electric Release to Edison - 41. Gas Release to Southern California Gas Co. - - - - - - - 42. CERTIFICATE OF OCCUPANCY `No Date - - I City of Costa Mesa Building Safety Department CERTIFICATE OF O C C U P A N C Y P.O. Bok 1200 3200 Costa Mesa. California The Building located at 265 ricci x rXiAue 111&-6 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group 1'-2 Occupancy. Use of Building T--xmnt 7Aty?YOJSr:..znt .Legal. 627-073,07 (See reverse side for Metes and Bounds) Fes? -3277 L��'-3277 Building Permit No BE -4084 Electrical Permit No. —n � � Plumbing Permit No'. - -+'-r+- _ E-3510 .Number of apartments —� and/or guest rooms —�— ISSUED TO: Building Official by�. WC= iul C n V. C. !i—j i L 6iaci D vji ;J= Djr,xc o Date / / G,�,CG27%fll . This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the iluiiding Official of the City of Costa Mesa under Sec. 306 lel U.B.C. , Form BU 34 Rey. 11/70 1 Ap Ili ' 'CITy?OFASTA_MPSA CONSTRUCTION PERMIT Address I511—N I FA(tiV IG Arch/Eng.- Address-- Address LICENSED CONTRACTOR -DEC �I hereby affirm that I am licensed mencing-with section 7000) of 'Professions Code, and my lice iucense class _(-.._ - Date "' Signature WORKERS'COMPENSATION DE II in all spaces within heavy border lines and sign all appropriate declarations r11T NO. &,eTRACT I`10i LOT NO..i BLDG- NO. TYPE OF (;ONEl 6 Phon 2L NEW HADD ElALTERATION i ❑ REPAIR ❑ CONVERSION ❑DEMOLISH cense No. ❑ OTHER DESCRIPTION OF WORK AVOIT]IOM 45P -IG L Phdne Li" YPEF PERM OIT ' - 7- - '- - ❑GRADINGy� C3 FOUNDATION LASTRUCTURAL L'ARATION _ :TENANT Jam, ELECTRICALtlIPLUMIB-ING ❑MECHANIC. under provl5lons of Charter 9 Glom- / ,Division 3 of _the. Business and C1OTHER. r nse is in full force and effect. _PROJECT-,- ES IPTION' License No: C LARATION_ - - OCCUPANCY = CONSTRUCTION TYPE I hereby affirm that I have a certificate of consent to self -Insure or a VALUATI QAN^CM• ZONE 'certificate of Workers' Compensation Insurance. or a certilied Copy ;thereof (Section 3800 Lab. C.). GRADING CU. YDS. _ ACRES .Company- SUMMARYOF FEES REMARKS _ - ertifi ,c p is emtyr furnished. .- certified copy is filed with the city Building Division. SO. FT. IEXEMPTION'FROM WORKERS' COMPENSATION -DECLARATION .(This Section need, 'not be completed if the permit is for one hundred ,I '(5300) or Iassl.- - I certify thatIn the performance of the work for which this Permit li Issued. I shall not employ any person in any manner so as to become - - - 'PLUMBING' .PLAN CHECK subjecLto the Workers' Compensation_ Laws of California. I_ BATHTUBS SHOWERS` - -- - Date I signature TOILETS_. .URINALS - - NOTICE: If after making this declaration. you Should become subject to the Workers' Compensation provisions of the Labor Code, you must ,forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS !revoked.. _ _-. _ - - -. - - - - .CONSTRUCTION LENDING AGENCY KIT. SINKS- -- DISHWASHERS SERVICE SINKS SUMPS- -- -- 'I hereby affirm that there is a construction lending agency for the per- formance,of.the work•fgrwhich this permit Is Issued/(Section 3097 Civ. CJ:_+- --- - r - - - - - I 'Lender's Name' ` FLOOR SINKS FLOOR DRAINS` Lender's Address - DRINKING FOUNTAINS - OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License law for INTERCEPTORS - CL'ARIFIERS' SWIMMING POOL P TRAP _ the following reason (Section 7031.5 Business and Professions Coda: .Any city or county which requires a permit to construct, alter, improve; demolish or -repair any structure, -prior to its issuance, also ro. quires the ap.licant for such Permit to file a signed statement that he WATER SERVICE - 'ALTERATION - GASSERVICE - OUTLETS---' - is licensed -pursuant -to the Provisions of the Contractor's License Law ' Chapter 9 (commencing with Section 7000) of Division 3 of the 8usines5 WATER HEATERS- BTU OUTPUT' and Professions Code) or that he Is exempt therefrom and the ,sis for the alleged exemption. Any violation of Section 7031.5 by I applicant -for a Permit subjects the applicant -to a civil Penalty not more than live hundred dollars ($500). _ SEWER -CONNECTIONS - - - SOLAR -TANK COLLECTORS ,L) 1, as owner of the property,'or my employees with wages as their sole com pen cation, will do the work, and the structure IS not Intended or offered for sale. (Section 7044, Business and Professions Cotle.^The' SOLAR PIPING SYS.' ' - Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who does Such work himself or ' ISSUE FEE- ' through his own employees, provided that such improvements are not MECHANICAL PLAN CHECK Intended Or offered for sale. If', however, the building Or Improvement' Is sold within one year of completion, the owner will have the burden HEATING SYSTEM 0-100,000 BTV - AND DUCTING 100,000. BTU build or improve for the purpose of Sale Af proving he did not ): I,.as owner of _the.properly, am exclusively contracting _with Iic nsed contractors to construct the project (Section 7044, Business and Professions-Cotle: The Contractor's License Law does not apply to _ _ REFRIGERATION 0-100,000 BTU SYSTEM 100,000 * BTU - - .an owner of property who builds or Improves thereon, and who con- tracts from such projects -with a contractor(s) IICeSned pursuant to the Contractor's License Law). �/ ,/ '❑'I am exempt under ct(Pn- - -/ r B. 6 P. C. for this BOILERS BTU reason &L4^t.W _ 'Date. a A ^Owner SYSTEM REPAIR, ALTERATION - I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE nfprmation is -correct. I agree to comply with all city and county ordinances and st aws relating to construction, and hereby authorize •¢pr¢Senta st Is It to r on the above mentioned- - oroperly or ince io 0IS ter _ rL4 gv ISSUE FEE Signature Date Drivers'-Licende or 55 $ CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor A.P. qp ZONE . 14•I�Ht...-.. -. REAR YARD (TO' PKG. SPACE -REQ. 0366 6/30/62 ZONING REGULATIONS r - PLNTG.. gREF. 9s ' PRO PE RTV LI P/L)'- -- ,I - Q1f - (PReOVIDED - - PARK FEE $ SPECIAL CONDITIONS: . - 139.76 TL - -I ISSUE FEE SUMMARYOF FEES ..BUILDING. - ELECTRICAL - a -AN CHET SO. FT. SO -'FTI - - GENERATOR 0-1 KW_ TRANSFORMER APPLIANCE ; 10-50 KW -50 1-10 KW i KW. 'MOTORS. ' !(INC. SOLAR)- - 0.1, HP.� -" 1, 10 1-1= 50?HP 'FIXTURES - OUTLETS SWITCH GAS TUBE SIGNS. POLE LIGHTS.. GRADING PLAN CHECK POLES METERED-- SUB PANELS - -- MAIN -SUB SERVICE -- - Al f TOTAL FEE $ PLAN CHECK.§ _ - . LESS 1 LANCEE P$_ - - 139.76 TL - -I ISSUE FEE SUMMARYOF FEES ..BUILDING. - p _ j Or I PERMIT $ O SMlP _ $ PLAN CHECK $ S^Z31` PERMIT - - _ ISSUANCE $ PLUMBING E� - -. 1 GRADING PLAN CHECK $ - -ELECTRICAL $ ' 1 E, _ PLAN CHECK $ 'MICROFILM §'- ' MECHANICAL f TOTAL FEE $ PLAN CHECK.§ _ - . LESS 1 LANCEE P$_ - - r. s FINAL FEE §Z37, _�G CONSTRUCTION AND PLANNING APPROVALS Permit # Date - - POOL & SPA Inspector_- :, - Date -inspector APPROVALS. - Permit # : I _ .1. Temporary Electrical Service or Pole _ 43. Pool &Equipment Location it 2. SoilPipe-Undrgrn - _ 44. Steel Reinforcement -- 3. Electrical Conduit Utility-Undrgrnt - _ r7,7-_� n 45. • Forms - - - - 4. Electrical Conduit•Undrgrn :X46. Electrical Bonding- - - - 5. Steel em orce . _. _ ,,. 47. Rough Plumbing & Pressure Test- 6.- Electrical UFER.Grn _ -. 48. APPROVAL TO COVER-GUNITE 7. Footings . _. _ _ ._ 49. Electrical Conduit-Undr rn B.- Foundation • - -- "-- - - - - 50... Go Pipe ❑ Undr rn, Test 9: Water Pipe-Undrgrn51'•'Backwash Lines,,P-Trap,El Undrqrn - - 10.'s Structural Floor System - - - 52. APPROVAL TO DECK - - - "-11. ' Property Sewer Line'& House Connection 53:• Backwash &'Rece for -Final • ' ' 12. Street Sewer Connection' 54. Heater & Vent -Final 13: Rough Plumbing 55, Plumbing Syster-n - - - _ -- - 14. Rough Electric -Conduit - -- - 56. Electrical -Final - - 15. Rough Electric -Wiring 57. Solar System -Final ' 16. Rough Heating & Air Conditioning bd. Fencing & Access Approval ` 17. 'Ducts in Structure r APPROVED FOR PLASTERING 18.- 19. 20. Ducts, Ventilating- -- - - - Gas Pipe -Rough & Test Roof Framing - - - - -- .60. - - - - _ . . - POOL/SPA SYSTEMS FINAL .. .' 21. 22. Roof Sheathing Frameand Flashing :! - _f Q NOTES: 23. Insulation ' -NIP- -- ' 24. Lathing & Siding - - -- 25. Drywall Nailing - _ ^Y✓) - - 26. Plaster Brown Coat - -- - - -- - - - - - 27. -Electrical Power Meter -Final - - - - - - - - - - - - - ' 28. Final Electric - -' - - t-fgz C e- -- - '- - 29. FinalHeating&-Air Conditioning - ---- --' - - -- 30. Final Gas Pipe -Test - - - 31'. Final Plumbing - -- - 32. Water Service -Final - - 33. Gas Service -Final - - - 34. Solar Domestic -Final 35. Landscape Srinklin System - 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed _ 40. Electric Release to Edison 't r 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date _ - Applicant to fill in all spaces wi hin heavy border lines and sign all appropriate declarations, s to be one Fp PLUMBING -PLAN CHECK '- _CITY OF COSTA$Q PERMIT NO. / TRACT NO. LOT NO. B G. NO. -- jl �/ '��i`— B/1.6/.82 -COIVSTRUCT'ION{�ERMIT s Le revoketl._ KIT7SINKS' -' -DISHWASHERS"-- '- -' - - 6107, 10.0 TL -'FLOOR SINKS - "FLOOR DRAINS 'Project Address {{{777 TYPE OF CONSTRUCTION -DRINKING FOUNTAINS--- OWNER BUILDER DECLARATION - I hereby affirm that I am exempt from the Contractor's License Law for --INTERCEPTORS - CLARIFIER$ Owner hone $' Z ❑ NEW ❑ ADD 0 ALTERATION WATER SERVICE - - -GAS SERVICE ---Ol'1TLET$ Address �- �- - --.❑.REPAIR El CONVERSION ❑DEMOLISH - - - SEWER' CONNECTIONSnot w -applicant fora -permit subjects the applicant -to a -civil penalty more than five hundred dollars ($500). J I, as'owner'df the -property, or my employees'with wages as their -SOLAR TANK -"- -' -COLLECTORS --- - ❑ OTHER' ZONING REGULATIONS SOLAR PIPING SYS. -- - -- - -- - IArch/En - License No. B -WORK A.P. .GRADING_.$ Addr¢ts - .. _. -- DESCRIPTION OF - _ - -- - - ZONE - PLNGJREF,.'01 _ •�_ Contractor - - Phone TYPE OF PERMIT' - -- �- - - SBU D - - TTOp BU�J1L,pIT PROPERTY 'I ECECTRICAI "Address - - - -_ I ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL- - -- .SETBACK ST. SIDE YARD - • -'- LINE - - - -- { `LICENSED CONTRACTOR.DECLARATION -' - ❑TENANT ❑-E CTRIOAL FPLUMBI . OMECHANIC MICROFILM - SEDFE Y - _ _t' - PLAN CHECK- 1 hereby affirm thGt I am licensed under provisions of Charter 9 (com- ❑OT,RER- RIGHT SYSTEM ALTERATION - -mencing with section 7000) -of Division -3 -of -the Business and- Professions Code, and my license is In full force and effect. 1 I REAR YARD (TO P/L) - _ 1License Class License No. PROJECT DESCRIPTION _ _ 'PKG. SPACE REQ. - PROVIDED _ 1 hereby certify that I have read this application and state that the above ,Date-- -'Signature i- . _ _ _ _ _SQ. FT. .. ___ _--,PARK- STREET WIDTH _ FEE$ LESS AO-` Y, 'WORKERS' COMPENSATION.D CLARATION_ _ OCCUPANCY"_ CONSTRUCTION TYPE -PLANCHECK I hereby affirm that I have a certificate of consent to self -Insure or a VALUATION ZONE - ZONING APPROVED BY "' - DATE ' cerci Ocate of Workers' Compensation Insurance, or a certified copy SPECIAL CONDITIONS: - - thereof (Section 3800, Lab. C.). --Iloy No. _ ^ - - _'Co mPa nY- 'GRADING CV. UDS. ACRES ' _ - Signature Certified copy.is'hereby furnished.-,REMARKSi 4T'i -- 1 - - . Certified copy isifiled with the city Building Division. - -i. - - - - -- ' -. --------'- - _-.-- -- -_ _ _ _ FROM WORKERS' COMPENSATIONDECLARATION- IEXEMPTION (This section need not be completed If the permit is for one hundred �- (5300? or lett). I I Cert fy that n the performance Ot the work for which shit permit It issued shat no a toy any person in a y nner 5 subje�tpplI,,77/yLLW wypp��f Y(p��Rslifor ni s to be one Fp PLUMBING -PLAN CHECK '- BATHTUBS- - - SHOWERS .Compens Daleignat �_ NOTICE: If after aking this tleclaratlOn, you ShOultl becom0 Subject TOILETS TURINALS' - - - - - to the Workers' Compensation provisions of the Labor Cotle, you mus forthwith comply with such provisions Or [his permit shall be tleeme LAVATORIES DOUBLE LAYS- - - - - revoketl._ KIT7SINKS' -' -DISHWASHERS"-- '- -' - CONSTRUCTION LENDING AGENCY - SERVICE SINKS v, SUMPS' I hereby affirm that there is a construction lending agency for the per. forme of the work for which this permit Is issued (Section 3097 -'FLOOR SINKS - "FLOOR DRAINS Civ;C')• - `� -- - - - -' - - --- -- -' 'Leotler't Name Lender's Address - -- - -DRINKING FOUNTAINS--- OWNER BUILDER DECLARATION - I hereby affirm that I am exempt from the Contractor's License Law for --INTERCEPTORS - CLARIFIER$ SWIMMING POOL - PTRAP' -- - - •-- the following reason (Section 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, WATER SERVICE - improve, -demolish -or- repair any structure, prior to its issuance, also re- quires the apoicant for such permit t0 file a signed statement that he -GAS SERVICE ---Ol'1TLET$ is licensed pursuant to the -provisions of the- Contractor's License law- (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT -- Business and Professions Code)-or-thathe is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by - SEWER' CONNECTIONSnot w -applicant fora -permit subjects the applicant -to a -civil penalty more than five hundred dollars ($500). J I, as'owner'df the -property, or my employees'with wages as their -SOLAR TANK -"- -' -COLLECTORS --- - sole compensation,. will do the work, and the structure is not Intended $ or offered for sale. (Section 7044, Business and Profession$ Code; The SOLAR PIPING SYS. -- - -- - -- - ContractOr•s License law does not apply to an owner of a property 'ISSUE FEE - -- - - ' who builds or improves thereon, avid who doessuchwork himself or through his own employees, provided that such improvements are not .GRADING_.$ ELECTRICAL- - '- ' "PLAN CHECK PLAN CHECK ' 'GENERATOR- TRANSFORMER f APPLIANCE - 0-1 KW_1-1OKW1 30-50 KW_SO+KW. - MOTORS -- t(INC..SOLAR)._ -0'1'HP=1-10 HP'- - - -10-50-HP=50+.HP FIXTURES -- -'OUTLETS' -SWITCHES-- • GAS TUBE SIGNS^ ^ --- - '- -- - -- - - <POL-E'LIGHTS- POLES 'METERED_ SUB _ .PANELS' - - MAIN- ,SERVICE-- '— -- - __AMP- '• - r li dosed contractors to construct the project (Section t Business 300,000 BTU I 4 i T PERMIT i and Professions.Cotle:.-fheConlractorls. License -Law tides not apply to es not to intended or offered for sale. If, however, the bwidmg or Improvement Sold within one year of completion, the owner will have the burden MECHANICAL PLAN CHECK ' 'SUMMARV,OF� FEES - �is proving he did -not build Or improve for the -purpose of sale).' HEATING SYSTEM - -- - - 0-100,000 BTU i BUILDING = -PERMIT- $ �,,'SMIP. ^y. --- -- - I, -as -owner. -of. -the property, -am. exclusively contracting with_ AND'DUCTING - -$- - li dosed contractors to construct the project (Section t Business 300,000 BTU I 'PLAN CHECK $ PERMIT i and Professions.Cotle:.-fheConlractorls. License -Law tides not apply to es not to 1 -- f - -- -ISSUANCE $ f 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)._Ilcesned pursuant to SYSTEM -.$ .GRADING_.$ the Contractor's License Law). 100,000 + BTU a" ) t i C 'T L :- }_PAN CHECK •�_ :,I O'1-am'exempt-under'Section" - B.&P:C. for this BTV _ 'I ECECTRICAI $ reason - { MICROFILM - _ REPAIR, _ _t' - PLAN CHECK- $- _$'' - Date - Owner SYSTEM ALTERATION - TOTA.L FEE'$ MECHANICAL-,$-" - - 1 hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE ' / I LESS AO-` Y, Information Is correct: 'I -agree to comply with all -City -and county -PLANCHECK $ - - _ - VANCE PC -'S_ ordinances and state laws relating to construction, and hereby authorize representatives-of'this' city to -enter upon' the -above - mentioned property- r ins_on c purpo II I ' TT /✓ Signature _ ate 1 - - FINAL FEE $ . Drivers' License or SS - ISSUE FEFI- _ _ _ CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # .i Date.,, Inspector `--1 POOL&SPA _{ •'` ' - - Date Inspector APPROVALS -Permit 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - I ' _ 2.-. SoilPipe-Undrgrn - _ 44. Steel Reinforcement 3.- ,Electrical Conduit Utility-Undrgrn _ 45. •Forms I- - - ..4. Electrical Conduit-Undrgrn 46. Electrical Bonding- _5. Steelem orce 47. Rough Plumbing & Pressure Test _ 6. _Electrical UFER Grn _ _ _ 48. -APPROVAL TO COVER-GUNITE- - 7.. - Footings . _ _ _ _ 49. Electrical Conduit-Undr rn' 8. .Foundation .. - -' 50. Gas Pipe, ❑ Undr rn, Test .9. Water Pipe-Undrgrn_- _ - _ 51. Backwash Lines P-Tra--O'Undr'rn 10.- Structural Floor System: 52.. APPROVAL TO DECK " 11. Property Sewer Line & House, Connection_ _ -.53. inal Backwash & Rece tor. Final- 12.- 12._ Street Sewer Connection-` -_ _ -- - - - - 54.- Heater &'Vent•Final 13. Rough Plumbing - _ _ - - - - ---" " - - 14. Rough Electric-Conduit - - - 56. .-Electrical-Final 15. Rough Electric-Wiring - _ - .-'57`- S_olarSystem-Final - - - "- 16. Rough Heating & Air Conditioning b8. Fencing & Access Approval 17. Ducts in Structure59. - - - - APPROVED FOR PLASTERING. 18: 19. 20. Ducts: Ventilating . - Gas Pipe-Rough & Test -RoofFrarning _ - _ 60. - - ,.' :''S. •'-' . ;.::.�• •; .', i " __', -I f' POOL/SPA SYSTEMS FINAL 21. • 22. Roof Sheathing- Frame and Flashing- - _ NOTES: , 23. Insulation - -- - L. 24. Lathing &-Siding 25. Drywall Nailing - - - - - - - - - 26. Plaster Brown Coat 27. Electrical-Power Meter-Final - - - 28: Final Electric - - - - - - 29. Final Heating & Air Conditioning - - - - - 30. Final Gas Pipe-Test- • 31. Final Plumbing- ,- 32.,-.,Water,Service-Final j - •- - - 33.' -Gas Service-Final 34. Solar Domestic-Final 35. Landscape Sprinkling System - - 36. Sound Attenuation - - - 37. Handicap Regulations -- r - - - 38. FINAL STRUCTURE & BUILDING " 4-/74P- B 39. Special Requirements Completed •' _ - 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date - Applicant to fill in all spaces within heavy border lines and sign an QF CQ, I ZSA 7 TRUCTION PERMIT -, P �43MIT NO. ' (5�� 3 27 % TRACT NO: x.1353 LOTIG. NO, Project Address a - TYPE OF CONSTRUCTION El NEW ❑ ADD ❑ ALTERATION .❑�(REPAIR 1-1CONVERSION❑DEMOLISH _ /D{ OTHER �fR'�T 1A4oU b A4Shr_ DESCRIPTION OF WORK Owner QPhon .(pU ' Address ( p�C17 ._ Arch/Eng. - - License No. - Address -- --- - - - -- - Contractor - - - - Phone- - '- TYPE OF PERMIT GRADING ❑ FOUNDATION ❑STRUCTURAL ENAiNT ELECTRICAL �P LUMBING.❑MECHANI Address -- - - - --- -- - LICENSED CONTRACTOR DECLARATION- I hereby affirm that I am licensed under provisions of Charter 9 (com- men cing with. section 7000) of Division. 3 -.of the .Business and Professions Code, and my license Is In full force and effect I __ ❑ OTHER .'PROJECT DESCRIPTION License Class - - - - -" - License No. SO. FT - _�Q Jf��_C_ 11ser4 ' •OCCUPANCY ONSTRUCTION TYPE Dale - - ATIO .D I - - - - WORKERS•,COMPENSATION.DEC LA RATION- .1 hereby affirm that 1 have a certificate of consent to self -insure oraVAL'VATIONZONE certificate of Workers' Compensation .Insurance, or a certified cop, SYSTEM - 100,000.+ BTU - - thereof (Section 3800, Lab. C.). GRADING CU. YDS. ACRES 'Icy No. - Company - - (ertlfied copy is hereby furnished. _ - _ REMARKS: j 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 �E100or less). - - __ -- ..' _. -,g PLUMBING-. PLAN CHECK -- - - Certi) fy, that in the performance of the work for which this permit I{ Issued, Vshall not employ -any person In any -manner so as to become subject to the Workers' Compensation Laws of California. . 7 _ Date Signature r _ BATHTUBS- SHOWERS " TOILETS. URINALS - _ --- NOTICE: If after making this declbration, you should become,subject to the Workers' Compensation provisions of the Ldbor Code, You most forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS-- revoked. t _ _ CONSTRUCTION LENDING AGENCY "-' -- KIT. SINKS -DISHWASHERS SERVICE SINKS - SUMPS - - - I hereby affirm that there is a construction lending agency for the per- formance of the work for which this permit is issued (Section 3097 FLOOR SINKS FLOOR DRAINS"- •- " Civ. C.)- -- - - '----- - ` ^' - -- - Lender's Name _.e_ NN. _ •__ -_ _ ..- _ -.-•— DRINKING' FOUNTAINS.- OUNTAINS._ -" V INTERCEPTORS `___CLARIFIERS.— _ I -, a�permit to construct, alter,. SWIMMING'POOL ,- PTHAP hat hg `WATER SERVICE ALTERAT se. Law "qAS AS SE VICE -- OUTLETS of the Business antl.PPfessions Code)-or.that he is exempt theiefrom,and the' 'as($ for the alleged exemption. Any violation of Section 7031.5 by WATER HEATERS BTU OUTPUT-' SEWER CONNECTIONS -- -� y. applicant -for a permit -subjects the applicant. toa civil_penalty not more than five hundred dollars ($500). -. SOLAR TANK - - -- COLLECTORS -y; -; J 1, as owner of the property, Or my employees with wages -as their sole Compensation, will do the work, and the structure is not intended -(W-15VIDED - or offered for sale. (Section 7044 Business and Professions Code: The- SOCAR PIPING SYS.- YS.Contractor's Contractor'sLicense Law does not apply to an owner of a property , " -ISSUE FEE who builds Or Improves thereon, and who does such work himself -or through his own employees, provided that such improvements are not Intendetl or offered for sale. If; however, the building or Improvement - is Sold within one year of completion, the owner will have the burden _ MECHANICAL PLAN CHECK HEATING SYSTEMi 0-100,000 BTU AND DUCTING 100,000,+STU of proving he did 'not build or Improve 'tor -the purpose' of sale). K/py��1. as owner. of the property, am exclusively contracting with i nsed contractors to construct the project (Section 7044, Business and Protessions_Code:.The Contractor's Llcense,Law does not apply to _ REFRIGERATION 0-100,000 BTU an owner of properly who builds or improves thereon, and who con- ursuant to tracts .from such projects _With. a .COntra Ct or(s). f1cesned pursuant, the Contractor's License Law). SYSTEM - 100,000.+ BTU - - ❑ I am exempt under Section B. & P. C. for this BOTLERS BTU - DATECf reason. Date Owner SYSTEM REPAIR, ALTERATION I hereby Certifythat I have read this application and state that the above EXHAUST SYSTEM MULTIPLE Information is correct. 1 agree to 'comply with all city and county E0 ortlinances and stale laws r toting to con Etr uctiOn, antl hereby authorize 'PLANCHECK $ 3,52 represents t' $- pis y -to ter n the above mentioned property r ins i s s �� Q4,� Drivers' License or S5 urpo Signature - - Date2(,�_ - -• - �) ISSUE FEE. CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod-ASWSSOr -ISSUANCE E 4610 4/14/62 254.76 'TL ZONING REGULATIONS A.P. . Q ZONEjrMD PLNG- REF.,$' RATOR-_0=1 KW_ 1-1BKW ' ISFORMER ANCE' 10-50 KW=50 + KW - IRS - 0-1' HP1-10 HP - SOLAR), .10-50 HP_50+HP. 19ES17 0,1ETS WITCHES -UBE SI( NS'1t`^'- _ _ - , inure_ -.. tu. •�: �•.... .. - .. - POLES' I RIGHT - REAR YARD (TO- SVB- jobt ;PKG.SPACE-REQ. -(W-15VIDED - ' STREET WIDTH- PARK FEE $ ,- ZONING APPROVED,BY IO 'DATE 'I(�'. - - SPECIAL CONDITIONS: - - •ELECTRICAL - - - PLAN CHECK - - RATOR-_0=1 KW_ 1-1BKW ' ISFORMER ANCE' 10-50 KW=50 + KW - IRS - 0-1' HP1-10 HP - SOLAR), .10-50 HP_50+HP. 19ES17 0,1ETS WITCHES -UBE SI( NS'1t`^'- _ _ - , inure_ -.. tu. •�: �•.... .. - .. - POLES' -METERED SUB PANELS' -MAIN- SVB- jobt - SERVICE- - - -AMPI - - - - - - 66' 'APPLICATION APPROVED BY -- - DATECf SUMMARY OF FEES- - BUILDING ��/999 �� ''' ' PERMIT E0 SMIP $ 'PLANCHECK $ 3,52 _ PERMIT, j PLUMBING .$ 2D:oe -ISSUANCE E GRADING' 'PLAN CHECK E .E • ELECTRICAL $WIN - $ •., 'MICROFILM $ PLAN CHECK $ _ - MECHANICAL $ TOTAL FEE $ LESS AD' PLAN CHECK E • I ' I -> r ,yx•+. s FINALFEE. E. 2r1Y76 CONSTRUCTION AND PLANNING APPROVALS Permit # P.3 77 Date Inspector POOL &-SPA APPROVALS Permit.# 71 Datar'" Inspec tar- 1. Temporary Electrical Service or Pole43. Pool & Equipment Location 2. SoilPipe-Undrgrn -_ i ,.•. '44. "SteelReinforcement 3. Electrical Conduit Utility:Undrgrn• 45. Forms . 4. - Electrical Conduit-Undrgrn 46. Electrical Bonding- - b. Steel ein orce 47. Rough Plumbing & Pressure Test - - - 6. -.Electrical UFER Grn 48. APPROVAL TO CO VER-GUNITE ' 7. Footings _ 49. Electrical Conduit-Undr rn' 8. Foundation 50. Gas Pipe,.❑ Undr rn, Test 9. Water Pipe-Undrgrn ..+ - 51. Backwbsb Lines P-Trap.❑ Undr rn 10. Structural Floor System - 52. ' APPROVAL TO DECK 11. . Propeity, Sewer Line & House Connection 5 Backwash & Receptor-Final 12. Street Sewer Connection A4. Heater & Vent=Final ' 13. Rough Plumbing 55, Plumbino System Final ' 14. Rough Electric-Conduit - -56. Electrical-Final - 15. Rough Electric-Wiring - �� a 57. Solar System-Final 16. Rough Heating & Air Conditioning bd. -Fencing & Access Approval 17. Ducts in Structure - APPROVED FOR PLASTERING 18. Ducts, Ventilating - 60. POOL/SPA SYSTEMS FINAL _ 19. Gas Pipe-Rough & Test - 20. Roof Framing- 21. Roof Sheathing NOTES: y 1" 2144 ' ' 22. Frame and Flashing ,_ - - � - 23. -Ihsulation: Lf - 24. Lathing & Siding -22.. - 25. Drywall Nailingo4tz _y>_ 26.- Plaster Brown Coat Z -Q nt 27. Electrical Power Meter-Final 28. Final Electric - (� Z _ 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 S rinklin System- 36. Sound Attenuation - - 37. Handicap Regulations •- - - - - 38. FINAL STRUCTURE & BU DING _/7-g2 i•✓) _ 39. Special Requirements Comple ad 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY A No 32-09 Date Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations CITY OF COSTA MESA PERMIT NO. TRACT NO. LOT NO.! BLDG. NO. CONSTRUCTION PERMIT ,� Project Address C TYPE OF CONSTRUCTION _ Owner 1 - Phon �] NEW C ADD ALTERATION C- 1 Addre y- - '. C1 REPAIR .0 CONVERSION El DEMOLISH �L� ' Arch/En icense No _ r'0 OTHER 1219 7/06/82 13.00 TL 9 - - - DESCRIPTION OF A.P. `F - - . - Address a_i4% - - - " - ZONE' - 'PLNG."REF. 5 Contractor .0 Phon TYPE OF PERMIT -- - B _ TToo ggUtI1l�p ING PROPERTY LINE !Addres C, --e ' - - - - r f1:1 ❑GRADING FOUNDATION - ❑STRUCTURAL- SET ACK LST.11 _'//, -' - 10 •LID YARD - LICENSED CONTRACTOR DECLARATION that I Charter 9 ,I TENANT. ELECT R ICAL�.CPLUMBING. ❑MECHANIC 5Ep __ _ _ I hereby affirm am licensed under provisions of (com-, 7000) Sion 3. Business 0 RIIG HTA menUng with section of ,Divi -of -the .antl.: Professions Code and my I ansa In full f e and effec -OTHER" " 'REAR YARD (TO P/L)-- qQ� g' t PROJECT- DESCRIPTION- 'I Cleanse CIa s �� Licence _ - } -- '- - -- PKG. SPACE REQ. "'- 'PROVIDED - '1 Date" -- Signature" -. r $Q.^;FT-: -' _ _ _ _ _ _ - - _ ."-- STREET WIDTH PARK FEE $ , WORKERS' COMPENSATIO CLARATION-_- % ''OCCUPANCY -_C ONSTRUCTIO N TYPE 'I hereby affirm that 1 hav art ificate of consent to self -insure or a VALUATION ZONE - ZONING APPROVED 'BV - "- DATE- - - certificate of Workers= CO pensatlon Insurance, or a certified copy r_ ' _ thereof (Section 3800, Lab. C.). 1 GRADING CU. YDS. ACRES iSPECIAL CONDITIONS` Policy No. -- Company'- - - - - - - - - - - - -- _ 0 Certified.copy-is hereby furnished. 1[ ,. REMARKS:'S ©,8 $10_ - Certified copy is filed with the City Building Division. 'XEMPTION-FROMWORKERS' COMPENSATION DECLARATION - -- - - (This section need not be completed if the permit is for one hundred - • ••t l --. _ --I.- j A � r' 1,' -J. 1E100) or lessj. ( 1 - _ ___ - _ _ cee. rtify that m the performance oft work for which this permit IS issuetl, I shall not employ any pari - f any'manne' as to become _ PLUMBING PLAN CHECK' - - ;ELECTRICAL- PLAN CHECK - Subject t t We kers' Compensati ws pf Cali a. - IJW�LLJNG"- Date1Signdturt r s- '- -BATHTUBS -r -SHOWERS '- - - - -" - -_ -- _- FT NOTICE: If atter making thIs_idp2ra,atIon. you Should become•SubjeCt ;4TOILETS - r r, ,URINALS - - - -- 'GENERATOR -- -0-1 KW_ 1-10 KW - - to the Workers' Compensati revisions of the Labor Code, you must TRANSFORMER rl forthwith comply with Such provisions or this permit shall be deemed LAVATORIES DOUBLE-LAVSr--- -- - APPLIANCE - - 10-50 KW_50+ KW revoked.. l r 'MOTORS _ _ , _ __-- __ _- . - CONSTRUCTION LENDING AGENCY -'KIT: SINKS- - '" -- DISHWASHERS - - -- -- - - ^^0-1-HP_1-70•HP�� ---- - - Iherebyaffirmthatthere IS a construction lending agency for the per- SERVICE SINKS•-„.SUMPS-'�-- - -- - -- i(INC..SOLAR)0.HP_'. 10-5 50+HP, ' formance of the work for which this permit Is Issued (Section 3097 Clv. C•)' -- "`- - ”" - - '- -- - FLOOR'SINKS- -'- - FLOOR -DRAINS '- - - - (FIXTURES- -OUTLETS- SWITCHES—� - --- - Lender's Name Lender's Address �- "DRINKING FOUNTAINS '- - -'---- - -'GAS TUBE SIGNS---- - -- - - - - OWNERBUILDERDECLARATION-- ----- - - hereby affirm that I am exempt from the Contractor's License Law for INTERCEPTORS -'- CLARIFIERS'-'-- s' -'-""-}POLE LIGHTS - ----- ----'--� he•following reason (Section 7031.5 Business -and Professions Cotle:'SWIMMING'POO L- - •^P TRAP-- "- - --- -- -'METERED SUR Any city or county which requires a permit to construct, alter, Improve, demolish or repair any structure, prior -to its Issuance, also re- WATER SERVICE- '- -ALTERATION- - -' - - - .POLES -'PANELS - -MAIN - •S - quires the ap Oirant for Such permit to file a Signed statement that he is licensed pursuant to the provisions of the Contractor's License Law GAS SERVICE "--- _ OUTLETS >"'"-� --.� j- _ 'SERVICE - - -- -AMP- --—' (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and-Prdessions Code) or that -he is exempt therefrom and the WATER HEATERS - - BTU OUTPUT - - - - - - - - - - - - - - - basis for the alleged exemption. Any violation of Section 7031.5 by 1- _ any applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS - - - -- -- - --ti- - - -- - -- - - -- -- -o' - -- - -1 not more than five hundred dollars ($500). 1, as owner of the property, -or -my employees'with wages as their- SOLAR -TANK-- - COLLECTORS - -j- - - _ - -^ - - �- - ' --- - - - - -- — will do the work, and the structure is not Intended �- - Offered for sale. (Section 7044, Business and'Professlon5-Code; The' Offered SOLAR PIPING SYS. "' - -' `-- - -, -- } -ISSUE-FEE - -- - -- - - - - -� Contractor's License Law tloes not apply to an owner of a property builds or improves thereon, tl _ FEE- " -" -- "I'- '- - qPp LICATIONAPP ROV ED BV _ G DATE who and whoes-such work'himself"or' through his own employees, provided that Such improvements are noto ISSUE Intended or offered for sale. If --however,- thebuildingor improvement' _ MECHANICAL - PLAN CHECK _ - SUMMARY OF'FEES, is sold within Ono year of completion, the owner will have the burden 'BUILDING of proving he did not build or improve for -the 'Purpose "Of sale): - - -- - -- - - - - - - --- - --- -- HEATING SYSTEM 0-100,000 BTU - -- - -,- (PERMIT - -. - - SMTP$ ❑ ns as owner of the property,. am exclusively contracting with. licensed to the (Section 7044, Business -AND DUCTING ---- ----- - - - ----- - �'.' ' contractors construct project 100,000.+ BTU I PLAN CHECK $ PERMIT 1 and•Professions Code: The.Contractor's-License Law does . not apply to_ an owner of property who builds or Improves thereon, and who con- _ _ - _ REFRIGERATION 0-100,000 BTU - PLUMBING $ ISSUANCE $ tracts -from such projeCts-with a-contrattor(s) licesned pursuant to_ the Contractor's License Law). SYSTEM- - -- ' _. -. 100,000j+ BTU -- CHECK E -' "'GRADING E • -=• -"- - � .PLAN �' ❑-I am under Section-" - - B. & P. C.'for this - -- - --^ -- - BOILER$ BTU ,ELECTRICAL'$ i - S - reasom- - - . -• PLAN CHECK E - __ _ -� MICROFILM!$ - Date Owner SYSTEM REPAIR, ALTERATION'' 'MECH TOTAL FEE $' ANICAL $- I hereby cartif h t 1 have read t pplitation antl state that lha above EXHAUST SYSTEM MULTIPLE ., LESS'AD- - 1 information rrect. 'I'agr comply with alt City antl county PLANCHECK $ VANCE PC • E Lt0 .'dInances tl ate laws rel R9 to construction, antl h¢reDy authoriEe _- representa ve of this c to enter upon -the above metionetl props rty or in pect ion rpoSes. �3�0 Signature FINAL FEE S Drivers' ;cense or S � -ISSUE FEE CI&0865.46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING[ APPROVALS Permit # E 7i9 Date Inspector POOL & SPA _. , APPROVALS Permit # Date - Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - - 2. Soil Pipe -Un rgrn 44. Steel Reinforcement- " 3. Electrical Conduit Utility- ndrgrn 45: Forms - -- - - - 4. Electrical Conduit-Undrgrn . - - 46. Electrical Bonding-- - - - -- • - - - - - - b. Steel ein orce _ 47. Rough Plumbing & Pressure Test - - - 6. Electrical UFER Grn 48. APPROVALTO COVER-GUNITE 7.. Footings _ 49. Electrical Conduit -Undo rn 8. Foundation - -- -- - - 50. Gas Pipe, ❑•Undr rn, Test' - "-9. -Water Pipe-Undrg�n . - - 51. Backwash Lines P -Trap,❑ UndFqrn- 1 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 13. Rough. Plumbing _ - = ,• _ - --- - -- 14. Rough Electric -Conduit - - •56.- Electrical -Final ' 15. Rough Electric -Wiring rL- 57. Solar System -Final - -- 16. Rough Heating & Air Conditioning -58.Fencing .& Access Approval 19. Ducts, in Structure - • „ - APPROVED FOR PLASTERING 18. 19. 20. Ducts, Ventilating- - Gas Pipe -Rough &Test - - Roof Framing•- -- , - - - 60.. POOL/SPA SYSTEMS FINAL - •" 21: 22. Roof Sheathing-- - Frame and Flashing - - -- - --- , - - - NOTES: - - - ' 23. Insulation-- - - - 24: Lathing & Siding- - - -- - - - - - -- - -- -- - - ' 25. Drywall Nailing - - - - - - 26. - Plaster Brown Coat - - 27. Electrical Power Meter -Final d- 28. Final Electric - - • - 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. FINAL STRUCTURE & BUILDING - 39.- Special Requirements Completed - 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co.. ' 42. CERTIFICATE OF OCCUPANCY No Date Applicant to fill in all spaces within heavy border lines and SI all appropriate declarations. ' —'CITY OF,GOSTA MESA PERMIT NO. TRACT NO. LOT NO. B7, - - 5709 b/ I i /B2 23.58 TU CONSTRUCTION PERMIT as l) V. —Ip — —. Project Addres _ TYPE OF CONSTRUCTION Owder Phone (�tj ❑NEW ❑ADD; ALTERATION- --s - _ -- - - Address � 0 REPAIR _0 CONVERSION ❑DEMOLISH - - "ZONING Arch/Eng. - License No. - 0 OTHER REGULATIONS _ _ - '- DESCRIPTION OF WORK .A.P.$ 'Address - - - -- -- _ ; - -T-- ZONE � PLNG. REF. ntrectOr ne C,- TYPE - U D _ TTpp BtL/1ILT - PROPERTYLINE q -Address - --`"0. ❑'GRADING -❑ FOUNDATION El STRUCTURAL 1 - SETBACK CIL ST. IDE YARD - LICENSED CONTRACTOR DECLARATION - I licensed Charter 9 - 0 TENANT�ELECTRICAL'OpLUMBING ❑MECHANICA SIEpFE yA _ I hereby affirm thzt am under provisions Of (com- section- 7000) Division -3 of the Business and. El OTHER .RIGHT mencing with of Code, Ilce I5 full. force AREA R'VARD (TO P/L) Professions and m se n and effect. -moi. ` ��•��is� / �jP PROJECT CRIPTION _ _ _ _ _ - - _ License &less i - Livens D7 ,.- - PKG. SPACE REO. _ PROVIDED DatesZ/-®�` SlBnat ure -� - - SQ. FT. _ _, WORKERS' COMPENSATION D ARATION I o-�t OCCUPANCVR_.� CONSTRUCTION TYPE (STREET VJI DTH -•ZONING PARK FEE'$: . I hereby affirm that I have a qtfificate of consent t0 self -Insure Or a VALUATION ZONE - APPROVED BY ' DATE - --- - 'certificate -of Workers' Compensation Insurance, or a certified copy _ -,- - --• _ SPECIAL CONDITIONS: - _ thereof (Section 3800, fab. CJ. I GRADING•CU. YDS. ACRES " Policy No. _. - __ -Company ❑ Certified.copy is hereby furnished. _ .. REMARKS. rF.A9 0 Certified copy is filed with the city Building Division. 7"e._ EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - - - - - - - ',,,,(This section.neee not, be completed if the permit Is for One hundred "($100) or less). ) ' q I Certify that% the Of a work for which this permit le - - - - ,performance Issuetl, I shall not employ any pars In any man �r so as,to become PLUMBING S'PLAN'CH CHECK - " - ,ELECTRICAL -- - - -- PLAN CHECK subject to the.Workers Compo .Laws of rnla. _ _ _ _ Date { 7Z'%�2 Signature _ _ BATHTUBS SHOWERS - -qO. FT, qQ FT - NOTICE: If after making this ISration, you should become•subjact TOILETS, --URINALS "- - - --j GENERATOR - -0-1 KW_1-10-KW to the Workers' Compensatio revisions of the labor Code, you must - - ;TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES_ DOUBLE LAYS - -, APPLIANCE - 10-50 KW_ 50 revoke tl._ CONS TRUCTION LENDING AGENCY ONS 'KIT. SINKS - DISHWASHERS - 'TMOTORS-01`HP_1-10 HP--' I hereby affirm that there is a construction lending agency for the per- 't SERV ICE SINKS SUMPS' - (INC. SOLAR)_ _ -30-50 HP 50+ HP 'c rmanc.aff formante of he work for whlth this permit Is issued (Section 3097 , Civ.'CJ.-- -'� 'FCOOR SINKS 'FLOOR'ORAINS- -� - 'FIXTURES OUTL-ETSIYSWITCHES - , enName Ler's _ _ _ _ _ _ _ � Lender's AddressDRINKING DRINKING'FOUNTAINS I ��--`" "t'--- "GAS TUBE'SIGNS'*"---�• ---- -- - Q- , o OWNER BUILDERDECLARATION-' ---' -- -- ••' INTERCEPTORS CLARIFIERS -Y" --'--' 1POCE CIGHTS"- - - - - I hereby affirm that I am exempt 31.5 u Contractor's License Law ler the'f ng reason (Section 7quire Business and Professionsconstruct, - SWIMMING POOL-' 'P TRAP '-' -- "- 'POLES METERED �•� �- .SVB � - Any city or county which requires a permit to construct, alter, city improve,'demollsh or repair -any structure, prior to Its issuance,- also re- WATER SERVICE 'ALTERATION --. "�' �' - - -jPANEL'S"-' - 'MAIN"' -- - SUB' - ^ quires the applicant for such permit to file a Signed statement that he - - Is I l tensed' purl us nt to the pro vi Sl o n Srof the- Co rut ra ctor's Licen se Law- GAS SERVICE OUTLETS - - ` j - �� - ^ 'SERVICE-- -- '-••- - --- - AMP- - - (Chapter 9 (commencing with Section 7000) of Division 3 of the - ' Business and ' Professions Code) or that he is exempt therefrom and the '-WATER HEATERS ' - BTU OUTPUT -- basis for the alleged exemption. Any violation Of Section 7031.5 by any -applicant for a permit subjects the applicant -to a civil penalty -SEWER CONNECTIONSof not more than five hundred dollars ($500). I r1 I,. -as owner of the -properly, Or my employees with wages as their SOLAR TANK" -' ' -"' COLLECTORS' - -- - - ----- - - - - - - - - - - - - compensation, will do the work, and the structure is not Intended Rferetl for sale. (Section 7044, Business antl Professions Code: The _ _ SOLAR PIPING SVS. - -I - ISSUE FEE'- ntractor'S_License Law does not apply to an owner of a property -gppLICATION _ who builds or improves thereon, and who does such work himself or ._ ,. - _ _ - ISSUE FEE- - _r-- APPROVED BV-- -- - -- -DATE- through .his. Own employees, provided that such Improvements are not j intended or offered for sale. If, however, the building or improvement' the burden MECHANICAL PLAN CHECK SUMMARY OF FEES i5 sold within one year of completion, the owner will have of proving he did not build or .improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU t 'BVILDING - -- PERMIT-^ $ .. if -- --- -- - •,_-�$'- 0-1, as owner of -the -property, am exclusively contracting with AND DVCTING _. _ _ __ _ -SMIP.. -j licensed contractors to construct the project (Section Business Law does to 100,000,+ BTU PLAN CHECK $ 1. PERMIT \ es not and Professions Code -The -Contractor's License not apply an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU -- - - - -- ... `PLUMBING $ �_ -'_ISSUANCE $ - ,f - tracts from -such projects. with -a contractor(s) IlceSned -pursuant to -SYSTEM - - -- - -- -CHECK -.GRADING �$ _ the Contractor's License Law). 100,000;+ BTU WEAN $ til r vf•' 0 I am exempt under Section "' '-- -'- "" - B: & P. C. for this - - - - - - -'-- - BOILERS BTV ELECTRICAL $-reason -.._ _. -. _ ___ .• ��' '. t "PLAN CHECK —$ ':^_MICROFILM'$ - - Dale Owner SYSTEM REPAIR, ALTERATION 'TOTAL FEE'S I hereby cc rt ify that have read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $-' _ - I LESS AD - information is ---rect. I agree to comply with all city and county PLANCHECK $ 'VANCEPC $_ - ordinances an to laws relating to construction, and hereby authorize representati s I this cit o enter upon the above mentioned property_ f r spection poses. _ _ _ _ S• FINAL FEE $ a3 Signature D te-- - - Drivers' ense or 55 $ - - ISSUE FEE -- - - - - CMF 065-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor 1\ — ' CONSTRUCTION AND PLANNING - - APPROVALS Permit # �0 Date Inspector POOL & SPA APPROVALS Permit # bate Inspeetor _ 1. Temporary Electrical Service or Pole - 43.' . Pool & Equipment Location - - - - - . SoilPipe-Un rgrn - - 44. Steel Reinforcement - - - 3.. Electrical Conduit Utility-Undrgrn 45. - Forms 1.- - 4. .Electrical Conduit-Undrgrn 46. Electrical Bonding - - - - - - -- _ _Steel ein orce _ 47. Rough Plumbing & Pressure Test 6. Electrical LIFER Grn - 48. APPROVAL TO COVER-GUNITE - - 7. Footings _ _ 49. Electrical Conduit•Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water-Pipe-Undrgrn 51. Backwash Lines P-Tra ' ❑ - ndr rn - 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line &.House Connection 53. .Backwash & Receptor -Final 12. Street Sewer Connection - - 54. Heater & Vent -Final 13. .Rough Plumbing - - - - ' - -- - 14. Rou h Electric -Conduit - -' - -56-= Electrical -Final 15. Rou h Electric -Wring' - _ 57. Solar System -Final _ - 16. Rou h Heating & Air Conditioning - - - Fencing & Access Approval _ 17. Ducts, in Structure _ _ ' APPROVED FOR PLASTERING ` 18: Ducts, Ventilating -. _ - _ - _'- -60. POOL/SPA SYSTEMS FINAL - 19. Gas pipe -Rough'& Test _ 20. Roof Framing 21: Roof'SKeathin - - - NOTES: 22." Frame and Flashing - 23. -Insulation 34= Lathing & Siding ' 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meth:Final - =- - - 28. Final Electric 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. FINAL STRUCTURE&BUILDING - 39. Special Requirements Completed- - 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY - - No Date 'Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. Y CITOF COSTA MESA PERMIT NO. TRACT NO. LOT NO. BLDG. NO. - - - - - - %245 6/11/82 .. 83.82 TL, 3S seesCONSTRUCTJONPERMIT Project Address ��• J� TYPE OF CONSTRUCTION Q Phone 0 NEW X -ADD 0 ALTERATION - --' - - t - -Address 1 ❑ REPAIR 0 CONVERSION' ❑DEMOLISH 0 OTHER ZONING REGULATIONS Arch/Eng. -License No. DESCRIPTION OF•WORK A.P. -Q " 6 7 t Address -- �L ,..'4 t! i� - 5 ,QG�� )ZONE 'PLNG. REF, 5r • Contractorx•L, jI,�;/;Q,e- PIQ(JI'!' - Phone_j4e,r3 TYPE OF PERMIT'- r "-' -BUILDING- - ��1p .�yNLINE. 4 /t/ - LtGS- G. in, - O GRADING FOUNDATION --❑ STRUCTURAL- SETBACK C pl�I - I LICENSED CONTRACTOR DEGL'ARATION - 'LICENSED � `❑ " 0 TENANT 0 ELECTRICAL• A3IPLUMBI NG ❑MECHANICA i1DE YARD - - -- - - -• - - \ 1 hereby affirm lhLt I am licensed under provisions of Charter 9 (com- SIEEDFFE VA RIGHT 1 mencing with, section 7000) of 'Division -3 •of the Business antl ❑'OTHER. Professions Code, :and my license is In full fort and a ect., - REAR YARD (TO P/L)-- - - - C - _Lldense l ' PROJECT DESCRIPTION _ _ _. _ _ :_ - License Class j PKG:SPACE-REQ.' PROVIDED. .0�i p7 7iLL:_�� SQ: FT. -. _ _- _ I Date Signature not erea� WORKERS'.COMPENSATION DECLARATION _ _ _ _ -. ''OCCUPANCY_• CONSTRUCTIONTVPE _ _. STREET WIDTH _ _ .- ",PAR-CATE , 1 hereby afflrm that I have a certificate of con sen to self -Insure, ora ;;VALUATION. ZONE 'ZONING APPROVED BV -- -DATE ^ 'certificate Of Workers' CompenOtlon Insurencp, or a certi(Ia0'copy _- - _- - _ thereof (Sect n 3800,p��j l / GRADING CU. YDS. ACRES _. (SPECIAL CONDITIONS:- PolicyNoF �'r /�^� "r�ompanY 0 Certified copy is.hereby furnished. REMARKS:. ;sCertified Copy is filed with the city Building Division. -- - - - - - -" -- - s - - - -' EXEMPTION FROM WORKERS -COMPENSATION DECLARATION - '- •- - - - ,---- l- '� (This section need_not be completetl if the permit is for one -hundred S 51ce0rtify0) or less). 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- - - PLAN CHECK - - - - subject.to the Workers' Compensat son Laws of California. - - Date Signature -BATHTUBS- - SHOWERS -'- -UWLLLING - -' - FT NOTICE: If after makingthis declaration, you should become subject TOILETS ; ; URINAL'S -- -- -GENERATOR-- - - -0-1-KW 1--30-KW ' to the Workers' Compensation provisions of the Labor Code, you must TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOVBLE LAYS - r -- - --�gppL-IANCE - - 30-50 KW—'50 + I<W revoked. - KIT. SINKS"' - •' '- DISHWASHERS - - -- MOTORS - - - 0.1 HP yl -30 HP - -- - CONSTRUCTION LENDING AGENCY - I hereby affirm that there is a construction lending.agency for the per- SERV IC E.SINK5.7� n• SUMPS'- - - -- -- (INC. SOLAR). 10-50 Hp + HP. formance of the work for which this permit is -Issued (Section 3097 , -FLOOR SINKS'" FLOOR'DRA.INS - FIXTURES----- OUTLETS --SWITCHES - Civ. -CJ. - •---- - --- -.-t _ .Lender's AtlName Lender's tlress. ;W _ N' FOUNTAINS-.�•-' -' .' ----. --- 'DRINKIG' --GAS-TUBESIGNS--- 4- - -' - OWNER BUILDER DECLARATION -- -- - -- '- 'INTERCEPTORS s �'; CLARIFIERS- - ;"' -` ^ -' )POL-E-L-IGHTS - - - - -'- -- -- - -- _ - - a hereby affirm that I am exempt from t he'C0 ntra dors ,License Law'for. the follows ng. reas0 n (Section 7031.5-Buslnessand-ProfessionsCotlei' SWIMMING'POOL -� PTRAP -•�- — - Any city or `: coun IY which requires a permit to Conslr I' alter, POLES'- METERED SUB - (WATER SERVICE -t ALTERATION ^' -- .PANELS- - MAIN - SUB - improve; tlemoltsh or repair any structure, priorlt0 its issuance; also, re- Tres the applicant for such per mil to file a signetl statem Cnt hathC ^% ' - s is Ilcensed pursuant to the•pr o vi sio ns 0f 1 he- Con t ratter's License Law is GAS�SERVICE - -.•, OUTLETS - "' -"-' '+" - �•-`_- - - -SERVICE---- --- - --- - AMP--- --_ (Cha pte,. (commencing with Section 7000). of Dl vision 3 of the WgTER HEATERS - ' f3TU-OUTPUT ^ - _ - -- - - 99 usin.ss-antl Professions Cotle) of thSY he is exempt therefrom and -the- basis for the alleged exemption. Any`viOlaliOn of 5ectlon 7031.5 by - SEWER CONNECTIONS any apple raM for a permit -subjects the applicant to a -U vii penalty- of not more 1M1an five huntlretl dollars ($500).- SOLAR TANK '- COLLECTORS - -^ - - -- - .-_- - ', as owner of the property; or my employees with Wages as their compensation, will do the work, and the structure is not Intended .ffered for sale. (Section 7044. Business and Professions Code: The --SOLAR PIPING SYS. I+- ISSUE FEE -- - - - - -- contractor's License Law does not apply t0 an owner of a property _ _ _ ISSUE FEE - _ -- - '- - s APPLICATION APPROVED BY who but Ids or improves thereon, and. who does such work himself or through his Own employees, provided that such Improvements are not - MECHANICAL PLAN CHECK ' -- SUMMARY RV OF FEES intended or offered for sale. If, however, the building ur Improvement- Is sold within one year of completion, the owner will have the burden of proving he did not build or improve for the purpose of Sale). -- - - - - -- - .-- HEATING SYSTEM 0-100,000 BTU Y -BUILDING S� �� _ 1 -- __ - - s`0 y$ am- exclusive) ❑-I, as owner of -t he_properlv.- Y contracting with, El -i, AND DUCTING 1 -- - -L - - PERMIT $ SMIP licensed contractors to construct the project (Section 7044, Business 100,000,+ BTU !PLAN CHECK$?._�- PERMIT n and Professions Code: The Contractor'S.LicOnse Law does not apply to _ _ISSUANCE $ ' an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU IPLUMBING-- $� - tracts from such projects-with-a-contractor(s) Iicesned pursuant -to SYSTEM - -. _-_ _ - �j,,,� GRADING $ the Contractor's License Law). 100,000 + BTU PLAN CHECK S- —I _ I am exempt under -Section• B. &'P. C. for this- BOILERS BTV 'ELECTRICAL'$ ' ' - $ reason - -- ---- -- - - - SYSTEM REPAIR, ALTERATION - PLAN CHECK -$ MICROFILM 8 _• ' - - -" Dale Owner - ' ' "' MECHANICAL--$-- - - NOTAL FEE $' - I hereby cert icy that have read this application and state the above Information is comply EXHAUST SYSTEM MULTIPLE ! PLAN CHECK- D- ' LESS AD- correct. I latee"t0 y a with all City and county' ordinances ordina noes and state laws relating to co tru<tien, and hereby authorise $ VANCE PC $ represents civ of - this' city Io'en upon the above mentlpned' property f inspection p-�p - ! " 8� ✓ \ Signatur V ✓✓1iL�9/L✓ Dat}O� - ISSUE FEE. FINAL FEE $ Drivers' License or •'S CMF 0865-16 White -Building: Canary -Applicant; Pink -Accounting; Goldenrod -Assessor _i1 CONSTRUCTION AND PLANNING APPROVALS Permit z# F3884 Date POOL & SPA- Inspector APPROVALS Permit Date• Inspector 1_ Temporary Electrical. Service or Pole _ 43.. Pool & Equipment Location - - - 2. -SoilPipe-Undrgrn _ , .; -- 44. Steel Reinforcement -- - - 3.- Electrical Conduit Uti ity=Undrgrn. 45. _ Forms--- . 4. Electrical Conduit-Undrgrn. 46. Electrical Bonding_ ---- -- - - - - -5.. Steelem orce 47. Rough Plumbing & Pressure Test - - 6. . Electrical LIFER Grn _ 48. APPROVAL TO COVER-GUNITE Footings - .- -.-,-' _ __ 49. Electrical Conduit-Undr rn -8. - Foundation. _ . _ - - 50. Gas Pipe ❑ Undr rn, Test - 9. Water Pipe-Undrgrn-. _ 51. Backwash Lines P-Trap,Ej Undrqrn '- 10.__ Structural. Floor System _ _ 52. APPROVAL TO DECK -11. --Property.Sewer.Line .&.House_Corinection. -r. -53. Backwash -& Receptor -Final- '- 12. Street Sewer Connection- - - - 54. Heater & Vent -Final 13.. Rough. Plumbing . - - - -- Plumb 14. Rough Electric -Conduit -- '-' - - 56.- Electrical -Final -- -'•+ ��' 15. Rough Electric -Wiring - - 57. Solar System -Final 16. Rough_Heating'& Air Conditioning - - - - - -- -encing & Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING - • -' 18' 19. 20.- Ducts, Ventilating- Gas Pipe -Rough &-Test - Roof Framing. - . - _ 60... POOL/SPA.SYSTEMS FINAL . 21: ' 22. RoofSheathing- - Frame and Flashing - - - - - - -- - - - NOTES: / '-. ' '•i"'' - 23. Insulation- - - - -- k..- 24. Lathing & Siding 25. Drywall Nailing - - 26. Plaster Brown Coat- 0- 27. Electrical Power Meter -Final 28. Final Electric 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. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison - - - 41. Gas Release to Southern California Gas Co. - 42. CERTIFICATE OF OCCUPANCY - No- Date m CMP 0` -46 White -Building; Canary -Appli�� :� A-;nunting;-GG0Idenrod-Assessor • Applicant to fill in a Fes yythin heavy border lines and sign all appropriate declarations. .CITY OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. BLD . O. - -'CONSTRUCTION PERMIT %�-3 %% ' 663.3_ 6_/01/62 11.00 Project Address _ TYPE OF CONSTRUCTION r� +.- JL - 'Owner Phone IX NEW 13 ADD,. ❑.ALTERATION •I #2181 -' Address' - - - -' - b-REPAIR ❑ CONVERSION ❑DEMOLISH- , .; .• ZONING REGULATIONS (Y� .Arch/Eng.- - - 1 ' License No. ❑ OTHER - _ , - - DESCRIPTION OF WORK i A.P. Address -- - - - _ ' '. ZONE PLNG REF.$, ' Contract _.. - - _.- Phone - - TYPE OF PERMIT', ' - - To gUI pY11IG - _ _ _- I{ SETBACK T. PROPE RTV LINE _ ;Address '- ., ., ,. ❑GRADING '❑ FOUNDATION. -❑STRUCTURAL SIDE YARD I-. -d t I LICENSED- CONTRACTOR' DECLARATION - - -t O TENANT-O'ELE CTR I CAL P LU M B I NG ,,yy L'7 NIECHAN IC A 'LEF DE VA _ I hereby affirm that' I am licensed under provisions of Charter 9 (com- .. •7 .• ,. -' 'OTHER-'^- -' -'- -- SSI RIGHT ' mencing with-section 7000) of Division"3--of- the'- Buslness'and'- - - Professions Code, and my license is in full force and effect.�• REAR YARD (TO P/L) -r,• -PROJECT DESCRIPTION 11 License s nseN J}' PKC. SPACE REQ. PROVIDED - - SQ FT. _ _ Date Signature - STREET WIDTH .r; ,PARK_ ;F,EE $. WORKERS' COMPENSATION DECLARATION - OCCUPANCY_ CONSTRUCTION TYPE I hereby affirm that 1 have a certificate of consent to self-insure or a" VALUATION ZONE, ZONING APPROV ED.BV v DATE - , certificate of Workers' Compensation Insurance, or-a certified copy 1 thereof (Sec Lab. C.). i$� . - -) -- Goodwin' Ins. Policy No. Company . GRADINGGU..YDS. "� ACRES - " -- — - SPECIAL CONDITIONS: '" - - -- - - - ❑ Certified copy is hereby -furnished'. - ^--- --- - - - - REMARKS_ - - -- J. ® Certified copy is filed with the city Building Division. _ _ •.� EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - - - - I -- - -- - - (Thls-section need not be completed if-the permitisfor-one huntlretl. _ __ _ _. - __ _ - _ - It �• "-•y I' ($100) or less). I i L, certify that in the performance•of the work for which.thlspermit is issued, I shall not employ any person in any manner so as to,become _ _ __ PLUMBING ':PLAN CHECK - _ _ __ _ �E ELECTRICAL' PLAN CHECK, subject to the Workers'-Compensation Laws of California. - -_ - _ Dat¢ Signature BATHTUBS SHOWERS i NOTICE: If after making this declaration, you should becomersubjecl ,:TOILETS,; Cl `-URINALS _ - GENERATOR -"'Q-1 KW_1r10 KW n to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed - LAVATORIES DOUBLE LAVS _-_ (TRANSFORMER APPLIANCE 30-50'KW_50 �'KW _ •;'- revoked.- �_ . __. _._ __ . . - --__ . _ _ _ _ l . _-...__. - _ KIT. SINKS DISHWASHERS _ . _ _ 'MOTORS"' -"0-1HP._1-10 HPC-• �� CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS '-;-j It SUMPS - -`- "'�` -' -'(INC.-SOLAR)- -10-50 HP- - 50 + HP-- - - - -- } formance of the work for which this permit is iss uetl (Section 3097 c 1 •••••- -"' t _. ___._.._. ____ _ FLOOR SINKS FLOOR DRAINS _ _ 71 _ -- -FIXTURES ---OUTLETS. SWITCHES- WITCHES Civ: C.I. ___ :_.__�___. ' Lender's Name _ Lender's Address -. _---- -- _ _ DRINKING FOUNTAINS l; ._ _ -- 'GAS'TUBE SIGNS '- - ---'----"--- i -- OWNER BUILDER DECLARATION.' __-.. _"-.- _... _._ _ _ _-__._-._. __ -. -. .._. .. -._ _� INTERCEPTORS CLARIFIERS _ _ _ 'POLE LIGHTS' --'-" h _ 1 hereby affirm that I am exempt from.the Contractor's License Law for 1 SWIMMING POOL— -PTRAP` --"IUN - 'POLES -- the following reason (Section 7031.5-Businessand-Professions Code: Any city or county which requires a permit to construct, alter, 1 METERED SUB s WATER SERVICE ALTERATION I "PANELS - - MAIN-'1. - improve, demolish or repair any structure, prior to its issuance, also re-- quires the ap.liwnt for such permit to fele a signed statement that he . - --- - _ GAS SERVICE OUTLETS '--' - - -- -- -- SERVICE-"- 'AMP- -' - - is licensed pursuantto the provisionsof"t he Contractor's Licen of (Chaptss 9 (commencing with Section 7000) Division 3 of the "WATER HEATERS BT U•OUTFUj - .. ,; r•..� •^ r exempt Business and Professions Code)-or that he is exempt therefrom and the basis for the-alleged exemption. Any violation of Section 7i-pen by ' _ _ SEWER-CONNECTIONS-----'-- - T"--'---'- -- -- - - - � - anY -a PPlica nt for-a - - ,permit"subjects the"applicant-to'a'civil'penalty of not more than hundred dollars ($500). SOLAR TANK COLLECTORS _five ❑ I, as"-owner of the property, or my employees with wages A their sole com pensalion, will-do-the.work,.and the structure.isnot intended. or,offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SVS. ;1 i ISSOE'FEE'---'-"""'- Contractor's License -Law-does not-apply-to an-owner of_a-property.. ISSUE FEE \� r_- _ _ _ APPLICATION APPROVED BY - DATE _ who builds or improves thereon, and who does such work himself or t through-his-own employees, provided-that such improvements are .not_ MECHANICAL PLAN CHECK SUMMARY OF FEES f. •,. intended or offered for sale. If, however, the building or improvement is. sold-within one.year of completion, the.ownecwill have the burden_ IBUILDGV �- of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU U NGTING' 4. O +m IT $ n SMIA: $ •" ❑'I, "'as-owner of- the'-property, --am exclusively-contracting-with- licensed contractors to construct the project (Section 7044, Business --HEAAND "' "" '' 100,000 ! BTU (PLAN CHECK $ 'PERMIT - p� and Professions-Cotle:-The-Contractor's License Law'does-not apply to who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU Q• O -( - - - -• - - ISSUANCE -$ 'PLUMBING ' an owner of property tracts from'such projects-with^a^contractor(s) Ilcesned pursuant to SYSTEM - - --'j) -- -" -- 100,0001 BTU ' '- t $ .•. '- - - - - - - --'GRADING_ $ IPLAN CHECK ) the Contractor's License Law). Cl T am exemptuntler Section - B. & P. C. for this t �ELECTR ICAL $ _ reason` "- `" - '--' - -'" _--- "--" BOILERS - BTU ,,.t..,.•,- 'PLAN $ - CHECK -$ '- -- - .MICROFILM ' 1 Date - -' - Owner - - - - - - SYSTEM REPAIR, ALTERATION - - TOTAL FEE $_J1�sts/_— "MECHANICAL .. _'� $ I hereby certify that read this application and state that the aunt¢- E%HAVST SYSTEM MULTIPLE - l"' 'I information is correct. I I agree to comply with all City and County VANCED- _' PLANCHECK $" --- --' VANCE PC $ tatrecL ordinances and state.lawe relating tconstruction, and hereby, authorize representative not this o to enter upon the above mentioned- property-.fry to _I W s. __. Signature U Date 15 0 - 1 - - FINAL FEE $ Drivers' Licanse or SS ISSUE FEE - 3•. O - •• - - CMP 0` -46 White -Building; Canary -Appli�� :� A-;nunting;-GG0Idenrod-Assessor r-Vk CONSTRUCTION AND PLANNIN�G� APPROVALS Permit # Date Inspector POOL& SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - - - - 2. SoilPipe-Undrgrn 44. Steel Reinforcement - - 3. Electric al Conduit Utility-Undrgrn _ 45. Forms - 4. Electrical Conduit-Undrgrn _ _ 46. Electrical Bonding _ Steel Reintorce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn _ _ 48. APPROVALTO COVER-GUNITE ' 7. Footings 49. Electrical Conduit-Undr rn. - 8. _Foundation _� - - 56. Gas Pipe, ❑ Undr rn, Test .• - 9.- Water Pipe-Undrgrn_ 51. Backwash Lines P-TramC1 Undrqrn 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' " 13. Rough Plumbing -_ - - _ - - - -- -• - 14. Rough Electric -Conduit - - - 56.• Electrical -Final- - t 15. Rough Electric -Wiring ' ' - ' - "'- , - 57. Solar System -Final - 16. Rough Heating & Air Conditioning encing & Access Approval 17. Ducts- in Structure59. APPROVED FOR PLASTERING ' 18. 19. 20. Ducts, Ventilating Gas Pipe -Rough &Test - Roof Framing l� - _ _ - 60. POOL/SPA SYSTEMS FINAL• •. - 21. 22:- Roof Sheathing Frame and Flashing - NOTES: - •' 23. Insulation - 24. Lathing & Siding - - 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric - - 29. Final Heating & Air Conditioning - 30i Final Gas Pipe -Test _ - - 31:. Final Plumbing 32� Water Service -Final' - 33. Gas Service -Final 34. Solar Domestic -Final: +t ' 35. Landscape Sprinkling System 36.- Sound Attenuation -- 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING " ' "• - - 4 - - - 39. Special Requirements Completed - t- - 40. Electric Release to Edison 41. Gas Release to Southern Califotnia Gas Co. ' 42. CERTIFICATE OF OCCUPANCY No. Date - '� Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. •'CITY OF COSTA MESA P RMIT TRACT NO. LOT NO. BLDG. N CONSTRUCTION PERMIT070 TYPE OF CONSTRUCTION 1:1 NEW 1-1ADD1:1 ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER DESCRIPTION OF WORK f - -• 0241 6/28/82 7.00 - - , ZONING REGULATIONS A.P. _ ZONE PLNG. REF.'S ' Project AddreSs A-6 Owner - - Phone tAddre V1eW an na Arch/Eng. - -License No. Address" - - ' Contra - Phone TYPE OF PERMIT - TTop gg��11ILDING - Addr - :' - 1' n - "' ❑GRADING ❑ FOUNDATION - ❑ STFNC -❑ TENANT El ELECTRICAL ❑PLUMBING' -SETBACK T. - SID YARD ECHANICA LW5Ip 111 7ROPERTY LINE - _ I � LICENSED CONTRACTOR DECLARATION - I hereby affirm that I am licensed under provisions of Charter 9.(com. mencing--with 'section -7000) of 'Division --3 of the Business and � -❑ OTHER -- RIIG HT Professions Cod my Il cense is In full force y t7ect. . - -- - L3T � � - - PROJECT -DESCRIPTION' - - - -- - - - -- REAR YARD (TO P/L) - - - -- •; , _ - - - -- License Cllaa ss Lice PKC. SPACE REQ. PROVIDED'. 1' 6-25-82 -Signature SQ. FT.' .. _ ._. -e Date- - OCCUPANCY_ CONSTRUCTION TYPE STREET WIDTH PARK FEES$'- WI WORKERS' COMPENSATION DECLARATION - - " hereby affirm that I have a certificate of consent to set .Insure oraVALUATION- ZONE ZONING APPROVED BY c 'DATE. certificate of Workers' Compensation Insurance,. or a certified copy -- - - - - thereof (Secj�on 38Q 0, Lab. C.). GRADING CU: YDS. ACRES SPECIAL CONDITIONS: Porgy Nn:.. /Fi4411 cgmpany 'Goodman Ins. -Certified copy is,hereby furnished, - -- _ - •' ' REMARKS: - - - - �y�T Certified copy is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - G '�'77 - --- - - - (This section -need not_be completed if the permit Is. for -one hundred _' -- . SS300) or less).+ - certify that In theperformance.of the work for which this permit Is Issued, I shall not employ any person In any manner so as to become PLUMBING'. _,,r ;s- ,' PLAN CHECK - - I ,ELECTRICAL PLAN CHECK I I o subject tthe Workers Compensation Laws of California.' _- r. BATHTUBS - SHOWERS.r LWt,LLINU_ _ _ Data Signature ) NOTICE: If after making this declaration, you should becomersublect --TOILETS Irl, ; URINALS I GENERATOR 0-1 KW_1-10.KW to the Workers' Compensation provisions of the Labor Code, -you must - TRANSFORMER forthwith comply with such provisions or this permit shall be deemed _ LAVATORIES DOUBLE LAVS - _ APPLIANCE 10=50 KW_50+KW' - _ revoked. CONSTRUCTION LENDING AGENCY KIT: SINKS DISHWASHERS' MOTORS--' - 0$ HP_1-10 HIP - I hereby affirm that there Is a construction lendin agency for the per- •- .. - SERVICE SINKS ' SUMPS - '— - (INC. -SOLAR) ) - •30-50'HP_'SO+HP -,- formance of the work for which this permit is Issued (Section 3097 __L - _. ._ __- FLOOR SINKS FLOOR DRAINS r.- - FIXTURES OUTLETS ._-�._ __ _ SWITCHES CIv.C.).-.--..•____ _..____. ___.-_ __- ._ _. Lender's -Name Lender's Address DRINKING -FOUNTAINS - - 'GAS TUBE'SIGNS OWNER BUILDER'DECLA RATION I hereby affirm that I am exempt from the Contractor's License Law for INTERCEPTORS CLARIFIERS •�'' -- 'SPO LE LIGHTS - - - - — - SWIMMING POOL --P TRAP-' '1 - the -following reason (Section 7031.5 -Business -and -Professions Code:' Any city or county which requires a permit to construct, alter, POLES METERED SUB _ WATER SERVICE ALTERATION • PANELS `-" MAIN SUB - - - - Improve, demolish or repair any structure, 'prior to Its issuance, also re- quires the ap, Ilcant for such permit to file a signed statement that he GASSERVICE' "OUTLETS' SERVICE'-" - - -•' --"" "' 'AMP~' - - - - Is licensed- pursuantto the provisions of the Contractor's License Law- (Chapter 9 (commencing with Section 7000) of Division 3 of the -WATER HEATERS- � BTUOUTP.UT Business and Professions- Code) ' or that he Is exempttherefromand the basis for the alleged exemption. Any violation of Section 7031.5 by 'SEWER -CONNECTIONS' any -applicant for a permit subjectstheapplicant-to -a civil -penalty of not more than five hundreddollars($500). SOCAR'TANK - COLLECTORS'-•��'I -� ❑ I, es owmer of the property, or my,employees with wages as ttielr sole compensation,_will.do the work,.and.the structure.is not Intended or offered for sale. (Section 7044, Business and Professions Code: The _ _ _ _ SOLAR PIPING SYS. _ _ I _ ISSUE FEE_ _ _ _ _ _ _ _ -' Contractor's License Law does not apply -to an owner of a property, _ _ _ _ .._ -, _ ISSUE FEE .-• - ,APPLICATION APPROVED "BV — - a - DATE who builds or improves thereon, and who does such work himself or through. his own.employees, provided.lhal such improvements are n0[ MECHANICAL PLAN CHECK SUMMARY GF„FEE$-'_ 'BUILDING�- Intended or offered for sale. If, however, the building or Improvement is.sold.within one year of completion, the owner willhavethe burden of proving he did not build Or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU 'PERMIT Li _ • 'SMIP... $1. ❑-I, - as owner of the property, am exclusively -contracting with- licensed contractors to construct the project (Section 7044, Business -AND DUCTING - I - _ - �100,000l+BTU $ - K - - - IPLAN CHECK $ - - -” - - 'PERMIT• ' and Professions Code: The Contractor's Licenser Law -does not apply to •--- - -- - - - - -ISSUANCE $ an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU 'PLUMBING E - - tracts -from such projects with a contractor($)•Iicesned pursuant to SYSTEM - - - - -a - - ---- - - GRADING --E the Contractor's License Law). 100,000,+ BTU PLAN CHECK $ - ❑ I am exempt under Section B: ii C. for this BOILERS BTU ELECTRICAL $ .$ - reason SYSTEM REPAIR, ALTERATI.ON EXHAUST SYSTEM MULTIPLE PLAN CHECK -E MECHANICAL $ - MICROFILM E_ 1 TOTAL FEE.$ 7 - nn, , "LESS AD- Date Owner � 1 hereby certify thatJ have read this application and state that the above- information is correct: I agree to comply with all city and county - ,PLAN CHECK $ VANCEPC $_- ordinances and Slate laws relating to construction, and hereby authorize , , representatives of " his city toyJJ nter uPpn the above mLeotiobetl- 1 ' property for i X1/0 /1 ` /y� /� _ - 2' 00>. 211 Signature .•I( 7Z((� Date J - ISSUE FEE - 3. D0 - FINAL FEE $ Drivers' License or 55 � %� CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # �q�� Date •. %, POOL &SPA'- Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - - -- - 2. SoilPipe-Undrgrn 44. Steel Reinforcement - - - _ 3. Electrical Conduit Utility-Undrgrn 45. Forms - 4. Electrical Conduit-Undrgrn 46. Electrical Bonding - - - 5. Steel em orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn - 48: APPROVAL TO COVER-GUNITE - - - 7. Footings - - -- - ` 49. Electrical Conduit-Undr rn - 8. _ _Foundation _' " - - 50.. Gas Pipe,. ❑ Undr rn, Test � 9. w __Water Pipe-Undrgrn- ' 51. Backwash Lines P-Trap.El' ndr rn - - --- - ' 10. Structural Floor System _ 52. APPROVALTO DECK- ECK`11. 11. Property Sewer Line & House, Corinecti ori ' 53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13: Rough Plumbing - = -Final-- - - ' 1 14. Rough Electric -Conduit - -- - 56. Electrical -Final ' 15. -Rough Electric -Wiring-- - ' -- - - = - -� 57. Solar System -Final . - 16. Rough Heating & Air Conditioning _ encing &Access Approval 17. Ducts in Structure` _ _ _ _ ' APPROVED FOR PLASTERING 18.. 19. 20. Ducts, Ventilating Gas Pipe -Rough & Test- _ _Roof'Framing _ ' 60. POOL/SPA SYSTEMS FINAL -. •• _' ' - 21. 22. Roof Sheathing - '' _ _ Frame -and. Flashing _ __ - - _ _ _ _ NOTES: ;' �� 7,� 30,-- ' 23. Insulation 24. Lathing & Siding - - -- 25. Drywall Nailing _ - - - 26. Plaster Brown Coat - 27. Electrical Power Meter -Final 28. Final Electric - - - 29.. Final Heating & Air Conditioning 30. Final'Gas.Pipe,Test- - 31. FinaliPlumbing 32. Water. Service -Final i33. Gas Service -Final - 34. Solar Domestic -Final 35. Landscape Sprinkling System ? i 36,-- Sound Attenuation r .. 37. Handicap Regulations• • ^ 38. FINAL STRUCTURE&BUILDING ' 39. Special,Requirements Completed - 40. Electric Release to Edison - - 41. Gas Release to Southern Calif rnia Gas Co. • 42. CERTIFICATE OF OCCUPANCY No Date - f ADDRESS OF SuIUMb 245 FISCHER AV UNT: A-6 ORNEnsN iF01DATL: CLOUGHERTY, MARGARET M AWREss: %ROBERT B MARUSCIH 27031 SANTA SUSANA CIR MISSION VI£JO,CA 92691 APDL. MMIALG ADORER: ARCHITECT OR fMi9EER: , \ l �C� \ Ur, NO: ANCNDRDWSAWRM: �i"vT uw. cwm4cTws;IAEE: DEL MAR HEATING & AIR (714)499-2805 COINPACIOn MMM 15 MONARCH BAY PLAZA ADOREss: MONARCH BEACH CA wtuc. 477331 92629 wu.. 384 UCENSEO CON"ACTORS DECLARATION: I hereby wdim uncia, pommy d pedary Mm I mn keened a poriaiaa of Chepa 9 (c ftttby Wh Smfion TOW) d DANNn 9 d Ria Buvirom mtd PMea.iom CWa, and my limos Is b IW brae and Wan. cfr'f UC. NO.: D 38177 9UC, cuss; C-20 ua NO, �477 13 1EJXP 0 ON.: " ✓ COMradn: T/ VfYIt / v-L,�RJ OWNER BUILDER DECLARATION: I lw.by affirm under mneYy d perjury Mat I am smm%ha. the Cormedon Limnee I for Me fdbWaq Imaon ISwleo TW IS Bmiims end PrdeMaa Cotle: Arty dy a ouudy MOM rmubm a Deana to oomwa, WIN. Mprow, +emalbh, a regi mY arches, prim ro Ea bwerca, ebo,punas rM mpkent fa mgr pemq to Me a signed eaaenwm Mal M or the ►luemed l==: 'I. Me, %.,aura of Me Corerm fors home. Lew ICtapa 9 (oommwvirp with Section 70W) d Divwion S of It, B mwtww aM Prdem+one CWeI or Met M or aM b e.emp Ihaehom end rlm Mee, for du NlWW eesr Nf n. AW vdtlun of Swim T Wt.s W eny eppYud IN a wmC wdjent Me applicant to It chd penalty of mt mea then five IarnAad doom (SSWD. I. m owner dtM popedY a my ampiwees wah wapm m they ode oompwmlu Lk do Oa wpu M ap Wuct or of resM.d aodeud he seblSxdm TON. BuinemmM PMmeiom Coda: TM Cauradonlbensetawdom nU appyumawwd %op.M wM buddt a in%ovm tMnm. and wiu dom euN wok fdmmd a MnM a deonW+hb a her own elnpioyes., pmided thtl wch imprwernema me N Wended li dlt pe Ina sale. d, a d4 rr.IM or ctoa'vnprwsmaa b add f ImA . yw d oornpltlbn, ua pwner-0uilder will have IM budm d puvilN M or Me db M hued a improve for du Damm. d nab). I. m owner d the l+operry. am *.*N,,W mmrect" with FcanW cmtrealm to m tM pain (swan l . Bueinms and prdesaiorm code: TM Camanon L� Lew low, not appy to m owma d popery e)n 60b a wwwm therein No e6o emewN Por mN pr*l erM • wruraaa(.) hcamd % tiaa ro Me Cpntrodae Lbeme Lew). I an hemp urge Sanun: B. A P.C.. for Mee meson: Dint: Owner: 16. hereby twig%dm I inn Nems of mW undamad Me roRvaerrlarm of CW rA Noah and Sday Code Secibra 25W. 25699. and 25Re. end Mai I a IN, Min building oa.dw end I w rot (drab ma) need to ommN eih said data rads. and the reeuiremaw for a Derma laxNbutiinamodGrAiontrom"AM y —mnagearaW Daldd. PMWWW owwrutun mpkmieu eroaw MM from Mina Dau: Appuma: WORKER'S COMPENSATION DECLARATION: 1 hasty 9" UrAW paaey of p./ruy oro of Mr foDowdrp da kitoobne: Ih.v. and wD meaaenacMScme dembdlpte6:mpVlefa wwkai mrtwanalipn,mpwbMla bySwim 97WdlM labor Code. fa IM pedam.rca of Me ewes fa wtiM Mie permit b NNN4. it *04IN mo, pinwmkoa''d MYwoion Irmuanos,m rpuvsd bySggn S rd dIM Labe CodabIM Padon^ama dIM 7i waM la whid� Sm perm% b bsuM. My wakara' romprnalion irouum. wrier and pocky rmmber aro: Cads 'E FUND EXPIRES Pcoo Numb,. R:R( P, � I� B 1 Z 3 • (IM1b swion riled rrd b mmpbtNd l IM parrot b M1 n e ejY' a ImaJ �) 1 wyN Mm'ut da pMmmme tl du w'" fa whuh of CadlapemN b bald. I shed t empty airy pawn b!nY marura w m to trm r wqw to ftNrtme' opnpwralbn t.- of nue. W ague Mai d I tlnuM trarm wakr.' wnPmrWioni�%iiwu�Jam d Swu/m 37M d IM Labor Cb , 1 stop civ aim. / ON.: ' !i til l7 Ap~u a%Ll./! �i/� WrmN9: fNpun ro a.cun amrbn' awnlp medm rovmp. b unband, and andl.b/aet en dTmmw ro nfMrul pwTa7llm myd aWl Dem W ro one hrndrW M.peerel dalbro f$I040I0A M addffbn ro Me cost of rorrpemefbq denrmm as pro~ for In Sacdm 97D6 of Ma Labor Cob, )mamL And e)romay's tam. CONSTRUCTION LENDING AGENCY: I hereby Nil. antler pwoe* of owpo IW the. b It mal ttaNn bndbp egawy IN M. pedanname of Um mark fa wldd Ihb permd b"ad (Sewn 9097, Ch. C), LENDERS NAME: LENDER'S ADDRESS: I telt, tW I haws sed Ods Appfdmi. and dim lhd the above Wormdwn is corrod.I moue to oompy with Wary end wady admmmm erw We baa uulbp towmiq oawwbn an hereby" wioefeaamnratiap of Ihle dry b waulsm the N,w ,,embnM W.Wry for{neladim purpaess, WALTER Nffl -ETZKI — Oda: ✓ ' �a� ` "C' (Sts1Je.WP) WhdsAuadip B SNW.. Gaon -Fla; Cmary-Appian; ftk-R enm; Oddavod-Aaaeuor CITY OF COSTA MESA — BUILDING PERMIT pERM NO; E 078391 PERMIT NO: E 078391 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE: ADD JOB DESCRIPTION CHANGE OUT 3 A/C UNITS 2.5; 3; 5 TON SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: B / COMMENTS: CHANGE OUT EXISTING ROOF MOUNTED A/C UNITS / AEF M-78390 Z O N I N G R E 0 U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- PERMIT --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 42729206 ZNE: REF NO: PLANNING NOTES> PLAN—CHECK iE �EMMdf******IE*N1EkdE*dfk�(•1k HE ifk**k***iF if iE*if SHE iE*HE**kHEk♦E***DIP 1E*tE iE if DIE DIP lE iP*HE***iE *HP DIE DIP DIP fE iE iE iE 1P HE HP HE > I N D I V I D U A L F E E B R E A K D O W N DIF DIP DIE DIP DIP DIP 1F DIP DIF *!F * k iE iE DIF DIF *!F!F N fP DIP DIE DIF 1F M•!F!E If DIE DIF if DIF SP iP M iP DIP DIF DIF DIP lF lP DIE fP dk DIP DIP )f 3P SP iP )t DIP )F DIE M•!F iE k iP iF DIF iF * iP iP DIP DIP IP iP iP iE iE DIP 9PfP DIP D E V E L O P M E N T S E R,V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY DATE: =� — APPLICATION ISSUED BY: DATE: �O dPDIPKLICATIODIPDIPDIFSSUEDiPBiP* N-DIP*iPiF*itN-iPiPi�itDIP LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT PLAN ISSUE FEE 8150E 22.00 SMIP/NON—RES BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 81.75 22.00 0,00 103.75 103,75 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 103,75 OVER/SHORT: ,00 ftb�, �Mf int-URbtNh tL�O'J3'R�S MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK iE �EMMdf******IE*N1EkdE*dfk�(•1k HE ifk**k***iF if iE*if SHE iE*HE**kHEk♦E***DIP 1E*tE iE if DIE DIP lE iP*HE***iE *HP DIE DIP DIP fE iE iE iE 1P HE HP HE I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 3 MOTOR/POWR APPARATUS 1,1 — 10.0 HP 11.00 3300 ELE 3 MISC APPARATUS NOT LISTED REQ PERMIT 16.25 48.,75 END OF FEE POOL tSr SPA CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector APPROVALS Permit #- Date Inspector 1. Temporary Electrical Service or, Pole 52. Pool & Equipment Locatioh 2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement -3; Electrical Conduit Uq'lity-Undrgrnd. 54. Forms Electrical Conduit:D*rgrnd. 55. Electrical Bonding ' Steel ReinforcernelItT 56. Rough Plumbing & Pressure Test Ejcvical UFEti'Gfr7d. 57, APPROVAL TO COVER-GUNITE - _7.:,F00tings - - 58, Electrical Conduit-Undrgrnd. ' �8� irodndation y' 59. Gas Pipe, (J Ur�argrnd., Test _ cc ,_$..Vdater PipeUndrgrixf. �; 60. Backwash Liner, P -Trap, C Undrgrnd. r0. Sliructural Floor System 61. APPROVAL T© DECK }4. Property Sewer Li`rj A Hausa Connection 62. Backwash &Receptor -Find 12. Severer 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 lirirtg .. _ l 67. Fencing & Acces"s APpro¢al _ 17. Rough Wiring Sign _ 68, APPROVED F87R PLASTE=RING 18. Rough Electrica;.T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19, Rouyb Heating•& Fair Conditioning FUp� DEPTcp EQUIREMENJ APP6O%43LS.�i' Permit # - 20. Rough Faptor�j Fi eplace - 1; S :r <. 21. BLctq, in trtietury' - g r, �, y r 70. ELlndergraWfd Hydro 22. Qucts, Ventili}ing�'-z z r�_ r✓X" 71. Product Oping OGas Ooil 23. Gas PjpeaRoujh & Test it 72. Undergr Flysh _ z end 24. Roof'Fraining ,; x `- ' ~' 'r _ . ` _ ^ 73: Undergrnd.StaraglITank'0Gas ❑Oil 25. Roof-Shdathing �� - £ '' v ,. > 74. Overhead Hydrb. 26. T;Bar,Feiling (Structural) &N�oijoeoat s > !" r 7i Dry Chemical 27. 6_ranie anB• Flashin7's 76. Dry $tar pipe _ 28. Latttfng kSiding y, - D` 7 FIXED SYSTEMIFINAt^ `r _ 29. Insulation ;;' <_ = * - i• 79; FIRE PREV. FINAL •' x y 30. Drywall (failing�1ALTFi REPT. REQUIR£iv1ENT 31, Plaster Brown Coate, ! > t v 79. FINAL Ne6PECTFON rEl _ 32. Electrica4Pos e Meto'Figat ; " P OD CERTIFtGATE ISSt7E0 - 33. Elnal�Eiedric- �J fila + otes• x n ^' _ "_ (p _ .r tr: r _�' 34, Einat Heaiing & Ai�Conditioning t , 35. Final Gas.Pipe•Test- ' - ix : - i. - = + •�, Ir• z•! $ M 1 .36. Hood or Canopy ginal,Factory Fireplace _,37. 38. FinaLPlumbing pt _ ' 39, Wates Service-Finar; 2- 40. Gas Service -Final 40. - 41, Solar DortiestiaFinatt it r _ r �*' ^s r. ^• 42. Backflow Preventc'r•' 43. Backflow Irrigatiorr 44. Landscape Irrigation;�System `"_ _ '' r '• ` ' Q i A - e ... 45. Sound Attendatinrr r r _ s r " 46. Handicap Regulations r - rtl 47. FINAL STRUCTURE & BUILDING z + 48. ANAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California,:Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date IDURy�g3OFBUIDING. 245 FISCHER AV UNIT. A-6 NMERaN "'KNOMN: CLOUGHERTY, MARGARET M ADRE! %ROBERT B MARUSCIH 27031 SANTA SUSANA CIR MISSION VIEJO,CA 92691 APM. MMIniD AODRE54: ARCHITECT OR ENOINEER: UC. NO: RCK OR Dell ADDRESS: UNIT: CONTRACTOR`S E: DEL MAR HEATING S AIR (714)499-2805 CORMACTORBMMUNG 15 MONARCH BAY PLAZA ADDRESS: MONARCH BEACH CA Lic-No, 477331 92629 =: 384 LICENSED COMRACTORS DECLARATION: I hwaby alum u pwely d pwiury ff W I am fcersd older Wov6im d Chapter B (commandnp win Section 7000) of DMsion 3 of the Business and Professions Cods, and my O.essa Is In full lace mei. CIYUC. NO, 03�8717�j7 LiC.CLAss: C-20 LIC. No 4 7331�� _�'/00 Dma:y 0 • 9G Contrast. OWNER BUILDER DECLARATION: I hereby algrm under penalty of perjury lhad 1 am exempt Irom the Conor don License Lew la the tolbwish or rep (Swiss 70313 Buenssa W Prnce. aoro Code: AMW a ooaey whip rreil to a parmn ed mmtruen shad Improve, 'amolieh, or repel any thestmetum.Vow iris b Ge ,Coelia, s, iomes the Ag eats la atwu eemm to fib a mind sW sof D BW he of the licemd pursuant si the Pr el or tie tlu Ca a I. a ra a the new IChaper 9 (mor the all oath Sedan 7000) d DNelon ] d 1M d 31.5 b and Prdeions Cade] a then hes she a exempt to chril a and of breis eI 0s eloped dremgion. bry vial. d Swian 7031.5 by any aPfaiceM la a permit subjects 1M opPfiuN to a dud peru4y d not oras than Me hudud dallere (S50p)). ❑ I. as ower of the properly or my employe with ww,es as Ihei sale campshemon, wig do Me watn, end tha etruwro is not intended or offered for Wa (Section 7014, Business; and Profeesons Cade: The Contredan License Lew dose not appy to an ownerol Property who builds or inpwu thereon, end who dose such work hnneeff or hemp o duouph his or her own employees, rwidi d IMt each improvements me not immea l or dlamd Ia eels, ff, however, the Wilding or vnlaasernem is sold within me yew of mmpldion. the .w i,ui d r will hew the Widen of W.4v he or and did M IwaU or i ,row b the anpwe of sale). ❑ I. as ower of the popMy. am mm®vdy mmradnp with licensed oonlomm a meV W the pgwl (Salon m7014,who&s'uess rand Cab: The Conrrmm Lienee Lew does n.I appy b an owner d Property who Wilds or wee imprthanson and w Coms b aurh proleds with a.aanedals) IEeroed purwled Io the Cam moss lice.. Lew). ❑ 1 am exempt under Section: B. A P.C., for the nasion: Data: C.: I do Mreby candy Ow I am ewers of and uMaasnd to andmments of California Ileehh end Safely Cods Smits 25503, MM. and ISSN, end Net I or any Mea buildup oosgana will f will cost (mole one) need s Core* with sed meta miss and IM repu'vamens for I WORKER'S COMPENSATION DECLARATION: I haraby mum soler panehy d parPay ane of the logowinp dadaMiom: ❑ I hew and will reakusn • canireta d.aewA to sa irswse As aorke W mnpanWbn. m awided la by Section 3700d IM Lebo Code, to the pdomrmva dBs work la which this Penrm obtained. I have and will maintain wonkan' oompamdi e, umwrce, wenecaid by Stadion SN0 d the labor COM. b IM pedamanw of IM work la whip Nis Dwml is a.urod. My waken' oonawsaton'vnuan.a wrier end poEw number ane: Cancer:STATE FUND EXPIRES Pokyhhon n7ana75-a 01/01/97 (Tide asdite mead nm As,'ame r i w pennn s As, ae bsded do4ra is M] a Arssl ❑ owgy Uet in de pdamerws d IM work la which Nis panne u issued, I shW n» employ any prem n an as to become anrbled to the war, c nversmion lows of CeBonve, and Agree CW g I mrou be.onr a to I .omD/syatm prwisbw d5(e�% /37M d IM labs Coda, 1 mhwhh O W Naions. Dora: yV 8 y (� Appfi.am: 7. Wi ming: Fellow b await w.Awi rorlperwdon c.r.r.p la rnYwM, weed alWl arE/ect an amployan to ohmrslpwelNes and dirty ff. W W nae hurdrd Chow and ddbw ($1cgOWA in saf non b the cost o1 dorTwsatbrt dansW ea pwddd bee In Section 3708 OI Me Lab./ Cada, InnresL weed artomeye 1. CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury That Ihere u e camrufioa ledirp againry for the pacamam, d the work for which the pamA is stood (Seaton 3041, Cs. C). LENDER'S NAME LENDER'S ADDRESS: I tend, that I hew sed this Application and date that the ebwe kdametion is comm.I Ag. to Campy with ass Pry and.ounty ordiwwae Ad stats laws naming b buddip consemen and hereby adndrae naaeaemwiwe of Baa oey to enter upon the ebosmemiwd Prop" for inspection wrpmes. WALTER rMZEVKI pan y0 9 Spcmure of 0wr*7AgerffAatwNContrmor (5151 4B.W P) Whits -Bur rhV A Safety GmemFb; Cartery-Appirao; Mk -Revenue; Gddenrod-Neea CITY OF COSTA MESA - BUILDING PERMIT PERM NO: M 078390 PERMIT NO: M 078390 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V -N PERMIT TYPE: MEC PURPOSE: ADD JOB DESCRIPTION : CHANGE OUT 3 A/C UNITS 2.5; 3; 5 TON SQ FT: CLAIM VALUE: CALC-VALUE: GROUP OCC: B / COMMENTS: CHANGE OUT EXISTING ROOF MOUNTED A/C UNITS Z O N I N G S E T B A C K S R E Q U I R E M E N T S ' ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REpp• PROV: PARCEL: 42729206 ZNE: REF NO: PLANNING NOTES> iE iE dE df !E 1E if iE ilk iF 1k 1F iE iE * if * ♦E iE iE iE 1E iE SE iF * iE * iE fE * iE fE 1E dE ♦E 1E1E1E ilk iE SE 1k 1F lE iE ib * * gE 1E iE SE iE * 1E 1b dE dE 1E * * * Ik iE * ii * iE fE iE ♦E ♦E dE * * SE ilk iE D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY DATE: 7p APPLICATION ISSUED BY: �7DATE: * ilk iF lE* i41H 1E 1E*lit 1E***♦E iE iP**ib iF *Sk ilk***dk*lH iE iE* LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 76.50 25% SMIP/NON-RES PLAN ISSUE FEE 22.00 BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS ---- > 76.50 22.00 -) 0.00 98"50 98.50 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 98.50 OVER/SHORT: •00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK '98.50 iE iE iE iE 1E iE 1E****4♦EMiE***StiEiEdh**iE****iE*+E 1F ilk ilk*iEiE it it it ie lk ilk iH*ie if ge lE iE*ilk*ie iE kiE it it***ilk if B(-k*it*ilk it ie iE SFft*iE 1E I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O;N UNIT COST TOTAL COST MEC 3 REPAIR/ALT COOLING iUNIT/SYS W/CNTLS 12.25 36.75 MEC 3 REFRIGERATION SYSTEM <= 100 K BTU/H 13"25 39.75 END OF FEES CONSTRUCTION AND PLANNING POOL SPA ARPROVALS Permit # DateInspector APPROVALS Permit # Date Inspector I. 'Temporary Electrical Service or, Pole 52, Pool & Equipment Location 2.'Soil Pipe-Undrgrnd. 53. Steel Reinforcement ' 3,. Electrical Conduit Uidity•Undrgrnd. 54. Forms :4 �Elecjrical Cond4�.Jr@r9rnd. 55. Electrical Bonding 5. Steel Reinforcertsertt= 56. Rough Plumbing &Pressure Test _ 6. Electrical UFERG�knd. 57. APPROVAL TO COVER-GUNITE " 7;, Footings _. 58. Electrical Cond BiUjndrgrnd. Foundation _ 59. Gas Pipe, O Und4g nd., Test 18: " .�%_Ter Pipe-Undrgrhd. 60. Backwash Lines,-PSTrap, gUndrgrnd. 10. Structural Floor'_Sy�tem 61. APPROVAL T(:fQECK 17. Property Sewer Liri� & House,-Conriectian 62. Backwash & Receptor-Final 12. Sevier Cap ._ 63. Heater & Vent-Final -- 13. Roof Drains 64. Plumbing System - Final f 14. Rough Plumbing- :.• 65. Electrical-Final ' 15. Rough Electrical Conduit 'T 66. Solar System-Fipal. • 16. Rough Electric IRjring, _ �c - 67. Fencing & Acce"s3 Approval 17. Rough Wiring Smit _ 68. APPROVED FgFi'LASTERING 18. Rough Electrical--T Bar Ceiling'- 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating_&Air fiConditioning _ •�, „-FLREnFPT.REOUIRfMENT ' . =, 'APPR:DVAi:S�.-Perllnit# - 20. RoughFauorK FirSpiace _ _ 21. Ducts; in Struixure� x r C* - 70. nderground Hydro 4 22, Ducts; Ventilating-1' _ C x.1;.•;71• Product.01ping 6 Bas OOil 23. Gas Pipe-Rough & Test - ' r, i ' 72, Underground Flush -' T .: 24. Roof4raning - 't> .73=Undergmd,S[or,aga-Tank'OGas�Obil 25. Roof Sheathing :_ « ¢ G k 7q?Overhead Hydrq-'. ` -i e y 26. T_-Bar`Ceil ng (StructVI) & To`abcoat75T Dry Chemical r,p r ,r- 27. Frame antt,Flashing--rc- - T ` 76. DryStant!'pipe r 1 -,28. Lathing &iSiding j wL' ? - "t 77'� FIXED $YSTEA4;FINA1: ' _ 29. Insulatiorn ''- r _ ' > - -t t 7&`. FIRE PREY. FINAL n 30. Drywall Nailing - ; H _ « NEpLTNEPt. REQUIREP_AENT 31. Plaster BrownrCoat t1 79 FINAL INSPECTION 32. E(ectricalPow¢} M,c_{� ARal ` 80,j'FOOD CEcR,TIF}SATE 1SSl4ED_ _ -'33. Finat-Electric, x e n/ Notes.q_jb` l�r,�(�(Wig F(/iAi.� Q 1•{ 34. Final-Heating 8d ACoefltioning• = - �!4.-pr6 -, f2 r 7•� T i , 0 1J� I-ti 35. Final Gas 8ipe.Test-. i; p t - ' ' -36. }food or Canopy- - 37. Fnal Factory Firep_lace_xrT .38. Finallumbing x r 'i' c c - " -ru C - 39. Water Service-FinaC;- rl 40. Gas Service-Final ,' ' - T ' '• C co' •-.41. Solar Domestic-Finale " �. • , r '-•j _ - 42. Backflow Preventer "• '7- ='f'"� ' 43. Backflow Irrigation 44. Landscape'Irrigation System ='T,� • =� r- r x`• - 01% .t .- - 45. Sound Attenuation .. X ` t:`- c a ,- 46. Handicap Regulations' T 47. FINAL STRUCTURE•&BUILDING X 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Rialease to Southern California-Gas Co y 51. CERTIFICATE OF OCCUPANCY - •' No. Date 'F..I1UUU,G.DRE. USOPBULDING: 245 FISCHER AV _ _ UNIT: A-6 / Slui, lWiDiDOYMCLOUGHERTY, MARGARET M • mmmA MARUSICH, ROBERT B 27031 SANTA SUSANA CIR MISSION VIEJO,CA 92691 WHITECTOREImEER:MC LEAN S SCHULTZ mw: S1963 RCKORENa'SADORESS: 3040 SATURN UW: 201 BREA CA 92621 cmmxTwsNAmH. R. NELSON CORP. (714)582-1598 COWRACTORSMA 27212 CORDERO LN ABDRESS:MISSION VIEJO CA uc.No: 255433 92691 UW: LICENSED COW RACTORS DECUBATION: I MraW Nrm under penalty of {wfory that I em IcmueE under P9daerm of Chapta 9 (mmmanotnq with �OD�wm d IM Busnees enhd Pnls'vn Cab. ad my 6nnx u n M1l0 Ntt ad Mect. Ic.N 8uss:B uc.No.:255433��j/EXP: 00/00 Dela: � Conthap. U r' i BUILDER DECLARATION: 1 ha l,, affirm under penalty of perjury them 1 am exempt from IM Comrmon Lxwe law for IM I neon (section 7031.5 Business and professions Code: AM eby or aouMy whi th nNuires a Mona to omamxY, eller, unprwe, a orrepair any stra haw. prior to it. bauarce, at" muses the applicant for such pamil to We a sip,md ewamant that M or am I, loaned punuenl to the Wonasims of ow Contntocre Lim. Lew (ChW. 9 (mmmenvq with Seaton 7000) of Diveim 3 of the Budnees atd Prdenione Code) or that he or she is ..of Ihsdrom and 1M betb ler the aBe9ed exemption. Arty yoolation of Section 7031.5 by aro, applicant for a pannii mj*m IM apphmnI to a dvd penalty of not mare than Ewe hundred do0ans )55001). ❑ I, uowmr d IM popedy u my empbyasa W h wages m IMn aob oompe,uetion, wi0 do the wank, enhd Na ehudun b M W ahead a Meed or sob ISedim 10u, Busneesand Proless"orn Code: The Comrmanlicoms tawdoes nes apply men dwnard property impme,aws we M immmad a often l fa agile, It. however, the Wimm or mpmgnaa b foal wLMn one year d cornplavl, the .Wm oo9dar will Mw, IM Wden of awi,q he a she dial not WiM or improv lar IM W,pase of aab). ❑ I. m owner of the properly, am eadusiytly cpnlrtliq with Unused comractors n m,mew the project (Semon 7W. Business anal Prdeaiav Cada: The Coolractos Lora act law does net apply to an owner of propedy, who Iwilde or bnprwes Thereon a d who cmaects lar tooth protects weh a mmmsor(s) licemed punuea to the Coatractpns Lksnse Law). ❑ 1 an, exempt under section: B. A P.C., for this ream: Date: Owner: I do hereby candy that I em a— of and un lasnnd IM neRu'vemern of California health end sdmy Code sedum ESEA5. 15533. and 2553x. end that I or any Mun WiKN ovaipenl will / wD not (dreb ow) need to comply with said slate codes W IM re truemerm for a pennn la mmvunon or rtiodiifaatbn from IM Ai emir illy anagen nt Claim. Raudsa®I wmtrudon a,Aoaiom en exempt fron these prwbtom. Data: Appliaam: WORKER'S COMPENSATION DECLARATION: I hereby elfin uMw panaRy of perp ay one of the Ialkwa t; dederaiom: ❑ I hive and Will mentah a cemlicate of ooeent to vaRinsum la workers c ,osnaoon, as prodied for by section 37M of the tabu Cale. for the ped.. d the wank lar wh ch this pend is time . ^ I hrve ad W maintain wonmo' compensation it... as nauin i by section 37W of the Lebo, Cod., for the r»domaros of the wok to which final psora tb souse. MY Woken' can minion "umreme order end play number ere: Cade,: STJKTE EXPIRES Policy Numher: 06/01/96 (This sedkw need mf be cunplared I the pen] b to aro hi net sd "Jam ISIWI or twos.) ❑ 1 a sty IW in IM Womhence of the work or which This perms b ®yyes s 1 n emptor ars' penin in any manna, m m to be,ama wbjw to The wwkae' eompenealion Tawe d Cdl/amia„QenYa e I el I 1 ah -W become wbj ct to the workero' compenselnn proowsiona 0 ed/'an 3700 0l the labor C vee R rt co ' h I e provision. Dote: S' CO -' 6 Appliiare civi/rp: Falun ro eacun worlrero' compwu a ($1 covneps la unbwful, end shell anconal sin anploysr n crhrsa pperrenles r In Sac r l 3 Iq fu ons abo,hurldnac!C. Mpumrd dabs (Af netya I In addlfon tp fhs coal of comperusfbR wmepm m pov/dW for In 9eallon 3708 of Mr labor Coda, /nfsrmh and artornsY'a Iws. CONSTRUCTION LENDING AGENCY: I Mnby elfin uhosr penalty of pelf, that Thai is a oornuuction Wdi,p alnmy ha the pedol,,w of IM wank ler which this perms is bauedi (Section 3097, Civ. C). LENDER'S NAME: LENDER'S ADDRESS: I cortifyhat I haw, road this application aci mete Ihet the aboye inlomation is cornu. I alae to ooreply with all dry ad otinly oNnhanhus and sm lom relating to WiMihp cnmtnaMn and M,Bbl annhobe neyreaentativm of this dry to enter upon the ebOye menlipnad property IOr iv,i. mlah pafpone,., w _ _�_ Dae: Euild.v A Slay; Gneer,Fle: C.."ppici m; Pink Rmenua: Goldenrod-Asewa CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 077719 PERMIT NO: B 077719 PLAN CHECK NO: 01920-96 A GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: SIR PURPOSE: ALT JOB DESCRIPTION : STRUC.SUPPORT FOR NEW A/C UNITS ON ROOF SQ FT: 5,000 CLAIM VALUE: 5,000.00 CALL—VALUE: 5,000.00 GROUP OCC: B / COMMENTS: STRENGTHEN EXISTING ROOF STRUCTURE FOR NEW A/C EQUIPMENT db dE***iE♦E iE dE 9f iE iE df**dE dE dE dE lE dE dE 9E 1E df♦E*db dE iE*db dE dE dip dE df dE ib*dF*iE dE dE dE dE dE*dE db dtrtiE**iE ib dE*iE dP iE***iE 1E 1E dP****iE ib ie dE* Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RIGHT: FT IN LEFT: FT IN RIGHT: FT IN PARKING REQ: PROV: PARCEL: 00000000 ZNE: REF NO: PLANNING NOTES> > ;1 dP**dE dE dE iE dE*dE df**dE*dE dE iE df.dE lE iE oft*dE dE iE*dEib dE dE iE*db dE dE db iE dE*dE*1E dE dE dE*dP if****1E♦E df ii iE dk*dE if lE dE dE irk lE irk db ♦E dE iE*IP dE4** D E V E L O P;M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY r�-: DATE: BUILDING APPROVED BY,� DATE: 6• /17 APPLICATION ISSUED/BY: DATE: dfiEdE**dEdEib***iE*1E ib**iEde*iE* iEkiEiE**drip*it ** LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 99.75 SMIP/NON—RES PLAN 16.21 1.05 ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 100.80 0.00 16.21 117.01 117.01 .00 REVENUE DIVISION TOTALS--> COLLECTED: 117.01 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 99.75 1.05 16.21 iFifiEiEiEiE***iEsei6iEiEdEit*iFdtiE9edEdEdEdEitit*it de sesEdedEitdESEsesEdedFiE**sEiPiEdedEsiiPiE*irkiEiEdEiPdEiErtdEdE*dPdEiPiEiEdt9e****iEdEdE* I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST SFC 5000 ALTER BY VALUE COMMERCIAL NOZONE 1.00 5,000.00 END OF FEES EXPIRED DATE '_ `Z/ 041 t: C �/'_.v' )st•l_° 1:i1� I` L, ONSTRUCTION AND PLANNINGP SPA^ F_;,�PROVALS Permit # �` i _ Date Inspector APPROVALS Permit # `• '� Date Insect 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil'Pipe- ndr9rnd. - 53. Steel Reinforcement �3 Electrical Conduit Utility-Undrgrhd. 54. Forms . 4, Hectrical C6nduit-Undrgrnd. 55. Electrical Bonding $teel Reinfdreerdent'- 56. Rough Plumbing & Pressure Test - ">6.- ectrical U_FER<Grnd. 57. APPROVAL TO COVER-GUNITE ell r1 58. Electrical Conduit.Undrgrnd. A-, Foundation `-• _ e 59. Gas Pipe, O Undogrnd., Test .9 -Water Pipe-Undryrnd. 60. Backwash Lines, P -Trap, 3 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK , Tt. Prqperty Sewer Line--& House,Connection 62. Backwash & Receptor -Final o• v] �. 12. Suer Cap 63. Heater & Vent -Final 13. Roof Drains 't - 64. Plumbing System - Final ' 14. Rough Plu,mtiing„ _ r 65. Electrical -Final 15. Rough Efectrical:Condult •• 66. Solar System-F7nal " 16. Rough Electric Wiring 67. Fencing & Access:Approval - 17. Rough Wiring Sign c 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. tRough Heating & Air Conditioning, -_ r r c *• t FaRE�DEPT.-REQUIREMENT APP8�AV.Allk_- 7 Permit 4L. 20. 43ougit Fiictoti FF§Olace 1 = ' - `• = �= ^ " 21. bucis,in$tructur,,yi. - 70.vUndergou.nd Hydro " r r 22. Ducts, V ntii@_tingF - r 71. ProducttPiping.0,Gas Oil r - 23. Gas Pipe _Roug- &-TeSt - < �;; .-V - - S * _ 72. Underground Flush > - 24. Roof FraLrtingt., 73{ Undergrnd. Storage' -Ta ❑ Gas OOil 25. •Roof-ShE3thing• ,J r - _ = 74.cOverhead Hydro w 26. _ 'T -Bar -Ceiling (Structural) & Monocoat = t 7F,_Qry Chemical z . 27. Frame and Flashing' - J Z7� 76. Dry Standpipe: r. - 28. Lathing IRSiBingX! �a;i- ' I i` 7T FIXED'`SY�TEM�FINAL' ' _ _ 29. Insulation _ r �- S 1 5+ 78: FIRE PREV. FINAL r _ 30. Drywall Nailing ;�" "' K E' 1 l •� �''KEALTH DEPT. -_REQUIREMENT 31. Plaster BrownyCoat,T i� x 79. FINAL NSPECTION r • 32. Electrical Polder Wetler-Final '" • I " 8 FOOD CE,RTIF.ICATE ISSUED- v y - 33. Final pr Bates: -Electric? . 34. Final Heating'& Air Conditioning t-•. ' ^ •f.i; r.. - _r - , .- 35. 'Final Gas Pipd-Test', . 36. Hood or Canopy _ .1 '.t; " 'n T n 37. Final'Factory Fireplace-Z- �G ` -38. Final Plumbing - r. 39. Water Service_FinO '- a_ "• ; r- -, r ;- v 1 • 40. Gas Service -Final ;', i- -- . x E_ <' r. -.41. Solar Domestic -Final 42. Backflow;Preventer• y %-J -• - - �*. T - - x - 2 0 _ 43. Backflow Irrigation 1 44. Landscape.iriigatitmnSystem� � - 'G �' a� - �' ;4 y 45. Sound Attendatiori _ " " r rr; T G •y _ 46. Handicap Regulations •• r w .I T Uo •- N r- cp• K 47. FIINAL STRUCTURE & BUILDING 48. FINAL PLANNING * '�/ - •• - � ; 49. Electric Release to Edison :. -Y 50. Gas Release to Southern California'Gas Co r - p r 51. CERTIFICATE OF OCCUPANCY No. Date w ON [s! faLouich 245 FISCHER AV °Ni` C-1 GtyNI NAME IF 1010tVIN: ADDREss CLOUGHERTY, MARGARET M IMARUSICH, ROBERT B 27031 SANTA SUSANA CIR P AVPLMAILING A1)1111 ,MISSION VIEJO,CA 92691 C ARCNRECT OR ENGINEER: LIQ NO.: J ARCK OR ENG'S ADIRIM: UNIT: CONTHACTOR'SNAME: J N PLUMBING (310)529-8040 R E Q U I R E M CONTRACTORS MAILING 3108 HARDWICK ST C "DDRB' LAKEWOOD CA uC.ND.: 562433 k 96712 UNIT. LICENSEO CONTRACTORS DECLARATION: 1 hereby affirm uMw pwely of perjury Chet I m IironeeE ureter provisions of Chapter 9 --------- (conmancv, whh Section TOW) d Divisum 3 of the Buwm mxI Profeeviona Coda, AM my lM uss Min lull lace net effect. --------- CNYLIC. NO, LIC. CUSS: C-36 u7jo` 562433 EXP: — t F Date: IC -1r. !I` Canlreaor. L OWNER BOILOER DECLARATION: I hmay affirm umim rj the Im Is from the ntwm licaue law la the FT IN Idbreason reon (Section 7034.5S Glossas. and Prdestlom y wry a court, wiexemrecuum a Mrmh to melts, am. koprays, PARCEL: 00000000 %omlish, or repair any structure. Prior to Is an , . as, requires the aPPeseul10 such pmts to file a sRned stateroom them M or she P i limmed purwmd to the Wmesloes of the Cmradm licensee law IChWw 9 (oomremon0 with Section 7000) of Division 3 of the F7 dn. set Prdess. Code]a mhemhe or she is enema iherehom and the Mus for the albped exemption. Aly yi Adion d Section TW 1.5 by sny appE l for a porta subjects the apptiwm to a uW peiehy of real more then five hurWM doom (SSOOA. ❑ I.acem, d the property or my employees wit, wapea n their wleampensation, will do the wak, mul the Structure is red intetcteci k a Mored ler sole(Section TO4a, Buummeat Pmfeaskw Code: theCmle mLi aLewdoesnotappytondwnerdwop" she Whilemat dosesal work Mroatmone, .thaiwbv r moymhisl e M ithereon,netwho Wiori akn ofcomdthatsuch whhbons YeardwrrhdMian,the ivmwemma era Nes sells. he year E R V I C E S,'. R I. [hemisee the budfsdaredla dWothe owwburYw sill hays int leaden d prwinp M a she d'ct ehct bhsld a impure la IM papoee of rob). 7i ❑ I, m owes of the papery, m uriuiyM, oowmihp whh E coved caroactos m carouse the project (Section 7O44, &shwa arct Prof. Cade: The Cwrectm license law does m appy b en owner of property who IsnIcs or irons« lereah and suet, B contracts for such prajede with a marecta(e) Iceme i Wnuset to the Coerectore Lkwae Law). ❑ 1 m exempt ureter Section: B. A P.C., ler IN. rmaon: A Date: Owner: k L I do hereby cent, that I m aware of sect understand IM resuiremms of CoMm a Neehh and Safey Cab Seduns 25505.25533. and p5534, sect lel I or dry future buildN omwanl will I wil m (circle aro) reed to campy wih said cats antes end IM reeuiremew be —9 G eperohlwmolationanwddxemt=IMAa'=t=e9ement Dings.ReeidedblmMnxmeppkmb a piironleve ww swsn P Dae: Appt'naM: E S U M M A R Y WORKERS COMPENSATION DECLARATION: I hereby el5rm under Penally of perjury oro of the follomm, declerelbm: F ❑ I have and WI maintain a cendc e d mean to vas-imum ler waken compenmtion, w provided fa by Basion 3TW d the labor I Cale. for the Md... of the work for which lis mrmh is 1.0d. B dtlu labor Code.lerIM pMamencadthe ❑ Ihave sectwD mermenwaken'canpeneokne' T comce,eton i..dby carni act X work to sural this permit h issued. MY waken' compensman insurance weer Bret pets, number are: GRADING CariefNamba. xr% FUND EXPIRES B 04/01/97 Pcyfmia aecybre need red M rompbiee r 1M peroi ie nw am naredree rat a l.a.. ❑ I cniY lel in iha pedwmerea d the sushi la which Chia peroh is issued. I shell m employ ny perem b any mnner so as to become subject to the workers' canpemelkm less of Cafibmw. arra ree that d 1 awuw become su k pmiaum d SectionA3TW d the Labor Cale. I shaft ton urn sunt Ihme Date: 7 �b Apptk:m: Wimlog: Falun ho secure workhms compwuelon cce,maps 1. an we lova fes criminal Fwufdes why T civil Mss W In aN hurdmd fhousdred ddb. ($10RDWA In /(len As the coef of compwuatIM deme as as lwarlded ler In PLAN—CHECK CONSTRUCTION LENOING AGENCY: I hereby affirm uncles Mmaff d perjury that them is s construction brdirp away for the P Idamatae of the work for which this parol a issued (Secs, 30P7, CN. C). LENDER'S NAME: LENDER'S ADDRESS: I cMJy that I revs reel l"s epplirmion sect nae thud thro dhow idofmadMI is correct. I Ree to campy, ehh aP city end bosomy oduunms set We laws m1wM to bukd V cmnruuion aret hereby authorize reprevenudiyes of Iris city to nta upon the ebcve-mmbned popery far imspetivh purposes. JERRY NATELBORG Dae: (515148 W P) W hhe-Buildm9 & Salcey: Omen-Fb: Cnery-APpkcant: Pink -Revenue; Goldenrod-Asaeeeor '1 CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 078237 ERMIT NO: P 078237 PLAN CHECK NO: N GOVT: N SUPP: N ONSTRUCTION TYPE: PERMIT TYPE: PLU PURPOSE: ALT OB DESCRIPTION GAS LINES FOR NEW A/C UNITS ON ROOF SQ FT: LAIM VALUE: CALL—VALUE: GROUP OCC: B / OMMENTS• NEW A/C EQUIPMENT / 1 GAS LINE kitkkkkkitk kkkkk k k k k kkkkkkkk kkk k k kitkkkkk kkkkkkkkkkkkk kk kkk kkk k k kkk kk k kkkkk kk kkk Z O N I N G R E Q U I R E M E N T S S E T B A C K S ----------- MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- RNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN EFT: FT IN RGHT: FT IN LEFT: FT IN RIGHT: FT IN ARKING REQ: PROV: PARCEL: 00000000 ZNE: REF NO: LANNING NOTES> 1 > kkkkkkkk,kkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkk D E V E L O P M E N T S E R V I C E S,'. R E Q U I R E M E N T S ONING APPROVED BY DATE: UILDING.,APPROVED BY : DATE: PPLICATION ISSUED BY: DATE: —9 G kkkkkkkkkkkkkkkkkkkkk kkkkkkkkkk kk EGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING ERMIT 5.50 / 25% SMIP/NON—RES LAN SSUE FEE 22.00 UILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE OTALS ---- > 5.50 22.00 t_ � 0.00 27.50 27,50 .00 EVENUE DIVISION TOTALS--> COLLECTED: 27.50 OVER/SHORT: •00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 27.50 kkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkitYtkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkk I N D I V I D U A L• .F E E B R E A K D O W N YPE QTY D E S C R I P T I O N^, UNIT COST TOTAL COST LU 1 GAS PIPING SYS OF ,1- TO 4 OUTLETS 5,50 5.50 END_' 'OF FEES h i CONSTRUCTION AND PLANNING I� Date Inspector POO, SPA Date Inspector APPROVALS Permit # APPROVALS Permit # • 1. 'Temporary Electrical Service or Pole - 52. Pool & Equipment Location 2. • Soil Pipe-Undrgrnd. 53. Steel Reinforcement :3.�1ec`trical Conduct Utiilty•Undrgrnd. it 54. Forms �^ZiT Ie6irical Conduits- fgrnd. 55. Electrical Bonding clx[ t Reinforce m p 56. Rough Plumbing & Pressure Test V'6--:Efe�trical UFERrU *+d. 57, APPROVAL TO COVER-GUNITE ^ >; M 7 Y ngs fir., 58. Electrical Condtp(-1: ndrgrnd. .f$.txFMundation 59. Gas Pipe, ❑ Undrgrnd., Test n..:, n•r1 r• 9a�6 er Pipe-Undrgra. 1 60. Backwash LinesrjP'rap, O Undrgrnd. M!7&ructural Floor System 61. APPROVAL TO: ECK ; 1�- Pr•S,'perty Sewer Line HouseGonnaction 62. Backwash & Rece0pr-Final 12. Sever Cap 63. Heater & Vent -Fin ; 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing` W 65. Electrical -Final - 15. Rough Electrical-eon'Suit a, 66. Solar System-Fi I_ I ' 16. Rough Electric IN Ing , 67. Fencing & Access Appro6al x.•17. Rough Wiring Sign 66. APPROVED FI -PLASTERING 18. Rough ElectricaCT Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating &Air Conditioning ,FIRE cr •DEPT. f#QUIR�MENT tr, APPR�VAt¢z)-Perrhit# * " 7 20. FM ugl�Fa Siory7 it@r"ace a7 21. Dr.ct4-dn StruMireM •• •• '-+ * ''1 X70. ghdergVbt- Hydro 22. CtS,Vepp Ilaing '•'Y. I F,, (',: p S 71: rr .4+r Y• 71. ProducerC,igin9 u �os OtOil pt Yf t- I « O f,`, r. 23. Gas Pcpe-RougL& Test i C 72. UndergroGhd Floh. + F^ •OOiI 24. RoofTrarbSng " •-`tr I F-"` ' 73.Under rnd:StorankT3Gas 25. Roof `6hedhinger, C N " 74(-OverheadHydro'=r I. 26. T-BarMLeiling (Strurgral) & N1 - Vat �� # t7 G 75Dry Chemical ; r, C G Fj 27.Flame and-,Flashing� � x x +• a >• c +: 76. Dry Stan r tpe � _ r• 28. Lathing &Siding 77.1 FIXED S.0r,16rEQ_I Fjl`[iAL ; 29. Insulatior>✓ 01111 SI 78 FIRE FRREV. FIN19 f. J t" x"30. Drywall Filing�rE:ALTI QEPfr000REMENT x X31. Plaster Brc wn,Boat * S i ,: t- T ( h: r79. •FINAL IN_SPECTI?N 'r y n� 32.E ctrical Powg`r M tee-Rl�al = i0400D CERTIFI ATE ISSUED,_ 7:33. gal�.lec�ic > ,.t* m 6 W 1' Notes: 4•'' r34. FSnal Heating ElAirC6nditioninTZ S [ F ;> I FK I ? "(t�� /(�` ��Yl i'•` s��.+�V. 35. F,i alUasPipe-'7est�'C,, �, I 1 iJ� L_l r'< / -� CH �: r-.:-• :36. Hood or Gnopy ? =37. Ftnal Eactary Fireplac r `_- -39. LVaterServite-Final o; *40. Gas Servic€Final T r-, ^0*F m i i`. C_t- Jru _ K r X41. Solar Domestic•Final+ S' '-i 77 n- 42. 42. Backflow Preventer r x I ✓F C 43. Backflow IrrigKion j' S k y M It Y _ 4k Landscape Irrigation System 4, 1l c; r ,., +• 3 d':K S E Gtr: '1 S F Z. So{tnd Attenuation !-G r -i ,... x 44, Handicap Reguiatioil.•. G ! x 5 r , n 47 FFNq STRUCTUREv&BUILbING I rj+ r 48. FINA -PLANNING x ' t-^`^ + ru .K t°' a, r 11 i z Ci p tp {+ G 49'. Electric Release to E .son n .r* 50: Gas Release to Southern Californte Gas Co 5.1. CERTIFICATE OF OCCUPANCY ■' _ No. Date PIaC w4 BwL : 245 FISCHER AV UNIT: A-6 MEWS RAME IF MK7NN: rLOUGHERTY, MARGARET M A0°" fMARUSICH, ROBERT B 27031 SANTA SUSANA CIR n APPL. MMUNO ADDRESS: MISSION VIEJO,CA 92691d�—IR ARCHITECTORPN0INEER: MC LEAN 6 SCHULTZ 11C'N0' S1�963 ARCH, OR ENG.'S ADDRESS: 3040 SATURN ° T: 201 BREA CA 92621 CONTRACTORS NAME J N PLUMBING (310)529-8040 CONTRACTORS MNISNS 3108 HARDWICK ST ADDRESS: LAKEWOOD CA mING: 562433 96712 DMT: LICENSED CONTRACTORS DECLARATION: I hereby affirm Iehder panty of pwjury sat I m Ilcamad uadar Provisions of Chapter B (mmmwkrg esh Section 7000) of Division 4 of chs Business and Profession Cods. sad Icy 6oensa b in fun face nd effect. CITY LIC. NG: / QL"LAs: C-136 LIC -i ` 562433 EXP: Dale: ^ / /S / Comes.. OWNER BUILDER DECLARATION: 1 hereby affirm trader perjury tc4lnA=ML=anrectm License Lew for IM Idkmig meson (Sevin MIS Roseate red Professions CaW. Any cloy or pouany which mgwes a parrot to opnwn, slow. impraw, anlbh, a repair ny ahuctae, prior s th Coatca, ape sense IM a for pro pens, to with a Sept.etaroerd that M a she bmrmad po Protection* to IM ode) orth s dr the License th tow [Chapter"theB (p for dca rg .eh diron 7000) d Div'skn S e IM dlnwess end Prdosskm Codd a this he a he pi exempt tMreban and the bens et chs aneped ched doll Airy, viD. d Section 7031.5 by ery epp5md f« a perms ermiscte chr eppfwe to a dN penalty d not mon than (ws Modred donee (4500D. ❑ 1.. owner of the Property a my employee win estate es Ilei Sole nmpwvation,.a do She sack W lhs strancer le vol Wended m dferod for ads (Sadiron 706a, Business sad Pmlusbs Cods: The Cammm limns taw don his apply to n bwner of poopery wad bide a enpomn IMson, ark wad dos such sack Fbnean a Meat a chaoupr M a her own ampkhyaes, pmaded that etch impn«mnwib sae m intukW or dwell for sale. n. (however. the Is iInO or knpowanwe b Sale within over year d mmplubn, the .-Isoeder silo have IM border d proviso M a sad Ad not build or knprohe 1« the porpoise of use). ❑ I. as owner or IM Property, aro asriotiw// mnlratlog w,h Swusd Gammas r areooll the pooled (Sed'on 704,1. &s'vrs And Prohniau Cods: The Contrmas License Lew don not apply W an awrrr of property wad bunds or kric.. Iherem aad wad contracts for such poolacts aoh a msrssa(s) fcerred ponausm to the Cant Limns Law). ❑ 1 ac exemp trader Section: B. A P.C.. for Uua raasn: Data: 0v . I do hereby eenny chat I em ewes of and IakMWk Are regtriremaas of California Heach oral Salary Cale Sections 25505, 05513, and 05546, anal that I or any, Muer WiWwq onorpad Mn /wit era (circle are) mad h comply wth asid rots codes ale IM rqulmmenw la . perms for mnstmd'onamad'Rmbn horn the AMMI—y emOamnl Diuss.ResidwN gomgmdion applications are exempt from tlwa poovbkna. Data: Apptind: WORKER'S COMPENSATION DECLARATION: I Msby ai oder penalty of puKcy, over of Shot holbWp dadimmio s: ❑ I haw and will meirnain • pnNimis d consent to se64mus for wakui ompenWbn, es Provided for by Section 070° d tad Leber Cods for IM pedamence of tad sack for wNch this pence is hued. I hew aad MI meldakn aokers' oanperrW kn I.. es required by Section 0700 d du Labor Code, W the ped«mnm of the work Iw whldr Ihb perms b Wped. My waken' oomirmanlen Lmmms mow sad parry mmbu we: Carrie'; STATE 1711`11A111 EXPIRES' Policy Number 9�3-9bF)0999336— 04/01/97 (This esdkn mrd era M PornpletM /tad pant b M ar hurWN Thus (Stool n AmJ ❑ I partly than . the pedamenpa of IM work to, "ich this Pascal b blued. I ales not sorploy ury parser in ny, mnner a u to become initial to IM workers' compenWkn lawsd CWomis yyrr e°res chran n I Would b. sabjsct to IM woTers' ear ion PrOWsler+ d Section NOo d the Labor Cade. I duo bnh h mmpy weh Boss poMabm. Data: — / �^ �` AppfreN: Wemhg: FeYun ro eSoae woMn' porrpersetlon endMR etllesf n erlployer ro ml pwfcu eM civil Rises w Toro ohWTec thousand cdbw (4104000A N scallion ro as cmc o u NP'Pyleee row In Section JIM of as Labs Code, Interest ora e0emq'e fen. CONSTRUCTION LENDING AGENCY: I hereby alum uadu penalty d parjry that then Is e tacranrudbn larrasg anamy, as chr peWameas of the sack for Milch the pent Is bawd (Section 3007. Cb. C). LENDER'S NAME: LENDER'S "DREW: I cwuly that I have read this application sad atate IMI tad Above bdarrrwicn is contact. l rp es to canpy wish m city and coaly adNenon and We less vildi g to bonding mnatruction and hereby ewhorbe npoeesatalivss d this Soy ro ads upon the ebwsmuvi«rd propery, for inspection purpose. JERRY NATELBORG (515146.WP) WAn.-Bulldog A Salary: Oraer,Fla; Cace"PpAmnl: Pink-Revanm; GoMsnmd-Asrossor CITY OF COSTA MESA - BUILDING PERMIT PERM NO: P 078236 PERMIT NO: P 078236 PLAN CHECK NO: N _ GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: PLU PURPOSE: ALT JOB DESCRIPTION GAS LINES FOR NEW A/C UNITS ON ROOF SQ FT: CLAIM VALUE: CALC-VALUE: GROUP OCC: B / COMMENTS: NEW A/C EQUIPMENT / REF B-77719 xRERE�SESrSPiE�ESESE�E*SESERERE�ESE x�E�E+ESP+E*�xx�E*+E*Ar+E*�**�SE+t�Px�*+r RE�ESE��ESPSP�RPAE*�ESr�EiE*SESriE*�*+rRr�*+E�E�EiESr Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RIGHT; FT IN LEFT: FT IN RIGHT: FT IN PARKING REQ: PROV: PARCEL: 00000000 ZNE: REF NO: PLANNING NOTES> f ***1f 1E*Rf irk db iE*k1E*SE*SP SE*SE S6 iE SE**iE Se*ie 16 iE*Se ie SF SE db RE SE 1liE dE iE ii*iE*"*ib dE SE SE SE RF SEiE tE lblF iE iE*dF*alt St It SE SE iE*d6*k*CE**Rt D :E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING IAP)PROVED BY - DATE: el, 1 APPLICATION ISSUED BY: DATE: 6- (8--96 161EM1F iF dE dE 1E iE SE'1h dE 1E**d6M*ibk lfk fEkit lF lE ♦E***M iE* LEGALIZATION:N F E E S.0 M M A R Y STRUCTURAL SEGMENT:N I BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 5�5t SMIP/NON-RES PLAN ISSUE FEE 22,00 BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS ---- > 5.50 22.00 0.00 27.50 27.50 .00 REVENUE DIVISION TOTALS--> COLLECTED: 27.50 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 27.50 fib*M**ia****1E**dFi6 iF***dE***if if lf*♦F iE KdF dF 1F iF**i6 iE iFMiF iF**dE*iFKi(•RE**aFK*Nes*i64iF iF iE iE iFMi6 Nf 1F 1f iF irk iFKK*iF** I N D I V I D U A L' _.F E E B R E A K D O W N TYPE QTY D E S C R I P T I O)N" UNIT COST TOTAL COST PLU 1 GAS PIPING SYS OF'- I- TO 4 OUTLETS 5.50 5.50 END, OF FEES / 1 l CONSTRUCTION AND PLANNING POO. -SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspe;tor 1. *Temporary Electrical Service or Pole 52. Pool & Equipment Locatidn 2. 'Soil Pipe-Undrgrnd. 53, Steel Reinforcement LZEleetrical CoadLjt tAjty-Undrgrnd. 54. Forms � A4 Ete�trical �`,cLiltitj�,-ggrgrnd. 55. Electrical Bonding -_:t--Steg1 Rein'brcerrmatC_ 56. Rough Plumbing & Pressure Test t'6 ricalTAER 57. APPROVAL TO COVER-GUNITE `�.ttd. T 7>s oolings �;5 i 58. Electrical CondptAUndrgrnd. r+ � 'D- 59. Gas Pipe, 0 Undrernd., Test r8?15undatidn 9�Vr,Gt`�r Pip ;,Pndr9r6b. 60. Backwash Lines;,P,''frap, ❑ Undrgrnd. TO?Squcturat Floor System 61. APPROVAL TQ;CK 1-1. FTg$erty Sewec Line & House''Cormection 62. Backwash & Recel3tor-Final 12. Sewer Cap 63. Heater &Vent -Final 13. Roof Drains r; 64. Plumbing System - Final 14. Rough Plumbing., 65. Electricat-Final 15. Rough Ele3ctrica hConduit 1766. Solar System-Finpf 16. Rough Elp:ctric6ing. 67. Fencing & Accer",Approval 17. Rough Wirirfg Sip 68. APPROVED Fd�FPLASTERING 18. Rough Electriral2r Bar Ceiling - 69. POOL/SPA SYSTEMS FINAL 19. Rough Heatin &Air Conditioning F{E QFr_PT. REQUIREMENT fAPPR V,E1ittijr Pek�tit- 20. tibugh:Fa�toryl:Fir ce �` `.�t''. * ; _ _ ^` dfurd•• '• 21. D_ucts--•in 8trurlX - 70. Pndergri'vnd H jfro 'r m n x 22. Duct Veptilaang L* "-V t 71. Producr ejping l7ras QOil 23. Gas Pape -Rough &Test �•_( 72. Undergr�n3 Flesh r - ^0 24. ffbo4ra n T -' 9 tr y S �c -+ Undergrnd. Stor,4 Tanktl7 Gas 011 r: r .737 25. Roof7Sheahing <K c > t•.:: 74-, Overhead Hydro,-, 0. r- •� z e 26. T,:Bar'teiling (Struct ra0 & Mocozoat ; 75� Dry Chetp;cat Y: ^ - Q F.-_ 27. Frame an¢,Flashing�F Vis:.:^, � * 76. Dry Stan •flee f _r �n `• 28. Lathing&'hiding O ••.Y ") 'n T H 77� FIXEDV)Y�TE'M'I�Alr 7t• �rF t t C 29. Insulatio tnx v jt: 78�E FIRE PREV. F N4iL r _ u30. Drywall qd ling F a o Ii DEPt V• EQDIRkMENT f SfVN o,�LTIi r31. Plaster Brown.Coat .. ..... 79 FINAL INSPECTION r2__ � _ 32. f�ectrical Power Mptt r i igal N 80,Z -FOOD CERTIF}SATE Itl.{ED^ O 733. Fgnal�legtric;.� IxKr.¢ r. (i L •N6tes:g-'� *t� K^ ,34. Fipal�f'9 teatl Air on Tioni y= .1 r� ' I".' tr 5�gl.J^ 35. rural Gas;bjpe•. estV. * p �� I t1: - ;e � M _36. HoodcorCanopy F -'n t:n 5 ,xm -37. FrnalTacQoiy Fireplace~ - o t "K 2 t J:,` _38. Final�um} in9 v t rn ' 39. We ter Service-Finalt- ~ �40. Gas Service -•Final . rt -r l* 5 x 7 'JX 7t- vn x -41. Solar Domestic -Final: S •r• K ' •7G - c 42. Backflow Preventer 43. Backflow Irrigation r, 44. Landscape Ir "-t*' = r'' - d O'' '1 't' M`v ` N ^6 ^r t Q V'•;K E Ox t 5 f• 45. Sound Attenuation r,•�`. t.: 46. Handicap Regutetions: - O K tc s Oc r 47. FtNAt STRUCTURE• & BUILDING r F 48. FINAL' PLANNING ' s �- t t^ •Q " 49. Flecti;c Release to Edison 50. Gas Release to Southern Californra�fas Co k Y. t JO • P} 510 CERTIFICATE OF OCCUPANCY - No. Date \t City of Costa Mesa Development Services Department Building Safety Division CERTIFICATE OF OCCUPANCY No. 0002.93 P. O. Box 1200 Costa Mesa. California. The Building located at 745 Fiarhar AVantta 4A-7 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group Er -2 Occupancy. Use of Building Tnfierior Alt-xat -ons — Office Legal Description 427-033-09 (See reverse side for Metes and Bounds) Building Permit No A—R987 Electrical Permit No. E-9681 Plumbing Permit No. P-8886 Mechanical Permit No. M-8942, F-9434 Number of apartments —0— and/or guest rooms —0— ISSUED TO: � Building C r Pulliam rl rt-ipFt by�� 1517 N. Fairview Santa Ana, CA Date This Certificate of Occupancy SHALL BE posted in a conspicuous place on the, Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. CMF 1015-46 rev. 1/83 White - Owner; Canary - Numerical File; Pink - Bldg. Permit File SHALL NOT BE removed except by the t, I I 71111111"- - - City of Costa Mesa =_ Building Safety Department ' CERTIFICATE OF OCCUPANCY ^ v P.O. Box 1200 - Costa Mesa, California The Building located at r4 Awrxml Az:--] has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto 'for a Group. '0 ccupancy. Use of Building - 111ZeXiCW lUtf '1ctiC06 - Legal Description'See reverse reverse side"for Metes and Bounds)' - Building Permit No' '�'--..,tleifi? Electrical Perm it o.-r3'=+m Plumbing Per No. Number of apartments •-ft-• - and/or'guest rooms ISSUED TO: Building Official ! by utliaa FrOr, xl~i s V. C. Newton, s1ildiny avisicr. lli.-ate: Date • This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 306.1e1 U.B.C. - - • Form BU 34 Rev. 11/70 . _ i' J. t; r =hyu,e y / Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. ".'CITU OF COSTA MESA -' PERMIT N '- - - TRACT NO. LOT NO. -'BG. NO. - LD --- - - - - _ - .. CONSTRUCTION PERMIT �� O TYPE OF CONSTRUCTION ''� NEW �I ADD - ❑REPAIR'❑ CON V�DEM_. ' OTHER. 5605 6/05/82 29.037 - -- =' -:" • _ ,r - - -^ - , _ -ZONING REGULATIONS- Project Address .Ry-s-'47.$�i ee. 11"Ie .Owner" - Phone--El-ALTERATION O P-LCJ/P-S -" }Addre55 • ./ 'Arch/Eng.- -- � --• . - -License No. - -u DESCRIPTION 'OF`WORK -t -- - - --- - - - i - I , - A.P. - gyp - ZONE - - - PLNG. REF.: - - 'Address - - - - -- - - Contractor / GQe Q.Tp Phon' L9 TYPEOFPERMIT• - ------'- - - .. e _ - 77pp BUI LppING r 'SETBACK LST. - PROPERTY.LI NE 0 GRADING - Q FOUNDATION ❑ STRUCTURAL LI DF YARD — ..O -TENANT O -ELECTRICAL .tpW LUMBING _O MECHANICA IDEV j -Address- '- LICENSED CONTRACTOR DECLARATION_-.._ that I licensed Charter 9 I hereby affirm am under provisions of (com- mencing with section -4000) of Division 3 the Business antl. L, .:� I ER' ' RIGHT -of Professions Code, ntl y license is in full force antl fact., __��OTH _ - REAR YARD (TO P/L)--'�-' -- ---'- --- --- ��• - 3 / PROJECTDESCRIPTION' ' LicenserSCrl ss'� License ' _ PKG. SPACE REG: - - PROVIDED -- - Date_ Signature- (. /..�-fn4 -_ SQL FT.' - �_ _. _ _ _ _ .. _ 'STREET WIDTH-'-'-'- - - FEE-$-- - PARK WORKERS' COMPENSATION DECLARATION.. '• +'OCCUPANCY " CON T_RUC_TION T_V PE I hereby affirm that I have a certificate of consent to self -insure or a rtyAL'V ATION ZONE ZONING APPROV ED BV- - --- - DATE - - -- Certificate -of -Workers' -Compensation Insurance, or a-certified'copY 1 '..SPECIAL`CONDITIONS - -- - - -- thereof (Section��7� 00 b.C). j ...�7 GRADING'CU YDS. - ACRES •_� _ `y No. µ CompanY'�///iL�i/O.f/.._ .. _ _ _ -. .__ ertified.copy is,hereby furnished.--_.� - _1:.,. i. REMARKS:': d copy is.filed with the city B mg Division._-- CertlfieDivision: - 1� c' EXEMPTION''FROM'WORKERS' COMPENSATION -DECLARATION' - - - - - t _ _ _ __ _ _____ -�, I ' t (This section_need not be_completed ifthe permit Is for one hundred -' '_ - ' •. ($100) or less),. t ) .. _-.`.'__. ._ - .. -_-. _ _- .. - d certify that in the performance of the work for which this permit ii , issued, 1 shall not employ any person in any manner so -as t become sued, ,PLUMBING �a,vV - �, PLAN"CHECK--^- -i - '� -- -iELECTRICAL-•-- PLANCHECK-- -- -- - --- - p on,Laws of California. .� s .to the Workempl om ensati BATHTUBS•. ' _. _'SHOWERS •' -_ -_ -}- - --- . .. ,. .... , ... .... , . , _ -_-- - --- �- -- ---- , . _ ... - -- ` Signature .Date NOTICE: If after making this declaration, you should become subject.r,TOILETS- Ir'I :I t ..URINALS- - - --j _ _._ _ 4GENERATOR--0-1-KW_1-30 to the Workers' Compensation provisions of the Labor Code, -you must 'forthwith , '- TRANSFORMER, X� comply with such provisions or this permit shall be deemed LAVATORIES DOVBLE-LAVS---- - - -- APPLIANCE---10-50.KW_50+-KW -- _ - ,revoked.. ;CONSTRUCTION LENDING AGENCY 'KIT:SINKS DISHWASHERS iMOTORS.--0-1 HP_1-l0 HP ---_ Il hereby affirm that there is a construction lending agency for the per- SERVICE SINKSl SUMPS-------s(INC..SOLAR) 50 +_HP; -formance of the work for which this permit Is issued (Section 3097 t -30-50-HP •- - -FLOOR'SINKS--- ---FLOORDRAINS'-"-- 'FIXTURES -OUTLETS. - _ TLETS--SWITCHES Civ: C.). ----------------- -- ^- - - ----- - -- !Lender's Name ,ender' - - --- -`-"-'-'" -"--"-"-' - �Lentler's Address- -DRINKING'FOUNTAINS -- - ---- - -'1" -' '- - GAS TUBE.SIGNS__,_.,____..-._.-:___-'- - -- 'INTERCEPTORS '-` -CLARIFIERS--.-'- - -`POLE-LIGHTS-- -- OWNER'BUILDER DECLARATION°--^---^ --------^ -•- I hereby affirm that I am exempt from the Contractor's License Law for -SWIMMING POOL- ---P TRAP-----------.---- - •POL'ES •-- the-following reason- (Section-7031.5.Business antl-Professions-Cotle:- Any city or county which requires a permit to construct, alter, -_.-'SUB-- '•' METERED - - -� -WATER SERVICE'-' - ALTERATION----- - - - PANELS - - ----.MAIN-- - SUB. - improve, -demolish -or-repair-any structure, -prior to its issuance; also re- quires the ap;licant for such permit to file a signed statement that he 'G'ASSERVICE ------OUTLETS'- '' - - - -)SERVICEAMP-- - is'licensed-pursuant-to the provisions of -the- Contractor's. License, Law (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS - -- BTU OUTPUT Business and-Prolessions Code) or that he is exempt therefrom and the '?6s for the alleged exemption. Any violation of Section 7031.5 by -SEWER CONNECTIONS - --�(- - ^•- - -}— _ �-- - _-•- ---.- t1'. _-- t' ,. ,.applicant - for -a permit subjects the applicant to a -civil penalty- *,j more than five hundred dollars ($500). -SOLAR TANK- --COLLECTORS-^-^---}------ ~ ;----.•--.--.--.._--._• -- _____- - _ _._ .- ,Cot <' - ILJ, as owner of�the"property;'or'my-employees-with wages as -their sole,compensation,-will do the work; and the structure is not intended ' z- or offered for sale. (Se@ion'7044-Business antl_Professions Code:'The' "'SOLAR- PIPING "SYS. "' --, - ^- '-'-"" �- - -- ISSUE -FEE �' ;Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who Hoes such work -himself -or' - ISSUE FEE - --- - - "' ," "' ..gPPLICATION.APPROV ED.BV_ .e _DATE _ -- -- - - ,through h15 own employees, provided that such improvements are not MECHANICAL PLAN CHECK - -' --'- -T - "" -- "SUMMARY -OF FEES` -- - ,through or offered for sale. If, however, the -building or Improvement- -is sold within one year of completion, the owner will have the burden of proving he ditl not -build or improve -for the purpose -of 'sale)- IQ -1; as. owner-oL_-the•property, am -exclusively. contracting -with- -' - -' - - HEATINGSYSTEM 0-100000BTU _ �.-.. , •AND --- BUILDING Z -I� [PERMIT, --$ �� SMIP, $� • ' ;Iicensetl contractors to construct the project (Section 7044, Business DUCTING - - - - -100 000;+ BTU, , L� x • PLAN CHECK' PERMIT and -Professions Cotle: The Contractor.'s-License-Law.does not apply.to _ - $-�� _ ('ISSUANCE' 'PLUMBING - :an owner of property who builds or improves thereon, and who con- REFRIGERATION 0400,000 BTU -$--- 'tracts,from-such projects with -a. contractor(s)_l i cesned.. pursuant. to. -SYSTEM--- - - - -^ ,the Contractor's License Law ),- 100;0001:. -BTU- -- - �- - - - - -- -- - -- - t'PL`AN CHECK=$�-`-'-" - . ` dn_ T—,* C, ____.-_ I am exempt under Section— - - -B: & P. Clfor this- - __.. ._. _ __ - -'- I •.+�.•t _ _ BOILERS BTV =_ (ELECTRICAL --$"'------ reason_. _-_ _ - _ _ _ _-_ - --- SYSTEM REPAIR, ALTERATION -; -- •7;' v' ,<M IC ROFILM$" ". '- ''PLAN CHECK- $ - _O :Date Owner' EXHAUST SYSTEM MULTIPLE 1- - TOTAL FEE, $t - -' )-MECHANICAL -$ - ...S .. LESS . r ��'�� '' :.I hereby certifythal 1 have read this application and state that the above 'information'is -correct:'( agree to Com with -all --cit and count Comply Y Y' -- - '.PLAN.CHECK `t $ '-'VANCE PC E P ordinances and state laws relating to construction, and hereby authorize -of jl _ representatives -this city to -enter upon' the -above' mentioned- •-? property_for in pection ur os _ _ _ Signature- Date -Z 2- 2-' - -- - - - -- ' -•- ISSUE FEE. -s'q FINAL FEE $sr" -1 _.-' Drivers' License x9 - ---' -' - CMF 0865-46 W4ite-Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor TLI 9 i CONSTRUCTION AND PLANNING Date Inspector APPROVALS Permit # POOL & SPA -�`- •... - - - - APPROVALS Permit# Date-- Inspector _ 1.- Temporary Electrical Service or Pole v , 43. Pool & Equipment Location - • 2. SoilPipe- n rgrn_ 44. _ Steel Reinforcement - - - -- -- - - - - -- - -- 3: - Electrical Conduit Utility-Undrgrn - - - - _ - _ _ _ � .. - - 45. - Forms - - - - - - 4: - Electrical-Conduit-Undrgrn_ a__ - .. .. _. _ _. - 46. "Electrical Bonding - - - - -- - - - -- -Steel _ : - - _ __.. ,_ _.,_ _ _ , � 47. Rough PlumbiA6 & Pressure Test 6. -•Electrical UF.ER Grn - 46.. APPROVAL TO COVE UNITE- = - - 7."_ -Footings _ _ __ _ 49. Electrical Conduit-Undr rn - *+ t 8--Foundatioh------ - --- - - - 50: (Gas Pipe,•O Undr rn; Test •' ` °" - 9. Water-Pipe-Un&grn -• •- --- 51._ Backwash Lines P-Tra - 'O'OFdr -rn • - --- - '- -- - 10 ---Structural Floor System -• _ _� 52. •.APP.ROVAL.TO DECK i--1.1 r--Property-Sewer Line& House Connection. -53: ' Backwash'& Receptor -Final 1. -12. --Street Sewer Connection---==�_-_::_==-_':.-' - --- -54. Heater & Vent -Final •�:= ,'' t '', -13.-- Rough Plumbing ---_55. Pl�mb6nu - - -al 14. Rough Electric -Conduit !- - -' - - - - - '56. - Electrical -Final- - 15. Rough Electric -Wring -' - '- --- '-' '57: --Solar System -Final ,' •" -',"'- •' ""' "" - " 16: -Rough'Heating,&'Air-Conditioning ... .__ - -Fencing & Access Approval "--17. �Ductsin-$tructure-s.r.: --- --- � -+------�---- - , APPROVE[) 18. 18. Ducts, Ventilating 19. Gas Pipe -Rough &Test --' " _ 20. Roof Framing 1- - - -- ---- - 60. POOL/SPA.SYSTEMSFINAL + 21. Roof Sheathing, 221 Frame and Flashing- <--- - NOTES:- - 23. Insulation - -- - - - -- ._... 24. Lathing &Siding- 25l Drywall Nailing - -' �� - -•rt r -��, -� -� ---+'--- - ._- -• - --.. _.. �.-. .�., �. 26.- -Plaster Brown Coat 271- - Electrical Power Meter -Final ---_ _ _ -- .._ _� - _ .._ __ _.. _- _ __ ... - �•^ :, r .,- .. , - '• -' 28' -Final Electric -' _ - ---- - - - - - ' 29. Final Heating & Air Conditioning 30. -Final Gas Pipe -Test - - --- - - - -- - - - - 31.-- FinalMumbing- - '-- - - -- - --- -_ -- -_ �--- - -------- - - -• .," _:.-,..., -.;"�. 32. " Water Service -Final - -- - - -- --- '"'•" " 33.Gas Service:Final= -- - - --- -- -- -' -- - - 34. Solar Domestic -Final' ' '' '� >.._ _ •_ - • v,•, 35. Sprinkling System 36. Sound Attenuation ' 37. Handicap Regulations'- 1 38. FINAL STRUCTURE & BUILDING ' 39. Special Requirements Completed - _ �' _- - - •- i 40. Electric Release, to Edison _ 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY i --No. - Date�- „ Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. wdrfy bF COSTA- MESA PERMIT NO. TRACT NO. LOT NO. BLD . N . _ _ 004/ O/ I ;I OC 8.00 CONSTRUCTION PERMIT CONSTRUCTION TV OF CONSTRUCTION EW DD ❑ ALTERATION - ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑OTHER. !; - - - ZONING REGULATIONS -' Project Address SL• - Owner Phone ' Address ' Arch/Eng. License No. DESCRIPTION OF WORK - _ - -'_ - -- - .' - - - 'ZONE - PLNG. REF. �- 'Address - - _ - . Contract.,- I Pho TYPE OF PERMIT= - ' - ❑ GRADING -❑ FOUNDATION ❑ STRUCTURAL 1 l i ❑TENANT ❑-ELECTRICALS ❑PLU MBING�rEeECHANIC - SETBACK _ - 1 YARD -- - --_ TToo gg�l/11�p IrvG P0.0PEf3TY LINE _ - Address ....��ss _ ' 1/1 LICENSED CONTRACTOR DECLARATION il'hereby affirm that I am licensed under provisions of Charter 9 (com- 1. ❑ OTHER _BID l HT mencing -with section 7000) of Division -3 of the Business` and Professions C { I my license is In full for �`fPFt•. /-1 - PROJECT DESCRIPTION '' - `REAR YARD (TO P/L) License la OO�� •ce - "- "-- KG: SPACE REQ: -- PKG.- PROVIDED ' Signature Sig t "'n SQ., FT. .1 if - - - - -- TYPE 'STREET WIDTH-- '_-' "" - PARK F,EE'$•- - - iWORKERS'.COMPENSATION DECLARATION_ - •OCCUPANCY—CONSTRUCTION _ _ _ _ _ - ,I hereby affirm that I have a certificate of consent to self -Insure or is VALUATION ZONE ZONING APPROVED BY'- - DATE --- , ,certificate of -Workers' Compensation -I sera W,.or- a filled copy' - - _�- ._ .. . SPECIAL CONDITIONSt - thereof (Se (3pp0,eb, C,). , /sem . 'cY No. r'IM U Company Qn- IY_ GRADING CU. YDS. ACRES '._.. L.. :._ _ - _ _ - - _ .. . ,' ••t ertified copy is hereby furnishetl. _ - _ . _ _ I REMARKS:; a n _ _ .. _ . _ _ _ _ _ -"- _ _ -- -- ertlfied copy is filed with the City Building Division. -_ -i• 1 ' . •• J-' .� •• i?P _ tip, )$' p� EXEMPTION FROM -WORKERS' COMPENSATION DECLARATION --- - (This section need not be Completed if the permit is for One hundred �.�'�_.,<.' - t.. l _ •� . ($100) or less). - - - -_.'". _ _ - - -_ _. -__.- - __ -.__ �'�� J"¢.- '. PLUMBING - '- PLAN -CH ECK• � .. ELECTRICAL- -- -^• PLAN CHECK - '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't 0become subject t0 the Workqrs_ Compensation Laws. of California. BATHTUBS' -- - SHOWERS-" '--- -'4"- -' UWL^--'-- - - -- t- - Date 1 Signature NOTICE: If after making this declaration, you should become•subject TOILETS URINALS ---- - - - , GENERATOR ---0-1'KW_1-30 KW - - - to the Workers' Compensation provisions Of the Labor Cotl¢, you must ,TRANSFORMER ,.. forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE-L-AVS-•---�- - - 'APPLIANCE- - -10-50 KW=50-+KW - - revoked.- KIT. SINKS ----• DISHWASHERS- - - - MOTORS- -- -0-1 HP -_1.10 HP - - - CONSTRUCTION LENDING AGENCY 1 hereby affirm that there Is a construction lending agency for the per. SERVICE SINKS 1 ;• -SUMPS '- ^ ^- -- ��--�- --- 1(INC..SOLARI __10-50 HP SO+HP formance of the work for which this permit is issued (Section 3097 -FLOOR SINKS- - " FLOORDRAINS�'• -:FIXTURES- - --OUTLETS - , -SWITCHES - - Civ: CJ. -'- ^ - -- - - - -. — ----- - 'Lender's, Name _ Lender's Atltlress DRINKING FOUNTAINS - - - --- - --�- -- !GASTUBESIGNS - -- - --- - - ' OWNER BUILDER-DECLARATION-"-�=-� =c -=• I hereby affirm that I am exempt.from the Contractor=s License Law for •INTERCEPTORS - "'-CLARIFIERS' "- - '- - - !POL-E'LIGHTS- ---- -- -- - - - SWIMMING POOL'' • -P TRAP- - - -- -}- - -" ' the -following reason (Section•7031.5•Business _ and -.Professions Code:. Any city or County which requires a Permit 'to construct, alter, -POLES METERED' SUB'-"' - -WATER SERVICE "' 'ALTERATION -- - 'PANELS - - - MAIN - • -SUB - - -- Imp rove, demolish or repair -any structure, prior -to its issuance, also re. file quires the ap,.Ilcanl for such permit to a signed statement that he Is -licensed pursuant -lo the provisions of the -Contractor's License Law -GAS SERVICE -- '"�'-OUTLETS - - - "' -'- ''SERVICE ••- - - - -- - - AMP--' - - 1Chapter 9 (commencing with Section 7000) of Division 3 of the Business -and Pro/essions Code) that he is therefrom _.WATER HEATERS- -BTU OUTPUT -%'..^ or exempt andthe. '-ls for the alleged exemption. Any violation of Section 7031.5 by 'SEWER CONNECTIONS - lj- -'^�-`-'- - r } --- ---- -- -- - - --- - - - applicant for a Permit subjects the applicant to a civil -penalty ol more than five hundred dollars ($500). OLLECTORS --- - ----: SOLAR TANK COLLECTORS- - - -- - - -- - - V I, as owner of the 'property; or my omployees'with' wages'as their sole compensation, will do the work, and the structure is not Intended sole or offered for sale. (Section 7044, Business -and Professions Code: The -SOLAR PIPING SYS. '-- lF "' - l - -ISSUE FEE- - - -• - _ - - _ Contractor's License Law does not apply to an owner of a properly who builds or Improves thereon, and who does such work himselforISSUE FEE - II - _ --- - - Iqpp LICATIONAPPROV ED BV- :.PATE -- - - - -- ' througgh his own employees, provided that such Improvements are not however, the building Improvement MECHANICAL PLAN CHECI( - -- SUMMARY ,BUILDING. OF FEES •.' I ntentled or Offered for sale. If, or the have the burden Is sold within one year Of completion, owner will of -proving he did not build'or improve for the purpose "of sale)- HEATING SYSTEM 0-100,000 BTU - E �`- • SMIP.> .❑ I, - as -owner of .the. property, am exclusively contracting with licenSed contractors l0 construct the project (Section 7044, Business AND DUCTING _ u ]00,000•,, BTU ,PERMIT PLAN CHECK $ _ .- •.$__ - PERMIT and- Professions -Code: -The Contractor's License -Law does.not, apply. to l _ _ISSUANCE..E� an owner Of property who builds or improves thereon, and who Con- REFRIGERATION 0-100,000 BTU 'PLUMBING E l tracts -from ..such .projects .wilt-a-COntractor(5) licesned-pursuant to SYSTEM -. -- _ _ _ - ' GRADING E the Contractor's license Law). 100,000 + BTU _ PLAN CHECK $EH am exempt untler Section '- '-'B. d P. C: for this BOILERS BTU - - - ELECTRICAL- E "- $ - reason - - - - - - r-- - SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE - - - PLAN-0HECK E 1 MECHANICAL $ MICROFILM E -" - TOTAL FEE $ - - LESS AD- Date Owner 1 hereby certify that I have read this application and state that the above Informatlon'IS correct. I -agree -to Comply with all city and county i +PLAN CHECK "E - VANCEPC- $_ ordinances and state IawS rale liry9 to construction, antl hereby authors ae , .Pres.nlatives ' s City) eme up n the above 'mentioned - property u, e FINAL i� Signature Date - ISSUE FEE r - FEE $ - Drivers' License � - CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor TL V_ l CONSTRUCTION AND PLANNING APPROVALS Permit .• ` Date •Inspector POOL & SPA APPROVALS Permit_#`-' Dates �.-Inspector, 1. Temporary Electrical Service or Pole_ 43. Pool & Equipment LOcatlon . 2. SoilPipe-Undrgrn -, 44. Steel Reinforcement - - -- - - 3. Electrical Conduit Utility-Undrgrn 45.• Forms - -4.--Electrical Conduit-Undrgrn _ 46. Electrical. Bonding �- - 5. Steel em orce _ 47. Rough Plumbing & Pressure Test - '6. Electrical UFERGrn. 48. APPROVAL TO COVER-GUNITE - - 7. Footings, 49. Electrical Conduit-Undr rn 8. Foundation - 50. Gas Pipe, ❑ Undr in, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Tra "-0 ndr rr ` - 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 _7.3. Rough Plumbing - - - 14. Rough Electric -Conduit -' - 56. Electrical -Final -- - ' 15. Rough Electric -Wiring ' - = 57. Solar System -Final 16. Rough Heating & Air Conditioning 58. Fencing & Access Approval ' 17: Ducts in Structure 59.. APPROVED FOR PLASTERING - 18: Ducts, Ventilating- x_'60. - - • --- _ POOL/SPA SYSTEMS FINAL. 19. Gas Pipe -Rough & Test r -20. Roof Framing 21. Roof Sheathing- - •- - - - - - '-' -` " ' .NOTES:. -22. Frame and Flashing - ' _ 23.- Insulation 24. -Lathing &Siding' - 25: Drywall Nailing - - - - -- Z-- ' 26. Plaster Brown Coat ` 27. -.Electrical Power Meter -Final - -- - - - • ' 28. - Final Electric - - - - - - 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. Landsca e Sprinkling System 36. 'Sound Attenuation - -- - - 37. Handicap Regulations - - '- 38. FINAL STRUCTURE & BUILDING - 39. Special Requirements Completed 40. Electric Release to Edison' 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date - ,- - '• - Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. FFITT-OF COSTA MESA - - 'PERMIT NO. TRACT NO. LOT NO. BLDG. NO: CONSTRUCTION PERMIT SEEP. 44 SZ // 353 �- TYPE OF CONSTRUCTION NEW ❑ ADD ❑ ALTERATION ❑CONVERSION ❑DEMOLISH I t 5781 8/10/82. 68.50 ' ZONING REGULATIONS Project Address Owner uL Phone u Address V i❑(REPAIR Arch/Eng.. -- License No. .tXOTHER DESCRIPTION OF WORK A'P' 2- -d - Address ZONE PLNG. REF. ¢ - • Contractor U Phone f4ZZ TYPE OF PERMIT'' - - �❑q GRADING ❑ FOUNDATION 11 STRUCTURAL /N TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHANIC - SETBACK C L T. 51DE-YARDLEFT Tp g�1I�LpDING PROPS RTY LINE Address r LICENSED CONTRACTOR DECLARATION 1 hereby affirm that I am licensed under provisions of Charter 9 (com- I `� , SIDE YARD - BRIGHT mencing with section .7000). of Division 3 of the Business'and -.❑OTHER. _ - - Professions Code. my license Is In full force and effect. REAR YARD (TO P/L) ,and PROJECT DESCRIPTION Licehse Class _ License No. Ai ¢ d�� M SQ. FT. ! !i / s PKG: SPACE REO. ,-PROVIDED - - ' Date ' Signature - _ _ - yy / OCCUPANCVyCONSTR VCTION TYPE - - - STREET WIDTH PARK FEE E , COMPENSATION DECLARATION WORKERS' I hereby affirm that 1 have a certificate of consent to self -Insure or a VALUATION A!5�1ZONE ZONING APPROVED BV DATE � d"• certificateofWorkers' Compensation Insurance, or a certified copy. _ __ _ GRADING CU. YDS. ACRES _ SPECIAL CONDITIONS _ thereof (Section 3800, Lab. C.). 'cy No. "'Company REMARKS:" _ (.�s" ]ertifled copy Is hereby furnisheG. _ -__ Certified copy,is filed with the city Building Division. .OBJ: /E %�MPTION FROM WORKERS' COMPENSATION DECLARATION (This section 'need not be completed If the permit is for one hundred . r: 4 •' (E100) -or lessl. - - - _ - - I certify that in the) performance o he work for which this permit is Issued, I shall not emPioy any per a in manne so as o become PLUMBING '_PLAN'CHECK- - ,ELECTRICAL' -- PLAN CHECK subject to the Workers_ Compensa_ti Law of Cali I_a. BATHTUBS SHOWERS - - -' UWELL -FT Dater.P%.�01-94� Signature NOTICE: If atter making this declaration, you sh uld become subject TOILETS - -, URINAL'S-'- ^'� • - GENERATOR .0-1 KW_ 1-30 KW ' _ 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 L•AVS— -- APPLIANCE- - - 10.50 KW_50 * KW - -- - revoked. KIT. SINKS - '-' ' " DISHWASHERS ^- ' - .MOTORS _ - - 0-1 HP_1-10 HP'-' _ LENDING AGENCY _CONSTRUCTION I hereby affirm,lhat there Is a construction lending agency for the per- _ �_ SERVICE SINKS ,.; I, SUMPS" ` (INC. SOLAR) -10-50 HP , - 50+ HP. •' - _ 7; - of the worklforvwhieh _this permit is issued (Section •'f FLOOR SINKS " :.cFCOOR-DRAINS- j' FIXTURES' OUT SWITCHES - ^ _3097" Civ. C:). - t` Civ. _ ``� _ Lender's.). Name _ _ _ _ _ _ Lender's Address w. - - _ _DRINKING FOUNTAINS "' - .- - -,GAS TUBE 51 NS - - - - - - - - - OWNER BUILDEWDECLARAT.ION-'`'�-`CJ •'T' -INTERCEPTORS -CLARIFIERS,p�. r - 'POLE LIGHTS --•� - - - -- 1'herebyy affirm that I am exempt from the Contractor's License law,for the' fol lowing reasonT(Settion 7031.5'Business and Professions Code'. SWIMMING POOL --.P TRAP a - POLES METERED - - - SU13 . Any city or county which requires a permit to construct, 'alter, WATER SERVICE ALTERATION' - PANELS ' - MAIN '- SUB-' ' Improve, demolish or repair any structure, prior to Its issuance. also re- quires the ap4BUnt Inr such permit to file a signed statement that he C - GAS SERVICE - OUTLETS- -" - SERVICE' -- ---- - - AMP-- - -- Is licensed pursuant to the provisions of -the Contractor's License Law C9 (commencing with Section 7000) of Division 3 of the Esiness-and _/hapter -WATER HEATERS 'BTU OUTPUT '- - - ^ -- - -- - - - -- - - Professions Code) or that he is exempt therefrom and the 'S for the alleged exemption. Any violation of Section 7031.5 by --SEWER' CONNECTIONS - ' - - - - - - - - - - -applicant for a permit subjects theapplicantto a -civil -penalty dol more than live hundred dollars (E500). SOLAR TANK -' COLLECTORS -' — - - - -- - - - - L 1; 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. (Section 7044, Business and Professions Code: The -SOLAR PIPING SVS. ISSUE FEE - - - - Contractor's License Law does not apply to an owner of a property ISSII EFEE - - • •- '' - - APPLICATION APPROVED BV ~ - - DAT /4 who builds or improves thereon, and who does such work himself or- through his own employees, provided that such Improvements are not MECHANICAL PLAN CHECK SUMMARY OF FEES Intended or offered -for sale. If, however, the building or Improvement Is sold within one year of Completion, the owner will have the burden of proving he did 'not -build or Improve for the purpose of sale). - - HEATING SYSTEM - BUILDING �D .. . - - - - - .1, as owner of. the-property.am exclusively ti -contracting with ^ 0.100.000 BTU AND DUCTING - PERMIT E - - SMIP - - - ic nsed contractors to construct the project (Section Business 100,000 +BTV (PLAN CHECK E 'PERMIT ri License Law es not apply to and. Professions Cotle: Tho_Conlds - ISSUANCE E and owner of property who builds or Improves thereon, antl wha con- orthereon, REFRIGERATION 0-100,000 BTU PLUMBING E-F�7L•'SL r•,. . tr ds with a contractor(i) Iicezned pursuant to the -SYSTEM - 1• _ _ - - GRADING License the Contrattor•s License Law). Contractor's 100,000.+BTU 1 PLAN CHECK E - - 13-1 am exempt under -Section - -- B. 4 P. C. for this - - BOILERS BTU ELECTRICAL E-// - E reason - - - PLAN CHECK' $ 'MICROFILM S - - Date �•��%� � O e BMECHANICAL SYSTEM REPAIR, ALTERATION C EXHAUST SYSTEM MULTIPLE E - - r - r NOTAL FEE EI -' - 'LESS AD - I hereby certify that I have read this application and state that the above information 'is corrects I agree to comply with all city and county PLANCHECK E VANCEPC S_ - ordinances and slate laws relating to construction, and hereby authorize r • , represenla 5' this- ly -lo enter�onlhe,bovemen lonetl r i _ urpo ete 0� ZFINAL So FEELicense or 55 - ' - ISSUE FEE CMF 0865-4 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING- APPROVALS Permit # Date Inspector POOL & SPA -- - - - APPROVALS • Permit # Date-t a Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - - 2. Soil- ipe-Undrgrn44. Steel Reinforcement - - - - _3. Electrical Conduit Utility-Undrgrn 45. Forms - 4. Electrical Conduit-Undrgrn 46. Electrical Bonding- _5. SteelReinforce 47. Rough Plumbing & Pressure Test " 6.. Electrical UFER Grn _ 48. APPROVAL TO COVER-GUNITE 7. Footings _- _ - 49. Electrical Conduit-Undr rn B. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water_Pipe-Undrgrn 51. Backwash Lines P-Trap.El UndrQrn - 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 13. Rough Plumbing _55. Plumbing'qv�tern - Final 14. Rough Electric-Conduit - 56. Electrical-Final 15. Rough Electric-Wiring - �jrQ� - 57. Solar System-Final - 16. Rough Heating & Air Conditioning _bF3. Fencing & Access Approval - 17. Ducts in Structure" _ _ _ APPROVED FOR PLASTERING - 18. Ducts, Ventilating ' 60. .POOL/SPA SYSTEMS FINAL 19. Gas Pipe-Rough & Test '. -'- 20. Roof Framing21: Roof Sheathing- - - NOTES: �^ 22. Frame and Flashing - - - X - -23. Insulation- -- - - - 24. Lathing & Siding - - - - 25. Drywall Nailing - . - //-3 -30'1 �- 26. Plaster Brown Coat 27. -Electrical Power-Meter-Final - - 28. Final Electric - - - -- - ' • 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. FINAL STRUCTURE & BUILDING 39. Special Requirements Coiitpleted 40. Electric Release to Edison • 41. Gas Release to Southern California Gas Co. 42. ' CERTIFICATE OF OCCUPANCY ' No.. '�2 9� Date &2a Cli' p--.OSTA MESA CONSTR -Ps:w�ecti'tiidress, 245 Fl SC{'}E1'L App cant's Mailirig Address ? • Ow,ner's Name•_115 St{ARJI A�•� Address - , Gp1(,Pe jt.�}71 ON PERMIT a4 Pr -1 c Applicant to' fill in all spaces except those within heavy border lines and sign all appropriate declarations. f .P 'f/ tl o282 T((K(3 [ V O7J UN IT,jVO� A.P.# l Arch/Eng" K ISS H7t_�-N' (.L' -`!JS License No. c`' L-IUU AddressS VIN -11 1 Contractor's Name _ MZ*71 Wone _WHO Address (mailing) ) City License No. J LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class License No. Date Signature v'^RKERS' COMPENSATION DECLARATION tby affirm that I have a certificate of consent to self -insure or a certificate orkers' Compensation Insurance, or a certified copy thereof (Section —0, Lab. C.) ' Policy No. Company Certified copy is hereby furnished. LJ Certified copy is filed with the city Building Division. Date Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (Th is section need not be completed if the permit is for one hundred ($100) or less). .' less). that in the performance of the work for which this permit is issued 1 shall not employ any person in any manner as to become subject to tits Workers' C m e anon L s of California.f^�^C,^� Date �is declaration, �o it 3 NOTICE: C aft tion this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Hereby affirm that there is a Construction lending agency for the performance of the work for which this permit is issued (Section 3097 Civ. C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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 fire a signed statement that he/she is licensed pursuant to the provisions of .ontractorep License Law (Chapter 9 (commencing with Section 7000) of ''.'San 3 of the Business and Professions Code) or that he/she is exempt "rom and the basis for the alleged exemption. Any violation of Section 7•.5 by any, applicant for a permit subjects the applicant to a civil ,.. penalty of not mor: than five hundred tlollars ($500). vy�m1/I, as ow n ci of the property or my employees with wages as their sole /compensation, will do the work, and the structure is not intended onoffered forsale (Section 7044, Business and Professional Code: The Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who tloes such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If,.however, the building or improvement is sold within one year of com- .pletion, the owner will have the burden of proving he/she did not build or im- prove efor the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon. and who contracts for such orcl ects with a con- tractors) license pursuant to the Contractor's License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exeTpt under Section _ B. & P. C. for this reason G7:iL�/LS7/I�� I have read this application and state that the above I agree to comply with all city and county ordinances TYPE OF CONSTRUCTION LJ NEW U ADD PLALTERATI N ,L PAIR ❑ CONVERSION 1:1 DEMOLISH El OTHER ¢- a DESCRIPTION OFvWORK/USE OF BLDG. TYPE OF PERMIT GRADING El FOUNDATION E STRUCTURAL TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION SQ. FT. OCCUPANCY— CON STRUCTION TYPE VALUATION$ In 45� GRADINGU.YDo ZONE �/fiyl NS.AV.fL-ACRES Remarks: ?L_0. i ZGefl bN Ii pa u 0-+ 2 - PLUMBING Bar Sink Showers Backflow Preventer Service Sink Backflow Irrigation Sewer Cap Bathtubs Sewer Connection Clarifiers Solar Collectors Dishwasher Solar Piping Drinking Fountains Solar Tank Floor Drains Swimming Pool w/Spa Floor Sinks - Urinal Gas Service Outlets .-Water,Closet Interceptors Water Heater Kitchen Sink Water Service .Lavatories Auto -Wash P -Trap Laundry Trays' Roof Drains S Main E T Front B Rear A C Right K . Zone II P1.n Ref. # I Parking Req./Provided Planning Notes: FEES Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Elec 7 Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Disposal . Generator 00-5 KW C Reinspection Fee ( $15 I I Issue Fee I $ 3 Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System O Multiple Firepl/Fact. Bit. ICBG # eHSeating System & Ductm po 0-100,000 BTU ❑ 100,000 iANICAL FEES Hood or Type ❑ Canopy Type I I ❑ Refrigeration System ❑0-100,000 BTU' ❑ 100,000 BTU System Repair/Alteration j Fire Dampers ' Registers ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+KW Meter ❑up to 100 amps Meter ❑over 100 amps Sub Panel Motors 1:10-1 HP ❑,L'/:-- 8 Inc. Solar 1:19-15 HP ❑16-15+ I Microwave Pole Light Range Standing Sections Trash Compactor FEES ReinspeMion Fee $15 '. Issue Fee DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Building Approved By 1'—Date�.�� Application Issued By I CU AfJ r l . SUMMARY OF BUILDING PERMIT $ 24-•oa PLAN CHECK $ PBL PLUMBING $ PLAN CHECK 25% $' DBL—ELECTRICAL PLAN CHECK 50%, $, D131 --MECHANICAL $ PLAN CHECK 25% $ O N N G R E Q M T S. ES 1 '� SMIP . - _ $ � PERMIT, ' ISSUANCE . $ ENERGY P.C. $ GRADING $ MICROFILM $ _ TOTAL FEE $ 3 S�{ inspection pu oses. � •- - Signatl � a^• ' ' Drive rsor SS �%� Reinspection Fee $15 Issue Fee 'i (i;?`�-r.451 uQO4;]v �4 5•--y`_ 0865-46, ev. 5/88 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor 1 q'ONSTRUCTION AND PLANNING_ POS ti SPA' AQPROVALS Permit #� Date Inspector - APPROVALS .nit# Date Inspector r '!4m orar'q Electrical Service or Pole p 52. Pool & Equipment Location --Z-- /' r, 7 3'Soil Pipe-Undigrnd. - 53. Steel Reinforcjvnent'. C1 . l ✓ /i Electrical Conduit Utility-Undrgrnd. 54. Forms 4 Electrical Co6duit-Undrgrnd. 55. Electrical Bonding 5'Steel�Reinfor6ement 56. Rough Plumbing & Pressure Test ElectricaIJU.ER Grnd.. 57. APPROVAL TO COVER-GUNITE 7= Footings 1 , - _ " 58. Electrical Conduit-Undrgrnd. 8 Foundation t�--1 '59. Gas Pipe, ❑ Undrgrnd., Test r 9. Wter Pipe -Unit rgrnd. - 60. Backwash Lines, f? -Trap, O Undrgrnd. �! Y 10. StructyraI Floo.•System - 61. APPROVAL TO DECK 7 11;.' Property SewerLine & House Connection 62. Backwash & Receptor -Final ' 12n S�eT Cap_.1. is ,�11 ' 63. Heater & Vent -Final 13}'Roc�fyOrai s �� 1 64. Plumbing System - Final . ' - 141:Rough Plum6m9 65. Electrical -Final ;Z„ 15"'Rough_Electnidal-Conduit 66. Solar System -Final 16. Rough Electr c Wiring �( 67. Fencing & Access Approval 17. Rough�Wiring'Sign 68. APPROVED FOR PLASTERING 78. Rough Electrical -T Bar/Ceiling-7:':j69. POOL/SPA SYSTEMS FINAL 19. Rough�Heating & Air Conditio'nin'g FIRE DEPT. REQUIREMENT l C APPROVALS Permit # .f 2d. Rough Factory Fireplace.; A.1 2Y. Ducts, in StructureiJ 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil / 23. Gas Pipe -Rough &T jst 72. Underground Flush 24-. Roof Framing 7 -/ !+� G 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing fJ ;' /4' "1, 74. Overhead Hydro 26, T -Bar Ceiling (Struct'ural) &iMonocoat 75. Dry Chemical 27 f Frame and Flashing 76. Dry Standpipe . 28. Lathing &Siding 129. 77. FIXED SYSTEM FINAL Insulation r l 78. FIRE PREV. FINAL 30. Drywall Nailing IV HEALTH DEPT. REQUIREMENT X31! Plaster Brown Coat `^ 79. FINAL INSPECTION 32. Electrical PoweriMeter=Final r� 80. FOOD CERTIFICATE ISSUED 33. Final Electric M66 04 Notes: J C 34. Final Heating & Air Conditioning GES ;.._ t' ty 1' 35. Final Gas Pipe -Test -36. Hood or Canopy 37. Final Factory Fireplace X38. Final Plumbing 39. Water Service -Final -. 140. Gas Service -Final ,'41. Solar Domestic -Final 42. Backflow Preventers �T i,- J; C \ 7- ` {qJ ackflow Irrigation. r 44. Landscape Irrigatiori System v 45. Sound Attenuation' 46. Handicap Regulations - 47. FINAL STRUCTURE &BUILDING z - 48. Special Requirements Completed 49. Electric Release iEdison `. 50. Gas Release to Soiuthern California Gas Co - f i- . 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- - - - - - - PERMIT NO. - TRACT NO. - LOT -NO. - BLDG. NO.- - - - - -- - '- - - -- - - - - CONSTRIJCTION PERMIT_.: -��.... _ Project Addres- ',-"_ TYPE OF CONSTRUCTION LJ NE D LJ ALTERATION- ,REPAIR App lice ht's Mailing dress .� �❑ CONVERSION '❑ DEMO_ LISH OTHER ' A p # ? Zone. _ 'S', Owner's Name Phoyqe, DESCRIPTION OF WORK ^[rl6'�%�^'t S Main Building: - 'Accessory Building - _ Z I / Address. '+-• L)O.x.Y��PE 7.00THER. OF PERMIT GRADING FOUNDATION' STRUCTURAL _ T Front" i' _ N Arch/Eng.' - License No. ❑' T.ENANT,/�J.E LECTRICAL ❑ PLUMBING ❑ MECHANICAL B' Rear .. , 1 Address i- A N + Contracmr's/ e G. G� �� o,.....e41��„/1' PROJECT DESCRIPTION. Sq. 1=T. - �0 CUPANCY - C K Right . - - - G Address(da g CON STRUCTION TYPE 'VALUATION S Left - I _ R E -,��i^'��.�/�j,/� City. License No. �%-2�}�[1/- 1 'Z�NE GRADING CU.YDS. 'ACRES Ping. Ref. # ng Park. Fees $: .. - U LICENSED CONTRACTOR DECLARATION Remarks: '` Parking Req./Provided + .. p I=hereby affirm [hat 'I am Licensed under prov isl o ns of Cha rter.9 (commencing - R with section 7000) of Division 3 of the Business and Professions Code, and •:1 i I Use of Building: ' + _ E my license -is In ( )• force ntl a ect . I - Planning Notes: - ; .r 1 M License Class - Lic No: ( 'Y ^ ' nr ! PLUMBING FEES -•j E - 'Date - - Signature + <Le�t Baf Sink I l Showers 11 T WORKERS' COMPENSATION RATION .ereby affirm thatI have a ti ' ate of consent to self -insure or a certificate Backflow Preventer - Service Sink: + r S Workers' Compensation ran ce; or a-certitietl'-copy-thereof (Section - _ s00, Lab. C.) Backflow Irrigation S ewer Cap 1 - i ELECTRICAL FEES Policy No. I - Company' ❑ Certified copy is hereby furnished. ' Bathtubs I Sewer Connection ^.r Automatic Washer ;Transformer ❑ 15x50 KW - ❑ Certified copy is filed with the'city Building Div{sion. { - Clarifiers j Collectors ��- 050+KW -Date Applicant ' Solar j i Construction Sub, I 1 1 -EXEMPTION FROM WORKERS•1COMPEN ION DECLARATION-- —• -- This section need not be completed it th far It Is for, one hundred ( ) s Issue or ) I certify that In the performance oft won for which thl� a It Is Issued, I - -- - - `- Dishwasher , -' "�'-- I "Solar Piping - - •'- - - - - - 1 - Cooking Unit' - 9 _ _ 'Meter ❑u to; 100 am s --- , - Drinking Fountains Solar Tank I V� Dishwasher t Meer ❑over 100 amps v s to t, shall not employ any person in any mann rso, a5 to,b o eiubjebt tothe- Workers', om ns Lo,. Laws of Ca forni , Floor Drains, , Swimming Pool w/Spa Dryers []Gas; DElectric 'Sub Panel. . ' Date Sig iatur G>./ '� NO' E: If,'after m king this deciar n, you sh Wd become subject to the Floor Sinks I - Urinal ! { I ; ' Fan' !Motors ❑C-1 HP IA1%-'B �- 'Workers' Compensation -provisio 0 the Labor Code; -you must -forthwith-;' comply with; Such, provisions r his. permit 'shall be deemed revoked. t Gas Service I -Outlets' iWater Closet f - < - --- - - F.A.U. `! - --- - Inc. Solar❑9-15 HP 016-15+ r CONSTRUCTION' LENDIN - NCV. `+ - I - n•'+ r- ,.� i , I hereby affirm that there is 2 struction-lending agency fdr the performance 'work 'C.} Interce tors I 1 l P t Water Heater Flxtllre$ ' ; Microwave + of the for ,which this, permit, is Issued-,(Secfion X3097 Civ: i - _ - Lender's Namn' - K,tchen Sink - -- Water Service _ - 1 , = = Device Boxes' Pole: Light i Lender's Address, - -- OWNER BUILDER DECLARATION , i '• ,. 1 .' 1 _ Lavatories " , ' - j I 1 , _ ' Outlets 1 I - i ;Range J I 3 6 (% I hereby affirm 4hat I am exempt from the; Contractor's License flaw for the 1 _ '� - c '. I "' p following reason'(Section 7031 -.5 -Bus and Professional Code; Any city or - P Trap j , ? _ 1 Switches' 1 1 i Sign county which requires a permibto construct, alter, Improve; demolish or. repair ,any structure, prior to Its -issuance, also requires the applicant for such permit l Rocft Drainst '?' I '� .,. -- �-,Y j I • ,�; - I i'1" ^. I, Garbage Disposal ! i Sianding'Sections ' } I to file a,signed statemen Lt hat :he/she is licensed Pursuant to'the•provlsions of ' - .. I - i Ge Contractor's License Law (Chapter 9 (commencing with Section 7000) of 3.ot the -Business and Professions Code),or that he/sheis exempt C , �- < i I _, i { i-, ;'� Generator ❑0.5 KW D5-15 W KTrash Compactor j + yisiont >l;efrom and the basis forllhe alleged exemption, Any violation'of Section :to l .� .- 91:5 byi any applicant fora, permit subjects the! applicant a_' civil haIt , of not more than five hundred dollars ($50b)J '- -Reinspection se i $25 = Issue Fee•' I ,- , 1;- as, owner of thel property'or_my :employees'. R1 wages as their sole Reinspection Fee ' �' S25 Issue Fee i $' 3 compensation, will do the work, and the -structure is not intended or offeretl1 _ - - _ ' ' MECHANICAL - - FEES for sale (Section 7044, Business and Professional Code:; The Contractor's License Law does not apply to an owner of a Pro Pertyl who'builds or Improves ! - ' j - I Boiler. Hood or: Type I i ❑ I - PUBLIC SERVICES REQUIREMENTS: 1 12aning I thereon; and who'tloes such work •h l mself herself / or.lhro ugh his or her own employees, provlded that such improvements are not intentletl or offered for _ , I' ' Canopy ; .Type Ili ❑ _ Approved By ' II i Date ' 1 - the building improvement is within Duct_ Under Ground j i 1 .1 1 ' Application Approved I I' sale. If, however, or sold one year of com- 'pietion„the owner will haveithe burden of proving he/she did not build or im- erove;for the purpose of'sa le). i By i , Application Issueday Date l / r� / I Data // 3 Duct -Structural I - - Refrigeration System .- ' LJ I, as owner of the property, am exclusively contracting with licensed con- I Duct Ventilatin - ' '' I ❑0-100,000 BTU ❑100,000'BTU , 1 tractors to construct the project (Section 7044, Business and Professions Code: License Res toan:Owner - 9 -.-1'. 1SUMMARV OF FEES t. , -not -The-Contractor's -Law oes-not apply of -property -who builds or improves thereon, and who contracts for such projects with a con- - 1 -- - -- - Exhaust System ❑ Multiple ❑ - _ - _.-- _ _ _ _ - i System Repair/Alteration _ _._ r BUILDING PERMIT $ SMIP .,$ ' 1 tractor(s) license pursuant to the Contractors License Law)! ' ❑' Section— ! - PLAN CHECK $ - ! PERMIT aam'exempt under B. & P. C. for this reason Firepl/Fact. Blt. ICBO # l + ' PLUMBING i • ISSUANCE $ f Date Owner ' Heating System & Ducting 1_ $ i PLAN CHECK 1 $ ENERGY P.C. • $ 1 hereby' cert” t t I have read this �licatiob and state that the above "p -'I' ❑0-100,000 BTU ❑100,000BT -' - - - - -' -" ELECTRICAL $ 1 GRADING $ ' in torr ct' t-agree'to co with all tit, and county'ortl finances ' v - - --r••-.- antl:5tate s re ting"to builtlin c str uctlon, and Thereby authorize repre- sentatives f t s: city'. to a it on the above-mentioned + . , PLAN CHECK $ `5,55 MICROFILM ' $ ! property ,for inspectioI ! , i pur as I y 1 MECHANICAL i $ TOTAL FEE $ 1 Signature + Date Drivers" cense or,55 + ' , , I Reinspection Fee `$25 ' j' ! Issue Fee f $ 3 PLAN CHECK 1 $ 1 ICMF 865-46 rev. -7/83 - White-Builtling: Canary -Applicant; Pink -'Accounting; - -__'_ ._ Goldenrod --Assessor ' ! .. .. a-.. _ ._. _. _ '. _ _- _ . _ J _ ' - > ., CONSTRUCTION AND PLAN IJf.y1v � - , -.: Date .• i APPROVALS -Permit # - , = I, Inspector, = - -_'. POOI ;PA .' -.APPROVALS '.Permit # Date Inspector ;. Temporary Electrica )'Service or Pole �:-..�52. Pool & Equipment Location;. ' ;-2. Soil Pipe:Undrgrnd' .`- - - _ 53.'Steel Reinforcement - 3r-plectricaI Conduit Utility;Undrgrnd. 54: Forms 4AElectrical*Conduit-Undrg-rnd'_ r 55.-Electrical.Bonding-' - `.5. 9teel Reinforceriient•• - - ; 56..,Rough:Plurimbing & Pressure Test - -E fElectrical,UFERGrnd 6+. 57.•APPROVALTOCOVER -GUNITE 7.�ootings , �� s_�,'` -..58.' Electrical Conduit-Undrgrnd.;, ; Er Foundation _ 59. Gas Pipe, ❑ Undigrnd., Test 9. Water Pipe-Undrgrnd. '60. '- Backwash,Lines, P-Trap,,0 Undrgrnd. 10, tructural Floor System - c ' 61.- APPROVAL -TO DECK - 11 P�operty 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. RoughElectrical-Conduit-" 1 66. 'Solar System=Final - 16. Rough Electric Wiring WAk=,, ' - �':', d ".67:, Fencing & Access Approval 17. Rough Wiring Sign -_ ' _ f ` ;, 68. •APPROVEDFOR PLASTERING - - 18. Rough Electrical -T Bar Ceiling 69.'P68L/SPA SYSTEMS FINAL 19. Rough Heating &Air Conditioning j FIRE DEPT. REQUIREMENT APPROVALS Permit # . 20. Rough Factory Fireplace. ' - 21. Ducts, in Structure '' I 70. Underground Hydro ' 22. Ducts, Ventilating '' i 71. Product Piping El Gag 0Oil ' 23. Gas �Pipe-Rough & Test ' I 72. Underground Flush 24. Roof Framing .. _ 73. Undergmd! Storage Tank.0 Gas G Oil 25. Roof Sheathing i' ;, 74.-6verheacl Hydro 26. T-Bar,Ceiling (Structural) & Monocoat + 75. Dry.Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding, 77. FIXED SYSTEM FINALS ' 29. Insulation 78. FIRE P,REV. FINAL 30. Drywall'Nailing 'r' I - HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat ; 79. FINALiINSPECTION 32. Electrical Power Meter -Final i 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: i 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 -Fina( (" ' 41. Solar Domestic -Final 42. Backflow Preventer - 43. Backflow Irrigation ' 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINALSTRUCTURE&BUILDING ' _ ' • 48. Special Requirements Completed i 49. Electric Release to Edison --I- - - -- -" - .- - - 50. Gas Release to Southern California, Gas Co ' + 51. CERTI FICATE 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 - x - - - - COIITSTRUCTION PERMIT, Service Sink PERMIT &. // TRACT rip. LOT NO. BLDy.-- Bathtubs Project Address ' - Applicant's Mail Address X��) / /7/R.��Vu 1 '. TYPE OF CONSTRUCTION - ' NEW ADD ALTERATION REPAIR . ❑CONVERSION ❑DEMOLISH OTHER 2 _ - O '!' L'O/UC A.P. - "Zone Solar Collectors `IJ '-- / Owner's Name /�la• 1 4-J- Phone' DESCRIPTION OF WORK I r S Main Building: } Accessory Building. \ Address TYPE OF PERMIT. 0 GRACING II��FOUNDATION ❑STRUCTURAL ❑ TENANT ❑, ELECTRICAL 251,PLUMBING ❑ MECHANICAL ❑OTHER' - PROJECT DESCRIPTION SQ. FT. OCCUPANCY CONSTRUdTIONTYPE VALUATION$ ZONE - GRADING CU.YD�j ACRES ami T Front _ Arch/Eng. ' License No. '- B A Rear ' Address rat,C Contractor's Nam - /�1 f one 96- Address Im ailing), - S'7S1 �li%f1'11 S U - City License No- LICENSED CONTRACTOR DECLARATION khereby affirm that 1 am licensed under provisions of Charter 9 (eomm¢nd ng with section 7000) of Division 3 of the Business and Professions Cotle, and my license is in full re dRffect. � p License Class `mo b A, t Licensedgo. 3U__ V/\ Gas Service -Outlets! - Right S Left Ping. Ref. # Park.Fees $' - Remarks NT Parking Req./Provided i _ Taj. �' — )-r7— - Use of Building: I 1J a fr91'f' �.�sa PLUMBING / FEES Planning Notes: 9 ' Date r° Signature WORKERS'COMPENSAT ION DECLAR O ' ,,r,�ereby affirm that I have a certificate of nsan to self -insure or a certificate ,,.,'Workers' Compensation Insurance,. or -a certifiedtcopy-thereof (Section - 'p00, Lab. C.) 91 Policy No. /r0^S^O/e.i-/. Certified copyIs hereby furnished. 7 `' Cert �"ed co y is '1 tl with the City B i Div'sion ate Applicant t" EXEMP ION'F ROM 0RKERS'CO ENSON CLARATION-- -. (This section need,not be completed if -the pert is fo one hundred ($100) or less). I ' • 1 I certify that In the performance of the work for which this permit is ISeuetl �I �' shall not employ any person in any manner so.as to become subject to tW Workers' Compensation Laws of California., Date -V Signature NOTICE: 1f, after•making this declaration, you should become subject to the%1' 'Workers' Compensation provisions of the Labor Code, you must forthwith comply 'with, such , provisions or - this permit • shall be • deemed revoked. 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- (Section 3097CI_v. C.) Lender's Name Lender's Address' - - - OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional; 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/she is licensed pursuant to'the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of 'vision 3 of thet Business and Professions Code) or that he/she is exempt refrom and the basis for,the alleged exemption. Any violation of Section 31v5 by any applicant fora permit subjects the, applicant to a civil nalty of not more than five hundred dollars ($500). , , 1, 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 (Section 7044, Business antl'. Professional Code: The Contractor's 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 employees, provided that such Improvements are not intended or offered for 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 - rove farr the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con- tractors to construct the project(Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner ofproperty who. builds or Improves thereon, and who contracts for such projects with a con- tractors) license pursuant to the Contractor's License Law). i ❑ I am exempt under Section B. & P. C. for this reason Date Ownerl_ I hereby certifyy that I have read this a information is Lb rrect- I agree to comoly Signature _ Drivers' Lic/ CMF 0865-4 Bar Sink17 r��j' Showers 3ackflow, Preventer Service Sink 3ackflow Irrigation Sewer Cap Application Approved By Bathtubs Sewer Connection. ' Clarifiers Solar Collectors Dishwasher Solar Piping `T"-- Dat Drinking Fountains Solar Tank SUMMARY OF FEES Floor Drains. Swimming Pool w/Spa BUILDING PERMIT $ Floor Sinks Urinal $ Gas Service -Outlets! - Water Closet Interceptors Water Heater _ PLUMBING Kitchen Sink - Water Service - ISSUANCE Lavatories PLAN CHECK $ P, -Trap '= . •_ I 1 - ELECTRICAL Roof Drains GRADING $ _ PLAN CHECK $ "-Reinspection 4Fee $25. Issue Fee 1 "� $ " i MECHANICAL - F Boiler ' TOTAL FEE Hood or Type I ❑ , - Canopy's Type I EJ ; , Duct= Under Ground Duct -Structural ' Refrigeration System 00-100,000BTU ❑100,000BTU Duct -Ventilating Exhaust System ❑ Multiple ❑ System Repair/Alteration Firepl/Fact. Bit. ICBG # Heating System & Ducting ❑ 0-100,000 BTU 13100,00013T or.# I I Reinspection Fee � 7/83 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod -'Assessor �. $25 I Issue F%e i $ 3 ELECTRICAL Automatic Cooking Unit ^ Dishwasher Dryers ❑Gas ElElectric Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generator ❑0-5 KW 115-15 KW 'Transformer ❑ 15-50 KW ❑ 50+KW i r - Meter ❑up to 100 amps '- Meter ❑over 100 amps Sub Panel Motors ❑ O7 HP ❑ 1 X - 8 'Ina Solar 119-15 HP 016-15+ Microwave Pole Light r Standing Sections Trash Compactor Z O N 1 N G R E I_ R E M _ E N T S FEES r'..1 I Reinspection Fee ' I $25 I Issue Fee • 1$ 3 I I PUBLIC SERVICES REQUIREMENTS: Zoning Approved By Date Application Approved By ' Date Application Issued By yL'7 / Dat SUMMARY OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT ' PLUMBING $ r� ISSUANCE $ PLAN CHECK $ S i d ENERGY;P.C. $ ELECTRICAL $ GRADING $ _ PLAN CHECK $ MICROFILM $ MECHANICAL $ TOTAL FEE $ " PLAN CHECK $ : y .= CONSTRUCTION AND PLA IN r APPROVALS Permit# Date Inspector POOI tPA 'APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52.'Pool & Equipment Location 2. Soil Pipe-Undrgrnd. D 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, 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 62. Backwash & Receptor -Final 12. Sewer Cap - 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 5. Electrical -Final 15. Rough Electrical -Conduit �6. 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 APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro P2. Ducts, Ventilating 71. Product Piping 0Gas 0Oil -23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank OGas 0Oil 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 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 'r 43. Backflow Irrigation 44..Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison - - 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. - Date - Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. " • CITY OF COSTA MESA - - CONSTBUCTION PERMIT ProjectAddress245 Fischer —Ase Ste A-7 Applicant's Mailing Address 3369 F Miraloma Ayp Anahp m Owner's Name •RI I I I i AM Properti as hone 554-6222 Address 1.5.17 N_ Fairviel,jr.Santa Ana Arch/Eng. n/a License No. Address \ - Contractor's Name. Villa Ht9 h Air fond hone --528-=0 Address (mai Iingg3369 €. M�„Ave. Anghpim A City License No. 26063 i_ W LICENSED CONTRACTOR DECLARATION 1 hereby affirm that I am licensed under Provisions of Charter 9 (commencing I with section 7000) of Division 3 of the Business and Professions Code, and \ my license is In f11 f rce and effect. 342319 License Class - No \Date '2 683 Signature44— ORKERS' COMPENSATION DECLARATION '3. ,ereby affirm that I have a certificate of consent to selftinsure or a certificate WorkersCompensation Insurance, or a certified cony 'thereof (Section `�IJffoo, Lab. C.) Posey No. 576440 Company— Goodman Ins. Certified copy is hereby furnished. Certified copy is filed with the city Bu�IpIn9 Divi Ion. Date 9-26-83 Applicant V11 la Ft9_ R Air Cnnd- EXEMPTION FROM WORKERS'.COMPENSATION DECLARATION (This section need not be completed if the permit Is for one hundred ($100) or ess)• 1 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 California. , Date Signature NOTICE: It, after making this declaration, you should become subject to the Workers' Compensation provisions of the tabor Code, you must forthwith comply with such provisions or this Permit shall be deemed revoked. 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 (Section 3097 Clv. C.) Lender's Name Lender's Address, OWNER BUILDER DECLARATION - I hereby affirm that 1 am exempt from the Contractor's License taw for the following reason (Section. 7031.5 Business and Professional Code: Any city or county which requires a Permit to construct, alter, Improve, demolish or repair anystructure, 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 '.the 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 refrom and the basis for the alleged exemption. Any. violation of Section 31.5 by any applicant for a permit subjects the applicant to a civil EE.e..nalty of not more than five hundred dollars ($500). 'U 1, 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 (Section 7044, Business and Professional Code: The Contractor's License Law doesnot apply to an owner of a property who builds or Improves tnereon, and who does such work himself/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 com- pletion, the owner will have the burden of proving he/she did not build or im- prove for the purpose of sale). I IJ 1, as Owner of the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044, Business and Professions Code: Tho Contractor's License law does not apply t0 an owner of property who builds or Improves thereon, and who contracts for such projects with a con- Hactor(s) license pursuant to the Contractor's License Law). ❑ 1 am exempt under Section B. & P. C. for this reason Date Owner. 1 hereby certify that I have read this application and state that the above Information Is correct. I agree to comply with all city and county ordinances and state laws relating to building conitr c11On, antl hereby authorize repre- sentatives of this city enter u he above-mentioned property for Inspection purposes Signature LI I I Reinspection Fee I $25 CMF 0865-46 rev. 7/83 White - Building: Canary - Applicant; Pink - Accounting: Goldenrod - Assessor Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet, . Water Heater Water Service Issue Fee Hood or Type 1 ❑ Canopy Type 11 ❑ 3tion System ,000BTU 0100,000 Repair/Alteration Issue Fee $ 3 ELECTRICAL FEES S Automatic Washer Transformer ❑ 15-50 KW � Construction Pole Sub. ❑ 56+ KW Cooking Unit - — Meter ❑up to 100 amps - "!� Dishwasher Meter Dover 100 amps a $ 3 - Dryers ❑Gds' ❑Electric Sub Panel PUBLIC SERVICES REQUIREMENTS: Zoning Approved BY Application Approved By Application Issued By ! Fan, Motors ❑&1 HP ❑1 %- 8 ti - _ • F.A.U. Inc.Solar ❑9-15 HP 1116-15+ Fixtures Microwave BTU 'q Device Boxes Pole Light BUILDING PERMIT PLAN CHECK PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK MECHANICAL PLAN CHECK Outlets Range SUMMARY OF FEES SMIP PERMIT ISSUANCE ENERGY P.C. GRADING MICROFILM TOTAL FEE Switches Sign - Garbage Disposal Standing Sections ' Generator 1:105 KW 05-15 KW Trash Compactor $ 3 Reinspection Fee $25 1 Issue Fee $ 3 FEES PUBLIC SERVICES REQUIREMENTS: Zoning Approved BY Application Approved By Application Issued By ! Date Date " Date /D • BTU 'q �' BUILDING PERMIT PLAN CHECK PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK MECHANICAL PLAN CHECK $ $ $ $ $ $ $ $ SUMMARY OF FEES SMIP PERMIT ISSUANCE ENERGY P.C. GRADING MICROFILM TOTAL FEE . $ . $ $ $ $ $ $ 3 - c CONSTRUCTION AND PLANNING APPROVALS Permit # >y� Date - -Inspector - POO 3PA APPROVALS Permit# Date Inspector Temporary Electrical Service or Pole 52. Pool & Equipment Location '2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. - 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. „ 57. APPROVAL TO COVER-GUNITE 7. Footings _ - 58. Electrical Conduit-Undrgrnd. B. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. Structural Floor System 9. - 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 75.� FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21: Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating ,. 71. Product Piping 0Gas 0Oil 23. Gas Pipe -Rough & Test - 72. Underground Flush 24. 'Roof Framing r 73. Undergrnd. Storage Tank 0 Gas 0 Ol. 25: Roof Sheathing 74. Overhead Hydro -- 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical - 27. Frame andPashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL •.' - 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing - HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 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 48. Special Requirements Completed ' 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. CITU OF COSTA MESA-. i I PEU4T,NO TRACT NO. LOT NO. BL ' ! 699 U 111/: 7V.-, i ! I 1 1'n') 'T' CON9T.FUCTION PERMIT d' //4 3 - A- % i ' TYPE OF CONSTRUCTION LJ NEW ADD REPAIR Applicant's Mailing�A�ddr�ess _ ProjectAddress 24'� 7•�eN�e /�� 'ALTTERATION% ❑'CO ❑ NVERSION , DEMOLISH OTHER I/s//yRr �� z i �,r� mss,, 'Owner's Name _'Pne d2ezzom Phone/1 DESCRIPTION OF WORK _ • I 'F - ZONING REGULATIONS �S� ^� Address J %fF�ii��r� P._ -STRUCTURAL: - TV E PERMIT- • IGRADING FOUNDATIONS o- A. P..aW Z / r O •ZONE ~ ' 1 �y7^ Arch/Eng.167/ �Llcense NO.' - TENANT❑ELECTRICAL' ❑PLUMBING 1:1 MECHANICAL _ BUtLDINGi ? Address ��''t c .: .EEE -❑.,OTHER 1 = - + .TO BUILDING ' 'REAR YARD (TO P/U:+ Contractor's Name'��l%1Pi�. �$L/ ' -Phone zZ PROJECT DESCR IPTION• 5 T 1 ,- +OCCUPAN Y P PE Y INE - I , Address(mailing) ' I - I I /1F, I - i CON STRU-TI ON TYP VALUATION$ LEFT SIDE YARD ,. RIGHTSIDEYARD. p - ,r• ZONE 4E GRAOINGCU.YDS. 'ACRES fKG.SPACE'REQ. PROVIDED . C" 1_ - - + ' License No; ,-I _ + LICENSED CONTRACTOR DECLARATION , - ' I Z Remarks: i ( •'G 1 LA% 31 5 ; , 'r STREET WIDTH PARK FEE $ 1.1horebylaffirm that I am licensed under provisions of Chartei 9 (commencing with section 7000) Of Division 3 of the Business and Professions Code, and !�`�� g �` i §'i�9.�Z, I SPECIAL CONDITIONS: my'Ilcense Is In full force andleffecl. ! , ! 1 License Class I i ' ' License No ' r_ 1 1 I ' ' I PLUMBING Date - I Slgnalure ! + - , I Bai Sink i + j Sewer Cap ) ' ELECTRICAL WORKERS' COMPENSATION DECLARATION, :. _yaby affirm that.! have a certificate of. consent to self-Insure,or a certificate --- - ` ' l _-_ •. _ r Backflow Preventer- - - -' -- Sewer Connection. -Solar _ — Automatic Washer _ - __ _ _ Meter ❑over_10b amps t _ - . - _ _ .. ) .- >q �+'-Iorkers' Compensation Insurance,' or a certified, copy thereof (Section ._ „ i Construction Pole Sub Paneh I -� ?bJ, Lab. C.) ' , I Backflow Irrigatioh Collectors • �„ i ) ' Policy No. ' - Company Certified copy Is hereby furnishetl. i Bathtubs ) Solar Piping i Cooking Unit I •Sub Pole Cer fled op s led witn the'cit B Ildin Ivi n I - - Clarifiers Solar Tank e' �r Dishwasher ' - 'Motors ❑0-1 HP ID X-8 Date_{Y, !wPliwntrL ��' _ - EXEMPTION FROM WORKERS' COMPENSATION DECLARATION Dishwasher Swimming POOI wJSpa _ Dryers ❑G5i' OElectric _ Inc`.$olai ❑9 -15 -HP ❑16-15+ -- (Thissection need not be Completed If the permit is for,one hundred ($100) or Fan' I + I Microwave Iecar I cart that hat in the performance an the work for so wh to this permit is Issued I shall, not employ any person in any manner so as to become subject to the Drinking Fountains Urinal_ 1 8 - - - +, �� F.A.U. , ' ! I Pole Light Compensation! Floor Drains ! Water Coseti f • DataNOT 1 Signature If of, ar making this Signature NOTICE: you should become subject to the-- n - -- -Floor-Sinks -- �- - — - -Water-Heater - Fi_xtures_; _ ? _ - 'Ren e - -- 9 Workers'1 Compensation provisions of the labor Code, you .m must. forthwith comply with; such Drovisionsgor' this permit 'shall be 'deemed revoked;. v i i s ,- Gas Service, Outlets Water Service - + w i , i :v� Device Boxes IN I ', I— - Sign! ' CONSTRUCTION I LENDING AGENCY 1 hereby affirm that there Is a;construction Jendin agency for the! erformance • 9 9 Y P _ - I , In terceptOrs' _� 1 ;+ C .- I _ s ` ( , Outlets 1 1 Standing Sections of the work for, which this permit -Is:Issued s(Sectlon -3087' CIV. C.). i ' -s Lender's Name - ' - -Sink' ' '' - - SwRches `. I Trash Compactor , I• - s _ '� ' 1 ' Kitchen I � Lender's Address �' " " ,I OWNER 13UILDER DECLARATION' - ; -- .�„ I '+ ' Lavatories ,� ,� ' - ��, 1 Garbage Disposal I I I hereby affirm .that 1 am exempt Trom that Contractor's.Li cense Law for the _ , •- - Generator, 0-5 KW 05-15 KIN ' 110-5 , I- following reason_(Sectlon?7031.5 Business and Professional Code: Any city or county which requires a permit to construct, alter Improve; demolish'or repair any structure; prior to its issuance„also requires theapplicant for such permit , - r« - Roof Dfalns, +'• r '- ' + ' 1 ' - Transformer E315-50 KW ' , ' .to file a signed statement that he/she Is licensed pursuant to the provisions of + - the Contractor's License Law (Chapter 9 (commencing with Section -7000) Of -or• = i - f ' - ' Reinspection' Fee . r $15. ❑5U + KW!' .Reinspection Fee ! $15' i ,Division3• of the :Business antl' Professions Code that he/she is exempt +-sr^*from and the basis for the alleged exemption: Any violation -of Section ' Showers s c ' ' _ ^ r ¢ Meter ❑up t0 100 amp' I Issue Feel 5�= 5 by -any applicant for, a � permit . subjects the applicant to's civil `�iiy of not more than five hundred dollars ($500). ”. I ' g -Service- _v a 'l Smk' _ 1 I b Issue Fee 1 .� $ 3 'ex -- -- Zpning Approved By - — r •Date - I,'as owner oft the, property or`my employees. with wageslas their sole ( compensation will, do the work, and, the.structure is not Intended or offered 1 i 'r' MECHANICAL l I ,• (r • 1 " i ' ! ' , Application Approved By I 1 i Dat4 + ! 1 f i fpr sale 1[Secflon 7044, Business; and. Professional. Cotle:. The; Contractor's 1 1,1cense Law does not apply 10'an owner of a propertyiwho builds or Improves ! his her _ 1 Boiler, -' 1 '- I I '' Refrigeration System ) ' - I I I Application Issued By 1 - + I I I at4 ' therreonoand%who:d Oes,Such work himself/herself or through Or Own employees, provided that Such improvements are'not Intended or offered for i yy I - ) El ❑100,000BTU -••• - - sale. I/, however, the building or improvement is sold within ona:year, of <om• I pletion, the owner twill have ,the burden of proving he/she did not bulla or Im- P-11 Duct'= Under,Ground ' i 1 . ! , i + ' UMMARV OF FEES t i I 1 r ve for the purpose of sale). ! ) .� 1 1 1 1 V , Duct -Structural + System Repair%Alteration 1 4 BUILDING PERMIT $ SNIP 1 $ 1pI I, az owner of the D}operty, am exclusively contract] nglwith! llcensetl con- tors to construct the project. (Section 7044,.Biiziness.antl Professions Code: Duct ;Ventilating—�„ ._ ,�- 2 , _!' _ !; !PLAN CHECK! $ i I , I PERMIT ! ' I W� .tr - _ The Contractor's License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such projects with a con. , _..!. i Exhaust System ❑ Multiple ❑1 " I i, "PLUMBING I I $l ISSUANCE I $ ' ' tractor(s) license pursuant to the Contractor's License Law). 1 ' . ' ❑ I am oisempt under Section + ' B. & P. C. for this reason ! - 1 'I Fiiepl/Fact. Bit. ICBO dk ! e I 9 PLAN CHECK $ , GRADING ' + s ' $ I 1 i i l + I ,., 'ELECTRICAL t $ Date 1 owner, ' ' + - - - Heating,System & Ducting + ! i I PLAN CHECK; $' I -MICROFILM $ , - fherebyy certify -That I have read this application and state that the above- ; I -- ❑0-100,000 BTU ❑100,000 BT - - - -� -- _' _ _ + i I I ' TOTAL,FEE $ I - i n formatl on is correct. agree to comply with all city and county ordinances and state laws relating to building construction, land hereby authorize repro- 1 -, , I Hood ' .= 'r , MECHANICAL' $ - I , , sentatives Rhls •cit to enter on he above-mentioned Property for p( Yi qp t Y / or TypeI 1 Reinspection Feel Cane [[33: t $1 PLAN CHECK' $ + LESS Inspection puiQose . _l'U /1 /1 In. 7 r�%(.i3 i T e II i , ' ADVANCED PC 1 I $ 1 - Signature Lf1) r�d• IAa.IJ Date 1 Registers Iswe Fee $ 1 ! /--' 9 • ; Drivers' License or,55 qp ,- I i t + i } FINAL FEE $ i ---"""---White -Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor f - . =U: .I:ONSTRUCTIONAND:PL'A IN - A POOL.P -�A .. =g.g�., .APPROVALS ;. Permit:#� ,';. .Jate . 'Inspector APPROVALS Permr.# Date Inspector Temporary�Electrical Service or Pole�.` I r•� - 52: Pool &•Equipment Location - . 2? 'Soil Pipe'Undrgrnd:- - I5 `-' ' f `• .. 53. Steel Reinforcement :, - - 3: ElectricaLConduit:utiIity-Undrgrnd. 54: Forma, Electrical Conduit -Undrgrnd':'- - 55.. Electrical Bonding''=� 5. Steel'Reinforcement ; .. I I = _ - 56. Rough Plumbing & Pressure Test 6. (Electrical UFER:Grnd! - • - = ? 57. APPROVAL TO_COVER-GUNITE' n 7. Fdotings_„��0 • i �' ° ' i, `58. -Electrical Conduit-Undrar:;d. - r a , •':�.^i 8. Foundation' .' I =" _ '. -59. Gas Pipe, O Undrgrnd:; Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines,.P-Trap, ❑ Undrgrnd. 10. Structural Floor•System 61. APPROVAL TO DECK - 11. Property Sewer Line &'House Connection = -`62. Backwash & Receptor -Final •- __ 12. Sewer Cap' I ,� i ' 1 `: 63. Heater & Vent -Final .,tea I 13. Roof�Drains ' ,- • r _ 64. Plumbing:System : Final 14.' Rough Plumbing- - 65. Electrical -Final 15. Rough-Electrical-Conduit`f :. -- --� - --66. Solar System -Final- - -- - - - - .� E.' Rough;Electric Wiring 67. -Fencirig &Access Approval 17. Rough,Wiring•Sign, �. , '� ; i 68., APPROVED FOR,PLASTERING 18:,Rough,Electri6i-TBar-Ceilin4 69. POOL/SPA SYSTEMS FINAL - .19. Rough Heating & Air Conditioning . ' FIRE DEPT. REQUIREMENT- ' . I APPROVALS- Permit# 20:1Rough Factory Fireplace ` ' , 21. Ducts, in Structure i ; I 70. Underground Hydro 22: Ducts, Ventilating' 71. Product Piping 11 Gas OOil 23. Gas. Pipe -Rough &Test _ I 72. Underground Flush 24. Roof Framing, i�}•' " l',. '.. u 73. Undergrnd. Storage Tank 0Gas ❑Oil 25. Roof Sheathing I r , - ,: ; ' 74. Overhead Hydro 26. T:Bar Ceiling (Structural)i & Monocoaf' ; ��=f3.,g ,� 75. Dry Chemical - 27.Fra m.e and Flashing -*""L -V l jl Z $3 i 76. Dry Standpipe . 28. (Lathing & Siding( �• - �; 1 . I 77: FIXED SYSTEM FINAL 29.'Insu6tiorl I 78. FIRE PREV. FINAL '30:'Drywall Nailing 1>' + - ', s3 Notes: 7 3 31. Plaster Brown Coat j i pst 32.' Electrical Power Meter, -Final t� p t IC f1 + )CPP p'3 .S' G p f 33. .Final Electric ' D Tore TrnDi. A.P 34. Final Heating &' Air Conditioning I - aA > 35. Final Gas Pipe -Test _ r r _ n 36. Hood "or,CanopY 37. Final Factory Fireplace - , ^•. ; , - I - _ '- 38. Final Plumbing( ' JI' i•' + 39. Water Service -Final + , - - 40. Gas Service -Final, 41. Solar Doniestic'Final 42. Backflow Preventer 43. Backflow Irrigation �i +_ ' I •i ' t _ 44. Landscape lirigation Systems - 45. Sound -Attenuation -: 46. Handicap Regulations' 47. FINAL STRUCTURE&BUILDING , 48. Special Requirements Completed I 49. Electric Release to Edison I •._ , . -.t _-_ , _ - _ - �' 50. Gas Release" Southern California Gas Co 51. CERTIFICATE:OF OCCUPANCY _ 'n - ` I _• No. /F3FI 293 Date Z (� • 0 i Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA CONSTRUCTION PERMIT Project Address ' Applicant's Mailing Address �y Owner's NameIRLILL4 Phone Address J-5177 14 • F20,NL V "Cr— No. Address Contractor's Nam �f ��A�,-�as �&� "� Phoneme 01 Address (mailing) S� / �rAt"WL In— SCJ'r 'City License No. - LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class I License No. Date Signature WORKERS' COMPENSATION DECLARATION - hereby affirm that I have a certificate of consent to self -Insure or a certificate if Workers' Compensation Insurance, or -a certified) copy thereof (Section - 3800, Lab. C.) Policy No. Company El Certified copy is hereby furnished. A /� .. CeyifieGcoP f�d with 1.Z h the cit ding eOn 7j :.a.?- _( EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit is for one hundred ($100) or less) I 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 as to become subject to the Workers' Compensation laws of California. Date Signature NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply ,with such provisions or this permit shall be deemed revoked. 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 (Section 3097 Civ. C.) Lender's, Name Lender's Address OWNER BUILDER DECLARATION ' I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031-.5 Business and Professional 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/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9(commencing with Section 7000) of io .Divisn 3 of the Business and Professions Code) or that he/she is exempt "'�,fiherefrom 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 nnalty of not more than five hundred collars ($500). ' I, as Of Of the property or my employees with wages as their sole mpensa[nm, will do the work, and the structure ISnot intended or offered for sale (Section 7044, Business and Professional Cade: The Contractor's 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 employees, provided that such improvements are not intended or offered for 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- r ve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con- ra tors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who 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 proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Sectlon _ B. & P. C. for this reason Date so"A 1 . PEI-- Owner I hereby certify that I have reap Information is correct. I agree to and state laws relating to buildir sentatives o this city to eqiioq above PERMIT NO. A`— /3 7Z-r� TRACT NO. 11,263 LOT NO. UNIT NO. 2906 6/26/64 24.42 TI TYPE OF CONSTRUCTION NEW LJ ADO LJ ALTERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A,P-'*, 2--7 — O 3 Zone DESCR IPTION OF WOR K/USE OF BLDG. VA" FW S Main Building: Accessory Building: TYPE OF PERMIT GRADING FOUNDATION ST RUCTU RAC ITENANT ELECTRICAL ❑ PLUMBING El MECHANICAL nQ ❑ ' OTHER d� Il �i� J��,a�(,a�� 7IDI PROJECT DESCRIPTION SO. T OCCUPANC CONSTRUCTION TYPE_- VALUATION ${/ E T Front - - r Z O B Rear - _ ( - N C Right -1" / - N K' $ Left / G R Ping. Ref. # I Parking Req./Provided, E D ZONE GRADING CU.YDS. ACRES Remarks: - - Planning Notes: e M Dryers ❑Gas ❑Electric T Sink Preventer Irrigation Drinking Fountains Floor Drains Floor Sinks Gas Service ' Outlets Interceptors - Kitchen Sink Lavatories P—Tap Roof.Drams Reinspection -Fee $15 Boiler Duct- Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Bit. ICBO # Heating System & Ducting [1&100,000 BTU ❑ 100,000 BTI Inspection p r uses ,s % ' / f' / -Q Signature �./ s�a�y D to L�Z� V Drivers' License or 55 _ Reinspection Fee CMF 0865-46, rev. 4/84 White - - Accounting; Goldenrod - Assessor $15 PLUMBING Showers Service Sink -- Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Issue Fee iANICAL Hood or Type I ❑ Canopy Type 11 ❑ Refrigeration System _ ❑0100,000 BTU 0100,000 E System Repair/Alteration Issue Fee FEES ELECTRICAL FEES Automatic Washer " Construction Pole Sub. - 1 Transformer ❑-15-50 KW- 0 56 + KW - - Cooking Unit Meter ❑up to 100 amps. _ Dishwasher Meter ❑over 100 amus Dryers ❑Gas ❑Electric Sub'Panel Fan Mat ors ❑01 HP❑1%-8 F.A.U. Inc Solar 09-15 HP'❑16-15+ Fixtures - - - - -- Microwave - - - Device Boxes Pole Light Outlets Range - Switches Sign Garbage Disposal Standing Sections Generator ❑0.5 KW 1:15-15 KW Trash Compactor $ 3 Reinspection Fee $15 Issue Fee $ 3 FEES DEVELOPMENT SERVICES RE E Zoning Approved By �' Building Approved By Application Issued By NT Date Date Dat J BUILDING PERMIT PLAN CHECK PLUMBING PLAN CHECK 25% ELECTRICAL PLAN CHECK 50% MECHANICAL PLAN CHECK 25% SU'M'M�R^V $ J�,L $ T2 $ $ $ $ $ $ OF FEES SMIP $ PERMIT ISSUANCE $ ENERGY P.C. $ GRADING $ MICROFILM $ TOTAL FEE • $ �•� /7 2 — $ 3 �. CONSTRUCTION AND PLANNING; Date, APPROVALS- Permit# Inspector POO �.� SPA •�; APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole . 52: Pool & Equipment Location 2.r Soil Pi0e-Unc1Fgrnd. 53. Steel Reinforcement 3-'Ihect?ical Conduit-Utility-Undrgrnd. 54. Forms 4 Erlectr-ical,Cgndui{-UndMrnd. 55. Electrical Bonding 5.; Stez7 Reinforcement - l� f3 56. Rough Plumbing & Pressure Test - ;6.( Elect`ical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE c 7. -.Footings.• •- - 7//�'�-j7il 58. Electrical Conduit-Undrgrnd. , 8. Fbundatjo mr - ! 59. Gas Pipe, 0 Undrgrnd., Test f I- '9: Water, Pipe-Undrgrnd-. 1+ 60. Backwash Lines, P -Trap, 0 Undrgrnd. .. 10.'Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line'& House Connection �r i `+ 62. Backwash & Receptor -Final ' 12. Sewer,_;Cap - 63. Heater & Vent -Final 13. Roof:Qrains;64. Plumbing System - Final 14. Rough'Plumbing•: n 65. Electrical -Final - 15. Rougff Electrical, -Conduit -� 66. Solar System=Final 76. Rough Electric Wiring ' 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19, Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20:; Rough Factory Fyreplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas ❑ Oil 23. Gas Pipe -Rough & Test I 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 29. Insulation - 78. FIRE PREY. FINAL 30:�Drywall, Nailing �� ' HEALTH DEPT. REQUIREMENT 31'.*" PlastenBrown Coat 79. FINAL INSPECTION 37. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test - 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final 40. Gas Service -Final ' 41. Solar Domestic -Final - 42. Backflow Preventer - 43. Backflow Irrigation44. Landscape Irrigation System 45. Sound Attenuation ' 46. Handicap Regulations 47. FINAL STRUCTURE& BUILDING 48. Special Requirements Completed, 49. Electric Release to Edison - -' 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date City of Costa Mesa Development Services Department Building Safety Division CERTIFICATE OF OCCUPANCY No. 000638 P. O. Box 1200 Costa Mesa, California The Building located at 245 FISCHER UNIT #A-8 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group B-2 Occupancy. Use of Building OFFICE Legal Description 427-033-09 (See reverse side for Metes and Bounds) Building Permit No 0-11717 Electrical Permit No. (7-11717 Plumbing Permit No. (111717 Mechanical Permit No. r2-11717,M-1')^ur Number of apartments /�- lel, guest rroo�mss ISSUED TO: Building Official �)Of ft r r%a21�— PULLLAM PROPEi2TIFS y 1317 N. FADW19q AVMUE, COSTA MESA, CA. Date / oav'c-, This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. CMF 1015-46 rev. 1/83 White - Owner; Canary - Numerical File; Pink - Bldg. Permit File • r Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 'CITY Of CQSTA M CPST UCTIO PEM�I•i T Sr �ProjU&Address CP Ia �••YA O1— � Appl1ciin8s MailingdrIT( If , Owner's Nbme L_ P ne G Address Arch/Eng. License No. Address- M�— Contractor's Nam]tjse hone Address (mailing) City License_ No. ' LICENSED CONTRACTOR D CLA ATI 1 hereby affirm that I am licensed under provisions of Charter 9 (commencing with section '7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class License No. Date Signature WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure or a certificate of -Workers' -Compensation Ins rance, or a certified copy thereof (Section 3800, La D. C. _l% _ s Policy No. Com any �(� Certified copy is here furnishe43—S Cert ifs tl 's f D Ap the cin. Date_ _ s M th the n 469 co EXEMPTION FROM WORKERS' C TI (This section need not be completed if he permit s t r hundmed $ ) or certify I certify that in the performance of the work fo w ch this perm;[ is Issued, I shall not employ any person f Cali man n¢r 50 to beGOm¢ subject to the. Workers' Compensation Laws a California. ia. Date Signature NOTICE: after making this declaration, you become subject to the C Workers' Compensation provisions of the Laborr Cod Cotle, you must forthwith comply with such provisions or this permit Shall be deemed revoked. CONSTRUCTION LENDING AGENCY 1 hereby affirm that [Here i5 a construction lendingIsue agency i for the 97 Civ. C.) of the work for which this permit is Issued (Section, 3097 Civ. C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also requiresthe applicant for such permit to file a signed -Statement that he/she Is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of 70ivision 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 enally of not more than five hundred dollars ($500). I, as' owner of the property or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement Is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or im- ve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does t apply to an owner o property who builtls or improves thereon, and wh contracts for such pro' c s with a con on license pursuant to the C tractor's icense Ww) I m aware that proof o 1 their Worker's Compensa r n insuraflle shoffltl b -to me. and statelaw elating sentatives o h's ciq inspection r s s. Signature Drivers' ise r SS CMF 0865-46, rev. 4/84 tion and/t -that the above all city d county ordinances TYPE OF CONSTRUCTION LJ NEW LJ ADD LJ ALTERATION L REPAIR SUMMAR�eYaon ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.S..# DESCRIPTION OF WORK/USE OF BLDG. S Main Building: TYPE OF PERMIT GRADING ❑ FOUNDATION 0 STRUCTURAL - E T Front ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL Drinking Fountains Solar Tank 11 OTHER A Rear PROJECT DESCRIPTION SQ.FT. OCCUPANCY C KLeft Right CON STRVCTION TV PE VALUATION$ - S _ ZONE GRADING CU. YDS. ACRES Ping. Ref. # Remarks: /�_ — _. Planning Notes: Bar Sink Showers SUMMAR�eYaon _ Backflow Preventer Service Sink Backflow Irrigation Sewer Cap $ _JL< Bathtubs Sewer Connection $ Clarifiers Solar Collectors $ Dishwasher Solar Piping Drinking Fountains Solar Tank $ Floor Drains Swimming Pool w/Spa $ Floor Sinks Urinal $ Gas Service -Outlets Water Closet $ Interceptors - Water Heater $ Kitchen Sink ! Water Service _ Lavatories $ P—Trep $ Roof Drains - I• I Reinspection Fee I $15 I I Issue Fee ' I $ 3 I I Boiler Hood or. Type I ❑ - Duct - Under Ground Canopy Type I El Duct - Structural Refrigeration System Duct - Ventilating 130-100,000 BTU ❑ 100,000 BTU Exhaust System ❑ Multiple ❑ System Repair/Alteration Firepl/Fact. Bit. ICBO # Heating System & Ducting ❑ 0.1 00,000 BTU ❑ 100,000 BT Reinspection Fee I $15 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Issue Fee $ 3 Automatic Washer Construction Pole Sub. Cooking Unit Dryers LJGas LJEI� Fan F.A.U. Fixtures - Device Boxes Outlets Switches Garbage Disposal Generator ❑0-5 KW 3186 6/29/84 Zone Accessory Building: ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+KW Meter ❑up to 100 amps Meter Dover 100 amps Sub Panel Motors 00-1 HP ❑ 1 h - 8 Inc.Solar 09-15 HP ❑16-15+ Microwave Pole Light Range VS tanding Sections . 5 KW I Trash Compactor Reinspection Fee I $15 I Issue Fee DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Building Approved By Application Issued Bv�%�� 15.017 TI FEES $ 3 Z O N I N G R E 0 M T S. SUMMAR�eYaon F FEES ING PERMIT $ _JL< Q SMIP $ PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK 25% $ ENERGY P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK 50% $ MICROFILM $ MECHANICAL $ TOTAL FEE $ /SQ PLAN CHECK 25% $ CONSTRUCTION AND'PLANNING VrIOVALS Permit Date Inspector POOL a SPA _ 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 1 - ` 56. Rough Plumbing & Pressure Test 6• Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE , 7'. Footings _ 7 �' Bi 58. Electrical Conduit-Undrgrnd. 8. Foundation - 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-llndrgrnd: - 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 $t'��/ L 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 �jl.� �Q FIRE DEPT. REQUIREMENT APPROVALS. Permit- 20. Rough Factory Fireplace 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 CGas 00il 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 Notes.*cJuQTWT- D 34. Final Heating & Air Conditioning I O Pic 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing eJ Z04 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 % Ile- 48. Special Requirements Completed 49. Electric Release to Edison - 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date -1 -1 -IIA ` % Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA CONSTRUCTION PERMIT Project Address 4413 Applicant's Mailer/g�Ad�dreeu,�., r. (JIU of 7u. [L 7r[/Irf7I) Owner's Name �I1/1�1I.ILIM �P.htonne� Address /Jl L --A ralryl ) — lyAM Arch/Eng. '0 License No. Address Contractor's Nam / hone+.1¢C2aMdl Address (mailing) &EU /k, i &Mi GhPm y City License No. �,0 k-3 LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is In f f ce and effect. License I ss - ranee o. Date Signature WORK R5 COMPENSATION DECLARATION r hereby affirm that I have a certificate of consent to self -in re or a cerli/irate I Workers' Compensation Insurance, or a certified copy thereof (Section ,800, Lab. C) qq/ 1/I' Policy No. �/Xiit/O Company Finan Certified copy is hereby furnished. Cer ' i tl 1a filed with the city 71 'ng Ion. Date Applicant tv_e�. EXEMPTION FROM WORKERS' COMPENSATIO DECLA A ION (This section need not be completed if the permit is for one hundred ($100) or less). 1 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 lire Workers' Compen Sa tion Laws of California. Date Signature NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the tabor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. 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 (Section 3097 Civ. C.) Lender's Nam. Lender's Address OWNER BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/she Is licensed pursuant to the Provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of nivision 3 of the Business and Professions Code) or that he/she Is exempt •refrom and the basis for the alleged exam pilon. Any (ion of Section 11.5 by any applicant for a permit subjects the applicant to a civil natty of not more than five huntlretl del Jars ($500). ❑ I, as OW her 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 (Section 7044, Business and Professional Code: The Contractor's 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 employees, provided that such Improvements are not Intended or offered for Sale. If, however, the building or Improvement IS sold within one year of com- pletion, the ownerwill have the burden of proving he/she did not build or im- rova for the purpose of Sale). I, as owner of the property, am exclusively contracting with licensed con- IractorSto construct the Droll act (Section 7044, Business antl Prof essl ons Cod 0: The Contractor's License law does not apply to an owner of property who builds or Improves thereon, and who contracts for such projects with a con- tractor(s) license pursuant t0 the Contractor's License Law). ❑ I am exempt under Section B. & P. C. for this reason Date Signature _J.JCZ I '^\ Drivers' License or SS `CMF 0865-46 rev. 7/83 Owner — I have read this I agree to comp) to building cons to enter upon a that above I p Sink Preventer Irrigation Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets Interceptors Kitchen Sink Lavatories P -Trap Roof Drains Reinspection Fee 1 $25 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. ICBO # sting System & Ducting 0. 100,000 BTU 0100,000 BTI Reinspection Fee 1 $25 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod -Assessor FEES Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinalt Water Closet Water Heater Water Service Issue Fee I S 3 Hood or Type ❑ Canopy Type 11 ❑ iefrigeration System 210.100,000 BTU 0100,000BTU System Repair/Alteration Issue Fee I $ 3 A.P. qW S Main Building: E T Front A Rear C Right K Left Ping. Ref. # Use of Building: Planning Notes: Washer Cooking Unit Dishwasher Dryers ❑Gas ❑Electric Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generator 1:10-5 KW ❑5-1 7731 3/30/84 Zone Accessory Park.Fees $ ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+ KW Meter ❑up to 100 amps Meter ❑over 100amps Sub Panel Motors ❑ 0.1 HP (7111%-8 Inc. Solar 09-15 HP 016-15+ 'Microwave Pole Light Standing Sections 5 KW I I Trash Compactor 63.00 TL Z O N 1 N G R E Q U R E M N T Reinspection Fee $25 1 Issue Fee $ 3 PUBLIC SERVICES REQUIREMENTS: - Zoning Approved By Date Application Approved By _ Dates_ SUMMARY OF FEES BUILDING PERMIT TYPE OF CONSTRUCTION LJ NEW LJ ADD LJ ALTERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER PLAN CHECK DESCRIPTION OF WORK PERMIT TYPE OF PERMIT 11 GRADING 0 FOUNDATION 11 STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ OTHER $ PROJECT DESCRIPTION SQ. FT. OCCUPANCY CONSTRUCTION TYPE VALUATION $ ZONE GRADING CU.YDS. ACRES Remarks: $ above I p Sink Preventer Irrigation Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets Interceptors Kitchen Sink Lavatories P -Trap Roof Drains Reinspection Fee 1 $25 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. ICBO # sting System & Ducting 0. 100,000 BTU 0100,000 BTI Reinspection Fee 1 $25 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod -Assessor FEES Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinalt Water Closet Water Heater Water Service Issue Fee I S 3 Hood or Type ❑ Canopy Type 11 ❑ iefrigeration System 210.100,000 BTU 0100,000BTU System Repair/Alteration Issue Fee I $ 3 A.P. qW S Main Building: E T Front A Rear C Right K Left Ping. Ref. # Use of Building: Planning Notes: Washer Cooking Unit Dishwasher Dryers ❑Gas ❑Electric Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generator 1:10-5 KW ❑5-1 7731 3/30/84 Zone Accessory Park.Fees $ ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+ KW Meter ❑up to 100 amps Meter ❑over 100amps Sub Panel Motors ❑ 0.1 HP (7111%-8 Inc. Solar 09-15 HP 016-15+ 'Microwave Pole Light Standing Sections 5 KW I I Trash Compactor 63.00 TL Z O N 1 N G R E Q U R E M N T Reinspection Fee $25 1 Issue Fee $ 3 PUBLIC SERVICES REQUIREMENTS: - Zoning Approved By Date Application Approved By _ Dates_ SUMMARY OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK $ ENERGY P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK $ MICROFILM $ MECHANICAL $ TOTAL FEE $ 103.E PLAN CHECK $ CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector I POOL >A . APPROVALS Permit # Date Inspector 1', Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Eiectricat Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. B. 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 APPROVALS Permit # 20. ,Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0Gas 0Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank OGas 0Oil 25. Roof Sheathing 74. Overhead Hydro 25, T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe "18. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning y() 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final 40. Gas Service -Final 41. Solar 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 No. Date Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. -13T"051F COSTA MESA COKISTRWCTIQN PERMIT Project Address Applicant's Mailing �A�ddress-, t/ Owners Name / - �+B!�f SPhone 55 Z' Address�'�%��}J, If2h'R0(�:r AwL!g Arch/Eng. r Sct/l.cr/�!4. License No. G 13%31 Address Contractor's Nam ,,p Phone Address Imailing) Z:rZ-7 (.ty License No. LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class License No. Date Signature WORKERS' COMPENSATION DECLARATION lereby affirm that 1 have a certificate of consent to self -Insure or a certificate Workers' Compensation Insurance, or a certifiedcopy th1er1eof (Section _ Policy Lab Policy No.. C,1 6 corn q - Certified copy,is hereby furnished Cer{iifi p le with the city Itlingcion�(//'� Da a sem, e.. Appticanty. �J�i�++^ EXEMPTION FROM WORKERS' COMPENSATION,DECLARA OT N (This section need not be completed if the permit islfor One hundred ($100) or less). 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 to become subject to the Workers' Compensation Laws of California. Date Signature NOTICE: If,after making this declaration, you should become subject to the Workers'. Compensation provisions of the Labor Code, you must forthwith comply with such provisions' or this permit shall be deemed revoked. 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 (Section 30 Civ. C.) Lender's Name _ - Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the Tom and the basis for the alleged exemption. Any violation of Section 5 by any applicant for a permit subjects the applicant to a civil y of not more than five hundred dollars ($500). 1 . as owner of the property or my employees with wages as their sole msation, will do the work, and the structure is not intended or offered le (Section 7044, Business and Professional Code: The Contractor's a Law does not apply to an owner of a property who builds or Improves n, and who does such work himself/herself or through his or her own yeas, provided that such Improvements are not Intended or offered for I, however, the building or Improvement is sold within one year of com. T, the owner will have the burden Of proving he/she did not build or im- for the purpose of sale). is owner of the Drooertv. am exclusively contracting with licensed con. DUIUS or Improves thereon, ane who contracts TOT such protects won a can. tractor(s) license pursuant to the Contractor's License Law). ❑ 1 am exempt under Section B. & Q.•C. for tplt reiiis.yn Date e... _� " , - n s Owner wa. `^ —�� I hereby certify that I have -read this application and state that the above Signature JUAAAA&W Drivers' License or SS CMF 0865-46 rev. 12/83 White- Building; Canary 35 TYPE OF CONSTRUCTION_ LI NEW LI ADD LICA LTERATION U REPAIR El CONVERSION D CONVERSION EMOLISH: ❑ OTHER ` A.P.0 47-1 DESCRIPTION OF WORK S Main Building: T1[PR'OF PERMIT GRADING FOUNDATION STRUCTURAL T !,On ENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B ear❑ OTHER A PROJECT DESCRIPTION S OCCUPANCY i C ight CONSTRI CT�N TYPE VALUATION $ 0 g Left ZONE /�fj' GRADING CU. YDS. ACRES Ping. Ref. 0 Remarks: � f4rs Z 7 q2 2 5 Parking Req./Provii J-0-0 4/ivpUse oB �W f uilding: PLUMBING FEES Planning Nates: Sink Preventer Irrigation Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets Interceptors Kitchen Sink Lavatories Drains Reinspection Fee 1 $25 Boiler Duct- Under Ground Duct - Structural Duct - Ventilating Exhaust System Multiple ❑ Firepl/Fact. Bit. ICBO # Heating System & D cling 00.100,000 BTU 100,000 BT Reinspection Fee ' $25 Pink - Accounting; Goldenrod - Assessor ., Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank i Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Issue Fee Hood or Type ❑ Canopy Type 11 ❑ Refrigeration System 00.100,000 BTU A00, System Repair/Alteration Issue Fee Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Electric .A.U. Device Boxes 253" 6/20/94 8 I Zone h Accessory Building: $ ELECTRICAL Transformer ❑ 15-56 KW ❑50+KW 7 - Meter 0 u to 100 amps , Meter over 100 amps Sub Panel Motors 00.1 HP ❑ 1'h - 8 Inc. Solar' ❑9-15 HP ❑ 16-15+ Microwave Pole Light. Range 4 390,6:, TI Z O N I. N G R E Q U 1 Sign 1 14 14L Garbage Disposal Standing Sections 'Generator 00.5 KW ❑5-15 KW Trash Compactor $ 3 Reinspection Fee fillillif $25 Issue Fee $ 3 FEES PUBLIC SERVICES REQUIREMENTS: Zoning Approved By Building Approved By Application Issued By '" - Date_LD__�._T Data Dat --2-1 za BUILDING PERMIT PLAN CHECK PLUMBING PLAN CHECK 25% ELECTRICAL PLAN CHECK 50% MECHANICAL l PLAN CHECK 25% c $ $ $ $ $ $ $ $ SUMMARY OF FEES 26A SMIP $ PERMIT ISSUANCE $ �'S(7 ENERGY P.C. $ GZ2 GRADING $ Z�I`f�y��.!�7�/^5� MICROFILM $ TOTAL FEE $ �- %S 3.1� _551014117 3 411201 $ 3 �;, ;� CONSTRUCTION AND PijANNING - , Date APPROVALS Permit - Inspector POOL SPA APPROVALS Permit# Date Inspector • 1. Temporary Electrical Service or Pole 52-.' Pool & Equipment Location - 2} Soil Pipe-Undrgrnd.' 25 53.: Steel Reinforcement `- . 3, Electrical Conduit Utility-Undrgrnd.' 54:. Forms : - . • .1 -, 4. Electrical'Conduit-Und"rgrnd. 55. Electrical Bonding 5. Steel Reinforcement' "- 7 ,� ` '56. Rough Plumbing & Pressure Test - 6. Electrical LIFER Gr.nd., 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical'Conduit-Undrgrnd.' ' 8� Foundation „ -: 59. Gas Pipe;^0 Undrgrnd., Test 9. Water Pipe.undrgrnd. 1,14ycil. %tv . 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. Structural Floor System r 61. APPROVAL TO DECK 11. Property Sewer Line 6, House Connection 62. Backwash & Receptor -Final. '• 12. Sewer Cap - 63. Heater & Vent -Final "-•i '. 13. Roof Drains _ 64. Plumbing System - Final' -- 14. Rough Plumbing SCl Z� , L�� 65. Electrical -Final ` i 15. Rough Electrical --Conduit- .'j - 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 -APPROVALS Permit ----------- 20. Rough Factory Fireplace 21. Ducts,.in Structure 21. 70. Underground Hydro 22.:Ducts, Ventilating ., - 71. Product Piping 0Gas OOil 23.. Gas Pipe -Rough & Test - - - 7T Underground Flush - 24.' Roof Framing' l _ 73. Undergrnd. Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26:,T -Bar Ceiling (Structural) & Monocoat r 75. Dry Chemical ' -27._Frameand Flashing / �a/! 76.DrjyStandpipe 28. Lathing & Siding - ' 77. FIXED SYSTEM FINAL - 29. Insulation 78. FIRE PREY. 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 Ol Nofas: F' 34. Final Heating & Air Conditioning'. �. 17A 0& 054 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory,Firep(ace - - 38. Final Plumbing i; _, cf1w U66 39. Water.Service,Final ` 40. Gas Service -Final 41. Solar.Domestic-Final 42. Backflow Preventers-„ 43. Backflow Irrigation i i ') I '• 44. Landscape Irrigation System - ;•j�-% 45. Sound Attenuation _ - 46. HandicapRegulations 47. FINAL STRUCTURE & BUILDING; 48. Special Requirements Completed 49. Electric Release to Edisbn + ^. • - - - - i '' - . 50. Gas Release to Southern California Gas Co " 51. CERTIFICATE -OF OCCUPANCY r No. - {/'�FRbate'. v D • C -- - Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. -ITY OF COSTA MESA CONSTRUCTION) PERMIT Project Address Z45 f'1SCtiER AAF Si. rra l% - Applicant's lvl li Address --'ME Owner's Name �E hone Address Arch/Eng. License No. Address Contractor's Name /s Re X'%Tr 2z�Z_ /e.14L Phone A 't,7 .<i -i Address (Mailing) SreWlgfle,4- City License No. LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class C'! I� nsa No.- • 7-— Date� i S'9 t 7LLien. WORKERS' OMPENSATION DECLARATION ',hereby affirm that I have a certificate of consent to self -Insure or a certificate ' Workers' Compensation Insurance, Or a certified copy thereof (Section 800, Lab. CJ Policy No. 4-0 Cs 14 -Gs ILI Company H Certified copy is hereby furnished. Certified co,�y is filed with the city Bui n Dlvision,- Date y' =_<'39 Applicant i EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (Thissection need not be completed If the permit is for One hundred ($100) or less). 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 as t0 become subject to the Workers' Compensation Laws of California. Date Signature NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with Such provisions or this permit Shall be deemed revoked. CONSTRUCTION LENDING AGENCY 1 hereby affirm that there IS a construction lending agency for the performance of the work for. which this permit is Issued (Section 3097 Civ. C.) Lender's Name -- Lender's Address ' OWNER BUILDER DECLARATION - I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professlonal 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/she is licensed pursuant t0 the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of ''rivislon 3 of the Business and Professions Code) or that he/she is exempt refrom and the basis for the alleged exemption. Any violation of Section 11.5 by any applicant for a permit Subjects the applicant to a civil 2.rally of not more than five hundred dollars ($500). 1, aS owner of the property or my employees with wages as their sole m ponsa tion, will do the work, and the structure Is not Intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's License Law does not apply to an owner Of a property who builds or Improves thereon, and who does such work himself/hInSell or through his or her own employees, provided that such Improvements are not intended or offered for sale. If, however, the building Or Improvement I$ sold within one year of Com- pletion, the owner will have the burden Of proving he/she did not build or im- rgve for the purpose of Sale). I, as owner of the property, am exclusively Contracting with licensed con- 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 builds or Improves thereon, and who contracts for such projects with a con- tractor(s1 license pursuant to the Contractor's License Law). I am aware that proof off their Worker's Compensation Insurance Should be provided to me. ❑ 1 am exempt under Section B. & P. C. for this reason Date Owner hereby certify that I have read this application and State that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize repre- sentatives of th' city to enter upon the above-mentioned property for inspection purpa Signature �' ri- Date 7 Z3 -d Q TYPE OF CONSTRUCTION LJ NEW LJ ADD LJ ALTERATION LJ REPAIR - ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P. 916 _ Zoned ~ DESCRIPTION OF WORK/USE OF BLDG. S Main Building: Accessory Building: E TYPE OF PERMIT GRADING FOUNDATION 0 STRUCTURAL T Front ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear ❑ OTHER PROJECT DESCRIPTION SO. FT. OCCUPANCY C Right K' CONSTRUCTION TYPE VALUATION 5 SCZ S Left ZONE GRADING CU.YDS. ACRES Ping, Ref. 9i' Parking Req./Provided Remarks: _r /% /. i ZZ5C Planninq Notes: Bar Sink Backflow Preventer Backflow Irrigation Bathtubs Clarifiers Dishwasher Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets rl ler cep u.n> Kitchen Sink Lavatories '-Trap Roof Drains. Reinspection Fee $15 PLUMBING Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Issue Fee FEES $ 3 FEES Drivers' License or SS !# - ( I I Reinspection Fee CMF 0865-46, rev. 4/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor $15 Issue Fee $ 3 Automatic Washer - Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Elec Fan F.A.U. Device Boxes Outlets Switches Garbage Disposal Generator 00.5 KW ELECTRICAL -Transformer ❑ 15-50 KW ❑ 50+KW Meter ❑up to 100 amps Meter Clover 100 amps Sub Panel Motors 00-1 HIP ❑1%-8 Inc. Solar ❑9-15 HP 016-15+ Microwave - Pole Light Range Standing Sections 5 KW Trash Compactor ' Reinspection Fee I $15 I I Issue Fee DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Building Approved By FEES $ 3 Z O N I N G R E 0 M T S. PLAN CHECK 25%, $ SUMMARY OF FEES BUILDING PERMIT $ _5-E.-_57 SMIP _ $ - v% PLAN CHECK $ -3 E. 77 PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK 25% $ ENERGY P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK 50% $ MICROFILM $ MECHANICAL $ TOTALFEE $ 93.ZL PLAN CHECK 25%, $ CONSTRUCTION AND PLANNING Date APPROVALS Permit # Inspector POO iPA 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 APPROVALS Permit # 20. Rough Factory Fireplace 21: Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0Gas 0Oil 23. Gas Pipe -Rough & Test - '72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank OGas 00il 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. IXED SYSTEM FINAL 1 q- 3 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 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 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date City of Costa Mesa Development Services Department Building Safety Division CERTIFICATE OF OCCUPANCY No. O G C t: S 3 P. O. Box 1200 Costa Mesa, California The Building located at 245 FISCHM A-9 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group B2 Occupancy. Use of Building Omputei dat=a storage Legal Description 427-033-09 (Sera reverse side for Metes and Bounds) Building Permit No G13234 Electrical Permit No. G13234 Mechanical Permit No. 613234 Number of apartments _ t ISSUED TO: NOM Plum Building Official C 1517 N. Faizview Ave. S.A. by i/ > Date_ This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premia, 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 G13234 .Plumbing Permit No. -0- -0- and/or guest rooms SHALL NOT BE removed except by the Aenneanf to fill In au •mew( --l ron•. mnMfn h ... v hnrtler unet and Nan all annrnn Hate declarations. CITY OF COST.=ti MESA _ CONSTRUCTION PERMIT . Project Address -7 f Applicant's Mailing Address . 1S1I&!%ljz �',,T,sA.�, Owner's Name MWA4 4L '/ Phoney ��,, Address V ✓ Arch/Eng. p / ' License No C �%3 Address 1.79 �✓��m��ZTn, �-�y/�'r�,s Contractor's Nam.__AW1,41, 9V Phone.2+TL- Address (mailing) City License No. - LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class License No. Date Signature WORKERS' COMPENSATION DECLARATION +.relay affirm that 1 have a certificate of consent to seif4nsure or a certificate Workers' Compee�nnsation Insurance, or a certified pcopy thereof (Section Q _.ALab. C.)19 Policy No. F ap-3 Company '.: c-'"�' I �•- _ ertified copy is hereby.furnlshetl. e lfleg rPpil Med with the cit Iilding Rl Asldq. ._#.0 /1 --if EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed If the permit Is for one hundred ($100) or' M L ' 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 a5 to become subject to the Workers' Compensation Laws of California.. Date Signature NOTICE: if,after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions- or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY' I hereby affirm that there is a construction lending agency for,the performance of the work for winch this permit is Issued (Section 3087 Civ. C.) Lender's Name f A Under's Address' f that I am exempt from the Contractor's License Law for the (Section 7031.5 Business and Professional Code: Any city or F;'.efrom and the basis for the alleged exemption. Any violation of Section 1.5 by. any applicant for a permit subjects the applicant to a civil Elfialty of not more than five 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 (Section 7044, Business and Professional Code: The Contractor's 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 amployees, provided that such Improvements are not intended or offered for 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- I r e for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con- tr tors to construct the project( Section 7044,.Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Lawl. ❑ I am exempt under Section B. . C. f r this ason Data Owner I -hereby certify that I have redo this application and state that the above Signature CMF 0865-46 rev. 12/83 White - Building;Canary 1353 d r 0615 5/2184 365.7.; T! TYPE OF CONSTRUCTION LJ NEW LJ ADD lJ L�ON LJ REPAIR F-1 CONVERSION ❑ DEMOLISH K OTHER DESCRIPTION OF WORK 1MP.F �' SIL / qq A,P-# 42— —LJ3 ^,D Zone S Main Building: Accessory Building: Z TV EOF PERMIT GRADING FOUNDATION STRUCTURAL TENANT ELECTRICAL PLUMBING/MECHANICAL OTHER PROJECT DESCRIPTION SO. T. OCCUPANCY CON STR CTION TVP a til VALUATIONS ZONE GRADING CU.YOS. !� ACRES E T Front O N B A Rear I N C Right G S Left R E Ping:'Ref..# Park, Fees $ O U Remarks:C � 'S Parking Rep./Provided I- s _ Use of Building:R E N E PLUMBING FEES Planning Notes: Bar Sink Backflow Pre Backflow Irri Bathtubs Clarifiers Dishwasher Drinking FOL Floor Drains Floor Sinks Roof Drains, Reinspection Fee $25 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System Multiple ❑ Firepl/Fact. Bit. ICBO # Heating 'System & D sting ❑0.100;000 BTUi100,000 BT Reinspection Fee I $25 Accounting; Goldenrod - Assessor Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank t Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Issue Fee Hood or Type ❑ Canopy - Type 11 ❑ ❑0.100,600 BTU IN100, System Repair/Alteration Issue Fee Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Elec Fan Fixtures ELECTRICAL Transformer ❑ 15-50,KW ❑ 50+KW Meter Uup to 100 amps Meter El over 100 amps Sub Panel' Motors ❑ 0-1 HP CII '/. - 8 Inc. Solar ❑9-15 HP 016-15+ Microwave Pole Light SIL 4,00utiets Range DC Switches Sign Garbage Disposal Standing Sections Generator ❑0.5 KW ❑5-15 KW Trash Compactor $ 3 Rei-nspection Fee $25 Issue•Fee $ 3 FEES PUBLICrSERVICES REQUI R[ELM N h// Zoning APProved BY1/ r� C— Date Building Approved By Date Application Issued By Date LI 100 BTU 4 SUMMARY OF FEES BUILDING PERMIT $ 1 ,L#-. SD SMIP $ PLAN CHECK $ 1-06-q 2- PERMIT PLUMBING $ lG.00- ISSUANCE $ PLAN CHECK 25% $ y', DO ENERGY P.C. $ ELECTRICAL $ 1� GRADING $ PLAN CHECK 50%.$ I`i-•r--rte MICROFILM $ MECHANICAL $ 19 .Dr.) TOTAL FEE $ —' PLAN CHECK 25% $ L},0 () . - $ 3 - CONSTRUCTION AND PLANNING Date •• -APPROVALS Permit # ,.,, Inspector - POOL A APPROVALS Permit# Date In }. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2.1 Soil Pipe-Undrgrnd. Zs(': (,F/� 53. Steel Reinforcement _ .+ 3. Electrical Conduit Utility-Undrgrnd. 54. Forms- i • 4. Electrical Conduit-Undrgrnd. b 55. Electrical Bonding - _7 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test:1 i 6. Electrical LIFER�Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings' "+ 58. Electrical Conduit-Undrgrnd. 8. Foundation ., -� 59. Gas Pipe, 0 Undrgrnd., Test • 9. Water Pipe-Undrgrnd. _ [, Ly'dk- (,BA 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 ''/� a7a[, �Q 65. Electrical -Final 15. Rough Electrical -Conduit 66.. Solar System -Final- ' 16. Rough Electric Wiring %/y -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 % i FIRE DEPT. REQUIREMENT APPROVALS Permit # ' 20. Rough Factory Fireplace 21. Ducts, in Structure 1, 70. Underground Hydro 22..Ducts, Ventilating 71. Product Piping IJGas OOil 23., Gas Pipe -Rough &iTest• 724 Unddrground Flush •. 24. Roof Framing - 73. Undergrnd. Storage Tank CGas ❑Oil 25y Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical ' 27. Frame and Flashing//n/s /y 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30:, Drywall Nailing ,' /�l� / HEALTH DEPT. REQUIREMENT' 31. Plaster Brown Coat -- 79. FINAL INSPECTION 32. Electrical Power Meter -Final i 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes:. 34. Final Heating & Air Conditionin Q �¢ - l �' t% •� ,.�,: 35. 9"we arPipu-T 36. Hood or Canopy - 37. Final Factory Fireplace - 38. Final Plumbing yII(��Y GLS 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 9� 48. Special Requirements Completed '- 49. Electric Release to Edison 50. Gas Release to Southern California Gas Go 51. CERTIFICATE OF OCCUPANCY No._6 Date /3 p / Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. . CITY OF COSTA MESA . PERMIT -NO. TRACT NO. LOT NO. B . / CONSTRUCTION PERMIT Applicant's Mailing Address s 'e �f 11 d ��66 TYPE OF CONSTRUCTION NEW DD ALTERATION REPAIR Project Address A7 4'7J� F2, Tu/rE A_� ❑'CONVERSION ❑ DEMOLISH hone —AyNd72r �l/Fs'i PDESCRIPTION OF WORK Owner'sName �� v Address dAkE - - TYPE OF PERMIT 0 GRADING FOUNDATION STRUCTURAL A. P.;0- Arch/Eng.' License No. ❑ TENANT ❑ ELECTRICAL LUMBING ❑MECHANICAL PLNG.REF.* following reawn_(Section. 7031.5 Business and Professional Code: Any city or �county which requires a permit to construct, alter Improve, demolish or repair Address - - Contractor's Nom Zo honed 3T76'r-� ,'OTHER - -• PROJECT DESCRIPTION SQ. FT. OCCUPAN • CONSTRUCTION TYPE VALUATION$, Address lmeihOg) 1��3 rfJ�I/�LLE 1% to file a signed statement that he/she Is licensed pursuant to the provisions of I LiNo. 'vei,Z/� i>E' f ZONE GRADING CU.YDS. ACRES.cense LICENSED CONTRACTOR DECLARATION Remarks: l - 5 by, any applicant for .a permit subjects the applicant to a civil C' s ally of not more than five hundred dollars ($500)- , .i CAr reby'affirm that'Vam licensed under provisions of Charter 9 (commencing ' _ I MECHANICAL ` with section 7000) of Division 3 of the Business and Professions Code, and $ my Iicense'Is In full force and effect. license class G' ca No.� �ZS� �' I PLUMBING Date Signature "`�� Bar Sink 1 Sewer Cap $ WORKERS' COMPENSATION DECLARATION - . Backflow Preventer - - Sewer Connection sale. I/, 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- ' drove for the purpose of sale). - vreby affirm that I have a certificate of consent'. to self4nsure or a certificate Vorkers' Compensation Insurance, or a certified copy thereof (Section Backflow Irrigation Solar Collector _ - _. -a _ LJ I, as owner of the property, am exclusively contracting wlthlicensed con- tractorsto construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who .5, Lab. C:)I Policy No. &12 7 gi_�Company I US /<< C- Certified copy Is hereby furnished. ! Bathtubs Solar Piping ' -' 'PLAN CHECK Certified copy Is filed with the city Bf; g Divis aig4g te Applicant CaL / R3/.a.R.! c! _; Clarifiers Solar Tank , Dishwasher _Swimming Pool w/Spa i — $• EXEMPTION, FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if Me permit Is for one hundred ($100) or - - Drinking Fountains Urinal Date Owner. less) t I I certify (that in the performance of the work for which this permit Is Issued I shall employ dOy pef500 In any manner SO ds t0 berome SUbjecl. to the 1 Workers" Compensation Laws of California. ( Floor Drains' I Water Closet t I hereby'certify that I have read- this'- and state that the above - ' Date I Signature Floor Sinks - - - Water Heater— - — - NOTICE: If, after making this declaration, you should become subject to the ' Workers' Compensation provisions of the Labor, Code, you must forthwith ' comply with such provisions 'or :this permit shall be deemed revoked. Gas Service I 'Outlets Water Service - - ' 1 I CONSTRUCTION -LENDING AGENCY - ' j I I hereby affirm that there Is,a construction lending agency for the performance of the work for,. which this: Is issued (Section 3057 Civ: C.) Lender's; Name ' Interceptors --' Kitchen:Sink ' a9nfdtlV85 of til fly to enter; upon the above-mentioned :property for Lender's Address OWNER BUILDER DECCARATION - ::� ' I 1 herebylaffirm that I am exemptlfrom the Contractor's License Law for the Lavatories_ 1 p—Trap ' following reawn_(Section. 7031.5 Business and Professional Code: Any city or �county which requires a permit to construct, alter Improve, demolish or repair P - any structure, prior to Its Issuance, alrequires the applicant for such permit so Roof Drains . 1 to file a signed statement that he/she Is licensed pursuant to the provisions of I ' -' the Contractor's License Law•(Chapter 9 (commencing with Section. 7000) of .@,Iylsion 3-01 theBusinessand Professions Code) or that he she is exempt from and the basis for the alleged exemption. -Any vlolatlon of. Section - Showers , Reinspection Fee' Service • - Issue Fee'. ' 5 by, any applicant for .a permit subjects the applicant to a civil C' s ally of not more than five hundred dollars ($500)- , .i ,Sink - ❑,1,'-2s'Owner of the property or'my employees with wages -as their sola _ I MECHANICAL ` compensation will do the work, and the structure is not intended or offered for Sale .(Secilon 7044, Business' and, Professional Code: The Contractor's_ $ _ Boller 1 f Refrigeration System �, 1 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 employyees, provided that such Improvements are not Intended or offered for $ Duct - Under Ground 00.100,000 BTU 0100,000BTU GRADING sale. I/, 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- ' drove for the purpose of sale). ELECTRICAL Duct -Structural System Repair/Alteration LJ I, as owner of the property, am exclusively contracting wlthlicensed con- 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 _. -' 'PLAN CHECK - Exhaust System 0 Multiple 0 builds or Improves thereon, and who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Law).' $• _ Firepl/Fact. Bit. ICBO'/k 0 1 am exempt under Section B. 6 P. C. for this reason Date Owner. TOTAL FEE; Heating System & Ducting - I hereby'certify that I have read- this'- and state that the above - $ 00-100,000 BTU 0100,o00BT -- - - -- - -- information is correct. 1 agree to comply with all city and county ordinances -' $ ' -• Hood or " - and state laws relating to building construction and hereby authorize repre- a9nfdtlV85 of til fly to enter; upon the above-mentioned :property for Canopy .Type II ❑' �) Ra nsPBttlOn Fee - Inspedlon purpoJJs�5 ms's , ' - -- Registers .. Issue Fee ! I . - 519nature �� Data I rlvers% - icense or SS - CMF 086546 rev. 12/82 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor $15 $ 3 LEFT SIDE YARD PKG. SPACE REO. STREET WIDTH Automatic Washer, Construction Pole Cooking Unit Dishwasher Dryers _❑Gas, ❑Electric' Fan' F.A.U. Fixtures _ Device Boxes •s 34.11 77D3/94 51e6 REAR YARD (TO P/L) RIGHT SIDE YARD PROVIDED PARK FEE $ 'Meter LJover 1111.12mps' Sub Panel. ^ ' Sub Pole Motors 00-1 HP 0154.8 i Inc: Solar 09-15 HP 016-15+ Microwave 'Pole Light' Range Upness Standing Sections Switches 1Trash Compactor Garbage Disposal I Generator 00-5 KW 05-15 KIN Transformer 015-50 KW 050+KW� Reinspection Fee $15 Meter Oup to 100 amps t Issue Fee $ 3 Zoning Approved By Date Application Approved By - Data • � SUMMARY OF FEES , BUILDING PERMIT $ .�.2�• �� •, SMIP $ - PLAN CHECK $ •ZO ire' PERMIT PLUMBING $ ISSUANCE' $ ' PLAN CHECK $ GRADING $ ELECTRICAL $ $t -' 'PLAN CHECK $ - ' MICROFILM. $• MECHANICAL 1. $ .I TOTAL FEE; $ " PLAN CHECK $ LESS : ADVANCED PC -' $ ' i ' i FINAL FEE' 1 $ st_ I �' ��•'CONSTRUCTION ANDTPLANNING- POOL E r Fi ', - o c ° Date FAP'PROVALS Permit'#` DO Inspector -z .. ` ° ^ u APPROVALS Permit# Date ' Inspector _ y ;Ic Temporary Electrical Service(;FNe K 52` Pool & Equipment Logation f , -2. Soil Pipe-Uhdrgrnd _O Steel Reinforcement" •' ` -^, •,r ,531 e c13`. Electrical Conduit Utility-Uhdrgrnd: a, - ! 54 Forms bo r °; 4. Electrical Conduit-Uhdrgrnd- ;q _ - ! 557 Electrlcal�Bon'dirig. , ,c� ro ,Test 5. Steel Reinforcement; 1:'56., Rougti PI_umbing;& Pressure - - 6: Electrical LIFER Grnd.� � � r = � - c PRROOTO COVER-GUNITE - 57:' AVA - , • r. � - A 7. Footings , ' :� m c - "' ' •,58' Electrical Conduit-Un&or� 8. Foundatior I _ ''59. Gas'Pipe, O`Und grnd' Test 9. Water, Pipe-UnErgrnd. ��60. Backwash Lines;P,Tra'p, O'_Undrgrnd. 10. Structural Floor System 61. APPROV.AL.TO-DECK - - • - i t_ 11. Property Sewer Line & House Connection : ^' TF 162. Backwash]&^Receptor -Fin al - ¢5 12. Sewer Cap , n i - 'iia 63. Heater &V1.ent-F,ioal r 13. Roof Drains 64. PlumbingSystem 14. Rough Plumbing Electrical'Final''-�`- - ,I 15=Rough Electrical-Cdnduit - - 'r- - f I I j f �' ? r S&WSystero-Fin`sl i _o 166y t '16..Rough_Electric,Wiring. +, 67.; Fencing & Access=A ..17. Rough Wiriirig,'Sign2 ;68.! APPROVED FOR PLASTERING 16. Rough Electrical -T Bac Ceiling,X69. POOL/SPA SYSTEMSTINAL _ 19. '.Rough.Heating & Air Conditioning !; I ; `-' .t ` I `FIRE DEPT.!REQUIREMENi ` APPR rVALS� Peimit,# I _ , �0. Factory Fireplace I j I + I ;Rough I i 21. Ducts,'in Structure,. ', I Ii 1 ! 1 I I 170.!Undergrountl Hydro 1 { , 22. Ducts, Ventilating a ! l I I I 171.' Product Piping DGas ❑Oil ! 23. Gas Pipe -Rough & Test - -� t72.Underground - -- -r - Flushi 24. 'Roof Framing 1 ; •� I ; • j i Undergrnd. Storage Tank 0 Gas 0 Oil : 173:. , 25. Roof Sheathing i ". h , - . j .; I _ ,74.1 Overhead Hydro 'I 7�A�>r`i (.J✓r0 26. T•Bar Ceiling (Structural), & Monocoat' I ! ` ` ^ Dry Chemical j z -- '; _ -, I I 175., _ i• •27. Frame and Flashing i i f 176.! Dry Standpipe "• e I ;• M. 'Lathing & Siding, ;,� i I I{ I ' .�, I FIXED SYSTEM=FJNAL I 177 r 1^ n II �, I _29. Insulation - t t I I 1 ' { 78.j FIRE PREV. FINAL Y 30.,DrywallNailing i „ ( I i Notes: I _ t 31. Plaster Brown Coat I I I I! I I I! , I! 32. Electrical Power Meter -Final l' 1 1 I'{ - I i. 33. Final Electric L (. iA , _ 34. Final Heating & Air Conditioning 35. Final Gas, Pi a=Test 36. Hood or'CanoPY- � 37. Final Factory Fireplace i `. ` i I i ! I ! 1 L+ (� I - . •� ,'•'.' - - I I 38. Final Plumbing i sl jt. i - I_' I I I ' ! I - _" 1,E 39. Water'Service-Final, it ; , i i f .1 c_ - 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer 43. Backflow Irrigation �_ ! I ' ._ : ! : j `, 44. Landscaoe;lrrigation:Systeml ,z 45. Sound Attenuation 46. Handicap Regulations - ` ; " i i °• ' ! -_'• I I 47. FINAL STRUCTURE & BUILDING I + • j 1 I l I i ; ',: j 48. Special Requirements Completed d I 49. Electric Release to!Edisori -'i 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date I 7 PRDJECT ADDRESS: 245 FI.SCHER AV OWNER'S NAME: FONTA WEMENS CLUB ADDRESS: SAME UNIT: = A6�U V 549-4751 ARCNIENGINEER: WILLIAM PERRY REG.NO.: C20152 ADDRESS: 28645 FRONT ST UNIT: TEMECULA CA 92390 A PERMITTEE: SMITH CONSTRUCTION (714)677-7001 ADDRESS: P . O. BOX 985 MURIETTA CA 92362 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7300) of Division 3 of the Business and Professions Code. and my license is in full force and ffect CITY LIC.: 050294 STATE LIC.: gn Q S S /Un — —_ %` Date: _ ature:Signr,—i WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure or a candidate of Workers' Compensation Insurance or a Certified copy thereof (Section 3800. Lab. C . 'OLICYNO.: 0689286-90 EXP. DATE: 03/19/91 COMPANY: STATE ❑ Certified copy is hereby tarnished. Certified copy is filed with the city Building Ston. Date: / — 7 — �?/ Applicant:. . EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the permit is far one hundred (S100) or less). 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 became subject to the WorkersCompensation Laws of California. Date: Signature: NOTICE: It. after making this declaration, you should became subject to the Workers Compensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a Construction lending agency for the performance of the work tat which this permit is issued (Section 3097, Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of 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/she is licensed pursuant to the provisions of the Contractors' Slate License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) of 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 penalty of not more than live hundred dollars (5500). 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 (Section 7044, Business and Professional Code: The Contractors' State License Law tloes 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 awn 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 will have the burden of proving he/she did not build or improve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B. 8 P. C. for this reason: Date: Owner: I do hereby teddy that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that 1 or any future building occupant will/will not (circle one) need to comply with said state codes and the requirements for a permit lot construction or modification from the Air Duality Management District. Residential construction applications are exempt from these provisions. Date: Applicant'. I hereby certify that I have read this applicalioo an slalelhat the ordinances and slate laws relalmg to building const Bion ono beret properly lot inspection purposes. I Date., 7' gnature. 4 Driver's License or Social Security x: all city and 1641-46 White—Building', Green—Code Enforcement: Canary—Applicant, Pink—Revenue: Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO; BEF 050487 PERMIT NO: BEP 050484 PLAN CHECK NO: 00107-91.S GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: ELE PLU STR PURPOSE: ALT JOB DESCRIPTION REMOVE 2 NONBEARING WALLS 6 ADD A BATHRO SQ FT; 8,000 CLAIM VALUE: 8,000.00 CALL—VALUE: 8,000,00 GROUP OCC: B-2 / COMMENTS: X *a<yE�c*Na<�c�*�F�-�F*�RitiF*�aF*��6�Lx->:k6*a>�6Tt+t�F**�L*�Pit�E+t��6a*�*lt_�r�76r✓TE•i�kk6+F�R��E*i6v�E*�6�a��E�rE 7. 0 N I N G S E T B A C K S R E Q U I R E M F, N T S ------------ --- MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR: FTIN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT 1.IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 42703309 ZNE: MP REF NO: PLANNING NOTES> TI TO ADD A BATH TO AN EXISTING OFFICE. > )f if * 1F * IE 16 * % )f iF iF Jf iF N k fF if iF ff iF K Xf gf 4 if 1E if If * Xf if * if'JF if * * iF )F if -961f iF k JE i6 iF iF I61( iE is of iF IF ih Y ii iE * a61f # )F 16 iF XfE iF M fF x M * # {cif if D E V E L O P M E N T S E.R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY S GL • DATE: 1q.) /sL BUILDING APPROVED BY : DATE: APPLICATION ISSUED BY: RC DATE.• ifiE+EiFiEiEIFiEiEiElEiFif�fiF?FIF7fiFifif3e Yr 3f 7ElE)c3EiFiFiEif If if aF if * 76 iF 1E XF BF iF * 96 iF if * IF iE 1E # JF i6 iF 1E A -1E 9F * iE if it # IE R6 if iF * * * � *?E 9c iE e41E 1E?E is if if iF * if if if i(- 34 if iIE B6 JE * is i41E !c 1F i6 if 9f i6 ±f 9f is IE s iE iE iF LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 99.00 6.00 6.75 25% 50% SMIP/NON—RES PLAN 64,35 1,20 ISSUE FEE 3,00 15.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE. TOTALS ---- > 112,95 18,00, 64.35 195.30 195,30 ,00 REVENUE DIVISION TOTALS— > COLLECTED: 195,30 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 99,00 9.00 21.75 i 1,20 64.35 iF iF it If N9F iE >E if * 1E if iF ♦E M7 1E iE 16 if * % if 16 iF Ni<i6 iE if JE 1E IE if it K ik` # IF if 161E if if if iF if # if iF # ie iE # if iE R it iE it J6> # iF Yi ♦<i6 � * x if ! # i6 if'1iif N N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST SFC 8000 ALTER BY VALUE COMMERCIAL NOZONE 1,00 8,000,00 ELE 1 FIXTURES LIGHTING 1 ST 20 EA, ,75 ,75 ELE 2 RECEPT/06TLET 1 ST 20 EA, .75 1,50 ELE 2 RECEPT/SWITCH 1 ST 20 EA;75 1,50 ELE 1 NON—RES APPLIANCE NOT OVER1,0 HP 3,00 3,00 PLU 1 SINK, PAR 1,00 2.00 PLU 1. WASH BASIN (SET) 2,00 2.00 PLU 1 WATER CLOSET (TOILET) 2,00 2,00 END OF FEES 01 00077427-00077491 TOT 1>r,31 DATE: 01/07141 TIn 13:01- ij CONSTRUCTION AND RLANNING APPROVALS Permit # Date Inspector L & SPA 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-Undigrnd. 54. Forms i 4. Electrical-Conduit-Undrgrnd. 55. Electrical Bonding - S. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER 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, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11 t . Property Sewer Line & House Connection 62. Backwash & Receptor -Final ' 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System • Final 14. Rough Plumbing 65. Electrical -Final >` 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring - _ 67. Fencing & Access Approval 17� Rough Wiring Sign ,r ' 68. APPROVED FOR PLASTERING` 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL ---- 19. Rough Heating & Air Conditioning FIRE DEPT, REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure - - 70. Underground Hydro 22. Ducts, Ventilating r-71. Product;Piping OGas 0Oil 23. -Gas Pipe!Rough & Test - 72. Underground Flush 24. Roof Framing -73. Undergrnd. Storage Tank OGas OOil 25. Roof Sheathing ' 74. -Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat - 75; Dry Chemical - 27i Frame and Flashing 76. Dry Standpipe '-28. Lathings&Siding ••• 77.' FIXED SYSTEM FINAL '29. Insulation 78. FIRE PREV. FINAL X30. Drywall Nailing HEALTH DEPT. REQUIREMENT - T 31. Plaster Brown Coat 79. FINAL INSPECTION - 32.-. Electrical Power ter -Final 80. FOOD CERTIFICATE ISSUED _ - 33. Final Electric �� J�J . - Notes: - °•34.- Final Heating & Air Conditioning 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing LFJ! -. 39. Water Service -Final - 40. Gas Service -Final _ 41. Solar Domestic -Final - 42. Backflow Preventer r 43. Backflow Irrigation - 44. Landscape Irrigation System - - 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING - 48. FINAL PLANNING - 49. Electric Release to Edison - - 50. Gas Release to Southern 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 _//J U PERMIT NO. TRACT NO. LOT NO. BLD - - " CONSTRUCTION PERMITro Reinspection Fee 1 $25 Issue Fee - G R E Q Project Address TYPE OF CONSTRUCTION NEW LJ ADD LJ ALTERATION Ll REPAIR ' Q ❑ ❑ ❑ Applicant's Mailin/g/A/d'dress 't. CONVERSION DEMOLISH OTHER A.P. Owner's Name /�Lt-/!% ��P S Phone - Z -� DESCRIPTION OF WORK N S - Main Building: S I Address, � TYPE OF PERMIT GRADING FOUNDATION STRUCTURAL T Front Meter ❑up to 100,amps - Arch/Eng. License NO. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B , 'Motors 00-1 HP El 1.'A: 8 ❑ Inc. Solar 09-15 HP Ell 5-15+ A Rear _ Address BOTHER Right Contractor's Nam • - Phone PROJECT DESCRIPTION, SQ. FT. OCCUPANCY—C $ $ ENERGY P.C. GRADING MICROFILM TOTALFEE rr ry•,� :t ��11 Address (mailing) ' C. /// Q,17ye, CONSTRUCTION TYPE - VALUATION $ S Left City Licomse No. %66/1n ZONE GRAOINGCU.YS- ACRES D Pin R g. ef. # LICENSED CONTRACTOR DECLARATION Remarks: Parking Req./Provided I. hereby affirm that I am licensed under provisions of Charter 9 (commencing PLAN CHECK i $ with section 7000) of Division 3 of the Business and Professions Code, and Use Of Building: my Iicen ie is in f,pyII&y�e and effect. /�/) AO �IJ75r7U Planning Notes: Ucens CI G=C.(J en se No.l PLUMBING FEES 1 Date ,O-9 Signaturer �a. I0O r_./.. Bar Sink Showers WORKERS' COMPENSATION DECLARATION iereby affirm that I have a certificate of consent to self -insure or a certificate Backflow,P,reventer Sink Workers" Compensation Insurance, or a certifietlt copy thereof (Section '" __Service - - 3800, Lab. ,C �� ;ZZ0,35 iJ ;,,,.,,/ t Backflow Irrigation Sewer Ca p- Policy No. L[� Company C'�."LY! �L�S Certified copy Is hereby furnished. Bathtubs " - Sewer Connection j - Automatic Washer Certifiq is filed with the city d ng Dlyis)9n Date �T/ APPlicant ��///L[ f-rnJ �' J - - i Clarifiers I - Solar Collectors , •-' Construction Pole Su EXEMPTION FROM WORKERS'. COMPENSATION DECLAR TION (This section need not be completed if the permit is for one huntlretl ($100) or D'Ishwasher 1 Solar Piping 1 " %r Cooking Unit i 9 less) - I I Certify that in the performance of the work for which this perm[[ is t to 1: I , shall not employ any in any manner so as to become subject to [rte Drinking Fountains 9 - Solar Tank ' .'Fl Dishwasher , person Workers' Compensation Laws California. ' Floor Drains Swimming Pool w/Spa Dryers ❑Gas ❑Eb Date —Signature NOTICE: 1f after making this you become subject to the FIpOf Sinks _- - - Urinal Fan y Cod provisions of the Labor Code, you must forthwith-, Workers', Compensation ions of _ - - comply with' such provisions or this permit shall be deemed revoked.- pr Gas Service' 'Outlets' Water Closet. - F.A.U. CONSTRUCTION LENDING AGENCY' ' I hereby affirm that [here is a construction lending agency for the performance Interceptors Water Heater, Fixtures ' of the work for which,' this permit'is, issued (Seca On 3097 Civ. C.) - Lender's flame. ' ' Kitchen Sink _ Water Service r -r Device Boxes Lender's Address , OWNER BVILDER DECLARATION Lavatories Outlets I hereby affirm that I am exempt from the Contractor's License Law for the 1P -Trap 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 Switches -any structure, prior to Its Issuance, also requires the applicant for such permit Roof Drains Garbage Disposal to file a signed statement that he/she is licensed pursuant to the provisions of R� nn« Law (Chapter d.'t n Contractor's thLicense Hadi eo ,c00emmft Generator 765 KW --/OJi.b by any applicant for a permit subjects the applicant to a civil enalty of not more than five 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 (Section 7044, Business and Professional Code: The Contractor's License Law does not apply to an owner of a property who builds Or Improves thereon, and who tloes such work 'h imself/herself or through his or her own employees, provided that such improvements are not intentletl or offered -for sale. If, however, the building or improvement Is sold within one year of com- pletlon, the owner will have the burden of proving he/she did not build or im- Uve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con- tractors t0 construct the project(Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner Of property who builds of improves thereon, and who contracts for such projects with a con- tractors) license pursuant to the Contractor's License Law). ❑ 1 am exempt under Section B. & P. C. for this reason an,p, _I / Signature , Reinspection Fee', 1 $25 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact. Blt. IC80'# (0 7H ting System & Ducting -100,000 BTU 13100,000 Drivers' License or SS 9P��Reinspeuction Fee CMF 0865=46 rev. 7/83 White -'Building; Canary - Applicant; Pink'- Accounting; Goldenrod - Assessor • $25' 2231 6/14/84 40.00 TL Zone $ 3 Accessory Building: Z O N I N Reinspection Fee 1 $25 Issue Fee G R E Q _ Park.Fees $ IANICALFEES U I R E - Data M E N Application Approved By Application Issued By S I ELECTRICAL FEES ' • Transformer ED 15-50 KW ❑ 50+KW i Meter ❑up to 100,amps - BUILDING PERMIT PLAN CHECK PLUMBING •Meter ❑over 100 amps SMIP PERMIT ISSUANCE ,Sub Panel I , 'Motors 00-1 HP El 1.'A: 8 _ Inc. Solar 09-15 HP Ell 5-15+ '• Microwave ' Pole Light Standing�Sections 15 KW Trash Compactor Issue Fee $ 3 Reinspection Fee 1 $25 Issue Fee $ 3 IANICALFEES Coad or Type ❑ DdnOPV Type I I ❑ PUBLIC SERVICES REQUIREMENTS: Zoning Approved BY Data Application Approved By Application Issued By Date Date leefrigeration System 6-100,0008TU ❑100,0006TU BUILDING PERMIT PLAN CHECK PLUMBING SUMMARY OF FEES $ $ $ SMIP PERMIT ISSUANCE $ $ , System Repair/Alteration L PLAN CHECK ELECTRICAL PLAN CHECK��r� MECHANICAL 1"i`-+` $ $ ENERGY P.C. GRADING MICROFILM TOTALFEE $ $ $ $ ' - Issue Fee $ 3 PLAN CHECK i $ CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL -SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement 3. Electrical Conduit Utili{y-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, EJ Undrgrnd., Test 9. Water Pipe-Undrgrnd, 60. Backwash Lines, P -Trap, ❑ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11.Property Sewer Line & House Connection 62. Backwash &,Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13.. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing -65. Electrical -Final l 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 APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping El Gas El Oil 23. Gas Pipe -Rough & Test- 72. Underground Flush �4. 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 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 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 j' 43. Backflow Irrigation _ t 44. Landscape Irrigation System. - - 45. Sound Attenuation { 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison " 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date - .. 0 City of Costa Mesa Building safety oepaitment' C E R T I F I C A'tT E OF :OCCUPANCY P.O. Box 1200 Costa Mesa, California The Building located at 945 1'Picnhnr A%r n1,o STT,,;+ a -i ' 'has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto, for a Group - _E-2 Occupancy. `"^ - >i . Use of Building Tenmt TMrQVF?Mznt 3 Legal Description A. P- 4427-033-1717 t - -•-_-(See reverse'side for Metes and Bounds)-. Building Permit No •13EP-2528 Electrical Permit No. E-254A/49275plumbing Permit NoA-9573/f-;.d9 ad7 2-2701 Number of apartments .-b— and/or guest rooms —f1— - ISSUED TO: 1 Building Official by *11 i i slm Prrrx�rt-i ac - f V. C. Nc�,-ton-b�u7ding ,DiviSmon Dec, -tor Date This Certificate of Occupancy, SHALL BE posted in a conspicuous place on the premises and SHALL NOT.BE removed except by.the ' i Building,Off ficial of the,City of Costa Mesa under Sec. 306j1e1U.B.C.- - /l` Form BU 34 Rev. 11/70 - " 1 Applicant to till i II spaces within hepw ,foes and sign all appropriate declarations. through his own employees, provided -that -such improvements are not_ ',MECHANICAL' PLAN CHECK - - -- .., CIT F COSTA MESA PERMIT NO, TRACT NO. LOT NO. BLDG- NO- of proving he Old not build or Improve for the purpose Of sale). - 1 501 2/01/82 -1 99.18 TL 1CONSTRUCTION PERMIT Zr � 3S3 ' and'Professions Code: The Contractor's' License Law does not -appl Y to REFRIGERATION 0-100,000 BTU an owner of property who builds or improves thereon, and who con- Project Address 124 TYPE OF CONSTRUCTION the Contractor's License Law). 1•^' ` - ❑ 1 am exempt under Section B. & P. C. for This' Owner Phcm�3 41 11 &0 NEW ❑ ADD ❑ ALTERATION I IPLANCHECK Data - - - Owner- - - - - - - Address - ❑I� REPAIR ❑ CONVERSION ❑DEMOLISH Information is correct. I agree to comply with all city and county • ,PLAN CHECK _ LESS AD- VANCE PC S_1 represents s of this cl y to ter upon the above ment.On tl l ZONING REGULATIONS Arch/Eng. License No. 1 -OTHER /DESCRIPTION Signature Date _ Drivers' License or SS -h,ISSUE A.P. SF 2_7–Q _ _ _ Address •hon OF WORK - 'ZONE PILING. REF. � Contractor (/ VPE OF PERMIT - - , "e ILpINC _ Address ❑ GRADING ❑ FOUNDATION -❑ STRUCTURAL - SETBAC LST. 'SSIDE YARD - - PROPS RTYLI NE � LICENSED'CON RACTOR 'clDECLARA O - ATENANT); ELECTRICAL LYMBIN LRIEIFGHT I hereby affirm that.I am Iicensed a or Is[ o arter om- 7000) 3-and ' -❑ - - - -- - me Itcing with section of Divi on the u ess Professions Code, and my Ilc se f I force of effect. OTHER REAR YARD P ( /L) '_PROJECT DE CRIPTION -- - - Class Llcentense o. PKG.SPACEREO. PROVIDED Date -w'- Slitnature _ _SO_FT. n- .. — _-.-... .._ STREET WIDTH _ PARKFEE$ ' WORKERS' COMPENSATION DEC ARATION - - that I have to sa lf-Insure a OCCUPANQ CONSTRUCTION TVP - �fl 'ZONING APPROVED DATE l 2Q I hereby affirm a certificate of consent of -Compensation f+a„', VALUATI ZONE certificate of Workers' Insurance, or a certified copy thereof (Section 3800, Lab. C.). _ GRADING.CU. YDS_. ACRES SPECIAL CONDITIONS: - 44acY No. .' Company $..ex �r rtified copy is hereby furnished. - - ---- - - t ` Is filed the Building Division. REMARKS: _- - - • entitled copy with city MPTION FROM WORKERS' COMPENSATION NO - - - _ -` - - - - This section need not be completed If the permi Lis for. one hundred ((E700) t'- i or less). 1. certify that in the performance of the work for which. thispermit isl -` Issued, I shall not employ any person in any manner so as to become PLUMBING , : , PCAN CHECK _ __ _ ELECTRICAL _ -PLAN CHECK.. -' subject to the Workers' Compensation Laws of California._ _ - _ OWELLTNG-_ _ _ - Date Signature BATHTUBS SHOWERS jGAM�Gl - NOTICE: If after making this declaration, you should become subject. TOILETS 'URINALS_ — GENERATOR' - 0-1 KW_ -1 10 KW - to the Workers' Compensation provisions of the Labor Code, you must _ _ -? TRANSFORMER 'APPLIANCE _ ' forthwith comply with such provisions or this permit shall be deemed LAVATORIES 12, DOUBLE LAVS 0 10-50 KW_50"+ KW revoked.- - - - - - KIT. SINKS DISHWASHERS !' MOTORS -- 0-1 HP_1-10'HP' - - CONSTRUCTION LENDING AGENCY 4D6 1 hereby affirm that there is a construction lending agency for the per. - SERVICE SINKS SUMPS- . n p'y SOLAR) --30-50 HP_ -50 + HP forma nce of the work for which thli permit is issued (Section 3097 - ,-�' r�D a;(INC. - FLOOR SINKS t FLOOR_DRAINS FIXTURES -OUTLETS 6 -SWITCHES - - Civ. C.). - - Lender's Name ..� , ,S . - - ` - Lender's Address _ _ _ ___ __ __ DRINKING FOUNTAINS •'I - � -- -:GAS TUBE SIGNS-- OWNER'BUILDER DECLARATION ---�'---- - I hereby affirm that I am exempt from the Con[rattor's LiCehsetCaw,tor t INTERCEPTORS "N\�C LARIFIERS. ty - .. .. v _ '- �. s �POLE'LIGHTS the following -reason (Section 7031.5 Business-and-Professlons Code: `SWlhlfvll �gG POOL P TRAP - 1 - POLES 'METERS SUB r Any city or county which requires�a permit to: construct, alter;, improve, demolishor repair any structure prior 'to its:iszuance, also re- WATER SERV ICE ALTERATION 'PANELS _ MAIN-� SUB quires the ap;.Iicant for such permit to'file a`signed-statement that her• t GAS •SERV ICE } `: OUTLETS SERVICE- - - / - AMP - Is licensed pursuant, to the provisions.of"the Contractor's License Law- (Chapter 9 (commencing with Section 7000)6of-Division 3 of the WATER HEATERS -BTU, OUTPUT j _ business'and Prolessions Code) or that he isexempt therefrom antl the basis for the alleged exemption. Any violation of Section 7031.5 by SEW ER CONNECTIONS '•, ��I '^ - `50LAR - '�' ' applicant -,for a. -permit subjects the applicanj;lto-a civil' penalty JL!morektharl•five' hundred dollars ($500): 1J .. ';. \ `r ._ TANK . ,. - - COLLECTORS as owner' of -the property„or my employees'with•wages as their Sole compensation, will do the work; and -the structure'Wnot.lntendetl3 who builds or improves thereon, and who does such work himself or ISSUE FEE through his own employees, provided -that -such improvements are not_ ',MECHANICAL' PLAN CHECK - - Intended or offered for sale. If, howevertthe-building or -Improvement iz sold within one year. of COmpletion,.the, owner_ will have -the. burden_ HEATING SYSTEM_ 0-100,000 BTU of proving he Old not build or Improve for the purpose Of sale). ❑'I,--as-owner-of the property, am. exctusivety-contracting- with- AND DUCTING - r licensed contractors to construct the project (Section 7044, Business 100,000+BTU_ -` - and'Professions Code: The Contractor's' License Law does not -appl Y to REFRIGERATION 0-100,000 BTU an owner of property who builds or improves thereon, and who con- tracts from -such projects -with a contractor(s)- Itcesned-pursuanl to SYSTEM - - ' the Contractor's License Law). 100,000. BTU - c• ❑ 1 am exempt under Section B. & P. C. for This' BOILERS -. ', •BTIJ- ' reason - I IPLANCHECK Data - - - Owner- - - - - - _ SYSTEM REPAIR, ALTERATION I hereby certify that I have read this application, and state that the above EXHAUST_SYST_EM MULTIPLE Information is correct. I agree to comply with all city and county • ,PLAN CHECK ordinances and state lawsrelating to construction, and hereby.authorize LESS AD- VANCE PC S_1 represents s of this cl y to ter upon the above ment.On tl l P prperty o .ins ti upo5 _.. azi a(J FEE Signature Date _ Drivers' License or SS -h,ISSUE CMF 0865-46 White -Building; Canary -Applicant; Pink-ACcounling; Goldenrod -Assessor i Do APPLICATION APPROVED BY- 'DATE SUMMARY OF FEES `'t'.^ i BUILDING ;PERMIT ��. - - - _ E SMIP t 'PLAN CHECK_ $—Z PERMIT, 1 PLV MBING - $ 2/ -en ISSUANCE $ - PLAN CHECK $ 'i GRADING b �. s � A,, I ;ELECTRICAL $$ t I IPLANCHECK E' '"- _ 'MICROFILM$' -MECHANICAL - $ '- TOTAL FEE E' • ,PLAN CHECK $- - '' LESS AD- VANCE PC S_1 FINAL FEEL $ CONSTRUCTION AND PLANNING APPROVALS Permit # 0 Date Inspector POOL & SPA APPROVALS Permit #' - Date _ Inspector F 1. Temporary Electrical Service or Pole 43. Pool & Equipment Locatiori _ 2. Soil -ipe-Undrgrn - 44.. Steel Reinforcement - - - 3. Electrical Conduit Utility-Undrgrn - _ 45. Forms ` - 4. Electrical Conduit-Undrgrn. _ _ 46. Electrical Bonding - _ _ tee Reinforce 47. Rough Plumbin & Pressure`Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNI-KE - - -. 7. _ _Footings _ - -`" 49. Electrical Conduit-Undr rn. - B. Foundation_. ' _ _ 50. Gas Pipe, ❑ Undr rn, Test •ndr .9. Water_Pipe-Undrgrn" _ _ _ 51. : Backwash Lines P-Trap.'El rn' 10. Structural Floor System_ _ 52. APPROVAL TO DECK - 11._,Propert'y Sewer Line & H_ou_se'Connection _ _ _ -53: Backwash & Receptor -Final 12. . Street Sewer Connection54. . - Heater &Vent -Final 13. Rough Plumbing p(C _Sr -e%_ ,�,.,,.� -2 S-,?_? -_ -•- - - _ -. 14. Rough Electric-Cgnduit - -- 56. Electrical -Final 15. Rough Electric -Wiring -' - -" "- ';-- - - - 57. Solar System -Final-• '•J" '' -" "- • - '' 16. Rough Heating & Air Conditioning - - __ encing & Access Approval 17- Ducts in Structure' _ - t -59. APPROVED FOR PLASTERING 18. Ducts, Ventilating _ 60. ` POOL/SPA SYSTEMS FINAL - _ 19. Gas Pipe -Rough $t Test - _ - 20. Roof Framing _ 21. Roof Sheathing. NOTES:_ - - 22... Frameaod Flashing-_ .//= ,//� 23. Insulation 1'-//-&�. _�/i"t -aK _ 24. Lathing & Siding 25. Drywall Nailing OZk 0 C KC/ rC4 oS f - 26. Plaster Brown Coat - ,L- 2 -`SL- . 61,45_ ie d. 27. Electrical Power Meter -Final _ I•i,C/1 �/� �! .7' e�3=&1 /d -O• 28. Final Electric 3 29. Final Heating .& Air Conditioning 30. Final Gas Pipe -Test _ 'S `�'i , '). a - • O-�'Z L • QB <T 'L 31:. Final Plumbing .. _�"' .�$ . .44 32. Water Service -Final _ ' _ _ rs, l •iK 041 33.. Gas Service -Final. 34. Solar Domestic -Final - '- m - 35. Landscape S2rinkling System 36. Sound Attenuation 37. Handicap Regulations - 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed _5 eivIraAl - 40. Electric Release to Edison - - - - - 41. Gas Release to Southern California Gas Co. - 42. fj CERTIFICATE OF OCCUPANCY No. ��i L G Date �L Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PERMIT TRACT NO. LOT NO. BLD . NQ. CONSTRUCTION PERMIT � TYPE OF CONSTRUCTION ❑ NEW eADD ❑ ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH 0 OTHER 157.3_ 2/02/82 1 1 a00 , 1 t+ + ZONING REGULATIONS .Project Address / — Owner I Phone Address Arch/Eng. License No. DESCRI TI N OF/N IZ A P gF Address p TVPE OF PERMIT ❑ GRADING 0 FOUNDATION ❑ STRUCTURAL ZONE PLNG. - SETBACK T. ID YARD REF. 7� Tp t�I�pI G PROBPERTPLI NE Convacror - Phone Address LICENSED CONTRACTOR DECLARATION 1:1 TENANT El ELECTRICAL El PLUMB I NG�BrMECHAN ICA SIDE Yq I hereby affirm that I am licensed under provisions of Charter 9 (tom- RIGHT man ting with section 7000) of Division 3 Of the Business and ❑ OTHER license Is In full for d if t. Professions Code, arit REAR YARD (TO P/L) _y `` PROJECT DESCRIPTION � - License��}}ss Llcon� PKG. SPACE REQ. PROVIDED Date O' Signature �(JA /SO. —� F FT. STREET WIDTH STREET PARK FEE $ WORKERS' COMPENSATION DECLARATION OCCUPANCV_CONSTR VCTION TYPE I hereby affirm that I have a of consent to wit -insure ora VALUATION ZONE ZONING APPROVED BY DATE nsation I certificate of Workers' Compensation On Insurance, or a cerlilletl copy - thereof (Se 'on 80 Lab. C.). 11 GRADING CU. YDS. ACRES SPECIAL CONDITIONS: Policy No. Oompany odA1(1- Ills e art(fl opYRhere yfurpishetl. -- ertified copy is filed with the city Building Division. REMARKS: �gg E'AEMPTION 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 became PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK subject to the Workers' Compensation Laws Of California. BATHTUBS SHOWERS Date Signature NOTICE: If after making this declaration. you should become subject TOILETS URINALS _ GENERATOR 0-1 KW_ 1-10 KW to the Workers' Compensation provisions of the tabor Code, you must TRANSFORMER for With comply with such provisions or this permit Shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE 10-50 KW_50+KW revoked. CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS MOTORS 0-1 HP -1-10 HP I hereby affirm that there IS a construction lending agency for the per. SERVICE SINKS SUMPS - (INC. SOLAR) 10-50 HP 50 t HP formance of the work for which this permit Is issued (Section 3097 FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES Civ. C.). Under's Name Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS INTERCEPTORS CLARIFIERS POLE LIGHTS OWNER BUILDER DECLARATION I hereby affirm that I ant exempt from the Contractor's License Law for SWIMMING POOL P TRAP POLES METERED SUB the following reason (Section 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, Improve, demolish or repair any Structure, prior t0 Its Issuance, also re. WATER SERVICE ALTERATION PANELS MAIN SUB quires the applicant for Such permit to file a signed statement that he GAS SERVICE OUTLETS SERVICE AMP Is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) Of Division 3 of the WATER HEATERS BTU OUTPUT Business and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS - a--' applicant for a permit subjects the applicant to a civil penalty A more than five hundred dollars ($500). SOLAR TANK COLLECTORS 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. (Section 7044, Business and Professions Code: The SOLAR PIPING SVS. ISSUE FEE Contractor's License Law does not apply to an owner of a property ISSUE FEE APPLICATION APPROVED BY DATE who builds Or improves thereon, and who does such work himself or through his Own employees, provided that such Improvements are not MECHANICAL PLAN CHECK SUMMARY OF FEES Intended or offered for sale. If, however, the building or Improvement IS sold within one year of completion, the owner will have the burden of proving he did not build or Improve for the purpose of Sale). HEATING SYSTEM 0-100,000 BTU PERMIT UILDING E SMIP E El I, as owner of the property, am exclusively contracting with AND DUCTING licensed contractors to construct the project (Section 7044, Business 100,000 + BTV PLAN CHECK $ PERMIT- ' antl Professions Code: The Contractor's License Law does not apply to ISSUANCE E 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 SYSTEMGRADING $ the Contractor's License Law). 100,000 + BTU PLAN CHECK $ ❑ 1 am exempt under Section B. 6 P. C. for this BOILERS BTU ELECTRICAL $ $ reason SYSTEM REPAIR, ALTERATION PLAN CHECK $- MICROFILM $ Dale OwnerF EXHAUST SYSTEM MULTIPLE MECHANICAL E TOTAL FEE $ LESS AD - I, hereby certify that I have read this application and state that the above Information is correct. I agree t0 comply with all city and county PLAN CHECK $ VANCEP PC $ _ ' and state laws relating t0 CpdzlrUon t and hereby authorizecned representatives representatives of this city to a er upon the above mentioned to property for in io - urpo AZ , FINAL FEE $ Signature Date/B Drivers' License or 55 yF / ISSUE FEE CMF 0865-46 white -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor TL CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & SPA'- ., APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Soil ipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn - 45. Forms 4. _ Electrical Conduit-Undrgrn 46. Electrical Bonding5. _ Steel ein orce _ 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVALTO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9, Water Pipe-Undrgrn 51. Backwash Lines P-Tra D•ndr rn - 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 13. Rough Plumbing55. Plurnhino System - Final 14. Rough Electric -Conduit .56. Electrical -Final 15. Rough Electric -Wiring x•57. • `Solar System -Final 16. Rough Heating &Air Conditioning 7,/Fencing & Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test 20. Roof Framing 21. Roof Sheathing NOTES: 22. Frame and Flashing 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning 3� 30. Final Gas Pipe -Test 31. Final Plumbing , 32. Water Service -Final ` 33. Gas Service -Final 34. Solar Domestic -Final 35. Landsca e Sprinkling System 36._" Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE &BUIL DING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern CaliforWb Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date r ILI '\- - Applicant to fill in all spaces within heavy border lines and sign all adorn prlate declarations. C)T�OSTA MESA P IT NO. --TRACT NO: LOT NO. BLDG. NO. ONS RUCTION PERMIT // S�(e - ' 1.574 2%02/82 1.0. Wroject Address . 1 /1'�♦. _ A'22 TYPE OF CONSTRUCTION A NEW Q ADD - M ALTERATION ❑REPAIR_❑CONVERSION El DEMOLISH ❑ OTHER - - .• - � ��.. - -- ZONING REGULATIONS -- - Owner // M /_' Phones ]2 Address ISI-7yj/may fM/- Arch/Eng. - License No. - - DESCRIPTION OF WORK - - - - - _ '- - -' A P: - .ZONE- - PLNTGp. ' •+-• Address - - - - - - - - - • Contractor - - Phone - PE OF PERMIT El RADING�,�❑ FOV NOATION ❑ STRUCTURAL ❑ TENANT R. -ELECTRICAL ❑PLUMBING ❑MECHANIC SETBACK /L 5T. ;SID YARD gRtE1FL. p# PROPEIf2TYNLINE. - Adtlress'-' :' ; -- [gyp LICENSED CONTRACTOR ECL'ARATION . I hereby affirm that 1 am licensed under provisions of Charter 9 (com- .LSI, E-yq RU •RIGHT ' mencing with- section -7000) of Division. 3 of .the Business .and '. ❑ OTHER Professions Code, and my license Is in full force and effect. - REAR YARD (TO P/L) Z PROJECT DESCRIPTION License Class Licens No- 1PKG.SPACEREQ. _ _ _ - PROVIDED 'Date )�� Y'--- Signal _ 6Q. -FT. - -- -"f "" WORKERS'-COMPENSATION.DECLARATION. OCCUPANCV_CONSTRVCTION TYPE_ STREET WIDTH PARK FEE E '1 hereby affirm that 1 have a certificate of consent to self -Insure ora _ .VALUATION ' - ZONE ZONING APPROVED BY,, - 1 DATE - ,certificate of Workers'. Compensation Insurance, or a certified copy y thereof (Se Ion 3 00, Lab. C.)., �m f/_ GRADING CU. YDS. ACRES 3PECIAL CONDITIONS: Polity No. � -� pany .. REMARKS; Certified copy is hereby furnished. _ -, _ - _ - - Certified copy is filed with the city Building Division. _XEMPTION'FROM WORKERS' COMPENSATION DECLARATION •' - -I' - - _ - - - - - -_ (This section need not be completed If the permit is for one hundred _- 5$3001 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' a s'to' become PLUMBINGf, C - .PLAN CHECK "- '_ ' ' - ' 'ELECTRICAL _ ' - ' -PLAN CHECK " subject to the Workers Laws of California.' " , i l' I _ BATHTUBS - - SHOWERS - - j---'" .---FT90 FT - .Compensation _ Date Signature NOTICE: If after making this declaration, you should become subject ,(TOILETS - [URINALS' """" s 'I^ _ ';GENERATOR' 0-1 KW_1-30 KW: to the Workers' Compensation provisions Of the Labor Code, you must ?RANSFORMER i forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE'LAVS-" _ - - APPLIANCE 10-50 KW_50'I KW -- --' --• revoked. "KIT. SINKS _DISHWASHERS - '.MOTORS -'- - 0-1 HP_1-10'HP"- _ _- CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the per. SERVICE SINKS . , SUMPS - .-.- _ _ �' - _ _ INC. SOLAR �( )• - 30-50 HP -50 + HP - formance of the work for which this permit Is issued (Section 3097 - FLOOR SINKS -- FLOOR -DRAINS ' - - ;FIXTURES "OUTLETS - WITCHES- Civ. C:). - .. - ..__ ... _-_ _ _ ___- -. ._ Lender's Name Lentler's Atltlress � DRINKING FOUNTAINS' _"' 1 -- ' - ' ")"- '- GAS TUBE SIGNS -- OWNER BUILDER DECLARATION INTERCEPTORS- ' _ -CLARIFIERS _ _ - 4POLE'LIGHTS '- ' -- - _ " ' - 1 hereby affirm that I am exempt from the Contractor's License Law for P - - SWIMMING POOL- ---P'TRAP- : - - -- the -following reason -(Section 7031.5 Business -and -Professions -Code: Any city or county which requires a permit to construct, alter, POLES - METERED SUBS - WATER SERVICE ALTERATION-- _ - -- 'PANELS' - MAIN - SUB - impr. ve, demo lash or repair any structure; prior to its Issuance, also re- quires the ap, Iicant for such permit to file a signed statement that he GAS SERVICE - OVTLETS - SERVICE - - AMP - - - - is licensed pursuant to the provisions of the Contractor's License -Law (Chapter 9 (commencing with Section 7000) of Division 3 of the .'Y: _ - WATER HEATERS' -BTU OUTPUT: - -'- --- - - - - — - Business and Prolessions-Code) or -that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by - -SEWER CONNECTIONS- a^ applicant for a -permit subjects the -applicant to a civil -penalty pL more than five hundred dollars ($500). r SOLARTANK'" COLLECTORS'. '- -- - - - - - -- - -- - - - - , as owner'ot the property, or -my -employees with wages as their s.•.c compensation,, will do the work, and the structure is not intended or offered for sale. (Se6tion-7044, Business and Professions Code: The __ SOLAR PIPING SVS.• - - "ISSUE FEE' -- 'Contractor's License Law does not apply to an owner of a property _ ISSUE FEE - _ `- --'APPLICATION APPROVED BY - - DATE who builds or Improves thereon, and who tloes such work himself or thrOugh his own employees, provided that such improvements are not MECHANICAL PLAN CHECK SUMMARY OF FEES, Intended or offered for sale.'If, however, the building or Improvement Is sold within one year Of completion, the owner will have the burden of proving he did not build or improve for -the purpose of -sale). BUILDING - - - - - -- ❑-1,.-as-owner of. the -property, am -exclusively contracting with HEATING SYSTEM 0-100,00 0 BTU -' PERMIT $ -•SMIP-c $_ _ licensed contractors to construct the project Section 7044, Business ( AND DUCTING 100,000+ BTU _ - - - PLAN CHECK $ - -- PERMIT' and-Professions Code: The Contractor's License law does not apply to. - - - -ISSUANCE ' $ an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU ,PLUMBING $ tracts.from such-wojects. with a contractor(s) licesned pursuant -to .SYSTEM - - - - - - - -- �- -- ._GRADING . $ the Contractor's License Law). 100,000 - BTU PLAN CHECK $ - - `, 0'1 am exempt under Section " B: & PTC. for this -- - - - - -- - - j - - - -- $ BOILERS BTU ELECTRICAL $ reason _ _ - !PLAN CHECK $ MICROFILM E - Date. Owner SYSTEM REPAIR, ALTERATION' EXHAUST SYSTEM MULTIPLE t ,MECHANICAL E- ' ' 'TOTAL FEE $ ' r 1 LESS AD- AD - I hereby certifythat I have read this application and state that the above information is' Correct' -1 agree to 'comply with all city antl-county :PLAN CHECK g• _ VANCE PC E ordinances and state laws relating to construction, and hereby author;ae I• •' _ representatives` Of -this City t0 enter upon the- above me nli0. netl" prop 'mpection urposes.,rye/ �7.,/IG�.nn� oses'ry�i- - ' �� $ignllfii��-i Datel`"- Y� 1, - ISSUE FEE FINAL FEE $ • Drivers' License or 55 • CMF 0865-46 white -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor ��L CONSTRUCTION AND PLANNING If- b�C� Date APPROVALS Permit# `d✓ Inspector POOL & SPA.- - Date Inspector , APPROVALS Permit# _ 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - ` - 2. Soil Pipe -Un rgrn- _ 44. Steel Reinforcement 3.. Electrical Conduit Utility-Undrgrn 45. Forms - - - 4...- Electrical Conduit-Undrgrn - 46. Electrical Bonding 5. Steel ein orce - 47. Rough Plumbing & Pressure Test - - - - 6. Electrical UFERGrn - 48. APPROVALTOCOVER-GUNITE-- -' - - -- - - 7. Footings_ _ 49. Electrical Conduit-Undr rn B. Foundation- _ 50. Gas Pipe, ❑ Undr rn, Test . 9.-. Water -Pi pe-Undrgrn _ 51. Backwash Lines P -Trap,-❑ -ridgy rn' - - 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 - - 13. Rough Plumbing _ _ - - - - ' " '- _ -' ' •" - '- - 14. Rough Electric -Conduit - - - =`56-' Electrical -Final 15. Rough Electric -Wiring 57. Solar System -Final 16. Rough Heating & Air Conditioning bb. Fencing & Access_ Approval 17. •Ducts, in Structure .' - _ APPROVED FOR PLASTERING -77 ': ' 18: Ducts, Ventilating -60. POOL/SPA SYSTEMS FINAL' 19. Gas Pipe -Rough &Test - 20. Roof Framing - -.' 21. Roof Sheathing"-' NOTES: 22.. Frame and Flashing 23S 'Insulation• -- - 24. Lathing & Siding - - - - -- - --- ' 25. Drywall Nailing -_ - 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric [7 ' 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. FINAL STRUCTURE & BUILDING 39. Special.Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. r - ' 42. -- CERTIFICATE OF OCCUPANCY No. Date ..- YY Aoolicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA P_E NO. TRACT NO. - LOT NO. BLDG. NO.- - I we cr a+r uc CONSTRUCTION PERMIT / - 2573 -,_-_ . TYPE OF CONSTRUCTION ❑ NEW ❑ ADD ❑ ALTERATION '•- ❑ REPAIR El -CONVERSION ❑DEMOLISH ❑OTHER - �� .\ ';F '1 -- -• - - - - - ZONING REGULATIONS ' Project Address Sf/SC'09ze -� Owner yl' - f lv - Phone •(oz's- :Addres O,e✓// -- UG �/ .__._ '1 Arch/Eng. __ License No. DESCRIPTION OF WORK _ TYPE OF PERMIT ', - - - -- \ ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL- - ❑ TENANT '❑ELECTRICAL ❑PLUMBING ❑MECHANIC _ A.P. $ ZONE PLNG'. REF. 991. - U RRLDING� - 'SETBACK C ST PROPERTY LINE - SIDE -YARD - -LEFT DE-Y -- --- - - -- - - - Address .. _ _ - 'Contractor / - i3�r _ Phone J2S0f3 Address /' - ,f//' .5,.� moo- L� . LICENSED CONTRACTOR DECLARATION - 1 hereby affirm that I am licensed under provisions of Charter 9 (com- } s RIGHT ' mencing-with section- 7000)_ of .Dlvlsi on 3 of..the Business :and : ❑ OTHER - Professions Cotle, land my license Is In full forte no effect. 1 PROJECT.DESCRIPTION' - REAR VARD (TO P/L) License Class G' '- Itense O_07� _I� _ _ _ F ,•� _ �. C �� • SO. FT. •- �.�� a PKG. SPACE REO. _ - PROVIDED' a ' Date /-,QL .Signaturo- _ _ OCCUPANCY__ CONSTRUCTION_ TYPE ._ -_ _._ WIDTH STREET "PARK FEE.$ - WORKERS' COMPENSATION D ARA I hereby affirm that I have a c dicate to sent to self -Insure ora _' VALUATION - ZONE ONING APPROV ZONING -APPROVED ED BV--" ' DATE' _ - certtfiwte of. Workers' Compensation surance, or.a certified copy _ _ _ __- , GRADING ,CU. YDS. - ACRES _ 'SPECIALCO CONDITIONS: -- -- -- s thereof (Section 3800, Lab. C.). _Policy No. �CompanY lertifled copy is hereby furnished. _ _ _ _ t REMARKS: _ _ _ ��-�•_:� _� -`4_t _`- _ �� _ _ _ _ _ - _ _ _ _ _ - --_ artlfied copy is filed with the City Building Division. enEMPTION FROM WORKERS' -COMPENSATION DECLARATION w . - - (This section need bot be completed if the permit is for one hundred I ($100) or less)._ _ , that In the performance of the work for which this permit Is issued. Issued, I shall not employ any person in any manner so'as- become PLUMBING:- PLAN'CHECK-'ELECTRICAL " ---' -"PLAN CHECK ' subject to the Workers' Compensation La s Ca[ifornla. • BATHTUBS•_ --_ __SHOWERS _ ..._ __ _.__- - --_ _ .__- - -- - ' �.� _ ..'- Date Signature NOTICE: If after making this de r on, she become.subject TOIL ,,,, URINALS _ ---�' - 'GENERATOR 0-1-KW_1-10:KW - - to the Workers' Compensation Ions he Labor Code, you must- forthwith comply with such pr Bions o his permit shall be tleemetl - LAVATORIES, DOV BbE LAYS - -- 4 TRANSFORMER APPLIANCE 10-50 KW_50 * KW- - - - - revoked. "KIT.SINKS- - - - DISHWASHERS- - - MOTORS- -- -- 0-1 HP -_1-10 HP° CONSTRUCTION LENDING AGENCY 6 6 - I hereby affirm that there is a construction lending agency for the per- _ - _ _ SERVICE SINKS , SUMPS, - _ N_4 (INC..SOLAR)_ . 10-50•HP 50 --HP -- �- formance of the work for which this permit Is issued (Section 3097 FLOOR SINKS -' - FLOOR DRAINS�-H- lIFIXTURES' OUTLETS' SWITCHES -- Civ..C.). _ - ¢� Lender's Na e �'�'•'_.^'��•^- '--T �- - = •�-- Lender's Address --- -- - '1'IRINKING FOUNTAINS -^ '- •--- - •-i'--� - -GAS TUBE SIGNS--- --- - -- - - OWNER'BUILDER•DE •'-11_� n'se -INTERCEPTORS' '- -' 'CLARIFIERS - 'POLE LIGHTS -- --•-- - - -- exemptI from t hereby affirm that 1 am exempt from the Contractor's License Law for _SWIMMING POOL -P-TRAP-- - - - - -- TUN 'POLES - - - METERED perms the following reason (Section 7031.5 -Business ofessio a t to nstruns_Cotle:_ Any city or county which resvires r permit to construct, alter, Improve, repair prior to its issuance, also re- to WATER SERVICE ALTERATION - - -- PANELS --' -- MAIN- SUB - -' for such fit [he a permit to file a Signedra statement that he ap,li ant f P quires P. �. GAS SERVICE - OUTLETS- _ -"' •'�-' ' SERVICE- __ .-.: - _ - -AMP-- scant CY License Law.. is licensed recant to the rph Section the Contractor provisions Pu p Di Chapter 9 (commencing with Section 7000) of Division 3 of the Professions Code) he Is exempt therefrom the WATER HEATERS- BTUOUTPUT - -- -- - !- - - -- -- -- - - - - - - - -- - e - and and or.-thatAny basis for tae alleged basis for by exemption. Any violation of Section 716 .SEWER CONNECTIONS - - -' -"' -- •—�--' " -} - -- •1 -- - -- -- - - _ •- - -•--- - --^ ' �- - r a permit subjects, -the applicanttoa [lull. penalty an ap a pen more tha t more than live hundred dollars ($500). SOLAR TANK- - - COLLECTORS '• -4 • "; - - - - -- -- --- - - - - --- -- as owner of the property, or -my employees with wages as their so- compensation, will do the work, and the structure is not Intended so- or offered -for sale. (Section 7044, Business and Professions Code: The -SOLAR PIPING SVSG - _-- - --- ISSUE 'FEE-- - -'--- Contractor's License Law does not apply to an owner of a property who builds or -Improves thereon, and who does -such work himself or ISSUE FEE - - - - 'APPLICATION APPROVED BY - DATE - through his own employees, provided that such Improvements are not MECHANICAL - PLAN CHECK _ - SUMMARY OF FEES . •sp Intended or offered -for sale: If, -however, the -building or improvement- is the have the burden sold within one year of completion, owner will of -proving -'he did not build or -improve for the-purpose�of sale). 0-1, the •- - - - - - -- - -- - HEATING SYSTEM 0-100,000 BTU , -BUILDING- - - PERMIT $ q, I" - ----- -- -- - SMIP $ - as owner of property,- am exclusively contracting with AND DUCTING - - _ I - - - - licensetl contractors to construct the project Section 7044, Business P 1 ( 100,000 + BTU (PLAN CHECK $ PERMIT Professions The Contractor's License Law tl not apply -to _ ISSUANCE $ opCode: , a ocon- an owner of property who builds or Improves thereon, and who con- 10-0-.000 REFRIGERATION 0-100,000 BTU PLUMBING E r: - tracts from such. projects with a contractor(s) licesned pursuant to .. - SYSTEM _ - _ _ - GRADING' $ the Contractor's License Law). 100,000 �i'BTU PLAN CHECK E ❑ I -am exempt under Section B. 8 P. C. for this - -BOILERS BTU - - ELECTRICAL $ -, . reason. SYSTEM REPAIR, ALTERATION ( _ _ _ -PLAN CHECKS- _ __ MICROFILM_$ •_' _ _-_ .11 - __ 1 sTOTAL-'FEE-$'- MECHANICAL $ - - - Date Owner _ _ _ I herebycertify I nave reatl this a y application and state that the above EXHAUST SYSTEM MULTIPLE 1 ./ . 'LESS AD- ihlormalion is -correct. I agree to comply with -all city antl county -PLAN CHECK- $ - VANCEPC $_' - ordinances and state laws relating to construction, and hereby authorize representatives of -t city -to a upon the above mentioned" property for p n pur Signature Dated ISSUE. FLEE r. - _ - /V 01 FINAL FEE E Drivers' c^ eor - r �"aF�516 Wail -Buildin Canar A g; y- pplicanl; Pink -Accounting: Goldenrod -Assessor CONSTRUCTION AND PLANNI APPROVALS Permit # Date Inspector POOL & SPA APPROVALSPermit`# Date Inspector 1. Temporary Electrical Service or Pole 43. Pool &Equipment Location --'" 2._- SoilPipe-Un rgrn-//$? 44. Steel Reinforcement - - - 3.. . Electrical Conduit Utility-Undrgrn. 45. Forms - - - -- - . 4._. Electrical. Conduit:Undrgrn - - 46. Electrical Bonding - - - -- - Steel Reinforce _ 47. Rough Plumbing & Pressure Test -' -- - - -- ,_ 6.. -Electrical UFER Grn_- 48. APPROVAL TO COVER=GUNITE _ 7. _Footings-_ 49. Electrical Conduit-Undr rn` _8._ Foundation_- _ 50.tr, Gas Pipe- ❑Undr in, Test.'" ` -9._ Water.Pipe:Undrgrn_ __ - 2-//-$2. (.U,t? 51. .Backwash Lines P-Trap,_❑ndr rn__ 10. Structural' Floor System 52. •.APPROVAL.TO DECK rV; r I—, .11,_Property Sewer. Line &.House Connection _ -53. - Backwash & Receptor -Final 12.- Street Sewer Connection. " - -- - 54: - Heater &Vent -Final, _ 13._ .Rough Plumbing _.. .. - _ _ _ _ -.._.. 2 -!/=SQ 1:r7,£4 " 14. Rough Electric -Conduit -- - ' - -:56: -Electrical-Final 15. Rough Electric -Wiring - - - - -57.Solar System -Final 16.-- Rough Heating & Air Conditioning -- -' = t - - - - - - encing &Access Approval '-17: Ducts in Structure,- '- APPROVED FOR PLASTERING - 18. Ducts Ventilating -, .. ... : '- . _ .. - -, ..- - -- -. - - "- - �`- - --- -^- " • _, _._..-_:; _ _ .. 60. POOL/SPA SYSTEMS FINAL', .. r - 19. Gas Pipe-Rough'&Test' -- - -- - 20. Roof Framing - - - - - - - - - -- - 21. Roof Sheathing- _ - -- - -- - - "-- ''NOTES: ' 22.-- Frame -and Flashing- -- -//' Z /af,`n 23. -Insulation .. a? -//-- v . '"Gfec ' 24: Lathing & Siding - - - - - -- S/ !4cA 5Ae'- 25. Drywall Nailing - - - - - - - - - _ '- - •' 26. Plaster Brown Coat - - - - - - - - - - - - - - - 27. Electrical Power Meter -Final - - - - - - - 28. Final Electric-- lectric-29: 29., FinalHeating&-Air -Conditioning - --- - - -- -- - - - _ - - 30. 31.• Final Gas -Pipe -Test - 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. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. ElectricRelease to Edison 41. Gas Release to Southern California Gas Co. - • 42. CERTIFICATE OF OCCUPANCY 'No Date - - - AORRESS OF BNUIMD: 7..—t FISCHER AV UNIT: B OANEBSNU491F RT WEST BUSINESS PAR ADD" .' FISCHER AV OSTA MESA, CA 92626 556-4990 APPL. MALI ADDRESS: ARCHITECT OR ENGINEER; UC NO.: UICK OR ENG.'S ADDRESS: UNIT: CONTRACTOBsIbAwPETRONELLA ROOFING (714)548-1645 CDNTRAcmR mmM 2626 NEWPORT ADDEEII COSTA MESA CA uc.No.: 00460707 92627 umT: 201 LICENSED CONTRACTORS DECLARATION: 1 hereby aRbm under penaey of perjury Had I Am Ikansad undpr er mAabm of Chapter 9 (commeeang wish Bacton TODD) of Division J d the BusinessJPab ode. and my Som e 1. in full force sitC 10032605 LIC.CLASS:C 3O.: 4607 7 EXP: 07/96 ate: — ContnR BUILDER DECLARATION: I Mnby eMrm under pery t Am mmpt from IM Contract. License Law fa the following reason (Section TUJ1.5 Business and Professions Cy a m my which requlros a Permit to mmtlud, ober, Improve,'amollsh, a repair airy structre, prior b h beuence, also rppl a such peon! to ile a signed ".mord that M orsitbamed Wlmanl to tit provisions d tit Contractan Unhapto B (cemmenclrq ahh Sedbn TODO) of Division 0 of tit,usinon and Profession Coit) a that he a she Is exempt id I basis fa the alleged exemption. Amy vb4lbn d SMM7=5 by airy "Ica l for a perm! voblscts tit applicem to nct mors then Ms hundred colon R5DDj). ❑ I, as owner tithe property or my employee, wish wages as their vola cmnIMMatlon, will do the work, and IM structure Is red Intended or offered for sols (Section 7044, Buss. end professions Code: TheConlrtlon Lines taw does red ap*toan bwnard property wit buddy or bnproves thereon, and wit does such work Aimee! or Mr.eb or through his or her own employees, praNded that such Improwmema are not Intended or offered for vale. R, however. IM buildim or rMormemem a sold wbhm ane year of complatM, Ur ow.m tMikan will haw the burden of proving M or she dM red build or improm fa the pupae of *We). ❑ 1, as awmr of the property. am exclusively contracting wan icensed contractors to construct fit Project (Benin 7044, Summon and Prodommom m Cods: The Contractors Lae law eed it ase red apply b an owr property wMinta m bop n" t" , and wit common Ice such project, with a vomrmmoffe) licensed pu suanl Io the Contracun U.. ❑ I em exempt M. Secfion: S. A PC.. for Nu mavon: 1 do hereby cendy that I an swat. of and understand the mcuiremema 0 California Vanish mal Safety Cite Sections 25505, 2 . and 25534, and that I or airy Mum buiwim comport will I we not (circle om) reed to campy wish said some codes seat the recubemems far a permit la construction or m clacalicn ham the AwMM Wa'ngenwm D tinct. Re®dsuil camngion appicatbm en exempt from than povisiau. Done: Applicars: WORKER'S COMPENSATION DECLARATION: I hereby affirm uMm pmWy of perp r, orw of the fabovanp dedsamiom: ❑ I hew mit veil meinnn a cenS'rme d mrmeel to.ebAnan fa wakens' c0mpenWion, es provided to M Sectiml 3)00 d IM labor Coit, /a IM pedomenca d sire wit la wNch the pmM u eaued. I new and W ones " at is m' ed. My el'on i compensation as nn I. by Section mad of Ms Lebon Code. M lit pedamera al iM —\\,work la wfi'x•N this Permit o issued. MY waken' mmmmation insurerce carim W paltry number oro: carder: ARGONAUT EXPIRES policy Number: 91 5701 15499 01/01/97 In nation need rwr M mmpletW of red pmmd a for on. hundred ddlam (drool or len.) ❑ 1 nnby that in the Mdomera d Iho wale fm which this pmmb n b�l ed. mall rel employ any ninon nam' Ary roomer vo m to become vobjed Io la woM1an' mrmemation few+ d Calaan.nII,'o^ agree that R I should became subject to IM wwken' compo tion prounion+ M Seagbn 3'!00 d the labor Cita. I mh ` nh amply with Ihoas provisions. GAppl mIng: Failure !+noun workers'compermallon row lm umewN/andaal/adriecf an ampfoym to cdnoml Plasmas and civil Am. up b one hundred fhouesnd dollen (SI00, 0003, n addldon fit coat of compencumbn, owne ssl n Prowded bee In Sect/on 3105 0l Are Labor Code, Intersel antl eamry'a / s. CONSTRUCTION LENDING AGENCY: I hereby affirm under of mriur, that tan is a conAmdion lending agency a the performance of the wale for which the cermb Is moued (Section 0097, Civ. C), LENDER'S NAME: LENDER'S ADDRESS: 1..Mfy that I hew reed this application end ane That the shove information I. come. I eg.IP campy wish ell dry and couray ordi. and ante nwa roMiq 1. budang emavuctnri end hereby authorize reptemer4etiw d this den to ever upon IM ebme memioned pro," la impenion mrpnea. 22ID WATTS (515146.WP) Gate: S-2�-`ib GmenRIs: Canary-Appicant; Pink-Rewnue: (laldenmd-M+usn CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO: B 077848 PLAN CHECK NO: N PERM NO: B 077848 GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: OTH SOB DESCRIPTION T/OFF BUR 6 REROOF W/SAME SQ FT: 17,000 CLAIM VALUE: 17,000.00 CALC—VALUE: 17,000.00 GROUP OCC: B / COMMENTS: REROOF 17000SF COMMERCIAL BUILDING W/BUILT—UP RE i4 RE RF 1E i41E iE bE iE M ♦E iE * * iE AE 1E 1E * ii 1E RE RE iE dE 1E RE RE 1E dE iE dE 1E dE 9E 1E RE 1E dE dE 1E 1E 1E 1E iE ♦f 141f 1E 1E * 1E 1E ♦E iE AE AE R4 * 1E * * RE 1E iE 1E 1f 1E 1F 1F 1E 1E 1f 1E 1E 1E iE Z 0 N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 00000000 ZNE: REF NO: PLANNING NOTES> > 1E 1E 9E 1E 1E 1E 1E 1E 1E iE ♦E * 1E 1E * AE ♦E ♦F ♦E 1E 1E AE 1E 1E dE 1E 1E 1E 1E AE 1E 1E 4 ♦E 1f 1E 1E 1E iE 1E ♦E * AE ♦E 1E * * 1F iE * 1E 1E iE 1E iE k 1f 1E iE 1f 1E 141E Air 1E 1E Air 9E AE AE1F 1E 9E ♦E AE ♦E iE 1E 1E D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE:/' BUILDING APPROVED BY ; DATE: I APPLICATION ISSUED BY: t�FiF� 00— 1E1tdERE1EiE**dE**rt1E1E1E1E iE*1E**iE7FiF�F7FiFifiFiF7FiFiE"iF"iF{F�F3F�F�F�F 3FTF3f�flF LEGALIZATION:N F E E S U M M A R Y BLDG PMT PLUMBING ELECTRIC MECHANIC PERMIT 249.75 PLAN ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTALS ---- > 253.32 0.00 0.00 REVENUE DIVISION TOTALS--> COLLECTED: BLDG PMT PLUMBING ELECTRIC MECHANIC 249.75 STRUCTURAL SEGMENT:Y FIRE SMIP RES, GRADING SMIP/NON—RES 3.57 TOTAL PAID DUE 253.32 253.32 ,00 253,32 OVER/SHORT: 00 FIRE SMIP/TOT GRADING PLAN—CHECK 3.57 * * * iE 4 * 1E iE * 4 * 1F RF 1f Af 1E iF iF 1E iF 1E 1E iE iE 1E 1E 1f 1E iE 1E 1E iE 1F 1F 1E ♦f 1E 1E iE 1E ♦E 1E 1E iF 1F * iE 1E AF Air ♦E 1f 1E iE iE 1E 1E 1E iE 1E 1E RE 1E 1E 1E 1E 1f AE 1E iE 1E 1E 1E 1E * 1E 1E 1E 1E I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST SFC 17000 ALTER BY VALUE COMMERCIAL NOZONE 1.00 17,000.00 END OF FEES I ^CONSTRUCTION AND PLANNING - APPROVALS Permit # Date r Inspector POOL PA APPROVALS Permit # Date Inspector f 1. Temporary Electrical Service or Pole i foil Pipe•Undrgrnd. 52. Pool, & Equipment Location 53. Steel Reinforcement ' Electrical Condui_j,Utility-Undi6mcl. 54. Forms 4.-Electrical Conduif-Undrgrnd. 55. Electrical Bonding _ 5: Steel ReinforcerrtePt.r 56. Rough Plumbing & Pressure Test ._6_1 Electrical UFER4 rid. 57. APPROVAL TO COVER-GUNITE -7. Footings 58. Electrical CondGit-Undrgrnd. - B. Foundation _ _ - 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undr`gind. 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 1-2. Sewer Cap L 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final `• 14. Rough Plumbing, 1 65. Electrical-Final v 15. Rough Electrical-Conduit .. 66. Solar System-Final 16. Rough Electric Wiring - - 67. Fencing & Accesg�Approval�- 17. Rough Wiring Sign - 68. APPROVED FOR PLASTERING. 18, Rough Electrica6T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air, Conditioning _ ,r 4r FIRE,DEP,T. REQUIREMENT APPROVALS - Permit # 20. Rough Factory Fic2p_lace _ 21. Ducts, in Structure- ,`- -70. 'Underground Hydro 22. Ducts, Ventilating - - 71. Product Piping 0,Gas ❑Oil " 23. Gas Pipe-Rough & Test - '_ 72, Underground Flush 24. Roof Framing _ n r 73, Undergrnd.StoratTank 0Gas 0Oil 25, Root Sheathing 74, overhead Hydra;.- 26. T-Bar Ceiling (Structural) & M_onacoat r _ 75. Dry Chemical 27. Frame and Flashing _ > > 76. Dry Standpipe K 28. Lathing &Siding -.... 77: FIXED SYSTEM FINAL ` '- 29. Insulation. - - 7g.. FIRE PREV. F1 4L 30. Drywall Nailing - HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat.;- 79. FINAL INSPECTION - 32. Electrical Power Meter:Final - M FOOD CERTIFICATE ISSUED 33. Final Electric Notes: - ' 34. Finat Heating & Air'Cocd_itioning 35. Final Gas Pipe-Test. x O 36. Hood or Canopy237. Final Factory Fireplai;P 38. Final Plumbing •• _ .' - " 39. Water Service-'Fina-f 40. Gas Service-Final 41. Solar Domestic-Final - -- 42. Backflow Preventer - _ - r• .J ' 43. Backflow Irrigation 44. Landscape Irrigation#System 45. Sound Attenuation' - •• - " 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING . 7 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date CITY OF COSTA -MESA Development Services, Division of Building and Safety CERTIFICATE.OF OCCUPANCY This certificate is issued pursuant to the requirements, of the Uniform'Buildmg Code, Section 308 adopted by the City of Costa Mesa certifies that at the time of.its issu ance,the build ing structure herem below described was inspected and approved foroccupancyasfollows: '\ Sys. \O \� i- 245 Fischer Rve. B-2 B04-01416 Building Address � � � Bldg_PermitNumber Use Commercial/ArcTuitecfa/ � 1 Group Type of Constructiomrry,reerane,Fire'Zone --." Use Zone OwnerofBuilding 245 Fischi ` r Avl-z B' 2__i�� r Tenant Irwin -`Pancake Architects Partne'i,s_hip S/ /,'! Address245 Fischer Ave.N,y\B-2, Costa M.esa-,=`CA Bc °^ Ed y BUILDING OFFICIAL-RicA: k ,Broi4 ; G B , ros; O DatejG l �Chief of Inspections 24/04 REQUIRED TO BE POSTED -INA CONSPICOUS PLACE City of Costa Mesa Development Services Department CERTIFICATE OF OCCUPANCY No. jj''�� f (� Building Safety Division OL,1 J U CJ 1 P. O. Box 1200 Costa Mesa, California The Building located at 245 Fischer Avenue, Unit 86 has been inspected and found to comply with the provisions I City of Costa Mesa Ordinances applicable thereto for a Group R2 Occupancy. Use of Building Office, Legal Description 427-033-09 (See reverse side for Metes and Bounds) Building Permit No R 3RADA Electrical Permit NO.R dSdFS Plumbing Permit No.o dea41 Mechanical Permit No. m 45204 Number of apartments and/or guest rooms ISSUED TO: Building Official Tonv CID-- Baca Imoarial Bank 245 Fischer Avenue, Unit B6 by t i .: r Costa mesa, CA 92626 Date Aoril 3, 1990 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 City of Costa Mesa Development Services Department Building Safety Division CERTIFICATE OF OCCUPANCY No. V U L 370 P. O. Box 1200 Costa Mesa, California The Building located at 345 FIS= AVENUE UNIT #B-2 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group B-2 Occupancy. Use of Buildi Legal Description (See reverse side for Metes and Bounds) Building Permit Nc,,C.11681 Electrical Permit No. r:11681.E12906Plumbing Permit NoQU681 Mechanical Permit No. G-11682,12119611 Number of apartments ,� 'rgannd/org/uest rooms ISSUED TO: Building Official �' A' U�Ief NOSLM PTTULTAM "� —/ ,Q by ` ��Gu11Q�d1ti`— 1517 N. FATRVTFW. SANTA ANA. r'A_ Date t,6"`T-- / %/�j0,w- This This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. CMF 1015-46 rev. 1/83 White - Owner; Canary - Numerical File; Pink - Bldg. Permit File City of Costa Mesa ' Building Safety Department C E R T I F I C AIT E OF OCCUPANCY y Q Y P.O. Box 1200 1.3° -3206 Costa Mesa, California The Building located at . 245 Fischer &B-2 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group B"2 Occupancy Use of Building ` emwit imrot7l3rmt Legal Description 427-033-07 (See reverse side for Metas and Bounds) ._ .- . it-%7go Building Permit No BIP -2490 Electrical Permit No. - f3fM�-26SD Plumbing Permit No. IT D-940 Number of apartments --0- 1. and/or guest rooms -0- ISSUED TO: Build�ing,OOffffii�c]ial by ✓ �// OAA ronu Pullim V. WW � Cvor � I�'. Buil&in1 Diva.�iari il s c Date s/ . L} 2 - This This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 306 lel U.B.C. Form BU 34 Rev. 11/70 Job Address: 245 FISCHER AV Suite: 8002 Vicinity: UNIT B-002 Parcel Number: 93898007 BUILDING PERMIT Zoning: Status: ISSUED Applied: 08/11/2004 Issued: 09/17/2004 FA Applicant: IRWIN, GREG ISSUED BY: 'PLANNING &ZON ///jjj'''1 y(�/,�7 / ` Address: 7400 CENTER AV - - - Phone: -X714-8940414 -:Rear,, 0-,0 HUNTINGTON BEACH; CA"' _ Zip: 92647 y Owner: 245 FISCHER AVE B-2 PARTNERSHIP Front Address 245 FISCHER AV B-2- Left - — 0-0 ,.-� - Phone:, 714-894-0414 _ COSTAMESA, CA , - Zip: 92626 PARKING Existing:; 0-__ Require& /,0 Contractor: CENTERPOINT.DEVELOPMENT_ Address: '22866 AKE.FOREST DR - i - -�%Phone: 949-770-4150 ' LAKE FOREST Zip: 92630;" License:_ 743621 Arch - - - Eng: Address: _ - ' �,, ." Address: - ; -'Phone: - - - Phone: - _ Zip: - License: License: ' SCOPE OF PERMIT TENANT IMPROVEMENT FOR "IRWIN PANCAKE ARCHITECTS". SCOPE,OF,WORK.TO INCLUDE: INTERIOR PARTITIONS, NEW CEILING, LIGHTING, ETC. NO NEW PLUMBING PER- APPLICANT FEE SUMMARY `- Plan Check: $261.58 ` �' -�_ � ' -�' Valuation: $210,000.00 Permit: _ _' _ $1,609.75 , . -Calc Claim Valuation: $210,000.00 SMIP Res: $0.00 SMIP Com: $44.10 Other: $0.00 Inspection: :$0.00 eTotal: $1,915:43 ING .:Right .0'0 i Right`, '0-0 ; 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California ste 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 suspen 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 applical required Inspections and final approval must be obtained. Failure to obtain Inspections and final approval will result in the expiration FOR INSPECTIONS CALL: (714) 7545626 2"6.46 (eroo) related abandoned as, and all permit. 'PLANNING &ZON SETBACKS MAIN STRUCTUREFront,0-'0 -:Rear,, 0-,0 'Left -.0-0 y ACCESSORY Front 0-'o ; Rear 0-0 Left - — 0-0 _ PARKING Existing:; 0-__ Require& /,0 Proposed: ING .:Right .0'0 i Right`, '0-0 ; 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California ste 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 suspen 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 applical required Inspections and final approval must be obtained. Failure to obtain Inspections and final approval will result in the expiration FOR INSPECTIONS CALL: (714) 7545626 2"6.46 (eroo) related abandoned as, and all permit. DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 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 tar which this permit is issued, .1 have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 'My workers' compensation Insurance carrier and policy number are: Carrier.— ST FU A 1 0 Policy Numtier OO 200,5 '200 1 �slsection need not be completed i1 the permit is valued at one hundred dollars IS 100) or less.),- ❑ I certify that in the perfom price of the work f hich this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of worms, and afire it I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shell forthwith comply with these prov' q / / Applicant Signature-. Date: / O WARNING:FAILURE TO SECUR WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECTAN EMPLOVER.TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: hereby affirm that bem licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business antlrotesC nss Code, and my license is in full force andeffefectllc� 36 LClass Contractor's.Signature: Date: O CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this pennit is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: Signature: w Date: OWNER-BUILDER DECLARATIONS: r' I hereby affirm that under penalty of perjury that l 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 civil penalty of Ilbt more than five 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 Cade: 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.). ❑ 1, 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.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑ Yes ❑ 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, talsework, 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 will 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: 1 Will 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? ❑ Yes ❑ 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 feet 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? []Yes ❑ No (Section 25533 of the California Health and Safety 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 feel of compressed gas at standard temperature and pressure). ........................................................................................................................................................................................................................................................................................................................................................................................ 3 Does or will the rGlicant 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. .............................................................................................................................................................................................................................................................................................................................................................................I........ 4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No ............................................................................................................................................................................................................................................................................................................................................................................................ 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication a p3emtit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Ll Yes LJ 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? ❑ Yes ❑ No (It 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? ❑ Ves ❑ No ............................................................................................................................................................................................................................................................................................................................................................................................ 6 (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 COMPLIANCE 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 all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. :Signal Le Owner(s) Date iy1M a 7 01/ 1v' r. Authorized Applica ��Date CODE I. INSPECTION TYPE DATE . INITIAL $ CODEC INSPECTION TYPE 17AIE INMIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Well 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval' 203 Final Sign 222 Final Site / O. 204 Final Demolition 250 FinalBuilding/Occupancy (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 MECHANICAL PERMIT .lob Address: 245 FISCHER AV Suite No 8002 Vicinity: 8002 Parcel Number: 93898007 Applicant: GLASER,BRUCE Address: 22865 LAKE FOREST�DR-- ,. Phone:949-770-4150 �•' LAKE FOREST Zip: , 92630 Owner:.% 245 FISCHER AVE B-2 PARTNERSHIP Address.' 245 FISCHER AV B-2 Phone: 714-894-0414 COSTA MESA, CA Zip: 92626 Contractor: CENTERPOINT DEVELOPMENT Address: 22865 LAKE FOREST DR - LAKE FOREST Phone: 949-770-4150 -Zip: 92630 License: 743621 Status: ISSUED Applied: 09/17/2004 Issued: 09/17/204 ISSUED BY: 111100141, SCOPE OF PERMIT REF B04-01416 SUITE 8002 FOR IRWIN PANCAKE ARCH. 5 ALT REPAIR ALR/COOLING/HEATING FEESUMMARY_ Quantity Quantity ISSUE FEE ,. $23.50 Repair/ Alt Absorbtion Unit $0.00 0 Inst FAU <100 k BTU $0.00, 0 •'_ • Repair / Alt Refrigeration Unit $0.00 - • 0 Inst FAU.>100 k BTU $0.00 0--- ` - - Ventillation System -$0.00 0' Repair/ Alt Cooling/Heat $54.80 '"4 Evaporative Cooler $0.00 0 Inst / Rep. Recess Wall Hit $0.00 0 Commercial Incinerator - $0.00 0 Refrig Sys <100 k BTU $0.00 0 Domestic Incinerator - ,' $0.00 0 , Refrig Sys >100 k BTU $0.00 0 Compressors /Absorption Systems Gas Piping. $0.00 0 - Up to 3 hp / 100 k BTU $0.00 0 Factory, Fireplace .' , 1 1 $0.00 0 . _ .,. `l, -' 3 To 15 hp / 500 k BTU ` $0.00' 0„ i Hood w/Mech Exhaust ,'. $0.00 0 15 To 30 hp / 1,000 k BTU - �,�'" $0.00 0 / VAV Box `. $0.00 0 ,.:�,}'� - - - 30 To 50h[57/ A,750 k BTU -' $0.00, , 0' Vent Fan / Single Duct $0.00 A - Over 50 hp /;Oyer 1;750BTU $0.00, 10 Appliances �'^$0.00; "-$0.00 0 Boilers Fire Dampers'' "moi 0 Up to 3 hp $0.00 0 Smoke Dampers ;� $0.00_' '0 -, 3 To 15 hp - - $0.00 0 Inst or Relocate Appl Vent '� :-x$0.00 �0 "�,`' - 45 to 30 hp, $0.00 0 Air Handlers < 10000cfm ` $0.00 - 0 - - 30 to 50 hp - "� $0.00 0 Air Handlers > 10000cfm , $0.00 0" - - Over 50 hp - $0.00 0 Floor Furnace �� .. $0.00 0 Other Mechanical Fee Floor or Suspend Heater s , $0.00 .-o • " Investigation Fee. , , $0.00 Plan Check,Fee $0.00 Reinspectlon,Fee $0.00 TOTAL CALCULATED FEES $78.30 AS 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) 7545626 2"15-0 (6=) r� DECLARATIONS WORKERS' COMPENSATION DECLARATION: ' I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -Insure fol workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ,jam phave and will maintain workerscompensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Fu Insurance carrier and policy number are: C, Garner: (, .) l 'u01.t) Policy Number— Il I `%a/7 21707 :Tf1 (Kis section need not be completed it the permit is valued at one hundred dollars ($100) or less.) ,,,r„arr✓ =j` ❑ I certify that in the performance of a work for which thi permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California d agree that if I s become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply mply with these provisions.1�� WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLL4RE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37M OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: hereby ay�(habRaF licensed under revisions of Chapte 9 (commencing with Section 7000) of Division 3 of the Business @ rid P(Qfessions Code, and my license Is in full force:endeffect. Lia N ,�Cless:r�f'F �Q—C Contractor's Sign re: Date: CONSTRUCTION LENDING AGENCY:' ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lender's Address: Signature: Pc. Date: OWNER -BUILDER DECLARATIONS: - I hereby affirm that under penalty of perjury that I am EXEMP 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 sheslicensed 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 isexempt 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 penalty of not more than F. hundred dollars ($500).): ❑ 1, 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 EXCLUSIVELYyCONTRACTING 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.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑ Yes ❑ 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 will 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: 1 Will 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? ❑ Yes ❑ 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 feet 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? ❑ Yes ❑ No (Section 25533 of the California Health and Safety 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 appplicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ J0 (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? ❑ Yes ❑ NO ............................................................................................................................................................................................................................................................................................................................................................................................ 5 Does or will the applicant or present or future building Occupant require for the work which is the subject of this a plication ayermil for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). ............................ ............. .... ..................... ........................................................ ............................................................................ .... ...... .................................................. -............... ....... ................................................................. -............................... 8 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ 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? ❑ Yes ❑ No ............................................................................................................................................................................................................................................................................................................................................................................................ 8 (II 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 COMPLIANCE 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 all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature Lega��ner(s 7/ Date /A And/Or Au i . ,pli n Date CODE # INSPECTION TYPE M3 INIMA § C.ODEI INSPECTION TYPE g&¢, 1616 Fixed System Final Fire Prevention 206 Final Mechanical a6 SOLI 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 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 FinalBuilding/Occupancy (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 PLUMBING PERMIT Job Address: 245 FISCHER AV Status: ISSUED Suite No 8002 Applied: 09/17/2004 Issued: 09/17/2004 Vicinity: 6002 ISSUED BY: Parcel Nunmber: 93898007 U Applicant: GLASER,BRUCE� Address: 22865 LAKE FOREST DR Phone: 949-770-4150 •' - LAKE FOREST.• Zip: - .92630 . Owner: '245 FISCHER-AVE B-2 PARTNERSHIP Address 245 FISCHER AV B-2- - - Phone: 714-894-0414 COSTA. MESA, CA Zip: 92626 1 , Contractor: CENTERPOINT DEVELOPMENT Address: 22865 LAKE FOREST DR -_Phone: 949-770-4150 LAKE FOREST Zip: 92630 License: 743621 ' Arch /Eng :i -- Address: - -._ ✓� -- '--- r r: `.�,_ ._.• _ Phone: - - _ _ Zip: Licenser SCOPE OF PERMIT • REF B04-01416 SUITE 8002 FOR IRWIN PANCAKE ARCH.- - 4WASHBASINS AND 2 TOILETS. v 4FEE'SUMMARY. ' AMT.`,'', QTY AMT `�•OTY%;�' - - AMT QTY ISSUE FEE = $23 50 - 'Laundry Tub /Washer .. $0.00 '-0 `_' Sump Pump - '. $0.00 0 Backflow irrigation. $0.00 ` 0 = - Landscape Irrigation , $0.00 0 Swimming Pool ,$0.00 0 Backflow Preventers i$0 00 �0�--- P -Trap - %' $0.00 '0 _` Trap Primer $0.00 0 Bathtub v �'� '$0.00: 0 � � j - Pressure Regulator $0.00 0 _ Urinal- -� .' $0.00 0 Clarifier System $0.00","/ 0; Process Piping (per 10 ft)" $0.00_ , 0 Vacuum Brkr Bkfidw(1-4) $0.00 0 Connect (Ice.Soda,etcj ' $0.00 0/ . , Receptors- -- -- $0.00 - "0 Vacuuri Brkr Bkfiow(5+) $0.00 0 Dental Units $0.00 ; 0 Septic Tank $0.00 0 • Wash Basin" '" $0.00 0 Dishwasher '$0.00\ 0 ' " Sewer Cap for Demo $0.00 -, 0 Wash Basin Set $39.20 4 Drain, Floor $0.00`- 0 Sewer Connect - S0.00' 0' Waste and Vent System $0.00 0 Drain, Rainwater $0.00,-�0- - � Sewer Private Line - , $0.00 -0. - ,Water Closet (Toilet) $19.60 2 Drain, Roof $0.00 0�1 �; -Shower`---j. 50.00- 0 %`Water Heater/vent $0.00 0 Drinking Fountain $0.00 0 Sink, bar --_ _ $0.00_-0-. Water Piping (Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 -`Sink,-commercial - ��_ -$0.00 ' _ -0-' Water Re -pipe $0.00 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes7and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This penult shall automatically expire and become void If work Is not commenced within 180 days, or if work Is suspended rabandoned 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 expiratiohIof this permit. FOR INSPECTIONS CALL: (714) 754.5626 244646 (8100) DECLARATIONS WORKERS' COMPENSATION DECLARATION: _ I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 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 section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatlon Insurance carder and policy number are: - ,Caarer: ITiFTE 9)S D Pollcy.Numbec: j%JaOj2po5-2ooY '(This section need not be completed it the permit is valued at one hundred dollars (51FO) or less.) ❑ I conity that in the performan of the work for which this pennit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Ce11 a, and agree th 201 should become subject to the workers' compensation provisions of Sec)fbn 3oft a labor Code, I shall forthwith comply with these prove ````—' jjj00 q / -] /}� Applicant Signature: Date; / /� / /D 7 WARNING: FAILURE TO SECURE WORKERSCOMPENSATION COVERAGFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION WOB OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Cha ter 9 (commencing with Section 7000) of Division 3 of the Busineaend ofesslons Code, and my license is in full force andeHect: Cic. 1l Class q_C�� y < n Contrecto`r's.STgneture: CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lenders 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 oishe 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 penalty of not Tore than five hundred dollars ($500).): ❑ 1, 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.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑ Yes ❑ No Drivers 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, talsework, 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 will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has e permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will 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? ❑ Yes ❑ 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 feet 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? ❑ Yes ❑ No (Section 25533 of the California Health and Safety 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 o1 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ....._..............................._..................._.......................__............._...................................__._.._............................. ................_................................................... ............................_............. ........_.........._._..........._......................_......... _....... 3 Does or will the appplicant 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. ..................................................................................... I ........._...................................................................................................._.................................................................................................................................... . ......................... . .................. 4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No .................._........ ........................ ..__............................................................. _...._....._.._................................................_._..................................................................................... _._..................._........................_............ _.......... _............ _. 5 Does or will the applicant or present or future building Occupant require for the work which is the subject of this a plication apemnit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agent? Yes ❑ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). ................................................................................................................................................................................................................................................................................................................................................................I...............I........... 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ 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 ppermit 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 appllcetlon, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No ..............................................................................................................................................................................................................................................................................................................................................................................I............. 8 (If'ves", 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 COMPLIANCE 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 all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I a e not to Occupy or allow Occupancy of any building authorized by this permit until final inspection. nature Of Legal r Date 2 440 16( z plicant ate CODE 1. INSPECTION TYPE 2AM INTIMd4$ CODE INSPECTION TYPE geIE INTITIA S 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 210 Final Electrical 201 Final Block/Retaining Well 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 (714) 754-5273 • Fax (714) 754-4856 • www.ci.eosta-mesa.ca.us \ 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: Suite No Vicinity: Parcel Nunmber: 245 FISCHER AV 8002 93898007 Applicant: GREG IRWIN Address: 245 FISCHER AV B-2 ELECTRICAL PERMIT - Phone: 714-894-0414 Status: ISSUED Applied: 10/21/2004 Issued: 10/21/2004 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 inexpiratlonof this permit. FOR INSPECTIONS CALL: (714) 754-5626 244646 (a=) COSTA MESA, CA -� -.--„-,._., Zip: 92626 Owner: IRWIN PANCAKE�ARCHI. IVESTM. LLC- i yyv Address l •M'FISCHER AVB 2 - - ��-- j Phone: 714-894-0414 , ” COSTA MESA; CA., Zip: 92626 " Contractor: - - - Address: - Phone: Zip: - - License: " ' SCOPE OF PERMIT TENANT IMPROVEMENT -FOR "IRWIN PANCAKE. ARCHITECTS". SCOPE OF WORK TO INCLUDE: INTERIOR PARTITIONS„NEW CEILING, LIGHTING,- ETC.: NO�NEW PLUMBING PER APPLICANT: ! REF.: B04-01416 ELECTRICAL TO INCLUDE: 21 LIGHT FIXTURES, 30 OUTLETS, 33SWITCHES, 28 COMMUNICATION, _ - - DROPS, AND 9 MISC. CONDUIT �. FEESUMMARY Quantity :,".` Quantity.`, ! ISSUE FEE $23.50 Temp Dist System / Lighting $0.00 Temp service test $0.00 Busway /100 ft $o.00 ,.' 0- Res.'a/c package�� j $0.00 1.?`;°": Standing Section $0.00,-y' 0 New Res (1-2,units) , x$0.00 0 - Misc Electrical Equipment $0.00” ',' 0 New Res (3+units) ', \$0.00_ _ 0 Transformers up,to.I kva/kw;_ . $0.00' ' 0 " ' Pool/ Spa �� $0:00 �. 0` `�` ................up to 10 kva/kw $0.00 0 - Lighting Fixts'\ V�� /," $22:7ZI— ; ., 21 - - _ ..,, .....up to 50 kva/kw . -$0.00 0 ' Recept Outlets - ` % ' $29.30 - `30 - ............up to 100 kva/kw "_ $0.00 ' 0 " Switches 33- u - _ - - .............over 100 kvalkw $0.00 �;',0 , Non Res Appl \ $0.00 `� 0 _� ^= .� Low Voltage Equipment- " /, $0.00/1, 0, Res Appl \ $0.00 .0, _ _ LowVolt Wiring System / Ckt \, .$0.00 " 0 Service to 200a _ $0.00,- %; 0- r Misc. Conduit __ $18.20 1� Service to 1000a �� $0.00 - 0 -, Misc. Conductor $0.00 - : "0 Service over 1000a '$0.00 O. -- - Circus ( gen or ride) '$0.00/ 0 Motors to 1hp _ $0.00.'--: -� _ 0 �" �,--• r �. yCircus (rriech•ride or lights) v $0.00 0 Motors to 10hp $0.00 \ - 0_-;-_ "„ Christmas Tree Stand "$0.00 0 Motors to 50hp $0.00 -6 , - Fireworks Stand.-' $0.00 0 Motors to 100hp $0.00 0 �" -- - Other Electrical Fee $0.00 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 inexpiratlonof this permit. FOR INSPECTIONS CALL: (714) 754-5626 244646 (a=) DECLARATIONS I WORKERS' COMPENSATION DECLARATION: r- ' 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, es 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 section 3700 of the Labor Code, for the performance of the work for which this permit is Issued. My workers' compensation Insurance carrier and policy number are: Cartier: Policy Number: (This section need not be completed it the permit is valued at one hundred dollars ($100) or less.)- - - - I cartity that in the performiango the work f r 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 Calif a, end agre at If I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, 1 shall forthwith comply with these provisi /� J Applicant Signature: Date: /021/0 WARNING: FAILURE TO SECAEACRI COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE (SI00,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3/06OF THE LABOR CODE, INTEREST, AND ATTORNEY'S 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. Lia 1t Class x Contractors 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, Civil Code). Lenders 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 Cade: 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 Lew (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 civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employeesmlft�lyg�(��gas 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 Conireitors 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) the Contra tors License Laws.). exam t ❑ 1 am or sec. Business and Professions Code for this reason: Signature: Date: O O 1 Owner ID drill y dri rs I cense. ❑ Yes ❑ No Drivers License 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 B, California Administrative Code). ❑ As owner-builder, I will 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: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response t0 release or threatened release of a hazardous material? ❑ Yes ❑ 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 feet 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? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time hes 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 appplicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes 11N0 (Section 25534 of the California Health and Safety Cade 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 en RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No ................................................._........_....................._...................................._............_.._...._.._.................................__..............................................................................................._..................................-..........__............._.........._............_... 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes U No (Section 65650.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). ...................................................................................................................................................................._..__.....................................................................................................................__...........................__.............._..........._............_........... 8 Will any pan of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ 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? ❑ Yes ❑ No ...9.......(If yes". attach certificate of compliance from the appropriate air pollution control officer). .......................................................................................................................................................................... CERTIFICATE OF COMPLIANCE: I cenify 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 COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that 1 have read this application and state that the information given is correct. I agree to complyyolth all state ws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described props ar Inspect10 purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. co/7l f0 �L n. tura Of Legal Owner(s) Date And/Of Authorized Applicant Date CODE /. INSPECTION TYPE DAM INTMALS CODE INSPECTION TYPE ,PATE IIfTITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 206 Final Plumbing 200 Final RB-Roof 210 Final Electrical 201 Final Block/Retalning Well 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 " (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 FIRE SUPRESSION PERMIT Job Address: 245 FISCHER AV Status: ISSUED Suite: B002 Applied: 10/04/2004 Vicinity: Issued: 10/13/2004 Parcel Number: 93898007 Zoning: ISSUED BY: - Applicant: LYNN PETERSON Address: 520 TEXAS ST- "- m Phone: 909-793-0676 i REDLANDS,,CA� `-_ , Zip: 92374 J ;' Owner: �IRWIN PANCAKE ARCHL IVESTM: LLC Address ' 245 FISCHER AV 6 2 Phone: 714-894-0414 - COSTA MESA, CA Zip: 92626 Contractor: - Address: G _: . , Phone: - Zip: - - License: =SCOPE OF PERMIT, - ADD 13 OVERHEADSPRINKLERSFOR "IRWIN PANDCAKE ARCHITECT" IN SUITE 8002. REF.: B04-01416 �, P- •/ FEE6SUMMARY ,- ;., . Plan Check: % $54.11 Calc Valuation. �`$2,500.00, Permit: $83.25 — ' " _: Claimed Valuation: $2,500.00 Other:_ $0.00 Total. $137.36 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 taaade iarool DECLARATIONS k;;a In one of th%fol declaration' - I nore;oyla:;fft?nllu:n:cPar::p:alna3iFtyloOT;pogury� lowin a. I oreoy a"" Under d 0 1 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 0 1 have and will maintain workeracompensaflori insurance, as required by section 3700 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: Came . — Policy Number: (71if section need not be completed if the perrnit is valued atone hundred dollars ($100) or less.) 1 0 1 certify that in the erformanco of the work for which this Remit is issued, I shall not employ any person in any marim so as to become subject to the workers' com a . aws f California, and agree that if I a" become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith with th a revisions Ali�mt Sig I net 0 15 /0 LUR To WA ILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EM(a�CSIMINAL ZP;�IES AND C& FINES 'UP TOONE HUNDRED THOUSAND DOULARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE I-ABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENS5ERS.04TRACTORS DECLARATION: harebCafflrm�ann licensed U d r provist s of Chapter 9 (commencing with Section 70GD) of Division 3 of the as and ProfessionsCode, and my license is in full orce I # 910 e�� 1� N C — Conlr=aLe: �_4� as / [� , — Z4 Zz g CONSTRUCTION LENDING AGENCY: 0 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lender's Address: Signature: Date: OWNER -BUILDER DECLARATIONS: 1 hereby affirm that under penalty of pertury 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, pror 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 DMsIon 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 civil penalty of not more than five hundred dollars ($500).): 0 1, as owner of the properly, or my emplooes 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. It, 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.). 0 1, 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.). 0 1 am exempt under sec. Business and Professions Code for this reason: Signature: Ir Date: Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by (type of document, Le. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: 0 1 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 pomnit, and that no building structure, scafffolding, falsework. or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 34 1, Title 8, California Administrative Code). As owner -builder, I will 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 Will the applicant or present or future building Occupant need to tile and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes ONo (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 anyone time during are led 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 feet of compressed gas at standarTto, mperature and pressure). .. .............. . ............... . ................... - .. . ............................. ............................................ . . . . ................ . ........................................ . ............ . ............ . ............ . .......... . ......... r will the applicant or present or future building Occupant need to file a registration form for acutely hazardous materials? El Yes ONO (Section 25533 of the California Health and Safety Code, with some exce tions, 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 oquarto or greater than a weight of 500 pounds, or a volume of 55 gallons. or 2DO cubic feet of compressed gas at standard temperature and pressure). ........ .. . .................................... . .................... . ........................... I ....................................................... . . ........................................................ . ..... _-1 ............... 1-1 .......................... I . .............. . ................ ...................................... . cas or will the applicant or present or future building Occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? 0 Yes ONO MSection 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fite artment of an RMPP by businesses which are requIred to register acutely hazardous materials with the Fire Department. ............................................... ................................................................................................ .... - ........................................................................................................ . .................................................................. is presently requited, has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No . ............................. I ...................... .................................................................................. I ....... ........................................................................... 11 1 ................................... I ............. . ............... I .................................................. If the applicant or present or future building Occupant require for the work which is the subject of this g2plication aRermit for such construction or modification from the South Coast Air Quality Management District or from any other air Pollution control district or agency? U Yes UNo (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building pearnits). .................................. ......................................................................................................... - ............. .................... .......................................................... ....... . .... .. 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundar6i of a school? 0 Yes O*NO (It -yes-, the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). .. ff;W : ........................................................................... . . .................................................................................................................... . ............................... . ................................................ . .. it 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 .. ....... . . . ................... . .................... . ........................................................................ . . . . . . ......................................................... . ..... . . . . . . .. . . ............................... . . ................. . .......... . ............. . .......... . .......... . ......... . .. , attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE I certify that under penalty of perjury the information given aboove is correct. I agree to cemply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE 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 all state laws and city ordinances relating to building construction, and authorize representatives of the City of COsta Mesa to enter upon the above-described property for inspection purposes. I agree not to Occupy or allow Occupancy of any building authorized by this permit until final inspection. Slign=al Owne>�� Date AdUVOr tf2riz"plicant Da CODE P. INSPECTION TYP 2AU INITTALS. CODE INSPE ON TYPE 206 1616 Fixed System Final Fire Prevention Final Mechanical dx4s 21 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 210 Final Electrical 201 Final BlocklRetaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 1 204 Final Demolition 250 Final Building./Occulpancy "WF (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 FIRE SUPRESSION PERMIT Job Address: 245 FISCHERAV Status: ISSUED Suite: B002 Applied: 10/07/2004 Vicinity: Issued: 10/20/2004 Parcel Number: 93898007 Zoning: ISSUED BY: Applicant: DICK TAKACS Address:- -�',. Phone: 714-937-7630 F Zip: Owner: ,IRWIN PANCAKE ARCH I. IVESTM. LLC ' Address ��, 245 FISCHER AV B-2 v' - i - Phone: 714-894-0414 _ • COSTA MESA, CA, Zip: 92626 Contractor: BAY ALARM COMPANY Address: 1000 E HOWELL AV - SUITE A Phone: <. 818-267-5825 ANAHEIM, CA Zip: 92805 - _ License: 261003- '-SCOPE OF PERMIT ALARM SYSTEM FOR "IRWIN PANDCAKE ARCHITECTS' SUITE 8002. REF.: B04-01416 FEE SUMMARY Plan"Check: $29.15 Calc Valuation: $1,200.00 Permit: $44.85-' - - Claimed Valuation: $1,200.00 , Other: $0.00 Total: $74.00 _ 1 VN 1 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 446-48 (6100) C DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby all 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. -r I have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit Is issued. My workers' compensation Insurance carrier and policy number are: ,Tcamar:,��/ .� ,�A oncy�N' ;umtier: %�' .� �✓ 8 �I/ Qri 33 843 Thjs.saotlon'need not be completed if the permit is valued at one hundred dollars ($100) or less.) ❑ 1 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 California, and agreeth t If I should bec me subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these provisions. / p_ AZfi� O rdt�RtCiuTmD GraRHiigneture: RNINCs'.FAILURE TO'SECUREWORKERS'COMPENSATION COVERAGE IS UNLAWFULAND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED DOLLARE ($100,1%x1), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES, LICENSED CONTRACTORS DECLARATION: .hha e y affirrb"r that.? em.11densed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 oLthe.Business and Professions Code, and my license is in full }oce'end'elfecCClc. a rC"n actor's Signature r -Data:--! - .Z _ O rF CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lenders Address: Signature: Date: OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am fAEMPT 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 civil penalty of not mor(Vhan five hundred dollars ($500).): ❑ 1, 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 Cade: 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 contractors) license pursuant to the Contractors License Laws.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑ Yes ❑ 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, An 2, Sec. 341, Title 8, Califomia Administrative Code). ❑ As owner -builder, I will 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 pernit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will 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? ❑ Yes ❑ 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 feet 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? ❑ Yes ❑ No (Section 25533 of the California Health and Safety 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). ................................ ....................................................................................................... ................................. ............................ ........................................................................ .............. ............................... ............... .......................... I......................... 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. .................................................................. ................................ ...................................................................................... ......................................................................................................... ...................... ................. ......................... I.......................... 4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No ............................................................................................................................................................................................................................................................................................................................................................................................ 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication a ppermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Li Yes LJ 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 pert of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? El Yes ❑ No (It '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? ❑ Yes ❑ No ............................................................................................................................................................................................................................................................................................................................................................................................ B (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 COMPLIANCE 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 all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Of Legal Owners) Date /B FNOr'Authoiized' _ plicilild .Da,Z_, ' CODE I. INSPECTIONWPE QAg-v�7yTQls4$_ gam.!. INSPEcnoN TYPE gy¢, INTMAL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Root 210 Final Electrical "3-041' T 201 Final Block/Retaining Well 212 Final Fire Prevention ! 14 202 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, CITYOF COSTA MESA PE MIT NO.. -TRACT NO. LOT NO.- - BL .. NO. - - -- - `CONSTRUCTION PERMIT G -!3 - sssT///...VPE OF CONSTRUCTION p(,I NEW - E) ADD. 0 ALTERATION, (L?J _ REPAIR-(] CONVERSION'ODEMO LISH- ' ❑ OTHER' - 8163- 9/23/82 n ZONING REGULATIONS - .. rojectAddress `Owner _ Phone tai ��\ _ Address /% )<Q', �. V I - _ 7"T�� _ Arch/Eng. License No. OESC RIPTIONrOF WORK• �' _ _ _ ___ _ _ �.; ..-1. _ _ _ ; _ _�._ __... � A.P, - ,,, ,' " ZONE PL'NG. REF. 9rl Address, ` Q� _ - _ _ _ __ _ __ ,Contractor _ _ _ _ Phone _ - Y •- - - - -- - - TYPE PERMIT i "' ❑GRADING'<.Q- FOUNDATION S ❑STRUCTURAL' -" ❑TENANT .ELECTRICAL OPLVMBING ❑MECHANICA - SETBACK C/L ST.7ROPERTY SID YARD -Lg IEpFE'YA Tp BtJILDING LI IJE - " - Address. ... .'- _ LICENSED CONTRACTOR DECLARATION •'ev that d am licensed'under Charter 9 I hereby affirm provisions of (tom= 7000) Division 3 - f`i�e' RIGHT mencing with section of of the Business antl'.(] Professions- Code, and' my license - Is In full' -force and effect. OTHER REAR YARD (TO P/L) - _ PROJECT DESCRIPTION _ �- � License Class License No. - - '- - - - - PKG. SPACE REQ. PROVIDED Date - Signature. '1 _SQ. FT. STREET WIDTH PARK FEE $ WORKBRS' COMPENSATION DECLARATION r.00CUPANCY `_CONSTRUCTION TVPE I hereby affirm that I' a certificate of consent to self -insure or a ,VALUATION - - ZONE ZONING APPROVED BY DATE .. - ev'HflCate of Workers' Compensation Insurance, orcertified copy - 'N � - - - _a of (Section 3800; Lab. C.). -G RADING CU. VOS: ACRES SPECIAL CONDITIONS: No. Company - - - -- REMARKS: - - - ' / L Certified copy Is hereby furnished. 0 Certified copy Is filed 'wlth'the city Building Division. - , EXEMPTION FROM -WORKERS' COMPENSATION. DECLARATION - (This section need not be completed If the permit is for one hundred - (E3001 tlr less). ._ - -- that In the Performance he for this is - •' - - " - PLUMBING - � .. . - PLAN CHECK _ "' __ _ _ ELECTRICAL PLAN CHECK I CooLt work which permit Issue shall not employ any- ersan-i any manner so -as t become subj to the or Compe a Iifor '-' SHOWERS "�" -FT, DateBATHTUBS _ NOTI E: If alter making this tleclaration, you should become subject TOILETS URINALS" -' 'GENERATOR 0-1 KW_' 1-10 KW, to the Workers' Compensation provisions o the Labor Code, you must TRANSFORMER '10-50 forthwith comply with such provisions or this permit shall be tleemed AVATO RIES DOUBLE LAVS - _ APPLIANCE KW 50 + KW re voketl. CONSTRUCTION LENDING'AGENCY -KIT.SINKS- - — -� DISHWASHERS- ' - - -- _- .. MOTORS _ 0-1 lip__1-10 - - - HP Ihereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS -- UNC-SOLAR)--30-50'HP SO+HP formance of the work for which this permit I5 issued (Section 3097 FLOOR SINKS' _ FLOOR DRAINS - FIXTURES OUTLETS SWITCHES , Civ. CJ. Lender's Name Lender's Address--^ - "'--' _ --` " ---' "' DRINKINGFOUNTAINS' i -' -" "GAS TUBE SIGNS INTERCEPTORS' --CLARIFIERS POLE LIGHTS- IGHTS - I• OWNER BUILDER DECLARATION I hereby affirm that I am exempt from.the Contractor's License Law for .. SWIMMING -POOL--- - P'TRAP - - "- the following reason (Section 7031.5- Business and Professions Code: the Any city or county which requires a permit to construct, alter, POLES METERED SUB - WATER SERVICE ” - ALTERATION'- ' PANELS MAIN SUB . - - improve, demolish or repair any _structure„prior to Its issuance, also re- qutres'the applicant for such permit to file a signed statement that he GA$'$ERV ICE -OUTLETS ---- - -- )� - - (: `� ^ -SERVICE - - _ -AMP..-, , is,licensed pursuant to the provisions of the Contractor's License .Law (r"titer 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS- - 'BTU OUTPUT --- ess and Professions Code) or that he is exempt therefrom and the for the alleged exemption. Any violation of Section 7031.5 by SEWER' CONNECTIONS a._ applicant for a permit subjects the applicant to a civil penalty of not more than"ftve hundred dollars ($500). SOLAR TANK - - --- COLLECTORS' ❑-I,-as.owner of. the..property, or my employees with -wages as their sole cp mpen sa tion, will do the work, and the structure is not intended _ or 0listed for sale. (Section -7044, -Business and Professions' Code: The SOLAR PIPING SYS. - - - _ _ ISSUE FEE r _ Contractor's License Law does not apply to an owner of a property _. _-_-__ ..�. _ _ ISSUE FEE it - --_ — -APPLICATION APPROVED BY DATE I. t who builds or Improves thereon, and who does such work himself or- through his own employees, provided that such Improvements are not _ MECHANICAL PLAN CHECK •S. SUMMARY OF•FEES _ intended or offered for sale. If, however, the building or improvement- is sold within one year of completion, the owner will have the burden of- proving he -did, not - build or improve forthepurpose of sale)' HEATING SYSTEM 0-100,0008TU BUILDING PERMIT $ •SMIP _ 13I, as owner of the property, am exclusively contracting with AND DUCTING - - - - - _ _! licensed* contractors to -construct the project (Section 7044, Business 100,000+BTU PLAN CHECK $- PERMIT' r•' and Professions Code: The Contractor's License Law does not apply to - - ISSUANCE . $ 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'slJceoseLaw), 100,000+BTU PLAN CHECK $ ❑, Lam exempt under Section B. & P. C. forthisBOILERS BTU ELECTRICAL $ '$ reason SYSTEM REPAIROwner, ALTERATION EXHAUST SYSTEM MULTIPLE PLAN CHECK $ MECHANICAL $� MICROFILM $ - TOTAL FEE• - $ LESS AD- " 1Dheereadreby Certify that I have ad this application and state that the above Information is correct. I agree -to comply with all city and county , PLAN CHECK $ VANCEPC .$ ordinances and state laws relating to construction, and hereby authorize ' o mentioned Prope y e t rear¢ atives of i city�- - CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor TL CONSTRUCTION AND PLANNING � �� ,p Date APPROVALS Permit # - POOL & SPA - -- '� ;�;• Inspector _ _ �ADate Inspector `4 APPROVALS _ Permit_# ' ...- 1. Temporary Electrical Service or Pole - 43. . Pool & Equipment`Location 7- 2. SoilPipe-Un rgrn, r _ 44. Steel Reinforcement; - _- 3. Electrical Conduit Utility-Undrgrn _ _ _ 45. Forms •" ' , ' --- `'- - - 4. Electrical Conduit-Undrgrn _ - _ _ _ _ _46. Electrical Bonding 5. Steel em orce I .. 47. Rough Plumbing & Pressure Test - - - 6. Electrical UFER Grn - 48. APPROVAL TO COVER-GUNITE 7. Footings - 49. Electrical Conduit-Undr rn B. Foundation _ 50. Gas Pipe, ❑ Undr rn, Test - 9. Water Pipe-Undrgrn " - 51. Backwash.Lines P -Trap.❑ Undrqrn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final - - 12. Street Sewer Connection _ - 54. Heater & Verit-Final 13. Rough Plumbing . , 14. Rough Electric -Conduit - - - 56. Electrical -Final" _ . 15. Rough Electric -Wiring " "--- "" - - - - - 57. Solar System -Final 16. Rough Heating & Air Conditioning. - encing &-Access Approval _ 17. Ducts, in Structure _ _ 59. APPROVED FOR PLASTERING • • 18. 19. 20. Ducts, Ventilating _- Gas Pipe -Rough & Test Roof Framing - 60.. _ - - - - - - - - POOL/SPA SYSTEMS FINAL 21. 22. Roof Sheathing Frame and Flashing NOTES: :r 23. Insulation _ - -- - - 24. Lathing & Siding_ 25. Drywall Nailing 26. Plaster'Brown Coat 27. 28. Electrical Power Meter -Final •'Final Electric 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. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. - 42, CERTIFICATE OF OCCUPANCY No - Date - - _ _.. Applicant to fill In ali spaces within heavy border lines and sign all appropriate declarations. CITY OE .COSTA MESA. PERMIT (VO, TRACT NO. LOT NO. ", BL G. 1`10. - ' �C'ONStRUCTION PERMIT 4J • ' J "" ; �. - , ' - !t OF CONSTRUCTION - 0 -NEW ❑-ADO D ALTERATIONOWnef. O'REPAIR CONVERS N ❑DEMOLISH ❑ OTHER E 'T�. • EW d I'C UOAIAAr y ' r ! 00 9/10/82 82y - -- ,- ZONING REGULATIONS' ' - 'Project Address .TYPE LJ_t ,e0 Z Z Address r17_ W1,CV14CtV r. 1A04 { ,Arch/Eng. _ License No. _ I D ESCRIPTION OFiWORik - -7 A.P. ZONE 'PLNTG.,RtE�Ft.. T-. . 's Address _ - ContrectOr ,499/IV,V C—(—Er—M6—o0 TYPE OF, PERMIT^ -� - �• ' ❑GRADING�(I❑'FOUNDATION -❑STRUCTURAL ❑ TENANT yp ELECTRICAL OPLUM13ING ❑MECHANICA BUILDING SETBACK SL EDE YARD Lr V PROBP EIRTV LGiNE - -- Address -,=C d,Uf yg107v/j/10 At s rQE/a • LICENSED CONTRACTOR DECLARATION that I -am licensed -6f Charter 9 I hereby affirm under provisions (com- mencing with section 7000) of Division 3 of the Business and ❑:OTHER - , professions- Code •and my,license is full for no of ect. - REAR YARD (TO P/L) - - PROJECT DESCRIPTION _ _.. - License Class- Cf 5 N PKG. SPACE REQ, PROVIDED - PROVIDED /O �Z Sq. FT. Date Signature OCCUPANCY_ CONSTRUCTION TYPE STREET WIDTH PARK FEE $' LARTION WORKERS' COMPENSATIO A I hereby affirm that I have a1cviftificate of donsent-to self -Insure ora VALUATION ZONE ZONING APPROVED BY DATE ---tificate of Workers' Compensation Insurance, or a certifiedcopy .- - - -- - I sof n T��o N, GRADING CU. UOS. ACRES SPECIAL CONDITIONS: 'y NoS! Company , •REMARKS:'S�Zeftlflecl V rtitleI copy S ereby furnished. copy is filed with the city Building Division. tx�MPTION FROM.WORKERS' COMPENSATION DECLARATION - - -- (This section need not be completed if the permit is for one hundred iS100)) or less11. for cert(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 PLAN CHECK. subject to the Workers' Compensation Laws of California._ _ _ BATHTUBS - SHOWERS net. " Signature - NOTICE: If after making this declaration, you should become subject TOILETS - URINALS - GENERATOR 0-1 KW -1.10 KW 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 10-50 KW—L-50 KW _ revoked. _ _ _ CONSTRUCTION'LENDING AGENCY "" KIT. SINKS - DISHWASHERS -- ... MOTORS - - - - 0-1 HP_7-SO HP - I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS '- - - '" (INC -SOLAR) "' 10-50 HP_- 50 + HP formance of the work for which this permit is issued (Section 3097 - FLOORSINKSFLOOR DRAINS FIXTURES OUTLETS SWITCHES Civ. C.). - ._ , - - — Lender's Name Lender's Address - _ DRINKING FOUNTAINS -' - - "--- - - _ GAS TUBE SIGNS __ INTERCEPTORS - -CLARIFIERS POLE LIGHTS OWNER BUILDER DECLARATION I hereby affirm that I am exempt from.the Contractor's License Law for L"- PTRAPIUN - POLES METERED SUB the following reason (Section_ 7031.5 Business and Professions Code:SWIMMING'PDD Anyrocity or county which requires a permit to construct, alter, WATER SERVICE -" " -ALTERATION PANELSZQO ;RAIN - ,SUB + impve, demolish or repair any structure, prior to its issuance, also re- quires the applicant for such permit to file a signed statement that he GAS SERVICE OUTLETS ' - " '^s 1 ` SERV ICE - - "�� d7 AMP_ is licensed pursuant to the provisions oLthe Contractor-'$ License Law pier' 9 (commencing with Section 7000) of Division 3 of the - WATER•HEATERS- -- -BTU OUTPUT _ . n •, 1 ex Cotle) or that he -is exempt therefrom and the for [he alleged exemption. Any violation of Section 7031.5 by forand alleged -SEWER CONNECTIONS" - _ applicant for a permit subjects the applicant -to -a. civil penalty. of not more than -five hundred dollars ($500). SOLAR TANK -- -' COLLECTORS _ ❑ I,.as owner.of .the "property, -or -my employees with wagesastheir sole 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 _ - ISSUE FEE - - - APPLICATIONS APPROVED BY DATE who builds or improves-thereon,.and who does such work himself or through his own employees, provided that such improvements are not _ MECHANICAL PLAN CHECK SUMMARY OF FEES ' - intended or offered for sale. If, however, the building or improvement- is sold within one year of completion, the owner will have the burden -- BUILDING ' of proving he did not build or improve for the purpose of sale).- HEATING SYSTEM 0-100,000 BTU PERMIT $ SMIP •-' $ ❑ 1, a4 owner of the properly, dm exclusively contracting with _AND DUCTING -- '- - -- licensed contractors to construct the project (Section 7044, Business 100,000 +'BTU PLAN CHECK $ PERMIT'... and Professions Code: The Contractor's License Law does not apply to - _ ISSUANCE Is - an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU l PLUMBING $ . - - '- tracts from such projects with a contractor(s) licesned pursuant to. SYSTEM - - - �- - '- V: "- - GRADING $ - L• the Contractor's License Law): 100,000 + BTU PLAN CHECK $ ❑ 1 amexempt.under Section B. & P. C. for this BOILERS BTU ELECTRICAL $ _ reason - SYSTEM REPAIR. ALTERATION EXHAUST SYSTEM MULTIPLE PLAN CHECK $ MECHANICAL $ MICROFILM-$- _- TOTAL -FEE - $ LESS AD--^ - Date_ -- —Owner I hereby certify that I atl this application and state that the above informatiol, is carr . I ree to comply with all city and county PLAN CHECK $ VANCE PC $ Ordinances andstat aelattn9 to con tion, and hereby authorize representatives is upon t above mentioned - property osee. l0 Q� O - _ ./ FINAL FEE $ Signatu CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor TL CONSTRUCTION AND PLANNING APPROVALS PermitY?7 # POOL& SPA. Date Inspector APPROVALS P-ermil4_ -Da _`ted Inspector ��i - s _ - r �•tcj %t,¢ ` 1. Temporary Electrical Service or Pole _ 43. ,Pool & Equi ment Loc_ation'• .- ��1wu= k%- ' -2: Soil-Pipe-Undrgrn.: . e - °�'Cati VJ7`Nq 'Al -W 6 k4',4','C'Steel Reinforcement - - 3. - Electrical Conduit Utility-Undrgrn `_ - 45. Forms --- 4. Electrical Conduit-Undrgrn _ _ 46. Electrical Bonding. - ',-�A, -nr, : rR;r=.�, tia -� �n+^\+s_ �th,N-1, -- 5. Steel em orce 47. Rough Plumbin .& Pressur ' e:Test,� "'.+ - - - n nc.m.�+ncav ....^1'� - 6.' Electrical UFER Grn 48. APP OVAL TO COVER-GUNITt' 7. Footings - 49. Electrical Conduit-Undr rn 8. _ Foundation - - - 50. Gas Pipe, ❑ Undr rn,,Teste e,4_l 9. Water Pipe-Undrgrn 51. P-Tra -Z(0 y' , U1A, Backwash Lines nr- n� 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�A+\'C \� Ok4k %\i�-c `L� \\ 13. Rough Plumbing _ -- \ 14. Rough Electric -Conduit - - - - - - -56. Electrical -Final _ - - 15. Rough Electric -Wiring- - '- -- 57. Solar System -Final - 16. Rough. Heating & Air. Conditioning W Fencing & Access Approval 17. Duets in Structure Jig. APPROVED FOR PLASTERING - 18. 19. 20. Ducts, Ventilating Gas Pipe -Rough & Test Roof Framing 60. POOL/SPA SYSTEMS FINAL 21. 22. Roof Sheathing Frame and Flashing - NOTES; 23. Insulation 24. Lathing & Siding 25. Drywall Nailing ' 26. Plaster Brown Coat 27. '28. Electrical Power Meter -Final RcaS Final Electric 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. FINAL STRUCTURE & BUILDING - 39. Special Requirements Completed 40. Electric Release to Edison - 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No' Date OF Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. ."*CII -Y OF COSTA MESA - O - TRACT NO. LOT NO. BLDG. NO. ,'� 24 2� I'6IBB -. B3• B2 II. CONSTRUCTION PERMIT r � eq /, �d ., _ .. _ ._ Protect Address TYPE OF CONSTRUCTION 'Owner ;40C/Z_ c./t4Q/..r P,Qoe/,�- Phone 1-1 NEW 'KAOD El ALTERATION ;Address• %/'�/� N, f jib aIA- - S"- -O REPAIR ❑CONVERSION ❑.DEMOLISH , ZONING REGULATIONS ' Arch/Eng. - License No. D OTHER c _ Address - _ - - DESCRIPTION OF WORK i✓T� f'Ta a.P. 3 3 . O • . - - G'•E ZONE'-- PLNG. REF. 4L - Contractor)(L /,Q,c �i 7�7T Phone5541Z/ YPE OF,P.ERMIT - I SETBAC C L Tp B ILTDING. - - - _ _ _ __ PROPE RTV LINE' -f I Address /349,d/ f 1A4e4' 14_1_15 '('j ,�'j . , O.GRADING;.,...� FOUNDATION' ❑ STRUCTURAL SIDE YARD ' LICENSED CONTRACTOR DECLARATION- - l ❑TENANT D ELECTRICAL ❑PLUMBING-OMECHANICA RIIG NTA I hereby affirm that I am licensed under provisions of Charter 9,(com- • �..� It, - RD mencing with -section -7000) --of 'Divislon-3 of--the-Business and D OTHER- -- _ - - - _ Professions :Cotle, and my license is in full force and effect. j • REAR YARD (TO P/L) - I �PROJECT'DESCRIPTION' 1 _ License Class �-' L ens= No.� I - ,'- PKG SPACE REG. PROVIDED:, ' 7 'Date 1_7 519natur�' .SQ. FT. - - - - %f• - j STREET WIDTH PARK FEE,$ ,WORKERS' COMPENSATION DEC ARA ION - - - 'OCC UPANCV_CO NSTRUCTION TYPE. _- - I herebyy affirm that I have a certificate of consent to self-insure�or a - "T� 'ZONING'APPROVED BY DATE i •ific2te of Workers' Compensation Insurance, -or a certified copy ,V ALUATI'ON'¢ x'^- ZONE 1 f ,of (Section 3@00 L,�,,�.j�} i GRADING CU' YDS. ' ACRES 'SPECIAL CONDITIONS. 'y/^%fit'Y�,.✓4anY •-i-lL /U,v- ._ Ll Certified copy is hereby furnished. - - - -• -- - --- - -REMARKS 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). i • .. .• ..'I. -_- __ .. .. __. _' - .__. _._ -. _ Lcertify that In the performance.of.the work for which this permit is ._ - issued, I shall not employ any person in any manner so as,lo-become -� PLUMBING �`1•? ZPLAN CHECK -- -' "'!ELECTRICAL - - - -PLAN CHECK,---- - "' subjectto the Workers' Compensation Laws of California. Date I Signature BATHTUBS - - SHOWERS - NOTICE: If after -making this. declaration, you should become -subject 5-jTOIL•ETS,T i, „^^ .:URINALS— -- '-- "IGENERATOR - `0.3 KW_1-10 KW ,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 "" 10.50 KW_50+KW - 1 KIT. -SINKS "- DISHWASHERS'-` ° "' -MOTORS -'o'1'HP_110 HP CONSTRUCTION LENDING AGENCY , 1 - I Thereby affirmthatthere isaconstructionit isigagency for the per- ,SERVICE SINKS 'e P_s:SUMPS-----'-'T (INC. SOLAR)-- .._3030 HP=-50+HP forman ce of the work for which this�per mit is issued '(Section 30.97- - -- '- - - .._ .. .-' -_ - - _-- Lender)'sName FLOOR SINKS- "FLOOR DRAINS-'� -�( ',FIXTURES""'-OOTCETS -''SWITCHES--^' ' r_DRINKING FOUNTAINS '1' '-- 'GASTUBE'SIGNS ._ Lender's Address '• : ' � � .. � 1 OWNER BUILDER -DECLARATION "' - '- _ - INTERCEPTORS, CLARIFIERS T '1L' POE LIGHTS-- I hereby affirm that I am exempt from the Contractor's License Law for .'.tY.� the following"reason-(Section`7031.5 Business. and ProfesslOns Code: SWIMMING POOLP'TRAP -' "-� - - - - - - ) Any city or county _which requires a permit to construct, alter, �� IPOLES METERED ' •SUR r Improve, demolish or repair -any str pct ure, prior to its issuance, also're= "-WATER SERVICE � � ALTERATION - IMPANELS' ""- MAIN-- 'SUB quires the ap,ticant for such permit to file a signed statement that he I is -licensed pursuant-to'the provisions of the Contractor 's'License Caw' GAS SERVICE -' OUTLETS -- ":SERVICE CAMP --- - r4'-npter 9 (commencing with Section 70 00) of Division 3 of the J :ess an Professions Cotle) orthathe is exe mpt'theretrom and the 'p.IgTER HEATERS ' ' BTU OUTPUT -.!"for the alleged. exemption. Any violation of Section 7031.5 by - af.i applicant for d permit- Subjects the'applicant-to'a-tivil-penalty SEWER CONNECTIONS -'-- _ '-- --- -- - '- -- - - of not more than five hundred dollars ($500).- - - - ' _ . _. _. -- , O I, a5 owner of the property, or my employees with wages t their SOLAR'TANK COLLECTORS- sole ^- -• or offered for sale. will do 7044,r Business the structure ions[ intended _ I � or offeretl far Sale. (Section 7044, Business antl Professions Code: The SOLAR PIPING SYS ("' r ISSUE FEE Contractor's r cense_ es thereon, of apwho d es owner. work property sor J APPLICATION APPROVED BY -- -- DATE who builds or improves thereon, and who does such work himself or 'ISSUE FEE --' ,�• •� i Intended own employees,-. prohowe that such improvements are not intentletl th offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK SUMMARY OF FEES - < r• ofprwithin.one not Lcomplebon,the owner will -have the purpose f sale. - - I of proving he tlitl not build or improve for the purpose of sale). - - (BUILDING-•'- - - 7q�, - - ---�-� ' HEATING SYSTEM 0-100,000 BTU ,PERMIT $ V SMIP" •$' - D n d towner of the property; p exclusively (Sects contracting with -_ __- _ _ _ AND DUCTING--""- I/ - licensed contractors to construct the project (Section es not Business 100,000+BTU 1PLAN CHECK $ ,PERMIT• 'M antlowner of p Code: The Contractor's License Law does a not apply to _ Y - - - -_--- -- - - ISSUANCE E -$ tr owner of property who with a or improves thereon, and who ton- REFRIGERATION 0-100,000 BTU IPLU MBING S - - - theCofrom-such projects with a-con[rattor(s)'licesnetl-pursuant -to -SYSTEM -"---- - - - -� — I - - -- �GRAOING_-$ _ the Contractor's License Law). 100,000 S BTU (PLAN CHECK ;$ y.q ^ •. , i � D 1 am exempt under Section 'B. & PSC. for'ttiis` BOILERS BTU 'ELECTRICAL - $ - '-$ reason __ _ _. _ _ _ _ _ _ I - MICROFILM $ .'2. SYSTEM REPAIR, ALTERATION ?PL -AN CHECK-$ - Date - - Owner - - - - - - - $'- MECHANICAL. certify that.l.have read this application and state that the above EXHAUST SYSTEM MULTIPLE (MECHANICAL $ -TOTAL• FEE 0 LESS AD information is correct. I agre t0 comply with all city and county :PLAN CHECK .$ - -' - -VANCEPC' $-',r"-' - ordinances and state layis rel ti ci to construction and hereby authorize I t. - •� representatives..of is ci r upor a above mentioned I - property fo sp}�)p p j 1 5lgnature �5i ^P��'�'�n�_ee ��•`�2 ) r FINAL FEE S_ Drivers' License or S5 %1I. �— -'ISSUE FEE ^-- - - - --'-- - - - - - --- - - - - -- _. CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrpd-Assessor CONSTRUCTION AND PLANNINGG^n^ ' _ APPROVALS Permit # Date Insaector POOL & SPA APPROVALS, - Permit # =Date :Inspector 1. Temporary Electrical Service or Pole _ 43. Pool &Equipment Location - - - - - - - ' _•2.. Soil_ Pipe-_Undrgrn_• - _ 44. Steel Reinforcement - - 7771. Electrical Conduit- Utility-Undrgrn _ - 45. Forms 4. Electrical Conduit:Undrgrn " _ 46. Electrical Bonding -- " - 5. Steel ein orce _ 47. Rough -Plumbing & Pressure Test „ 6. Electrical UFE_ R Grn _ _ _ _ 48. APPROVACTO COVER-GUNITE - _ 7. Footings - - 49. Electrical Conduit-Undr rn• �-&-.Foundation _ 50. -Gas Pipe,- ❑ Undr rn, Test - - ,.. 9-._ Water Pipe-Undrgrn--� _ _ 51. Backwash Lines,.P-Trap: E- ndr rn�"- I _1,0. -_-Structural Floor System_ _ -. 52. APPROVALTO.DECK'"- 11... Property- Sevder.Line & House Connectiori -"'- _ _ 53._ - Backwash &.Rete for -Final - - .1.2- Street.Sewer.Connection- _ • -54. Heater & Vent -Final'" - - -13.- Rough Plumbing_55. - - Final-- -' -" --`---- ---- 14. Rough Electric -Conduit - - - - -- •56.---Electrical-Final 15. Rough Electric -Wiring -` - - - - - 57. Solar System -Final- i. ' 16.- Rough,Heating &'Air Conditioning - - - - -'- - -- -- - - -- encing &.Access.Approval -17: Ducts in Structure__ _ APPROVED FOR PLASTERING - - - '" •� 18: Ducts, -Ventilating 19. Gas Pipe -Rough &Test „ - - _ _ _ .. 20. Roof 'Frarriing' -60. POWSPA SYSTEMS FINAL •- "� - - 21 i Roof $heatfiin6 22. Frameand-Flashin _ - -_ _ __ _ _ NOTES:' �lT'¢y{s,q,p'- ,1-� 3$=-- ' 23: Insulation ! •�' 24. Lathin & Siding 25. Drywall -Nailing - - - -- -- - -' --26. Plaster BrownCoat` - - - - 27. Electrical Power Meter -Final.- ' 28. Final:Electric- 29: Final Heating & Air Conditioning A ` 30: Final Gas Pipe -Test- - ' -31.: Final 'Plumbing 32:- Water Service -Final 33:- -Gas Service -Final 34. Solar Domestic -Final ' 35: Landscape Sprinkling System i - •^' ' t 36. Sound Attenuation - -' 37. Handicap Regulations 38- FINAL STRUCTURE & BUILDING - - - 39. Special -Requirements Completed_ 40. Electric Release .to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY ._ ' No; - Date - -- Will Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. 0 CITY Af COSTA MESA PER IT NO. - -TRACT NO. LOT NO. CONSTRUCTION PERMIT a`J� '1693_ ,2/04/82, 1 1.00 TYPE OF CONSTRUCTION - NEW -❑ ADD ❑ ALTERATION _ ❑ REPAIR ❑ CONVERSION 11 DEMOLISH ✓. - ❑ OTHER & - `� "I r. ' � -ZONING REGULATIONS - - - Project Address P Owner - Phone -/2Z .-Address'' /� /J! �f/��/aEl(/. ._ Arch/Eng. - - _ License.No. _ DESCRIPTION OF WORK 's _ _ _ _ - _ i - _ _ "4'P' 31 - - - - ZONE' - - PLNG. REF. � Address - - _ . _ _ _ - _- y ' ;Contractor fl S' „ in - Phoned TYPE OF -PERMIT- - -. --- - - •- '- - .B _ _ SETBACK ❑GRADING-- ❑-FOUNDATION_ 1.STRUCTURAL SIDEYARD - _ ❑ TENANT. ❑ ELECTRICAL OPLUMBING ❑MECHANICA LS IEEpFTy - To�l�i�plNG 'PR RT.V. LINE - .Address- _ 5/ O �O'�%i' LICENSED CONTRACTOR DECLARATION - _ - that I licensed Charter 9 d hereby affirm am under provisions of (com- mencing-with section of Division and, ) ❑ OTHER_ - - .7000). .3..of _the. -Business Professions Code, and my license is In full force and effect. - - - - - REAR YARD (TO'P/L) -- - -- - - - -- - ._ _ �1. •. 970 - PROJECT DESCRIPTION , License Class �t:icense - - - - �-�.--. - - - - +PKG. SPACE -REQ. -- ---PROVIDED -- - Date "a- - 2' -Signature' /h+T. SQ..,FT:-- STREET'WIDTH �- - PARK FEES - WORKERS'COMPENSATION A IOCCUPANCV"_CONSTRUCTION TYPE 'I hereby affirm that I have a c rtlfica of nsent to self -Insure ora -`- - - - - +ZONING APPROVED BY -- -_ - DATE _ - •Ificate of Worker,' Compensation In rance,-or.a certified copy, VALUATION ZONE of (Section 3800, Lab. C.). GRADING CU. YDS. ACRES SPECIAL -CONDITIONS: - - - - - ,y NO. - - " Com Pant EJ_Certified copy is hereby furnished.. _ _ - REMARKS:'.' i+i_ I -i'.i, j!_ `_- ^-' -• '0 Certified copy I5 •filed with the city Building Division. _ _ -- EXEMPTION -FROM WORKERS' COMPENSATION DECLARATION (This lection need not be completed if the permit is for one hundred - -. �,.: , � - ($]00) or -less)', -__ .-_ _- _ _ _ _ _ _ _ 'I certify that in the performance of the work for which this per it Is - Issued.- I shall -not employ -any. person In -an -manner so as to ome PLUMBING _ i _ PLAN CHECK - -ELECTRICAL - - PLAN CHECK subject to the Workers' Compens n BATHTUBS- '-- -- - SHOWERS -.. - i _ _..SQ _ _ __. _ _ _California. Dateri'�-��'-.Signature s _ _ NOTICE: If after making this a ration, y Sho become subject ,TOILETS.. URINALS -y- - [J GENERATOR _ 0-1- KW_ 1-10 KW to the Workers' Compensati ovisions One or Cotle,you'must - TRANSFORMER if comply with suc ovlsions his p mit shall be deemed LAVATORIES- DOUBLE.LAV S--- - -c - -APPLIANCE ._ 10.50 KW_56 + KW' revoked. -_ __ _ _ _ 'CONSTRUCTION LENDING AGENCY - KIT-. SINKS---- - DISHWASHERS--- .:MOTORS _- 01 HP_1-30 HP _ I hereby affirm that there is a construction lending agency for the per. SERVICE SINKSSUMPS - - - - _ (INC_ SOLAR) 10-50 HP 50 + HP formance of the work for which this permit Is issued (Section 3097 ICiv. +^-'fl - - - - - - - -- FLOOR'SINKS,� ---sFLOOR DRP.INS'= -' =.• - 'FIXTURES-- OUTLETS- _ SWITCHES' i ,! - C.).- - - -- -. -- - - ` `- - ;` -- ,; `_ - (Lender's,\Name: _ _ '�`-' s'� -�-Y , v�" iDRI,NKINGFOUNTAINS--,- --- — ! -(GAS TUBE SIGNS ILentlersAtldress OWNER BUILDER•DECCARATION \%iNTERCEPTO RS CL -ARI FIERS - i^- -- - 'POLE.LIGHTS. I hereby afflrm:that_ I•am exempt from the Contractor's License Law -tor . SWIMMING -POOL- - .- PTRAP - - -� the -following reason' -(Section 7031'.5 Business'antl'.Professions Code: "permit Any city or county which_require5 a '!to construct,. alter, ._ _ "'.POLES' - --METERED-- sued -- - ,WATERSERVECE - - ALTERATION - •PANELS. - improve, demolish or repair any structure, prior to its issuance, also re- quires the ap, licznl for such permit to file a Signed statement that he -. -MAIN - ___SUB 'GAS SERVICE '- OUTLETS-- -- --{- -a- Ci- SERV ICE .- AMP' ' is licensed pursuant to the -provisions of the Contractor's. License Law I- �pter 9 (commencing with Section 7000) of Division 3 of the , _�_- - - - WATER HEATERS^ BTU OUTPUT- ess-and-Processions-Cotle) or that he IS exempt therefrom and the for the alleged exemption. Any violation of Section 7031.5 by w - SEWER CONNECTION& - -----•—_ - _-._ _ __ _ - sem' ' 'a,., -applicant -for -a. permit subjects -the applicant-to_a civil penalty of not more than five hundred dollars ($500). - -SOLAR TANK -- - -- COLLECTORSS.: -- I, as'ownerof' the 'property; or my employees -with wages as their sole Compensation, will do the work, and the structure is not intended .' or oflared f'or sale. -(Section 7044; Buslness'and'Professlons-Codei-The SOLAR' PIPING -SVS:----- --�- - - .1 -- '• - - ASSUE,FEE - - ' _ - !Contractor's License Law does not apply t0 an owner of a property ISSUE FEE -- -- - I� -- -- - - - -� 'APPLICATION ARRROVED,BY., _ _ . DHTE ,who builds or improves thereon, and who does such work himself or ,through his own employees, provided that such improvements are not MECHANICAL '- -PLAN CHECK- "' -' ---- "'"---'- --SUMMA'RY'OF FEES-' Intended or offered for sale. If, however, the bullding'or Improvement is Sold within one year of completion, the owner will have the burden 'o( he did not build OrImprovefor the -of sale). - - - - -- -0-100,000 _ _ proving purpose property,- ly_contracting with rbcs-. as Bectu( HEATING SYSTEM BTU I rBUILDING_-�..- PERMIT $ L -SMIP - $ ' _owner_of _the a Contractors to construct the project (Section 7044, Business p 'antl 'and AND DUCTING _ 100,000+ BTU _ .PLAN CHECK $ _ PERMIT - "- Professions Cotle: The Contractor's License, t.ap to 'ISSUANCE Sr c owner of property who builds or Improves thereon, antl who con- thereon, REFRIGERATION 0-100,000 BTU ••- - fPLI'1MBING $ pD _ tr such projects .with a contractor(s)_.Ilcesnetl..pursuant. to_ the SYSTEM. �- �- �' _ GRADING $" Contractor's the Contractor's Li cense law). _ 100,000+BTU PLAN'CHECK'.$ '-- -- - ❑ I-am'exempt' under Section - ---- - B.&P:C: for this- BOILERS BTU ELECTRICAL-�$--, reasonPLAN _ - _ ___ Y- SSTEM REPAIR, ALTERATION'^ 1 ';b, CHECK .$ •MICROFILM$ 'Date Owner I EXHAUST SYE STEM MULTIPL . $ MECHANICAL i TOTAL FEE S• LESS AD. II hereby certify that 1 have read this application and state that the above information Is correct. --1 agree to c mp Iy with -all city and county - -- ---- __ _ - .PLAN CHECK "S VANCEPC $_ ordinances and state laws relating t ns uction, and hereby authorize representatives -of tl -city-t Pon the above mentioned - - -• -- - - - p property fol in ton p t Signature - Date - --' - - - ISSUE FEE FINAL FEE $ Drivers ''Ll Sc - - - CMF,�W65-:6i� W:Iite-Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor TL CONSTRUCTION AND PLANNING APPROVALS Permit # _C55 '• Date Inspector _ _ POOL & SPA ', _ '-•1 'i - -' `-` . , Date Inspector APPROVALS • Permit # 1.. Temporary Electrical Service or Pole 43. Pool & Equipment Location- -2. Soil -Pipe -Un rgrn- 44. Steel Reinforcement - -- --- - - 3.- Electrical Conduit Utility-Undrgrn- - - - -- 45. Forms- - 4. -- Electricals Conduit_Undrgrn----- - - -• - - - _ _. 46:- Electrical Bonding - - -' - - - - _Steel- .- em orce . - �._ -_ t . 47.- Rough. Plumbing & Pressure Test ---6.--Electrical UFER�Grn. �._ _ - _ .•,�, 48. APPROVAL TO COVER"-GUNITE '- 7: --Footings• - - - - - - - -- -~ -_ . - - 49. Electrical Conduit-Undr rn 8: -Foundation-- ---- -- - -- - - - - -,. --- 50..r Gas Pipe j] Undr rn, Test - - 9. WatarPipe-Undrgrn- --- - - -" = -_ - _51. -Backwash-Lines" P -Trap,-❑ Undmm - 10. -Structural Floor System. - - - • 52. ' APPROVAL TO DECK 11. -Property Sewer Line & House Connection - - - - - - - •tr' - 53. -Backwash & Receptor -Final. 12. Street Sewer Connection ---- - - --54- Heater& Vent -Final ' 13. -Rough Plumbing - - -- -_ - --//-$ - - -- - - 14. Rough Electric -Conduit - -- 56. Electrical -Final ' 15. Rough Electric -Wiring _ - -' '- _-' - 57. "Solar System -Final' - 16: Rough Heating &Air Conditioning- - - - encing & Access Approval 17. Ducts, -in Structure _< - _ - - -;, - - APPROVED FOR PLASTERING ' 18. Ducts, Ventilating - - -- - - - 60.-OOUSPA �•. - - •" - - _-_ ' -- �_ __ _ .- � P SYSTEMS FINAL - -"` 19. Gas Pipe -Rough &Test � - - .- - 20. Roof Framing --- ---' _ - - 21. Roof 'Sheathing -NOTES: -- 22. Frame and Flashing 23. Insulation- 24. Lathing & Siding - ' - _ -- _ 25. -Drywall-Nailing 26.- Plaster Brown Coat 27. Electrical Power Meter -Final - - - -- - - - - -' 28. Final Electric- -- - -- -- - ___ _ . " __ . .. - 29. Final Heating & Air Conditioning - - - - - - - 1 30. ' 31.-- Final Gas Pipe -Test - - - - -- Final- Plumbing- -- -- - - -- - -- ' er.• ` 321 Water Service -Final- ,` 33: -` -Gas Service -Final -' -- - - -- - - -- - - • 34. Solar Domestic -Final 35. Landscape Sprinkling System -- -- - 36. Sound Attenuation - - - - 37. Handicap Regulations 38.. FINALSTRUCTURE & BUILDING - 1 39. Special'Requirements Completed • 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No- ' Date - Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. 'CITY-GE6tOSTA MESA P RMIT NO. JEP 2 TRACT NO. LOT NO:, BLDG. NO. 13.1-6 1/27/92 - 1 10.72 TL t6PA_TRUCTION PERMIT � 1 • Z - . Project Address TYPE OF CONSTRUCTION l s. ... r !Owner Phone 7i ❑NEW 1:1 ADD EJ ALTERATION - Address a - ❑ REPAIR ❑ CONVERSION ❑DEMOLISH r, _ ZONING REGULATIONS Arch/Eng. License No. X OTHER I A.P. � C> _ - Address G DESCRIPTION OF WORK Contractor N (�(�(' S G VPE OF PERMIT I - '- ` ZONE AA PLNG. REF.:h-' - �� BP LINE ' Address - U ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL" ' ' SETBACK C T. LIDS VA RD O EIIiTV LICENSED CONTRACTOR DEC TI -r TENANT )( ELECTRICAL' XLUMBING*MECHANICA IEDFE VAR _ I hereby affirm that I am Ilcensetl nper ovi Ions a ter 9 om- mendng with -section 7000) of visl '3 of �(e B si s and - ❑pTHER- - - RIGHT sem, 2 - t Professions Code, and my Ilc ns is 1 nl rce effect. i REAR YARD -- - - -. License as I Lic e Dat Signatum ) -- - PROJECT CRI .T ON 'SQ'FT' PKG. SPACE REQ. - -- _ PROVIDED. - _- - •COMPENSATION OCCUPAN' •'Y CoNSTR VCTION TVPE� STREET WIDTH PARK FEES WORKERS DECLARATION - - I -ereby affirm that I have a certificate of consent to self -Insure or a a/ _ 'VALV N ZONE ZONING APPROVED B DATE 'Ictite of Workers' Compensation Insurance, or -a certified copy ATI of (Section 3800, lab. C.). 1 GRADING 'C U.fYDS. ACRES SPECIAL CO CONDITIONS: �F.,..cY No. - . Company - _ ❑ Certified copy Is hereby furnished. - - REMARKS:- Certified copy Is filed with the city Building Division. _ E%EMPTIOIJ FROM WORKERS' COMPENSATION DECLARATION- (Thls.sectlon.need not be completed if the permit Is.for_one hundred _ - +-• .� 1 ($100) or less). 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 PLUMBING PLAN CHECK - - ELECTRICAL - PLAN CHECK - - subject tothe.Workers- Compensation Laws of California. - Date Signature - _ __ BATHTUBS SHOWERS _ _ FT "-' - NOTICE: If after making this declaration, you should become.subject, 'TOILETS •URINALS - `GENERATOR 0-1 KW_ 1-10 KW to the Workers' Compensation provisions of the Labor Code, you must .TRANSFORMER r forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE-LAVS nka APPLIANCE - -10.50 KW=50+.KW '•' - - - revoked.. KI T. $INK$ - DISHWASHERS?MOTORS- - 0-1-HP=1=10 HP ti ' CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the per. SERV ICE SINKS ', "'• ; ` -" ""' :-' '- ),'SUMPS.-- ' , l _ ,(INC. SOLAR) -30 -50 -HP_ -50 * HP -- -( ; forma nce of the work for which this permit is issued (Section 3097 FLOOR SINKS "� .FLOOR DRAINS, - FIXTURES OUTLETS P SWITCHES 2 QO ' i Civ.. C:). - - - Lender's Name _ _ _ Lender's AtltlressORINI(ING FOUNTAINS GAS TUBE SIGNS OWNER BUILDER DECLARATION" _ INT,E RCEPTO R$ tPOLE LIGHTS' I hereby affirm that I am exempt from the Contractor's License Law for w-CLARIFIER$LZ- - - • v a SWIMMING -POOL PTRAP' -'- - - - theJollowing reason (Section 7031.5' Business and -Prof essto ns Code i- Any city or county which requires a permit to) construct : alter, - - -- (POLES METERED SUB.. �VyATER SERV ICE ALTERATION _- •. :PANELS -' MAIN - -"SUB- -• improve, demolish or repair any structure prior to its Issuance, also.re-- quires the ap.licant for such permit to fili a(signed Statement that he is �/Icensed pursuant lo't he provisions of the Contracto Cs License. Law. GAS SERVICE'?. -3 OUTLETS ,SERVICE - " AMP ' 1�'{ .,pter 9 (commencing with Section 7000) of Division 3,,o CstheV WATER HEATERS BTU OUTPUT" - " 7 -" _- ' - - s �- Igo ,"less and Profeisions'Cotle) or that he Is exempt therefromandthe the alleged alleged exemption. Any violation of Section 7031-5 by ,"SEWER'CONNECTIONS "i'of - -- - ; any',appliwnl5for4a pef mjt'. subjeds-lhe.applicint tota civil -penalty- not'.mofe,than five-nundred do nars•($500) _ .�-�s„': , -i, SOLAR -TANK `" 'COLLECTORS El as owner of the property, or•m; employees with wa9ei as`thev, sole compensation, will do -the work, and the structure.is not.intended or offered for sale. (Section 7044, Business and Professions Code: The _ _ _ SOLAR PIPING SVS. ISSUE FEE' - - OB - Contractor's License Law does not apply.to an owner of a.property. who builds or Improves thereon, and who does such work himself or - - - - _ - - -DO ISSUE FEE 1gpPLICATION APPROVED BV' " - `DATE'/ 27 through his own employees,. provided, that such improvements are not MECHANICAL PLAN CHECK ' l - SU MARY _ `BUILDING' - _ OF FEES -- Intended or offered for sale. If, however, the building or Improvement Is.sold within one year of completion,.the owner wilLhave the burden Improve for of proving he did not bulb or the purpose of sale). HEATING SYSTEM 0-100,000 BTU r ?PERMIT E SMTP .$ • �• r ❑-I,- as 'owner of the property, -am exclusively contracting -with licensed contractors to construct the project (Section 7044, 'Business -q AND DUCTING - - -- "� 100,000. -BTU -- -' - 3G•�Z - - and Professions Code: The -Contractor's License Lzw,does not apply'to an owner of property who builds or improves thereon, and,who'con-.' - 'FREFRIGERATION 0-100,000 BTU PLAN CHECK E O ,PLUMBING - E—?•� PERMIT _' ,ISSUANCE E e - - l l tracts fromsuchprojects with a"contraetor(s) licesnetl ppi(suant`[O� 5�$TEMAI'r •-\'� -. s'- '� '� - ',PLAN GRADING "E the Contractor's License Law). t . ❑lam exemptunderSection-' B. P. C. foilhis` ( 100,000 ! BTU -\ t'� CHECK $ r E BOILERS BTU( -•ELECTRICAL $ reason -'----� - - �' CHECK E MICROFILM$ Date- - -- - -Owner - -- -- -- SYSTEM REPAIR, ALTERATION :PLAN -MECHANICAL TOTAL FEE E E I hereby certifythal.l have read this application and state that the above EXHAUST_'SYSTEM MULTIPLE AD - - LESS AD- Information is correct. I agree to comply with all cit and count 9 PY Y PLAN CHECK '$ -- - VANCEPC $- 1 ordinances noes antlstate laws relating to construction, and.hereby authorize e , r re rerty ti es his cit to eJJ��ter upon the above mentioned properly f In I yrposes(/ : - /10, �n al •1 -to Signature ' 4A MYYM�s Date W _L � h ''s � - 1 FINAL ',FEE `E Drivers' License or SS %ISSUE FEE _ _-MF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Golden rod -Assessor / /i CONSTRUCTION AND PLANNING r APPROVALS Permit # ��% 5'9(! Date Inspector P _ - POOL & SPA' - Date Inspector APPROVALS '. Permit #' - = 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. - SoilPipe-Undrgrn - _ -/ -$ Z 44. Steel Reinforcement - - 3. Electrical Conduit Utility-Undrgrn _ _ 45. Forms _ 4. Electrical Conduit-Undrgrn _ 46. Electrical Bonding ' 5. Steel ein orce 47. Rough Plumbing & Pressure Test "r' ` 6. Electrical UFER Grn _ _ _ _ - 48. APPROVAL TO.COVER-GUNITE 7. Footings - _ 49. Eledtiical Conduii-Undr rn t • 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn. 51. - Backwash Lines P -Trap,❑ Undrqrn- 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 13: Rough Plumbing_ _ 2-//-$�Y a-'� - - 14. Rough Electric -Conduit -- - 56:--Electrical-Final- - 15. Rough Electric -Wiring - - Z C- - 57, Solar -System -Final - _" ,•_' 16. Rough Heating & Air Conditioning- M. encing & Access Approval 17. Ducts in Structure APPROVED FOR PLASTERING 18. Ducts, Ventilating 60, POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test __ 20. Roof Framing - 21: Roof Sheathing - NOTES: 22 -Frame and Flashingy. // $? t/ • 23. Insulation 24. Lathing & Siding - - 25. Drywall Nailing 26. Plaster Brown Coat - / -- 3 ? /8 %Z 0 27. Electrical Power Meter -Final - - - r-'• w.f�� ' 1�71ec C_ - 28. Final Electric _ 29. Final Heating & Air Conditioning 30. Final,Gas Pipe -Test 31. _Final Plumbing .( b .@ 32.'. Water Service -Final - 33.: Gas Service -Final - - 34. Solar Domestic -Final' 35. Landscape Sprinkling System r 36. Sound Attenuation 37. Handicap Regulations !.y ' 38. FINAL STRUCTURE & BUILDING % 1 39. Special Requirements Completed B 40. Electric Release to Edison - - 41. Gas Release to Southern California Gas Co. 42. CERT ICATE OF OCCUPANCY No�� Date 9 9J44-49 / - Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. •dFFY OF COSTA MESA PE MIT NO. TRACT NO. LOT NO. BLDG. NO. IONS RUCTION PERMIT /� a TYPE OF CO TRUCTION ❑ NEW ADD ❑ ALTERATION ❑ REPAIR ❑ CONVERSION'❑DEMOLISH V� 2029 •2l 11162 19.OG 2 'Project Project Address t 18-2— Phone Address 1:1OTHER DESCRIPTION OF WORK, install tenant'im rovements TVPE OF PERMIT GRADING ❑ FOUNDATION -0 STRUCTURAL ZONING REGULATIONS A'P- $ _ ZONE PLNG. REF. Tp gl1I?p1NG I - SETBACK C ST. PROPERTY LINE SID�YARD -Arch/Eng. - License No. _ Address ,ContractorHtg.Phone - Address NIp❑ LICENSED CONTRACTOR DECLARATION - - - licensed ❑ TENANT C1 ELECTRICAL. ❑PLUMBING •I0MECHANIC I E YA - ' ' I hereby affirm that I am under provisions of Charter 9 (com: section 7000)" Of Division- 3 o the Business and , _ 0 -OTHER - RIGHT rtrencing with Professions CO d my license is In full forts offed. I7 ' PROJECT DESCRIPTION REAR YARD (TO P/L) " A License Class_ L7c7T2 - . SQ. FT. - - - _ - - _, .. PKG. SPACE REQ. STREET WIDTH PROVIDED ' - PARK FEE Er to Signature WORKERS' COMPENSATION DECLARATION - 'a OCCUPANCY_ CONSTRUCTION TYPE ZONING APPROVED BY I ^er affirm that I have a certificate of consent to self -Insure or VALUATION ZONE s Ibb 41cate of Workers' Compensation- Insurance, or a Certified copy _ -- 'Of (Sec °j� AQ1 lab. C.). �rs &b Goodman Ins. GRADING CV. YDS. ACRES - - - - - SPECIAL CONDITIONS: iuncy No. Company - - copy is hereby furnisher!.-- - -- - --- -REMARKS:-' - --✓•-- - - f❑fmm'Certified R.-Certifted copy is filed with the city Building Division. _ - EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - - - This section need not be -completed ifthe permit Is for one hundred. ` ($100)or less). s , I certify that in the+performance-of the.work for which this Perms Lli issued, I shall not employ any person in any manner so asfto become -PLUMBING,, 'PLAN CHECK _ ELECTRICAL -PLAN CHECK subject to the Workers' Compensation Laws of California. BATHTUBS SHOWERS Date ) Signature NOTICE: If after making this tleclaratipn, you should become subject to the Workers' Compensation provisions the Labor Code, must TOILETS URINALS - - - GENERATOR '0-1 KW TRANSFORMER 1,10 KW� of you forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS _ _ - APPLIANCE - 10-50 KW -L_50 . KW _ revoked. --- - -'- t - ` --- -. — '' - -' CONSTRUCTION LENDING AGENCY - - -_.. KIT. SINKS, DISHWASHERS -_ MOTORS 0-1 HPm �1-10'HP "- 1 hereby affirm that there is a construction lending agency for the per- SERVICE SINKS j' r SUMPS -- ' '(INC: SOLAR)- 10-50 HP 50 * HP - formance of the work for which this permit is Issued (Section 309_7 FLOOR SINKS FLOOR DRAINS - FIXTURES -- OUTLETS" "SWITCHES' - Civ. - er' Lender's -Name Lender's Address DRINKING FOUNTAINS - , - GASTUBESIGNS INTERCEPTORS CLARIFIERS I POLE 'L-IGHTS" OWNER BUILDER DECLARATION '- - - -' I hereby affirm that I am exempt from the Contractor's License Law for -Business SWIMMING POOL 'PTRAP - POLES METERED SUB-• the folio wing reason (Section 7031'.5 and -Professions Code: Anyrocity or -county - which requires a permit t0 construct, alter, Impve, demolish or repair any structure; prior to Its Issuance, also re- _ WATER SERVICE ALTERATION 'PANELS -- - MAIN - SUB quires the ap,.licant for such permit to file a signed statement that he GAS SERVICE OUTLETS -SERVICE-- AMP - l• 'I tensed pursuant tethe provisions of the Contractor's License Law' •pter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS - BTU OUTPUT.N� 1 f"Sc +l --f \^� 1, `•�. b!1 - ^ - ness and Professions Code) or -that he -is exempt therefrom and the -,s for the alleged exemption. Any violation of Section 7031.5 by _ SEWER CONNECTIONSe;. \�'n^4" ~r'�� any applicant for a permit subjects the applicant to -a civil penalty of not more than five hundred dot ars ($500). SOLAR TANK COLLECTORS _ -" _ r a' - ' -"' ' _ El I, as owner of the property, or my employees with wages as their Sole Compensation, will do the -work,. and the.slructure is not intended I' 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 ownerof. a.properly ISSUE FEE APPLICATION APPROVED BY -- - - DATE who builds or improves thereon, and Who does such work himself or through his own employees, provided that such Improvements.ar0 not. Intended or offered for sale. If, however, the building or Improvement MECHANICAL PLAN CHECK SUMMARY _ OF FEES ; r is sold within one year. of completion, the owner wlll.have the.burden of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-300,000 BTU (BUILDING PERMIT E '_' ° ' $MIP, $ Eh, -as owner of 'the property, am exclusivety -contracting with _ "AND DUCTING - _ , ( licensed contractors to construct the Project (Section 7044, Business 100.0001 BTU PLAN CHECK E PERMIT, r. and Professions' Code; The Contractor's License Law does not apply to - - - - --ISSUANCE an owner of property who build$ or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $"•r tracts 'fro m-Suth projects -with 'a'-contractor(S) llcesned pursuant to SYSTEM' �- - - - - - •L; GRADING $. the Contractor's License law). 100,000'+ BTU I PLAN CHECK $ . ❑ I am exempt under Section - B. 6 P. C. for this OILERS BTU ELECTRICAL $ - $ reason - '"' SYSTEM REPAIR, ALTERATION PLAN CHEC SIG—' 'MICROFILM $ Date' -' - Owner � --- - � - � � - - EX AUST SYSTEM M VLTI"_E J�Q'f/_ �.(�(/✓ _ MECHANIC S� TOTAL FEE E LESS AD- s I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all city and county _ It -t PLAN CHECK $ _ VANCEPC $_-- ' ordinances and state laws relating to Construction, and hereby authorize representatives of JJJJJJ t& city to en}/r upon the above mentioned property. for sots t�urpo$P!"J _ /� - z -_ _q_A_82 ' $i gnature �/ fjL('G1Oate L Y OL - - FINAL FEE Drivers' License or SS aF - ISSUE FEE- �- - - - - - - - - - +F 0865-•:6 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor TL CONSTRUCTION AND PLANNING - APPROVALS Permit 4# /N.LS9�i Date Inspector" POOL & SPA APPROVALS v Permit , •k Date Inspe&or 1. Temporary Electrical Service or Pole 43. Pool &Equipment Location - SoilPipe-Undrgrn - _ 4T Steel Reinforcement - 3. Electrical Conduit Utility-Undrgrn _ 45. Forms - 4. Electrical Conduit-Undrgrn .46.. Electrical Bonding 5. Steel ein orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn _ 48. ' APPROVAL TO COVER-GUNITE 7. Footings - 49. Electrical Conduit-Undr rn " 8.. Foundation- 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P- ra -0 iJndrqrn''""' 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 13. Rough Plumbing - - - 14. Rough Electric -Conduit - •- 56. Electrical -Final 15. Rough Electric-Wirifig - - - 57. Solar System -Final 16. Rough Heating & Air Conditioning _ ---ST--Fencing --ST--Fencing& Access Approval - 17. Ducts in Structure - _ APPROVED FOR PLASTERING 18.' Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL - - 19. Gas Pipe -Rough & Test - _ 20. Roof Framing 21. Roof Sheathing7 NOTES: �O C" _ 22., Frame and Flashing . 23r Insulation -- 24. Lathing & Siding' 25.: Drywall Nailing 26. Plaster Brown Coat _ 27. Electrical Power Meter -Final 28. -Final Electric 29. Final Heating & Air Conditioning ((y •/$�$ 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. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison . t ,, N-+ - - -- - 41. Gas Release to Southern Califdroia Gas Co. - 42. CERTIFICATE OF OCCUPANCY ._ .._._ No Date j _. ..__. • •- �1 Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. -ao:.r•Y OF -COSTA MESA P T NO. '" - TRACT NO. LOT NO. BLDG9NO. -CONSTRUCTION PERMIT _L -Project 5702 8/09/92 13.00 TL Address P; .STF 2 TYPE OF CONSTRUCTION Owner t `mrst Phone - ❑NEW ❑ADD ❑ALTERATIONAddress: - --❑ REPAIR ❑ CONVERSION ❑DEM ZONING REGULATIONS 1 Arch/Eng. - License No. ❑ 071-1E1`1' * _ DESCRIPTION OF WORK P # A.P. Address _ ZONE - 'PLNG. REF. W�, \ • Contractor VI 114, ' M h - �J IQ Phone S2¢ pIoo TYPE OF PERMIT - - - - - - TO BUILDING LINE ' Address 336 4 E' M14,4 •LOegJ C%M ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL - SETBACK T. IDE PROPERTY ',LICENSED CONTRACTOR DECLARATION - ❑ TENANT-❑ ELECTRfICAL ❑PLUMBING ❑MECHANIC '1 hereby affirm that I am licensed under provisions of Charter 9 (com- 'and I ❑ - - 9IEEpFE RIGHT ' mencing with section 7000) of , Division --3 of the Business - profasslons Cod ono my license Is In full force and ffect. OTHER_ -REAR YARD (TO P/L) 2 9 PROJECT DESCRIPTION I� Llcen CI LicensV,lq,' ��_ a -- - - PKGC SPACEREQ.' 'PROVIDED - '• f (J XT 9'° 2- ' -Signature r "y't'y- % SQ. FT. Data9- - - - -_- -- -STREET WIDTH' "' - - PARK FEE $ WORKERS' COMPENSATION DECLARA ION OCCUPANCY •_CONSTRUCTION TYPE I I hereby affirm that 1 have a certificate of consent to self-insure,or a, VALUATION '' ZONE ZONING APPROVED BY DATE 'ficate-of Workers' Compensation- Insurance, or a certified copy - - -- - -- - SPECIAL CONDITIONS: - �' _ of (Section 3800, Lab. C.). GRAOING'CU. YDS. ACRES i .y No. Company-'600v/NL{YI--'.�/✓�' _ f. _ - ❑-Certified copy is hereby.furnishetl. - _- ... __. .REMARKS: ElCertified copy is filed with the city Building Division. EXEMPTION'FROM' WORKERS' COMPENSATION DECLARATION (This section,neetl_not be Completed if, the permit is for one hundred _ - I` - oF, , ($100) or less), r _. _ _ _ / n' - -^-f I certify_lhat.in,lhe performance of the work for which this permit Is Issued, I shall not employ any person in any manner so -as fo become -'PLUMBING,'ti 'PLAN CHECK - "�' - - -- ELECTRICAL' '- PLAN CHECK - subject tohe Workers Compensation ws of Cal or �a. _ Date i �-f 2 Signature BATHTUBS-- 'SHOWERS"'- -' ', - NOTICE: If after making this declaration, ou should become subject TOILETS- URINALS- - - - - -- - I - GENERATOR 0 -1 -KW_ 1' -10,KW - - to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS - - - - TRANSFORMER - -•APPLIANCE - 30-50 KW_50 1 + KW _ ,revoketl.__ _ _ -_ __ _ _ .. _ - . - - 'CONSTRUCTION - - - '- - KIT. SINKS '"-"' DISHWASHERS --�- • t -MOTORS • 0-1-HP_1-30 HP LENDING AGENCY 11 hereby affirm that there Is a construction lending agency for the per. _ - _ _ - - - _ 1(INC.,SOLAR) 30-50.HP_50.+. r• HP formance of the work for which this permit is Issued (Section 3097 SERVICE SINKS- ✓,,�)SV MPS- _ _� _ _ FLOOR SINKS -- FL-OOR DRAINS ''FIXTURES ---- OUTLETS SWITCHES• ,Civ: C:): - -' -""' -' - --- _ _ Lender's Name i,I _ _ _ Lender's Address - - DRINKING FOUNTAINS" 'i. "' --" "- - GAS TUBE -SIGNS OWNER BUILDER DECLARATION _- - - ---- - - - 'I 'INTERCEPTORS - -' 'CLARIFIERS- "� I - +POLELIGHTS - -- --- -- - - -, hereby affirm that I am exempt from the Contractor's License Law for SWIMMING POOL--' ' P TRAP - - _ •- - - - - U - - -' -.POL-ES METERED" SUB - the following reason -(Section 7031-.5 Business and-Professlons Cotle:- Any city or county which requires a permit to construct, altar, WATER SERVICE - -- ALTERATION PANELS - MAIN - SUB- - improve, demolish orrepalr any structure, -prior to -its issuance, also re- quires the ap.licant for such permit to file a signed statement that he GAS SERVICE - -OUTLETS` - _ •SERVICE •- -- - - .AMP is Ilcensed'pursuant'to the provisions of the•Contractor's License Law 'pter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT _ - - - - - - •- - - -- iess'and,Professions- Code) or that he -is exempt therefrom and the for the alleged exemption. Any violation of Section 7031.5 by - SEWER CONNECTIONS '- --" - -- - - -' - -- any applicant for a -Permit subjects the -applicant to a civil penalty of not more than five hundred dollars ($500). SOLAR TANK COLLECTORS - - - - --- - -- - --- - - - I❑1Y, as owner of the property, or my employees wilh'wages as their sole compensation, will do the work,_and the structure Is not Intended 1 or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SVS. _ ISSUE FEE Contractor's -License Law does not apply. to an _owner of a property " - - -'ri- APPLICATIONAPPROV ED BY who builds or Improves thereon, and who does such work himself or ISSUE FEE 1 _ _DAT ,Who hls.own employees. Provided that such Improvements are not MECHANICAL PLAN CHECK SUMMARY OF -FEES -'- , r 'Intended or offered for sale. If, however, the building- or improvement burden is sold within ona.year of completion, the owner will have the of proving he did not build or improve for the purpose -of sale). - HEATING SYSTEM 0-100,000 BTU BUILDING ,PERMIT $ , SMIP $ 0-1, as owner of the -property, am exclusively contracting with AND DUCTING - ' -- licensed contractors to construct the project (Section 7044, Business 100,0670 BTU PLAN CHECK $ PERMIT - and Professions Code: The Contractor's License Law does not apply to _ _ ISSUANCE $'- an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING E tracts from such-proiects -with a contractor(s) Iicesned pursuant.to -SYSTEM- - — ', - _ - _ f PLAN CHECK GRADING' E'` the Contractor's License Law). I am exempt under'Section- - B: &" P. C. for this 100,000: BTU BOILERS BTU E ELECTRICAL Ereason - - - --� CHECK -$-__MICROFILM $^ISYSTEM Owner REPAIR, ALTERATION _ ,PLAN _ OO' +MECHANICAL-EIereby •TOTAL FEEDate cerlify foal have readagre this application antl state that the above E%HAUST SYSTEM MULTIPLEI r LESS AO- ' .information is correct. 'I agree to comply with all city 'and county " f PLANC HECK E VANCE PC E-- and state laws relating to construction, and hereby authorize - representatives of this City l0 enter upon the above mentioned a 0 LIM ' pro rty Ilves property for spectlon '�ses. �f Signature �•044e �^`�^�^ Date �- •"c _ - FINAL FEE $_/I O O ISSUE FEE - - - - - - 0 Drivers' License or9S � ' - - CMF 0865-46 White -Building; Canary -Applicant: Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # .s�-- Date POOL & SPA -� Inspector - •APPROVALS' Permit # Date Inspector i 1. _ Temporary Electrical Service or Pole �i - 43. Pool & Equipment Location - 2. Soil ipe-Un rgrn - _ 44. Steel Reinforcement - - 3.- Electrical Conduit Utility-Undrgrn 45. Forms - _4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel em orce _ r 47. Rough Plumbing & Pressure Test - - 6. Electrical. UFER Grn - -48. APPROVAL TO COVER-GUNITE - 7. Footings 49. Electrical Conduit-Undr rn - 8. Foundation. - - = 50. Gas Pipe, ❑ Undr in, Test 9. Water Pipe-Undrgrn.. 51. Backwash Lines P-Trap❑ Undrqrn -- - - ` 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 _ 13.. Rough Plumbing_ _ ' - - - -'' 14. Rough Electric-Conduit - - " ' -56. Electrical-Final 15. Rough Electric-Wiring - 57. Solar System-Final - - 16.- Rough Heating & Air Conditioning - - encing & Access Approval ` 17. Ducts, in Structure APPROVED FOR PLASTERING 18: 19: 20! Ducts, Ventilating Gas Pipe-Rough & Test - -Roof Framing• . - --. _ .60. POOL/SPA SYSTEMS FINAL -- I' 21. 22. Roof Sheathing- Frame and Flashing - -- - -. - °•'' ' _ NOTES:, ' 23. Insulation - - - - - - - 241 Lathing & Siding- 25. Drywall Nailing - - - - -- - - - -" ' 26. Plaster Brown Coat - - - - 27. Electrical Power Meter-Final -- - - - - 28. Final Electric - 29. Final Heating & Air Conditioning - / - - •- ..a- 30. Final Gas Pipe-Test crygko- - 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. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed ' - 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date V ,aDREss: 245 FISCHER AV. UNIT: ( CITY• OF COSTA MESA — BUILDING PERMIT' PERM NO: M 045204 NAME: ROXBURGH AGENCY E•.g 4.7 ft7 `' . :Ii•s AOORESS:'SAME AS ABOVE PERMIT NO: M 0452Q4• PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: MEC PURPOSE: NEW ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION 2 HVAC _ SQ FT:' ADDRESS: Gxlr: CLAIM VALUE: CALL—VALUE: GROUP OCC: PERMITTEE: MAGNUM—AIR (714)630-4192 ADDRESS: 3911 E. LA PALMA U ANAHEIM CA 92807 LICENSED CONTRACTOR DECLARATION: I hereby affirm } that I am licensed under 'ons of Chafer (ceinmancing with Section Cm)LIC Dilyslgn 3 p gotBusiness ATE UC.. • J o my license rs in f no eD Date: DVT4 `� 11J�/,L/� Signature: WORKERS, TION DESA CIARATION: I hereby affirm that I have a certificate of cement to self -insure or a certificate of Workers Compensationtogrg5o,@ r&gi(9 copy thereof (Section 3000, Lab(F)9/01/90 POLICY NO.: C I,GNA EXP. DATE: WMPANY: �[ Certified copy .s hereby f mished. U Certified copy is filed with the c' i1 Division. Date: Z9 Applicant: �- EXEMPRON FROM WORKERS' COMPENSATION DECLARATION: (This section heed not be completed if the permi is for one hundred ($100) or less). 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 California. Date: Signature: NOTICE: Il, after making this declaration, you should become subject to the Workers Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit. shall be deemed revoked. CONSTRUCTION LENDING AGENCY: hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that) am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of 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/she is licensed pursuant to the provisions of the Contractors' State License taw (Chapter 9 (commencing with Section 7000) of ONision 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 applicam to a civil penalty of not more than five hundred dollars ($500). I, as owner of the DropeM or my am DVbyeses with wages as their sole compensation, will do the work, and the '❑ structure is not intended or offered for sale (Section 7044, Business and Professional Code: The ContractorsState License Law does not appy to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his at her own employees, provided that such improvements are not intended or offered for sale. If, however the building or improvement is sold mouth one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). - 1, as owner of the property am exclusively contracting with licensed contractors to construct the project (Semion 7044, Business ❑ 'and Protessio s Code: The Contractors'State Llci se Law does rutapplyro an ownerof property who builds or improves thereon and who contracts for such projects with a contractor(s) license comment to the Contractors' State License Law). I am aware that proof of their Worker's Compensation' Insurance should be provided to me. ❑ I am exempt under Section: B. 8 P. C. for this reason: Dale: Owner I do hereby cerety that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that I or any future building occupant wilUwill not (circle one) need to comply with said state codes and the requirements for a permit for construction or modification from theAir Ouality Management District. Residential construction applications are exempt from these provisions. r Date:- Applicant Driver s 1n01Ae rat I have read this ap ate laws meeting to bur ec ion pury0 s. J� or Sodal Security Green—Code Enforcement: Canarv—Applicant: Pink—Revenue: Goldenrod—A ssor . COMMENTS: Z 0 N I N G R E Q U I R E M E N T S S F. T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ; PROV: PARCEL: 00000000 ZNEI: REF NO: PLANNING NOTES>- > 1E * iE fE aE * eE dE M M M Oe iE 3E iE Oe M * 3f OE 3E iE ie 1E 1E 1E ail # Of rt 3E OF ik � ♦E ie Oe if-* Ot * ie iE ie iE iE iE iE iE * iE 1E aE if 1E ie iE ee if dE k i0 * is k iE OE Of if iE'if iEiE � * eE iE iE iF D, E V E L 0 P M E N T S E R -V I C E S R E Q U I R E M E N T S ,ZONING APPROVED BYt, I___ :DATE: __ BUILDING APPROVED BY " DATE: ' e.APPL*CATION*ISSUGELD*B** lF'TF'iF'iF TFiF�€�F'iF1Fif'it�FiF3F iFiF itNat D+A�+TE*fk+t• ifiE♦FBE*aEiEaEiEiEiEiEiEBE*eE*iEiEkiE*iE*OEeF1EiEk*atkiEOE♦Ek*ie kitiHiEeeieie#9EafiaiE*eEie#iE)E*iFaEie*ifieiflEOEiEieiEOE*lE*aEiEiEieOeaE LEGALIZATION:N F E E S U M M P R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 57.50 • ;25% SMIP/NON—RES PLAN ISSUE FEE 15.00 BUILDING—DIV—> PERMIT ISSUE PLAN—'CHECK TOTAL PAID DUE TOTALS-----> .57.50 15.00 0.00 72.50 72.50 .00 REVENUE DIVISION TOTALS--> COLLECTED: '72.50 OVER/SHORT: 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 72.50 iE eE iE iE eE iE iE iE**#*♦E aE iF ieM MkaEkat#aE*1F eE iE*kit lfieiE iE kif ae kiE iE it at iE iefEiE dE iefE**aE*kif kek as ie if aE iE lE iE ie**9E aE aE***iE lE iE it* I N D I V I D U AIL F E E B R E A K D O W N TYPE QTY. D E S C R I- P T I: O N UNIT' COST TOTAL COSI' MEC 2 INSTALL FORC/AIR FURN <= 100 K BTU/H 9.00 18.00 MEC 1 VENTILATION SYS NOT UNDER PERMIT;EA. 6.50 6.50 MEC.. 2. INST/REL BOIL/COMPR 3.1 — 1.5.0 HP 16.50 33.00 END OF FEES 01 00048708-00048708 TOT 72.50 DATE: 11/30/89 ME: 15:53 CONSTRUCTION AND, PLANNING - - APPROVALS Permit # - Date Inspector PO_ _ & SPA APPROVALS Permit # Date Inspector 1. 'Temporary Electrical Service or Pole- j 52. Pool & Equipment Location - 2. Soil Pipe-Undrgrnd 53. Steel Reinforcement .3.- Electrical Conduit Utility-Undrgrnd. 'N - 54. Forms ' =4. Electrical. ConduitUndrgrnd. (Y 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO'COVER-GUNITE .7. Footings _ I 58. Electrical Conduit-Undrgrnd. ; - B. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. (Ii • 60. Backwash Lines, P -Trap, O Undrgrnd. 10. Structural Floor System �� + ;'r7f 61. APPROVAL TO DECK 11. Property Sewer Line &'HouselConnection} n!.62. Backwash & Receptor -Final i 12. Sewer Cap ' ,Aj - 63. Heater & Vent -Final !� 13. Roof Drains -• •�� - 64. Plumbing System - Final - 14. Rough Plumbing r f %� 65. Electrical -Final 15. Rough Electrical-Conduii , ..1 66. Solar System -Final - ••� 16. Rough Electric Wiring '{ 1 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. -POOL/SPA SYSTEMS FINAL 79. Rough Heating & Air'Conditioning • _ ! (7 Q�'-%t� FIRE DEPT. REQUIREMENT APPROVALS Permit # - 20: Rough Factory Fireplace-_ .y; 21: Ducts, in Structure -- 70. -Underground Hydro 22. Ducts, Ventilating, •-- 71. Product Piping OGas ❑Oil 23. Gas Pipe -Rough & Test - "' _ '. _ 72. Underground Flush ' 24. Roof Framing - 73. Undergrnd. Storage Tank O 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 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 ' ' K. Electrical Power Meter -Final k 80. FOOD CERTIFICATE ISSUED. 33. Final Electric _ Notes: 34. Final Heating & Air Conditioning i 3 g w 4xw 35.' Final Gas Pipe -Test 36. Hood or Canopy 1 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 r r; _ ' 45. Sound Attenuation 46. Handicap Regulations " - - 47•. FINAL STRUCTURE & BUILDING _ 48: FINAL PLANNING 49: Electric Release to Edison 50: Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date IOIECT ADDRESS:244 FISCHER AV UNIT: B6 DWNER'SRAME: ROXBURCH- AC£.NCY INC - ADDRESS:. 245 TISCHER B4 ARCHIENOiNEER: • REG.MO.: ADDRESS: UNIT: PERMITTEE: LLOYD STRICKLAND ELECT (714)639-2163 ADDRESS:.? 2652 OVERBROOK DR S. A. CA 92705 LICENSED CONTRACTOR DECLARATION: I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section 701 of Division 3 of the Business and Professions Code, and y license is in lull force and effect. CITY LIC.: O 1 Q ) 7STATE UF:Q !�/} Date: _" - f/ Signature: c WORKERS' COMPENSATION DECLARATION: I hereby affirm hat I ha e a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. Q. POLICY NO.: EAP. DATE: 'MPANY: Certified copy.is hereby furnished. ❑ Certified copy is filed with the city Building Division. Date: Applicant: - EXEMPTION FROM WORKERS' COMPENSAnON DECUARATION: (Ois section need ret be ti Intone hundred ($100) w less). I cer ity that in the performance of the work for which this permit 'Slued, I shall not ploy athe behind is In ny in any manner so as to become subject to Ih Wo xrs' Com ensetion Laws of California. i7 „ Date: Signature Ati NOTICE: It, after making this declaration, you should become subjeft to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. 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 (Section 3097, Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professiodal Code: Any city of 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/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that helshe 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 penalty of not mare than five hundred dollars (5500). 1, as owner of the property or my empployees with wages as. their sole compensation, will do the work, and the j C1 structure is not intended or offered for sale (ation 7044, Business and Professional Code: The Contractors' State License Law it 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 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 will have the burden of proving he/she did not build or improve for the purpose of sale). I, as owner of the properry� am exclusive contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code: The Cadractors' State License Law does not appy tow owner of grope m7 win builds or improves thereon and who contracts for such projects with a contractor(s) license pursuant to the Contactors' State License Law). 1 am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B. 8 P. C. tar this reason: Date: Owner: ' Ido hereby certify that l am aware of and understand the requimments of California Health and Safety Code Sections 25505, 25533, and 25534 and that I or any future building occupant will/will not (circle one) need to comply whin said stale codes and the requirements for a permit for construction or modification from the Air Duality Management District. Residential construction applications are exempt ftom these provisions. Date: Applicant: I hereby candy that I have read this application and sate that the above information's correct. I agree to comply with all city and county ordinances and sate laws relating to building construction and IffiereWiiahorize repre Iatives of I city to enter upon the above-mentionegg// property for inspec on gu X , / Date: � Signature: r Driver's License or Social Secunty M: 1641- White-NulMino: Green -Code Enforcement: Canary-Aophcant: Pink-Revonue: Goldenrod -Assessor CITY OF COSTA MESA'..-- BUILDING PERMIT PERM Nb:" 'E' 045465 PERMIT NO:,E 045465 PLAN CHECK N0:.02027-09 A GOVT: N• SUPP:.N CONSTRUCTION TYPE: PERMIT TYPE': ELE PURPOSE: ALT JOB DESCRIPTION ELECTRICAI, & ENERGY .SQ FT: CLAIM .VALUE: CALC-VALUE: GROUP 'OCC:, / COMMENTS: REFER TO' #B38804 Z O. N .T N G R E B A K Q U I 11 L•' M E N T S � E T C' J J ---- ---- -- MAIN BUILDING-------"------------7-'ACCESSORY i BUILDING FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RG11T,- FT IN LEFT: F'I IN RGHT: ' FT IN PARKING REQ: PROV: PARCEL: 00000000 ZNE: REF NO: PLANNING NOTES> D E V E L O P M E N T S E -R V I C E S R E Q U I.R E M E N T'S ZONING APPROVED BY, DATE: BUILDING APPROVED BY DATE: APPLICATION ISSUED BY:SS�� IIJJ DATE:2 -ZC� - �SFF 3F 3E) LEGALIZATION:N F,E.E "S U M M A R Y, STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING ' PERMIT 135.30 -508 SMIP/NON-RES PLAN 1.6.91 ISSUE FEE 15.00 BUILDING DIV--> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS ---> 135.30 .1,5.00 16.91 167.21 '167.21 .00 REVENUE DIVISION TOTALS--> COLLECTED: 167.21 OVER/SHORT: .00 BI.,DG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 150.30 16.91 I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C- R I P T I O,N UNIT COST TOTAL COST ELF. 20 FIXTURES, LIGHTING 1 ST 2.0 EA. .75 15.00 ELE 100 FIXTURES, L.IGIITING ADDITIONAL EA. .45 45.00 ELE 20 RECEPT/OUTLET 1 ST 20 . EA. 75 15.00 ELE 54 RECEPT/OUTLET ADDITIONAL EA. 45 24.30 ELE: 20 RECEPT/SWI'PCH 1 ST 20 EA. .75 15.00 ELE2 MOTOR/POWR APPARATUS 1.1 - 10.0 HP 7.50 15.00 ELE 2 NON --RES APPLIANCE" NOT OVER 1.0 HP 3.00 6.00 t END OF FEES, 1 . 01 00050163-00050164 TOT 167.21' DATES 12/20/89 TIME: 08:43 CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector PC & SPA APPROVALS Permit # - Date Inspector 1. ,Tempolary 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 �l�t ], B G 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING .18. Rough Electrical -T Bar Ceiling - 6 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating'& Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # - 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof.Framing 73.-Undergrnd.Storage Tank OGas 00il 25.. Roof Sheathing .` - 74. Overhead Hydro 26. T-Bai Ceiling (Structural) & Monocoat 75: Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. 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' 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace , 38. -Final Plumbing - 39. Water Service -Final 40. Gas Service -Final r 41. Solar Domestic -Final '- J'l 42. Backflow Preventer ' 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING a 49. Electric Release to Edison ' 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. - I Date ECT ADDRESS: , 245-FISCHER AV OWNER'S NAME: CLAUDIA ROXBURGH ADDRESS: SAME AS ABOVE ARCN/E13GINEER: ADDRESS: REO.NO.: UNIT: H / UNIT: PERMITTEE: ISAACS PLUMBING (714)641-1499 ADDRESS: 2033, S. MAIN SANTA ANA CA 92707 LICENSED CONTRACTOR 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 fug force and effect. CITY uc00c s:C5 Date: Signature: WORXEBS' COMPENSATION DECLARATION: I hereby affirm that l have a6rti0cete of consent to ulbmsum or a cerlific of aAm Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C). POLICY NO.: EAP. DATE: COMPANY: 1 Certified copy is hereby furnished. ❑ Certified copy is fled with the city Building Division. ' Date: Applicant: EXEMPTION FROM WORXEBS' COMPENSATION DECLARATION: (ft �Wto~o reed not be competed B oc permit's for arc hundred ($100) Or less). certify that ld Ua pedarmance of Iho work for which this peissue •I shag n mplay any person in any mann o as to become subject to th Workers'1Co anon Laws of Cantonal Data: ' Signature: NOTICE: If, after making is declaration, you should becom' subject to the Work rs' Compenuton pro i of the Labor Code, you must forthwith comply with such provisions or 1 permit Shan be domed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a,cormmction lending agency for the mance of the work lot which this permit is Issued (Solon 3097, Civ. Q. LENDER: ADDRESS: OWNER BUILDER OECLAUTION: I hereby affirm that I am exempt tam the Contractors State License law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requites a permit to construct, atter, improve, demolish, or repair any structure, prior to Is issuance, also request the applicant for such Dermic to life a signed Statement that heishe is licensed pursuant to the provisions of the Contractors' State 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 pinally of not more than two hooted dollars (S500). I, as owner of the property or my empeyen with wages as Ush sole compensation. vAI do the work, arrd the ❑ structure is not Intended or offered for sale (Section 7060, B Liss and ProlessbrW Code: The Contractors' State License Law does not apply to an owner of a property who bW% or improves thereon, and who does such work Nmsell/herself or through his or her own employees, provided that such improvements are not intended at offered for sale. If, however the building or improvement is sold within one year of completion, the comer will have the burden of proving hershe did not build or improve for the purpose of sale). I, as owner of the property, am exGusivery comnctinq with licensed contractors to construct the project (Section 7064, Business Eland Professions Code: The Contractors State License Law does not appy to an owner of properly who builds or Improves thereon and who contracts for such projects with a cmdaao f ficense pursuant to the Contactors' State License Law). I am aware that proof of their Workers Compensation insurance should be crowded 10 me.. ❑ I am exempt under Section: B. E P. C. for this reason: Date: Owner I do hereby certify that I am aware of and understand the requirements of California Heabh and Safety Code Sections 25505. 25533, and 25534 and that I or any future building occupant YARMI not (circle one) need to comply with said state coon and the requirements fora permit for conhuction a MDdifintion from the An Quality Management Districl. Residential construction applications are exempt from these provisions. _ Date: Appficam: I hereby cerhfy that I have read Mus application and state that Me above i 1 rmat n is correct. I ag ordinances and state laws reading to buiding co stnxtion and hereby r¢e went hoes of flus i prop eM tori pec9an purpose . ^, Date: Signatum: Driver's License or Social Security 1841-46 White—B riding; Green—Code Enforcement; Canary—Applicant; Pink—Revenue; to comply with an dry CITY OF COSTA MESA - BUILDING PERMIT PERM NO: P 044843 PERMIT NO: P 044843 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: PLU PURPOSE: NEW JOB DESCRIPTION PLUMBING FOR T.I. SQ FT:, CLAIM VALUE- CALC-VALUE: GROUP OCC: / COMMENTS: ado O MMMMMMieMMMMM MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMIEMMMiEMMMMMMMMMMMMMie Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING-------•--- FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT 'IN LEFT: FT IN RGHT: FT IN. PARKING REQQUIRED: PARKING PROVIDED: PARCEL: 00000000 ZONE: PLANNING NOTES> MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMiEMieMMM D E V E L O P M E N T. S E R V _I& C E S-'-' R E Q U I R E M E N T .S ZONING APPROVED BY °' DATE: BUILDING APPROVED BY : DATE: APPLICATION ISSUED BY: r !' DATE: MMMMMMMMMMMMMMMMMMMMMM MMMMMMMMMM MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMieMMMMMMMMMMMMMMMMMieMMMMMMMMMMMieN LEGALIZATION:N F E E S,U M'M A R Y - STRUCTURAL SEGMENT:h BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 24.00 25t SMIP/NON-RES PLAN ^ ' ISSUE FEE 3.00 BUILDING -DIV-> PERMIT ISSUE PLAN7CHECK TOTAL PAID DUE TOTALS---->' 24.00 3.00 0.00 27.00 27.00 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 27.00 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 27.00 MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMieMMMMieIeMMMMMMMMMMMMieMMMMMMMMMMieMMMMMMMfEMifMMM I N D I V I D U A L ''F E E B R E A K D O W N TYPE QTY D E S C'R I P T I 0 N; UNIT COST TOTAL COST PLU 1 FIXTURE SET/TRAP W/PIPING 6'BACKFLOW 2.00 2.00 PLU 1 DISHWASHER 2.00 2.00 PLU 1 SHOWER 2.00 2.00 PLU 1 SINK, KITCHEN 2.00 2.00 PLU 3 WASH BASIN 2.00 6.00 PLU 3 WATER CLOSET (TOILET) 2.00 6.00 PLU 1 WATER HEATER AND/OR VENT 2,00 2.00 PLU 1 GAS PIPING SYS OF ' 1 TO 4 OUTLETS 2.00 2.00 END OF FEES 01 a- CONSTRUCTION AND PLANNING POO SPA APPROVALS Permit 4# Date Inspector APPROVALS Permit Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location - ;$.Soil Pipe-Undrgrnd-u -L OVA2�� 53. Steel Reinforcement ; L•;3._Electrical Cond`'yii 'Utility-Uncirgrnd. - - 54. Forms ' Condait lsndrgrnd. 55. Electrical Bonding ,.,Electrical d.1steel Reinforcement 56. Rough Plumbing & Pressure Test - a '"? 6.EElectrical UFER Grnd.a 57. APPROVAL TO COVER-GUNITE - Y5.X-Footings f+S a 58. Electrical Conduit-Undrgrnd. _ 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!& Hoase,Connection _ - 62. Backwash & Receptor -Final 12. Sewer Cap I 63. Heater & Vent -Final 13. Roof Drains 1. 'O 64. Plumbing System - Final 14. Rough Plumbing 1- 65. Electrical -Final ' 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric -Wiring �• 67. Fencing & Access Approval ,17. Rough Wiring Sign 168. APPROVED FOR PLASTERING _ 18. Rough Electrical -T Bar Ceiling 69.-POOL/SPA SYSTEMS FINAL -19. Rough Heating &.Air Conditioning FIRE_DEpT. REQUIREMENT , v •_� :1 Z f . •.. f_ =APPROVALS;~=:p-Per`,ri, # -• - _ _ 1 lJ J ! ,..' 20 cpRough Fe cto�y Fireplace S;� t�k: !. L) x S J V 1. C:k *.: ...r c•^,..,f• 21.--DuHl ill'y!'St uct uFe; '• " ;� ?70. lJpdergrou6d' Hydro w rS- �? 22_-gunnr '_-° s, Ventil@ti9 t: •C471. Prod pingO_ G_as D -Oil , 23.'Ga, Pipe'RoGu h & Test '•"S ?., o' r� " ') 7y, Underground Flush ^ __ n s' x a S+: 7' .,,. , 24�Roo'f F aming * _�`_' Ht' _ �.1 _ _ c^ T =• v _ _ .K d: .., 1-:K a: �' HJ - J73^Undergrnd. Storage Tank D Gas ❑ Oil 25. Roof Sheathing, d 'T "' rJ t' a; 741 -Overhead Hydro.,.Jr .F 26' -T -Bar CeilingfSiuc[ural) &'Monocoat s ; O r � o t: * O> 4: y - _ 75gDry Chemical < u .��: <•e'•; '2 Frameand Flas `g: 5cz^ * 01 W4�' : _ 76. Dry Standpipe "' " ^27> -n "28. Lathin & Sidi `'n 7C^ [-� 9� �1: CIS~ 4 S x ••� & •,I * t 77x7 FIXED SYSTEM FINALk ca^ 29. Insulation '! 78FIRE P_REV. FIjVAL `'• 'fir ':-" "_ - '! X30. Drywall Nailing � I I rt DEPTI: FEQUIREMENT' A.: Ir SON oHEALTH 031. Plaster Brown Coatf. = t*t•' : r79. FINAL IN2SPECTION x =" o Q32 Electriral Power Meter -Final' 80.7F000 CERTIFICATE ISSUED_• 7_33�E:Final Electric- ;: ;n No�?es: -4' , p(C. ti F L_6�rb'� IV 34 'Find Heating& Ai Co dition ng' ti �.1z Arc crc-u i�s>♦ �i� QIL40 ^Fi 35'nal Gas Pipe -Test!: Zr_ �O v� �i - _ -•r" �36._Hood or Canopy A' Z) r., -j .. X., e) :t 'r t S Ct0 R: . D :r Ct Gn r IN: d' I_,, n`O ac _ 737iF incl Factory Fireplaces i -,'r x • ( n e - _ "' i• +'K n M K X38. Final Plumbing r, 1�39. Water Service -Final g - "40. Gas Service -Final t, 1• na r, ti41. Solar Domestic-Final- �Backflow ny 42. Backflow PreventeFi o: ` 1: ' 43. BackflowIrr gation - •,44. Landscape firigation System,?m.-, O * n 7 C O's +: ^.: t'3 '^q t' r7 - - `'45=Sound :Atter7uatior � •• •• O x t*: `1x i. - � ¢-• E-^_ s: _ Handicap Regulations '-t j: .46.* ^47FFINAL STRUCTURE & BUILDINGS a: E- 1 I - F .� `_ .% ;•. 48=FINAL PLANNING '` . ro r' t 7 _n _ r s49 : Ele tric Release to;Edison :' W5Gai'Release to Southern Califgnia Gas Co I r;.^ ` => G 51. CERTIFICATEOF•OCCUPANCY No. Date PROJECT ADDRESS: 245 FISCHER AV OWNER'S NAME: B-2 PARTNERSHIP ADDRESS: SAME 0 ARCN/ENGINEER:y ADDRESS: REG.NO.: UNIT: B-2 UNIT: PERMITTEE: FRAN NELSON (714)751-1883 ADDRESS: 245 FISCHER AV B-2 C.M. CA 92627 LICENSED CONTRACTOR DECLARATION: I hereby affirm that 1 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. CITY LIC.: STATE LIC.: CLASS: Date: Signature: WOBXER$' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell -insure Or a certificate of Workers' Compensation Insurance. ar a certified copy thereof (Section 3800. Lab. C). POLICY NO.: EXP. DATE: COMPANY: Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. Date: Applicant: EXEMPTION FROM WONXERS' COMPENSATION DECLARATION: (This section need not be tompteted it me permit is faradic hundred (SI00) or less). 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 sublecI to Ido W rkers' mpensalion Laws of California., s ' Dale: �/ � Z Signature: Z /d /� � - +�s+� NOTICE: II, after making this declaration, you should become subject to the Workers' Com povisions of the Labor Cade, you must forthwith comply wild such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance at the work for which this permit is issued (Section 3097, Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure. prior to its issuance. also requires the applicant lot such permit to :its a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law lChaptet 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 penalty at not more than five hundred dollars ($500). I, as Owner 01 the property or my employees with wages as their sole compensation, will do the work, and the El structure is and intended or offered lot sale (Section 7D44, Business and Professional Code: The Contractors' State 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 employees. provided that such improvements are not intended or offered for sale. 11, however the building or improvement is sold within one year of completion. the owner will have the burden of proving he/sone did not build or improve lot the purpose of sale). I. as Owner of the property, am eXCIUSIvelcontracting with licensed contractors to construct the project (Section 7044, Business aro Professions Code: The Contractors' State License Law does not apply to an owner of polcolo builds or improves thereon and who contracts for such projects with a conuaclarls) license pursuant to the Contractors' Blate License Law). I am aware that proof of their Walker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B. 8 P. C. _ for This r Date: �� 1 I do hereby loftily that I am aware of and understand the requirements of Calilornia Health and Safety Code ctions 25505, 25533, antl 25534 and that I or any future building occupant will/will not (circle ane) need to comply with said Slate Codes and the requirements for a permit for construction or modification Irom the Air 5uality Management District. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby Lenny that I have read This application and stale that the above information is cormGt. I agree to comply with ad city and county ordinances and stale Lam retailing to Wilding construction and hereby authorize representatives of this city to enter upon the above-mentioned properly for i spec lion urposes. �.// Date: / ') 1 Signature: t>,•,/-�� Driver's License or Social Security n: 1641,46 While—Building: Green—Code Enforcement: Canary—Applicant. Pink—Revenue: Goldenrod—Assessor CITY OF COSTA MESA — SIGN PERMIT PERM NO: SB PERMIT NO: SB 060089 PLAN CHECK NO: 04593-92 S GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: STR SIG PURPOSE: OTH JOB DESCRIPTION ; 21SF NONLUMNATED WALL SIGN SQ FT: CLAIM VALUE: 1,741,00 CALC—VALUE: 1,741,00 GROUP OCC: B-2 / COMMENTS: "ACC COMMUNICATIONS INC/PERSONNEL JOURNAL" SIGN kkkkkkkk*kkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkk S I G N I N F O R M A T I O N DISTRICT: 3 TYPE: WALL ILLUMINATION: NON CATEGORY: NEW DIMENSIONS: 7FT OOIN X 3FT OOIN AREA; 21,OOSQFT LETTER HT; 7 INCH STREET FRONTAGE 1; 429,78 STREET 1: FISCHER AVENUE STREET FRONTAGE 2: 0,00 STREET 2; PARCEL: 00000000 ZONE: MP LOCATION > FRONT: X REAR: BUSINESS NAME; ACC COMMUNICATIONS > LEFT; RIGHT• O T H E R T O T A L S G R O U N D S I G N THIS ACTIVITY 21,OOSQFT OVERALL HEIGHT: OFT OIN THIS SITE 429,OOS FT GROUND CLEARANCE: OFT. OIN ITEMS OF INFO : 6 PLANTER AREA: O.00SQFT ITEMS FOR ACTIVITY: 3 BLDG SET BACK: 20FT.=., COPY VERBIAGE ; ACC COMMUNICATIONS INC. PERSONNEL JOURNAL PLANNING NOTES: k kkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkikkkkkkkkkkkkkkkkkk D E V E•L O P M E N T S E R V I C E S R E Q U I R E M E N;T S ZONING APPROVED BY Co • L DATE; 11I L L L BUILDING APPROVED BY : DATE: APPLICATION ISSUED BY: DATE: (qL k kkkkkkkkkkkkkkkkkkkkk kkkkkkkkkk�'iFifkk LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC SIGN SMIP/RES GRADING PERMIT 41,00 PLAN 26.65 ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTALS ---- > 62,50 0,00 26,65 REVENUE DIVISION TOTALS--> COLLECTED: BLDG PMT PLUMBING ELECTRIC MECHANIC 41,00 21,00 SMIP/NON—RES ,50 TOTAL PAID DUE 89,15 89,15 ,00 89,15 OVER/SHORT: ,00 SIGN SMIP/TOT GRADING PLAN—CHECK 21,00 ,50 26,65 1E BF ikik iE iF ik iFk kikkkkkkiE ikkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkk I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST NO FEES WERE SELECTED FOR THIS PERMIT POOL K CONSRUCTION AND PLANNING ' - Daector APPROVALS Permit # te Insp APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pile-Undrgrnd, 53. Steel Reinforcement 3..Electrical Condpit oility-Undrgrnd. 54. Forms ' • 4. Elec:tical Conduit=Undrgrnd. 55. Electrical Bonding `.5. Steel Reinforcement 56. Rough Plumbing & Pressure Test " 6. Electrical UFER:Grnd. 57. APPROVAL TO COVER-GUNITE c - T•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 Lina & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap a, 63. Heater & Vent -Final 13. Roof Drains '= 64. Plumbing System • Final 14. Rough PlumbKg -` 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 Eactory Mreplace -'ty-•QJ =- 'r �G - C • APT�,r ZALS I Pe-rmk �k ^ 21 Ducts, in Styaur.e: z 5 -. s ' 70; Underground ydrp- S_ x 22. Oucls,�entilati• •_ liPfuct Piping olc�I T! 23: Pip Roth &Fest.. �C�j � �-. ' 72�Underground F lus, ,Ga5 lw`��i -i �,; 24J -_Roof FramingSx '•i-oS [^(ir �« t 73. Urlder`nd.Store g�Tank'E;'G s ©Oil t- a' r r-�II . 1 l'S 25. Rogf S ["' ` > :: ('Jc ••-. �eathin 9 V x .r, ,,y c z 5- •r ^= .� s 74jNerh4ndsHyOr o 7,.r rc, 7 > x 26 -T -Bar Ceiling (SiL turalt &-Monodoet .- W tt 75?%Dry CFi�mi ca 1 l-• K - � _ r vr- .-_ ~• 27 Frameand Flashini ;`D 0 "••' "'n cv c „z 76, bry Sta ncdpi Pg' 28 Lathing& Siding s_ 77•• ¢IXED SYSTEM FINALS 29. Insulation _,.; 78. IRE FINAL ,_ -�, x . LP,,REV. Y 30. DrywaINNaiUng _x -- c0 (-.No - _S _ .-. HEALTH DEPT. AEQU9EMENT�1 31. Plaster �rowq Coa (' - a: r 79. �INAL'INSPECTIOLJ t- , •:32. Electrical PowerVeterFinal ;i 0. > J ROOD,6ERTIFICATE I6S47EDxz 331Fifr'•dl E1Ectri'cr cx '� •� x r Not • • r ;_ r .. ¢ •_ (^ X,'. 34 .Final Htatiriy & Q.ic (sAnditioning < J, ,x N y - 35' Final Gas Pipe -rte T X S _ r s.- _T 36. Ho,& or.Cano Pyr:Y" 37: Final Factory Fire lace :T z ` "' •` -cOn ," ._ s c38 -Final Plumbing=•x .� ;�a AM, ..>- 39. Water Service=FiriaY:'-•- s".^ * s- = K •c L `K H c40.; Ga5 Service Final a y a JZ .. 4fJ� -41%-Solar Domestic - Finale -,x � ^� zi, t 42: -Backflow Preventey n;:x `A'-." nc r^ a ¢_ qG 43. Backflow Irrigation ^fir tom. x4 - < w rrc a t'- { 1; A; 44. Landscape IFrigation Systgr4g ;y .R <;j _ - q ;i - 45.Sound Attenuation L S 46:' Handicap Regulations ;- . . ; , :� x „ r „ K * 47i:FINAL STRUCTURE & BUILDING' 48t_FINALPLANNIO 49. -Electric Release to.Edison_ r 50. Release to Southern California Gas Co " S '• _ `o _ _ -Gas -51 CERTIFICATED OCCUPANCY> r - No. Date 5525 3/07/84 TL Zone NJ Q Accessory B (00 : Z O N ..I N G R E Park.Fees $ - _ O U I E, MREMENTS + ! -M Applicant I, Y OF. COSTP, MESA'' CONSTRUCTION PERMIT '' to fill in.ail spaces exCelit those within heavy border .linand,sign all appropriate declarations. - MIT NO. TRACT NO. — A �O�l _ �� LOT O. -'I -BLDG. NO." L5- z--: Ce Ifl$$d cg�gjy' s filed with the:clty Itling DI i �• ❑50+KW-:+ Construction Po_Ie firlipmnress r�d�y `,1 ,aw I 1 f Z - Applicant's Mailing Address 11� '�L�{'�-t�«t %- -- TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR El CONVERSION 1-1 DEM ❑ THER A.P. #' 4i -n - b5 OC+ e•(/ Applicant Phone Owner's Name 140124M hone DESCRIPTION OF WORK S Main Building: Q Address �,��I�n 7�pl tj ,'-n�V��_ '}? Arch/Eng. (.C!C! (ls.t(yc.y �1�'J� Q License No. AddressZ��Mv LT�• TV EOF PERMIT GRADING FOUNDATION STRUCTURAL TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL - OTHER - PROJECT DESCRIPTION SQ. FT. OCCUPANCY CONSTRUCT/I�p NTVP N VALUATION$ �� M/-- T Frorit B .A Rear '�^j/�� q�.� �� Contractor's Nam `, Phone -50-�� Addrew(mailing) I �-7 f" f' 0 S =� C Right $ Left ' Ping. Ref. g� ' shall not employ any person in any manner so as t0 become subject to ithe Workers' Compensation Laws of California.! I City License No. -/ � / o// ZONE GRADING CU. YDS. �� ACRES �� G Remarks: \�-f2 03 - s - Parking Req./Provided Date Signature + i LICENSED CONTRACTOR DECLARATION - a I -hereby affirm that tam llcensad untler provisions of,Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license.is In full force and effect. 19cense Class License No. v /'•• i/ _ G S• Use of Building: -' PLUMBING ! FEES Planning Notes: HOLD FOR SPEC Date ' Signature ' WORKERS' COMPENSATION OECLARATION i ' hereby,affl rm that I have a certificate of consent to self -Insure or a certificate if Workers' Compensation Insurance, or a-certifietll copy thereof-(SectionJ 3800, Lab. C.)_ '�.�e7C_:eLi - -. L� T j % . PUIicY No. �w_c.t Company �GN� ` bar Sink Showers f i 2 O OL is s -I, W V ` Backflow Preventer Service Sink - .t - _ MECHANICAL i Backflow Irrigation - Sewer Cap-'-"-. ,.;t - _ �_ -, . -.�,. I E 5525 3/07/84 TL Zone NJ Q Accessory B (00 : Z O N ..I N G R E Park.Fees $ - _ O U I E, MREMENTS + ! -M to its issuance. also p;ei n, ine OWner-WIILna Ve me pu r e for the, purpose of sale). I, as owner of the property, am Ir torsto construct the project (Seg The Contractor's License law doe builtls or Improves thereon, and w tractor(s) license pursuant to the CO ❑ 1 am exempt under Section— Date Owner: I hereby certify that I have read information Is correct. I agree to u and state ws m1a g.to bull g sent ati yes this i y t0 offish Inspectio Doses.. $:gpd[u Drivers' Likxmse or SS MF 0865-46 rev. 7/83 '' White'- B ind Professional Code:•Any, city Or t, alter, improve, demolish or repair uires the applicant for such permit msec pursuant to the provisions of ertified &PY-is hereby furnishetl. -� "•'� Bathtubs,,,'--, Sewer Connection -'� I •,. Automatic Washei. :Transformer ❑ 15-50 KW ' 1ppfication'Issueil By Ce Ifl$$d cg�gjy' s filed with the:clty Itling DI i �• ❑50+KW-:+ Construction Po_Ie Clarifiers Solar Collectors' l f e•(/ Applicant Reins ' Fee Pection _ :$25, Issue Fee_. -- I Sub. . DlShwaSh¢r! Solar Piping' P g _ -1' Q Cooking Unit v 'Meter ❑up to 100'amps MJAC - EXEMPTION FROM WORKERS',CO ENSATION'DEC ARATION If is -'PLAN CHECK (This section need or be completed the permit for one hundred ($100) Or .p , 1 _ _ .. - Drinking;Fou ntairis Solar Tank„' �; j•, :r' • • PLUMBING less I certify: that IMthe performance Of the work for:which this permit islissueE;.l' _ Dishwasher Meter Over 100 amps :_ 8 rely contracting' with licensee con- 44, Business and Professions Cotle: shall not employ any person in any manner so as t0 become subject to ithe Workers' Compensation Laws of California.! I Floor Drains, Swimming�Poobw%Spa 1 / Dr ers OGas ❑Electric ✓ ( S V Sub Panel ENERGY P.C. Date Signature + i Floor Sinks 1 ' - Urinal i9 -' ' - a Fan ' _ _ .Motors ❑61 HP ❑1'h - B - GRADING NOTICE: If, -after making this declaration, you should become subject to the ilicalion and state that the abo `e ._ �Ith all city and county ordinances Workers' CO mpensation provisions of the Labor Code, you must forthwith- Gas Service Outlets Water Closet - j i O _ i F.A!U I Inc Solar❑9.15 HP ❑16-15+ ' .tion;and hereby authorize repre- comply iwith' such l provisions Or r this,, permit: shall be deemed revoked. - "- SO CONSTRUCTION LENDING AGENCY' "' - Interceptors. Water Heater MECHANICAL i Fixtures - I i Micrpwave •%. rSOr I hereby affirm that there Is a'construction lending agency for the performance $ �y.L. of the 'work for which this permit Is l issued -(Section 3097 Cly. -C.) _ _ - Ti t Kitchen Sink i Water Service , : i - Device.Boxes'• - • Pole Light - Lender's Name', I- _ _ _ ' - ' Under's Address -' _ OWNER BUILDER DECLARATION ! `- 1 : 1 , •� Lavatbrles - - I : O OutletS:e �r i Range I hereby affirm. that I am exempt from the:Contractor's License Law for the _ y I- - to its issuance. also p;ei n, ine OWner-WIILna Ve me pu r e for the, purpose of sale). I, as owner of the property, am Ir torsto construct the project (Seg The Contractor's License law doe builtls or Improves thereon, and w tractor(s) license pursuant to the CO ❑ 1 am exempt under Section— Date Owner: I hereby certify that I have read information Is correct. I agree to u and state ws m1a g.to bull g sent ati yes this i y t0 offish Inspectio Doses.. $:gpd[u Drivers' Likxmse or SS MF 0865-46 rev. 7/83 '' White'- B ind Professional Code:•Any, city Or t, alter, improve, demolish or repair uires the applicant for such permit msec pursuant to the provisions of P -Trap Z3Y , 'Roof Drains) = Date 1ppfication'Issueil By -mmencing with Section 7000) of s Code) or that he/she Is exempt- Dat mrotion. Any violalion.ot Section Reins ' Fee Pection _ :$25, Issue Fee_. -- I -- S'3 .t ;ubjectshe applicant to 'd civil rs ($500). 1 - - nployeei with wages as If.... sole ructure Is not Intended or offeree : - MECHANICAL '+ ^ FEES fessional Code: The Contractor's i a property who!bullds or Improves herself or through his or her own Is are not Intended or offered for ant Is sold within one year of com- -'PLAN CHECK Boiler Hood or. Type I' ❑ l m Canopy Type III El Duct -Under Ground i I PERMIT proving he/she did not build or im- • • PLUMBING - Duct -Structural Refrigeration System - ZZ op rely contracting' with licensee con- 44, Business and Professions Cotle: Duct -Ventilating ❑0-100,000 BTU 100,000 BTU PLAN CHECK $ Ply to an owner of property who -; acts for such projects with a con- .s License Law). ENERGY P.C. Exhaust SystemMultiple El. System Repair/Alteration . ELECTRICAL i $ Firepl/Fact. Bit. ICBO;# GRADING & P. r.or this red ilicalion and state that the abo `e ._ �Ith all city and county ordinances r /. Heating System &Ducting 00-1 00,000BTUA100,00OBT _ - MICROFILM $ .tion;and hereby authorize repre- SO e agev@-mentioned property for MECHANICAL i $ rSOr Reinspection Fee Issue Fee $ 3 Canary - Applicant Pink 'Accounting; Goldenrod : Assessor _ Switches` . Sign I 18 O kr Garbage Disposal Standing Sections i Q Generator 00-5 KW ❑5-15 KW ' Trash Compactorpp keinspeition Fee $25 Issue Feel IS 3 lipplication,Apprbved By Z3Y Date 1ppfication'Issueil By i Dat • �- SUMMARY OF FEES BUILDING PERMIT $ X13. 00 SMIP $ -'PLAN CHECK $ PERMIT • • PLUMBING $ ZZ op ISSUANCE $ PLAN CHECK $ .OD ENERGY P.C. $ ' . ELECTRICAL i $ 5� 70 GRADING $ PLAN CHECK $ 3� .3S• MICROFILM $ - SO �� 33 MECHANICAL i $ rSOr TOTALFEE $ �y.L. - PLAN CHECK $ Ti - COVSTRUCTION AND PLANNING '' POOL_ SPA Date ' ? ROVALS Permit # Ins ector p - APPROVALS Permit # Date Ins ector P . 1` emporary Electrical Service or Pole ' 52. Pool & Equipment Location 2. Soil Pipe•Ondrgrnd. G�ra,7f 53. Steel Reinforcement 3. Iectr,Sal;Coriduit Otifity-Undrgrnd. 54. Forms 4.;ElectricalConduit^Undrgrnd. 55. Electrical Bonding 5..Steel Reinforcements 56. Rough Plumbing & Pressure Test 6.-ElectricaN`UF,ER Gend. 57. APPROVAL TO COVER-GUNITE 7.' '65tings"1 =' ""'.y `- L� a 58. Electrical Conduit-Undrgrnd. a 8."FquhdatiDn i<" • ;� :> 59. Gas Pipe, 0 Undrgrnd., Test v 9..Wai%rlPi-e-Undrgrpol •' 60. Backwash Lines, P -Trap, ❑Undrgrnd. 10. Structural Floor System's - 61. APPROVAL TO DECK 11. Pfoperty Sewer Line & House Connection 62. Backwash & Receptor -Final 12. $e•iver.'Cap . ; • -- 63. Heater &Vent -Final o-+• 13. Roof 64. Plumbing System - Final "Drains.3 14. RougK;,PlumbingJ 14(;+( LV 65. Electrical -Final 15. RoughlElectrical-Conduit �- 66. Solar System -Final - ' 1�6. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T BarCeiling 69. POOL/SPA SYSTEMS FINAL P9. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # - 20. Rough Factory Fireplace 2 'Ducts, in Structure, 70. Underground Hydro 2:'. Ducts, Ventilating •J / 71. Product Piping 0Gas O0il . Gas Pipe -Rough &Aist % 72. Underground Flush 24. Roof Framing „� � 73. Undergrnd. Storage Tank ❑Gas 0 Oil '.`25. Roof Sheathing Lr 1r26.,T;Bar 74. Overhead Hydro Ceiling (Structural) & Monocoat 7 75. Dry Chemical 27.. Frame and Flashing r oq 76. Dry Standpipe 2$. Lathing & Siding 77. FIXED SYSTEM FINAL `29. Insulation 78. FIRE PREV. FINAL 30 Drywall Nailing 4-V'tf")e4" �ys�y (,Eo HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coai.•7 ; 79. FINAL INSPECTION 32. Electrical Power tMeter-Final 80. FOQD'CERTIFICATE ISSUED ✓s• ' 33. Final ElectricNotes: F l0 N : i , • •) 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test '00ez 36. Hood or CanopyAq6*44r1-ol, ' `p 6 AJ 37. Final'Fa'etory Fireplace 38. Final Plumbing -- (,��2�P�'/ LF9 39. Water Service -Final 40. Gas Service -Final 41. Solar.Domestic-Final "I 42. Backflow Preventer 43. Backflow Irrigation 44. ,Landscape Irrigation System - 45. Sound Attenuation 46. Handicap Regulations r 47. FIN'ALSTRUCTURE&BUILD ING vC� i' 48. Special Requirements Completed 49. Electric Release to Edison' 50. Gas Release to Southern California Gas Co r 51. CERTIFICATE OF OCCUPANCY r ; t �' No. i 70 Date r �7 � - r , .`� ••' �) A Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. CITY QF COSTA MESA' PERMIT NO TRACT NO. I L -QT NO.e I BL ,CO"b.. PERMIT Project Address 245 Applicant's Mai lin Address Owners Name // //Jil/ / M Address -LW t z/Pu 2 Arch/Eng. 1210YA, License No. Address �.y� Contractor's Nam Phpne^5.M_p dJ Addren (mailing)%7 City License No. C,24"06 LICENSED CONTRACTOR DECLARATION 1 hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license IS In fu' to ce and of lett. a IJCB�se, CJdss License No. '••' Date/ >_ sig t !4 dew WORKER Sj COMPENSAT ION DECLARATION .ereby affirm that I have a certificate of Consent [o .lf4 sure ora certificate Workers' Compensation Insurance, or a certifi�edd copy thereof (Section .6800, Lab. C.'SIs �l Qn Com Pant Polley No. .rtifietl copy is filed withrthehcitlY :: in9 I I top; i Date AP P l item tr/JY/% t -0%r EXEM TIO FROM WORKERS' COMPENSATION DECLARATION (Thissection need not be Completed If the permit Is for one hundred ($100) or less). 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 tke Workers' Compensation Laws of California. Date Signature NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions' or this permit shall be deemed revoked. 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 (Section 3097 Civ. C.) Lender's Nam. Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/she Is licensed pursuant to the provisions of •he Contractor's License Law (Chapter 9 (Commencing with Section 7000) of ,ision 3 of the Business and Professions Code) or that he/she Is exempt refrom and the basis for the alleged exemption. Any violation of Section ,31.5 by any applicant for a permit subjects the applicant to a civil enalty of not more than five 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 (Section 7044, Business and Professional Code: The 'Contractor's 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 employees, provided that such Improvements are not Intended or offered for sale. If, however, the building or Improvement Is sold within one year of com. potion , the owner will have the burden of proving he/she did not build or Im- loveforthe purpose of sale). I, as owner of the property, am exclusively contracting with licensed con. 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 builds or Improves thereon, and who contracts for such projects with a con- tractors) license pursuant to,the Contractor's License Law). ❑ 1 am exempt under Sectlon B. 6 P. C. for this reason Date . Owner have read this agree to compl o building cons {e enter upon 33 TYPE OF CONSTRUCTION U NEW U ADD U ALTERATION U REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P. DESCRIPTION OF WORK S Main Build TYPE OF PERMIT GRADING 0 FOUNDATION 11 STRUCTURAL T Front ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL BRear A ❑ OTHER C Right PROJECT DESCRIPTION $D. FT. I OCCUPANCY K CONSTRUCTION TYPE VALUATION$ S Left ZONE GRADING CU.YDS. ACRES Ping. Ref. Remarks: �. /III,Parking Req./Pr Use of Building PLUMBING FEES Planning Notes: Bar Sink Showers Preventer Irrigation Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets Interceptors Kitchen Sink Lavatories P—Trap Roof Drains Reinspection Fee . 1 $25 Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact. Blt. ICBO # RH ating System & Ducting 0.100,000 BTU Ell 00,000 Signature - tn—Dates/d/ I I Reinspection Fee Drivers' Lice se or SS 9r CMF 0865-46 rev. 7/83 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor $25 8027 4/05/84 61.75 TL Zone Accessory Building: Z O N 1 N G R E Park. Fees $ Q U I R E M E T Service Sink I S Sewer Cap ELECTRICAL FEES Sewer Connection Automatic Washer Construction Pole Sub. Transformer ❑ 15-50 KW 11 50+KW Solar Collectors Solar Piping Cooking Unit Meter ❑up to 100 amps Solar Tank Dishwasher Meter ❑over 100 amps Swimming Pool w/Spa Dryers ❑Gas ❑Electric Sub Panel Urinal Fan Motors 110-1 HP ❑1 %- 8 Water Closet' F.A.U. Inc. Solar 1:19.15 HP El 16-15+ Water Heater Fixtures ' Microwave Water Service Device Boxes Pole Light ' Outlets Range - - Switches Sign - Garbage Disposal Standing Sections ' - Generator 00-5 KW 1:15.15 KW Trash Compactor Issue Fee $ 3 Reinspection Fee $25 Issue Fee $ 3 IANICAL FEES PUBLIC SERVICES REQUIREMENTS: PUBLIC Approved By Date Application Approved ByDate Application Issued By �-�% Dat Canopyy Type I I ElHood Type El l/eefrigeration System ;!f -100,000 BTU ❑100,000 BTU B BUILDING PERMIT PLAN CHECK PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK MECHANICAL PLAN CHECK SUMMARY OF FEES $ SMIP $ $ PERMIT $ ISSUANCE $ $ ENERGY P.C. $ $ GRADING $ $ �- MICROFILM $ $ TOTALFEE $ $ System Repair/Alteration •• Issue Fee $ 3 CONSTRUCTION AND PLANNING ,APPROVALS Permit �G Date Inspector POO 'PA APPROVALS Permit# Date Inspector ' I. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. `4. 54. Forms Electrical.Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER 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 11 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 Vj9Y ium FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating r 71. Product Piping OGas 00il 23. Gas Pipe -Rough & Test 72. Underground Flush *24. Roof Framing 73. Undergrnd. Storage Tank OGas 00il 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 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 48. Special Requirements Completed , 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co i 51. CERTIFICATE OF OCCUPANCY No. Date ' Applicant to fill In all spaces except those within heavy border lines and sign all approeriate declarations CITY OF COSTA MESA PERMIT NO TRACT NO. LOT NO.., • BL w 1265' 5/30/64 'TI CONSTRUCTION PERMIT _ Applicant's Mailing AddreA ar TYPE OF CONSTRUCTION LJ NEW DD LJ ALTERATION REPAIR Project Address C7! - ❑CONVERSION ❑ DEMOLISH ❑ OTHER ' Owner's Name U hone ztl.iYfZ-• DESCRIPTION. OF WORK i t, ,_ ZONING REGULATIONS Address TYPE OF PERMIT= 'GRADING�1 STRUCTURAL A. P.. ZONE - - � � •- � Arch/Eng. License No. �FOUNDATION ❑TENANT ❑'ELECTRICAL�LUMBING ❑MECHANICAL BUILDING ' _ -- ; - p SIL•J/c � PLNG. REF. q1E gr1g,el. 11, QT Address Contractor's Name.C'd�0 ciro. /�i�uT• : phone4%776zr_• L��OTHER�Cl2F '. PROJECT DESCRIPTION, SO. FT. � Cc/CS - OCCUPANCY' TO BUILDING. ROPE INE - - REAR YARD (TO P/L1 ' Address { � CONSTRUCTION TYPE � VALUATION $,Z�,4 �.� LE FTSIDEYARD RIGHT SIDE YARD aa,1 License No. __ � ZONE GRADING CV.VDS. ACRES PKG. SFACE! REO. I � PROVIDED - LICENSED CONTRACTOR DECLARATION Remarks: STREET WIDTH �PggK FEE $ - I here D ylafO rm that I am licensedunderprovisions of Charter 9 (commencing - with section 7000) of Division 3' of the Business and Professions Code, and - ,� SPECIAL CONDITIONS: my Incense is I' full force antl;effect. license class_ Iceroe No. 36 LSri' 9 ^Signature - , . PLUMBING I 1 Dale y�� Bar Sink Sewer Cap ELECTRICAL N WORKERS' COMPENSATIODE L NRATION I hereby affirm that 1 have a certificate of consent to self -Insure or acertlfiwte - _ Backflow Prevent it - Sewer Connection - Automatic Washer ( -t •Meter over 100 amps - if Workers' Compensation Insurance, or a certified copy thereof (Section • I 3900, Lab. C�,�1l• �rn� Backflow Irrigation - Solar Collectors Construction Pole I i Sub Panel ' i PoIICY No. ,:5 Oo 44A 1424 VSf �� .. - - Company ❑ Certified copy li hereby furnished. Bathtubs Solar Piping , Cooking Unit Sub Pole rtlfietl copy is flied with the cnty,8u�••�yfy" Dlvii ) ' Dishwasher -Motors ❑0-1 HP 01 R -B Data Applicant ��T�l--/��k/�L�'� _ Clarifiers Solar Tank EXEMPTION FROM WORKERS'COMPENSATION DECLARATION' _ Dish Washer - Swimming Pool w/Spa J Dryers ❑Gas' ❑Electric 'Inc.Soler,❑9-15 HP ❑16-15+ (This section need not be completed H the permit is for one hundred ($100) or I certify that In the performance of the work for which this permit Is Issued I Drinking Fountains j Urinal Fan Microwave I shall not employ any person In any, manner so as to become subject to the Workers', Compensation; Laws Cal itornia., Floor F.A ,U. Pole Light of Drains: water Closet, Date Signature NOTICE: If, after making'this'declaration; you should become subject to -the ' Floor Sinks- - - - Water Heater, Fixtures . - Range 1 Workers', Compensation provisions of the labor Code, you must forthwith, comply with, such provisions. -Or, this permit .shall be . deemed' revoked. des Service, Outlets I Water Service- Device Boxes Sign. CONSTRUCTION; LENDING AGENCY - Outlets $ . I hereby affirm that there is a'construction lending agency for the performance' 1 • Interceptors - f Standing Sections of the ,work for which" this- permit -is Issued ,(Stion 3097 Civ. C.) ec Lender's Name' - " Kitchen Sink' - "' Switches Trash Compactor r .fenders 'Address-. OWNER BUILDER DECLARATION' .i Lavatories - - - - - - Garbage Disposal , — that I am exempt from Law for the I following Ing P -Trap Generator El 0-5 KW 05-15 KW - ss and.ntractsionallCode reason (Section' 7031:5 Business t alta o Improve dem Any city or count county which. priorrequiresto l permit c construct, alter improve; demi such repair any structure, prior to requires applicant for such permit P Transformer ❑15-50 KW I ' ' r ' RoOf Drains "' " . t0 file a nt that e Is statement that he/she i9 he/she pursuant pursuant to the provisions - • - , I 050+ KW. Csignedontractor's (comlicensed >he Contractor's'ucense Law'(Chapter 9 (commencing{with Sactlbm 7000) of f `.`-vialonl3`Of the'Busis fo antl Prafessiaxe Code) or. that la/she Is. exempt rafro 'and?,an the' basis for the alleged ion Showers "" _ 1 Reinspection)Fee' $15 - - 1 Reinspection Fee $15� Meter ❑up 100 _ ekemption-Any viola of Secclon J=ti31.5 Dy. any applicant for -a permiiF subjects _the' applicant to a civil _ - t -, r Service Sink - - I $ 3 to amps _ _ - `Issue Fee ' _ $ 3 lana[' of not more than Ove hundred dollars ($500). • 1 - Issue Fee ;: Zoning Approved By Date U 1, as $Owner of the property or' my cm ployees with wages,as their 5010 compensation will do the work, and the.structureJs not Intended or offeretl I for sale:( Sec/Ion 7044', Business and Professional Code:' The Contractor's MECHANICAL - ! Application Approved E ,I �7`� nate ,•`ZL�-� License Law does not apply to an owner a property or improves Boiler -+ ; , Refrigeration System ', Application Issued BY Jr^ Sc 'Date if twhohrough gh his emplon ss, ,who does,suchwork himself/herself or through his or her Own employees, provided that such Improvements are not Intended or offered for - $ - Duct"- Under Ground ❑0;100,000 BTU ❑100,000 BTU pp sale. Iff however, the building or Improvement is sold within one year of com- - - , SUMMARY OF FEES pletlon, the owner -will have the burden of proving he/she did not build or Im- Duct Structural ( drove for the purpose of sale). $ j LJ I, as owner of the property, am exclusively contracting withtlicensed con- - System Repair/Alteration r BUILDING PERMIT $ �T_�_�+ SMIP - tractors to construct.the project (Section 7044, Business and, Professions Code: > Duct - Ventilating - - _ - PLAN CHECK- $ SSS Z. P T The Contractor's License Law Boat not apply to an owner of property who -' builds or Improves thereon, and who contracts for such projects with acon- Exhaust System ❑ Multiple ❑ '%/ " / ---r 'PL-b"Birl Z fes $ -z�n ISSUANCE $ - tractor(s) license pursuant to the Contractor's License Law): ❑ lam exempt Soctlon B. & P. far - " I $PLAN CHECK' $ $ GRADING $ ; under C. this reason Firepl/Fact. Bit. ICBO V/' " ' l Heating''System&Ducting $ l .Ir r 'ELECTRICAL $ t $ Date r Owner' " ' I hereby 'cart ify that '1. have -read this application' and state that the -above ❑0100,000 BTU ❑100,000 ,I 'PLAN CHECK $ MICROFILM ( $ _ Intormatlon'Iz correct. I agree to comply with all city and county ordinances , 4' '..,' . MECHANICAL $ TOTAL,FEE $ and state laws relating to building construction; and hereby authorize repre- ( 'thl Hood Or Type I ❑ - ' ' - santatives of y$ to enter upon the above-mentioned property for Inspection purpo Cano T p e II ❑ Reinspection Fee[ - $15 PLAN CHECK' $ LESS ' Signature/�-_.�..•�+•e,.�.v Date - I -Qi 4-, ADVANCED PC $ Drivers' License or'S51K i Registers , Issue Fee j I t ; $ 3 - - /'' FINAL _FEE $ /�'`�i'-� CMF 0865-46 rev. 12/82 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor i �— �`_CONSTRUCTIOWAND„PLANNING _ { �'-'=�.�t.o ,-'•j.`o'r ,;POOL .PA -APPROVALS Perm it-# " ., Date 'Inspector ,;-'APPFIOVALS - Permit -#Ir Date ' Inspector m 1- Temporary Electrical SerJice'or�Pole ic: :° oF•52.'.Pool&Equipment'Locati on':•� v 2: Soil Pipe-Undrgrnd m �• ;� r `' ; ` c `-" '� Steel Reinforcement 1 n' Electrical ConduitlUtiliyv;Uridrgrtid., ' M1. _ �>�- 5-54n' Forms 4:, Electrical Conduit-Undrgrtid"' + 4 : - _ G; `-' 3 > 55C Electrical Bonding 5: Steel Reinforcementi 56. Rough' Plumbing Pressure Test. - ' .& 6: Electrical!UFER Grndt' t ` ! �! s" 57. AP.PROVALTO;COVE R-GUNITE 7. Footings ' ! ' m - "` `758� Electrical.Confd6it-Undrarn.1.- I I r _ . - B. Foundation- O:Un59Gas Pipe,.drgrnd Test =' _ 9. Water Pipe-Undrgrnd.t;60. Backwash: Lines; P-Trap,-Undrgrnd.= _ 10. Structural Floor System 61. APPROVACTO DECK 11. Property Sewer Line& House Connection 62. Backwash'&`Receptor-Final 12. Sewer Cap L '--63. Heaters&-.Vent-Final .. 13. Roof,Drains_^ - s 64. Plumbing:System --,Final - 14. Rough Plumbing °-65. Electrical -Final' •- - - L 15. Rough Electrical -Conduit^- - 66TSolar System=Final - - " .:16. Rough Electric Wirings l i' ) P ='' ,'.ei W _; I-:}.=-_', "'67 Fencing &=Access,`Approval • - _ -, - - i. 17. Rough Wiring Sign �. ; l '. I i; _ ' j _ ! -. i 68. APPROVED FOR PLASTERING - , `_1 8. Rough -Electrical T.Bak Ceiling) ! -Heating ; ( 69.! POOUSPA SYSTEMS FINAL . 19.' Rough &Air Conditioning ! `_= 1 1 j ;. I I 1 FIRE DEPT.REQUIREMENT- I_ APPROVALS Permit!# - ' 20. 'Rough Factory Fireplace 21. Ducts, in Structure'; '' I '; 6 I I ' I 70.' Underground Hydro I 22. 'Ducts, Ventilating ' r I: II I 1 I ( , I 71.1 Product Piping 0 Gas C3 Oil Gas Pipe -Rough & Test = j;-_ j 7 72.1 Underground Flush? .23. ; i '24. Roof Framing l ^ 1 i73.j Urideigmd.StolageTank 0 Gas 06il ! I''' I -' 25. ,Roof Sheatltirig I �Ir 74. Overhead Hydro 26 -Bar Ceiling (Structural)y & Monocoef- l J. !� - 0T 1 75.M Dry Chemical 1 1 ,T l 1 G 27. Frame and Flashing; '. ! I j� Q l 11 Dry Standpipe , i ,, I 176.; •%-" 28.'Lathing &-Siding• j 1 l I �.-� X77•; FIXED SYSTEM FINAL ��, j�. 29..Insulation j ' ` '` �• I I I I ;78' FIRE PREV. FINAL 30. Drywall Nailing - •,t Notes:' 31. Plaster Brown Coat 32. 'Eectrical,Power Meter, -Final l !; I I ,; -� t t 33. .Final Electric '' -.'_-,.t-..-: '_.... I '...�_ _.'. 1 i . . •._ .!_-'f^ _._, 34. Final Heating &'Air Conditioning +, 35. Final Gas Pipe=Tess! -' :'� i'S - ?_ j -X I°! 36. Hood or Cano�,i 37. Final Factory Fireplace• 38. FinalPlornbing, 21- , 39. Water Service -Final,- , ill 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventers 43. Backflow Irrigation i n- _ - ''- ,- � c, 44. Landscape Irrigation System 45. Sound Attenuation'. ! �_ 4 , ',;' I - I - • - - 46. Handicap Regulations i 47. FINAL STRUCTURE&BUILDING 48. Special Requirements C"pleted- 49. Electric Release;to Edison, _ , , .� 50. Gas Release to Southern California Gas Co j 51. CERTIFICATE 'OFIOCCUPANCY '_-__` !� i__,'„-_� =_tel__ _--�_�_ •`'' - - ., i, No I I r I i , -Date Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. 650I I OF COSTA MESA PERMIT N TRACT NO. LOT NO. BLDG. NO. - - 8/30/82 , 10.00. - -- -• • -. CONSTRUCTION PERMIT - - TYPE OF CONSTRUCTION ❑NEW ❑ ADD ❑ ALTERATION ❑ REPAIR -❑ CONVERSION ❑DEMOLISH- - ❑ OTHER_ 1" .. •. " 20NING REGULATIONS .A.P.-9P 'Project Address Owner ' Phone _ Address" ( �rJ V✓' S eR 'Arch/Eng. - - License NO. DESCRIPTION OFWORK - . - -' ZONE PLNG. REF. $• Address '- -- - _ - Contractor t✓N �s� v, J* .. PhoneTYPE OF PERMIT - - - . - - TO gl�I DING - - - ISETBACK S . PROOW LINE, .' ❑GRADING -❑_ FOUNDATION TRU CTURAL' - •SID YARD --- ❑ TENANT ECTRICAL ❑PLV G OMECHANICA LWI E.Y - - _ Address LICENSED - CONTRACTOR DECLARATION Linder 9'(com. I hereby affirm thet I am licensed provisions of Charter mencing with section 7000) -of jDivislon 3 -of the Business and . r I -❑OTHER-- RIGHT - - Code, and my license ,s In full force and effect. ,REAR YARD (TO P/L)Professions PROJECT. DESCRIPTION _ _ - License Class ' License No. - _ _ 1 -SO.-FT. - _. _ _.. _ _ X10 CCVPANCY_CONSTRUCTION TVPE _ _ PKG. SPACE REO. -PROVIDED. - . _ _ _ _ 'STREET WIDTH PARK FEE'E Date Signature - -' ^ -. - • WORKERS' COMPENSATION DECLARATION--- -- i1 hereby affirm that 1 have a certificate of consent to self -Insure ora -copy - - VALUATION ' ZONE ZONING APPROVED. BY - t -' 'DATE --, - ' certificate of Workers' -Compensation Insurance, or a certified _ - - - SPECIAL CONDITIONS: thereof Section 3800, Lab. C.). , _ (Section - YGR ADING•CU.'•VDS.E$ i `nIiCY NO. Company - - _ _--_ _ .. __ - _ _ _ _ _ -Certified copy is hereby furnished. - - --- - - "J REMARKS: -'✓ . y ,1• J Certified copy is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - - - - -- - - - - - - - (This -section need not be completed. I L.the permit is for.one hundred _ _ _ 1 �� •• '1 •: •' ($300) or Ie ss11 I „ 14 _ -__ _ _ I __1_ -._ -:. - - - _ _" -- -__ -- _ _ _. _ _ 1 certify that -the performance of the work -(or whlth_this permit is - • - - �`-' issued, 1 shall not Cm ploy any person in any manner so as,to become PLUMBING-, -e .PLAN CHECK -' -;-' _ ' _ ';ELECTRICAL:' ' -' - 'PLAN CHECK -- - subje to the Workers' Compensation w5 oLCd lifo i ..1 - _ _' _' _ -- _ _' _ BATHTUBS SHOWERS r- -'- - - HAUL _ - - - u ' Da[¢ �ignature NOTICE: If a er making this declaration, you should become subject;TOILETS_1„ ., •Iy .., URINALS-"' -', 1GENERATOR -- -0-1 KW_ 1.10 to the Workers' Compensation provisions of the Labor Code, you must ;forthwith comply with such provisions or this permit shall be tleemetl - LAVATORIES DOUBLE LAYS-'-- --' -""1'APPLIANCE (TRANSFORMER 4" t d - 30-50 KW_50-+KW-�� - --- - ,revoked. - — s - - -. _. - _ _ _ _ _ CONSTRUCTION LENDING AGENCY KIT. SINKS -` DISHWASHERS—— , ' '-"MOTORS--^-0-1"HP--'-1'-30-HP --^ — - - - -- J(INC..SOLAR).-_.10-50•HP__.-50.+-HP ,f hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS ^''SUMPS' '- --- i -- -- c�T'r• • -'� - iformance of the work for which this permit is Issued (Section 3097 FLOORSINKS FLOORI]R'AINS---'i '•`- _... tFIXTV RES---"OUTL'ETS--SWITCHES -- -- - - ;Cl Lend.). e ILentlr's Name _ _ Lender's Address DRINKING -FOUNTAINS --- - -•'fGAS TUBE -SIGNS -:7-.— --OWNER INTERCEPTORS _CLARIFIER$ -�` �' 1 -'- 'sPOLE'LIGHT$---'---- -' -� -- - - OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for --SWIMMING' POOL -"'-`-P TRAP-'_"� -•'�—" LPOLET METERED -SUB- -- - - - the following reason (Section 703175' Business and^Professions Code:' Any_ city or countywhich,requires a permit to construct, alter, Improve, demolish *or repair any structure, prior to Its Issuance, also re= WATER SERVICE— - * ALTERATION --` '�-" --- PANELS' - MAIN - -'- SUB quires the ap, licant for such permit to file a signed statement that he _ --- --- - -- - ---AMP---- - - is Il tensed pursuant t0 the provisions of the 'Contractor's License Law -(SERVICE (Chapter 9 (commencing with Section 7000) of Division 3 of the - WATER HEATERS- "---BTU OUTPUT' -' j---- - ^'�- '- -- - -- - ---- - - - - - Business and Professions Code) or that he Is exempt therefromand'the- `isis for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS -- - '-^''- -^ -'-' ! - - - - -- -- •---- - - - - - •'applicant'for a permit subjects the'appllcant to'a civil penalty- not more than five dollars ($500). SOLAR'TANK- -----COL•CECTOR$ -' -�' - -' '� •--' -' -- .. -.-' --- -- -fir i - - -- _huntlretl —1 I, as owner of the property, or my employees with wages ai theii sole compensation, will do the work, and. the.structure is no Lintended _. �- or offered for sale. (Section 7044, Business and Professions Code: The __ _ _ _ _ _ _ SOLAR PIPING -SYS. - -- '"- -- s "-ISSUE FEE -'- -• -- - - - -^-- - ,Contractor's License. law does not.apply to an owner, of .a property who builds or improves thereon, and who does such work himself or _ _ _ _ _ ISSUE FEE —fir - - - --- _ :APPLICATION APPROVED BY -- --- -GATE _- through ,"his.Own-employees,.provided that such improvements are.not. _ _ _ MECHANICAL PLAN CHECK _ __ _ - SUMMARY OF FEES intended or offered for sale. If, however, the building or improvement is sold -within one yoar_of.com plction, the owner.will have the burden - r - p;; E) 1p' =- of proving he did not build or improve for the purpose of sale). '❑-t" - HEATING SYSTEM 0.100,000 BTU I '- BUILDING--- j/l -nO'-- -- -- PERMIT $ SMIP - S_-= as- owner' of -the property,. am- exclusively contracting -with licensed to the 7044, Business licensed -AND DUCTING - '-'- ---' F" --- - - - ' 100,000p gTU --- +- - - - - - -+ =' .. - = - - _— - contractors construct project (Section ( jPLAN CHECK E PERMIT. ,t .•t. -^ '$ and•Professlons-Code: The Contractor's License Law does not apply to builds Improves thereon, and who con- REFRIGERATION 0-100,000 BTU _ _ _ _ .- _ _ISSUANCE - I - an owner of properly who or tracts from'such' -with' a contractor(s) Iicesned- pursuant t0 - - - /- PLUMBING E '. GRAOI•NG5`$' projects the Contractor's License Law). SYSTEM - - - -- 100,000•+ BTU ^ r- - v , - - _ .s - •_ f PLAN CHECK E -' , ❑ I am exempt untler Section - B. 8-P: C: for this BOILERS BTU I ELECTRICAL E - $ _ `reason' -- - - --' - - - - SYSTEM REPAIR, ALTERATION T - EXHAUST SYSTEM MULTIPLE spCANH EC K -y :MICROFILM E •C - I t NOTAL FEE $ 'MECHANICAL-$- - - - -- 1 "1• • CE55 AD- ' CHECK- -- - - Date - --Owner that have, read this application and state that the above i formationcertify information is correct. I agree to comply with all city and county 'ordinances I- PLAN $ VANCEPC $_ ' and state laws elating to construction, and hereby authorize - representatives t, pro a rtyfor. of this city f0 enter upon th¢ above mentioned fpr so n poses. • - _Dat¢.0 � I7 �'^ SlgnaLu a ISSUE FEE- - - 'I--- - - FINAL FEE $16.4040 — - -- -- _ -- - - -- - ' _ - Drivers' License or SS # CMF 0865-:6 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor ,TL CONSTRUCTION AND PLANNING- APPROVALS Permit - Date Inspector APPROVALS POOL & SPA_-,. Permit#_ w Date Inspector " 1. Temporary Electrical Service or Pole _ 43. Pool & Equipment Location SoilPipe-Undrgrn _ 44. Steel Reinforcement - - --- 3. Electrical Conduit. Utility.-Undrgrn _ 45. Forms - - 4. -Electrical Conduit-Undrgrn- _ _ 46. Electrical Bonding -5.- -Steel Reinforce _ _ _ _ _ 47. Rough Plumbing & Pressure Test 6. Electrical -UFER Grn _ _ _ _ " 48. APPROVALTO COVER-GUNITE-- - ,_ 7,. Footings . 49. Electrical Conduit-Undr rn - - - ' .8. - Foundation _ __ . _. ` ._ .. - - - 50. - .. Gas Pipe Undr rn; Test - 9.. Water Pipe-Undrgrn 51. Backwash Lines P-Trap.'E' ndr rn 10.. Structural Floor.System. n _ _ 52.. APPROVAL TO DECK- -- --- - - - -- - 11.- Property Sewer Line.&.House'Connecfion 53. Backwash & Receptor -Final • �� - - - - 12.- Street Sewer -Connection . _ "" - - - - 54. Heater & Vent -Final? - 13. Rough.P.lumbing 14. Rough Electric -Conduit- - -- - --56r, •Electrical -Final 15. Rough Electric -Wiring _ - -- - - - - - 57: Solar System -Final •' - •'- - ' ^' - 16. Rough Heating &'Air Conditioning --- - - - - -- _b5. Fencing & Access Approval 17. Ducts in Structure59. APPROVED FOR PLASTERING' 18. Ducts, Ventilating 60. - POOL/SPA SYSTEMS FINAL - 19. Gas Pipe -Rough & Test - _ _ • 20. Roof Framing 21. Roof Shestfiin NOTES: 22: Frame and Flashin - - - - - - - _"- 23: Insulation - -- - - - - --- - - - - -- - - -- -- 24. Lathing & Siding - - - - - - .. - - - - ' 25. Drywall Nailing- ,. ... .. - . . .. -.. .-n - 26. Plaster Brown Coat 27. -Electrical Power Meter -Final - I- ' 28': Final'Electric 29. Final Heating & Air Conditioning 30. FinaliGas Pipe -Test - - - - - '" - •• 31'. Final Plumbing - - -- - 32. Water Service -Final -- -- _ '" - ' A 33. Gas Service -Final - -- -- - - 34. Solar Domestic -Final • �' " 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations - - -- - - 38. FINALSTRUCTURE & BUILDING - 7-%A 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date - -- i `r Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. • CITY OF COSTA MESAIT �c6NSTRUCTION P NO TRACT NO, LOT NO. G. NO.' 81 a 5 9/23/82 13.017 PERMIT TYPE OF CONSTRUCTION NEW ❑ ADD ❑ ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑OTHER 1 ZONING REGULATIONS Address Prot I OWnert IeI\A_Phone 6511- Addfess 1<1-7 ArchlEng. License No. DESCRIPTION OF WORK A.P. $ . PLNTGp. REF. � AddfessD=L)ZONE Contractor Phone TYPE OF PERMIT'BUILDING ❑ GRADING ❑ FOO ❑ STRUCTURAL ❑ TENANT 11ECTaICAL'❑ L GING ECHA SETBACK T. IDYARD A 51 FFE E YA p gRT PROPEIV LINE ' Address - LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (com- El mencing with section 7000) of Division 3 of the Business and Professions Code, and my license I5 in full force and effect. OTHER REAR YARD (TO P/L) PROJECT DESCRIPTION License Class License No. SQ. FT. PKG. SPACE REQ. PROVIDED Data Signature _ - - STREET WIDTH PARK FEE $ WORKERS' COMPENSATION DECLARATION OCCUPANCY—CONSTRUCTION TYPE I hereby affirm that 1 have a certificate of consent to self -Insure or a VALUATION ZONE ZONING APPROVED BY DATE certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C.). GRADING CU. YDS. ACRES SPECIAL CONDITIONS: "cy. No. Company ertlfled copy is hereby furnished. REMARKS: - .:ertified copy Is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - - (This section need not be completed if the permit i5 for one hundred - - ($1001 or less).. -- - - ' 1 cartlly that In the Performance of th work for which this ermit is Issued I shall not employ any p a r sinner so as to a PLUMBING PLAN CHECK- - ELECTRICAL PLAN CHECK subje o the Workers Co mpens tib Cal Tor a BATHTUBS SHOWERS UWELLINUgo, rT- IrO RFT Date �Z2i9nat I NOTICE: If after making this aratlon, You shoultl become subject TOILETS -URINALS GENERATOR 0-1 KW_ 1-]0 KW to the Workers' Compensation provisions o the Labor Cotle, you must - TRANSFORMER forthWlih Comply with such provitions or this permit shall b¢ tleemetl LAVATORIES DOUBLE LAVS APPLIANCE 10-50 KW -50 + KWr re voketl. KIT. SINKS - DISHWASHERS 'MOTORS 0-1_ HP -1-10 HP CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS SUMPS - ' - - (INC. SOLAR) -10-50 HPC 50-+ HP formaoce of the work for which this permit is issued (Section 3097 - FLOOR SINKSFLOOR DRAINS - - -FIXTURES OUTLETS _ SWITCHES - Civ. Cd. - - _ - - Lendef's Name Lendef's Address -- - DRINKING FOUNTAINS - '- '- GAS'TUBE SIGNS - " -' • k - INTERCEPTORS CLARIFIERS - POLE LIGHTS .'. • - OWNER BUILDER DECLARATION I hereby affirm that I am exempt from,the Contractor's License Law for the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL PTRAP - — '-- - Any city or county which requires a permit to construct, alter, POLES METERED SUB , WATER SERVICE ALTERATION - - -- PANELS - MAIN SUB improve, demolish or repair any structure, prior to its issuance, also re - quires the applicant for such permit to file a signed statement that he GAS SERV ICE' OUTLETS' SERVICE - ' AMP - r is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER -HEATERS -BTU OUTPUT - - - - -'- Business and Professions Code) or that he is exempt therefrom and the b+''% for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS ---- -•-•- -• -' - �"`- ""' "" "- - - applicant for a permit subjects the applicant -to a civil penalty ,t more than five hundred dollars ($500j. SOLAR TANK COLLECTORS '-" -' ' •' - .:� L ,, 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. (Section 7044, Business and Professions Code: The SOLAR PIPING SVS. - - - - ISSUE'FEE - Contractor's License Law tloes not apply to an owner of a property - ISSUE FEE - - '- - APPLICATION APPROVED BY - _- DATE who builds or Improves thereon, and who does such work himself or through his own employees, provided that such Improvements are not -MECHANICAL PLAN CHECK SUMMARY OF FEES 1. I ntended.or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner will have the burden of proving he did, not. build or improvefor. the purpose of sale). "- - HEATING SYSTEM 0-100,000 BTU V BUILDING ' PERMIT $ SMIP' ❑ I. as owner of the property, exclusively contracting with AND DUCTING - - - - - -- - - IlceeSed contractors to ce the project Business 100,000 -,BTU PLAN CHECK $ PERMIT' Law tloes not apply t0 Contr sLce(Section es not and Code: The Contractor's L o - - - - - -- ISSUANCE $ - - - vese owner of Improves thecesn who con- wrier f Property REFRIGERATION 0-100000 BTU PLUMBING $ �$' uchpjects iuiltls-or d p tracts from such projects with a contractor(s) Iicesnetl purtuant to tr SYSTEM - - L - - GRADING - [he Contractor's License Law). 100,000 + gTU PLAN CHECK $ � ❑ 1 an, exempt under Section -B- & P. C. for this BOILERS BTU ' ELECTRICAL $ $ reason SYSTEM REPAIR, ALTERATION PLAN CHECK $ - MICROFILM $ - TOTAL FEE $ n Date Ower 1 hereby certify that I have read this application and state that the above HAUST SVS EM MULTIPLE MECHANICAL S ,00 LESS AD--' information is correct. 1 agree to comply with all. city and county- -PLAN CHECK $ VANCEPC S ordinances and state laws relating to construction, and hereby authorize O Q representatives of this city, to enter upon the above mentionetl proper f r ins Pur s. --�� p —I. - - FINAL FEE Q� Llr1 l}cJ=O Sig -�— _ -_ ISSUE FEE 3 Ad, - -- - - _$/ - - Drivers' License or 55- _ CMF 0665.46 White -Building; Canary-APPIlcanl; Pink -Accounting; Goldenrod -Assessor TL CONSTRUCTION AND PLANNING Date Inspectors,. APPROVALS Permit# _ POO L& SPA - �- , • Date Inspector APPROVALS Permit - 1. Temporary Electrical Service or Pole -' 43. Pool St Equipment Location - 2. Soil Pipe-Undrgrn 44. Steel Reinforcement - - - - 3. lectrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn _ 46.. Electrical Bonding 5. Steel em orce •` 47. Rough Plumbing & Pressure Test -' - - 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE • 7. Footings 49. Electrical Conduit-Undr rn - - - 8. Foundation _ 50.. Gas. Pipe; ❑Undr rn,Test 9. Water Pipe-Undrgrn 51. Backwash Lines P -Trap,❑ UnWrgrn 10. Structural Floor System _ 52. APPROVAL TO DECK 11. Property Sewer Line & House ConnectioA 53. Backwash & Receptor -Final ` 12. Street Sewer Connection 54: Heater & Vent -Final 13. Rough Plumbing 55, Plumbino System - Final 14. Rough Electric -Conduit - - 56. Electrical -Final 15. Rough Electric -Wiring 57. Solar System -Final 16. Rough Heating & Air Conditioning - - Fencing & Access Approval 17. Ducts, in Structure 2, 59. APPROVED FOR PLASTERING ' 18. Ducts, Ventilating 60. - - - - POOL/SPA SYSTEMS FINAL 19. GasPipe-Rough&Test- • 20. Roof Framing- • 21. Roof Sheathing- - - - - -- _ -. NOTES: 22. Frame and Flashir • 23. Insulation - - - - - - -- - 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 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. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison - - 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date •- -'--- - - APPlipnt to fill In all s aces within heavy border lines and, sign all appropriate declarations. WY OF COSTA MESA PERMIT,,[{�40. — 'TRACT NO. LOT NO. BLDG. NO. CONSTRUCTION PERMIT 7a /SZ I TYPE OF CONSTRUCTION ❑NEW ❑ADD. ❑ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH-, ❑OTHER +� ` ` 6491 7/09/8120 e0[i ZONING REGULATIONS Project Address ,S .ge Ownar hone Address - Arch/ling. License No. DESCRIPTION OF WORK A.P. Sys ' Address '\ ZONE PLNTGp. Contractor Phoner"242911 TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑PLUMBING E1mEcHANicAt BUILDING V RD gRtE1F�. p#�f�G PROPEIRTv LINE Address —'L LICENSED CONTRACTOR D CLARATION Ihereby affirm that I am licensed under provisions of Charter 9 (com- 1 nlencing with section 7000) of Division 3 of the Business and ❑ OTHER Professions Code, d �Y license is in full force ,yid effect, --//PROJECT DESCRIPTION REAR YARD (TO P/L) License Cl LlcenSa a PKC. SPACE REO. PROVIDED _ Date Slgnatu SO. FT. - - _ WORKE S' COMPENSATION'O C RATION - - OCCUPANCY— CONSTRUCTION TYPE STREET WIDTH PARK FEE f I hereby affirm trial I haw a certificate Of consent to sal sure or a VALUATION ZONE ZONING APPROVED BY DATE certificate of Workers' Compensation Insurance, or a certified copy t ereof (Section 3800, Lab. C.). _ Pllcy GRADING CU. YDS. ACRES SPECIAL CONDITIONS: '- No. Company -"Certifled copy Is hereby furnished. '-� REMARKS: L 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 553001 or lain. 1 rtfify that n the performance of the work for which this permit Is _ PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK issuedI shall not employ any person In any manner so as to become subject to the Workers Compensation Laws of California. - BATHTUBS SHOWERS Date Slgnature NOTICE: If after making this declaration, you should become subject TOILETS URINALS GENERATOR 0-1 KW_ 1-10 KW to the Workers' Compensation provisions of the Labor Cotle, you must TRANSFORMER - forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE 'APPLIANCE 10-50 KW 50 + KW revoked. - KIT. SINKS DIS ERS MOTORS 0-1 HP -1-10 HP CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS S (INC. SOLAR) ' 10.50 HP 50 + Hp - formance of the work for which this permit Is Issued (Section 3097 Civ. C.). \ Lender's Name - FLOOR SINKS 0< OOR DFZ-60 FIXTURES OUTLETS SWITCHES Lender's Address DRINKING F I GAS TV BE SIGNS OWNER BUILDER DECLARATION -- 1 -hereby affirm that I- ami exempt-from.the Contractor'S'Llcense law for \ INTE RS LARIF IER - POLE LIGHTS S MING - L TRAP , the following reason (Section 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, POLES METERED SUB W E SE C ALTERATI PANELS MAIN SUB ' Improve, demolish or repair any structure, prior to Its Issuance, also re- quires the applicant for such permit to file a signed statement that he Is licensed pursuant to the provisions of the Contractor's License Law 'V&SERWICW SERVICE AMP - sChapter 9 (commencing .with Section 7000) of Division.3 of the EATERS / TPUT `,iziness and Professions Code) or that he Is exempt therefrom and the Is for the alleged exemption. Any violation of Section 7031.5.by SE ER CONNEC applicant for a permit Subjects the applicant to a civil penalty not more than flve hundred dollars ($500). SOL TA COLLECTORS L7 I, as owner of the property, or my employees with wages as their sola compensation, will do the work, -and the structure is not Intended Or offered for Sale, (Section 7044, Business and Professions Code: The SOLA SVS. ISSUE FEE Contractor's License Law does not apply to an owner of a property ISSU EE APPLICATION APPROVED BY DATE who builds or Improves thereon, and who does such work himself or through hisown employees, Provided that such Improvements are not MECHANICAL PLAN CHECK SUMMARY OF FEES Intended or offered for Sale. If, however, the building or Improvement Is sold within one Year of completion, the owner will have the burden of proving he did not build or Improve for the purpose of Sale). HEATING SYSTEM 0-100,000 BTU BUILDING PERMIT $lice ' ❑ I, as owner of the Properly, am exclusive) contractingwith- AND DUCTING E SMIP construct the project (Section 7044, Business . - 100.000'- BTU PLAN CHECK E PERMIT and Prtl codoncontractofSd ; and Professions Code; The Contractor's License Law does not apply tot_ ISSUANCE $ a owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING f — tracts from such projects with a contractor(s) Ilceinatl pursuant to the SYSTEM GRADING E the Contractor's License Law). C 100,000 BTU PLAN CHECK 5 ❑ 1 am exempt under Section B. 6 P. C. for this BOILERS BTU 'ELECTRICAL E 5 reason SYSTEM REPAIR, ALTERATION- PLAN CHECK E - MECHANICAL E MICROFILM E - TOTAL FEE E Date Owner - I hereby certify that I have read this a pll tion and state that the above EXHAUST SYSTEM MULTIPLE LESS Information is correct. I agree to omny with all city and county PLAN CHECK E E P VANCE PC E ordinances antl s to laws relatin con ruction, antl hereby uthoviza - re presen this city n,ter uDcn the above ent na proper for ctlon Dur Signature Data ISSUE FEE - FINAL FEE E '^""• - - - Drivers' U cense or SS qF ' White -Building; Canary -Applicant; Pink -Accounting; Goidenrod-Assessor CONSTRUCTION AND PLANNING APPROVALS Permit Date _ '- Inspector POOL & SPA ,APPROVALS, Permit# - - - - �� • Date- -_Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location r - -- - - - Soil ipe- n rgrn -, !..,, n_ 44: Steel Reinforcement - - 1 3. Electrical Conduit 077ht_-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel ein orce-,,•' 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn ,'•; _' - - - "'48. APPROVALTO COVER-GUNITE• - 7. Footings -" "' " -49: -Electrical Conduit-Undr rn i 8. Foundation "- - -'--- - 507 =Gas:Pipe, ❑Undr rn;-Test- -• •- •. r - - 9. Water Pipe-Undrgrn - 51. -Backwash Lines P -Trap-❑ Undrarn 10. Structural Floor System ;. , - ECK- 52-APPROVALTO DECK-- 11. 11. Property Sewer Line & House Connection a 53. Backwash & Receptor -Final 12. Street Sewer Connection • •c. - -- - 54. Heater &Vent -Final - ' 13. Rough Plumbing-- - - - - -- tem:- Final -- - - ---- _ " _--- - -.- ... 14. Rough Electric -Conduit ' _5EElectrieTftal 15'-- Rou h'Electric-Wiring•- --- --- - -• -- - - - . 57._- Solar System -Final t. 16.,_ Rough Heating -&-Air Conditioning,-_ ,- - - _ encing & Access Approval - - „•nv,n :,. 171 Ducts in Structure jq59. APPROVED•FORPLASTERING• - •• i�.•-._.;:: 18l _ Ducts, Ventilating t ." _ "�,j 1 I �n •,v _- '60. - POOL/SPA SYSTEMS FINAL 191. Gas Pipe=.Rough •&Test • + i' _ i _. \ 201 Roof.Framing j-- 21'- Roof•Sheathin - T ' •-"' _'__ •�,- NOTES'„- .. tom• 22. Frame and-Flashin' - -' ' ' 23. Insulation 24. Lathing & Siding 25. Drywall Nailing • 26. Plaster Brown Coat - 27. Electiical Power Meter -Final• " 28'. Final;Electric 29. FinalHeating& Air Conditioning -"-' - 30. Fina6Gas Pipe -Test 31. Final Plumbing r i 32t - Water Service -Final •- r - - .-r•' �• 33. Gas Service -Final- 34. --- Solar Domestic -Final •rr ' 35. Landsca e Swinkling System 36. Sound Attenuation ' 37.- Handicap Regulations -- 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric'Release to Edison -- - - - -- --- - - - 41. Gas Release to Southern California•Gas Co. 42. I CERTIFICATE OF OCCUPANCY No - .. Date - --- --- - • - - -- _ 9 City of Costa Mesa•' Wilding Safety Department .'P.O. Box 1200 Costa Mesa, California f The Building located at .245 Vi-ohpr has been inspected and found to comply with fora Group R-2' Occu pancy. provisions of all City of Costa Mesa Ordinances applicable there Use of Building Tpnant Ttm�rrtrrwrmnf• - - - Legal Description 497-1138-07 + _ (See reverse side for,Metes and Bounds) x-1840 ; 1-4243 8-4579; Building Permit No T-4647 Electrical Permit No. Plumbing Permit No. B-291 . bi-4924 !. Number of apartments —D" and/or guest rooms —n— ,I ,ISSUED T0: ' Building Official �}--- byC ��Gfrdfm i• Pulliam Prouertias V. C. New'�}'t, B 1 Division Director Date ! �4fGACi �?L This Certificate of Occupancy SHALL BEposted in.a conspicuous placeon the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa 'under Sec. 306 lel U.B.C.:,;, _ Farm BU 34 Rev: 11/70 ' Applicant to fill in all spaces within heavy bottler lines and sign all appropriate declarations. CVrY OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. BLDG. NO. 6719 6/25/62 13.00 CONSTRUCTION PERMIT TYPE OF CONSTRUCTION ❑ NEW ❑ ADD ❑ ALTERATION El REPAIR 1:1 CONVERSION ❑DEMOLISH Project Address —/—� Jj� ' Owner v( Phoneme Address 5-717(/ El OTHER ZONING REGULATIONS Arch/Eng. License NO. DESCRIPTION OF WORK A.P. 5r ZONE PLNTG.. R1tE�JF.. Address Contractor `vim Phone .�f� TYPE OF PERMIT ❑ GRADING ❑ FOUNDATII�IO///N ❑ STRUCTURAL ❑TENANT ❑ELECTRICAL OQ PLUMBING ❑MECHANICA X BUILDING SETBACK C ST. SIDE YARD LSIEpFE YARD pp$ PRO PEIRTYNLINE Address j /y LICENSED CONTRACTOR DECLARATION I hereby thi.t I licensed Charter 9 affirm am under provisions of (Com- men Clog with section 7000) of Division 3 of the Business and ❑ OTHER RIGHT an Professions Code, and my license Is In full for d effect. REAR YARD (TO P/L) e_ 3c_ S' PROJECT DESCRIPTION License Class License No. 70 SQ. FT. OCCUPANCY_ CONST R UCTION TYPE PKG. SPACE REQ. STREET WIDTH PROVIDED PARK FEE Date Signature WORKERS' COMPENSATION DECLARATION I hereby affirm that 1 have a certificate of consent to self -insure ora VALUATION ZONE ZONING APPROVED BY DATE certificate of Workers' Compensation Insurance, or a certified copy. thereof (Section 3600, Lab. C.). GRADING CV. YDS. ACRES SPECIAL CONDITIONS: ^' -icy No. Company . :ertlfied copy Is hereby furnished. REMARKS:'P 14 d ertifled 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 S$300) or less l. C¢rUfy that n the performance of the work for which t is permit is issued, I shall not employ any person In do nner to become PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK subject the WOr rs Compen to lit Date BATHTUBS SHOWERScO. FT _Signatur NOTICE: I( after making [hl a rats u shoultl become subject TOILETS URINALS GENERATOR 0-1 KW— 1-10 KW to the Workers' Co mpensatl outs f the Labor Code, you mus[ TRANSFORMER forthwith comply with su rovi5i r this permit shall be tleemetl LAVATORIES DOUBLE L V APPLIANCE - 10-50 KW_50+ KW revoked. KIT. SINKS DIS WA S MOTORS 0-1 HP -1-10 HP CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the per. SERVICE SINKS L SUM (INC. SOLAR) 10-50 HP 50 + HP formance of the work for which this permit is issued (Section 3097 FLOOR SINKS O DRAINS FIXTURES OUTLETS SWITCHES Civ. C.).— Under's Name Lender's Address DRINKIN F UNT V I GAS TUBE SIGNS OWNER BUILDER DECLARATION INTE RCE R CLARIFIERS - POLE LIGHTS N1 hereby affirm that I am exempt from the Contractor's License Law for SWIM MIN P L PTRAP e following reason (Section 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, POLES METERED SUB WATER SE VICE ALTERATION PANELS MAIN SUB Improve, demolish or repair any structure, prior to its Issuance, also re- quires the ap, Ilcanl for such permit to file a signed statement that he GAS SERVICE OUTLETS SERVICE AMP Is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commenting with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT Business and Professions Code) or that he is exempt therefrom and the b+pis for the alleged exemption. Any violation o1 Section 7031.5 by SEWER CONNECTIONS applicant for a permit subjects the applicant to a civil penalty rt more than five hundred dollars ($500). SOLAR TANK COLLECTORS,,t+� t.• .. 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. (Section 7044, Business and Professions Code: The 'SOLAR PIPING SVS. - ISSUE FEE Contractor's License Law does not apply to an owner of a property ISSUE FEE APPLICATION APPROVED BY DATE who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not MECHANICAL PLAN CHECK SUMMARY OF FEES intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner will have the burden of proving he did not build or Improve for the purpose of sale). HEATING SYSTEM 0-100000 BTU BUILDING PERMIT $ SMIP $ I, as owner of the property, am exclusively contracting with 1:1, AND DUCTING licensed contractors to construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK $ PERMIT ' and Professions Code: The Contractor's License Law does not apply to ' J ISSUANCE $ 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) Iicesned pursuant to SYSTEM GRADING $ the Contractor's License Law). 100,000+BTU_ PLAN CHECK $ Cl I am exempt under Section B. & P. C. for this BOILERS BTU ELECTRICAL $ $ reasonPLAN SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE CHECK E - MECHANICAL E MICROFILM $ TOTAL FEE $ LESS AD - Date Owner I hereby certify that I have read this application and state that the above information is correct. 1 agree to comply with all City and county PLAN CHECK E VANCE PC $ ordinances and state laws relating to construction, and hereby authorize _ representatives. of t CIDy to t upon the above mentioned property fn �—� ' 3- _ 5( 1 FINAL FEE $_ Signature Dale Drivers -Y', se ISSUE FEE CMF K65-46 V vte-Building; Canary -Applicant; Pink -Accounting: Goldenrod -Assessor TL CONSTRUCTION AND PLANNING APPROVALS Permit # f Date _ POOL & SPA Inspector .-- Date - _ Inspector APPROVALS Permit # 1. Temporary Electrical Service or Pole - ' . 43. Pool & Equipment Location --2.- -SoilPipe-Un rgrn - -' -__ - ._ _ 44.- Steel Reinforcement- 3.-- Electrical Conduit Utility-Undrgrn 45. Forms 4- -Electrical-Conduit-Undrgrn - •- - - - 46. Electrical Bonding5. - - - Steel em orce- -_ "_ 47. Rough Plumbing & Pressure Test -- - 6. - Electrical UFER Grn - 48. APPROVAL TO COVER-GUNITE - 7. Footings.. - _ _ _ _ - _ 49. Electrical Conduit-Undr rn. - - B. -- Foundation - -- -•- - -- - - - -- - 50'. - Gas Pipe, ❑ Undr rn Test ' ' -9. WaterPipe•Undrgrn- - -•• - .51. Backwash Lines P-Trap.13 Undnirn-"- -10. Structural Floor -System 52. APPROVAL TO DECK % 11--Property-Sewer Line•& House Connection- - - -- -- - - 53. Backwash & Reca for -Final 12. - Street Sewer Connection - - - -- - - --- - - 54. Heater & Vebt•Final - 13. Rough Plumbing- -- -- .. - - -' - 14. Rough Electric -Conduit - - 56.' Electrical -Final - 15. Rough Electric -Wiring 57.- Solar -System -Final 16; Rough Heating.& Air Conditioning- - - - - - _Fencing-& Access Approval • 17' Ducts, -in -Structure c' - - -- - - -APPROVED FOR PLASTERING -18: Ducts, Ventilating 19: Gas Pipe -Rough & Test 20: Roof Flaming, - 60. - POOL/SPA SYSTEMS FINAL; 21! Roof Sheathing,.• - •' 22+ Frame and Flashing - �., - - -- "' - ' NOTES:. -: 23. Insulation 24. lathing &Siding - - - - - 25. Drywall Nailing - -- - - - - - - - 26. Plaster Brown Coat - - - - 27. Electrical Power Meter -Final 28. Final. Electric -- 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 - '' • y 36, Sound Attenuation 37, Handicap Regulations - 38, FINAL STRUCTURE & BUILDING 39. Special Requirements Completed - 40, Electric Release to Edison i 41, Gas Release,to,Southern California Gas Co. 42. -CERTIFICATE OF OCCUPANCY No . , Date - CMF 0865-46 While -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. JrA MESA PER IT Npp. "TRAC NO: '" -LOT NOv BLDG. NO. "�. y �3— - -6669- 1-1/24161 _ _ -320..57({_ _ L, W11" asr UCTION PERMITD-3 IProect Address - 1 TYPE OF CONSTRUC�TI/ON ;Owner PItonIf%j5�-•- NEW ❑.ADO ZALTERAT16N'-' ..0 ,e(J - Address- - f �1� / _G ❑ REPAIR-❑�CONV ERSI IN! 'ODEM•--}ISH- � ' s - - LATIONS� s - ZONING REG - - r-•1 OTHER - - A cl /Eng,--" &A;( ��'i%�%`7 /4r LfE6�No. DESCRIPTION OF WORK' �i ! .- IA.P. -t•��r., "fBTf- jAddress _ .,_ - --- - - Phone Contractor - - 9 TYPE OFPERMIT, -- -- -- --� - -- •-' -- -' ;� -,e' ---- - - -Tp gI�I LYING - -•-,^--I 7ROPEf7T-K LINE I r Address O,��/'GRADINGL;-O-FOUNDATION---O'STRUCTURAC '" SETBACKC T. _I I 'YARD- "--'--' '- --�,"T "- -"pj "'t LICENSED CONTRACTOR DECLARATION - - - --- - - CJ TENANT ❑-ELECT RICAL• ❑PLUMBING OMECHANICA '. 11 { IpE'Y ----- —•' ---- -- -- - 'BIGHT ' I..hereby-affirm that'_I am licensedunder provi I mencing With section 7000)-of''DIVislon' 3' ns of Charter 9'(tom- f"the-Business 'and, r r v, r ❑'OTHER - ---'--- ' -------- - -•-• -- - ------- - — Pro fesslons Cotle,_'a_nd my Ilten I_s In /9 force and effect 2 ' PROJECT DESCRIPTION --_- ,REAR YARD (TO P/U ' License CI s i LI, o. 2' t f• •) rpkG.SPACE REO. ,PRO V,IDEDc - Date�L. Sign t " SG; -FT. �- _- 1 --F— TYPE- — 'STREET WIDTH - PARK FEE $ - WORKERS'COMPENSATIO COMPENSATION- - '- - I hereby affirm that I have a certificate of consent to self ure or a -Compensation OCCUPANCY CONST VCTION VALUATION ZONE 'ZONING APPROV V' D T _-7- ., '_ a certificate of Workers' -'Insure nte; "Or'd cer fletl 'copy ,. - - -- - - -- I - '---- __ _ - .SPECIAL CONDITIONS. - ~ thereof_(Se_ction 3800, Lab. C_.). I ,GRADING'CU: YDS. - ACRES t - p'c No. Company 'oll ertifled- copy Is hereby furnished.- - - - --- - '-REMARKS: ertified copy is filed with the city BUllding Division. Ex EM PTION FROM WORKERS' COMPENSATION DECLARATION _� - '�-LT S%Y (Thirsectlon need -not -be -completed -if -the permit ISLfor_ona hundred ' y�L6 cf9/5�/°i 5` - -� 10 $01 or leu)). 1—- S-certify-that-in-the;performance of -the -work -for which this -permit i Issued, I shall not employ any person In any manner so as to become _ _�- . PLUMBING[, y� 7, ,p.PLAN CHECK"' -'T •-' " - ,ELECTRICAL----"-'PL"AN CHECK--- --'-"'-'1 subject' to'the' Workers' Compensation Laws of California.-' - ^ _ _: -, _ Date I Signature BATHTUBS SHOWERS i NOTICE: If after making this tleclarallon, you should become'subjecP :Z�OICETSSQ^.Ji ,C ;URINALS -'- -- -'— - `�G EN ERATOR'-`O-YKW_1-10-KWI-- ER to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed TTRANSFORM LAVATORIES DOUBLE LAVS-- ` -�- "'- APPCIANC E' 10-50 KW--- KW- - _- revoked: ------r--^-- CONSTRUCTION LENDING AGENCY ---=------^-- -- - -- 'KIT. SIf`II(5--'---DISHWASHERS--- -�`••--- ' 'MOTORS, -'-'---0-1"HP_1=30-HP^•—"-' - •r , 1 hereby affirm that there is a construction lending agency for the per- - - - -- SERVICESINKS;C7"i�, SUMPS—'"-'"'- •'j" I(INC. SOLAR)-- 10 -50 -Hp 50 formance of_the work for which this permit is issued 3097 - ' 'S' _(Section .t _ _ FLOOR SINKS„ FLOOR DRAINS I - -"'FIXTURES""' -OUTL'ETS' --SWITCHES-.---- --•", Lender's Name. - Lender's DRINKING FOUNTAINS i - — - -f-^ -!GAS'TUBE-SIGNS------'---- —,--- - • Lender's Andres' OWNER BUILDER DECLARATION - --- 1 1-hereby.affirm lhaLI am exempt from the Contractor's License for ; INTERCEPTORS .��; \'+CLARIFIERS 1 - "IPOCE'CIGHTS'!"'--- ----'-'--^'--- - --� the following reason (Section 7031.5' Business -and Professions Code; -SWIMMING POOL -P TRAP- - __ --_ •POLES METE D SUB - Any _city -or--.county which _requires•_a permit. to ,construct; alter, ' - - - - y Improve, demolish. or repair any structure, prior to its issuance, also re-' quires.the,appllcant for -such . permit to. file -a. signed stalementthat he WATER SERV ICE ALTERATION---- -I - 'PANELS"-' - - 1 - - S - --- — I Is licensed,pursuant,to the provisions,of, thexontractor.'s License Law OUTLETS' - SERVICE"--- --- -- - --- - 1 (Cha pier_9"-(tommencing.with_Sectlon_7000)_ of"'Divlsion,3 ol•:the� s,GA5,5ERVICE'% ^`"ti" Business and professions Code) or -that -he is exempt therefrom and the WATER HEATERS _R BT U OUTPUT -- j`- -- - - - - - "- — ---- -I basis -for -the -alleged -exemption. exemption. Any -violation of, Section 7031.5 by - - --^- _ a : epplicant for a permit subjects the appli�nt to a civil -penalty, tive_hund,ed dollars "' i .•" •'V SEWER CONNECTIONS 'k" l -'---""'- '--' _ - - -- - 1 ..Lmore_than -($500)' r' s owner of, the -property; or, my.prp ployees with -wages as theirs, ll dothe'work, antl llhe-str Uct ure� is-no6 Intended' _ SOLAR TANK '� `- •, -COLLECTORS--'-'— ` ' a�sf " Sp'R`b0mpensatlon-wi .oc offered for -Sal¢. (SectIon''7044,-Business antl Prof e551ons Code: The ..... _-. SOLAR PIPING'iSYs. , 1 ... SO EE' ' - Contract or's-Li cense Law does not'-adPIY td•a'n owner of a property?; who builds or, Improves\theon; and who does such work hlmself-or\ er - - - ---- _ - - ; ISSUE FEE ,- -APp CATION' APPROVED B ! through -his own employees, provided -that such Innprdverrients'are.n Ot. - Intended or offered for sale: If, howeve[, the bulltlip9 or'impro vemeht Intended or MECHANICAL s ,',PLAN CHECK `,- • 7 SUMMARY OF FEES -.-- -�- 1 of-completion, the owner wl ll. have; the,burden. of -he did not build or., improvelfor the,purpose of sale): HEATING'SYSTEM ' -BUILDING _ __ _ .. .. _ 193. ^,I -Proving __> _ _ ._ .. ,El I, as owner . of'tlie property, am'e xclusively ,contracting' with' 0-,100,000 BTU AND DUCTING " ` ,PERMIT $ SMIP $- �.� licensed contractors to construct the. project (Section,,7044 Business' 'License 0 100,000 BTU - ,PLAN CHECK E�„}-._i.Y PERMIT and Professions Code:.The Contractor's Law does not apply to` __ ..- - -_ .ISSUANCE $. an' owner of. property who builds Or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU 'SYSTEM,"" I PLUMBING $ NG `$ tracts from such projects-with'a'contractor(s)'Iicesnetl'pursuant to r 1 f- 100;000 + BTU • ` I '\ _• PLAN CHECKGRFiDI Ih¢ Contractor's License Law). 1.1 ,l r ) _, I E ❑ I am exempt Iin�der Section -B:'& P C for this- ,. +-r "� - - - - ' BOILERS' �',R\ BTU ) '' ELECTRICAL` $ - - - - - ry l7 .+. .- "o ,-' MICROFILM S reason �. - + ,'- - - 1. Date - -' SYSTEM REPAIR; ALTERATION ! - - '-PLAN'CHECK - 'E' - - - - ' SOTAL FEE $�{s. /s ��,_7�� 1 Owner tion and slate tha Lthe: above,. '1 hereby certify that l ha"reel'to -EXHAUST.SYSTEMlr_ MULTIPLE 1 ,MECHANICAL $ - - - r I '.. i f. e.' ^, ,.LESS AD- 1 _ information is torrect3,ly'with all city, antl county • PLAN.CHECK- $-• VANCEPC $_ ordinances and -state lawruction, and.hereby author(ie. representat of thispo the a�0 e t fmm- ¢�tio- '- - t 1property > /J�n i �. " FINAL FEE $-(,O. Z. ' d{•' Signature`-- "_ "" at • '. - - ' '1 - - Drivers' License or SS -ISSUE'FEE -' -' — - - --- - s- - - - - - - - - CMF 0865-46 While -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNIN(C,A� Y APPROVALS Permit #..��1�4�- Date Inspector POOL & SPA .. APPROVALS Permit # _ Date ` Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location Soil Pipe-Undrgrn 44. Steel Reinforcement - - 3.--Electrical Conduit Utility-Undrgrn 1- 45. Forms - -4: =Electrical-Conduit-Undrgrn 46. Electrical Bonding Steel ein orce _ 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn, 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn S. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water.Pipe-Undrgrn 1 51. Backwash Lines P-Trap.❑ Undrarn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property'Sewer Line & House. Coanection 53" =Backwash & Receptor-Final 12. Street Sewer Connection - 54. Heater & Vent-Final 13. Rough Plumbing 55, Plumbina System - Final 14. Rough Electric-Conduit • 156: `,Electrical-Final 15. Rough Electric-Wiring _ - - 57. - Solar System-Final 16. Rough Heating & Air Conditioning encing & Access Approval 17. Ducts in Structure APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe-Rough & Test 20. Roof Framing 21. Roof Sheathing NOTES: 22. Frame and Flashing 23. Insulation 8'Z tis i.+ O 't ov ` Icat" 24. Lathing & Siding 25. Drywall Nailing _ /20 .Q 26. Plaster Brown Coat 12 u i. ✓.t O s C.cu 27. Electrical Power Meter-Final S < , 3 jQ ^ - 28. Final Electric ae A14E44-o' / A- /"L i % 29. Final Heating & Air Conditioning 30. Final Gas Pipe-Test _.e Final Plumbing - em 32. Water Service-Final 33. Gas Service-Final f W 34. Solar Domestic-Final 35. -Landscape Sprinkling System L✓� / 36. Sound Attenuation C H.� t 37. Handicap Regulations Coll-IV LT.61.aclz�, 38. FINAL STRUCTURE &BUILDING _gam - ' 39. Special Requirements Completed 01 LLOeit ' '40.. Electric Release to Edison _ �/_ a r- 41. Gas Release to Southern California Gas Co. 42. . . CERTIFICATE OF OCCUPANCY No 3 3`�-S Date ^� / \1 I Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF fOSTA MESA ' • IT TRACT NO. LOT NO. BLD . NO. - CONSTRUCTION PERMIT P22114 /NO �'i % TYPE OF CONSTRUC ION ❑ NEW •ADD IWALTERATION ..❑ REPAIR ❑CONVERSION ❑DEMOLISH 13 OTHER 3 - - _ 'ZONING 2895 7/15/82 18. GO REGULATIONS'- Project Address iZ S EQ . r Owner (JLL A Pl2e� o Phone S Addr¢a /�(�/E/,(/ • sI /=% • Arch/Eng. - License No. DESCRIPTION OF WORK C C A'P•V ZONE _ PLNTGo. RglE�FL. T- Address - - _ /�. p Controctor /�-� I/VS 4'.C. - /e /� Phone TYPE OF PERMIT - -- El ❑ FOUNDATIONS -❑ STRUCTURAL ❑ TENANT^ELECTRICAL ❑PLUMBING ❑MECHANIC SETBACKST. $I YARD I E P ROPEIRTDVNLI N E. - - - - - Address r I v A10 #Z AD, E` • LICENSED CONTRACTOR DECLARATION hereby that 1 licensed Charter 9 I affirm am under provisions of (com- RIGHT mencing with section 7000) of Division 3 of the Business and Professions Cotle, an m license is I force e a .❑OTHER. REAR YARD (TO P/L) - C X PROJECT DESCRIPTION " License Class for "� c PKG. SPACE REO. PROVIDED - SO. FT: - Date 'Signal Sar STREET WIDTH PARK FEE S- WORKERS' COM PENSATIO D LARATION OCCUPANCY_ CO NST RUCTION TYPE -ZONING I hereby affirm that I have a t6rtificate of consent to self -Insure or a VALUATION ZONE - APPROVED BY DATE - certificate o/ Workers' Compensation Insurance, or. a.certllietl ropy _ thereof '0 0 b. CJ. a A/O N GRADING CU. YDS. ACRES SPECIAL CONDITIONS: / / PoIICY No. r DOmPdpY L17.- o. lertlfiedcopylsherebyfurnished. REMARKS:_ - ertified copy is filed with the city Building Division. 'EX91APTION FROM WORKERS' COMPENSATION DECLARATION ---- - (This section need not be completed if the permit Is for one hundred ($100) or less)n , - - - - - I certify that 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 - PLAN CHECK- ' subject to the Workers' Compensation Laws of California. _•_' - BATHTUBS'-' - SHOWERS - --SO FT qQ FT- _ Date Signature NOTICE: If after making this declaration, you should become subject TOILETS ., URINALS - -- - .GENERATOR - 0.1 KW-1-10KW - - to the Workers' Compensation provislons of the Labor Code, you must TRANSFORMER • - forthwith comply with Such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS - _ ' APPLIANCE 10-50 KW=50+KW - revoked._ _ _ _ CONSTRUCTION LENDING AGENCY 'KIT: SINKS - - DISHWASHERS - MOTORS 0-1 HP' 1- 1 hereby affirm that there is a construction lending agency for the per. SERVICE SINKS . SUMPS - `(INC. SOLAR)..1050 HP 's-. C' formance of the work for which this permit is Issued (Section 3097 FLOOR SINKS'"-- FLOOR DRAINS - FIXTURESZOOUTL-ETS /- WITCHES 40 Civ. C.). -- - - - -- - - - - Lender's Name Lender's Address - - DRINKING FOUNTAINS - GAS TUBE SIGNS - OWNER BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for INTERCEPTORS" - CLARIFIERS 'POLE LIGHTS - - r SWIMMING POOL - PTRAP - - - the following reason (Section 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, POLES METERED SUB WATER SERVICE ALTERATION- - PANECS MAI 9tlE- - Improve, demolish or repair any structure, -prior to its Issuance, also re- quires the apl.licant for such permit to file a signed statement that he -GAS SERVICE' -- OUTLETS t SERVICE 0,4 AMP Is licensed pursuant to the provisions of the Contractor's -License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERSBTU OUTPUT - - -' -- - - - Business and Professions-Cotle) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS - L - - _ - - - -• - - a-" applicant for a permit subjects the applicant to a civil -penalty •t more than five hundred dollars ($500). SOLAR TANK - COLLECTORS - - - - - - - - -as owner of the property,'or my employees with wages as their su,e'eompensalion, will do the work, and the structure is not Intended. or offered -for Sale. -(Section 7044; Business and Professlons Code: The - SOLAR PIPING -SVS.--- - ISSUE FEE Contractor's License Law does not apply to an owner of a property ISSUE FEE " -APPLICATION APPROVED BY - - -- DATE .he buildsbr improves thereon, and who doe$ such work himself or through his own employees, provided that such improvements are not _ MECHANICAL PLAN CHECK SUMMARY OF FEES - Intended or offered for sale. If, however, the building or improvement Is sold within one year of completion, the owner will have the burden t of proving he did not 'build or improve for -the purpose of sale). HEATING SYSTEM 0-100,000 BTU - ,BUILDING - PERMIT E - ---- - - SMTP -$ ❑ I, as owner of the property, -am exclusively contracting with AND DUCTING - -' - licensed contractors to cc the project (Section Business 100,000,+ BTU 'PLAN CHECK E PERMIT - he Contractor's es not and Professions Cotle: The Contractor's License Law does not apply to ISSUANCE S an owner of properly who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU ,PLUMBING $ tracts from such projects -with. contractor(s) Iicesned pursuant to SYSTEM_ _. - GRADING the Contractor's License Law). 100,000+BTU tPLAN CHECK S� ..$ •rl 1 ❑ 1 am exempt under Section - -- B. & P. C. for this BOILERS BTU - ELECTRICAL $%-�-- $ reason _ SYSTEM REPAIR, ALTERATION PLAN CHECK E MECHANICAL E "MICROFILM E ' - TOTAL FEE E -- • Date. ,nor I hereby certify that I o read this application and state that the above EXHAUST SYSTEM MULTIPLE LESS AD - c . arae to com I with all cit antl count 9 PY Y Y inform41� PLAN CHECK $ VANCEPC S_ ordinanI relat. tt nstr uct ton, and hereby authorize represethe - - ' O er u above mentioned proper" n r Sign CMF 0865-46 While -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor TL CONSTRUCTION AND PLANNING - - APPROVALS Permit Date Inspector 13� POOL & SPS, - 'APPROVALS Permit' c _Date Inspector �tit1'l � = 1. Temporary Electrical Service or Pole 43. Pool & Equipment ipe-Un rgrn - 44. Steel Reinforcement - 3... Electrical Conduit.Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding - _5. SteelReinforce 47. Rough Plumbing & Pressure Teet.. 6. Electrical UFER Grn - 48. APPROVALTO COVER-GUNITEb 7. Footings _ _ 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, 0 Undr rnrT:est.n Z1 9. Water Pipe-Undrgrn 51. Backwash Lines P -T a .0•Und rr' . !'+-1_-4-- 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 �.rtf.h: :Ca- ti a. 13. Rough Plumbing _ - ��--' 14. Rout Electric -Conduit '56. -Electrical-Final 15. Rou h Electric -Wiring 57. Solar System -Final 16. Royh Heating & Air Conditioning - -Fencing & Access Approval 17. Ducts in Structure - APPROVED FOR PLASTERING 18. 19. 20: Ducts, Ventilating Gas Pipe -Rough & Test Root Frarping _ - 60. POOL/SPA SYSTEMS FINAL -21. 22. Roof Sheat6iri r& "Frame etrid Flashing �_ NOTES: 23. Insulation' 24. Lathing & Siding - - 25. Drywall Nailing - 26. Plaster Brown Coat - 27. Electrical Power Meter -Final 28. Final Electric - 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 • - - 1 35. Landscape Sprinkling System 36. Sound Attenuation _ 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. - 42. *CERTIFICATE OF OCCUPANCY No. Date Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. COSTA MESA PERMIT[ TRACT NO. LOT NO. BLDG. NO. �.� f :q Q RUCTION PERMIT �NO. -- / 2 �/ %/ 3S3 Q-3 TYPE OF CONSTRUCTION ❑'NEW El ADD El ALTERATION ❑ REPAIR- C CONVERSION ❑DEMOLISH C OTHER DESC RIPTION'OF WORK L/ -) 3092 ]/ 19/62 96 • $� A P ZONING REGUL37 ATIONS o _Qroject Address S 7, Q - Ws Owner V ) n Phone �'f1 Address -�/ ,y - - Arch/Eng. ds'i License No, Address d. /'- - ' V/ ZONE PLNG. REF:'ZE .�0 p Contractor - C - / - Phone - - TYPE OF PERM( _ "' - - - TToo B�1J1ILLppING- - - SETBACK ST. PROPERTY LINE El GRADING, 'C -FOUNDATION ❑ STRUCTURAL ID YARD - - - -- '_•C TENANT C1 ELECTRICAL PLUMBING CMECHANICA - SIDE V -- - - - Atldf¢ss LICENSED CONTRACTOR DECLARATION .__ _ __ hereby thi.t I licensed Charter 9 1 affirm am under provisions of (com: mencing-with section 0000)- oP'Division -3-of-the Business -and _•l, -C OTHER - -- RIGHT _ _ _ ,._ _ Professions Code, and my license is In full force and effect. - � _ 1 .PR. DESCRIPTION' _ REAR YARD (TO P/L - LlcenseClass License No. _ - -(�- - FT.; - SPACE REQ. PROVIDED -19 1 .• _ _ -_ . 50. FT! ' - `•, '. ,PKC. _ - Date Signature + _ _ STREET WIDTH PARK_ _ 'FEEE WORKERS'COMPENSATION DECLARATION. OCCUPANCY=_ CONSTRUCTION TYPE I hereby affirm that I have a certificate of consent to self -Insure or a VALUATION ZONE �. IZONING APPROVED -BY_''- certificate of Workers' Compensation Insurance, or a certified copy - _ ._ _ _ - thereof (Section 3800, Lab. C.). ,GRAOING!CU. UOS. ACRES SPECIAL CONDITIONS:" _ P^IICY No. - - ' Company" 'ertlfied copy is hereby furnished._. - _r, _:REMARKS: .ertified copy Is filed with the city Building Division. EXEMPTION FROM -WORKERS' COMPENSATION DECLARATION 0 This section need not be completed,if the permit is for one hundred. - - - -, •.� •�� ., f ($1001 or less). _ „ . - .. _ _ __ r-- _ ... ) the work for which this i Is 1 certfy that in e, performance ........., - - . rs , become Issued, shall not employ any person in any manner so as to,.1 PLUMBING -�h9 Ir" .PLAN CHECK- 'I "' (ELECTRICAL:- "' "'- - PLAN CHECK sub)eCLtO.the.WOrkers' Compe tion" sof lifor is. -- BATHTUBS - __SHOWERS -' _. ., ._ .� - - _-. _ - ' tE ---/ �'-�y Date Signature - _ NOTICE: If attar making this declaration, you should become sub TOILETS_ - . -.r -, TV NAILS - - - 'GENERATOR - -0-1- KW_ 1=10 KW -'- -. ',TRANSFORMER ' ( ` to the Workers' Compensation provisions of the Labor Code, you m t- :. forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE'LAVS" -• " - -APPLIANCE - - 10.50 KW=50 + KW - - - revoked.-__- __1 �. KIT. SINKS-' --' 'DISHWASHERS- - - MOTORS--- - -- - --- --0-1-HP_1-30 HP _. _ - CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS.- SUMPS,_ .�' a�� .-s" t(INC. SOLAR)._--10-50.HR_50-+ HP- •I - -- formance of the work for which this permit is issued (Section 3097 CFLOOR`SINKS " -�� _FLOOR DRAINS'- -- -" 'FIXTURES —' OUTL'ETS--'SWITCHES -' --- - Civ: C.): t ;,` ` •- - -- - Len' Ndme, r - - 11 .e z - _ _ _ Len&tle,'s Atldress s �T v "+. DRINKING OU NTAINS- - - -�-- - - --- F - -'GAS-TUBE SIGNS -- - --- - -- - - OWNER BUILDER DECLARATION--'•'- 1 - •' - J- - 'INTERCEPTORS _ - ,CLARIFIERS. . �� - POLE LIGHTS ---- - - -- - - - --- -+ - I herebyy affirm that I.am exempt from the �Con[ aeloyr.'s LLiIcense Law9or. 'the-followingreason (Section•7031-.5-Busine5sf and Pr o(essiouS Code` SWIMMING POOL 'P TRAP -j' �4 -- 1 - - - POLES - METERED -~45UB " Any, ;Uty or, cobnty,whieh requiCes a permit to'construct, alter„ WATER SERVICE' ALTERATION' - - �•+• _r PANELS -- MAIN - SUB- - - - ' Improve, demolish�or repali any'structurd,' prior to its Issuance, also re-" filet ' quires the applirarit for such_per mitst0 igned stalementJhat he Is licensed to the of the. GAS SERVICE( `1 OUTLETS- - - - SERVICE - - - -- -AMP-- --- -- - pursuant provisions ontractoi'S=LIdenSe'L'dw -the (Chapter 9,(commencing' withr Section,7000)`of Dlvision 3 -of Business.and Professions Code) or,that-lie`is:exempt therefrom and the_ WATER -HEATERS BTU OUTPUT - - - - - •--- - basis' for the alleged exemption. Any,violatlon of Sectiori„7031.5 by, _ a v 'applicant `for a° -permit subjects'the applicant to a Civil"penalty SEWER CONNECTIONS - 'i - --' - -' - --- --- ^--- - - --- - - - "Prt more than five hundred dollars ($500). �� 'SOL'AWTANK'�' -'-' • 'COLLECTORS - L '' __ner of the property, or .. employees -with wages as [hely S sole compensation,_will do the work, and the structure is not intended P or offered for sale. (Section 7044, Business and Professions Code: The _ _ _ VS. ;� - - '- "` - SOLAR PIPING SYS.- -- ISSUE FEE -- ' --- - -- - - - - - - Contractor's Contractor's License Law does not apply to an owner of a property- - _ ___ _ _ _ - - ISSUE FEE- II - - '" _ 'APPLICATION APPROVED BV- -fjqDATE _� - who builds or Improves thereon, and who does such work himself -or through his. own employees, provided that such improvements are not _ MECHANICAL PLAN CHECK _ -) ^- - SUMMARY OF FEES ` intended or offered for sale. If, however, the building or improvement is sold within One year of completion, the owner will have the burden of proving he did not build or Improve for the'-purpose'of sale).- - _ HEATING SYSTEM 0-100,000 BTU n -BUILDING-/ - - - -- PERMIT 9G„wS MIP, E, C-I; as- owner -of-the--property, -am exclusively contracting with AND DUCTING - - _ �$ - - - - - - - licensed contractors to construct the project (Section 100,000+BTU 'PLAN CHECK E PERMIT and Professions Code: -The Co Law does not apply [o es not apply - - - ISSUANCE $ r Improvese owner of property who builds or Improves thereon, and who con- builds REFRIGERATION 0-100,000 BTU 'PLUMBING $ ,. [rads from sr'sL projects -with a mntractor(z)-licesnetl. pursuant to tracts SYSTEM - - - - ,i - - .. GRADING'_ $ 1PLANCHECK �t e Contractor's License Law). -2 o 100,000.+BTU -- .� � s < $ $ f am exempt ynper Section B. & P. C. for this LV BOILERS BTU 'ELECTRICAL $ -- - . , reason CJ �s _ SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE PLAN CHECK E'--- -MICROFILM E _ TOTAL FEE $ MECHANICAL” E - - I it " i LESS AD - Date? -1 4-YZ Owner I herebycertify that I have ret his a the ab ve y application and state information is torsed. y a agree to comply with all city and con PLAN CHECK- $� - - VANCE PC $ _ ' s ordinances and state laws relating [e construction, and hereby authorize _ representatives of [M1Is city to enter- upon the -above' mentioned mentioned property Insp cti n urposes. I ' Q� � FINAL / Com•' O � �qq $(gnat ure�ZD t L=L_L:�'.� FEE $ Drivers' License or SS: , ISSUE FEE - - - - - CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING ,'APPROVALS Permit#_ ~Temporary Date Inspector -POOL & SPAS" .' Date Inspector, -; APPROVALS - Permit#'• - 1. Electrical Service or Pole 43. Pool & Equipment L"ocation-'\ • ' �' 2. Soil Pipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit" Utility-Undrgrn 7 45. Forms - - -4. Conduit-Undrgrn _ _:,.' - •„46: -'Electrical Bonding5. Steel ein orce _ 47. Rough Plumbing & Pressure Test - - 6. , Electrical UFER G_rn _ 48. APPROVAL TO COVER-GUNITE - - 7. ,Footings _ �,, •� t - _ _ 49. Electrical Conduit-Undr rn - _8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P -Trap.❑ - ndr rn .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 13. Rough Plumbing _ -'- '1,4., Rough Electric -Conduit y `56:. Electiical-Final 15. Rou h Electric -Wiring 57-' Solar System -Final 16.` Rough Heating & Air Conditioning bd. Fencing & Access Approval -17. Ducts in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating - _ - 60. P.000SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test - - _ 20. Roof Framing 21. Roof Sheathing-- - NOTES: 22. Frame and Flashing -30- - 23.- Insulation - - •-'$Z 24. Lathing &Siding 25. Drywall Nailing g -/I_24-/1- i' 26. Plaster Brown Coat L. AIR 27. Electrical Power Meter -Final - - 28. Final Electric " - - - - $- I 29. Final Heating & Air Conditioning 30: -Final Gas Pipe -Test - - 31. Final Plumbing - �, 32. , Water. Service -Final - - - - ` 33`. "Gas Service -Final - - -- 34. Solar Domestic -Final 35. Landscape Srinklin System• -- 36. Sound Attenuation - 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING _ $8- 49 222- . 39. Special Requirements Completed 40.' Electric Release to Edison - - ' 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No: Date #22241 Applicant to fill in all ' CIT.Y OF COSTA MESA P�MIT NC CONSTRUCTION PERMIT I M — L Addre,1517 N.! -Fairview, Arch/Eng. Address 'ContractorVlI I a' HtQ. treby affirm thtt I am Iicen icing 'with - seetlon-7000)- fesslons Code,'and -my_ - Phone i a na -92 License No.' 1C Phone 5' ION - - _ - vovisions of Chz n 3- of the- B In full force„ within heavy border lines and sign all appropriate declarations. TRACT NO. LOT NO. I BL.R. N I-� TYPE OF CONSTRUCTION f-VGL ❑ NEW ❑.ADD 'Cl .ALTERATION I - )- ❑REPAIR 11 CONVERSIONS ❑DEMOLISH ❑ OTHER DESCRIPTION OF WORK TYPE ORPERMIT ,I ' ❑ GRADING ❑ FOUNDATION - ❑ STRUCTURAL' 9 (Com "❑ TENANT '❑ ELECTRICAL ❑PLUMBING' KMECHANICF ass and - ❑ OTHER "--- - - - -- — - J2yf4 PROJECT DES[ %ION. 7:' .SQ. FT. .: /V% .' WORKERS' COMPENSATION DECLARATION - ' OCCUPANCY_CONST.RUCTION TYPE I hereby affirm that I have a Certificate of consent to Solt nsu -Ord VALUATION ZONE 'certificate of Workers' Compensation Insurance, or -a -cc /l copy - - - thereof (Se Lab. C.). .GRADING CU!YDS. 1'. ACRES ,;Cy No. ib �' - - Comcady'-Goodman_Ins. - .__ 'ertifieo copy Is hereby furnished. - - _ - _ ..3, REMARKS:- .:ertlfied copy Is tiled with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECCARATION - Q'- -LX ' (This section need.uot.be completed If.the permlL.is Tor one hundred _. _ - (§100) or less). - ,. I certify that In performance.of.the work for which this .permit is Issued. I shall not employ any person in any manner so asrto become subject to the Workers' Compensation Laws of. California._ I . . _ _ _ PLUMBING BATHTUBS Date ' Signature r TOILETS I,+ ,r NOTICE: It after making this declaration, you should become sub)act, to the Workers' Compensation provisions of the Labor Cotle, you must forthwith Comply with such provisions or this permit shall be deemed LAVATORIES revoked. CONSTRUCTION LENDING AGENCY - KIT. SINKS , SERVICE SINKS )' I hereby.affirm that there'is a construction lending agency for the per- formance'of the work for which this permit is issued (Section 3097 FLOOR SINKS Lender's Name Lendcr^Sy�Atldl¢Ssn ` c - \DRIryKIfJG FOTAINS rr cr' _ r - _ -- REFRIGERATION 0-100,000 BT to URINALS DOUBLE LA VS"_ _t-- DISHWASHERS �iYIYYi�® alter, - so "--- re- . VJA7211 SERV ICE ALTERATION GAS SE Business and Prolesslons Code) or that ne Is' exempt' therefrom and the s,for. the�allegedTexemption. *Any -violation sof ,Section 17031.5.�by� pplicant for permit zuD)etts Ihe''a pplicant to a civil penalty WATER HEATERS - BTU OUT PUTy- - - _ _ - SEWER CONNECTIONS )a°!_=- `->t more than five hundred dollars ($500). _ SOLAR TANK - COLLECTORS- •'S, as owner of the property, or my employees with wages as their sole.compensation,.will do the.work, and -the structure.is.n Ot.Intendeci. _ or offered for sale. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to.an owner ot.a properly -who SOLAR PIPING SYS. (: ISSUE FEE builds or improves thereon, and who does such work himself or through his.own employees,. providetl_thal. such Improvements are not. MECHANICAL PLAN CHECK Intended or offered for sale. If, however, the building or Improvement Is.sold.within one year of completion, the owner will have the burden HEATING SYSTEM 0-100,000 BTU ,24,015 AND DUCTING - l 100,000'+BTU " of proving he did not build or Improve for the purpose of sale). []-[.-as owner of the- property, am exclusively contracting with- licensed contractors to construct the project (Section 7044, Business and Professions -Code:' The- Contractor's License Law tloes not apply to REFRIGERATION 0-100,000 BT an owner of property who builds or Improves thereon, and who con- tracts- from -such projects with a contractor(s)-licesned pursuant -to the Contractor's License law). SYSTEM -- -- - 100,000'+BTU ❑ I am exempt under Section - - B._& P. C. for Thi$ BOILERS BTU ieason__- - 50 + HP Date�Owner- - SYSTEM REPAIR, ALTERATION , 1 hereby certify that I haver his appli Cation and state that the above EXHAUST_ SYSTEM MULTIPLE 1 Information Is correct. I agree to comply with all city and county .. ordinances and slat aws relatin to construction, and hereby authorize 114\ _'Wilm 01A representatives his city - enter upo he above mentionetl property_1 n5 a it n is s /p0 ^/D.a _ Signature Date J LL OOG Drivers' License or SS ISSUE FEE - - GMF 0065-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor r 3376 7/20/82 A.P. REAR YARD PKG.SPACE ZONING APPROVED BY SPECIAL CONDITIONS: PLNTG.. gR�E/F.. p$ PRO PEIRTY Llf• ;PROVIDE[ PARK FEE OAT PLAN CHECK -: aa.a0 TL NU 'SO. FL DATE 2_ SUMMARY OF FEES t ' GENERATOR 0-I KW_ 1-10 KW s) TRANSFORMER PLAN CHECK_ s APPLIANCE 10-50'KW_50+KW -MOTORS _ 0-1'HP=1-10'HP § ' ,INC_ SOLAR)- 10-50 HP_- - 50 + HP - 4 § ELECTRICAL t FIXTURES OUTLETS SWITCHES -MICROFILM s 'GAS TUBE SIGNS 'TOTAL FEE MECHANICAL § ( PLANCHECK 4 -POLE LIGHTS FINAL FEE § • oO .POLES METERED 'SUB PANELS MAIN SUB ' ;SERVICE AMP ' I 'APPLICATION APPROVED BY DATE 2_ SUMMARY OF FEES t ' BUILDING PERMIT s _ PLAN CHECK_ s PERMIT i ISSUANCE s PLUMBING § GRADING _ PLANCHECK § ELECTRICAL 1i PLAN CHECK E J - -MICROFILM s 'TOTAL FEE MECHANICAL § ( PLANCHECK S '- LESS AD. VANCE PC S' - FINAL FEE § • oO CONSTRUCTION AND PLANNING APPROVALS Permit #y�6 �O Date Inspector POOL & SPA - APPROVALS Permit q� - Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Soil Pipe-Un rgrn - •' 44. Steel Reinforcement -- - - 3. Electrical Conduit_Utility-Undrgrn _ 45.. Forms _ 4. _ Electrical Conduit-_Undrgrn _ 46. Electrical Bonding - 5. bteel Reinforce 47. Rough Plumbing & Pressure Test 6. _ Electrical UFER Gin_ 48. APPROVAL TO COVER-GUNITE 7, ootings - 49. Electrical Conduit-Undr rn' -- 8. -Foundation _ _ _ _ _ _ _ _ _ - - . 50. Gas Pipe, ❑ Undr rn; Test 9. Water Pipe-Undrgrn 51. - Backwash Lines P-Trap. ❑ Undrarn 10. Structural Floor System 52. . APPROVAL TO DECK _ 11. Property Sewer Line & House Connection 53. Backwash & Rece for-Final - 12._ Street Sewer, Connection - - 54. Heater & Vent-Final 13.. Rough Plumbing -- - - -55.'- Plumbina System - 14. Rou h Electric-Conduit - ---- - 56. Electrical-Final 15. Rout Electric-Wiring -'-- -' - - -- - 57. Solar-System-Final `- 16. Rou h Heating & Air Conditioning 158. Fencing & Access Approval 17. Ducts in Structure •• _ - APPROVED FOR PLASTERING __18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL - •^ 19. Gas pipe-Rough'&Test _ 20: Roof Framing- - 21. Roof Sheathing- - NOTES:b - 22. Frame and Flashing- _ _ 23. Insulation 24. - Lathing & Siding 25: Drywall Nailing - _ C 26. Plaster Brown Coat_ /,v '^ 27. Electrical Power Meter-Final 28. Final Electric i 29. 30. Final-Heating & Air Conditioning Final Gas Pipe-Test uJ - 31.. Final,Plumbing 32: Water Service-Final 33.- Gas Service-Final - 34. Solar Domestic-Final ••- ' 35. Landsca e Sprinkling System 36. Sound Attenuation - 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING - 39. Special Requirements Completed ' 40. Electric Release,to Edison - - - 41. Gas Release to Southern California Gas'Co. 42. . CERTIFICATE OF OCCUPANCY No Date - I Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. -- [ r/ ,•�- q �- T M Vr COSTA MESA - RM IV N TRACT NO. LOT NO. BLDG. NO. GC7 vc/L /q 77 /" /J *�X 17J/z c'-LC7 ISP/ 0'X,,` p"„4. -CONSTRUCTION PERMIT_ S I —3 TYPE OF CONSTRUCTION )PRNEW ❑ ADD I] ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH 0 OTHER 5836/ 8/10/82 23.00 _ - - - ZONING REGULATIONS Project Address?-'•� �AS %SC(111•G ®' 3 Owner /j/p2� - au CG s.,)t✓...L Phone SS -9r 7,Z Address/6/7 W/ iQir�d%�W --- - Arch/Eng. License No. DESCRIPTION OF WORK.- A,P. ZONE PLNG. REF,. 9F Address -- - - Convector �(a, ',�ix/ Phone Z;_r-DS'3 -TYPE OF PERMIT - - O.G RADING ..'❑' FOV NDATION ❑ STRVGTU RAL �,( ❑ TENANT- OrEL.ECTRICAL >^PLUMBING ❑MECHANICA SETBACK I 'YARD T4'p 8g0l/�pING PROPEfiTV LINE - r Addfess O 4 LO LICENSED -CONTRACTOR DECLARATION I hereby affirm thiol I am licensed under provisions of Charter 9 (Com- / - r 9Ip y BIGHT men cing with section 7000)- of3 of- the Business and -DOTHER ,Divislon Professions Code, and my Ilcenso Is In full torte an I. q - REAR YARD (TO P/L) At /41 PROJECT DESCRIPTION Li cense cense Class LiNo. .-�-ea-i-a- - PKG. SPACE REO. -- PROVIDED Date- Signature - WORKERS' COMPENSATION DECLARATION . SO- FT- _ OCCUPANCV_CO NSTRUCTION TYPE - - STREET WIDTH PARK FEE E - -77 1 hereby affirm that I' have a certificate of consent to self -Insure or• a V - I ALUATION ZONE ZONING APPROVED BY 1' DATE •I certificate -of Workers' Compensation -insurance, or -a certified copy _ - thereof (Section 3800, Lab. C.). GRADING CU_YOS. ACRES ,SPECIAL CONDITIONS: ' ''cy No. - ComPenY - ertifiedcopy-ishereby-furnishetl.-- _ _ _ _.-:;i REMARKS: :ert Ifled copy is filed with the city Building Division. - - - ,' - - _•,i '- EXEMPTION -FROM WORKERS' COMPENSATIONDECLARATION (This.'ectlon need not be completed if the .permit is for one hundred _ w4 . 'r" -r -. 6 - .,I ••'- '1 " , ($100 or less). �eV: _ _— _ _ I.certify.that nAhe:perforance of the work for which this permit ii m PLUMBING I - PLAN CHECK '" - '-i' ,ELECTRICAL PLAN CHECK Issuetl, I snail not employ any person In any manner so as [o become subject to t_he Workers -Compensation La pf. California - _ _ BATHTUBS -SHOWERS - "'LJWI "' ET So FT _ - Data NOTICE: I1 after making this tl��gleiation-, ou sh6ultl become subject to TOILETS URINALS - - -- - GENERATORS 0-1 KW TRANSFORMER 1-10 KW the Workers' Compensation provlsb.D ih Labor Cotle, you must permit LAVATORIES DOUBLE LAYS-' - 10-50 KW_50+ KW- forthwith comply with such provisj6ns or tnls shall De deemetl QQ APPLIANCE- r.voketl. CONSTRUCTION LENDING AGENCY KIT:SINKS - DISHWASHERS' - MOTORS- -• 0-1-1!P=1'-10-HP� - - 'ohencOaffirm that thereIs ation for the per- SERVICE SINKSs -. SUMPS -. t- -(INC. SOLAR)- 10;50 HP 50+HP' -- the (Section 3097 �;. . Civ. C.)f - Lender's Name __ _ FLOOR SINKS FCOOR'DRAINS — _ - -- )FIXTURES -OUTLETS ' 'SWITCHES - Lender's Address DRINKING FOUNTAINS -= - GAS'TVBE SIGNS - - -- - OWNER BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for INTERCEPTORS �CIARIFIERS - lPOCE LIGHTS "- - - - POOL "' PTRAP- - -- -SUB the following reason -(Seaton 7031.5 Business -and -Professions Cotle:SWIMMING Any city or county which requires a permit to construct, alter, IPOLES METERED WATER -SERVICE PANELS-' -' MAIN SUB' - -' Improve, demolish or repair any structure, prior to Its Issuance, also re- quires the applicant for such permit t0 rile a signed Statement that he GAS SERVICE - 'OUTLETS - )SERVICE -- _ - - - AMP - is licensed pursuant to the provisions of the Contractor's License Law Chapter 9 (commencing with Section 7000) of Division 3 of the (lness WATER -HEATERS BTU OUTPUT- - - and Professions Cotle) or that -he is exempt therefrom and the hps�s for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS-' -- -- - - -' -- - - - - - - - applicant for a- permit subjects the applicant to a civil -penalty ;"'l[ more than five hundred dollars ($500). SOLAR TANK'-' "' --COLLECTORS, -' _ ; - - -'-- •-- - -- - - - - as owner of -the property,'or ti r my employees with wages as their sole -compensation, will do the. work, and the,struclure I5 not intended or offered for sale. (Section 7044, Business and professions Code: The SOLAR PIPING SVS._ _ ISSUE FEE - Contractor's License Law.does not apply to an owner of a property _ ISSUE FEE - - - APPLICATION' APPROVED BY - ^DATE - - who builds or Improves thereon, and who does such work himself or through his own employees,provided that such Improvements are not MECHANICAL PLAN CHECK $UMMA RY OF FEES Intended or offered for sale. If, however, the building or Improvement is sold within.one year of completion, the owner will have the burden Of proving -he did not build or Improve for the purpose of sale). .BUILDING - - - - -- - - - - - owner OI the property, ti Contracting with ❑ am exclusive) HEATING SYSTEM 0-100,000 BTU *AND DUCTING- - - PERMIT $ - -- SMIP;" $' -; licensed contractors construct the (Section Business 100,000,! BTU CK_ 'PLAN CHECK $ •PERMIT and Prtl :- and Professions Code: -The Contractor's License Law does not apply to s License es not ISSUANCE. $ owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU :PLUMBING E-73 tracts tracts from such protects with a cont ractor(s) Iicesnetl -pursuant to SYSTEM-- - - '{ GRADING $ the Conlractor's'L icense Law). 100,000 1 BTU PLAN CHECK $- ❑ 1 am exempt under Section BI"S P. C. for this - BOILERS BTU -- - ELECTRICAL - E $ I reason - - SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM' MULTIPLE - 'PLAN CHECK E - - '�'M ECHANICA L- E r 'MICROFILM $ _TOTAL FEE E� � AD - LESS AD Date Owner hereby certify that I have read this application and state that the above m is correct. I agree to comply with all city and county PLAN CHECK $ LANCE E-_ ordinances ordinances and state laws relating to construction, and hereby authorize -city - _ representatives of this taj enter upon- the above mentioned or ms cllon - Qty property p oyes' Signature TiN ��'� t` - - CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNIN - APPROVALS Permit # �y4,s� Date Inspector POOL & SPA APPROVALS Permit # bate Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. SoilPipe-Un rgrn - - 44. Steel Reinforcement - - 3. Electrical Conduit Utility-Undrgrn _ 45. Forms 4. Electrical Conduit-Undrgrn _ 46.. Electrical Bonding 5. Steel em orce _ _ 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn _ 48. APPROVAL TO COVER-GUNITE - -• 7. Footings - 49. Electrical Conduit-Undr rn 8. Foundation 50., Gas Pipe, ❑ Undr rn, Test 9. -Water-Pipe-Undrgrn 51. Backwash Lines P -Trap,❑ - nd r rn - 10. Structural Floor System 52. APPROVAL TO DECK - - - 1.1.. Property Sewer- Line &.House Connection 53. Backwash & Receptor -Final ' 12. Street Sewer Connection 54. Heater &Vent -Final - - 13. Rough Plumbing _ _ /y - - - 14. Rough Electric -Conduit - - `-56: Electrical -Final - 15. Rough Electric -Wiring - - - 57. Solar System -Final '• "' ` - 16. Rough Heating & Air Conditioning -- - Fencing & Access Approval 17. Ducts in Structure - ' _ _ APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test __ .. 20. Roof Framing -. - 21. Roof Sheathing - -- - NOTES: 22• Frame and Flashing 23. Insulation - - - - -- _ ' 24. Lathing & Siding - - �- 25. Drywall Nailing - 26: Plaster Brown Coat 27. Electrical Powei Meter -Final - - 28. Final Electric - 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. FINAL STRUCTURE&BUILDING 39. Special. Requirements Completed ' 40. Electric Release to Edison - - - 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. 3.Op TL CITY OF.COSTA'MESA PERMIT - TRACT NO. LOT NO. BLOG.. O. OJCo aI C.V uC - - I 'CONSTRUCTION PERMIT 3 TYPE OF CONSTRUCTIpIN ❑NEW ❑ ADD ALTERATION ❑REPAIR ❑CONVERSION ❑DEMOLISH ❑ OTHER - - _ - ZONING REGULATIONS Project Address , _�Sl[fC'� 0`�' Owner (�(_(, /lq p"•'�p, Phon .S• G�I2 Address - J /fQ (f/Eyv' lr Arch/Eng. - - License No. DESCRIPTION OF WORK - - - - - A.P. $ 'ZONE - - -- - PLNG. REF: 5p' - Address - - - - - Contractor �} r,1A/,S[-aZ GC7X/ C Phone O (/ TYPE OF PERMIT—" -"' - `- � - �- - , 0 GRADING s� O FOUNDATION ❑ STRUCTURAL- '0 O( ❑MECHANIC - SETBACK C T. YARD - SID YARD- Lye Tp glllLpl NG , _ GROPE RTY LINE- -_- - - - Address - f W • • ,*� VA' Q -- LICENSED- CONTRACTOR '' F. -DECLARATION 1 hereby affirm that, i am licensed under provisions of Charter (com- affirm TENANT PLUMBING LECTRICAL�ORLV - yq RIGHThereby section 7000) -of -Division of -Business and ❑'OTHER / _3 .the Professions Code, and my license IS full fore d efts t. 1 REAR YARD (TO P/L)- _ 'PROJECT DESCRIPTION= - --"--- Lice ri CISe_ a �G.-"� Uce Date LSignatur _ SO -PT'. PKG.'SPACE REO. - --PROVIDED,' - - - '�OCCUPANCY_3 CONSTRUCTION TYPE -• - - -- ..._ ,STREET'WIDTH' PARK FEE E' - WORKERS'COMPENSATION LARATION I hereby affirm that I have a certificate of consent to Self -insure or a - ,VALUATION ZONE -ZONING APPROVED BY -' ' - DATE - - - certificate of -Workers' Compensation Insurance. -or a certified copy _ _ _ SPECIAL thereof (Secj�n 3 D. CJ• onllCy No. ll.�� l T l -• Company �7�/2Mo fV r _ GRAOING_CU. YDS. ACRES _ _ _ _ _ REMARKS:-: _t_-�: _ _ _ _ _I _ CONDITIONS: Certified copy is herebyfurnished,_ _ _ .. Certified copy is filed with the city Building Division. EXEMPTION -FROM 'WORKERS' COMPENSATION DECLARATION - - ! _ 77 I S• (This section need not be completed it the permit IS for one hundred - - - ...... 5100) or. less).' - - _ - Certify that In the,performance of the work for which this permit Iz i issuetl,.l.Shall not employ any person'In'any manner so as to become PLUMBING -- PLAN CHECK--'- - - ,ELECTRICAL -" - --•--PLAN CHECK - - subject to the Workers' Compensation Laws of "BATHTUBS --- -SHOWERS "- - -UWtLLING OFT ---, - - - - - - _California. _ _ Date Signature NOTICE: If after making this declaration, you should become subject TOILETS URINALS -- - GENERATOR - 0.1'KW" -1-10 KW - 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 -LAV S- - — - ,APPLIANCE- - 10-50 KW_50-+ KW - revoked. _ _ CONSTRUCTION LENDING AGENCY KIT. SINKS �-• DISHWASHERS- - -�- -- --- MOTORS - 0.1•HP--�1-10•HP A - _ - I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS SV MPS - - - - - - - --- - _ (INC..SOLAR) 10-50 HP 50 +.HP.' •' f"t' -I ' formance of the work for which this permit is Issued (Section 3097 1 FLOOR SINKS "-- - FLOOR'DRAINS -' -;FIXTURES --OUTLETS SWITCHES--- - -- - Cly. C.)r ---------- - - - - _ ..- - - - - - ;Under's Name Lender's Address - -' DRINKING FOUNTAINS -,f -------- L - -- GAS -TUBE SIGNS -- - - - - --- - - OWNER BUILDER DECLARATION - 'I hereby affirm that 1 am exempt from the Contractor's License Law for -INTERCEPTORS- -'"-CLARIFIERS"'--' ---- 'POLE LIGHTS - - - -- -- -- -- -- '- ' the4ollowing reason (Section -7031.5 Business -and Professions Code: SWIMMING -POOL ---•PTRAP- - `-- --" "' - -- Any city or county which requires a permit to construct, alter, POLES 'METERED- " SUB'- - WATER SERVICE- --'ALTERATION- - - - � - PANELS -ZOO40 - SUB - QQ improve,�demolish or repair -any structure, prior to its Issuance, also re- quires the ap, licant for such permit to file a signed statement that he is licensed pursuant -to- the provisions of the -Contractor's -License Law- -GAS SERVICE -- --OUTLETS -" -' - ERVICE Z ��!'� c AMP--- • 9 (commencing with Section 7000) of Division 3 Of the _ - �� WATER HEATERS- - BTU OUTPUT> - - -- E(Chapter siness and Professions Code) -or -that he is exempt therefrom and the. basis for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS - ---- - - - - - ----- - - - _ applicant for a permit - -subjects -the applicant to a Civil penalty 3l more than five hundred dollars ($500). SOLAR TANK -•- -- COLLECTORS - - - - - - -- -- -- --- - - -- - - - ., az owner of the property','or my employees with wages-as'their sole compensation, will do the work, and the structure Is not Intended ' SOLAR PIPING'SYS. _ - --' - - - ISSUE FEE - - - --- - jJ- ' or offered for sale: (Sd tlon 7044, Business and Professions Coda: The Contractor's License Law does not apply to an owner of a property ISSUE FEE - _I - '-- "' - APPLICATION APPROVED BY - - - DATE -�'- .who builds or'improves thereon, and who does such work himself or 'through his own employees, provided that such improvements are not - MECHANICAL PLAN CHECK - - - SUMMARY OF FEES Intended or offered for sale. If, however, the bulldiny or Improvement is sold within one year of completion, the owner will have the burden ",•li T ofprovinghe-did-net builtl or Improve -for the purpose ot'salel. -- -'- - --- -- HEATING SYSTEM 0-100,000 BTV - - - BUILDING ❑ I,_ as owner of _the property,. am_.exclusively_co6tracting. with AND DUCTING ---- -- - - PERMIT E I. SMIP •, E � licensed contractors to construct the project (Section 7044, Business 100,000'+BTU j PLAN CHECK S PER and -Professions.Code:. The -Contractor's_Llcense. Law doeS.not apply to. _ISSUANCE f an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU _ _ PLUMBING E tracts from. -such projects -with a contractor(s). licesned pursuant to- .SYSTEM _. ._ , _ "t 'GRADING V the Contractor's Ucenso Law). 100,000 + BTU - - PLAN CHECK' -E -- I am exempt under Section - B. 6 P. C. for this - BOILERS BTV - ECECTR ICAC E - reason SYSTEM REPAIR, ALTERATION - - EXHAUST SYSTEM MULTIPLE I - - +PLANCHECK- It - -,MECHANICAL E _MICROFILM'S -- - -- •TOTAL FEE E' - LESS AD- - l 4 • - Date ne, I hereby certify that 1 ead this application and state that he above informatton-is car gree to comply�wlth all -city and county' PLANC4el< f VANCEPC E_ ordinances antl sl g -W -construction, and hereby authorize r¢pr¢sentati Chi city to ntar t the above-me��7nntio(lneedyd- r s Propert s .c our -a-Z) Si re - - CMF 0865-46 White -Building; Canary -Applicant: Pink -Accounting: Goldenrod -Assessor M CONSTRUCTION AND PLANNING APPROVALS Permit # (3� Date POOL & SPA Inspector APPROVALS Permit* - -Date Inspector 1. Temporary Electrical -Service _or Pole 43. Pool & Equipment Location - i ipe-Undrgrn" _ _ _ _ 44. Steel Reinforcement- - 3. Electrical Conduit Utility-Undrgrn -. - _45. Forms - - - - - 4. .Electrical Conduit-Undrgrn _.. _ _ ._ _ ._ 46. Electrical Bonding-- ---- - - _ - - •- ,. . -Steel em orce- _'�. " -•.•, 47. Rough Plumbing & Pressure Test - --� - -- - -- - - - -- - _6. --Electrical _UFER..Grn - _ __ 48. , APPROVAL TO COVER-GUNITE -' - - -- - - 7._- Footings_ - 49. Electrical Conduit-Undr rn - -8, -Foundation- - --- - - - - - 50:t,,Gas.Pipe, 0 Undr rnjest •- 9: Water Pipe•Undrgrn51. _ Backwash Lines P-Tra 7 Elnd_r_ rn 10...Structural Floor System,_ r .52., APPROVAL TO DECK - t -11. -_Property Sewer Line & House Connection_ _ -53.- Backwash & Receptor -Final. • 12. -Street Sewer Connection.- •- "•- -- - - -54. .- ., Heater Vent -Final, - -13.- Rough Plumbing-' - _ -. _ _ -. 55, . -Plumb- , _ -_ -Final qtem 14. Rough Electric -Conduit - " _ - 56- Electrical -Final 15. Rough Electric -Wiring `--' -- 57. Solar System -Finan -- n rn 16. -Rough Heating &'Air Cdnditioning - - _ - - - - -_ ---Fencing &.Access Approval- 17: Ducts; in Structure 59. _APPROVED FOR PLASTERING 18. 19. 20. - Ducts, Ventilating Gas Pipe -Rough & Test Roof Framing - 60. - .POOL/SPA SYSTEMS FINAL, 21. L 22. Roof Sheathing- -- - Frame and -Flashing- - - - - -- - --- - - - - - •' '" ' . - -_ .- :_ . NOTES: 23: -Insulation- - - - h - - - - -- - - - 24. Lathing & Siding - 25. -Drywall-Nailing - - --'- -- - - - = - - - - • 26: Plaster Brown Coat - - - - • 27. Eiectr,icai-Power Meter -Final - ---- - - -- --- - 28. 29. Final Electric - - - -- -Final Heating & Air Conditioning - - ---- - - - - - ' - - - - 30. Final Gas Pipe -Test- - - - - - -- - ' 31.. Final Plumbing ' 32: Water Service -Final 33.- Gas Service -Final -- - 1 34. Solar Domestic -Final •"" _ ''` `' - ' 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING - 39., Special Requirements Completed 40. Electric, Release to Edison 41. Gas Release to Southern California Gas Co. - 42. CERTIFICATE OF OCCUPANCY No .• - Date - - - I Applicant to 1111 in all spaces within heavy border lines and sign all appropriate declarations. C--_ r 'f CITY OF COSTA MESA PE MIT NO. TRACT NO. LOT NO. BLDG. NO. CUNSTRUCTIONPERMIT ^�/.7 TYPE OF CONSTRUCTION BNEW ❑ ❑ 1781 7/28/61 12eii!I Project Address iS er B 9,,Q7Y Owner Pulliam Properties Phone ADD ALTERATION ❑REPAIR ❑CONVERSION ❑DEMOLISH ❑ OTHER #1229 II ZONING REGULATIONS Address1517 N.Fairview Santa Ana O - Arch/Eng. License No. s OESCRtPTION OF WORK' A.P. ZONE PLNG. REF. 9F Address Convector Villa Haatln & Air Ph6ne 528820 TYPE OF PERMIT ❑GRADING ❑ FOUNDATION 11 STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑PLUMBING CRMECHANIC SI OBYARD T 5lD E YARD 'Fp gUI�pING PROPERTY LINE Address 3369 E. Miraloma Anaheim LICENSED CONTRACTOR DECLARATION 1 hereby that I licensed of Charter 9 (com- affirm am under provisions men ting with section 7000) of Division 3 of the Business and ❑ OTHER - {11G HT Professions Code, and my license Is In full force and effect. REAR YARD (TO P/L) C-20PROJECT DESCRIPTION - License Class Lice No. PKG. SPACE REQ. PROVIDED SQ. FT. Date 8-8I Signature STREET WIDTH PARK FEE $ WORKERS' COMPENSATION DECLARATION OCCUPANCY_ CONSTRUCTION TYPE 1 hereby affirm that I have a certificate of consent to self -Insure ora VALUATION ZONE ZONING APPROVED BY DATE certificate of Workers' Compensation Insurance, or -a certified copy - thereof (Section 3800, Lab. C.). -576Q4f) GRADING CU. YDS. ACRES SPECIAL CONDITIONS: Policy NO.Company rnnAMan Tnq- F�-ertified copy is hereby furnished. - REMARKS: entified copy is filed with the city Building Division. _MPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit IS for one hundred ' ($100) or less). - 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 PLUMBING S PLAN CHECK- ELECTRICAL - PLAN CHECK subject to the Workers Compensation Laws of California. _ BATHTUBS SHOWERS Date Signature NOTICE: If after making this declaration, you should become subject TOILETS URINALS GENERATOR 0-1 KW_ 1.10 KW t0 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 10-50 KW_50+KW revoked. KIT. SINKS DISHWASHERS MOTORS 0-1 HP -1.10 HP CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS -SUMPS (INC. SOLAR) 10-50 HP_ 50 + HP formance of the work for which this permit is issued (Section 3097 FLOOR SINKS• FLOOR DRAINS FIXTURES OUTLETS SWITCHES Civ. C.). f. S l- Name -''� - -1-•+ -s ,• LenLender's -r Address, - ' - - DRI NKING_ FOUNTAI NS -- GAS TUBE SIGNS INTERCEPTORS CLARIFIERS - POLE LIGHTS OWNER BUILDER DECLARATION ri hereby affirm that'I am exempt from the Contractor's'License Law for. the following reason (Section 7031.5 Business and Professions Cotle: SWIMMING POOL P TRAP POLES METERED SU Any city or county which requires a permit to construct, alter, WATER SERVICE ALTERATION PANELS MAIN SUB improve, demolish or repair any structure, prior to its issuance, also re- quires the applicant forsuch permit to file a signed statement that he GAS SERVICE OUTLETS SERVICE AMP Is licensed pursuant to the provisions of the Contractor's License Law RChapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT osiness and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS - anv applicant for a permit subjects the applicant to a civil penalty r +t more than five hundred dollars ($500). SOLAR TANK COLLECTORS as owner of the property, or my employees with wages as their s. :ompensation, will do the work, and the structure is not Intended SOLAR PIPING SYS. ISSUE FEE or offered for Sale. (Section 7044, Business and Professions Code: The Contractor's License Law does not.apply to an owner of a property ISSUE FEE gPpLICATION APPROVED By DATE who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not MECHANICAL PLAN CHECK SUMMARY OF FEES intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner will have the burden of proving he did not build or Improve for the Purpose o1 sale). HEATING SYSTEM 0-100,000 BTU PERMIT G SHIP E ❑ 1, as owner of the property, am exclusively contracting with 7044, Business AND DUCTING 5 00 S licensed contractors to construct the project (Section 100,000+BTU PLAN CHECK $ PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BT 4 QQ PLUMBING E ,GRADING tracts from such projects with a contractor(s) Ilcesned pursuant to SYSTEM E the Contractor's License Law). 100,000+BTU PLANCHECK s ❑ I am exempt under Section B. & P. C. for this BOILERS BTU ELECTRICAL $ - S reasonMICROFILM SYSTEM REPAIR. ALTERATION EXHAUST SYSTEM MULTIPLE PLANCHECK s MECHANICAL s=Z32}LLL• b 11TAL FEE,% 12.00 LESS AD - Date Owner- 1 hereby certify that I have read this application and state that the above information Is correct. I agree to comply with all city and county PLAN CHECK $ VANCE PC s ordinances and state laws relating to construction, and hereby authorize _ r presentatives (his 1 1O enter upon lh0 Above mentioned �"9oyf for .i/jf e t n `rrp'oiFj._m�A av s� l ^ n FINAL FEE $J..4�lL Sign trty uce ase o �//7/A Dalc Drivers' License or 55 vk �%/� ISSUE FEE 3 0 'I�MF 0865-46 White -Building; Canary -Applicant; Pink -Accounting: Goldenrod -Assessor 17 >kl- GCNSTRUCTION AND PLANNING APPROVALS Permit # POOL & SPA , Date Inspector APPROVALS Permit # Date Inspector' 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location"- SoilPipe-Undrgrn - 44. Steel Reinforcement: 3.. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding b. Steel em orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P -Trap. ❑ ndr rn 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 13. Rough Plumbing - 14. Rough Electric -Conduit 56. Electrical -Final 15. Rough Electric -Wiring 57. Solar System -Final 16. Rough Heating & Air Conditioning encing & Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING 18. 19. 20. Ducts, Ventilating Gas Pipe -Rough &Test Roof Framing 60. POOL/SPA SYSTEMS FINAL 21. 22. Roof Sheathing Frame and Flashing NOTES: 23. Insulation 24. Lathing & Siding _ �/ 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final " 28. Final Electric 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, FINAL STRUCTURE & BUILDING 39, Special Requirements Completed 40. . Electric Release to Edison " 41. Gas Release to Southern California Gas Co. I" 42. CERTIFICATE OF OCCUPANCY No Date "A �J nnar'ana-slgn all appropriate declarations. STA MESA PERMIT NO. TRACT NO. LOT NO. BLDG. NO. 6NSTRUCTION PERMIT 1 6,;29/ I I 1 ,D - Project Address o:( kr 2 .5? j ,- TYPE OF CONSTRUCTION wne Or .t7 /A AdIttAln Phone ❑ NEW ❑ ADD It ALTERATION Address AM ❑ REPAIR,❑.CONVERSION ❑DEMOLISH Arch/Eng. License No. VOTHER Address DESCRIPTION OF WORK Contractor sQ/Ll _T ifJ/L�i/FZ, /.�i/<,a'.d/3htin Tvpc np s: s: noir Address ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL LICENSED CONTRACTOR DECLARATION man Onherebg with affirm secttiona am licensed sod under DivisionOv3slof tf Charter 9 he Business and ❑ TENANT ❑ ELECTRICAL ❑PLUMBIN( OTHER /•�E S�.�/•✓w✓Lc�-i Professions Code, an my license Is In ful forced and effect. License Class C— Uc se O.a ssu3� PROJECT DESCRIPTION Date Signature =. SQ. FT. OCCUPANCY,$ CONSTRUCTION TYPE VALUATION ) ZONE WORKERS' COMPENSATION DEC ARATION I hereby affirm that 1 have a certificate of consent to self -Insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800 Lab. C.). IGRADING Policy No. �-17 '3112-29( Company rblL/1Li,Ui LJ•j/d CU. YDS. ACRES _ P Certified copy Is hereby furnished. REMARKS: artifled copy Is filed with the city Building Division.' and the 31.5 by .MPTION FROM WORKERS' COMPENSATION DECLARATION This section neednot be completed if the permit is for one hundred - 7$300) or less). SWITCHES II cartllfy 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 California. PLUMBING - PLAN CHECK - BATHTUBS SHOWERS' Date Signature NOTICE: if after making this declaration. you should become subject TOILETS URINALS' to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS revoked. _ KIT. SINKS DISHWASHERS CONSTRUCTION LENDING AGENCY SERVICE SINKS SUMPS - I hereby affirm that there is a construction lending agency for the per- formance of the work for which this permit is Issued (Section 3097 FLOOR SINKS FLOOR DRAINS Civ. r's Name Lender's Lender's Address DRINKING FOUNTAINS N is licensed pursuant to the provisions of the Contractor's (Chapter. 9 (commencing with Section 7000) of Divls B uslness and Professions Code) or that he is exempt then basis for the alleged exemption. Any violation of Sectll any applicant for a permit subjects the 'applicant to a o' t more than five hundred dollars ($500). I as owner of the property, or my employees with S. :ompensation, will do the work, and the structure is Law for INTERCEPTORS CLARIFIERS s.Code: SWIMMING POOL PTRAP ,!alter, alsore- net he WATER SERVICE - ALTERATION ise Law of the GAS SERVICE OUTLETS and the 31.5 by WATER HEATERS BTU OUTPUT penalty SEWER CONNECTIONS SWITCHES as their SOLAR TANK - COLLECTORS Contractor's License Law does not apply to an owner Of a property who bullus or Improves thereon, and who does such work himself or through his 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 will have.the burden of proving he did not build or Improve for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply tO an owner of property who builds or Improves thereon, and who con. tracts from such projects with a contractor(s) licesned pursuant to the Contractor's Ucense Law). ❑ 1 am exempt under Section B. & P. C. for this reason Date Owner I have read this application and state that the above !ct. I agree to comply with all city and county laws relali to construction, and hereby authorize vs city o enter upon the above mentioned , ISSUE FEE 04 KW_ MECHANICAL PLAN CHECK HEATING SYSTEM AND DUCTING 0-100,000 BTU 100,000 + BTU _ REFRIGERATION SYSTEM 0.100,000 BTU_ 100,000 + BTU BOILERS BTU SYSTEM REPAIR, ALTERATION EXHAUSTSYSTEM MULTIPLE Signature /4-' Date U— I Drivers' License or SS Vt _ / %/ ISSUE FEE CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor 0322 7/20/81 cl ZONING REGULATION A.P. $ .2 — 0 _43 — O ZONE - PLNG. REF. $ REAR YARD (TO PILI PKG.SPACEREQ. PROVIDED STREET WIDTH PARK FEE $ SPECIAL CONDITIONS: ELECTRICAL PLAN CHECK GENERATOR 04 KW_ 1-30 KW TRANSFORMER 6.q _ APPLIANCE 30-50 KW_50+KW_ $ ��- MOTORS 0-1 HP -1-10 His (INC. SOLAR) 30-50 HF_ 50+HP_ FIXTURES OUTLETS' SWITCHES GAS TUBE SIGNS $ POLE LIGHTS GRADING - PANELS MAIN SUB SERVICE -- AMP 103.62 TL ISSUE FEE I 'LICATION APPROVED By - DATE FINAL FEE $ 103.e oP- SUMMARY OF FEES BUILDING 6.q _ PERMIT $ 'So SMIP $ ��- PLAN CHECK $ PERMIT " ISSUANCE $ PLUMBING $ GRADING $ PLAN CHECK $ $ ELECTRICAL $ MICROFILM $ PLAN CHECK $ TOTAL FEE $ MECHANICAL $ _ LESS AD - PLAN CHECK $ VANCEPC $_ FINAL FEE $ 103.e oP- CONSTRUCTION AND PLANNIN APPROVALS Permit' Date -- inspector POOL & SPA `- t APPROVALS Permit # Date Inspecto" 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. SoilPipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms A. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel ein orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE - 7. Footings - 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P -Trap" CJ Undrarn ' 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 13. Rough Plumbing ' 14. Rough Electric -Conduit - 56. Electrical -Final 15. Rough Electric -Wiring 57. Solar System -Final 16. Rough Heating & Air Conditioning encing & Access Approval 17. Ducts in Structure APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test 20. Roof Framing 21. Roof Sheathing NOTES: - 22. Frame and Flashing 23. Insulation r -D .K i 24. Lathing & Siding n eA14.0 I! 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 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, FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date City of Costs Mesa Badding Safety Department CERTIFICATE OF OCCUPANCY P.O. Box 1200- 1,2 3175 Costa Mesa, California The Building located at )At', S. TT ;I.. tom..•6 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group ' -•? Occupancy. ' Use of Building "'Al6iro .Tn�L—,.r.5nr Legal Description R. D. IS" reverse side for Metes and Bounds) Building Permit No 3/f"247GE lectrical Permit No. 't"—q'dr,4/' 16r=j Plumbing Permit No.-•.Ih)/ ISSUED TO: Number of apartments`: - —n- and/or guest rooms Building Official by 3 tri `` "C i LcRS C. i,—,=r,fAa2.w-v:, LIIVI'NL:1 tJ_i:,1IIu Date Fiiit-U—Z 25, 1962 This Certificate of Occupancy SHALL BE posted in a conspicuous place on the promises and SHALL NOT BE removed except by the Building Official of the City of'Costa Mese under Sec. 306 (e) U.B.C. t Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. ;CITY OF COSTA MESA PERMIT NO. FF TRACT NO. LOT NO. •BLDG. N"O� 5547 5/06/82 "1. 4•. 64x02 • CONSTRUCTION PERMIT TYPE OF CONSTRUCTION ', ❑ NEW 1'K ADD ❑ ALTERATION ❑ REPAIR ❑.CONVERSION, ❑DEMOLISH ❑ OTHER ;� - ZONING REGULATIONS . Project Addressr4/ N - Owner 8 Phone Address - - r Arch/Eng. -- License No. _ DESCRIPTION OF WORK / A44 A.P.; _ 0 -107 _ -•r ZONE -' PLNTGp. qp +• Address - -- - .., Contractory;- �o hone TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL B SETBACK -SID YARDP'gE - - gR�E1FL. PROVEIRTV TINE ' Address'/ (/ v,Q " LICENSED.CONTRACTOR OECLAR ATI N ❑ TENANT ❑ ELECTRICAL ArPLUMBING-MMECHANIC l E Y I hereby affirm thLt I am licensed under provisions of Charter 9.(com- .. 7 s RIGHT - mencing with section 7000) of Division 3 of the Business and ❑ OTHER• Professions Code, and my license is in full force and effect. REAR YARO'(TO P/L) - _ 1 •License PROJECT DESCRIPTION r Class Licen oI•�,p,.$�'- "-"' - - SOFT' - - __ - PKG. SPACE REO. - PROVIDED, - Dale�•2R•R7. Signature - - ' WORKERS'- COMPENSATIOWDECLARATION _ - OCCUPANCY_CONSTRUCTION TYPE .STREETWIDTH "-PARK FEES ' fl hereby affirm that I have a certificate of consent to self -Insure oraVALUATIONtn9 S?Q7 20NE ZONING APPROVED BY'DATE - Certlficate of -Workers' Compensation Insurance, or .a Certified Copy ;thereof (Section 3800, Lab. C.). I _ GRADING CU. YDS. ACRES SPECIAL CONDITIONS: - - - -' Icy-NoA)Z eagA Company-MLCfz.Y%e/&Or, 44w_ •_ REMARKS: ]ertified copy.is.hereby furnished._ _ __ Certified copy Is filed with the City Building Oivislon. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - (This section not be completed if the permit k for one Hundred Ir • L, J'1 - •_ 1E300) or less).. ). - - - _, ._ _ _ _ -- _ __ _ _ - ._ _ _ _ ___ c¢rtl; that m the mance the work for which this permit PLUMBING - .PLAN CHECK - - - _ -.'ELECTRICAL- - -PLAN CHECK - ploy person any Issued- I shall not employ any person e I as to. become a California. subject to the Workers' Compensatio_n Laws of California. BATHTUBS - SHOWERS ISO- - PT •GENERATOR - - -- - - � _ bate Signature I ,NOTICE: If after making this declaration, you should become subject TOILETS . , , URINALS -- - --- - - -0-1-KW 1-10 KW to the Workers' Compensation provisions Of the Labor Code, you must ,forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS ,TRANSFORMER 1,APPLIANCE - 10-50 KW_50 '1 +.KW _ revoked. d -KIT. SINKS -' - DISHWASHERS MOTORS - 0-1 HP_1-10 '(INC.,SOLAR) HP - - 'CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS SUMPS -i -_30-50 HP + HP .formance of the work for which this permit is issued (Section 3097 - ' ��A -50 _ - Civ. -C.). -- - - - - - -- -- - -- - - FLOOR SINKS "' - FLOOR DRAINS" r- -' FIXTURES - •-OUTLETS SWITCHES - - :Lender's Name - _ ;Lender's Address - 'DRINKING FOUNTAINS j -- - - - GAS TUBE SIGNS - - OWNERBUILDERDECLARATION I hereby affirm that I am exemphfrom the Contractor's License taw for -INTERCEPTORS' - CLARIFIERS'-"' --.POLE LIGHTS - ' - the following reason (Section7031.5 Business' and Professions Cotle:.SWIMMING 'const, POOL.^" PTRAP- - - - - Any city or county which requires a permit to uct, alter, POLES -' METERED SUB _ ', .WATER SERVICE - ALTERATION' - •PANELS - - MAIN --- SUB ' ' Improve, demolish or re pair: any structure, prion to Its Issuance, also re-' quires the ap, licant for such permit to file a signed statement that he •• - f - . - GAS SERVICE - - SERVICE - - - AMP Is-Ilcensed pursuant to the -provisions of the Contractor's License Law (((9Chapter 9 (commencing with Section 7000) of Division 3 of the OUTLETS- -. _ he is om and the and leged n WATER HEATERS - ••BTU'OUTPUT- - - - - - - violation of Sectiompt "_u" fort a aless exemptiessions on. Any 031.5 by SEWER CONNECTIONS .applicant for a permit subjects the applicant to a-olvil- WnaltY of more than live hundred dollars (1500). SOLAR TANK - - -COLLECTORS I,'as owner of the property, 0r my employees' with wages' as their- sole cpmpensa tion, will do the work, and the structure is not Intended or ofler¢tl'fpr zale.'(Section 7044, BusinessandProfessions Code: The SOLAR PIPING SYS. _ --' ISSUE FEE Contractor's License Law does not apply to an Owner of a property - ISSUE'FEE- - "" - -- 'APPLICATION APPROVED BY - -__ DATE ` , who builds or improves thereon, and who does such work himself or through his Own employees, Provided that such improvements are not MECHANICAL PLAN CHECK - '- - SUMMARY OF FEES Intended or offered -for sale. If, however; the building or Improvement' Is sold within one year of completion, the owner will have the burden of proving he did not build or Improve for the purpose of -sale). HEATING SYSTEM 0-100,000 BTU ,PUILDING ERMIT 3g.SO •' ASO ❑ I, as owner _of. the property, am exclusively contracting with. AND DUCTING- - f - $MIP, E licensed contractors to construct the project (Section 7044, Business 100,000+TU B _ PLAN CHECK E zS. 0,7, PERMIT and Professions Code: The.Contractor_'s License Law does not apply to ISSUANCE 'f an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU f _ - - tracts from such_prolects with a,. contractor(s) llcesned pursuant to ..SYSTEM - __ - - ,PLUMBING GRADING E the Contractor's License Law). 100,000+BTU "'- PLAN CHECK E. _ _ ❑ I -am exempt under Section - B.6 P. Cr for this gO1LER5 BTU -- -- ELECTRICAL E reason - SYSTEM REPAI R, ALTERATION - -- - •• PLAN CHECK E '-MECHANICAL E -MICROFILM E _ _ rTOTAL FEE E .Dale Owner 1 hereby Certify that 1 have read this application and state that the above EXHAUST SYSTEM MULTIPLE LESS AD- ' Information is correct: I agree to comply with all City and county 1-PLAN.CHECK E - VANCEPC s_ - ordinances and std laws relating to construction, and hereby authorize - represemailves this ty enter upon -the above mentioned ' , property for ec p p es. Signature Date 9•zR_SZ - ISSUE FEE _ ._ i _ , - FINAL FEE E •\ Drivers' Li ense or SS ? - CMF 0865-46 White -Building; Canary -Applicant; Pink-ACCOunting; Goldenrod -Assessor CONSTRUCTION AND sPLANNING APPROVALS Permit #- Date Inspector POOL &SPA ' APPROVALS Permit # - Date Inspector 1. Temporary Electrical Service or Pole 1 43. Pool & Equipment Cocatiori - - • • - _ 2. SoilPipe-Undrgrn - _ _ 44. Steel Reinforcement - 3. -,Electrical Conduit,Utility-Undrgrn .. - - 45. Forms - 4. Electrical Conduit-Undrgrn. _ . 46. Electrical Bonding - - - - - - - - .. Steel Reinforce- :. 47. Rough Plumbing & Pressure Test 6. .ElectricalUFER-Grn.. _. _i 48. APPROVAL TO COVER-GUNITE `-- - - 7.. Footings . _ - 49. Electrical Conduit-Undr rn - 8. - Foundation- - - ---- - - --- 50. Gas Pipe, C] Undr in, Test ' - 9. Water Pipe-Undrgrn- - - - - ' - 51. Backwash Lines -Trap.'Q' U nor rri - - --- 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 • 13.. Rough.Plumbing -55. Plumbine System.- Final 14. Rough Electric -Conduit "-- - - - 56. Electrical -Final - 15. Rough Electric -Wiring 57. Solar System -Final 16. Rough Heating &Air Conditioning - -- - - encing &-Access Approval 17. Ducts in Structure' -- - - - - - _ APPROVED .FOR .PLASTERING ' 18. Ducts, Ventilating -- - ' 60. _ - - _ .r POOL/SPA SYSTEMS FINAL -• 19. Gas Pipe -Rough & Test - t - - - • 20. Roof Framing 21. Roof Sheathing -- - - - i�r `- �j - ''/ NOTES:., 22. Frame and Flashin - 23. Insulation 24. Lathing & Siding - -- - - -- - - - -- - ,. -- 25. Drywall Nailing - - - - j v ( Y� 26. Plaster Brown -Coat - - -- 7 - - 27. Electrical Power Meter -Final - - - - - - - -- - - - - - 28. Final Electric ---• - - - - -- - -- - 29. Final'Heating & Air Conditioning - 30. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Finan - - - - - - - + 33. Gas Service -Final -- 34. Solar Domestic -Final 35. ' Landscape Sprinkling System 36. Sound Attenuation- _ - 37. Handicap Regulations 38. FINAL STRUCTURE&BUILDING 39. Special Requirements Completed 40. Electric Release to Edison - 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No. Date - _ K F TYApplicant to fill in all spaces within heavy border lines and sign all appropriate declarations. OF COSTA MESA - PERMIT '' TRACT NO. LOTNO. BLDG. NO. - - - - 4B9I 4/2!/82 - - 20:73 ONSTRUCTION PERMIT 3 3ScaL D� TYPE OF CONSTRUCTION - ❑ NEW 0 ADD - IKALTERATION ❑REPAIR,❑CONVERSION ❑DEMOLISH_- 0 OTHER I - - -'_. - - ZONING REGULATIONS *' _ Project Address ( �• _ % - ' Owner Phone - - 'Address- -. -_ _ Arch/Eng. - --- - License No. DESCRIPTION OF WORK -_. - ' A.P. � ZONE _ - - - - - •• ' ' •- __ _ PLNG. REF. fA - - Address - - - - . _ .. � -Contractor (,el tp Phone 53 - K TYPE OF PERMIT '- - - " - SETBACK ST. -- -rp BVILpI NO - PROPERTY LINE. Address -lb-SAI ❑ GRADING'- ❑ FOUNDATION - ❑ STRUCTURAL EJ1''t ,rel -TENANT-p•ELECTRICAL EIPLUMBING - - ❑MECHANICA SI DF YARD - - LE SIDE VAR - - - ---, I- - - - LICENSED CONTRACTOR DECLARATION _ 1 hereby affirm that I am licensed under of Charter 9 (com- provisions mencing with -section 7000)-.of'Dlvision,3-of the Business. and r 0OTHER: RIGHT Professions Code, ;and my license is In full force and effect.. - 'REAR YARD (TO P/L) -' U' PROJECT DESCRIPTION: LcensleI/IClass -- �- - "License'No. - SQ. FT. 'OCCUPANCY' CONSTRUCTION TYPE 1 PKG.-SPACE REQ. (STREET WIDTH - "' - PROVIDED, _ - - _ PARK FEE $ DatO Signature. - {� - - WORKERS' COMP.E NSATION.DECLARATION - II hereby affirm that 1 have a certificate of consent to self -Insure oraVALUATION ZONE , ZONING -APPROVED. BY^ - - - DATE - certificate of.WorkerS' Compensation Insurance, or a certifletl' copy . - - - -- .thereof (Section 3800, Lab. C.). - - •. _GRADING CU. YDS. ACRES SPECIAL CONDITIONS:' _ 'Icy No. _ _ -.__Company''.•,. . _ REMARKS::, :ertified copy Is.hereby fur-nishetl._ _- _ Certified copy Is filed with the city Building Division. - - -- - - - -• - --I-: - _ - ��-�� - EXEMPTION -FROM WORKERS' COMPENSATION DECLARATION - (This section need not be completed it the permit Is for one hundredle ss <erbfy that in the performance Of the work for which this p¢rmit I5 izsuetl-I'shali-hot'employ"any person'In'any manner so'as to -become PLUMBING-�, PLAN CHECK - - - ELECTRICAL _ - --• --PL-AN CHECK • -- - -' - subjecl tq th Workers' Compensation- ws of California_ r'�j - _ ' - - - _ Date Signature BATHTUBS SHOWERS .. - ' NOTICE: If after making this decl$ratio n, you shout— d`be subject TOILETS,.., IOC, r.,URINALS - GENERATOR •TRANSFORMER -0.1 KW_1-10 ` to the Workers' Compensation provisions of the Labor Code, ydb must } f; - r• , I .forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE. L -AVS - - -10-50 APPLIANCErevoke KW_50+KW - _ ^ COK5d- j_. CO NSTR VCTION LENDING AG ENCV KIT:SfNKS-- - - DISHWASHERS-- - -MOTORS -' 01 HP_1-30-HP --- 1 hereby affirm that there Is a construction lending agency for the per. SERVICE SINKS, SUMPS- • --- - - - .;(INC. SOLAR) _ -30-50. - HP 50 -1 -HP' formance of the work for which this permit is issued (Section 3097 FLOOR'SINKS----FLOOR'DRAINS.'-•' - FIXTURES /C/ -OUTLETS SWITCHES ),a --- Civ. -C.).- -----"-"'- - - -- -- - ---" Lender's Name --" eC;_ - -- - -" -- - - Lender's Atldress DRINKING -FOUNTAINS- --f - - - -•-- - --- 'GAS TUBE SIGNS - 'OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for -INTERCEPTORS ' -CLARIFIERS' - I POLE•LIGHTS - - - ^ • ---_ - - -- - - SWIMMING POOL----PTRAP-- - -- -- - - -METERED - 'SUB' - the following reason (Section 703L.5.Business,and Professions Code: Any city or county which requires a permit to construct, alter, .POLES WATER SERVICEALTERATION-- -- - :PANELS- - ---- - MAIN SUB - - improve, demolish -or -repair any structure, prior to its issuance, also re- quires the apl-licant for such permit to file a signed statement that he GAS SERVICE' '" ' OUTLETS- - - 'SERVICE- -- - - - ---AMP-- - --- Is licensed pursuanbto-the provlsions•of the Contractor's License Law.- (Chapter 9 (commencing with Section 7000) of Division 3 of the WgTER'H EATERS • - BTU OUTPUT Business and. Professions Code) or -that he is exempt therefrom and the. "-is for the alleged exemption. Any violation of Section 7031.5 by -SEWER CONNECTIONS s�. --- •- - ----- -- -- -. - -- -- - applicant for -a -permit subjects_the applicant -to a.civil penalty. A more than five hundred dollars ($500). SOLAR TANK - ' -COLLECTORS --- - - - -- - -- - - - - - - - - - - - L I; az 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.'(Section 7044; Buslness and -professions Code: The SOLAR -PIPING SYS. - - - ISSUE -FEE--- - - - -- -- - - - - -� Contraclor'S License Law does net apply to an owner of a property ISSUE FEE '1 - s -- '- -- APPLICATIONS APPROVED BY- - =- = _ = - DATE- -- --- who -builds or Improves thereon, and whodoessuch work himself or- through his own employees, provided that such improvements are not MECHANICAL PLAN CHECK ' - �- - SUMMARY OF FEES Intended -or offered for sale. If: however; the building or Improvement- is sold within one year of completion, the owner will have the burden I of proving he did not build or -improve for the purpose -of'sale): - -- - - - -- - HEATING SYSTEM 0-100,000 BTU _ )- ,BUILDING----,--- ,PERMIT $ - -- .-.-. -`_:SNIP ❑-I,-as. owner of. the.. property, am exclusively contracting with AND DUCTING - - - 1•_ licensed contractors to construct the project (Section 7044, Business 100,000;+ BTU PLAN CHECK $PERMIT. - and . Profsions-Cotle: The Contraoto Cs. License Law. does not apply to es - _ _ ISSUANCE $'" an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU I 'PLUMBING $ tracts -from such. project s_wi t h. a -contract or (s). l i ces netl_ p u is ua n t to. SYSTEM.-- - - _ GRADING - $ the Contractor's License Law). 100,000 + BTU PLAN CHECK $ - I am exempt under Section -- - B. & P. C. for this - BOILERS BTU ELECTRICAL $ ,fs��-'-'- �LIJ (-,Z reason - - PLAN CHECK -$ -0 1" __ ' MICROFILM $ - Date Owner SYSTEM REPAIR , ALTERATION EXHAUST SYSTEM MULTIPLE MECHANICAL $- FEE$ '•t r" .,LESS AD - i hereby certify that I have read this application and State the above y a information is correct. I agree to comply with all city PLAN CHECK $' - VANCE PC $ and state laws relating to construction, and hereby authorize y authorize _ representatives -of nta representati ves-of this city to enter upon the above mentionetl- -- - - - property of� ins ectlon purposes. Signature /"/) r - CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNINNG APPROVALS Permit # '•' ��. Date Inspector POOL & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. SoilPipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms - 4. Electrical Conduit-Undrgrn 46. Electrical Bonding-., - b. bteel Reinforce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48, APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. - Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines. P-Trap,Q Undrqr6 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 ' 13. Rough Plumbing 55,-Plumbina System - Final 14. Rough Electric -Conduit 56. Electrical -Final ' 15. Rough Electric -Wiring .g 57. Solar System -Final - 16. Rough Heating & Air Conditioning _btJ. Fencing & Access Approval 17. Ducts in Structure . 59.. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. - POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test 20. Roof Framing :•- 21. Roof Sheathing- - - - ' NOTES: - 22• -Frame and Flashing -23. 'Insulation -• - - 24. Lathing & Siding -- - - - - 25. Drywall Nailing 26. Plaster Brown Coat - 27- Electrical Power Meter inal - 28. -Final Electric •$'L _e 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. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. I- 42. CERTIFICATE OF OCCUPANCY No Date Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. ' `CITY (1F COSTAJNESA'-- PE'RIVIT NO. - - TRACT NO: LOT NO. S DG. N AWBf$TRUCTION PERMIT M- 3 '/ TYPE OF CONSTRUCTION - '• L0 NEW --El ACID - 'E- ALTERATION ❑ REPAIR. ❑ CONVERSION' DDEMOLISH - L)OTHER 5413 5/04/82 _ ll 1.00- . -•.... , .): �-- C,.: ._ f t•,'i •, - ZONING -REGULATIONS'-- _ I Project AAdress �' E _ �• wrier-- Phon (. Address ' Arch/Eng: - - - - License No. - -DESCRIPTION OFF WORK ' _ _ --- _ •rVPE OF'PERMIT: - , - •" - --- - A.P ZONE ",. PLNG: REF..9P-' - -" -rp B ILDING _ • - T PROPS E. • Address - - - - - - - _ - _ _ _. I ' 'Contractor- �, Phone Address ' ;LADING FOUNDATION- -•STRUCTURAL SETBACK T. SI DpgYARD - - - RTY.LIrJ -ld - - - - - '!LICENSED.CON ACTOR DECLARATION -6 •.E] -TENANT ❑-ELECTRICAL ❑PLV MBING ❑MECHANICA 1 hereby affirm that I am licensed under provlsions of ha er om- .LS (EIGHT mencing -with sectlon-7000) of DlviSlon 3- of -the Business antl 'OTHER. Professions - Cotle, tl y license is n full forcS a f - - J - T P JECT DESCRIPTION' ; r _ REAR YARD (TO P/L) _ _-_ Liten Se Class L ense No. r. - tl - . "--"'-- ' --I r , ,- _" -- PKG. SPACE REO. - -- PROVIDED - -- Date _Slgnatur' SO..FT. _. _ _ _. ._- `OCCUPANCY T .. .. ST REET WIDTH -:PARK-FEE-$- - _ r {WORKERS' COMPENSATI ECLARAT ION .._-_• _ '= CONSTRUCTION T_V_P E - I hereby affirm that I have a certificate of consent to self -Insure or a1 t VALUATION ZONE . ZONING-APPROVEO BY- Y; - DTE A or ..a of -Workers' Compensation Insurance, o.a .certified copy ,thereof (Section 3800, Lab. C.). I _ - GRADING CU. YDS.ACRES _ ,SPECIAL CONDITIONS: 'Icy No: - - Company - :art iffed. cc py.Is,hereby f urnished. _ ._ __ _REMARKS:, Certified copy is filed with the City Building Division. ) ''' EXEMPTION -FROM WORKERS' COMPENSATION DECLARATION - - - - - - - 1.-- ' fl This section need not be completed if, the permit is for one hundred -,i,jiy' „ c' n - i$100) or less). l Cartify that in the performance of the ork for which this permit I5 _ - issued, 1 shall not -employ any person any manner so as'to'be me L MBING"' -- PL-AN'CHECK' - - ^I - _ ELECTRICAL " ' -- PLAN'CH ECK -- - - - -- - subject W ,ComDens o of rn BATHTUBS—- - ' " SHOWERS - "-- UWLLLINGFT_-• UAKAUL - _'-- ith �rs _ws [Dat Signaler NOTICE: If after making this de laration, you s ould become subject TOILETS URINALS-- - -- •-' - - +DOUBLE 4GENERATOR 0=1tKW_ 1-1 O.KW -" - to the Workers' Compensation provisions of the Labor Code, you must [TRANSFORMER -•vr••.� 1 ��.^ forthwith comply with such provisions or this permit shall be deemed LAVATORIES LAYS--^- -•�--^ - APPLIANCE - 10-50•KW_50+.KW - -- revoked. _ -{_T CONSTRUCTION LENDING' AGENCY —_ -KIT. SINKS' -- --DISHWASHERS --- --MOTORS ---'-0-1••HP'=1-10'HP^-- -- hat there a for n3097 er.SERVICE SINKS '-� -- -- - - '(INC.SOLAR)_ _30-50 HP -' 50-+-HP1'I _ LS formance ofirVhe which thiscpion ermit is issued (Sectio work fors , ,:,; ,SUMPS -FLOOR SINKS---"'--'FL-00 R'DRAINS " �' �• FIXTURES- -- OUTLETS -SWITCHES - - .Civ: C:). ---- -- -- -- - - - - -- - -- --- Lender's Name '-Pdtle-�-r-'S Atl-tlr¢55 L DRINKING' FOUNTAINS --i. --'---• - - -- - GASTURE-SIGNS ' - ` - --- --- -'- OWNER BUILDER DECLARATION - I hereby affirm that I am exemPt from the Contractor's License Law for INTERCEPTORS- _"- CLARIFIERS- -` -'-- •POLE'LIGHTS --•- - _ --- - --- - •- -- the following reason (Section 7031.5 Busi ness-and Professions-Cotle:SWIMMING POOL-" --"•P'TRAP -----•- - --- - - 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- quires the ap•,licznt for such permit to file a signed statement that he -GAS SERVICE--'- " -OUTLETS -` - - SERVICE-- - -- - - - AMP- - - - is -licensed pursuant to the pro Weions-of the Contractor's license Law. ((Chapter 9 (commencing With Section 7000) of Division 3 of the 1 WATER'HEATERS- - -BTU OUTPUT- -- - _1 - - •--- - -- -- - - - =- Business and Professions Code) or -that he is exempt therefrom and the `-sls for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS --' applicant far a permit -subjects the applicant to civil penalty ;of more than five hundred dollars ($500). _ -SOLAR -- ---COLECTORS--- - �- -- - -COL!LECTORS--- • -� - - - - •-' - - -- -- .-...,_ L'__ u I, as owner of theor my employees wlth-wages as their sole Compensation, will do the work, and the structure Is not Intended or offered for sale. (Section 7044;'Business and Professions Code: The SOLAR PIPING SVS: - -" -,{ -"'- - '- -- ISSUE FEE - - - - - - - - Contractor's License Law does not apply to an owner of a property - ISSUE FEE "'I; --' - - - [APPLICATION APPROVED BY. _ '- - _ = DATE- -- who builds or improves thereon,' and who does -such work'himself or 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 of proving he' did -not build or Improve for the 'purpose of sale). -' - - - --- - -- - - - HEATING SYSTEM 0-100,000 BTU BUILDING - - - - . - =- - -.- - ❑-I,..as..owner_ol .the. prdperly,_am _exclusively contracting with -ANDOUCTING --- - - -7--- -/-- - PERMIT E - -- -SMIP ^. S. - licensed contractors to construct the project (Section 7044, Business 100,000,'+BTU :PLAN CHECK E _ PERMIT I, and Proiessions Code: The Contractor's. Lfcense.Law tloes not apply _to.. _ __ - _ ISSUANCE� an owner Of properly who Puilds or Improves thereon, and who con. REFRIGERATION 0-100,000 BTU [PLUMBINGE tracts- from . suchprojects with..a contractor(s). Iicesned pursuant -to. SYSTEM ---_•___ 1' ..__ _ GRADING `S' ' Law). the the Contractor's License :PLAN'CHECK b - - _ __ —"GRADING- ❑ -I•am exempt under Sectfoo -- 'B: & P. C. for this -BOILERS S .t BTV - - - - --- - - ,ELECTRICAL E• _ - - PLAN CHECK § '- MICROFILM S .reason ateher Owner SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE MECHANICAL- "E Q I - . TOTAL FEE $ _ -- LESS AD- I this application and state that the above I hereby certify that I have readagree -comply information -is'mrrect.-1 agYee [o with -811 city'antl county PLAN CHECK E - VANCEPC ordinances and slate laws relating to construction d he y authorize - - represen fly of this city t0 a to On e a ve me IO pro ge f inspection p _ •- Signalu atC�� K— ISSUE FEE - - - Q r. •'- FINAL FEE -- Dri s' License or SS CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor T LI CONSTRUCTION AND P : LANNING Date''Inspector APPROVALS Permit POOL & SPA APPROVALS Permit #_' Date � I nspectorr 1. Temporary Electrical Service or Pole ..43. Pool & Equipment Location 2.. Soil Pipe-Undrgrn 44. Steel Reinforcement - 3. Electrical Conduit Utility-Undrgrn 45. Forms I I 4.. -Electrical Conduit-Undrgrn 46. Electrical Bonding_ 5. -Steel Reinforce 47. Rough Plumbing.& Pressure -Test -Electrical UEER jGrn. •48. APPROVAL TO-COVER-GUNITE- -7.-, Footings 49. Electrical Conduit-UndrgrIn -8. - Foundation - 50. Gas Pipe,,0 Undrgrn,-Test -9.- -Water PiPe:Undrgrn 51. Backwash Lines, P -Trip-, El'Uh-d?qrn _10._Structural.Floor.System 52. APPROVAL TO DECK' - - --' -11. Property Sewer. Line & House Connectiori 53_ Backwash.&.Recept;r-Firial .12. Street Sewer Connection-- - - 54.- Heater &.Vent -Final 13., -Rough.Plumbing 55, P I 16mbina System- Final 14. Rough Electric -Conduit ---- -- i56.-- Electrical -Final 15. Rough Electric -Wiring -57- -,'Solar System -Final 16. Hough Heating & Air Conditioning --W. f Lncing &-Access Approval 17: Ducts, in Structure. ?A 59. APPROVED -FOR PLASTERING . 180' Ducts, -Ventilating 19. Gas Pipe -Rough &Test 20. Roof Framing_ .60. POOL/SPA.SYSTEMS FINAL 21; Roof Sti&atfiing 22. Frame and Flashing _NOTES:` 23. Insulation 24e- Lathing & Siding 25. Drywall Nailing 4__ - 26. Plaster Brown Coat 27P Electrical Power Meter -Final - 28; Final Electric 29. Final Heating & Air Conditioning 30. FinakGas Pipe -Test 31: Final Plumbing • 32. Water -Service -Final 33. Gas Service -Final 34. Solar Domestic Final 35. Landscape SDrinkling System 36. Sound Attenuation 37. Handicap Regulations • 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date I I M Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. 1,on'] 1.1I0/on 24.75 ' TLI I Y OF ESA PCIC P RMIT NO. TRACT NO. LOT NO. BLDG. NO -= NSTRUCTION PERMIT - Lf,314 TYPE OF CONSTRUCTION ❑ NEW ❑ ADD ❑ ALTERATION ❑;q EPAIR ❑CONVERSION ❑DEMOLISH '� �• .. ' Project Address Owner Phone _ - 1AddressQ. 1• '0 OTHER ZONING REGULATIONS ArchlEng. -� - Li nse No. - DESCRIPTION OF WORK r �• A'P-$ ZONE PLNG. REF. r - Address Contractt>cJA , f - - - Phon _ TYPE OF PERMIT -- ❑ GRADING r FOUNDATION ❑ STRUCTURAL ❑TENANT- ❑ ELECTRICAL ❑PLUMBING MECHANIC l` - TTpp 8g1l111 ING - SETBACKC ST. PROPE RTV LINE 1 YARD SIpE-V - - - - iAddress LICENSED CONTRACTOR DECLARATION - — I hereby, affirm thtF I am licensed under provisions of Charter 9•(com- mencing with section 7000)- of Division 3 of the Business and '❑ OTHER "- -- q -- RIGHT ProfessionsCode, and my license is in full force and effect^ i REAR YARD (TO P/L) I -- • •n_ PROJECT -DESCRIPTION'-- , _..._ L -_ Licensyel la_5 ' ' tensa N � I,. PKG. SPACE REO. PROVIDED - _ _ SO., FT. ate "` Signature .1 OCCUPANCY_CONSTRUCTION-TYPE c STREET WIDTH PARK FEEE - DATE ZONING APPROVED By il _ WORKERS' COMPENSATIOWDECLAR ION-- •- - - 1_1hereby_affirm that I have a certificate of consent to self -Insure or a Workers' VALUATION ZONE - certificate of Compensation" Insurance,-or'a'Certified copy" thereof (�( C 11 380 �a7b� C.). a - GRADING CU. YDS. ACRES SPECIAL CONDITIONS: 'Cy No "" ' "' ComLrny --REMARKS:- -'317— :ertified Copy Is hereby furnished:' - -- - — ------ Certified copy.is_filed with the. city Building Division. It - MPTION FROM WORKERS' COMPENSATION DECLARATION- - "' '-- • — - _ _ __ _ _ _ _ _ _ (This -section need not -be completed -if the -permit is -for -one -hundred. (E300) or leu). fy In the the for this Lis PLUMBING , ' ' PLAN CHECK - ELECTRICAL PLAN'CHECK - - ---" - - 1 cart that performance -of work which permi issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of -California.- - -- - _ BATHTUBS SHOWERS �' s _ _ _ - , UAHAU PT_ Date Signature FT 0 NOTICE: If after making this declaration, you should become subject _---'SO TOILETS',. URINALS - - GENERATOR "0-1 KW_ 1-301(W -- to the Workers' Compensation provisions of the Labor Code, you must _ _ TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBCE•LAVS i (APPLIANCE- 10-50 KW_50 + KW revoked. KIT. SINKS - DISHWASHERS - MOTORS'--" 0-1 HP -1-10 HP - CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for the per. SERVICE StNKS.... T" SUMPS - ..(INC. SOLAR) -10-50 HP_ 50+ HP- - 1 formance ofthe work for_ Which this permit -is issued (Section 3097 SINKS FLOOR DRAINS - OUTLETS-- -SWITCHES'" Civ. C.).-FIXTURESFLOOR Lenden's Name Lender's Address DRINKING FOUNTAINS - � GAS TUBE SIGNS- -' _ - INTERCEPTORS CLARIFIERS POLE'LIGHTS' %l OWNER BUILDER DECLARATION - - I hereby affirm [hat I am exempt from the Contractor's License law for SWIMMING POOL P TRAP - - - - - POLES METERED SUB the following reason (Section 7031.5 Business and Professlons Code: Any. city orcountywhich requires_ a_ permit to construct, alter, Improve, demolish or repair any structure, prior to Its issuance, also re- WATER SERVICE ALTERATION .PANELS - -MAIN -SUB - -' qulres.lhe.ap'.licanl for such permit to file a signed statement that he r GAS SERVICE OUTLETS s SERVICE- '- AMP' - is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the -exempt WgTER HEATERS BTV OUTPVY ` -` - - Business and Professions Code) or that he is therefrom and the -'s for the alleged exemption. Any violation of Section 7031.5 _ SEWER CONNECTIONS .-by applicant for a permit subjects the applicant to a cMI penalty .0t more than live hundred tlollars_(§500). SOLAR TANK COLLECTORS L 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. (Section 7044, Business and Professions Code: The SOLAR PIPING SVS. ISSUE FEE Contractor's- License Law does not apply to an owner of a property - - -APPLICATION ISSUE FEE APPROVED BY - - DATE Who builtls or improves thereon, and who does such work himself or through his -own employees, provided that such improvementsarenot MECHANICAL PLAN CHECK I ' SUMMARY OF. FEES Intended or offered for sale. It, however, the building or Improvement is sold within one�year ot-completlon, the owner .will have.lhe burden. � _ of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU I BUILDING[1-1*,** PERMIT $ SMIP.11 • -, E' as- owner -of 'ttie"property, am exctu5lvely-contracting_wlth AND DUCTING - _ - fr licensed contractors to construct the project (Section 7044, Business 100,000 + BTU ' PLAN CHECK E PERMIT, antl Professions Code: The 's License Law does'not'apply to- - .1 - — -ISSUANCE- E - - - an_owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU - PLUMBING Is ' -' pursuant' tracts from -such-Projects with-a-contractor(s) IlceSned . - - _ - SYSTEM - - - - - - - GR ADIN E the Contractor's License Law)_ 00,060 S� 'PLAN CHECK § .. ,' ❑ 1 am exempt under Section B. d P. C. for this BOILERS BTU ELECTRICAL - SYSTEM REPAI R, ALTERATION EXHAUST SYSTEM MULTIPLE MICROFILM $ " Is _ MECHANICAL §-GX1L_ TOTA L.FEE $ � MECHANICAL I - LESS AD- I . Date "- Owner - -- - _ I hereby certify that-khave read thisapplication and state that the above information is correct. 1 agree to comply with all city and county PLAN'C HECK E" VANCE PC $- ordinances and state laws relating to onst ruction, antl hereby au[ aria¢ r¢presentatives o this ci to�Ieupon the above me Ion tl for 1 coon . _ _ Signare ate CC -Property. FINALFEE S. Drivers' License or SS ISSUE FEE - `� - _... ;\ CMF 0865-46 White -Building; Canary -Applicant; Pink-ACcounting; Goldenrod -Assessor CONSTRUCTION AND PLANNI G APPROVALS Permit # Date Inspector' 19 7-7 POOL & SPA ' i• • .' fi APPROiVALS Permit # •Date ' Inspector 1. _ Temporary Electrical Service or Pole 43. Pool & Equipment docation.-- - 2. itPipe-Undrgrn 4 Steel Reinforcement -- 3. .-Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn _ 46. Electrical Bonding 5. Steel ein orce 47. Rough Plumbing -& Pressure -Test' 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUN1TE _ 7. Footings - - 49. Electrical Conduit-Undr rn 8... Foundation -- - 50. - Gas Pipe, ❑ Undr rn, Test ,9.. _ Water Pipe-Undrgrn 51. Backwash Lines P-Tra - EJ-L)ndrqrn 10. Structural Floor System 52. APPROVALTO DECK -- ECK- •1 1. •11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12.. Street Sewer Connection ' 54. Heater & Vent -Final. 13. Rough Plumbing -- • - - - 14. Rough Electric -Conduit - - - - - 56.. -Electrical-Final -' 15. Rough Electric-Wirih - - - - 57. Solar System -Final -16. Rough Heating & Air Conditioning 7- encing & Access Approval , - - 17. Ducts in Structure APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL - 19. Gas Pipe -Rough & Test _ 20. Roof Framing. 21.' Roof Sheathing' NOTES: - 22• Frame avid Flashing 23. Insulation _ 24. Lathing & Siding _ 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final -- 28. 29. Final Electric Final Heating & Air Conditioning30.- 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. FINAL STRUCTURE & BOLDING 39. Special Requirements Completed - 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. - - 42. CERTIFICATE OF OCCUPANCY No. Date _ - - -- Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. 'CITY?. F COSTA MESA PER�MM ITN,A] TRACT NO. LOT NO. BLDG. N 4.34d __ - --- 4/Utl/tic( 22eUU " CONSTRUCTION PERMIT "CONSTRUCTION /e'er �p `/ TYPE OF CONSTRUCTION ❑ ❑ ADD ❑ ALTERATION • ' _ Project Add y Owner Phor Gp NEW REPAIR ElCONVERSION ❑DEMOLISH - Acidress zr " Q'r—❑ ❑ OTHER ' ZONING REGULATIONS Arch/Eng. License No. DESCRIPTION OF WORK A.D. � ZONE 'PLNG. REF. $ Address - ContractorW'�L p Phone r�J- TYPE OF PERMIT - ❑GRADING ❑ FOUNDATION ❑STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHANICA SETBACKC 5 . I YARD SIDE V - - TTpp ggit1ll INC PitOPE RTV LINE' - - AdtlressS ,�,a✓ • / .2 LICENSED CONTRACTOR DECLARATION I hereby affirm that I am II anted under provisions of Charter 9 (com- ❑ OTHER BIGHT mending with section 7000) of Division 3 of the Business and Professions Code, a y license is in full force n effect. REAR YARD (TO P/L) -- _ ) - PROJECT DESCRIPTION -" License Clasi License o •- PKG. SPACE RED. - PROVIDED - 3� 92" SQ: FT. Date S 519 nature ! - , STREET WIDTH PARK FEE E WORKERS'.COMPENSATIO CLARATION OCCUPANCY_ CONST R UCTI ON TYPE I hereby affirm that I have a certificate of consent to self -Insure or a VALUATION- ZONE • ZONING APPROVED BY DATE - Certificate of Workers' Compensation Insurance, or a certified copy - '- - - - thereof (Section 3800, Lab. C.). ` GRADING Cu. YOS. ACRES SPECIAL CONDITIONS: ' --Iicy No. .. Company ]ertified copy is thereby furnished.. _ - ,REMARKS: Certified copy Is filed With the city Building Division. IEXEMPTION-FROM WORKERS' COMPENSATION DECLARATION this section need not be completed if the permit is for One hundred '($100) or leu- -'-- - - - - - In. I certify thdt the performance of the rk for which this permit is issuetl. I shall not employ any person any manner so -to beco PL BI NG - PLAN -CHECK ELECTRICAL - PLAN CHECK ' subject t the or i Compels 6 wS of UII ornia 'Date Signatur BATHTUBS SHOWERS'TU SQFT SM F NOTICE: If after making this tle clxration, you sh Id bec a subject TOILETS URINALS - - - GENERATOR '0'-1 KW_1-30 KW .to the Workers' Compensation provisions of the Labor Code, you must .,forthwith Comply with Such provisions or this permit shall be deemed LAVATORIES DOUBLE-LAVS - - - �a TRANSFORMER APPLIANCE -30-50 KW -50 +,KW revoked.. KI T.9NK5 - DISHWASHERS - -- :MOTORS - 0-1 HP_1-10 HP - _ _ 'CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS SUMPS - -- - - (INC.. SOLAR) • 10-50 HP 50 +.HPC Iformance of the work for which this permit is issued (Section 3097 FLOOR SINKS- '- FLOORDRAINSFIXTURES- -OUTLETS -SWITCHES Civ. C.). •- - - •- --- - - .Lender's Name Lender's Address DRINKING -FOUNTAINS - - - - GAS -TUBE SIGNS 'OWNER BUILDER -DECLARATION INTERCEPTORS CLARIFIERS - - �' - POLE LIGHTS -- - - - I hereby affirm that I am exempt from the Contractor's License Law for SWIMMING POOL PTRAP - - POLES" - METERED - SUB' the -following reason (Section 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 re- WATER SERVICE - ALTERATION - PANELS MAIN SUB quires the apslicant for such permit to file a signed statement that he GAS SERVICE- -- OUTLETS - SERVICE - - -AMP ' is -licensed pursuant -to the provisions of the Contractor's License -Law ((Chapter 9 (commencing with Section 7000) of Division 3 of the Chapter WATER HEATERS BTU OUTPUT - - and Professions Code) or that he Is exempt therefrom and the haSls for the alleged exemption. Any violation of Section 7031.5 by -SEWER'CONNECTIONS - - - - `x ., applicant for Permit subjects the applicant to a civil penalty -,�ot more than five hundred dollars ($500). -SOLAR TANK COLLECTORS -`I, as owner of the property, or my employees with wages as their Sole componsallon, will do the work, and the Structure is not Intended or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SVS. -' - '" ' - ISSUE FEE - ,Contractor's License Law does not apply to an owner of a property i� - ISSUE FEE _ APPLICATION APPROVED BY _ — DATE .who builds -or Improves thereon, and who does such work himself or ,through his own employees, provided that such improvements are not 'Intended or offered for sale. If, however, the bulidln9 or Improvement MECHANICAL PLAN CHECK — SUMMARY OF FEES - is sold within one year of completion, the owner will have the burden -ate for BUILDING- - - - of proving he not build or Improve the purpose of sale): HEATING SYSTEM 0-100,000 BTU PERMIT $ SMIP $ ❑ I, as owner -.of -the property, am exclusively contracting with AND DUCTING licensed contractors to construct the project (Section 7044, Business 100,000+BTU PLAN CHECK $ PERMIT and -Professions Code: The Contractor's. License.Law does not apply to , �s OO-_ ISSUANCE' $ an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU • PLUMBIrJG $ �{ 4 - - tracts from such projects witha contractor(s) licesned Pursuant to SYSTEM- - _ GRADING. '$ the Contractor's License Law). 100,000 i BTU PLAN CHECK $ 0 am exemptunder Section - B. & P. C. for this BOI LERS BTU ELECTRICAL S - $' reason SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE PLAN CHECK -$ MECHANICAL S MICROFILM $ - i TOTAL FEE S . r LESS AD - Date Owner I hereby Certify that I have read this application and state that the above information Is correct. -I agree to comply with all city and county PLANCHECK $ VANCEPC $_ laws relating to const r uct t0 nd hereby authorize ordinances and Slat , d represe ntatives this -city to er upo the !>eve mentioned property r spection FINAL FEE Signature Date _ ISSUE FEE _ • - $� _ Oliver dense or SS r=` CMF 0865.46 White -Building; Canary-APPlicant; Pink -Accounting; Goldenroo-Assessor T L- CONSTRUCTION AND PLANNING APPROVALS Permit # -� Date Inspector POOL & SPA. APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - 2. Soil ipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding,, -- 5. Steel ein orce 47. Rough Plumbing & Pressure Test 6. Electrical LIFER Grn 48. APPROVAL TO COVER-GUNITE 7. ootings 49. Electrical Conduit-Undr rn B. Foundation 50. Gas Pipe, ❑ Undr rn, Test - 9. Water pipe-Undrgrn 51. Backwash Lines P-Tra " ❑ ndf rn - 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 13. Rough Plumbing -$v, e, 14. Rough Electric-Conduit '56. - Electrical-Final 15. Rough Electric-Wiring - ' - ' 'S7: Solar System-Final 16. Rough Heating & Air Conditioning _797-- encing & Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL' 19. Gas Pipe-Rough &Test - 20, Roof Framing 21. Roof Sheathing- NOTES: 22. Frame and Flashing 23. Insulation 24. Lathing & Siding - 25. Drywall Nailing ' 26. Plaster Brown Coat 27. Electrical Power Meter-Final 28. Final Electric - - 29. Final Heating & Air Conditioning - - - - 30. Final Gas Pipe-Test y¢2 31. Final Plumbing 32. Water Service-Final - 33. Gas Service-Final 34. Solar Domestic-Final 35. Landscape SDrinklinq System 36. Sound Attenuation ' 37. Hanclicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date • 11111� Applicant to fill in all spaces within `CITY OF COSTA MESAPkgMITrN, -CONSTRUCTION PERMIT IOKJ 55 Owner .r% .i -, d i - ., 4 l N'If , Phone Address ,:r ' ,- License No. Address Contractoi'�,! f '. •'f'%/-1•''"onef r'= Address.' z: ,,,. if -f may,. •.`, Card i!,,r44 •� LICENSED CONTRACTOR DECLARATION I hereby affirm th;.t I am licensed under provisions of Charter 9 (corn. mencing with section 7000) of Division 3 of the Business and Professions Code, aqq. rr)y license is In full force q effect. License Class— Date lass o Date Signature ^" •i',r"' =- Wr..RKERS'COMPENSATION OECLARATION eby affirm that I have a certificate of consent to self -insure or a Icate of Workers' Compensation Insurance, or a certified copy act (Section 3800, Lab. C.). Pr'- No. Company C filled copy is hereby furnished. L. _ertified 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). I certify that to the performance of the wgrk for which this permit Issued, I shall not employ any person,-yi-any manner so as �o.Vecome subject to the Workers! COmpenSj tlory ws of I' rola. /S' Date sv NOTICE: If after making this'deElaration, you should become subject to the Workers' Compensation provisions of the Labor Cotle, you must forthwith comp:y with such nrovi5ions or this permit shall be deemed CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the per. formance of the work for which this permit is issued (Section 3097 Civ. C.). Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professions Code: Any city or county which req Vires a permit to construct, alter, - Improve, demolish or repair any structure, prior to its issuance, alto re. r' "res the ap.licant for such, permit to file a signed statement that he 'ensed pursuant to the provisions of the Contractor's License Law Ater 9 (commencing with Section 7000) of Division .3 of the .fess and professions Code) or that he is exempt therefrom and the ba, for the alleged exemption. Any violation of Section 7031-5 by ar •plicant for a permit subjects the applicant to a civil penalty o: more than five hundred dollars ($500). ❑ 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. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner Of a property who builds or improves thereon, and who does such work himself or through his Own employees, provided that such improvements ate not intended of offered for sale. If, however, the building or improvement is Sold within one year of completion, the owner will have the burden of proving he did not .build or improve for the purpose of sale). ❑ I, as Owner OI the property, am exclusively contracting with licensed contractor. to construct the project (Section 7044, Business and Professons Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and whe con. tracts from such projects with a contractor(s) licesned pursuant to the Contractor's License Law). ❑ I am exempt under Section B. & P. C. for this reason -- - ---- Date Owner 1 bereby certify that I have read this application and state that the above Information is correct. I agree to comply with all city and county ordinances and state laws relating to construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection oUr POSe5. Signature'' I.e- Date? Drivers' License or SS # border lines and sign all appropriate declarations. CHECK EIECTRICAL TRACT NO LOT NO. BLDG. O. BATHTUBS SHOWERS �9, .3 s ! D GRADING $_ TYPE OF CONSTRUCTION URINALS DOUBLELAVS TRANERATOR NSFORMER .;APPLIANCE ❑ NEW ❑ ADD 0 ALTERATION _ 1-10 KW KIT. SINKS SERVICESINKS ❑ REPAIR ❑ CONVERSION ❑DEMOLjS - MOTORS ., (11' C. SOLAR) 0-1 HP -1-10 10-50 HP ❑ OTHER ';7-" ' '-1 2Od ZONING REGULATIONS DESCRIPTION OF WORK '-✓;' A.P. OUTLETS SWITCHES ZONE PLNG.. REF. W TYPE OF PERMIT SETBACK RC PERTVNLI NE E3 GRADING ❑ FOUNDATION. J TRUCTURAL C L ST. LI L�TVARD POLE LIGHTS ❑ TENANT EJELECTRICAL ❑PLUMBING ❑MECHANIC 90 HTA SWIMMING POOL ❑ OTHER R1IG METERED PROJECT DESCRIPTION REAR YARD (TO P/L)PKG. ALTERATION PANELS SPACE REO. PROVIDED PROVIDED SD. FT. __ OUTLETS SERVICE OCCUPANC;ONSTRUCTION TYPE STREET WIDTH PARK FEE $ BTU OUTPUT ZONING APPROVED BY. DATE VALUATION ONE SEWER CONNECTIONS .I GRADING CU. YDS. ACRES SPECIAL CONDITIONS: r PLUMBING -PLAN CHECK EIECTRICAL PLAN CHECK BATHTUBS SHOWERS GRADING $_ TOILETS LAVATORIES URINALS DOUBLELAVS TRANERATOR NSFORMER .;APPLIANCE 0-1 KW_ 10-50 KW_50+KW 1-10 KW KIT. SINKS SERVICESINKS DISHWASHERS SUMPS - MOTORS ., (11' C. SOLAR) 0-1 HP -1-10 10-50 HP HP 50+HP FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES DRINKING FOUNTAINS GAS TUBE SIGNS INTERCEPTORS CLARIFIERS POLE LIGHTS SWIMMING POOL PTRAP POLES METERED SUB WATER SERVICE ALTERATION PANELS MAIN SUB GASSERVICE OUTLETS SERVICE AMP ' WATER HEATERS BTU OUTPUT SEWER CONNECTIONS SOLAR TANK COLLECTORS , SOLAR PIPING SYS. ISSUE FEE ISSUE FEE APPLICATION APPROVED BY i -.. -- DATE= - MECHANICAL PLAN CHECK HEATING SYSTEM 0-100,000 BTU AND DUCTING 100,000+BTU REFRIGERATION 0-100,000 BTU SYSTEM 100,000 + BTU I BOILERS BTU I I SYSTEM REPAIR,ALTERATION EXHAUST SYSTEM MULTIPLE ISSUE FEE CMF 0885-46 Whlte-Buildinq; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor SUMMARY OF FEES I BUILDING. .�„( a( PERMIT $_ SMIP $ PLAN CHECK $ is •:r PERMIT FINAL FEE $ ' i ISSUANCE $_ PLUMBING .$ GRADING $_ PLAN CHECK $ ELECTRICAL $ PLAN CHECK It MICROFILM $_ MECHANICAL $ _ TOTAL FEE $ _ PLAN CHECK $ LESS AD- VANCEPC $_ FINAL FEE $ ' i CONSTRUCTION AND PLANNING APPROVALS Permit # B-3175 Date Inspector POOL & SPA ., ppPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Soil ipe-Un rgrn 44., Steel Reinforcement 3. Electrical Conduit Utility-Urdrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel em orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings m•o /8 2 49. Electrical Conduit-Undr rn B. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Trap.❑ Undrorn 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 _ 13. Rough Plumbing 55, Plumbino System - Final 14. Rough Electric-Conduit 56. Electrical-Final 15. Rough Electric-Wiring 57, Solar System-Final 16. Rough Heating & Air Conditioning encing & Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe-Rough & Test 20. Roof Framing 21. Roof Sheathing NOTES: 22. Frame and Flashing 6 S t Gv 23. Insulation !C U' T i, 24. Lathing & Siding - 25. Drywall Nailing 26. Plaster Brown Coat !QO vi 2P.0l� v S 27. Electrical Power Meter-Final - 2 4 c/ i o L i1 p iy/ 28. Final Electric &/..7 7W 2 400a 29. Final Heating & Air Conditioning ---I 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. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No 3175- Date G �� I• F osta Mesaty Department _t 0CERTIFICATE�OF OCCUPANCY ��- 3235 ox 1200, California �• - - r�'i�'The Building located at -,.245 Fischer -Avenue, -Suite D-5 - A. P. jn in,n l'nr has been inspected and found to comply with the -provisions of all City of Costa Mesa Ordinances applicable thereto for a Group A-2 Occupancy. r Use of Building Fri>rr'iad Ciffir.F Tntrsior. A:LteratiorS & Acid Mi-vt7anine . t - Legal Description A-P-td27-n1;3-f16 - — (See reverse side for -Mates and Bounds) JBuilding?Perm it No-!---i"o `---- _-Electrical-PitirmltNa-•=-g' a-4a�p' P,Iubing.Perm-itNorn=tc++7 '=1 t- ' .. _ m Number of apartments �and/or guest rooms ISSUED 'TO - Building Officiali n t� ✓ J by-- Y/.9iPicd� Pb-iZI iM PROPEKP710 Victor C. Ncsaton-Director Building DAvisicc Date Dece nLer , 1981 6 . . T This Certificate of Occupancy SHALL BE'posted In a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 306 lel U.B.C: I Form BU�34 Rev. 11/70 - - Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. CIT?( OF COSTA MESA PERM T NO. TRACT NO. LOT NO. BLDG. NO. CONSTRUCTION PERMIT TYPE OF CONSTRUCTION ❑ NEW ❑ ADD IL ALTERATION ❑REPAIR �❑ CONV'E`RSION ❑DEMOLISH 11 OTHER . BJa82 `5V76 9/21/61 ZONING REGULATIONS - Project Address ( S Owner (;L Phone Address - - Arch/Eng. License No. DESCRIPTION OF WORK A.P. ZONE PLNTG.. Address Contractor f a ne TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL ❑ TENANT ❑ L€CTRICA ❑PLVM IN ❑MECHANICA SETBACK c T. IO YARD SIEpE VA gR UEF`. piF PROPEIR-TV LINE Address LICENSED CONTRACTOR DECLARATION 1 hereby affirm that I am licensed under provisions of Charter 9 (com- r RIGHT mencingg with sectlon 7000) of Division 3 of the Business and KOTHER REAR YARD (TO P/L) Profess ns Code, and my license Is In full force antl effect. PROJECT DE§ERIPTION Lice e I s}p� n lAV 11 PKG. SPACE REO. PROVIDED Dat Oq SIg [ q -X&AUZ ' - SG. FT. STREET WIDTH PARK FEE $ WOR ER COMPENSATION DECLARA N OCCUPANCY CONSTRUCTION TYPE I hereby affirm that I have a certificate o consent to self -Insure or a VALUATIO F$O�—OZONE ZONING APPROVED BY DATE certificate of Workers' Compensation Insurance, or a certified copy thereof I 3 Lab. Q). rrlue GRADING CU. YDS. ACRES SPECIAL CONDITIONS: Policy No. Company l^% [C As rte^ o.1 � . -.ertified copy Is hereby furnished. REMARKS: Jertlfied copy is filed with the city Building Division. E)IEMPTION FROM WORKERS' COMPENSATION DECLARATION " This section need not be completed if the permit is for one hundred - $300or Tess). .1 rt1 fy that In the performance ofthe work for which this permit is _ Issued, I shall not employ any person In any manner so as to become PLUMBING - PLAN CHECK' ELECTRICAL - PLAN CHECK - subject to the Workers Compensation Laws of Californla. BATHTUBS SHOWERS I - Date Signature NOTICE: If after making this declaration,you should become subject TOILETS URINALS GENERATOR 0-1 KW_ 1-10 KW 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 10-50 KW_50 + KW revoked. .. CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS MOTORS - 0-1'HP_1'-30 HP ' 1 hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS - (INC. SOLAR) - 10-50 HP So + HP formance of the work for which this permit is Issued (Section 3097 FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES C.). Civ. CJ. < 1, \ ..:'• Lender's Ndme - _ Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS INTERCEPTORS CLARIFIERS POLE LIGHTS " OWNER BUILDER DECLARATION I hereby affirm that I am exempt from.the Contractor's License Law for POOL PTRAP - the following reason (Section 7031.5 Business and Professions Cotle:SWIMMING Any city or county which requires a .permit to construct, alter, POLES METERED SUB _WATER SERVICE ALTERATION - PANELS- MAIN SUB Improve, demolish or repair any structure, prior to its Issuance; also re- quires the applicant for such permit to file a signed statement that he GAS SERV ICE OUTLETS - 'SERVICE AMP Is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS - BTU OUTPUT" - - -' '- Business and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS - - - o applicant for a permit subjects the applicant to a civil penalty d more than five hundred dollars ($500). SOLAR TANK COLLECTORS „ 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. (Section 7044, Business and Professions Code: The _ SOLAR PIPING SVS. ISSUE FEE Contractor's License law does not apply to an owner of a property - - ISSUE FEE 'APPLICATION APPROVED BY DATE who bullds or Improves thereon, and who does such work himself or ihrough his own employees, provided that such Improvements are not MECHANICAL PLAN CHECK SUMMARY OF FEES ntended or offered for sale. If, however, the building or Improvement Is sold within one year of cpm pletion, the owner will have the burden of he did not build or Improve for the purpose of sale). _ G _ D proving HEATINGSYSTEM HEATING SYSTEM 0-100,000 BTU PERMIT $ '� �'S� SMTP $ ' ❑ I, as owner of the property, am exclusively contracting with AND DUC- Ilcensetl contractors to construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK $ 36 •R.2. PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts from such projects with 'acontractor(s) Ilcesned pursuant to SYSTEM �- GRADING $ the Contractor's Ucense Law). 100,000+gTU 'PLAN CHECK $ ❑ I am exempt under Section B. & P. C. for this BOILERS BTU ELECTRICAL $ $ reason SYSTEM REPAIR, ALTERATION PLAN CHECK $ MECHANICAL $ MICROFILM $ - TOTAL FEE $ Date Owner hereby certifythat 1 have read this application and state that the above EXHAUST SYSTEM MULTIPLE I-" "LESS AD: Information is correct. I agree to comply with all city and county PLAN CHECK $ VANCE PC $ _ ordinances and state laws reld Ing to construction, and hereby authorize representat s of this it to enter upon the above a tioned property (nape on p ses. JJ//q7e,.' Signature Date .�� ISSUE FEE FINAL FEE $ ' Drivers' License or 55 � r\ CMF 0865-46 White-Building;Canary-Applicanh Pink -Accounting: Goldenrod -Assessor Tl: CONSTRUCTION AND PLANNI G APPROVALSPermit # fa.Aj a' Date POOL &SPA Inspector' APPROVALS Permit �\ i Dat r Inspector 1. Temporary Electrical Service or Pole 43.1 Pool & Equipment Location 2. SoilPipe-Undrgrn 44. Steel Reinforcement 3. .Electrical Conduit Utility-.Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding Steel 47. Rough Plumbing & Pressure•Test.1 • " • t -�' i ' 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE - `" - ' =t ��' • t �- 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Tra ' •❑ ndt'in� h 10. Structural Floor System 52. APPROVAL TO DECK '•N'' 11. Property Sewer Line & House Connection 53. ' Backwash & Receptor -Final t 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing • 14. Rough Electric -Conduit -56.. Electrical -Final 15. Rough Electric -Wiring 57. Solar System -Final - 16. Rough Heating & Air Conditioning bU. Fencing & Access Approval 17. Ducts in Structure APPROVED FOR PLASTERING - 18. 19. 20. Ducts, Ventilating Gas Pipe -Rough &Test Roof Framing - 60. POOL/SPA SYSTEMS FINAL 21. 22. Roof Sheathing Frame and Flashing NOTES: 23. Insulation / Z 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 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. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date tit•. '-- Applicant to fill In all spaces wilnln'4iea, r-..,., all 'a ppro priate declarations. CITY OF COSTA MESA pE R MP NO. _ TRACT NO. LOT NO. BLDG. NO. - - PERMIT RJ CONSTRUCTIONS Project AddressoC �" 'p— TYPE OF CONSTRUCTION OWner Q P 11 NEW ❑ ADD El ALTERATION _ Address IS one El REPAIR C3 CONVERSION []DEMOLISH AEng. License No. -- ❑ OTHER ' cd !.\ �I .'� V6, \ i- ZONING REGULATIONS - 3F - DESCRIPTION OF WORKA.P.--_ ' ' Address ZONE PLNG. REF. # .;ertified copy is filed with the city Building Division. nq EXEMPTION FROM WORKERS' COMPENSATION DECLARATION U (This section need not be completed if the permit is for one hundred iE100? or leu). --- +-- A- �- —_ cert fy that n th� / ' w v Is permit Is Issued, I shall note :to become PLUMBING PLAN CHECK subject to the Wor4, 1 1. - Date I //�7, % BATHTUBS SHOWERS NOTICE: If after I� Ime subject TOILETS - URINALS to the Workers' Cd a, you must forthwith comply Ibe deemed LAVATORIES DOUBLE LAYS revoked. KIT. SINKS DISHWASHERS CONSTRUCTION ' I floret,y affirm, In for the per- SERVICE SINKS SUMPS torm.nce of the v ction 3097 Civ. C.). FLOOR SINKS FLOOR DRAINS Lentler's Name I� Lender's Address i�O 5 I DRINKING FOUNTAINS OWNER BUILDEP C� I INTERCEPTORS CLARIFIERS I hereby affirm that I am`exemp£from:the-Contractor•S70cense Law for the following reason (Section 7031.5 Business and -Professions Cotle: SWIMMING POOL PTRAP Any city or county which requires a Permit to construct, alter, Improve, Cemousn or repair any structure, Prior to its issuance, also re- quires the applicant for such permit to file a signed statement that he wmracwr �f / rnone ( TYPE OF PERMIT Address P,151r 11 WATER HEATERS BTU OUTPUT ❑'GRADING ❑ FOUNDATION ❑ STRUCTURAL �1 ❑ TENANT ❑ ELECTRICAL >rPLUMBING ❑MECHANICA ❑ OTHER LICENSED CONTRACTOR LARATION- I hereby affirm that I am licensed under provisions of Charter 9 (com- mencing with section 7000) of Division 3 of the Business and L. 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 Professions Cotle, a my (cense Is In full f /ce an cl. P_ -� ( �� / License C/I)'ss LI<ense o PROJECT DESCRIPTION - _ Date�%" r SIg t s // � '1 Q O SO. FT. OCCUPANCY—CONSTRUCTION TYPE VALUATION ZONE WORKERS• OMPENSATION D CLAWATION /J I hereby affirm that 1 have a certificate of consent to self sure ora certificate of Workers' Compensation Insurance, or a certified copy OUTLETS thereof (Section 3800, Lab. C.). r�� - GRADING CU. YDS. ACRES D yarn S "cy No. Com an -a-' REMARKS: E �v entitled copy is hereby furnished. .;ertified copy is filed with the city Building Division. nq EXEMPTION FROM WORKERS' COMPENSATION DECLARATION U (This section need not be completed if the permit is for one hundred iE100? or leu). --- +-- A- �- —_ cert fy that n th� / ' w v Is permit Is Issued, I shall note :to become PLUMBING PLAN CHECK subject to the Wor4, 1 1. - Date I //�7, % BATHTUBS SHOWERS NOTICE: If after I� Ime subject TOILETS - URINALS to the Workers' Cd a, you must forthwith comply Ibe deemed LAVATORIES DOUBLE LAYS revoked. KIT. SINKS DISHWASHERS CONSTRUCTION ' I floret,y affirm, In for the per- SERVICE SINKS SUMPS torm.nce of the v ction 3097 Civ. C.). FLOOR SINKS FLOOR DRAINS Lentler's Name I� Lender's Address i�O 5 I DRINKING FOUNTAINS OWNER BUILDEP C� I INTERCEPTORS CLARIFIERS I hereby affirm that I am`exemp£from:the-Contractor•S70cense Law for the following reason (Section 7031.5 Business and -Professions Cotle: SWIMMING POOL PTRAP Any city or county which requires a Permit to construct, alter, Improve, Cemousn or repair any structure, Prior to its issuance, also re- quires the applicant for such permit to file a signed statement that he 6E ALTERATION ERVICE 6liFi$5 Is licensed pursuant to the provisions of the Contractor's License Law Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT LGAS usiness and Professions Code) or that he i5 exempt therefrom and the b --'s for the alleged exemption. Any violation of .Section 7031.5 by SEWER CONNECTIONS applicant for a permit subjects the applicant to a civil penalty A more than five hundred dollars ($500). SOLAR TANK COLLECTORS L. 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 Contractor's License Law does not apply to an owner or a property who builds or improves thereon, and who does Such work himself or through his own employees, provided that such' improvements are not Intended or offered for sale. If, however, toe building or Improvement Is solo within one year of completion, the owner will have the burden of proving he did not build or Improve for the purpose of sale). ❑ I, as owner of the prolierty, am exclusively contracting with licensed contractors to construct the project, (Section 7044, Business and Professions Code: The Contractor's License Law tloes not apply to an owner of property who builds or improves thereon, and who con. tracts from Such projects with a contractor(s) licesned pursuant to the Contractor's License Law). ❑ I am exempt under Section B. & P. C. for this reason Date Owner Thereby certify that 1 have read this ap Plicationand State that the above Information is Correct. 1 agree to.comply with all city and county ordinances and state laws relating to construction, and hereby authorize representatives of this city to -enter upon the above mentioned property for ' inspection purposes. - - ISSUE FEE 5 JNk MECHANICAL PLAN CHECK HEATING SYSTEM AND DUCTING 0-100,000 BTU _ 100,000 + BTU_ REFRIGERATION SYSTEM 0-100,000 BTU_ 100,000 + BTU _ BOILERS BTU SYSTEM REPAIR, ALTERATION 0-1 HP -1-10 EXHAUSTSYSTEM MULTIPLE Signature Date 'ISSUE FEE # Drivers' License or SS CMF 0865.46 White -Building; Canary-APPuCant; Pink -Accounting; Goldenrod -Assessor REAR YARD (TO P/L) ' . PKG. SPACE REO. PROVIDED STREET WIDTH PARK FEE $ ZONING APPROVED BY ,RATE SPECIAL CONDITIONS: ELECTRICAL PLAN CHECK ' . GENERATOR 0-1 KW_ 1-10 KW TRANSFORMER SUMMARY OF FEES' _ APPLIANCE 10-50 KW -50+ KW _ MOTORS 0-1 HP -1-10 HP,_ ' (INC. SOLAR) ' I0-50 HPL_50 + HP _ FIXTURES OUTLETS SWITCHES GAS TUBE SIGNS ISSUANCE $ POLE LIGHTS PLUMBING_ E �v 'POLES METERED SUBf'" PANELS MAIN f SUB SERVICE AMP APPLICATION APPROVED BY DATE SUMMARY OF FEES' BUILDING PERMIT $ SMIP $ PLAN CHECK $ .PERMIT ISSUANCE $ PLUMBING_ E �v GRADING E PLAN CHECK $ ELECTRICAL $ � r • E '� i� PLAN CHECK_ $ MICROFILM $ MECHANICAL $ TOTAL FEE $ PLAN CHECK $ LESS AD- VANCEPC.'$-- ' O 0 FINAL FEE E—� CONSTRUCTION AND PLANNI UG APPROVALS Permit # Date POOL & SPA - InspectorAPPROVALS Permit,# a - -Date . Inspector - 1. Temporary Electrical Service or Pole '' 43. Pool & Equipment Location._ _ 2. SoilPipe-Undrgm - - - .: . - /- - -/ LEY 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn \ - - -45. Forms - 4. Electrical Conduit-Undrgrn - 46. Electrical Bonding 5. Steel ein orce • 47. Rough Plumbing & Pressure Test _ 6. Electrical UFER Grn 48. APPROVAL'TO COVER-GUNITE _ 7. Footings - 49. -Electrical Conduit-Undr rn - 8. Foundation - - - ' - "50. Gas Pipe; ❑ Undr m, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Tra -❑ - ndr rn - 10. Structural Floor System 52. _.APPROVALTO DECK - 11. Property Sewer Line & House Connection - - 53. Backwash & Receptor -Final - 12. Street Sewer Connection - :MC 54. Heater & Vent -Final' - 13. Rough Plumbing - _ - - --- -- - - - 14. Rough Electric -Conduit' -.56. Electrical -Final - 15r Rough Electric -Wiring- - -- - _57.- Solar System-Final1- ._ 16. Rough Heating .& Air Conditioning J.. _ _ _58. Fencing & Access -Approval - - - 17. Ducts, in Structure APPROVED.FOR PLASTERING n ir-s -. 18. 19. 20. Ducts, Ventilating Gas Pipe -Rough &Test_ Roof Framing _ 60. - POOL%SPAISYSTEMS FINAL \ -- - - - . a1 .0 . ',1q ,.• ,. = •• 21. 22. Roof Sheathing Frame and Flashing - NOTES , A, �, j, --- -�•' -^� + /%'� 23' Insulation 24. lathing & Siding _ 25. Drywall Nailing vol Ani. : ,o_ .. 26. Plaster Brown Coat 27. Electrical Power Meter -Final -- 4_ •_ •• 28. Final Electric - t' - 29. Final Heating & Air Conditioning - - V ' 30. Final Gas Pipe -Test - 31. Final,Plumbing I 32. Water Service -Final ' 33. Gas Service -Final 34. Solar Domestic•Final, �i. - •.�-r - .r 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison - - - -- - - - - - - - ---- - 41. Gas Release to Southern California Gas Co. - 42. CERTIFICATE OF OCCUPANCY ` No Date _ / a Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. Y CITY OF iOSTA ME CONSTRUCTION PERMIT P IT NO. TRACT NO. LOT NO. UNIT NO. �`+ �. ��/ 113x3 D5+DCo q�8-9�-18 Project AddresiZ�S FtKHefF kV• 1 D -S ` D -l. n < Applicant's Mailing Address Z4•S F71knell kV, a D _ TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR SO -3f! ^ Owner's Name 1pe'1E 'SaSI Phone 751 •ZZ 70 ❑ CONVERSION 1:1 DEMOLISH ❑ OTHER q p # DESCRIPTION OF WORK/USE OF BLDG. Address Arch/Eng. Skt efPA`2-3' License No. Address I'SJL "V<w a Leis' Contractor's Nama'�-"-6fPARD� g:a-tyT Phope Z -S9 -I Address(ou.iling) I3gZ �aregL,wM Lae ^P -1L City License No. 2vp ISI _ LICENSED CONTRACTOR DECLARATION`V I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class ,9 =_ can No. 40 88 L— Date_J_ L=\21 0" Signature WORKERS'COMPENSATION DECLARATION hereby affirm that I have a certificate of consent to self -Insure or a certificate Workers' Compensation Insurance, or a ce 'fled copy the ( ection 00, Lab. C.) W Policy No. Company Certified copy is hereby furnished. Certified cow !"led with the city Bj�i tlin Di)')si0�/ � Dated 1- 1,7--137 Applicant ✓ vu IG' "`^T EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (Thissection need not be completed If the permit Is for One hundred ($100) or ess). 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 California. Date ----Signature 'NOTICE: If, alter making this declaration, you should become subject to the Workers' Compensation provisions Of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. 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 (Section 3097 Civ. C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the fallowing reason (Section 7031.5 Business and Professional 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/she is licensed pursuant to the provisions of 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 ^refrom and the basis for the alleged exemption. Any violation of Section 31.5 by any applicant for a permit subjects the applicant to a civil nalty of not more than five 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 (Section 7044, Business and Professional Code: The Contractor's 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 employees, provided that such improvements are not intended or offered for sale. It, however, the building or Improvement Is sold within one year of com- plellon, the owner will have the burden of proving he/she did not build or im- prove for the purpose Of sale). .I, as owner of the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044, Business antl Pfofessions Code: The Contractor's License Law does not apply to an owner of properly who builds or Improves thereon, and who contracts for such projects with a con- tractor(s) license pursuant To the Contractor's License Law). II am aware that proof of their Worker's Compensation insurance should be Provided to me. ❑ I am exempt under Section B. & P. C. for this reason Date Owner `�` I hereby certify that I have read this application and state thdt the above information is correct. I agree to comply with all city and county,ordinances hind state laws relating to building construction, and hereby authorize repre- otatives of this city to enter upon the above-mentioned property for action p rppses. � •ure III/�� Date ll-ILcbb S Main Builds TYPE OF PERMIT77qq(( LJ GRADING pn� FOUNDATION STRUCTURAL T Front 1:1RY TENANTELECTRICAL Y�f PLUMBING NMECHANICAL A Rear G' El OTHER C Right PROJECT DESCRIPTION SO. FT.6 1� 0o OCCUPANCY FS -2 K CONSTRUCTION TYPE -�5PIZ VALUATION $%S�� S Left ZONE GRADING CU.YDS. ACRES Ping. Ref. # Remarks: I l_ 1,5 Planning Notes: 1... L✓.: Sink Preventer Irrigation Drinking Fountains Floor Drains Floor Sinks - Gas Service Outlets Interceptors Kitchen Sink Lavatories P -Trap Roof Drains Reinspection Fee 1 $15 Boiler Duct- Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact. Bit. ICSO # /Heating System & Ducting �Ip100,000 BTU 11100,000 or t I I Reinspection Fee I $15 10/84 White - Building: Canary - Applicant: Pink - Accounting; Goldenrod - Assessor 3938 11/12/85 I Zone Accessory Building: 5 1i l �� V sitVt� Parking Req./Provided 16E.20 TL anial rvU Showers — / ELECTRICAL FEES Service Sink - Automatic Washer Transformer ❑ 15750 KW - Construction Pole Sub. 1:1,50 + KW Sewer Cap - . r Sewer Connection � Cooking Unit '' Meter ❑up to 100 amps Solar Collectors rD Dishwasher - Meter Clover 100 amps Solar Piping Dryers ❑Gas ❑Electric Sub Panel Solar Tank Fan Motors F-10.1 HP❑1'A-8 Swimming Pool w/Spaa — _ I F.A.U. Inc. Solar 09-15 HP 016-15+ Urinal Q Fixtures Microwave Water Closet — Device Boxes Pole Light Water Aeater .' — Outlets Range Water Service 4 Switches Sign Auto -Wash 41 — ' Garbage Disposal Standing Sections Laundry Trays Generator'00.5 KW 05.15 KW Trash Compactor Issue Fee $ 3 Reinspection Fee $15 Issue Fee $ 3 1ANICAL FEES-. DEVE LOPMENT SER6C4S REQUIREMENTS. ��-� �`� Zoning By ,(,) //— C — KC Date _1 _1L— oning Ap Building Approved By Date._L1=1� Application Issued By Data' Hood or Typel ❑ Canopy Type II ❑ Refrigeration System 90.100,000 BTU 11100,000BTU _ SUMMARY OF FEES ��a53 BUILDING PERMIT $ -�R 517 SMIP $ PLAN CHECK $ �I4 F1 ?i PERMIT PLUMBING' $ !S'. '� ISSUANCE $ `'PIAN CHECK 25% $. -3 '-"" ENERGY P.C. $, .ELECTRICAL $ GRADING $ V ...PLAN CHECK 50% $ MICROFILM $ MECHANICAL $ TO LFEE $ "PLAN CHECK 25% $ w O System Repair/Alteration Fire Dampers Registers -� Issue Fee $ 3 P N G R E Q M T S CONSTRUCTION AND PLANNING POOI 'PA APPROVALS Permit # Date Inspector APPROVALS Permit # Date Ins 1 1. Temporary Electrical Service or Pole V '. 1 52. Pool & Equipment Location 2s Soil Pipe-Undrgrnd. f/ L/.lyY COO 53. Steel Reinforcement 3.ifElectirical Conduit Utility-Undrgrnd; 54. Forms 4A 'Electrical Conauit-Undrgrnd. 55. Electrical Bonding 5 'Steel.Reinforcement. ' 56. Rough Plumbing & Pressure Test ' 6,=Electr'icalLIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7."Footings - 58. Electrical Conduit-Undrgrnd.; 8:'i Foundation .. i 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 vProperty 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 /�, �S ( 65. Electrical-Final" 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 7� 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 APPROVALS Permit# 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0Gas 0Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24'. Roof Framing .' 73. Undergrnd. Storage Tank OGas 000 . 25. Roof Sheathing + 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27•. Frame and Flashing r a.rs 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation // 6' LL 78. FIRE PREV. FINAL 30.' Drywall Nailing tri�•6 HEALTH DEPT. REQUIREMENT 31,. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric ' 1 1 (_ Notes: 34. Final Heating & Air Conditioning i� L 35.`Final Gas Pipe-Test ' 36. Hood or Canopy A 37. Final Factory Fireplace 7- 38. Final,Plumbingt" 39.•WaterService7Final" 40.`Gas,Service-Final 41 ' Solar Domestic-Final _ 42. Backflow Preventer 7 r 43. Backflow Irrigation T• ,' ' ' 44. Landscape Irrigation System • 45. Sound Attenuation n 46. Handicap Regulations r ' 47. FINAL STRUCTURE & BUILDINGWIX (/ 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas,Release to Southern California Gas Co W ' "•�% 51. CERTIFICATE OF OCCUPANCY Oft No. Date �'- , City of Costa Mesa Development Services Department CERTIFICATE OF OCCUPANCY No. Building Safety Division 000136 P. O. Box 1200 Costa Mesa, California The Building located at 245 Fisichgr AVenua OD -7 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group 13: Occupancy. Use of Building TtntArior Alt-ratinnc — Offioa Legal Description 427-033-07 (See reverse side for Metes and Bounds) E-5625 P-5676, P-5825 Building Permit No BEP -3531 Electrical Permit No. SEP -3531 Plumbing Permit No. BEP -3531 Mechanical Permit No. M—e SRfir r.AR51 Number of apartments —a and/or guest rooms —0— ISSUED TO: Building:lam.ui�ldiinngOfficial P1il.liam e /////o ✓�i�_ 1517 N. Faizui-ew, Santa Ana, CA Date //_ This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and/SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. CMF 1015-46 rev. 1/93 White - Owner; Canary - Numerical File; Pink - Bldg. Permit File City of Costa Mesa Building Safety Department C E R T I F I C A TE OF OCCUPANCY P.O. Box 1200 Costa Mesa, California The Building located at ;TAR W#nnhnr A"#hn n—A has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group rl-7 Occupancy, r Use of Building r,7r51na Ar.-oratrnr�xt5_ — AP.QA�� Legal Description A. A. 6477-0338107 (See reverse side for Metes and Bounds) Building Permit No 2222 1250 Electrical Permit No. F)DI17,7 1C,0 Plumbing Permit No. LI -3223 Number of apartments -n— and/or guest rooms —A— ISSUED TO: Building Official by nm V. C. P7et?'an— DU:11disaQ Div{ a9ott F?—OC Z Date / 27,Z This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises end SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 306 (e) U.B.C. , - Form BU 34 Rev. 11170 p A City of Costa Mesa Building safety Department CERTIFICATE OF -OCCUPANICY P.O. Box 1200 3343. Costa Mesa, California The Building located at 245 r13ibh6r #D-8 has.been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto.4 ! if I for a Group R-2 Occupancy.'d l. Use of Building IntP-xior Alteraf-ims Legal Description 427-033=07 (See reverse side foriMetes and Bounds) 1-4 M-4557 Building Permit No BPE-3704 Electrical:Perm it No Plumbing Permit No. Wil' -j704 F-441'6 Number of apartments —n— and/or guest rooms _n_ ISSUED TO: PProperties. This Certificate of Occupancy SHALL BE Building uilcling Official of the City of Costa Mesa Form BU 34 Rev. 11/70 Building Official e�" b if y V. Wp�' TtctWi X Dil� ision DjXect& Date P!fstecl conspicuous in a cdn uous plece on the premise s if S and SHALL NOT BE removed except by the u ndei Sec. 306 (a), U.B.C. if 1 f 3 £ $�t� '�' x'd''P" `.t ...r• h, �'Fa jYw✓ ��t=�`�t„ - W. ^� J Tv Crty bf Cos[a Masa . v i?, °k �7 + r ' i ` I' Building Safety Department . s + ° e t '- E ° �J J CERmTIFICATE",OFvOCCU,PANC'Ya,4 x ,s rtx PO .Box 1200 iP,'1-'z{'' - 5 M ha' '(Gq. S'tt �. _ 1Y �' a' :" NIR )a Costa Mesa Calrfornia �„ � .. rc. ,s Il� - + _ ' fi'.' • '• t } - 1 Z4 The; Bulldinglocated'at+..i'>d`C•Fici,iidr�3rSn�ii-o.T1-s: e x : ,has beenjnspected and found°to comply'with�`the ,provisions'of;all City of Costa-Mesa.Ordinances applJcable there4o }.Y�`,r •. J' i 'ila.eeJ fyu��aJS t_ z,TJ� ,�; ..` J Y. .+� t ' " 5 for a Group A 7. �'t"%AOccupancy ': ' S` .-y L - l 4 4! i. - yf }• ' C1 �t1 t) V t r . !'' w •nF E �' AFey - •U,seofBuildiAg Tanant•.7innrnvnmt>nt 'Af€.ircc.3.a- �', � e{ �-�'�a -. '' x a .t^•s R. ;5` j Vis. "t •• _ �5.,' _ - ~ # LegalrDe &ip'ti6n A'r- P &d7? f12'iHn7�� A ,,.-'J .y ('Sas reverse side for Metes and Bounds) /. J 'r a# a. �r �`tb� a ] ,.y iYF 4 i .d r:}7 1x"+ ° a .�-z"T - - ^{yE ✓ �1L •,fix < .4,. aJ �-'�r a° r� .t: �s .�i��.�J'' °1 Fey �cr`,wt (.3 :.`-`.r•i Sm B.- �Ci'Z±g�.rt y uilding PermitNo" nvw ')aaa-:Electncal Permit No too V •Plumbing Peimrt No.t",nnF_auFo jj"i..�x� 2 3:.41 y�^ 1�'1 Number of apartments n - and/or guest rooms ; .14 +n ' ED TO ° ISSUED P tp v' a, KK V "'x ` '�t, ,�Bullding Official! � u 3.s• '� & - r ,e 5 *y Fe"t r"{n 'y. +4,r a"'l" *''�C yr � c x x / s.,ry • '� '�' ti x "ffi•• - r r� 3M ra 5 tp g R x ) 0 ) 'i . i,5 R . ts-^�} -k' k dt " - .w!1 r� ! d�,�,L ? ji. � Y4 •' ^ �'T&. � s -'E i.t.=a 'by �t y W:�'A * A7nrm .Pn11 i'a'm ��} M� '` �" _' ` •�` _Buildi �j; ,�,. Mau& DivisionD -iract ?x " ThisCertificate of Occupancy SHALL` BE posted m a conspicuous place on the premises and SHALL NOT BE removed except by ,-,Building Officlaltof the�City of Costa Mesa under Sec 306 (e)iU 8 C x FOIm BU e'",34'Re' 11/70 p *,k .^ °a ''` " �� 6 -^'`+t {'* "` "'r4: "'�,R • rk�.. r ^s s �5 CITY OF COSTA MESA all BUILDING DIVISION > 77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us t "•� FOR INSPECTIONS CALL: (714) 754.5626 �� PERMIT NUMBER!' BX07-00094 PERMIT TYPE B_MISC STATUS: ISSUED DATE ISSUED: 08/28/2007 ISSUED BY: RMD JOB ADDRESS: 245 FISCHER AV; CM Suite/Unit: Vicinity: ROOFTOP Primary Occ:. Const Type :?? SQ. FT: 0 — "Valuatiori: $5,600.00 SCOPE OF WORK: PLASTER AND; Jf 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. ❑ 1 have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Insurance carrier and policy number are: Carrie, i- (rhisSeYnnneed rid he cornpleted dlhe penni is vat ^at Core hunddmd cb this 100) ix teu) PolicyNumber D CI-ce ify 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 California, and agree that if 1 should become subject to the workers' Compe sation provisions of Section 3700 of the Labo e, I sh rt with Con �wilh these provisions. �7 Ap/plrrar nt'e Sgpa/ tore '��ej�Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS 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. f`y Class # B Conti* _IpPsMignature DalO 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, Civil Code). Lender's Name: Lender's Address: S,gnat,e I Date r OWNER -BUILDER DECLARATIONS: I hereby affirm that underrmpenalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city o?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 Iwith 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 civil penalty of not more than five 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 riot 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.). ❑ 1 am exempt under sec. business and Professions Code for this reason: 305746(M17) Owner ID verified by driver\ se. []Yes ❑ No Drivers License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 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 vnth work authorized by this permit, and that no building structure, scaffolding. falsework, a 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 will 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. Applicant's Signature Date Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will 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? ❑ Yes ❑ 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 feet 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? ❑ Yes ❑ No (Section 25533 of the California Health and Safety 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 feel 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? ❑ Yes ❑ 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? ❑ Yes ❑ 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? ❑ 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? ❑ Yes ❑ 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 cored. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. CERTIFICATE OF COMPLIANCE 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 all slate laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. 'g ce egai reqs Date And/or Authorized Applitent Date Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA P IT NO. _ } - TRACT NO. LOT NO. BLDG. O. , - - • -- -- - - - - - - - • -- - - CONSTRUCTION P RMIT CSL/J� OF CONSTRUCTION '>NEW D El ALTERATION REPAIR O'_CONV ERSION.ODEMOLISH ❑ OTHER I 6575 "•8/23/92' 62.00 ,Q- ZONING REGULATIONS .Project AddressTYPE OWner _ Phone I Addl I - f - - ' Arch/Eng.�>• - - License No. DESCRIPTION OF WORK A•P - 3 a I Address - ' -'- _ - ZONE - -� PLNTGp. Contractor -� -- - .Phon02502XTYPE gRLE�FL.�p,g� OF PERMIT - - - ' • -' P R OPEIRTYNLGI N E - - SETBACKC ST. - - ❑.GRADING ,uQ FOUNDATION � � STRUCTURAL X51 YARD � - �J - ❑ TENANT -O -ELECTRICAL OPLV MBING,�77MECHANICA Addr :- - ry - - - -- I, _ _ _ - LICENSED CONTRACTOR DECLARATION "" - I hereby affirm that I am licensed under provisions of Charter 9 (com- 'and' � -- ) ❑ SIpE-V - 'RIGHT ..� � mencing-with section- 7000). of ;Division- 3- of the --Business professions Co d my license is in full fore f d. tl�e• I OTHER,'•' - _. REARWARD (TO P/L) _ - - - - 'PROJECT DESCRIPTION _ • ,Licens:af{• `-' ---Lico/� _. _ ESQ. __; __ PKG. SPACE REQ.- - PROVIDED- 'Date �D , - 'clghat re .' , _ _ _ _ _ _ - FT. _ STREET -WIDTH `,PARK FEES:-,. ',WORKERS'.COMPENSATION.DECLARATION -OCCUPANCYCONSTRUCTION TYPE I hereby affirm that I have a certificate of consent to self -Insure ora VALUATION 20NE ZONING APPROVED BY - 'GATE -' 'cert ifirzle-of Workers' -Compensation Insurance, or a -certified copy - _ _ _ _ -- _ - 'SPECIAL thereof (Se It GRADING CU: YDS. ACRES CONDITIONS: •- . :ertified,copy is.hereby.furnished.. _ - . _ -„ - _ . REMARKS: i _ _ .. s eertifietl copy i5 filed with the city Building Division. �.. _ _.. _ W- EXEMPTION'FROM-WORKERS' COMPENSATION DECLARATION I - - - ^- --L - - - - (This section need not be completed if the permit is for one hundred _1 - - ($100) or less). { - 'I certify. that n the performance of the work for which this perml( iS _ , issuetl, I shall not employ any person in'any manner So-;Wto become' -PLUMBING-- "" PLAN CHECK .1 ' ELECTRICAL - -- PLAN'CHECK - - subject to the Workers' compensation Laws of California.- 1-- _' BATHTUBS - - 'SHOWERS- -'-- - --- ""_ - - - '- -- UVVLLLDate _ Signature I NOTICE: If after making this declaration, you Should become -subject to the Workers' Code, TOILETS - URINALS '- '- - -' 'GENERATOR--- 0-1-KW_1=30-KW TRANSFORMER Compensation provisions of the Labor you'must forthwith comply with Such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS- - APPLIANCE --" 10-50'KW_50--KW -- - revoked._ -KIT. SINKS" '-DISHWASHERS MOTORS ---0-1'HP=1_10HP CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the per. SERVICE SINKS ,(SUMPS -- - - (INC. SOLAR) 10.50 HP=50 +HP. - -- - formance of the work for which this permit is issued (Section 3097 ,� -FLOOR-SINKS -' - 'FLOOR DRAINS '- -;- --' FIXTURES' - --OUTLETS --'SWITCHES-' -"'---'- ,•- Civ.. C:).-- ------ - --- -- --- - -- -- - -' L.ender's Name Lender's Address r _DRINKING FOUNTAINS' GASTUBE SIGNS--= --- --- - - -- - - - OWNER -BUILDER- DECLARATION- -- •INTERCEPTORS - - CLARIFIERS POLE LIGHTS'-- ---- --'" - - - I hereby affirm that I am exempt from the Contractor's License Law for -SWIMMING POOL '"'-P'TRAP - -- - - - - N - ' 'POLES the -following reason -(Section -7031.5 -Business and -Professions Code:- Any city or county which requires a permit to construct, alter, 1 METERED- SUB_ - SERVICE ALTERATION"'--' *WATER - - -_ "-'PANELS' '—' -MAIN "-' "SNB - — - improve; -demolish or repair an structure, prior to its issuance, also re- Y P permit to file a signed Statement that h¢ quires the ap, truant for Suchthe r _ GAS SERVICE' - -- "OUTLETS -` "`" - ,SERVICE - -' -- - AMP- - - - - pursuant to t provisionsof-theContractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the g WATER HEATERS -- BTU OUTPUT•- - 1'" -. {- - - ----- - - - •-- - -- - - Business and Professions Code) or and the- Business is ion of Section 7 by exemption. Any violation of Section 7l Any violation bsis for the afor _ 'SEWER CONNECTIONS- -" _ -- - - -- - -- - - _ -pen -applicant for fi permit subjects the appl)canl4o a -civil -penalty a of more than five hundred dollars ($500) � l- s - SOLARTANKCOLLECTORS - - -' -•-- --- - - - - -- - -- - - - 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. -(Section 7044, Business and Professions Code; The _ -SOLAR PIPING SVS. - ( - '- -' - ' ' - j'- YSSU E'FEE--- - -" • - - - --" - - -' Contractor's License Law does not apply'to_an owner of a property -" ISSUE FEE - -- " - '" - APPLICATION -APPROVED BY - - - -PATE-- - -- who builds or improves thereon, and who does such work himself or his own employees, provided that such improvements are not MECHANICAL PLAN CHECK — w - -' -- SUMMA RV OF F,EES,y,,, . inlentletl orpfferetl for sale. If, however, the build in9sor Improvement- intended Is sold within one year of completion, the owner will M1ave the burtlen -sale). . - of proving he did not build or improve for'the-purpose-of Q -I,. S- wner_.ot_the- ro e,t am exdusivel coniractin wit d o p p y, y. g - - EATING SYSTEM 0-100,000 BTU NDOUCTING-'- -- - - --- - �/j�s BUILDING -- - - - -- -- . - - -- -- 'PERMIT E licensed contractors to construct the project (Section 7044, Business noLappls,Ao. 100,000!4 gTU �J tPLAN CHECK E PERMIT- ) �iC antl-Professions. Code: The -Contractor -'s -License Law -does _ + _ _'• -(SSU ANC E --E'• an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU (PLUMBING E_ I��GRADI ` tracts- from-such_projects-with a_contractor(s)_Iicesned_pursuant to. SYSTEM --- - - .- --- - .__ IN .-S the Contractor's License Law). 100,000+BTU .PLAfJ CHECK E X161 �'I'a m'exempt-antler Section ------- - B. & P. C: for this BOILERS BTU ELECTRICAL"$ reason- - --- SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE ( MICROFILM'$ 'PLAN CHECK -$ - - TOTAL FEE E•' _ MECHANICAL E �- -, - - - - - �E ''=- -' Date Owner I hereby certify that I have read this application and state that the above information -is 'correct.: I*agree ' to comply with all cily'and county' •PLANCHECK VANCELESS C VANCE PC E _ ordinances and state laws relating to construction, and hereby authorize -. I representati veS- f- this cit. to -enter -upon- the above- mentlonetl- /� 6 /�S n 1 -� P f- tion sP _ _ Signature It Date L l; / - FINAL FEE $ Drivers' License or - " - ISSUE FEE - - - - - _- .- _ CMF 0865-46 While -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING -4/5 p(o Date Inspectoi APPROVALS Permit 4# JJ_L-L11J.5�- POOL & SPA ; - "" -' �• Date- Inspector APPROVALS Permit - 1. _ Temporary Electrical Service or Pole _ 43. Pool &Equipment Location' 2. Soil Pipe-Undrgrn •' ^• _ 44. Steel Reinforcement - - - --' - - 3.-_ Electrical -Conduit Utility;Undrgrn _ 45. . Forms -- - - - -- 1 4. Electrical Conduit-Undrgrn 46. Electrical Bonding.,: - --- - - - •5. Steelem orce : 47. Rough Plumbing &-Nessure Test- - -- - - - -- - ' - - - - - .6. Electrical UFER Grn -_ _ 48. APPROVAL TO COVER-GUNITE - - ' - -- Footings- _ 49. Electrical Conduit-Undr rn ' _7. 8._..Foundation _ 50. Gas Pipe,. E]Undr rn, Test " = 9. -..Water Pipe-Undrgrn M '._ .� '� ..'_. _ - 51. Backwash Lines P-Trap� ❑'ndr rn'' "` "'• `�' - j-10..-Structural Floor System 52. APPROVALTODECK - "-----'-` "- �. 11._ Property .Sewer Line & House Connection _ 53. .Backwash & Receptor -Final 12. Street Sewer•Connection. - - - - - -- 54. Heater &Vent -Final _.13. Rough Plumbing -' 14. Rough Electric -Conduit i- ---- - --- -56. -Electrical-Final ' - -• - 15. Rough Electric -Wiring --' - - - - 57. --Solar System -Final 16. RoughTHeating &Air Conditioning -- - Fencing & Access Approval 17. Ducts, in StructurIa, - APPROVED FOR PLASTERING 18: 19. 20. -Ducts, Ventilating- Gas Pipe -Rough '&'Test - - -Roof Framing - 60.- POOL/SPA SYSTEMS. FINAL'=' 21: 22. - Roof, heathing Frame and Flashing T -- 23. -Insulation -24: Lathing & Siding • 25: Drywall Nailing 26. - Plaster Brown Coat - - i 27: Electrical Power Meter -Final - - - - - - 28t Final -Electric - - --- - '" 1 29. Final Heating & Air Conditioning 30: Final Gas Pipe -Test- - - - - ' 31. FinalPlumbing - 32. Water Service -Final - - - - - - ' 33:- Gas Service -Final. 34. Solar Domestic-Fi6aI`'-` - 35.•- Landscape Sprinkling System 36.- Sound Attenuation - - ° _ - - •' • 37. Handicap Regulations ' 38. FINAL STRUCTURE & BUILDING - --- - 39. Special Requirements Completed - 40. Electric Release to Edison - 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date ' �; ., - -v.•. Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. • CITY OF COSTA MESA " - PERMIT N""O' - . TRACT -NO.- LOT NO. pp CONSTRUCTION PERMIT % t1SSl VG. I - 1 TYPE OF CONSTRUCTION ,. =❑-NEW ADD 0 ALTERATION- ❑ REPAIR ffCONVERSION ❑DEMOLISH ❑ OTHER- '' - P' '' •'' ' .7BIV 9/17/82 143..49 -„ -_ _ ,' : ^ - _ - _ - - - - ,ZONING REGULATIONS ' Project Andress' _ i Owner T -• Phone - - . Address Arch/Eng. License No - - -( DESCRIPTION OF WORK G -^r -�re I !�? - TYPE PERMIT - i '-v❑ _ _ A.P, qj '• ' ,ZONE - ---PLNG. REF. - TTpp Bss�1I LDING �- 'SETBACK LS . WO RTV LINE' I ' Address _ _ "Contractor PgSa-U,Phone - Addres 11 -GRADING FOUNDATION -O STRUCTURAL— ❑TENANT .�=ELECTRICAL ❑PLUMBING - - ,SLI❑ VARO - - ❑MECHANICA E '`wa YARD -- - - -- iLICENSED CONTRACTOR -DECLARATION _ __ ";•• Y 'I hereby affirm that I am licensed under of Charter 9 (com- Provisions mencing with ion- 7000) of Division. 3 of. the Business and ,••r, '� - I' ' I HT ' 'Professions Code, an m license is In full fort a effec ar..� I �� -(]:OTHER: ] I REAR YARD (TO P/L) _ "- _ License Iasi - nse I' J PROJECT DESCRIPTION- _SQ. FT.' -- �1 -- - - t y '- - IOCCUPANCY�' ' CONSTRUCTIONTVPE r - -- - - - PKG-SPACE REO. - - - PROVIDED.; ,,,•7-; - - STREET WIDTH -- - , .PARK'F,EE,$;. . - Data Slgnat ure - - WORKERS'COMPENSATION.DECLARATION •- hereby affirm that I have a certificate Of consent to self -Insure ora 11 hereby L - - -VALUATION ICO, ZONE _ _ I ',ZONING APPROVED BY - - - DATE ' Workers' Compensation Insurance, or a.certifled copy ,thereof (Se [ n 38D0 , P-gcy No� Y I .�' ..��p GRADINGICU.,V05. ACRES !SPECIAL CONDITIONS - - - •, - nY- ertifled copy is hereby furnished. - -LAP '_REMARKS: !y' � •It:r s. ' f .ertified copy is filed with the city Building Division. sEXEMPTION - - -- --' - .- - - - - - - FROM -WORKERS' COMPENSATION DECLARATION -_._ ((This section need not be Completed if the permit Is for one hundred .• (E300)or less. - - -.. _-_-_ ___. _ _ _ _ _ _ _. ___- �_ -- _ I Certify that in the performance of the work for which this permit Is PLUMBING '-''_ 'PLAN CHECK- f I ^q �'' -' ,ELECTRICAL -- --' --- -PLAN-CHECK Issued, I shall not employ any person in any manner so as to become subject to the-W,orkersP Compensation Laws of Callfornla._. BATHTUBS) SHOWERS _ '- - FT_- - - _ ,LINU Date Signature f NOTICE: If after making this declaration, You should become subject (-.TOILETS, -s t„ ,-.URINALS - -^' ,'-- GENERATOR 01 KW=1=10-.KW - - 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 -10-50 KW_50'+KW - - revoked.. KITfSINKS •" --DISHWASHERS •' -' 1 MOTORS-- - 0-1'HP_1=10'HP - �, �'- - - _r CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the Per- SERVICE SINKS- �,SU MPS' -' ' - - - j-' - ` ,(INC. SOLAR).. __30 -50 -HP_- r--^ f 50 + HP- -- -- -- _ formances of the work for which this permit is Issued (Section 3097 -Clv�Q)-- - - -- - - - - - - -'---- --- - _ - - 'Lender's Name' • -FLOOR'; SINKS- " " •'FL•OOR DRAINS ' - - -' ' FIXTURES - •' -OUTLETS SWITCHES - •'-" - _ Lender's Address -DRINKING FOUNTAINS -'-I:'-'� - -- - -G AS -TU BE SIGNS- IGNS -- - - - -- - -- OWNERBUILDERDECL:ARATIONt` •�'-� - -•-' -`—' ,- -_ OWNER I hereby affirm that I am exempt from the Contractor's License Law for INTERCEPTORS- - ---CLARIFIERS .- 'POLE LIGHTS' -^---' I ----- - -' - - the -following -reason -(Section -7031.5- Business and Professions Code: Any city or county which' requires a permit' to construct; altery SWIMMINGPOOL•"' 'P TRAP- - - - POLES - - - METERED - - __,SUB `WATER SERVICE - '-'AL'TERATION ---' .. '' - - 1 '.PANELS - - - MAIN - •-•�SVB -- - Improve, -demolish or repair any structure Prior to its issuance, also re- quires the api..licant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's -License -Law- -• - ____ GAS SERVICE- `OUTLETS' - _ -_ 'SERVICE - __ _ __ �.__ —AMP - (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS -BTU'OUTPUT--•• - - - - -- - - -- - - - -- - - Business and Professions Code) or -that he is exempt therefrom and the - basis for the alleged exemption. Any violation Of Section 7031.5 by - -SEWER CONNECTIONS -- �Ir - -- -- -- - - - •- --- -- - -- - - - -- - - applicant for -a-permit subjects -the applicant -to a civil Penalty- ,t more than five hundred dollars (8500). _ SOLAR TANK-'-- - - COLLECTORS' - - _ - - -- -- - - - - -- - -- - as owner of the property, or my employees with wages as their Sole compensation, will do the work, and the structure is not Intended 'SOLAR'PIPING'SVS. -- --- - - - - - ISSUE FEE- -' -' -'- -- - - or offered for sale. (Section ]044, -Business and Professions Code: The Contractor's License Law does not apply to an owner of a property ISSUE FEE -' -' - APPLICATION APPROVED BY 'D •7",- -• -DATE - who bullds or improves thereon, antl who does such work himself or [hrough his own employees, provided that such improvements are not - - - - MECHANICAL PLAN CHECK - ------ - - - - SUMMARY OF.FEES ' !BUILDING-- ,Mended or -offered for sale If, -however, " he buildingor improvement IS sold within one year of completion, e owner will have the burden of proving he did -not build or Improve for the purpose of sale). _ - - - -- - HEATING SYSTEM -- - -----' -'� •- �"''7__ 13.1, as -owner of the property, am exclusively Contracting with 0-100,000 BTU AND DUCTING -' -- 1 - - PERMIT E, - SMIP ...- .PERMIT. licensed contractors (Section Business 100,0001+ gTU CHECK E s License es not : he Contractor's and Professigns Code: The Contractor's LlCense Law does notapply to 'REFRIGERATION .PLAN - '.ISSUANCE- E an owner of property who builds or improves thereon, and who con- 0-100,000 BTU 'PLUMBING E - tracts. -from. such projects with a. contractor(s) licesned pursuant _to... SYSTEM - -- - _ - R E the Contractor's License Law). 100,000 + BTU _ _ ,PLAN CHECK § -GRADIN@ 0-1 am exempt Section - -- B: & P. C. for this -BOILERS b BTU -- -- SYSTEM REPAIR, ALTERATION EXHAUST - -- ELECTRICAL E PLAN CHECK E - , MECHANICAL 'E MICROFILM E - TOTAL FEE E: - - - {eason DateOwner . I hereby Certify that have read this application and state that the above SYSTEM MULTIPLE 41 LESS AD- s Informalion'Is correct. 'I agree to comply with all city -and county PLAN CHECK E- LANCE PC E _ ordinances and state laws relating to construction, and hereby authorize ^ representative, ntafives f [h city o nte' uPon the above mentioned f - pro prop¢rty bepn r o5e 0. �Q 3-40 Signature Dale V - FINAL FEE E Drivers' License or 55 � SSUE FEE -` ' - - _ - � - � - - - - - CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting: Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit'#F-t,Date - POOL & SPA Inspector APPROVALS Permit #- Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location ' 2. SoilPipe-Undrgrn ' _ 44. Steel Reinforcement ' 3. Electrical Conduit Utility-Undrgrn - - 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding> - - _5._Steel Reinforce 47. Rough Plumbing & Pressure Test- • 6. Electrical UFER Grn _ 48. APPROVAL TO COVER-GUNITE- 7.outings - 49. Electrical Conduit-Undr rn 8. Foundation _- 50.. Gas Pipe_ 0 Undr rn, Test 9. Water-Pipe-Undrgrn- 51. Backwash Lines P-Trap.El Undeqrn, \' 10.- .Structural Floor System, 52. APPROVALTO DECK i_.11.. Property Sewer Line.&.House Connection_ - 53. - Backwash & Receptor -Final • 12. - _ Street Sewer Connection. - -- _ - 54. Heater & Vent-Finah • 13._ _-__ .Rough.Plumbing _ _ - - 14. Rough Electric -Conduit '- - - '- 156. Electrical -Final - - 15. Rough Electric -Wiring - - - - - 57. Solar System -Final 16. Rough -Heating & Air Conditioning - - -- - - - _ • _ encing & Access Approval , �,- 17. Ducts,in Structure- ': APPROVED FOR -PLASTERING 18. 19. 20. Ducts, Ventilating Gas Pipe -Rough & Test Roof Framing - - -_ - - - - - - -- - 60. POOL/SPA SYSTEMS FINAL - - - ' 21; - 22. Roof Sheathing- Frame and Flashing •' NOTES: ' ' 23: Insulation - 24. Lathing & Siding - - - r - - ' 25. Drywall Nailing - - - n , - 26. Plaster Brown Coat- - - O- L i 1 27S Electrical Power Meter -Final - F 28. Final'Electric - - - - - - 29. Final Heating &Air Conditioning - - - - 30. Final Gas Pipe -Test - ' 31. Final Plumbing 32.- -Water Service -Final - ---- -- • -33. Gas Service -Final - 34., Solar DomestidFinal •- ' •' s• 35.' 'Landscape Srinklin System 36. Sound Attenuation ; 37. Handicap Regulations -- ' 38. FINAL STRUCTURE & BUILDING - - - 39. Special -Requirements Completed 40. Electric Release to Edison - - 41. Gas Release to Southern California Gas Co. - 42. ' CERTIFICATE OF OCCUPANCY No 1 Date - - - 5 a I .PP"/ Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. CITY OP COSTA MESA FPERMIT NO. - TRACT O LOT NO.' BLDG. NO. - - - 0929.1t/23/62 16.50 _CONSTRUCTION PERMIT S 1 TYPE OF CONSTRUCTION 0 e -0 ADD LTERATION 0 REPAIR ETCONVERSION--DEMOLISH - /A t • Project Address Ji. /V7, P%L {/ P,PhoneS'.5 2 Owner QL[/L/ Address -- - - - 0 OTHER • • ZONING REGULATIONS - Arch/Eng. - License No. DESCRIPTION OF'WORK - A•P'� -) ZONE PILING. REF. N - Address- - • Contractor Ff'/L'ri/f/1" EGECTJZ%C?hdne -fl1 .TYPE OF PERMIT ' - ❑GRADING . ❑ FOUNDATION C) STRUCTURAL 0 TENANT )(ELECTRICAL ❑PLUMBING ❑MECHANIC SETBACK T. SIO YARD - LS5EDD - ' TTop BgOl1 LpINC - 'PROPE♦iTV LINE - - Address ,� v({J• VAli,ri A/CD 1/Le/¢ •CAL / P LICENSED CONTRACTOR DECLARATION that I Iicensed'under Charter 9 1 hereby affirm am provisions of (com- Section 7000) Division 3 of the Business and 0 OTHER - RIIGHT mencing with of Professions Code, and my license Is I full forte and effect. - REAR YARD (TO P/L)' v`7C7 6 PROJECT DESCRIPTION _ L.Icense Class ossa o - SQ. FT. - PKG. SPACE REQ. PROVIDED - - ' Date)hat Sara WORKERS' COMPENSATION D9C RATION OCCUPANCV_CONSTRUCTION TYPE STREET WIDTH - PARK' E I hereby affirm that I have a certificate of consent to self -Insure ora VALUATION ZONE - ZONING APPROVED BY DATE DA Certificate of Workers' Compensation Insurance; or a certified copy thereof (Section 3800, Lab. C.). „GRADING CU.,YDS. ACRES SPECIAL CONDITIONS: Icy No. Company -, :ortifled copy Is,hereby furnished. - REMARKS: .� Certified Copy Is.filed with the City Building Division. 'EXEMPTION FROM WORKERS' COMPENSATION DECLARATION- (Thli section need,not be Completed If the permit is for one hundred _ _ I�E30 or less). _ - certify that.in the performance, of the work for which this permit Is t? 'Issued, 1 Shall not employ any person in any manner so as to become PLUMBING. PLAN CHECK - ELECTRICAL PLAN CHECK_ : subjoct to the Workers' Compensation Laws of California. .-_ BATHTUBS SHOWERS - Date Signature NOTICE: If after making this declaration, you Should become Subject TOILETS URINALS GENERATOR - 0-1 KW_ 1-10 KW 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 LAYS' - APPLIANCE 10.50 KW_50 + KIN revoked.-' KIT. SINKS 'DISHWASHERS MOTORS ' -0.1 HP_ 1-10 HP - CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS - ' - SUMPS - - UNC. SOLAR) 10-50 HPL_50 + HP - - - formance of the work -for which this permit IS Issued (Section 3097 FLOOR SINKS -FLOOR DRAINS - FIXTURES 'OUTLETS SWITCHES ' Civ. C.).- - Lender's Name - _ _ _ _ _ Lender's Address DRINKING FOUNTAINS' - - GAS TUBE SIGNS INTERCEPTORS CLARIFIERS - POLE LIGHTS ' OWNER BUILDER DECLARATION - - I hereby affirm that I am exempt from the Contra Ctor•S License taw for 'SWIMMING POOL -P TRAP-ICURS-i RUL I JUN POLES METERED -SUB _ the following reason (Section 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 re- WATER SERVICE- ALTERATION - PANELS ' quires the ap,.licant for such.. permit to file a signed statement that he GAS SE RVICE OUTLETS SERVICE y�j,0 -- AMP':_ Q Is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9. (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT - - Business and Professions Code) or that he IS exempt therefrom and the ^g for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS .;applicant for a permit subjects the applicant to a civil penalty syol more than five hundred dollars ($500). SOLAR TANK COLLECTORS ,IJ.1*asowner of the property, or my employees with wages as their S ole Compensation, will do the work, and the structure is not intended or offered for Sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SVS. ISSUE FEE - Contractor's License Law does not apply to an owner of a property who builds or Improves thereon, and who does such work himself or ISSUE FEE APPLICATION APPROVED BY - DATE /��. through his own employees, provided that such Improvements arc not MECHANICALPLAN CHECK SUMMARY OF FEES �- Intended or offered for sale. If, however, the building or Improvement Is sold within one year of completion, the owner will have the burden ' of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU .BUILDING PERMIT E SMTP '• E 0 I, as owner of the property, am exclusively contracting with AND DUCTING - ' licensed contractors lo.construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK S PERMIT - and Professions Code: The Contractor's License Law does not apply to - ISSUANCE E - an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTQ PLUMBING 5' tracts from such projects with a contractor(S) lCeSned pursuant to SYSTEM - - GRADING E the Contractor's License Law). 100,000 + BTU PLAN CHECK E 0 1 am exempt under Section - B. 6 P. C. for this BOILERS BTU ELECTRICAL E 76-57- S reasonPLAN CHECK' E MICROFILM E Dale Owner SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE MECHANICAL $ TOTAL FEE S LESS I hereby certify that I In cad this application and state that the above Is information Is torr¢ . I gree comply with all city and county PLAN CHECK E VANCE PC E ,and Slat a elating to construction and hereby authorize ordina nces rOpreSe,tatives O Is It upon I}IC above mentioned Oerly peel, rpow _ "fi// FINAL FEE E.(�"� s� Slg Date C ISSUE FEE - - •• Drivels' Li nse or CMF 0865.46 White -Building; Canary -Applicant; Pink -Accounting: Goldenrod -Assessor -TL ?Z - CMF Z CONSTRUCTION AND PLANNINGL' _6 Date • APPROVALS Permit+ e 6 Inspector POOL & SPA APPROVALS Permit 4 Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - - 2. Soil Pipe-Un_d_rg_rn Steel Reinforcement 3. lectrical Conduit Utility-Un rgrn 45. Forms 4. Electrical Conduit•Undrgrn 46. Electrical Bonding-. 5. Steel entorce 47. Rough Plumbing & Pressure Test - - 6. Electrical LIFER Grn 48. APPROVAL TO COVER-GUNITE - 7. Footings 49. Electrical Conduit•Undr rn 8. Foundation 50. Gas Pi Q Undr rn Test - 9. Water Pipe-Undrgrn 51. - Backwash Lines P-Trap. Q Undidrn_ '_ 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 ' 13. Rough Plumbing _55- Plumbono System - Final 14. Rough Electric-Conduit - :56. Electrical-Final 15. Rough Electric-Wiring_ - -57. Solar System-Final 16. Rough Heating & Air Conditioning _ encing & Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe-Rough &Test 20. Roof Framing "21. -^ Roof Sheathing NOTES: ' 22. Frame and Flashing- 23. Insulation 24. Lathing & Siding 25. Drywall Nailing ' 26. Plaster Brown Coat 27... Electrical Power Meter.•Final. - - 28::-Final Electric ec 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 1 36. Sound Attenuation 37. Handicap Regulations - - ' •• - - 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40- Electric Release to Edison - - '- - -- 41. Gas Release to Southern California Gas Co. - 42. CERTIFICATE OF OCCUPANCY No Date 1 -. Applicant to fill in all spaces within heavy border lines and.sign all appropriate declarations. .CITY OF COSTA MESA "' ^ PERMIT NO. TRACT NO. LOT NO: BLDG. NO. - - - - - CONSTRUCTION PERMIT 5I ' J JO 1194 12/01/69 7.00 Project'Address /e�S -Phan TYPE OF CONSTRUCTION ❑ NEW ❑ ADD ❑ ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH Owner �/ �/ / C10THER • , ZONING REGULATIONS Arch/Eng. License No. DESCRIPTION OF WORK - - TYPE OF PERMIT - - - El GRADING ,❑ FOUNDATION 11 STRUCTURAL ❑.TENANT'❑ ELECTRICAL XPLUMBING ❑MECHANICA A.P. $ ZONE PLNG. REF. VE TTpp ggsl��ILp ING ..... SETBACK ST. PROPERTY LI NE- ID VARO - - - ggEpD Address - - - - Contractor -� ' .h Phone Addre55 LICENSED CONTRACTOR DECLARATION... 'I 9 I hereby affirm thatam licensed under provisions of Charter (com. mencing with section 7000)- of Division 3 of the. Business and - ❑ OTHER •RIIGHTA Professions Code, and my license Is In full torte nd effect. REAR YARD (TO P/L) c'- _ �' 'PROJECT DESCRIPTION LI<enSa Class IcenseN ""' "--"" -'- PKG'SPACE REQ: "' PROVIDED -- Date �Y"_/�2-519nat ure/'-�'t _ SO. FT: t •_ -. OCCUPANCV_CO_ NSTRUCTION TYPE _ STREET WIDTH ZONING APPROVED BY - 'PARK,FEE - - DATE - WORKERS' COMPENSATION D R I hereby affirm that I have a c Ical sent to self -Insure ora VALUATION ZONE certificate of Workers' Compensation Incur nce, Or d <ertilled Copy thereof (Section 3800, Lab. C.). GRADING CU. YDS'. ACRES SPECIAL CONDITIONS: ' 'y No. Company- - --. - - _ vtified copy.1s hereby furnished.. _ ' REMARKS: _-ertified copy is filed with the city Building Division. - EXEMPTION FROM WORKERS' COMPENSATION DECLARATION -- ((Th15 section need not be Completed if permit is for dna hundred - ' -the SN00) or less). ertiffy that in the performance of the work for which this.permit is issuetl, I shall not employ any person in any manner so yyto become -PLUMBING -' PLAN CHECK — ELECTRICAL - - PLAN CHECK- subject to the Workers Compensation La f Calif or n' !� { BATHTUBS '" SHOWERS - - - , . _ Dale ��`•'Z Signature NOTICE: If atter making this ratio ou d become subject TOILETS a URINALS - - GENERATOR- -- 0-1-KW_1-30 KW to the Workers' Co mpensatlo outs 5 t Labor Cotlo, you must forthwith comply with such rovisl r t permit shall be deemed LAVATORIES DOUBLE LAYS - - _ - TRANSFORMER APPLIANCE- -30-50 KW_SOa - , KW'' revoked. •_ _- KIT. SINKS'- - DISHWASHERS - r - - MOTORS:- 0-1 HP HP CONSTRUCTION LENDING AGENCY _3-10 1 hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS - , SUMPS - -' (INC. SOLAR)_ 10-50.HP 50 - HP- _ - formance of,the work for which this permit is issued (Section 3097 - FLOOR SINKS% :FLOOR DRAINS -' FIXTURES-- - -OUTLETS -SWITCHES - - Clv. C.)- • I_- I I % '" Lender -s Name - _ _ Lender's Address. '-- - '' DRINKING FOUNTAINS `- GAS TUBE SIGNS' INTERCEPTORS CLARIFIERS '• - - POLE LIGHTS - - - - '- - OWNER BUILDER DECLARATION - - _ - I' hereby affirm that I am exempt from the,Contractor's License Law for ..SWIMMING POOL- PTRAP ---- - - - POLES'- METERED' -'SUB- the following reason (Section 7031.5 Business and Professions Code: Any city or county which, requires a permit to construct, alter, WATER SERVICE ALTERATION' - - PANELS- MAIN- - - SUB - Improve, demolish or repair any structure, prior to its issuance, also re- quires the applicant for such permit to file a signed statement that he GAS SERV ICE OUTLETS - SERVICE • - - - • - AMP . is 'licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS' BTU OUTPUT- _ Business and Professions Code) or -that he is exempt therefrom and the b^- for the alleged exemption. Any violation of Section 7031.5 by SEWER -CONNECTIONS - ' - - -- - - ppllcant for a permit subjects the applicant to a civil penalty t more than five hundred dollars ($500). SOLAR TANK c COLLECTORS �:.. ,, 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. (Section 7044, Business and Professions Code: The -SOLAR PIPING SVS". - -' ISSUE FEE- -- - - _ Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself or ISSUE FEE -' - - gPPLICATIONAPPROV ED BY DATE. - through his own employees, provided that such improvements are not MECHANICAL PLAN CHECK - - - ` - - SUMMARY OF -FEES Intended or offered for sale. If, however, the building or improvement is sold.within one year of completion, the owner will have the burdenv. BUILDING of proving he did not build or improve for the purpose' of sale). HEATING SYSTEM 0-100,000 BTO ' - _. .. PERMIT $ SMIP E' ©n as owner Of the property, p exclusively contracting with Ilcensetl contractors to construct the project (Section Business AND DUCTING - - 100,600 "BTU' - - --= -' PLAN CHECK $ IT. - - PERMIT. - es not antl Professions Code: The Lbens not apply to _ _ __- ISSUANCE E • a or Improves [hereon, antl who con- owner Of property who bolds or I thereon, REFRIGERATION 0-100,000 BTU—PLUMBING $ with a tracts from Such projects with a contractor(5) licesned pursuant to. tracts - SYSTEM- - _ - _ GRADING" the Contractor's License Law). 100,000 +BTU- PLAN CHECK E lam ex pt nder'Se<tion B:'& -P -C. for this - -- -- BOILERS BTV ELECTRICAL -'E E ' reason��• Q%4/. SYSTEM REPAIR, ALTERATION - _ ,- PLAN CHECK -E MICROFILM$ - - TOTAL FEES 7 Oale,lL'/S'v _Owner I hereby certify that I have rea s app can and stale that the above EXHAUST SYSTEM MULTIPLE •MECHANICAL-$ LESS AD - information is correct. 'I'a a to ply with all city and county -PLAN CHECK- E VANCEPC $ ordinances and state laws relating t 2bnstr uctipn, and hereby authorize representatives of is cily't nter pan the above mentioned - - - property do ze_s_.�� Signature Da ISSUE FEE - FINAL FEE E Drivers' en , =CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # t Date Inspector POOL '& SPA APPROVALS Permit # - -Date -' Inspector - 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location -- - - - - - - -2. SoilPipe- ndrgrn.. .. - _ _ 44. Steel Reinforcement-- 3. Electrical Conduit Utility-Undrgrn-- _ • 45. Forms - - - - 4.- -Electrical Conduit-Undrgrn. _ _ _ _ .. 46.- Electrical .Bonding - - - - - -- - - - - - - . Steel.Reinforce _' . - _ 47. Rough Plumbing & Pressure Test - -- -- - - - -6. Electrical UFER Grn. ._._ . `�. 48. APPROVAL TO COVER-GUNITE 7. --Footings _ _ •___ 49. Electrical Conduit-Undr rn - 8. - Foundation - -- • - - - - - _ 50: Gas Pipe, -❑ Undr rn, Test ` - - 9. -Water Pipe-Undrgrn - - 51. Backwash Lines P -Trap.❑ Undrarn 40. Structural Floor System 52.: APPROVAL TO DECK - - " - - 11. -Property-Sewer Line&.House-Connection- - - 53. Backwash &'Recefor-Final - 12. - -Street Sewer -Connection- - =- "_ - -- - -- - 54: Heater & Vent -Final 13. Rough Plumbing-_Plumb nal i 14. Rough Electric -Conduit - - - - - 56." Electrical -Final ;t c. 15. Rough Electric -Wiring _ -- - -' 57: Solar System -Final- '- Ms Rough Heating & Air Conditioning- - _ _-_ -•r ' -- --- - ' -- - - -bU. Fencing.&Access Approval 17-, -Ducts-in-Structure- - APPROVED.FOWP•L'ASTERING' `. Ducts,Ventilating' x - - f t--`= - - -- - - - --' - - - x'60._ -POO L/SPA.SYSTEMS FINAL 19.' Gas Pipe-Rough,&Test' ' '" ' " ' i -,i. - -, - - -20.-' -Roof Framing 1 21.! Roof Sheathi -- -NOTES: -22. Frame and Flashing, - - - -- -- - -- y--- t -. _ 1-23t -Insulation- -24'-- Lathin &Siding - - -- - -- - --:-' - -= - - - - '- - 1-25.4- Drywall Nailing -_.- --- rr , r• - -. -- ,-26.:...Plaster Brown Coat- --- - -- -- - --1 - -- .. r - 1- 27. - Electrical Power Meter -Final - - - -- - - --- - -' - ;- - -- - ! • 28:1 Final Electric- - - - - i 1Z : . n` t 29:i --Final Heating-& Air Conditioning-- -- - - -- - - - - -- 30a Final Gas Pipe -Test- :a ' -31. Final -Plumbing-- 32.'- Water Service -Final--- - 33.- Gas Service -Final= -7 34. Solar Domestic=Final 35. Landscape Sprinkling System 36. Sound Attenuation -- - - • _ __ _ _ - - --'c - -• - ' 37. Handicap Regulations - ., • c .. _._ - ,. ", " • U .. " .,• 38. FINAL STRUCTURE & BUILDING .39. Special Requirements Completed - _ _ _ _ _ `•'_ -'-- - -"` •' •` •" ' 40. Electric. Release •.to Edison - _ T•� �� - - --' - 141. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY - No= Date - :- - --- i "' Applicant to fill in all n CIKV'OF COSTA MESA PE IT Nc e CONSTRUCTION PERMIT. I �' License No. Address Contractor t hereby affirm that I am licensed under provisions mencing with section 7000) of Division 3 of Professions Code. and my license is in full within heavy border lines and sign all appropriate declarations DateL " a � Signature TRACT NO. LOT NO. 31 p/ 1 N - TYPE OF CONSTRUCTION Z NEW ❑ ADD ❑ ALTERATION I hereby affirm that I have a of is consent to self -insure or a Certificate of Workers' COmpensatt nsurance, or a certified copy ❑ REPAIR ❑ CONVERSION El DEMOLISH ZONE - - ❑ OTHER GRADING CU. YOS. DESCRIPTION OF WORK aIlcy No. - Company TYPE OF PERMIT - ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHAI PLAN CHECK ,ertlfied Copy Is hereby furnished. :ertified Copy Is flied with the City Building Division. er 9 (Com- iness and ❑OTHER �d effect. C7/] PROJECT DESCRIPTION SQ FT EXEMPTION EXEMPTION FROM WORKERS' COMPENSATION DECLARATION DateL " a � Signature ' GASSERVICE _ WORKERS' COMPENSATION A 'OCCUPANCY_ CONSTRUCTION TYPE_ I hereby affirm that I have a of is consent to self -insure or a Certificate of Workers' COmpensatt nsurance, or a certified copy , VALUATION - ZONE - - thereof (Section 3800, Lab. C.). GRADING CU. YOS. ACRES _ aIlcy No. - Company MECHANICAL PLAN CHECK ,ertlfied Copy Is hereby furnished. :ertified Copy Is flied with the City Building Division. REMARKS: 3,5-3 0-100,000 BTU_ 100,000 + BTU ' EXEMPTION EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (ThIS-section need not.be completed if the permit is for one hundred EXHAUSTSYSTEM . MULTIPLE ($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 sqA to become PLUMBING , PLAN CHECK subject otho/W�orkera Compensation Edi CaliforryiS -_ BATHTUBS - SHOWERS Date �' e ° `�Slgnature / NOTICE: If afar making this C Oo u ultl became subject to the Workers' Componsa[Ioi51 s f the Labor Code, you must forthwith comply with such Vlw Of r this permit shall be deemed TOILETS- ,( URINALS LAVATORIES DOUBLE LAVS revoked. - . - KIT. SINKS - DISHWASHERS CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the per- formance of the work for which this permit Is Issued (Section 3097 Civ. Lender's Name - - C.). SERVICE SINKS SUMPS FLOOR SINKS FLOOR DRAINS' _ _ Lender's Address DRINKING -FOUNTAINS OWNER BUILDER DECLARATION - I h b ffi that l t f theContract t INTERCEPTORS CLARIFIERS ere y a rm a am exemp rem Or s License Law or the following reason (Section 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 re- quires the applicant for such permit to file a signed statement that he Is licensed pursuant to the provisions of the Contractor's License Law EChapter 9 (commencing with Section 7000) of Division 3 of the usmess'and Professions Code) or that he is exempt therefromandthe basis for the alleged exemption. Any violation of Section 7031.5 by applicant for a permit subjects the applicant to a Civil penalty of more than five hundred dollars ($500). ., downer of the property, or my employees With wages as their sole COsmpensatlon, will do the work, and the Structure is not Intended or ollered for sale. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of a property who builds or Improves thereon, and who does such work himself or through his 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 Will have the burden of proving he did not build or Improve for the purpose of sale). ❑ I, as owner of the properly, am exclusively Contracting with licensed contractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to. an owner of property who builds or Improves thereon, and who con- tracts from such projects with a contractor(s) litesned pursuant to the Contractor's License Law). ❑ 1 am exempt under Section B. & -P. C. for this reason S2CL� Lliaaf /y Dale /l; � Owner I hereby certify that I have read this application and :tate that the above Information Is Correct. I agree to compiY With all City and county Ord lnances and state lawsrelating to construction, and hereby authorize representatives of this city t , enter upon the above mentioned Property f r t pU Ses. _ WATER SERVICE ALTERATION GASSERVICE OUTLETS- ' WATER HEATERS 'BTU OUTPUT SEWER CONNECTIONS ' SOLAR TANK - COLLECTOR: SOLAR PIPING SYS. - '• -- - ISSUE FEE - POLE LIGHTS MECHANICAL PLAN CHECK HEATING SYSTEM AND DUCTING 0-100,000 BTU_ 100,000 « BTU _ REFRIGERATION SYSTEM 0-100,000 BTU_ 100,000 + BTU BOILERS BTU SYSTEM REPAIR, ALTERATION EXHAUSTSYSTEM . MULTIPLE Sign lurq�Odt1g 2'-" / Drivers�LIC n5 r��- - ISSUE FEEr��-" ' ISSUE FEE - -- CMF -46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor A.P.. 99 ZONE 1919 .12/17/72 ZONING REGULATIONS PLNG. REF. �F. REAR YARD (TO PKG. SPACE REQ. STREET WIDTH ZONING APPROVI SPECIAL CONDITI ELECTRICAL PROVIDED PARK FEE $ DATE PLAN CHECK' '- GENERATOR ' TRANSFORMER APPLIANCE 0-1 KW— •10-50 KW_50+KW KW 'MOTORS (INC. SOLAR).. 0.1 HP -1.10 10-50 HP_--50+HP HP ' '- FIXTURES'" -OUTLETS - SWITCHES - ' GAS TUBE SIGNS - '• -- - - - POLE LIGHTS $• PLAN CHECK POLES METERED SUB - PANELS- MAIN- - '-'SUB '- SERVICE - -' Is AMP - GRADING. Is PLAN CHECK $ - ISSUE FEE $ - h.09 TL APPLICATION APPROVED BY(le,Ct7, s -•f DATE/Z"/f/ L SUMMARY OF FEES - 'BUILDING - - - - PERMIT $ .SMIP $• PLAN CHECK SPERMIT ISSUANCE $ PLUMBING Is - GRADING. Is PLAN CHECK $ ELECTRICAL $ - $ PLAN CHECK $ - MICROFILM Is MECHANICAL $ TOTAL FEE $ • PLAN CHECK $-- - LESS AD - - VANCE PC $ _ _ FINAL FEE $ C` �T CONSTRUCTION AND PLANNING- APPROVALS Permit # ::J u� Date - Inspector POOL & SPA, APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole - _ - _ 43. Pool & Equipment location- - - 2. SoilPipe-Undrgrn 44. Steel Reinforcement - 3. Electrical Conduit Utility-Undrgrn -45. Forms 4. Electrical Conduit-Undrgrn _ 46.. Electrical Bonding - 5. Steel ein orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn _ 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P -Trap.❑ Undrqrn - - - - - 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 13. Rough Plumbing-. _ _55. Plumbina System - Final 14. Rough Electric -Conduit - - - -- -56: Electrical -Final - 15. Rough Electric -Wiring - - 57. Solar System -Final 16. Rough Heating & Air -Conditioning - - -- .. _bd. Fencing & Access Approval - 17. Ducts in Structure 59. APPROVED FOR PLASTERING: 18. Ducts, Ventilating 60.•, POOL/SPA SYSTEMS FINAL - 19. Gas Pipe -Rough & Test 20. Roof Framing 21. Roof Sheathing NOTES:_ 22. Frame and,Flashing - 23.- -Insulation --- 24. Lathing & Siding _ 25. Drywall Nailing -.- - . • - - 26. Plaster Brown'Coat - 27.- Electrical Power Meter -Final- --28. - Final Electric-- - 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 Srinklin System - 36. Sound Attenuation 37. Handicap Regulations - - 38. FINAL STRUCTURE & BUILDING ' 39. Special Requirements Completed 40. Electric Release to Edison - -- 41. Gas Release to Southern California Gas Co. 42. • CERTIFICATE OF OCCUPANCY _ No Date Applicant to fill in all spaces within heavif'iidrd¢Yllne nd sign al0eppropo.te declarations. 'O� COSTA MESA F -PTB MIT NO. - TRACT NO. LOT NO. B'cOG. NO. • CONSTRUCTION PERMIT AF SS 131 -' � AO - Project Address 17J5G TYPE OF CONSTRUCTION _ W NEW ❑ ADD 13 ALTERATION Owner Phon -C, --ZONING-REGULATIONS ❑REPAIR ❑CONVERSION QOEMOLISH Addre55 A OTHER _ Arch/Eng. -- - License No. - DESCRIPTION OF WORK Address ..._ .__ SETBACK T. PTTROPERTYNLI NE 'Contractor D - - Phone- " .TVPE OF PERMIT. - - Address - - ' - - - Q FOUNDATION ❑ STRUCTURAL R-MmT _ - ��❑///GRADING pQ T ENANT piiELECTR ICALXPLUMBING QMECHANI / ` ❑ OTHER LICENSED CONTRACTOR DECLARATION - I hereby affirm III I am licensed under provisions of Charter 9-(com- 'mencing with section -7000) of Division 3 of the Business'and. REAR YARD (TO'P/L)- .. - - - - - - Professions Code, 'and my license Is In full force and ,effect. PROJECT DESCRIPTION PKG. SPACE REQ: -,_,7-- -- IDED- - License Class License No.- - "�-a„.;t, SQ • FT. •�- •" !'rtI•� - OCCUPANCY%' ONSTRUCTION TVP VALUATION20NE Oate - - -' Signature _ _ _ . _ _ .t' :WORKERS'COMPENSATION DECLARATION_ _ 1 hereby affirm that I have a certificate of consent to self -Insure or a 0 certificate of -Workers' Compensation Insurance, or a certifled.copy .thereof (Section 3800, Lab. C.). GRADING CU. VCS. ACRES Oertified �'cy No. - Company - - ke t.:ertifiedcopy l5 hereby furnished. _ - .. copy Is�flled with the city Building Division. jEEMPTION-FROM'WORKERS"COMPENSATION DECLARATION (This section need not -be completed if the permit is for one hundred ;($100) or less). I I 11_certify that n the performance of the work for which this permit Is issued, I shall not employ any person In any -manner so as to become - - - REMARKS. _. _ lv 1- _ '•, - ,=,s2 / PLUMBING '-PLAN CHECK ' subject -to the Workers Compensation Laws of California._. � BATHTUBS "'"" 'SHOWERS - -- - - _ i -- IDate Signature If after making this declaration, you should become subject -(TOILETS-- .URINALS -- �- ,NOTICE: to the Workers' Compensation provisions of the Labor Code, -you must ,forthwith comply with such provisions or this permit shall be deemed - LAVATORIES DOUBLE LAYS-- --- '- ,revoked.- CONSTRUCTION LENDING AGENCY KIT.SINKS- - -DISHWASHERS F SERVICE SINKS1 SUMPS- - -I - :I hereby affirm that there is a construction lending agency for the per- 'formance of the work for which this permit is issued (Section 3097 'FLOOR SINKS ', FLOOR -DRAINS h .Civ.C.). -- - - --'-'- Lender's Name "LenderY'Atldresz ` .\ - _ 'DRINKING FOUNTAINS- I! •- -- .OWNER BUILDER DECLARATION '.hereby -affirm that) am exempt from,the Contractor's License Law for - A 'INTERCEPTORS - CLRIFIERS ' ' ,( the'followin-g reason'(Seation 7031.5°Business and' Professions Code: Any city or county;which'requires a permit to construct, alter, improve, demolish or -repair any itructilre; prior to its 'Issuance, also're= quires'the applicant for such permit to.file a signed statement that het is licensed pursuant to -the provisions of the Contractor's=License-Law (Chapter 9 (commencing with Section 7000) of Division' 3'of the SWIMMING POOL " P TRAP - - ' WATERSERVICE"" ''ALTERATION - - GAS SERVICE OUTLETS - ` WATER HEATERS BTU OUTPUT Business and Professions Code) or that he is exempt therefrom and the nasis fo r'the alleged exemption. Any violation of Section 7031.5 by w --applicant for a permit subjects the applicant to a civil penalty r;"rof more than five hundred dollars ($500). _ SEWER CONNECTIONS - r SOLAR TANK •. •- COLLECTORS - u'I, as owner of the property,. -or my employees with wages a5 Meir �sole. compensation, .will do the work, antl the structure is not intended or offered for sale. (Section 7044, Business and Professions Code: The' _ - SOLAR PIPING SYS. -- - Contractor's License Law does not apply to an owner of a property '- ISSUE FEE' who builds or improves thereon, and who does such work himself or through. his.own employees„provided that such improvements are not intended or offered for sale. If, however, the building or improvement tis sold within frac year of completion, the owner will have the burden proving J)€ did not build or Improve for the purpose of sale). I, as, owner of the property, am•exclusively contracting. with lice sed contractors to construct the project (Section 7044, Business MECHANICAL PLAN CHECK - _ HEATING SYSTEM 0-100,000 BTU - AND DUCTING-- 100,000 + BTU and Professions Code: The Contractor's License Law does not apply to _ . REFRIGERATION 0-100,006 BTU an owner of property who builds or improves thereon, and who con- !tracts -from such projects with a - co of ractor(s) IIces ned pursuant -to .the Contractor's License Law). SYSTEM 100,000 + BTU - ❑ 1 -am exempt under Section' - - B.'!L P. -C. furthis reason - - - - BOILERS BTU Date Owner SYSTEM REPAIR, ALTERATION I hereby certify thatf have read this application and state that the above EXHAUST SYSTEM MULTIPLE Information Is correct. I agree to comply with all city and county .. 'ordinances and state laws relating to construction, and hereby authorize ,representat,f9ps of 5 ck to-' n er t the' above mee��!boned' property- o in5pe pos-a Signature Date - e �\ \ • I PLUMBING - E Drivers' License or S - -- ISSUE FEE CMF 0865-46 Wlite-Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor 6331 5/25/82 ,349.88 - r --ZONING-REGULATIONS A.P. 5F' '- - 'ZONE - - PLNGpp. gRg �iE/1�F��. pp$'LC SETBACK T. PTTROPERTYNLI NE YARD . _ CA R-MmT _ - ' REAR YARD (TO'P/L)- .. - - - - - - - PKG. SPACE REQ: -,_,7-- -- IDED- - 6 STREETWIDTH-- PARK FEE$- - ZONING APPROVED BY r V DATE SPECIAL CONDITIONS:- - ,ELECTRICAL - -- 'PLAN CHECK'. ' SQFT_ SO -FT 'GENERATOR 0 -1 -KW -1-10K W s TRANSFORMERtit 'APPLIANCE --10-50 KW-2t_KW MOTORS - -.-_.0-1 HP_1-30 HP' _ _ ((INC. SOLAR) .10-5.0 HP 50+HP' -FIXTURES 7-OUTLETSV SWITCHES GAS TUBE SIGNS. .` • ' 7 POLE LIGHTS .-. POLES - METERED - SUB - PANELS- --MAIN SUB SERVICE. _ _ _ _ _ -� AMP'_' - ISSUE,FEE i. -'APPLICATIONBy, DATES; OAPPROVED SUMMARY OF FEES "� -- - i BUILDING. �$ PERMIT PLAN CHECK E=- -PERMIT ISSUANCE $- PLUMBING - E ' GRADING' PLAN CHECK” $ , • ELECTRICAL- $ �) MICROFILM E PLAN CHECK E I TOTAL FEE $ MECHANICAL $ LESS AD PLAN PL/AJ�N CHECK '$ VANCE PC cSr 77-�Q_'FINALFEE $y V"= 3' � _4 APPROVALS CONSTRUCTION AND PLANNING Permit # -•35'.31 Date Inspector POOL & SPA , • �' - Date Inspector APPROVALS Permits _ 1. Temporary Electrical Service or Pole _ _ - 43. Pool & Equipment Location - 2. SoilPipe-Undrgrn 44. ,Steel Reinforcement T. Electrical Conduit Utility-Undrgrn - - 45. Forms - 4. Electrical Conduit-Undrgrn- -. - - - - - 46. Electrical Bonding - 5. Steel em orce - .. 47. Rough Plumbing g & Pressure Test - -6.- Electrical UFER Grn-_ _ _ _ _ - 48. APPROVAL TO COVER-GUNITE -- - 7. - Footings i _ _ __ - 49. Electrical Conduit-Undr rn - 8. --Foundation- -- - -- - ----- - - - 50. „Gas Pipe, ❑ Undr Fn; Test ' - 9. Water-Pipe-Undrgrn -- - - - dZ - 51. Backwash Lines P -Trap❑ ndr rn 10. Structural Floor System - - - - 52..- APPROVAL TO DECK - 11. Propert Sewer Line & House Connection 53. =Backwash & Receptor -Final 12: -Street-Sewer-Connection - -- - - ` - - - - - - - - 54. Heater & Vent -Final - 13r Rough Plumbing - - - - 14. _ Rough Electric -Conduit 56. -Electrical-Final 15. Rough Electric -Wiring -57. .:Solar System -Final- 16. Rough Heating & Air Conditioning-- _- - - _ - encing'&.Access Approval " 17. Ducts in Structure 5F APPROVED FOR PLASTERING 18.' Ducts, Ventilating - .60. POOL/SPA SYSTEMS FINAL - .. 19. Gas Pipe -Rough .& Test - - - - - ' 20. Roof Framing. _ _ . - - . - - - - - -f - --- 21. Roof Sheathing- -'-- -•• - - - ' NOTES:,- 22.- -Frame and Flashin %_ - 23. Insulation - - - - t 24. Lathing & Sidint- - - - -- -- --- - - - -- • - - 25. Drywall Nailing •- /o._ - - 26. Plaster Brown'Coat - - - - 27. Electrical Power Meter -Final - - - - - -- § f I -u >802 28. Final Electric" -- -" - - - / - - 2Z -221. U' 29. Final Heating & AirConditioning 30. Final Gas Pipe -Test - -- - - - - - - - -- - - - ' 31c Final'Plumbing 12-20 32. • Water Service -Final - - - 33. - Gas Service -Final - 34. Solar Domestic -Final - - 35. Landsca e Sorinkling System 36. Sound Attenuation 37. Handicap Regulations - --� ' 38. . FINAL STRUCTURE & BUILDING -;z/-132 -39. Special Requirements Completed 40. Electric Release to Edison• - - - - 41. Gas Release to Southern California Gas Co. • 42. CERTIFICATE OF OCCUPANCY No. - t' Date - , 3 - -- - Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITE'! OF COSTA MESA - Pe�MI-NO.Q� TRACT NO. LOT NO. BLDG. NO. f I CONSTRICTION PERMIT 7 {3/\ Project Address - TYPE OF CONSTRUCTION - 'Owner Phone,667- Q D NEW D ADO. D ALTERATION, iAddre ❑REPAIR 000NVERSION El DEMOLISH Arch/Eng. -- License No. D OTHER Address - - - - - OESCRIPTIONOFWORK \ Contractor Phone - TYPE OF PERMIT Address - - —" D GRADING --D FOUNDATION- DSTRUCTURAL LICENSED CONTRACTOR DECLARATION— �s I ', D'TENANT D ELECTRICAL EIPLUMBING-OMECHANICA I hereby affirm that I am licensed under provisions of Charter 9 (cam- r I mencing with -section 7000) of Division 3Of' the 'Business-and-D'OTHER' 934i. ' 3/ 16/6/62 ZONING REGULATIONS A.P. T- I ZONE PLNG. REF.$ ProfesslonS Code. and my 'license is in full force and effect. PROJECT DESCRIPTION REAR YARD (TO P/L) License Class License No. - - - - - - _ PKC. SPACE REQ, Date Signature ' - - - •SQ �FT. STREET WIDTH WORKERS' COMPENSATION DECLARATION- - - — - OCCUPANCY_CONST,RUCTIONTYPE I hereby affirm that I have a certificate of Consent to self -Insure or a 'Certificate' of Workers' Compensatlon-Insurance', or a certified copy_ VALUATION - ZONE, 1' -of (Section 3800, Lab. C.), - - -.. _ _ ..RADING CU. YDS. G I Np. Co mPany _ .-ACRES _- L _drtified copy is hereby furnished.-- - -- - - - - D Certified copy 15 filed with the city Building Division. REMARKS: - - - --• - - ------ 0-100,000 BTU _ 100,000:1 BTU _ EXEMPTION FROM, WORKERS' COMPENSATION DECLARATION This section -need not be completed -if the permit -Is -tor one hundred - -�-�- I - 1$100) or less). -- SYSTEM REPAIR, ALTERATION _ I certify that in the performance of the work.for which this.pwmlL is Issued, I shall not employ any person In any manner so as.to become ' PLUMBINGI - -PLAN CHECK• subject lathe Workers Compensation Laws of California. --. BATHTUBS SHOWERS Date Signature � NOTICE: If after making this declaration, you should become subject TOILETS . URINALS to the Workers' Compensation provisions of the Labor Code, you must forthwith Comply with Such provisions or this permit shall De deemed .. , LAVATORIES DOUBLE LAVS revoked: CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS - t SERVICE SINKS „) • �. SUMPS I hereby affirm that there Is a construction lending agency for the per. formance of the work for which this permit is issued (Section FLOOR SINKS FLOOR DRAINS _3097 Civ. CJ' Lender's ,Name Lender's Address DRINKING FOUNTAINS OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following- reason (Section 7031.5 Business and Professions Code: Any, City or county which -requires a permit to constr ucl, alter, Improve, tlemolish or repair any structure, prior to Its issuance, also re- quires the ap,.licant_for such permit to file a signed statement that he Is •licensed pursuant to the provisions of the Contractor's License Law INTERCEPTORS CLA'R IF IERS SWIMMING POOL PTRAP WATER SERVICE ALTERATION GAS SERVICE OUTLETS =ess antl Professions Code) or that he is -exempt therefrom -and the ;/or the alleged exemption. Any violation of Section 7031.5 by ?]pplica nl for a permit --subjects the applicant to a civil -penalty i,ot more than five hundred dollars ($500). _ 1, as owner of the property, or my employees with wages as their I Compensation, will do the work, and the Structure is not.intanded )ffered for sale. (Section 7044, Business and Professions Code: The ,tractor's -License -Law does not. apply to an owner of a property ) builds or imoroves thereon. and who does Such work himself or his one year or compieuon,.tne owner wm.nava.n did not build or improve for the purpose or of the property, am'exclusively'contrac an owner of property who oullas or Improves thereon, and vvnp Con- tracts from Such projects with a- Contractor($) licesned'- p ursuant to the Contractor's License Law). ❑ 1 am exempt under Section B. & P. C. for this reason - _ - Date- - -- Owner' - - - L hereby. Certify that I have.read this application and State that the above OInformation is correct. 1 agree to Comply with all city and County ordinances and,State laws relating to Construction, and hereby authorize representatives f this City to enter upon the above mentioned Property for pe on .pulpas§� Slgnat urq� G i Oate 1-'CZ� or SS /' ISSUE FEE White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor SEWER CONNECTIONS SOLAR TANK COLLECTOR! SOLAR PIPING SYS. y -I ISSUE FEE -SMTP $' MECHANICAL PLAN CHECK HEATING SYSTEM AND DUCTING 0-100,000 BTU _ 100,000:1 BTU _ REFRIGERATION_ SYSTEM 0-100,000 BTU_ 100,000.1 BTU _ BOILERS BTU SYSTEM REPAIR, ALTERATION _ EXHAUST SYSTEM MULTIPLE IAL CONDITIONS: PROVIDED , PARK FEE $^ DATE I. .r t ' I ELECTRICAL - PLA1N CHECKUWLLLING, 9Q. FT. - _ -90 FT- _ GENERATOR" 0-1 KW_1-10.KW TRANSFORMER APPLIANCE 10-50 KW -50 + KW I MOTORS 0-1 HP_1-3U HP rf S. (INC. SOLAR) 10-50'HP_'-- 501 HP FIXTURES OUYLETS SWITCHES GAS TUBE SIGNS - -- POLE LIGHTS - N - SUB I, - APPLICATION APPROVED BY'-'-' -'DATE - 1 SUMMARYOFTEES ,) BUILDING -- y -I 'PERMIT - $ -SMTP $' PLAN CHECK $ IPERMIT ^C ' - - ISSUANCE $, PLUMBING $ - GRADING- $ PLAN CHECK $'' ' - $ 'ELECTRICAL $ ' MICROFILM $ PLAN CHECK $ MECHANICAL -$ l TOTALFEE$- PLANCHECK-$ - VANCEPC $_ f FINAL FEE $�rOV TION AND PLANNING �J- n Date Permit#�'�'IiG`7 7Electrical Inspector POOL & SPA - _ - - -• .- .. Date nnspe6toi APPROVALS Permit#•� - ctrical Service or Pole 3_�a_ '43. Pool & Equipment Location - - - - - - - rn - _ 44. Steel Reinforcement - --- - - uit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel em orce 47. Rough Plumbing & Pressure Test. - - 6. _ Electrical LIFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49: Electrical Conduit-Undr rn B. Foundation - 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn - 51. Backwash Lines P-Tra 7-El Undrqrn 10. Structural Floor System 52. APPROVALTO DECK - ' - - -• 11. Property Sewer Line & House'Connection 53. Backwash & Receptor-Final 12. Street Sewer Connection 54. Heater & Vent-Final, 13. Rough Plumbing - - - - - 14. Rough Electric-Conduit -- --- 56. Electrical-Final - - 15. Rough Electric-Wiring 57. Solar System-Final 16. -Rough Heating &-Air Conditioning- - __ encing & Access.Approval i 17. Ducts in Structure -59. APPROVED FOR PLASTERING - 18. Ducts, Ventilating, _ 60. POOL/SPA SYSTEMS FINAL 19: Gas Pipe-Rough & Test _ - 20. Roof,Framing 21. Roof'Sheathin NOTES: - 22. Frame and Flashing _ 23. Insulation _ 24. Lathing & Siding. 25.__ Drywall Nailing 26. -Plaster Brown Coat 27. Electrical Power Meter-Final 28. Final Electric - - 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. FINAL STRUCTURE & BUILDING - 39. Special Requirements Completed - - 40. Electric Release to Edison - 41. Gas Release to Southern California Gas Co. - - ! 42. CERTIFICATE OF OCCUPANCY No Date - - - - - - Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. WATER SERVICE - -ALTERATION T + CITY OF COSTA MESA -- PERMIT NO. TRACT NO. LOT NO. BLDG. NO. - - - CON$TRUCTION PERMIT J�(o 3_8_31 3_/29/82 Project Address 24.JC ,=/_,�-E 1&5 D6 TYPE OF CONSTRUCTION . '? .• - ' Owner P[�[�J Ov�,e7/ ne ❑ NEW IOADD ❑ ALTERATIONIj SOLAR PIPING SVS. - '-Address--- - - - - ❑REPAIR CONVERSION ❑DEMOLISH through his own employees, provided that such Improvements are not MECHANICAL PLAN CHECK '11 ❑ ZONING REGULATIONS' -Arch/Eng,' - - License No. - - - OTHER f/- A P 9F 49f7 '0 -0 Address DESCRIPTION OF WORK SYSTEM REPAIR, ALTERATION I hereby certify that I have read this application antl state [hat the above EXHAUST SYSTEM MULTIPLE - - ZONE PLNG. REF. qp r CpntraclorjCL 7=/,QF Phone S"4.e-/j TYPE OF PERMIT �R0%TIkjpylNa q Address I -W41' 11',Wl,!"/[(/$ GAQW41t/ G .O GRADING ❑' Fp UNDATION O STRUCTV RAL SETBACK ID YARD - -LICENSED-CONTRACTOR DECLARATION_ ❑ TENANT ❑ ELECTRICAL"OPLUMBING ❑MECHANICA I hereby affirm th4t I am licensed 'under provisions of Charter 9 (com. $ 55EpD _ RIGHT 'mencing-with-section 7000) of; Division 3 of -the Business and ❑OTHER 1 Professions Code, and my license is In full force and effect., REAR YARD (TO P/L) -/-� --- r PROJECT DESCRIPTION ;LlcenzeC sd- t.lcen`ze'N ,y, PKG. SPACE REQ. PROVIDED (Date / E "- Signature 'v Q. FT' +• - WIDTH PARK FEE E IWORKERS'COMPENSATION DECLARATION- --- —'CONSTRUCTION -TYPE ,STREET II hereby affirm that I have a certificate of consent self-Insureor.a ,VALUATION 240'0 ZONE - ZONING APPROVED BV S• DATE •" -certificate of -Workers' Compensation dnsurance,-or-a-certified-copy ;thereof (Sectlon� X�38809q ] . GRADING CV. YDS. r ACRES SPECIAL CONDITIONS: Icy Nf?Za.C/C./% _ nn��.-omPanY_ Certified copy,ishereby furnished." _.. _ __ _ - REMARKS: µ'I= -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 tobecomePLAN CHECK ELECTRICAL PLAN CHECK subject to theWorkers' Compensation Laws of California.' a Sl9nature I SHOWERSDate t SOFTNOTICE: If after making this declaration, you should become subject(t>URINALS +GENERATOR- 0-1 KW_1-10'KW .to the Workers' Compensation provisions of the Labor Coda, you must ;-�- 'TRANSFORMER 'forthwith comply with such provisions or this permit shall be deemedDOUBLE _ LAVS - APPLIANCE 10.50 KW=50 + KW revoked.--_ I s_ "-DISHWASHERS '�MOTO Rs'- 0.1 HP_1-10 He _ _ _CONSTRUCTION LENDING AGENCY 9 hereby affirm that there is a construction lending agency for the per -.Sumps -' `" - (INC: SOLAR)- - 30.50 HP -50 + HP .formance of the work for which this permit Is Issued (Section 3097 SINKS + FLOOR DRAINS FIXTURES * -OUTLETS-- SWITCHES Civ: Col.- IL.ender's.Name Lender's Address ^i DRINKING FOUNTAINS ' - - GAS TUBE SIGNS "- OWNER BUILDER DECLARATION -^ ' " ,'S -' - - - — IN INTERCEPTO Rs CLARIFIERS POL"E LIGHTS - 1 hereby affirm that I am exempt from the Contractor's License Law for POOL P TRAP " -- "- - - - the following reason (Section -7031.5 Business and Prof esSio ns Cotler- .Any city or county which requires a permit to construct, dl[er, POLES METERED SUB uiresthea Ilcant for such ��> �! ,u v„o, q p. Perms[ to file a Signed statement that h¢ WATER SERVICE - -ALTERATION T - GAS SERV ICE OUTLETS - Is licensed Pursuant to the provisions of the Contractor's License Law' (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the `•SIS for the alleged exemption. Any violation of Section 7031.5 by WATER HEATERS BTU OUTPUT I SEWER CONNECTIONS -' applicant for a -permit subjects the applicant to a-civll penalty lot more than five hundred dollars ($500). SOLAR TANK' ' -- COLLECTORS- ' .� 1, as owner of the property, or my employees with wages'as'their Sole compensatl on, will do the work, and the structure Is not Intended -(Section or offered for sale. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of a property SOLAR PIPING SVS. - ISSUE FEE - who builds or improves thereon, and who does such work himself or through his own employees, provided that such Improvements are not MECHANICAL PLAN CHECK Intended or offered for sale. If, however, the building or Improvement Is sold within one year of completion, the owner will have the burden of proving he did not build or improve for the purpose of sale). (] 1, -.as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply Lo HEATING SYSTEM 0-100,000 BTV gryD'DUCTING"' - - 0 100,00+ BTU REFRIGERATION 0-100,000 BTU SYSTEM - '- -- 100,000+ BTU an owner of property who builds or Improves thereon, and who con. tractsfromsuch-projects with -a contractor(s) Iicesned- pursuant to- the Contractor's License Law). ❑ I am exempt under Section - - - B. & P. C. for this reason BOILERS BTU Date Owner SYSTEM REPAIR, ALTERATION I hereby certify that I have read this application antl state [hat the above EXHAUST SYSTEM MULTIPLE - - information is correct. I agree"to' co�1ply wi th'all city antl"county ordinances and state laws relating toy�pf}� and hereby authorize �njtruction, representative of "this city to a upon the above mentioned property f ospection __ Signature /L✓ A��+ -- "tX Date�� rivers' License or SS III, ISSUE FEE -46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor PANELS - MAIN , 64:02 TL 1, -NJ ',APPLICATION APPROVEDBY&/ 'DATE7Ta SUMMARY OF FEES, I BUILDING . SD". - - PERMIT $ SMIP -. ATE "S�_ i PLAN CHECK $ _ PERMIT .r. t.. -�T"' ISSUANCE E 'PLUMBING $ �§ GRADING $ - - - PLAN CHECK � ELECTRICAL E - PLAN CHECK $ MICROFILM E MECHANICAL TOTAL FEE$ _ •PLAN CHECK E LESS AD- VANCEPC, E_ ` -_ / FINAL FEE E CONSTRUCTION AND PLANNING y� 30%� Date Inspector APPROVALS Permit # J POOL & SPA - APPROVALS Permit Date Inspector, 1. Temporary Electrical Service or Pole 43. Pool &'Equipment Location• 2. SoilPipe-Undrgrn - 44. Steel Reinforcement - 3. Electrical Conduit Utility-Undrgrn _ 45. Forms - - - - 4. Electrical Conduit-Undrgrn 46. Electrical Bonding5. - - Steel em orce 47. Rough Plumbing & Pressure Test -- 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE -- 7. Footings - 49. Electrical Conduit-Undr rn 8. Foundation - 50. Gas Pipe, ❑ Undr Fn, Test • ' 9. Water Pipe-Undrgrn 51. Backwash Lines P-Trap.0 Unclrtrrn - - 10. Structural Floor System 52: APPROVALTO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final - 12. Street Sewer Connection ' ' - _' 54. Heater & Vent -Final 13. Rough Plumbing 55 Plumbina System----- - - - - - 14. Rough Electric -Conduit -- -56. Electrical -Final ' ' 15. Rough Electric=Wiring - _ ' - - - 57. Solar System -Final 16.- Rough -Heating & Air Conditioning - - - _ _ __ encing & Access Approval 17. . Ducts, in Structure _ _ _ _ APPROVED FOR PLASTERING 18. 19. _ 20. - Ducts,.Ventilating Gas Pipe -Rough &Test _ _ Roof -Framing 60. POOL/SPA SYSTEMS FINAL' 21. '- 22. Roof Sheathing• Frame and Flashing _ _ _ NOTES: • ,�' 23. Insulation / _ 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27._ Electrical Power Meter -Final 28.-.Final'Electric 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 ••� t - 35. Landscape Sprinkling System ' 36. Sound Attenuation - - - - r 37. Handicap Regulations - - - - 38. FINAL STRUCTURE & BUILDING `•- 39. Special Requirements Completed - -' 40. Electric Release to Edison -- 41. Gas Release to Southern California Gas Co. . 42. CERTIFICATE OF OCCUPANCY _ - No Date APPlicant to fill in all spaces within heavy border Ifnesand sign all appropriate declarations. *21 C11'Y OF COSTA MESA - P MIT O. TRACT NO. LOT NO. BLDG. NO. _ 3795 3/26/82 9.00 CONSTRUCTION PERMIT 2-y'677 OF CONSTRUCTION NEW ❑ ADD ❑ ALTERATION :W ❑REPAIR ❑CONVERSION ❑DEMOLISH ❑ OTHER - DESCRIPTION OF WORK ` - - A.P. $ -ZONE - - - ZONING REGULATIONS - PLNG. REF. T Project Address par, Fiqrhpr Stp _- Owner Phone Add 55 2 N pw - Arch/Eng. - License No. ' - - Address - -. Contractor Phone ^ - TYPE OF PERMIT - 'SETBACK ING ��etiFv uNE MO Add ss 1' Om n0 eim _ ,❑GRADING .-❑ FOUNDATION ❑ STRUCTURAL ❑ TENANT'I] ELECTRICAL ❑PLUMBINGIMECHANiC • T SIO YARD I E Y LHI�HT - -r LICENSED CONTRACTOR DECLARATION= ` 1 horeb affirm thLt I licensed under Charter am s tom• y provl5lof of mooting with section 7000) of .Dlvi5lon-3 of [h0 Business and , ,', r-, ' ` rOTHER' - --- - Professions Cof�e, d my license is In full fort au{ p�fecl. ly . ; PROJECT DESCRIPTION'. _ -. - - - _ REAR YARD (TO P/L) - __ License Class "-2� Lice No.�Y� , ' PKG. SPACE REQ. PROVIDED -A-83 _' - - SQ. FT. - - Date Signature WORKERS"COMPENSATIONDECLARATION . - OCCUPANCY_ CONSTRUCTION TYPE STREET WIDTH -PARK FEE E -D ,Lhereby affirm that I -have a certificate of consent t0 self -I sure or a - - ZONE -ZONING APPROVED BY - _ ATE I` 'rci/lcate of -Workers' Compensation Insurance, or a-certifled-copy --VALUATION thereof (Sec' 3 lab. C.). I ka!F'- I GRADNG.CU. YDS; ACR IES SPECIAL CONDITIONS: - - ,cY Np. company- Goodman Ins: - - - - - - erti/led copy Is hereby furnished, - - - - REMARKS:- - �r Certified copy Is filed -with the city Building Divislon. _ EXEMPTION FROM WORKERS' COMPENSATION DECLARATIONThis section nped.not be completed if. the permit Isfor one.hundred ' or IesSI. 1$1001 cert fy that n Cha 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 _ PLAN CHECK subject to the Workers' Compensation -Laws. of California. _ BATHTUBS BS SHOWERS - _ ate pate Slgnature If after making this declaration, you should become subject TOILETS_ URINALS -' ' GENERATOR 0.1 KW_ 1-10 KW to the Workers' Compensation provisions of the Labor Code, you must TRANSFORMER _ - forthwith comply with Such provisions or this permit shall bo tleemed LAVATORIES DOUBLE LAYS' ( APPLIANCE '10-50 KW_50 + KW' - revoked. 'CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS , -" " -'MOTORS --' 0-1 HP 1-10 HP 1 hereby affirm that there IS a construction lending agency for the per. SERVICE SINKS '- SUMPS - -- ,(INC. SOLAR) 10.50 HP_50 + HP - - - - formance of the work for which this permit_ Is issued (Section 3097 FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS' SWITCHES- C.). Len - - - Cie. C.).r's Name _ _ _ Lender's Address DRINKING FOUNTAINS_ a - ;GAS'TUBE SIGNS -- OWNER BUILDER DECLARATION" - INTERCEPTORS CLARIFIERS .. POLE LIGHTS" - -- I hereby affirm that I am exempt from the Contractor's License Law for -SWIMMING POOL - P TRAP - - " --' POLES - - - ' METERED T -SUB the following reason (Section 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 re- WATER SERVICE ALTERATION - -,PANELS ---MAIN' - -, SUB quires the ap, licanl for such permit to file a signed statement that he GAS SERVICE OUTLETS - SERVICE - ' - AMP-- ' Is licensed pursuant to the provisions of the Contractor's License Law E(Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT _ iners'and Professions Code) Or that he Is exempt therefrom and the I- --s for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS - applicant for a' permit subjects the applicant'to a 6,11 -penalty of more than live hundred dollars ($500). SOLAR TANK •COLLECTORS - V 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the slruclure.i5 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 properly - I�.' ISSUE FEE 'APPLICATION APPROVED BYDATE who builds or improves thereon, and who does Such work himself or through -his own employees, provided lhat.such Improvements are not MECHANICAL PLAN CHECK SUMMARY OF, FEES Intended or offered for sale. If, however, the building or improvement Is sold within one year Of completion, the owner will have the burden of proving he did not build or improve for the purpose of sale), r HEATING SYSTEM 0-100_000 BTU BUILDING' PERMIT E MIP S. ❑ I, as owner of the property, am exclusively contracting with AND DUCTING -- '-' - -- licensed contractors to construct the project (Section 7044, Business 100,000+ BTU PLAN CHECK $ PERMIT' and Professions Code: The Contractor's' License Law does not apply to - - - - - -ISSUANCE- $ -V=M-- an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING E tracts from such projects with a-c,ntractor(s) Iicesned pursuant to SYSTEM - •' - 100,000': r - - GRADING -$ ' the Contractor's License Law). ❑ I am exempt under Section B. & P. C. for this BTU PLAN CHECK E . -• E BOILERS BTU ELECTRICAL E - season --- � - SYSTEM REPAIR, ALTERATION EXHAUST__S_YSTEM_ MULTIPLE -PLAN CHECK' `$ 'MECHANICAL $ ! _ 'MICROFILM E - -��— _ 'TOTAL FEE E LESS AD- r ' Dale - "- Owner - I hereby certify that 1 have read this application and state that the above Information is correct. I agree to comply with all city and county PLAN CHECK E - VANCE PC IS ordinances and State relating to construction, and hereby autM1orize - representatives of this city O enter upon -the above mentioned representatives his 9.06 Property for .i c2i p s Signature �� Date •�� 3 FINAL FEE § Drivers' License or SS T� ISSUE FEE - - - _- .]00 _. _ .-' - CMF 0865-46 W'tite-Building; Canary -Applicant; Pink -Accounting; GOIdenrod-Assessor CONSTRUCTION AND PLANNING Date Inspector APPROVALS Permit# rn� POOL & SPA - APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - - 2. SoilPipe-Undrgrn 4 Steel Reinforcement - - - - - 3. Electrical Conduit Utility-Undrgrn _ 45. Forms - 4. Electrical Conduit-Undrgrn _ _ 46. Electrical Bonding 5. Steel em orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Gr_n 48. APPROVAL TO COVER-GUNITE - - 7. Footings 49. Electrical Conduit-Undr rn - 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test _ 9. Water Pipe-Undrgrn - 51. Backwash -Lines P -Trap.❑ Un5rgrn 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 13. Rough Plumbing - - - - 14. Rough Electric -Conduit - - - - •56. Electrical -Final - - - 15. Rough Electric- Wiring " - - 57. Solar System -Final' 16. Rough Heating & Air Conditioning.- _ - encing & Access Approval 17. Ducts in Structure _ - APPROVED FOR PLASTERING ' 18. 19. 20. Ducts, Ventilating Gas Pipe -Rough & Test '� - Roof Framing ' 60. POOL/SPA SYSTEMS FINAL +. 21. 22. Roof Sheathingr Frame andFlashin ._j _ -•� NOTES: 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster.Brown Coat - 27. Electrical Power Meter -Final 28. Final Electric ' 29. Final: Heating & Air Conditioning(Z- 30. Final Gas Pipe -Test 31. Final'Plumbing. 32: Water Service-Final- ervice-Final--33.- -33.- Gas Service -Final- 34. Solar Domestic -Final 35. Landscape Sprinkling System ' 1 36. Sound Attenuation - - - - 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING - ' 39. Special Requirements Completed - 40. Electric Release to Edison - - - 41. Gas Release to Southern California Gas Co. - 42. r CERTIFICATE OF OCCUPANCY No - Date - Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. J41= .7/ID/Dc! I.aa TL - CITY OF COSTA MESA FPEFMIT NO, TRACT NO. LOT NO. - BLDG. NO. 'CONSTRUCTION PERMIT — -CO TYPE OF CONSTRUCTION O NEW ❑ ADD, O ALTERATION ❑REPAIR ❑ CONVERSION. O DEMOLISH - - Project Address 171-6 48P Owner Fu I I I clill Phone "' Addre74 Eairview - ❑OTHER( ZONING REGULATIONS , ; Arch/Eng. - License No. DESCRIPTION OF WORK ! f - - - - A.P. r -- ZONE PLNG. REF. 9F , -.. Address - - - - Coritra 1or - Phone _ .TYPE OF PERMIT 1 O GRADING , -El FOUNDATION []STRUCTURAL ��ss,," - O TENANT O ELECTRICAL I]PLUMBING'BJMECHANICA - 'SETBAC T. lO YARD Ep Tp g�1I�pING PROPERTY LINE _ _ _ ' AddressMiinaInmaAnAhelw D O LICENSECNTRACTOR D CLA ATION - I hereby affirm thzt I am licensed under provisions of Charter gl com- r - RIIGHT H - s mencing with section -7000) of Division 3of the -Business and O OTHER - -- " - -• - -' - - - . Professions Code, and my (license is in full force and effect. •' • - - 'REAR YARD (TO P/L) - �L" PROJECT DESCRIPTION: _ en o. License C�lasj - r PKG. SPACE REO. PROVIDED. oat .S-1 Signal ure - _ -50. FT. STREET WIDTH PARK,FEE$ WORKERS' COMPENSATION DECLARATION - -- - --- ' OCCUPANCV_r4 CONSTRUCTION.TYPE ZONING APPROVED BY. DA TE - I hereby affirm that 1 have a certificate of consent to self -Insure or d 1 VALUATI OIV ZONE, certificate of Workers' Compensation -Insurance, or a'certified copy thereof ('��jpp $� 0, Lab: C.). - -y NO A41 Dpm anYGoodman Ins. - . GRADIN6,cu.' YDS. _ACRES — - - SPECIAL CONDITIONS: - - ertlfledcopyIsherebyfurnished. ----- - --- --REMARKSe` ;'/% •-- --. _ _ .. p. Certified copy _Is filed with the city Building Division. - ' .. .,� 1 -, EXEMPTION FROM WORKERS' COMPE NSATIONDEC CAR ATIOIJ - - - - - - - - - - This section need not -be completed -if the Permit is for one hundred $100) or less). I ,-- certify that in the Performance of the work for whlch.this-permit is - - Issued; I shall not employ any person in any manner so as to become . PLUMBING PLAN CHECK ELECTRICAL - - PLAN CHECK - subject to lhe,Workers' Compensation taws of California.- - -.- _ BATHTUBS SHOWERS r _ . _ ' I Date ( Signature NOTICE: If after making this declaration, you should become subject _ _ _ TOILETS ,- -URINALS 'GENERATOR" - 0-1 KW_ 1-10 KW to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS - - •TRANSFORMER - TRANSFORMER "APPLIANCE - 10-50 KW_50+KW'- -- - -' -- revoked. -- - - - - - _ C CONSTRUCTION LENDING AGENCY _ _ KIT. SINKS DI SFIW ASH ERS MOTORS --- 0-1 HP _ ---1:10 HP - , I hereby affirm that there is a construction lending agency for the per- SERVICESINKS SUMPS - (INC. SOLAR) - -10-50 HP_50+HP formance.of the work for which this permit is issued (Section 3097 _ FLOOR SINKS FLOOR DRAINS '-FIXTURES OUTLETS ' SWITCHES - - - '-'- Civ. C.). Lender's Name, Lender's Address DRINKING FOUNTAINS J - - !GAS TUBE'SIGNS' -- - -- '-- " ^" - - INTERCEPTORS CLARIFIERS POLE LIGHTS' - OWNER BUILDER -DECLARATION -- - - - I hereby affirm that I am exempt from the Contractor's License Law for PTRAP - POLES METERED SUB' the following reason (Section 7031.5*Business and Professions' Code:'SWIMMING-POOL Any ,city or county which requires permit to construct, alter, WATER SERVICE ALTERATION- PANELS - - MAIN - - SUB - - - - •' _a improve, demolish or repair any structure, prior to its issuance, also re- quires the ap,. licant_for such permit to file a signed statement that he GAS SERVICE OUTLETS 'SERVICE -AMP Is licensed pursuant to the provisions of the Contractor's License law (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT - y _ - Business and Professions Code) or that he is exempt therefrom and the F- ^s for the alleged exemption. Any violation of Section 7031.5 by _ SEWER CONNECTIONS - �• - - ---- '- "- --- - - - _ applicant for a permit subjects the applicant to a civil penalty at more than live hundred dollars ($500).. SOLAR TANK COLLECTORS-- L, I, as owner of the property, or my employees with wages as their' solecompensation, will do the work, and the structure Is not Intended or offered for sale. (Section 7044, Business and N'olessions Code: The SOLAR PIPING SVS. - - I ISSUE FEE - - ' Contractor's License Law does not apply to an owner of_a property - - - - ISSUE FEE -'qp LIGATION APPROVED BY - - - 'DATE '- who builds or improves thereon, and who does such work himself or through his own employees, provided that such Improvements are not MECHANICAL PLAN CHECK SUMMARY OF FEES Intended or offered for sale. If, however, the building or improvement is sold within one year.of completion, the owner wit.have.the burden "BUILDING - of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100 BTU PERMIT § - APER E' a El i, -as owner of -the property, am exclusively con trading. with :000 AND DUCTING _ licensed contractors to construct the protect (Section Business 100,000+ BTU PLAN CHECK EPERMITand Professions Cotle: The Cuntratter's License Law do, es not F - - -- ISSUANCE E anp who c.to owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTV PLUMBING $ tracts-from"such projects with a contract Or(s) Iiceznetl pursuant to tr SYSTEM - - - " _ - - - --- - - - G0.ADING-E [he Contractor's License Law). 100,000+gTU PLAN CHECK $ � •• ❑ I arrexempt under Section B. & P. C. for this BOILERS BTV ELECTRICAL $ -- - - - - - - reason - - - - '� - - SYSTEM REPAIR, R, ALTERATION _ PLAN CHECK $ - ' MECHANICALS$ - ��' _ MICROFILM $ TOTAL FEE E l 1-0 Dale - '-' � Owner � -- - - - _ I hereby cert ifs that I have pylic and state that the above EXHAUST SYSTEM _ MULTIPLE LESS AD Information is correct. 1 agree '[o comply with all city and county agree to comply -- - -- '1PLANCHECK $ - _ - - VANCEPC $_ - ordinances and state.laws.relating to construction, and hereby authorize representatives thi city o enter upon the above mentioned - Property _tor e t n. ir - _ 1 FINAL FEE § Signature - jute ,a Drivers' License or 55 $ ISSUE FEE --' - - -- - - - - - - - - CMF 086546 W'iite-Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # Date' Inspector N POO4 SPA ' --- - -, APPROVALS_ ;, .. , ,•J Permit # - �•, .._ - Date' "Insp@ctor . _ 1. Temporary Electrical Service or Pole - '43. Pool& Equipment Location- - - ---- ------ -- - - - - - - Soil ipe-Undrgrn-_',•'. '• r. ". - 44. Steel Reinforcement 3. _Electrical Conduit Utility_Undrgrn 45.,. Forms 4.-_ Electrical, Conduit Undrgrn _ _ __ _ _ 46. Electrical Bonding _5. Steel_em orce _ _ - -' II 47. Rou"h Plumbin"& Pressure Test 6. Electrical_ UF_ER G_rn_'-'4$. ' ApPROVAL'TO COVER-GUNITE 7,Footings 49: 'Electrical Conduit-Undr rm Q _8. Foundation _ _ __ ' _•r '' _ - -- "--- - -- 50.,, Gas.P.i e,_D.Undr r,n,.Test '+•1 _ -9.- Water Pipe-Undrgrn- - 51. Backwash Lines P-Trao. ClUn r n"w"I ^--- - 10. Structural Floor System_ 52. APPROVAL TO DECK---------- - - - 11.. Property Sewer Line &House Corinectiori 53. Backwash .&Rece tor-Final -. 12.- -Street Sewer Connection J^ °' -..J.,_: __ __54._ Heater&Vent-Finals 13._ Rough Plumbing Q__ 55=- .. .- -- . _ _ 14. Rough Electric-Conduit i---- ------- -456.- Electrical-Final _�! . ,,.•. :...,-..:.., --15 RoughElectric-Wiring -----'-"'-"------------- - 57: -Solar_System:Final j',3ltl'AUITA2K1 -C•O' '1.'•:a)POw'Or.� AWT4Y'7X: -16:- -Rough Heating &-AirConditionin - _ r _. 2 i _ -__ - encing & Access.Approval .!- •' • _-^:-�^ -17: Ducts in Structure_ _. _- ___. __'_'"_"_'_ �_ - i ' 9• APPROVED FOR PLASTERING •^• 'rn' "' +-'-"-• ' .' --18:- Ducts, Ventilating---,-,-__ _._ -- ! - t - 60. ,•., �,. _ _ POOL/SPA-SYSTEMS FINAL, -. •. r., ,� . , -r ar „..- _J! �,. 19. Gas Pipe-Rough &'Test - ., - _�.__.- _ ' -20;. Roof Framing_, _ �- - 21. Roof Sheathing- - - L_ j _ ___ ...; _ - _ ` ''' NOTES: !' ' '• ,, r.•_ ^. ,; •n r i_ o . , ; ; ' L 22!__ Frame and Flashing 23: Insulation. - _ - 1,--i---- -1- i- uc . , _ r - : , • y •., 24! .. ., . Lathihg & Siding� - - - _ .L_! ' 25: Drywall Nailing - t -- _ -'' ' 26:- Plaster Brown Coat _L ` • - ' -27I Electrical Power Meter-Final737, I _ '• '' "' " •• - - - -- -28- -Final Electric- - ---- ! 29i -Final'Heating.&Air.Conditioning_- _.t_ _ __ ,�. `].�_ _ __ - •• _" ;; ,,,,;, - ';;- i .30: - F.inal;Gas Pipe-Test-_ N - '•_; ° " io „�� ': ° 1_31. Final Plumbing- I -f ', •� :r ,• - . _ ,... ,.cw ,,,,. vo'Q . .. . . 32. - Water Service-Final- ' - -- -- - • - - -- "--L- -1- - - - -- -- , .:. ,.. ..t ., .,.'-- i -'. ' : -, - .,. L 4•.,.,. ...:..:. ; r c --33.- -Gas Service-Final - _ _�.__ 1._. _ ! ' • "• ` 4 ` - "' ' 34. Solar Domestic-Final''�' " .:a I ., •, .tn-.: ;.t ,,i-:: 35. Landscape Srinklin System - i , .. ' `• °' '- - "'•' I 36.. Sound Attenuation .. , .., ! I L_.._ _-_i `- '; -• = ,• - - - - 37. Handicap Regulations •+ -,y - '- "'; ' 38. FI NAL STRUCTUR E & BUI LDI NG 39. Special Requirements Completed - '''' ! I !;,; 1 ""'-.0----- y " -•""' " " I 40. . Electric. Release to Edison' I I , _• • _ - - ---- -' - '-'�--- - - - ----` 1 41. Gas Release to Southern California Gas Co.' ! - -- ----""----- it ------__-- • _ 42. - CERTIFICATE OF OCCUPANCY No Date Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA -- PE MIT NO. - - TRACT NO. LOT NO., - •BLDG.^- - -- + -- - -CONSTRUCTION PERMIT f ''3/09/82' TYPE OF CONSTRUCTION - 0 NEW -' 0 ADD 0 ALTERATION 0 REPAIR ❑ CONVERSION ❑DEMOLISH 0 OTHER- DESCRIPTION OF WORK "'1 '3020 31.00 - ZONING REGULATIONS - _ _ A.P. Project Address ,SC 41g_,f W Owner o�Z61,9 _I. Phone 'Address `. /s:/ �� .�' 'ZGi _ Arch/Eng. License No. Address - _ _ _ _ - - TYPE OF PERMIT - '` '" 0 GRADING- 0 FOUNDATION G1 STRUCTURAL / ��/ I -O'TENANT" EL ECTRICALvLKMBING OMECHANICA ZONE - -- - SETBAC L T. 51 YARD - LEF PLNG. REF. -f TOBVILDING- PROSE R'fY LIN& - - •- L', 'Contractor (s�f],y __ �Phdne7.35=G83 Address V;L$O .4/Ia/P.P�- GO �• 91216 0' LICENSED CONTRACTOR OECLARAYION - ' -"'1- I hereby affirm that I am licensed under provisions of Charter 9,(Com- �•, ' SIDEV - RIGHT - - - mencing .with. sec of 'Division 3 of the. Business and _0'OTHER Professions Code, antl my license is In full for Ce a d effect. 1 REAR YARD (TO P%L)-- 2- C- ` 70 PROJECT DESCRIPTION License class' -- - I,Icense - • - - •' -- " PKG. SPACE'REO. P,ROVIOED� - - Date 3 - -y Y Signature- _ - SO. FT., _ - '� _.- •• ''. - --- `_CONSTRUCTION -.�' - - ', STREET WIDTH -- "- +^-•-- - --. ;PARK F,EE 8• WORKERS' COMPENSATION D A O if OCCUPANCY TYPE _ it hereby affirm that 1 have a f nsent to salt -Insure Ora _. ON o c' ZONE _ ZONING -APPROVED BY certificate_of Workers'_Compensati _Insurance, or a,certifled copy +,r-- - thereof (Section 3800, Lab. C.). GRADING,CU. YDSM ACRES- SPECIAL CONDITIONS : ' 'y No. Company srt if letl copy Is hereby furnisheC._ -•y. c •filed REMARKS: -_ w �. Jertified copy Is with the cf[Y Building DiZion• _ - - - "- - _ -- -.,� - EXEMPTION FROM WORKERS' -COMPENSATION DECLARATION _- -- - (This section need not be completed if the permit is for one hundred (5100) or less11 _ I cart(/y that In the performance of work for which this permit PLUMBING - -PLAN CHECK - - ELECTRICAL'-' . 'PLAN CHECK- employ any person Imany manner n 1 toroecomo e Issued; 'to thelWot ia. c, subjecttotheWorkers Compensation Laws of Callfornia.o •'t - "BATHTUBS _ SHOWERS - Q -uqv-LINU-- " - -UARA FT- CQ FT -' - - - Date - - _ - Signature - -- -� --- -- NOTICE: If after making this declaration, You should become subject TOILETS .3 _URINALS - •-- - - Q- GENERATOR 0-1'KW=1-1'O -KW- - to the Workers' Compensation provisions of the labor Cgtlo, you must .TRANSFORMER ,- forthwith comply with such provisions or this permit shall be deemed LAVATORIES 3 DOUBLE LAYS --- - - APPLIANCE'- -10-50 KW_50 *-KW revoked. KIT. SINKS - - - DISHWASHERS MOTORS --• - 0:1 HP=1-10 HP' - - _ _ _ CONSTRUCTION LENDING AGENCY Iherebyafflrmthatthereisaeonstructionlendingagenayfortha per. SERVICE SINKS. SUMPS "-' --- (INC.SOLAR) - 1050HR 50+HP -- - - formance of the work for which this permit Is Issued (Section 3097 s Cid: C.). - - - - -- -!� Lender's Name FLOOR'SINKS s -,FCOO R'ORAINS FIXTURES '-'---OUTLETS-- SWITCHES" Lender's Atldress "- DRINKINGFOUNTAINS", '-- 1 - • -GAS-TUBE SIGNS - IGNSOWNERBUILDEROECLARATION OWNER BUILDER DECLARATION 1 hereby affirm that I am exempt ham the Contractor's License Law for INTERCEPTORS-- - CLARIFIERSPOLELIGHTS •1 -'--- -- -_- - -- -- - the.following.rCason .(Section .7031.5 Business .and .-Professions Code:_. SWIMMINGPOOL-•-PTRAP - --t - -- - - Any city or county which requires a permit to construct, alter, POLES METERED SUB _ Improve, demolish or repair. any structure, Priocto itsissuance,. also e. WgTE R-SERVIC E'-- - ALTERATION "'- - PANELS --MAIN •SUB- quires the ap,.licant for such permit to file a signed Statement that he Is. licensed. pursuant to_the.provisions of-tbe.Contracto,'s-Llcenso.Aaw_ -GAS'SERVICE '•" '-OUTLETS- '-' I SERVICE --- --^ - - - - - AMP' -- (Chapter 9 (commencing with Section 7000) of Division 3 of the usiness and Professions. Code) or that he.is exempt therefrom and the WATER HEATERS /r -BTU OUTPUT- - - - - --- -- -- - - - - - - - hr for the alleged exemption. Any violation of Section 7031.5 by - SEWER CONNECTIONS- - - - - - -- - - - aPpllwnt for a permit.subjectsthe applicant.to a civil penalty '5t more than five hundred dollars ($500).- L-J'I, es -owner of the property, or my employees with wages as their SOLAR TANK - -- COLLECTORS - - - •- -- - - - - - - - -�, sole compensation,. will do the work, and the structure Is not Intended I _ 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 properly ISSUE FEE - _ - - APPLICATION APPROVED - DATE '- who bullds or improves thereon, and who does Such work himself or through his own employees, provided that such Improvements are not _ MECHANICAL PLAN CHECK - SUMMARY OF intended or offered for sale.- If, however', the building or Improvement Is sold within one year of completion, the owner will have the burden of proving he did not build or -improve for the purpose of salo)- HEATING SYSTEM 0-100,000 BTU �- BUILDING -- - - - - - - - - EIJ, as owner of the property, am .exclusively contracting with AND DUCTING- PERMIT -$ - - SMTP, • licensed contractors to construct the project (Section 7044, Business IOO,000'a BTV PLAN CHECK $ PERMIT - ?' and Professions Code: The Contractor's License Law does not apply to - ISSUANCE - f -an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING § /• ..I "acts from such projects with a contractor(s) lieesned pursuant t0 SYSTEM- _.3 _ .GRADING S 'r. 'he Contractor's License Law). 100,000 t BTU PLAN CHECK $ - 0 I -am exempt under Section B: & P. C. for this BOILERS BTU ELECTRICAL $ $ reason.- •- SYSTEM REPAI R, ALTERATION PLAN'CHECK- $ - MECHANICAL-^ MICROFILM $ - - _TOTAL FEE $ - - Date Owner Ihereby certify that have read this application and state that the above EXHAUST SYSTEM MULTIPLE _ .$' s, �§ LESS AD- LESSVANADC ihformation-is-correct. I agree to c m -with-all-city and county PLAN CHECK - _ - _ _ S_ ordinances and state laws relating t nsl Nctlon, and hereby authorize , . �. - r $ r representatives of Ih s-, City to ter upon the -above mentioned - --- - - - _ . - property for in o our p S Signature- date -7:5- - ISSUE. FEE _ ' _ _FINAL FEE SS.lx Drivers' LI e'a - - CMF 046-46 hite-Building; Canary-APPlicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNI G APPROVALS Permit # -� Date -� POOL & SPA ,� \ - r" •.,.. Inspector AppROVALS Permit # - Date Inspector 1. _Temporary Electrical Service or Pole 43. Pool & Equipment Location - ' _ Soil Pipe-Undrgrn.. t(�rL 44. Steel Reinforcement 3. .Electrical.Conduit Utility-Undrgrn 45. Forms - 4... Electrical Conduit-Undrgrn 46. Electrical Bonding- ' Steel em orce 47. Rough Plumbing & Pressure Test - -- 6 Electrical -UFER Grn _ 48. APPROVAL TO COVER-GUNITE - - - 7. Footings _ 49. Electrical Conduit-Undr rn 8. Foundation 50.. Gas Pipe, ❑Undr rn, Test 9.. Water Pipe-Undrgrn_ 51. Backwash Lines P -Trap,_ ❑ ndr Fn - 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 13. .Rough Plumbing _ _ -- _ Fong- - - 14. Rough Electric -Conduit - - - 56. Electrical -Final - - - • 15. Rough Electric -Wiring - - - ' 57. Solar System -Final- -'16.- Rough Heating & Air Conditioning- - _ - - - - - - - M encing & Access Approval. 17: Ducts in Structure -L - 59. APPROVED FOR PLASTERING - - - 18. 19:. 20. Ducts, Ventilating Gas Pipe -Rough & Test Roof Framing -: .-_ __ ' _ - - 60. POOL/SPA SYSTEMS'FINAL ,'• •• - - •' 21: 22. Roof Sheathing Frame and Flashing - - _ NOTES: 23. Insulation ' 24. Lathing & Siding - - - - - - - - -- 25. Drywall Nailing 26. Plaster Brown Coat 27: Electrical Power Meter -Final 28.- Final Electric - 29 . Final Heating & Air Conditioning -- - - - - - - - - - r 30. Final Gas Pipe -Test - - - - - - - - -- - - - = 31. - Final Plumbingo - - 4-74,99L- 32. 32. Water'Service-Final - - - - - 33. Gas Service -Final 34. Solar Domestic -Final - 35. Landscape Sprinkling System ' 36. Sound Attenuation 37. Handicap Regulations " ' 38. FINAL STRUCTURE & BUILDING ' 39. Special Requirements Completed _ 40. Electric Release to Edison . 41. Gas Release to Southern California Gas Co. F 42. CERTIFICATE OF OCCUPANCY No Date - Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. . CITY.OF CQSTJ1 MESA PSfRMIT NO. TRACT NO. LOT NO.B��ppG. t ,CONSTRUCI'ION PERMIT 3,'1' - U TYPE OF CONSTRUCTION ❑ NEW ❑ ADD * ❑ ALTERATION- ❑REPAIR ❑.CONVERSION.E1DEMOLISH OTER ' - ❑ H 4371L ,4/08/82,' .1 ,•-; 5.50 ZONING REGULATIONS -' - -- Project Address C Owner (. 4& Al Phone - -Address '-� - Arch/Eng.- License NO.- - DESCRIPTION OF WORK _ - 7 __- -A'P' _ _ . - _ `i' - _ -- - 'ZONE- _ - PLNG. REF.•#.. Address •Contractor 77 -IN r CL\ 7�t - .+SETBAC ' i B KC LS— p JBPULTYNLGINE RADING ❑FOUNDATION - ❑STRUCTURAL--- ISIDE-VARO' =❑ TENANT-�•ELECTRICAL-OPLUMBI NG MECHANICALSIDE YARD - D_C �"_Aadre§ LICENSED CONTRACTOR DECLARATION. _. _ =:' I hereby affirm that I licensed 'under Charter 9 am provisions of (com-. mencng-with-section 7000) -of' Division-3-Of-the-Business-'antl I n„ ) - �-OTHER'- - -- - I RIGHT 'Professions Code, 'and my license is In full force ntl ff 1-.� - ' DESCRIPTION:._. __- TREAR YARD (TO P/L) 'License Class_x;:_-_ - _�D `^^`" N .PROJECT - -_ _- PKG-SPACE REQ. - -- PROVIDED: + SQ..FT. V ' -PARK �OCCUPANCY— 'CONSTRUCTION TYPE STREET WIDTH FEE.E�'. WORKERS''COMPENSATION 13ARATION - _. _` I hereby affirm that I have a certificate of consent to self -Insure Or a - 1 VALV ATION ' ZONE 7ZONING APPROVED 13Y certificate Of Workers' Compensation insurance, -or a certified copy. ' - thereof (Section 3800, Lab. C.). -' ,GRADING CU:YDS. ACRES SPECIAL CONDITIONS:- ...... 'cy No., "_ - Company - - ` - -__ -__ - -__ - - -- - :ertlfled copy is hereby furnished.- - __ _ _ REMARKS: . _ _- .• t _ u Certified copy Is,flled with the city Building Division. _ _ -_-___ _ __ _ a ` EXEMPTION FROM WORKERS' COMPENSATION DECLARATION '(This.sectlon. need not.be complet¢d-if.the-permit-is for one hundred - 9 a l ($100) or less1. .. jl .certify that n the. performance of the work for which this permit is _ .. !m— ., . . issued, I shall not employ any person in any manner so as to become PLUMBING, t -PLAN CHECK----- -- -')ELECTRICAL ---PCAN'CHECK - subject. to the Workers Compensation Laws of.Califcrnia._._ .- - - BATHTUBS - SHOWERS' - '+T3V7ECCTMI7 GARAGE Dale Signature r 'NOTICE: If after making this declaration, you should become subject, TOILETS. .• �.. ,.URINAL'S- - - ^" - _ 'iGENERATOR - - 0-1 tp�7-10 KW to the Workers' Compensation provisions of the Labor Code,, youmust1 TRANSFORMER >? forthwith comply with such provisions Or this permit shall be deemed LAVATORIES DOUBLE L'AVS-- --- -- KW (APPLIANCE - 30-50 KW_50+KW- - - revoked. __ _. _; _ - - - ---- --" CONSTRUCTION LENDING AG ENCV KIT. SINKS ""'- "DISHWASHERS' -": '- -' MOTORS--- -"0-1'HP_1'-30 HP - - 1l tiereby affirm that there is a construction lending agency for the per- SERVICE SINKS ;SUMPS - '' - -- -- . (INC. SOLAR)_ - 10-50 HP 50.+ Hp' s- - formance of the _w_ork for_which this permit is Issued (Section 3097 -FLOOINKS -- FLOOR DRAINS - - R S '-OUTLETS-FIXTURES - -OUTLETS- -SWITCHES - 'Civ.C. - -- v. er's Name l s :Lender's Atltlress -DRINKING FO UNTAINS�' ,GAS TUBE SIGNS - - OWNER BUILDER'DECL'ARATION' - INTERCEPTORS - -CLARIFIERS ` --' - �' -•� - - - - -•' -- -- - 'I hereby affirm that I am exempt from the Contractor's License taw for r rPOLE-L'IGHTS the -following reason (Section 7031.5 Business and Professlo ns- Cotle: - SWIMMING'POOL:" �'P TRAP --- - - 1 -- � - - - .POLES 'METERED'- -SUB Any city or county which requires a permit to construct, alter, Improve' demolish or repair any structure;' prior to Its Issuance; also re- WATER'SERVICE- ALTERATION - - PANELS -MAIN- -SUB — - quires the ap,licant for such permit to file a signed statement that he GAS SERVICE - OUTLETS - - - - - 'SERVICE AMP- islicensedpursuant'to'the provisions of the Contractor's License -Law (Chapter 9 (commencing with Section 7000) of Division 3 of the - s� 1 - WATER HEATERS'-- 'BTU OUTPUT- - - •r' - - - Businesi-and Professions Code) or that he Is exempt therefrom and the- ' -sis for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS * - 'applicant for a''permit subjects the- applicant- t0 a civil penalty not more than five huntlretl dollars ($500). SOLAR TANK '-'--" COLLECTORS -' - 1 - -- - -- -- -- • - - - - -- - - �J 1, as owner of the property, or Foy employees with wages as their sole compensation, will do.lhe work, and the structure is not intended or offered for sale. (Section '7044, Business and Professions -Codes The SOLAR PIPING SVS. ' " -' -I ISSUE'FEE- - - --- - - - 'ContractoCs-License Law. does not apply to an owner of a property_ __ _ _ _ _ _ _ ISSUE FEE .1 - - - 'APPLICATION APPROVED BY - - - .- DATE - who builds or improves thereon, and who does such work himself or through his own.employees„provicietl that Such improvements are not 'intended MECHANICAL PLAN CHECK / -� MARY OF FEES SUM or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner will have the burden t . ofproving he did not build or improve for the purpose of sale). - - - BUILDING --- - ---- - -- -- -=-- •- -. - 0-1; as owner of the property, am -exclusively contracting with HEATING SYSTEM 0-100,000 BTU 1 PERMIT E SMTP' $ licensed contractors to construct the project Section 7044, Business P 1 ( and- Professions Code: The Contractor's License Law does not apply to AND DUCTING 100,000 +gTU 1 , PLAN CHECK PERMIT --.ISSUANCE' $ an owner of property who builds or Improves thereon, and who con. REFRIGERATION 0-100,000 BTU PLUMBING $ r tracts -from such -projects 'w'rl h a contractor(s) Iicesned-pursuant to. -SYSTEM - --- - _ _ GRADING. 'E .the Contractor's License Law). ❑ 1 arts exempt Section- - - P. for 100,000 +gTU PLAN CHECK S�� - E under B. & C. this BOILERS BTU • ELECTRICAL $ ""�•• - - - - reason- - - - PLAN CHECK $ - -- MICROFILM E ” Date Owner _ SYSTEM REPAIR, ALTERATION _ TOTAL FEE S ,MECHANICAL-, $ - -- - I hereby certify that I h e reatl this application and state that the above information is co red to Com I with all cit - andcount 9 p Y Y Y brtl ina ores antl s e la elating to construction, and hereby authorize EXHAUST SYSTEM MULTIPLE 1 PLAN CHECK E - _ LESS AD - VANCE PC" $•-' r¢presentative- o ci - u the above rgJl�en[ionetl property ur (� 1 - - Sign O �G 1 FINAL FEE $ y - jZate7 • O CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor - TL• i CONSTRUCTION AND;PLANNI'NG APPROVALS Permit Date Inspector POOL& SPA Date. Inspector APPROVALS Perm -it 1, Temporary Electrical Service or Pole 43.. Pool & Equipment Location 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrt), 45. Forms 4.. Electrical Conduit-.Undrgrn 46. Electrical Bonding 5. . Steel Reinforce � 2., 47. Rough P16'mbirig & Pressure ure Test 6. -.Electrical LEER Grn 48.* APPROVACTOCOVEk-GUNITE 7. -Footings 49. Electrical Conduit-Undrgrn' 8. Foundation_ 50. Gas Pipe, EJ Undrgrn,-Test- 9. Water Pipe-Undrgrn 51. Backwash Lines. P-Trari, ETUAcImm _10. Structural,Floor System 52. APPROVAL TO DECK I.I.- - Property Sewer Line.& House Connection 53_ Backwash & Receptor -Final 12. .- Street Sewer Connection 54. Heater & Vent -Final 13.. .,Rough Plumbing.- 55, Plumbmna.Svsten� - Final 14. Rough Electric -Conduit -56- -Electrical-Final 15. Rough Electric -Wiring 57. Solar�System-Final 16. Rough Heating & Air Conditioning Approval 17. Ducts, in Structure' 59. APPROVED FOR PLASTERING 18. Ducts, -Ventilating 4 '60. POOL/SPA SYSTEMS FINAL, - 19. Gas Pipe -Rough &Test 20t -Roof Framing 21. Roof. Sheathing ''NOTES:'g 22.- Frame and Flashin 23. Insulation 24. Lathing & Siding 25': Drywall Nailing J 26. Plaster Brown Coat 2T Electrical Power Meter -Final 28 Final Electric - 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. FINAL STRUCTURE& BUILDING 39. Special Requirements Completed 1 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY1IF COSTA MESA P MIT NCS,, T CT NO. LOT NO. -, BLDG. NO. CODIS"UCTION PERMIT E- r 3� C%" 2786_ 3/03_/82 197.57 TL Project Address '� 69Z TYPE OF CONSTRUCTION r �-'• 1 Owner m (J(fi� Phon 'ji 9.0NEW ❑ADD -❑ ALTERATION - - - - - - i I Address 15'17 NaEl• REPAIR-0 CONVERSION ❑DEMOLISH �A �-y - ZONING REGULATIONS Arch/Eng. - - - License No. !j�� OTHER - A P # - Address - - - - _ _ _ .. IICSCRIPTION OF WORK-- ZONE PLNG. REF. # �Contractor Phone-- -TYPE OF PERMIT:" - - - ry --_ _ ". -RpoBlll1lLDM r SETBACK LST. PfEOPE TV LINE Address --' -- - - - • - - - - _' ❑.GRADING - ❑ FOUNDATION C1 STRUCTURAL - LI DF -YARD -- -To�•- ,LICENSED CONTRACTOR DECLARATION •' " TENANT ELECTRICAL-1ad�(PLUMBING ❑MECHANIC SIEpE-YA "1' hereby affirm that I am licensed under provisions of Charter 9 (com- ,x • • •RIGHT mencing -with section-7000) ofDivision .3 of- the.- Business and. ❑OTHER. .REAR YARD TOPL '•Professions Code, and ny license is In full force and effect., ( ) - _ .PROJECT DESCRIPTION' License Class - -� - - -License No. - '- - PKG. SPACE REG. OVIDED Date - r"'Signature _ _ _- SG: FT. _ __ - _ - - _ WORKERS'COMPENSATION.DECLARATION (OCCUPANCY Z CONSTRUCTION T_VPE STREET WIDTH-_"' PARKFEE ,1 hereby affirm that I have a certificate of consent to self Insure ora / - — -- ZONING APPROVED CU DATE 3 , certificate of Workers'-Compensation-Insurance, or. a.certlfied-copy VALUATION ZONE thereof (Section 3800, Lab. C.). GRAOING'CU. YDS. ACRES 'SPECIAL-CONDITIONS: •Ppllty No. --Company •,Certlf letl copy Is,hereby furnishetl. REMARKS:- .'Certified copy Is filed with the city Building Division. Z- •- EXEMPTION-FROM WORKERS' COMPENSATION DECLARATION - - -: '(This section need not be completed if the permit is for one hundred '($100) or less). I certify that in the performance of the work for which this permit'19 - y issued. 1 shall not employ any—person—in any manner so as to become PLUMBING-.,;,;5 -,PLAN CHECK' - ,ELECTRICAL- -^ - PLAN CHECK. subject to the Workers Compensation Laws of C_allf_ornia.e _ 1, •_. 1 (Date I Signature BATHTUBS"' SHOWERS - CID SO-FT "" -' -- - -- -- (NOTICE: If after making this declaration, you should become subject T_O_ 1LETS f eP , URINALS - - - - pa- -GENERATOR.- - 0-1 KW_ 1-10 KW ' - 1 ,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 LAYS- - - p -APPLIANCE ---- 10-50 KW_SO+KW revoked. _ ; J- -�_ r _ : KIT: SINKS -"'- "DISHWASHERS- ♦-- -QQ 7MOT0 RS ,:0-1•HP•+_4-10•HP- - - 'CONSTRUCTION LENDING AGENCY - I r 11 hereby affirm that there is a construction lending agency for the per- SERVICE SINKS -". (� .SUMPS-' - - - _7 - .I(INC.. SOLA R), 10-50.HP 50 t HP .formance 01 the work for which this permit is issued (Section 3097 Civ;-C.)'. -- _ .__" -"-_ - -_ _" - .- _ _. �. . 'Lender's Name - "FLOOR SINKS {F,LOOR DRAINS FIXTURES OUTLETS SWITCHES iLender's-Address DRINKING FOUNTAINS - - .GAS TUBE SIGNS - - - - 'OWNERBUILDERbECL'ARATION -'INTERCEPTORS" - CLARIFIERS-- -"' :POLE LIGHTS --- t 1 hereby affirm that I am exempt from the Contractor's License, Law for - I the following-reason (Section J031.5 Business=antl Professions Code: -SWIMMING POOL - - P TRAP - -- - - - - � - - t 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 SERV ICE- - r'ALTERATION• -• -- - - ,PANELS - -- - - -MAIN SUB - - - quires the, ap.licant'for such. permit to'file-a signedstatementthat he, , - is licensed pursuant to the provisions of'the Cont ractor's, License. Law' 3 of the GAS SERVICES \ y�OUTLETS 'SERVICE - - -- - - AMP'= - - (Chapters 9, (commencing ;with, Section 7000) of ;EOivislon usiness and 'Professions Code) or that he is-exerhpt'therefrom antl-tfie' " WATER HEATERS � BTU OUTPUT -- basis for the allegedsexemption. Any viuolation Of Section,7031.5 by, _ 'v applicant 'for' a permit subjects 'tbe'applicarl4--to a civil penalty '- SEWER'CONNECTIONS - - - - - -- - ' -- not more than five hundred dollars ($500). - '♦ Y "- ' 'I, as owner of the property, or my employees,wit h. wages as their `SOLAR TANK- '-COLLECTORS +_ - • -- - - - - - - - - - .. t sole compensation, will do trie work„and the structureNs not Intended ISSUE FEE or offered for sale. (Section 7044, Business and Professions Code: The. -"SOLAR PIPING SVS. , - - OQ' Contractor's License Law dpes.not apply to an'owner-,of a property I 'who, builds or improves thereon, and wholdoes such work;himself'or - ISSUE FEE" ” --" '"' - - -APPLICATION APPROVED RV . -_ DATES J through his own employees,- provided that,suchImprovements are n011 _ _ _ 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 owne,will have the burden, .r gU1LDING - r' of proving, he tlitl not build-or improve for' the `purpose a of 'sale).• .!BUILDING 0-100,000 BTU 'PERMIT- E SMTP S=3S, ❑-I, as'owner of�the property,"am-exclusively., contracting -with AND DUCTING �' - licensed contractors to construct the project (Section ,7044, Business t • 100,000+BTU PLAN CHECK E �•�2 PERMIT and Professions Code: The-Contractor's License' Law does not'apply to ". _ _ ISSUANCE, an owner of property who,builds'or improvei.t hereon, and who con- , REFRIGERATION 0-100,000 BTU PLUMBING S_ 30. oo •z tracts-from- such. projects' with.a_contractor(s) licesneWpursuant to: •SYSTEM ' t• 1 _ GRADING 'S, the-Contra Ctor„s License _ Law).�t- >c - v _ (f „j' •, , s; 1100,000,(+BTl1 `I '-v\- r,v. PLAN CHECK -E•-may- -,f - •'E ❑ I'am exempt unoei Section 1 B. & Ti,: C. for this _ - t ELECTRICAL" $ ��r_.� - -' ` s v we ' BOILERS s • - BTU reason - MICROFILM $ Date SYSTEM REPAIR, ALTERATION PLAN CHECK- $ - ,TOTAL FEE $ MECHANICAL $ - - - 1 hereby cart ify th ave r atl this pp1 state that the above EXHAUST SYSTEM MULTIPLE PLAN CHECK- LESS AD- informallon is rr t. '1 gS�¢"to cb (ply wi all city' and county- „ - -$ VANCE PC E` -- t ordinances and a[ la s e(alin nstruc n, antl hereby authorize _ I repr¢sentative of this ty' -e r u n 'the' above -mentioned property Or ma ectlo Pure zes.` f♦ s ~ \ •\S`, \\. FINAL-PEE,$ Signalure Dale Drivers' Ice se or SS 9r.' - ISSUE FEECMF 0865-46 0865.46 White-Building;Canary-Applicant; Pink-Accounting; Golden rod-Assessor CONSTRUCTION AND PLANNING APPROVALS Permit + Date Inspector POOL& SPA APPROVALS Permit 4 Date Inspector 1. Temporary Electrical Service or Pole jPo 43. Pool & Equipment 'Locatio5n 2. ScCiITii-pe-'U-ndrgrn 44'. Steel Reinforcement 3. Electrical Conduit Utility-Un6grn 45. Forms 4.- Electrical-Conduit-Undrgrn-.- 46. Electrical Bonding .-Steel Reinforce 47. Rough Plumbing & Pressure Test - 1 -6. Electrical UEER Grn. 48. APPROVALTO COVER-GUNITE .7 --Footings- 49. Electrical Conduit-Undrgr-n 8. Foundation 50; Gas Pipe,- 0 Undrgin, Test .9. Water Pipe-Undrgrn-. --51. [§ickwalfi Lines. P -Trap, 0 UrTdFc[r6 10. Structural Floor System 52. APPROVAL TO DECK- - - I - • 1.1. - Property Sewer Line & House Connection -:53...Backwash & Receptor -Final 12. Street Sewer 'connection 54.- Heater 8CVent-Final 13- Rough Plumbing .7LI -q� 55, Plumtjng System -'Final 14. Rough Electric -Conduit 56. Electrical -Final 15. Rough Electric -Wiring 57. -Solar-System-Final- 16. Rough Heating & Air Conditioning 58. Fencing & Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING 18. Ducts, -Vent i lati ng .60.1-'--POOL/SPA SYSTEMS FINAL 19; Gas Pipe -Rough & Test- 20. Roof'Framing t- J. 211 _i Roof Sheii t q 7 X NOTES:'- 22! Frame and Flashing - -23. 'Insulation -) , c%r 41!� <- 24. Lathing & Siding Al e L.P-, J rl t A /cf.;o i4 , I Aems Tr 0..,, 25; Drywall Nailing -3 -0Y-62 26. Plaster Brown Coat F 27. Electrical Power -Meter -Final 28. Final Electric ------- L -r- f 7 W, .3 -;2 T- Y 2 29. -Final.Heating & Air Conditioning vA7-7,'a - Dt-lul 30. Final'Gas Pipe -Test 31. Final Plumbing 32. Water Service-Final- rp - 33.- 'Gas Service -Final- :;L c:7VX,? 34. Solar Domestic -Final ,)- L, - �z 35F. 'Landscape Sprinkling System 0 y 36. Sound Attenuation obip 7�-d-Ae �A�, 37. Handicap Regulations 614- Z k, f 1 13 38. FINAL STRUCTURE &.BUILDING A,/ D27tYg 7�7 if% 39. Special Requirements Completed Jdz (.1 Out L( 40. Electric Release to Edison • 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date Applicant to fill in all space=vithln heavy border lines and sign all appropriate declarations. C r OR COSTl MESA a€w.�ll-jJ TRACT NO. LOT NO. BL D �NStRUCTION PERMIT L�-3 ��//��// TYPE OF CONSTRUCTION (/ 0 NEW ❑ ADD ❑ ALTERATION (�•/X�. ❑ REPAIR ❑ CONVERSION ❑DEMOLISH t `, _ 8441, , 6/ 18/821 16.00 '" , Project Address -Z - S¢/E'.e —8 Owner F9'U �` bp, Phone 21 Address f- - - - ❑ OTHER 1 - ZONING REGULATIONS Arch/Eng.- - - License N (rl DESC RIPTION OF WO RK A.P.991 ZONE PL.NG.. REF. Address p -�p� Contractor AK I -V ��-/w-/C_ Phon 4� TYPE OF PERMIT ❑ GRADING -'❑ -FOUNDATION '-❑'STRUCTURAL El TENANT ELECTRICAL- ❑PLUMBING ❑MECHANICA BUILDISETBANGT SID YARD - - L99IEppE YA p# PROPUEIRf I NLINE - - -- - Address ^(,t/ I✓ A (J.4je� Q� ^-r -LICENSED CONTRACTOR DECLARATION I hereby that I licensed affirm am under provisions of Charter (com. mencing with- section --7000) of Division- 3 of the Business and r-. I] OTHER f11GHT - - - - - Professions Code, and my license is In full farce no a t. - REAR YARD (TO P/L)- G-- t:I PROJECT DESCRIPTION License/Class sef� PKG. SPACE REQ. PROVIOED Date -`rJI 2619 t \ 50. F7. OCCUPANCY—CONSTRUCTION TYPE STREET WIDTH PARK FEE $, GATE WORKERS' COMPENSATION ARATION -- _ I hereby affirm that 1 have a ce ificate of consent to Self -Insure or d VALUATION ZONE ZONING APPROVED BY certificate' of Workers' Compensation r a certified copy - thereof (Se �3 LalysJ. ..-- �slf GRADING CU. VOS. ACRES SPECIAL CONDITIONS: 1 'Ilcy No. Company e4o - - - - - - - - Certified copy Is hereby furnished. - .. REMARKS:' 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 hued red -0 - ,. - �•;, - - " E100) or less . 1.$ I. certify that �n the performance of. tha work for which this permit is issued , 1 shall not employ any person in any manner so as to become _ PCUMBING,-�- --PLAN CHECK -` - -- ELECTRICAL - PCAN CHECK - - subjecLto.the Workers Compensation Laws of. California... - • BATHTUBS SHOWERS ' Date Signature' NOTICE: If after making this declaration, you should become subject TOILETS. URINALS - 'GENERATOR' '0-1 KW_ 1.10 KW to the Workers' Compensation provisions of the Labor Code, you must TRANSFORMER 7 forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS ' APPLIANCE '10-50'KW_50+KW - - revoked.— CONSTRUCTION CONSTRUCTION LENDING AGENCY - • KIT. SINKS '- DISHWASHERS-- -- - - MOTORS- - 0-1 HP -1-10 HP I hereby affirm that there is a construction lending agency for the per SERVICE SINKS SUMPS - -' "'-" - (INC. SOLAR) -10-50 HP_ -50 +-HP- - - - formance of the work for which this permit is issued (Section 3097 �FIOOR51 NICs �� FLOG R•DRAINS - FIXTURES OUTLET SWITCHES r CIV. C.)--- '-- P t Lencer's Name t` ' ��_ _ _^• Lender'sAddress C _- DRINKING FOUNTAINS' - - - - GAS TUBE'SIGNS- INTERCEPTORS CLARIFIERS 'POLE LIGHTS *OWNERBUILDERDECLARATION' -' -' I hereby affirm that 1 am exempt from the Contractor's License Law for t SWIMMING POOL PTRAP' - -- POLES METERED - - SUB. the following' reason (Section' 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, WATER SERVICE ALTERATION -' -- � PANELS'- MAIN - SUB - - Improve- demollsh-or repair any structure, prior to Its Issuance, also re- quires the apoicant for such permit to file a signed statement that h¢ 'GAS SERV ICE OUTLETS ,- - SERVICE 00 A 0= -' AMP is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS - BTU OUTPUT _ Business and Professions Code) or that* he Is exempt therefrom and the `•sis for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONSnot f applicant' for a permit subjects the applicant to a"civil penalty more more than five hundred dollars ($500). SOLAR TANK COLLECTORS J 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. (Section 7044, Business and Professions Code: The SOLAR PIPING SVS. ISSUE FEE e Contractor's .License Law does not apply to an owner of a property, - - - - - - ISSUE FEE APPLICATION APPROVED BY - DATE who builds or improves thereon, and who does such work himself or through his own employees, provided that such Improvements are not MECHANICAL PLAN CHECK SUMMARY OFF ' ' intended or offered for sale. If, however, the building or Improvement is sold within one year of completion, the owner will have the burden of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU -BUILDING- - - PERMIT $ - - - SMIP $ 0-1, as owner- of the property, am -exclusively contracting with AND DUCTING 1 licensed contractors to construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK E PERMIT - and Professions Code: The Contractor's License Law tloes not apply to - - - ISSUANCE $ Owner of property who builds Or Improves [Hereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts tracts from such projects with a conlrattor(s) Ilcasnetl pursuant to SYSTEM - - - -- GRADING E the Contractor's License Law). 100,000 + BTU PLAN CHECK $ I am exempt under Section - ' -'B. & P. C. for tfiis ELECTRICAL $ •�- $ ' 'reason - - - - BOILERS BTU --'PLAN CHECK $ - - MICROFILM $ Dale- - Owner - SYSTEM REPAI R. ALTERATION EXHAUST SYSTEM MULTIPLE MECHANICAL $ - TOTAL FEE E LESS AD - 1 hereby certify that I Have read this application and state that the above information is torte ¢e [o comply with all city antl c0 unty - 'PLAN CHECK $ - VANCEPC $_ ordinances and stat aws r In t0 construction, antl hereby authorize 'represenlatives [t =111 - r upon the above mentionetl property for " 1 Ur J Signatur Dat ISSUE FEE - - - - - -- - -- - - - FINAL FEE $/ - - -- - Driv s' ense or 55 # - CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING _ APPROVALS Permit# Date Inspector- POOL & SPX ' APPROVALS Permit# •i ��- Date Inspector v �< _ _ _ Temporary Electrical Service or Pole 43. Pool & EquipmentLoc"on' t _J_ t y1. 2. SoilPipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit UtilityUndrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding -<.,.i:: 5. Steel em orce 47. Rough Plumbing & Pressure`Test ' �t7e ��t �\A 6. Electrical UFER Grn 48. APPROVAL TO COVER`-GUNITE ��N1w Nva nti1 - N " •� "=' 7. Footings 49. Electrical Conduit-Undr rn ' 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-TrTE &Wr rn 10. Structural Floor System 52. APPROVALTO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final . 12. Street Sewer- Connection • 54. Heater & Vent-Finak%' •V%._,,,_ .:. _ .. 13. Rough Plumbing ystem 14. Rough Electric -Conduit -56.% Electrical -Final 15. Rough Electric-Wiring:7L- 57. Solar System -Final - 16. Rough Heating & Air Conditioning bd. Fencing & Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING 18. 19. 20. Ducts, Ventilating Gas Pipe -Rough & Test Roof Framing - 60. POOL/SPA SYSTEMS FINAL - 21. 22. Roof Sheathing- Franje.and Flashing.,-. - _ NOTES: - " 23. _ Insulation `u \ o� /Ccq 64i? -et C4 / 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final _ 28. ' Final Electric • `t vkta `,;i�% _ 2 - 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. FINAL STRUCTURE &BUILDING - 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. - 42. CERTIFICATE OF OCCUPANCY •No.- Date _ ci .lam- �i +\• CMF 0865-46 White -Building; Conary-Applicant;Pink-Accounting; Goldenrod -Assessor lipApplicant to fill In all spaces within heavy border lines and.slgn all appropriate declarations. ' CI 'Y OF COSTA MESA — -- -PER IT"NO .' ' TRACT NO: --' LOT No. .r"BLDG. Nj Or -- ---, --- ----'- -- -- --- --- -• -- - -- - - �; / C�ISTRUCTION PERMIT /(� J'1 • T - _ a } 5612 8/05/62 26.90 -TLi Project Address yS'- 2 SC- Je : f I TYPE OF CONSTRUCTION „ .ac:' ''.i `i_ ;n •'r R •' ` !t}""�_• ,^' M _ j Owner. O f Phone- .O NEW ' ADD -0 ALTERATION : -:: . ' . , - -- i `Address-- - �, --�' - .. tO REPAIR ❑.CONVERSION'.D.DEMOLISH. Op �- �f-- ZONING REGULATIONS'. l-Arch/Eng. -- - - - - - License No. O DESCRIPTION OF WORK -t G SCRIPT" _ _ A•N # ''Q_ ,-Q Address-.-. - - .- _ I - .. _ I_ ___ - ?ZONE- -- "- _ G REF. ,9F..r- PLN f ;Contractor - r t ---'- Phone S'SJ%6" ... .4_. TYPE OF PERMIT, ' ' - ' "'""' t U,u,.. ' T)- -'i _ - -e -- -----Tp BUILDING- SETBAC ST. PERTV.LI NE Via.• i , - ,., .-_.. ...-_ x , :P'!o -Address -' r- --'-•' ��;� • - GRADING`• -O'•FOUNDATION--EISTRUCTURAL:-- SIDE YARD -- _- _- _PRO `1ctJ ILEF LICENSED- CONTRACTOR .DECLARATION.. ' I I �-TENANT- & _'.' `ELECTRICAL PLUMBING -O MECHANICA 4 hereby affirm th:,t I am Iic¢ns¢tl 'under provisions of Charter 9 (com 7000 Division 'and. O - ) SIDE -VA - `RIGHT mencmg-with section- - of' -3 ll the Business- Professions Code, I no my license Is in full force and effect.' l. _ - OTHER ', 'PROJECT DESCRIPTION ice_ REAR YARD TO'P I ( /U - _w...� __/Z. _ . License Class Llcense No, - i It -'-. ' I- - _ _ ' -` �. PRO. SPACE REO:` - --' PROVIDED - -; n `_. SO .FT: - - _ _ __ (Date >_1 S)i�` �-� w.</ _^�-bJ - _-_4"--- Z -Signature' _ -;-STREET .1 `WORKERS'COM PE NSATION.DECLARATION ._._. I ., ,i tOCCUPANCV ''—•1 CONST RUCTION TYPE_ WIDTH PARK FEE$. - - - _ il hereby affirm that I have a certificate of consent to se li Insure or a, �%�n °~ Y-^ ;-- �; ^,- 'ZONING APPROVED BV `DATE - •-•+ +• : • 1 Icertifuat¢ of orkers' Co m pansa t tom Insurance,-or-a-carHhetl'copy. _VALUATION _ZONE _^ - - I _ _ _ ;SPECIAL'CONDITIONS. r )thereof (Section 800 b. G $ 1 ._Y %$90 Pant "�li-/.5.�/d _ _ GRADING CV. YDS. ACRES _. 7r_. " ^ .. No-�21J%l m 7✓- ertified.copyishereby-furnished.-__ -_._ x^' 'REMARKS r- 1 It_ ,�;•.-„} _ - 1 - �' _ _-- -_ _ 'd" 'ertified copy Is filed With the city Building Divlslon. EXEMPTION"FROM WORKERS' -COMPENSATION DECLARATION' • -- �(This section_need_not_be completed,if the Is for one hundred d I ,permit ($100iI or less). 'I cert fy_that in the, performance of the work for which this permit is -shall ,.- issued, .1 not employ any person"in any manner so as to become = PL'UMBING'ti ;PL`AN'CHECK -- --"- - :ELECTRICAL-- -' -- PLAN CHECK:; I - subject to,the Wor kers_Compensation Laws of -California.' -' ' Date 1 Signature _ _A. BATHTUBS - SHOWERS-' - -'-' - - UW LiN�'---"FT _ -'1 ;NOTICE: If after making this declaration, you should become subjectJTOILE TSS_ „,URINALS __--' `- r - -- `GENERATOR -•'01"KW` 1--10-KW" _ -' -- r- TRANSFORMER —.•r, - - - l to the Workers' Compensation provisions of the Labor Code, you must ,forthwith comply with such provisions or this permit shall be deemed _ LAVATORIES DOUBL-E'LAVS - -- -�^- „j Iiy,-. - - - '.APPL-IANCE' 30-50 KW=50 +KIN =--- - - •- - - ---t -_ - -_ " -" --"" ;CONSTRUCTION LENDING AGENCY - "KIT. SINKS-'-DtS11WASHERS--- ;---- --'-MOTORS-- - 0-1 HP_1-10 HP--'- -- -_- :1 hereby affirm that there is a construction lending agency for the per- SERVICE SINKS��SUMPS^-- - '(INC., SOLAR)-. _10-50.HP 50.+ -HP .. 7 ,. iformance of the work for which this permit is issued (Section 3097 "F[OOR`$INKS ` ---FLOOR-DRAINS---- s'FIXTllRES•- —OUTLETS-- SWITCHES-- - - - CivrCJ: - I Nam¢ lLentler's 1 - - -- - -- ---- --- - --- `- "- - L¢ntl¢r'S Atldr¢sa -DRINKING,FOUNTAINS-- "- - -i' - - ;GAS -TUBE SIGNS-� ---- - --- -- - - -- ' - -' - - OWNER'BUILDER DECLARATION^- - - -INTERCEPTORS' "- -=CLARIFIERS - -"' ! - .� L sPOLELIGH TS - --- - - - -- - -- - I hereby affirm that I am exempt from the Contractor's License Law for - - SWIMMING POOL- P TRAP - ^ • -' - SPO LES` - - - METERED -SUB - the following reason -(Section -7031.5 -Business and. Professions'Code: Any city or county which requires a. permit to construct, alter, -WATER SERVICE - -J- --7 --PANELS ----- -MAIN------SUB--��- --' -' improve -,demolish or -repair -any structure; prior to its -issuance, -also -re- quires the ap, for such permit to file a signed statement that he GAS SERVICE .TLETS- "" 'i'- -"-'-- --SERVICE-- -- --- - ---=-AMP-----•� - - scant a provisions on the License -Law 9 (commencing with Section 7s (Chapter 9 (commencing 7000) of Division Division 3 of the 'WgTE R'HEATERS --BTU OUTPUT- -^- � -- ---- • - Business exempt therefrom Business -and Professions Cption. r -that he isation ' of " for the allegedor-a exemption. Any violation of Section 7l 1.5 by by ; -SEWER CONNECTIONS'-- a -----^- '- - -- -- -- - -- - - liw nt for-a-permit•subjects- the- applicanh to•a-civil penalty- pp-pen tmore than five hundred dollars ($500). "SOLAR TANK-- - COLLECTORS - ---- ; asowner of"t M1epropert y,'br my em ployees'wllh wages 'as'their sole compensation, will do the work, and the structure is not intended 1 or offered for sal¢: (Section 7044," Business antl Professions Code: The SOLAR PIPING SVS. -r+l _ - - '- '- }—`- --- ISSUE -FEE --- -- - - Contractor's License Law does not apply to an owner of a property who builds or improves thereon, antl ti who does such -work work himself or - "ISSUE FEE "'-- ' ----` -" "j -" -- -- -- ;APPLICATION APPROVED BK _ DATE-.- - - through his own employees,. provided that such improvements are not -MECHANICAL PLAN CHECK - '- SUMMARY OF FEES y -- ' intended or offered for sale. If, hove -ver, the -building -or improvement' is sold within one year of completion, the owner will have the burden of proving Ke did not build or improve 'for -the purpose of sale):- '�-I,-as owner - of -the-property, am -exclusively contracting. with. _"'- -- - - '-- '-' - - HEATING SYSTEM 0-100,000 BTU 1 AND -DUCTING-- •-fF --- - -1-BUILDING -- - G� _. .' PERMIT $ SMIP ...$ licensed contractors to construct the project (Section 7044, Business 100-,000,+ BTU ; PLAN CHECK $ X19 PERMIT•.,, and. Professions Cotle: The Contractor's License.Law.does not apply to. - `ISSUANCE _$ an owner of properly who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU I PLUMBING $ - tracts from such_projects .with_a-contractor(s)_licesned pursuant -to SYSTEM- - - _ __ '.- - GRADING the Contractor's License Law). 1OQ000 + BTU • PLAN CHECK $ - "- - -r` O I am exempYunder Section '- - - B. & P. C. for this - -- -- - - ---- - - - y P $ 7EL'EGT0.ICAL"$,- reason- BOILERS BTU __.- __ _ '- - I '1 q<"�.'t MICROFILM $ - PLAN CHECK -$ - - _ Date Owner SYSTEM REPAIR, ALTERATION FEE $-_ EXHAUST SYSTEM MULTIPLE MECHANICAL,$ - - - ----- - - - - ) s 4 i' ' LESS AD- • / - - :I hereby certify that I have read this application and state that the above information is correct"I agree to comply with all city and 'County .. - PLAN CHECK $ - - -VANCE PC $-_ - ordinances and state laws relating to construction, and hereby authorize -of' - - representatives this--city-to enter upon the above mentioned for property ..in��siip""ection urposes. ��o Si9nalurey' ,L2 -.-.. Date 7-" S. -+f J� -_ (. FINAL FEE $�`�"' - ---ISSUE FEE I _ Drivers' License or 55- '- CMF 0865-46 White -Building; Conary-Applicant;Pink-Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # F y4i �p Date POOL & SPA' Inspector ' - r APPROVALS ' - Permit # - '- Date Inspector � -.1_ 1. Temporary Electrical Service or Pole -_ _ ^• 43.. Pool &Equipment Location _- - 2. Soil Pipe-Undrgrn . ' _ _ _ 44. Steel Reinforcement - - - -- - - --- -3. Electrical Conduit Utility-Undrgrn . _ - - 45: Forms -- - - -4. _.Electrical.ConduiLUndrgrn__ _ - _46. Electrical Bonding - - - -- 5. Steel Reinforce- 47. Rough Pfumbin6 & Pressure Test - - - ---- - - - -6... Electrical UFER Grn ;� ., 48. APPROVALTO COVER-GUNITE -- - -- - - - - - --- -" = •- „- � __7. Footings - - 49. Electrical Conduit-Undr rn --8. - •Foundation•-- _ _ . _ __ __ _• :.:. .' 50., Gas Pipe, Ed Undr rn, Test 9.. -Water P -i a-Undr rn.._.._ P 9 51. - " Backwash Lines P -Trap, '� ndr in "'•-- _ - 10., Structural.Eloor System.-. - - 52. , APPROVAL TO.DECK -11._ Property.Sewer_Line &.House Connection. _53..:. Backwash .& Receptor -Final 12: - Street. Sewer.. Connection._. _' `__ _ __. _ --- -- - - - 54. Heater & Vent -Final }_13._ Rough -Plumbing_,_ __--•_ _ _ •-.- -•-_ .._ _-- - -...- Final 14. Rough Electric -Conduit - - - -- - - -- - -- 56. -Electrical-Final •---- t, 15. Rough Electric -Wiring ' - - - - -- - -- - 57: Solar System -Final- *16. -Rough Heating &-Air Conditioning -- - - - "- - - --- - - encing & Access Approval 17. Ducts, -in -Structure APPROVED FOR PLASTERING 18. Ducts, Ventilating- ' 19. Gas Pipe -Rough &Test '_""' - ••I -20. -Roof Framing _t - --_- -. _ "'60. - -POOL/SPA.SY.STEMS FINAL 21. Roof Sheathing 22. -Frame and Flashing- - - - �-- --- -- - - " ... ,, - -- - --- - -NOTES'- ---- �- - , r..` , 23. Insulation -_ - 24. Lathing & Siding --- -- - -- _ :- -� -- ---- - .. " - - _-- -- - ,---- - ---- --• :+1 a ' 25. Drywall Nailing _ 26. Plaster Brown Coat - - - - -- - - r 27. Electrical-PowerMeter-Final ' 281 Final Electric' - --- -- - -- -- - '--- - - -- - -- _ - ,i•c-- - i. it 29: -Final Heating -& Air Conditioning - - -- - - - - - - - - - -- -- - -- --- - -- '• 30. Final.Gas Pipe -Test - - -- - - -- - - - - "-' - - - --� 31. Final Plumbing , 32. Water Service -Final- ' -33. Gas -Service -Final "---- - --_ - _ 34. Solar Domesiic-Final r 1 ..� _ I i, .:F `I�i�, • •'�, 35. Landscape Sprinkling System -' - - - - - • • " ' 36. Sound Attehuation 37. Handicap_ Regulations •' '� --- -- 38. FINAL STRUCTURE & BUILDING - i 39. SpecialkRequirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date I: _ Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. OF COSTA MESA- P R I .•,C Erg A�` TRACT NO. LOT NO.. BL G. O5.. .—.. _ 6 8/20%82 13.00 C60STRUCTION PEWIT /M, TUBE OF CSTRUCTION NEW D❑ ❑ALTERATION - ❑ REPAIR ❑ CONVERSION' ❑DEMOLISH- L . . - " - "' - ' ' ' roject Address OWner Phone Address 1,15117- ZONING REGULATIONS . i Aim/Eng. License No. ❑ OTHER- - DESCRIPTION OF WORK ' A.P. $ (ZONE -_ - .PLNG. REF',.,yf': . TYPE OF PERMIT '- '- -BUILDING- - -- WOR , SETBACK T. PIEOPE RTV LINE ❑.GRADING--;❑ FOUNDATION -- OSTRUC URAL- IDB YARD-- ❑ TENANT"C] ELECTRICAL �PL'UMBING S•tECHANICA SIEEpE VA - - - ', i ' Address - a _ _ Conhr7tor -- Phone _ Address � _ _ ,.., LICENSED CONTRACTOR DECLARATION - licensed 'under 9 I hereby affirm thLt I am provisions of Charter (com- mencing section7000) -of Division- 3 -of the Business and •.. , 0 OTHER '^ RIGHT with is _'REAR YARD (TO P/L) . Professions Cotly �� a4�I my license In full for pt t. -1. .- - PROJECT DESCRIPTION - -.- _.--. .. .. c Lltens¢�1pss��s�a�/��•cense Ne�� * PKG. SPACE REO. PROVIDED _ ._ .. SO..FT; ; _. ', __. _ _ _ - .. .. _ _. Date /�!7 Ciel,..."11.., /f/l/ STREET WIDTH ,,PARK FET E ,WORKERS' COMPENSATION DECLARATION -- - OCCUPANCY_CONSTRUCTION TYPE, f ZONING APPROVED BV -DATE" '1 hereby affirm that I have a certificate of consent to self -Insure of a VALUATION' ZONE I ,� s ,certificate o/ orkers• Compensation 1 ura ce, or a certified copy - - :SPECIAL CONDITIONS: lhereof (Se< 7B 16ab. C.). .GRADING CU. YDS. ACRES z Y No. IF 11 Company E i•�rtl tied Copy is hereby furnished.- - - - - -. _ _ _ - REMARKS: - -• - - --- -- . - -- d"- �ertifietl Copy is /tied with the city Building Division. J 1 EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - (This section need -not be-Completod if the.permitIs-for one.hundred - r �f ,- '- 'v '•� -�.'\_ - _ _ .i _ . _ __ ._ _ _ '-_ _. 1$100) or lessl. f _ 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 PLUMBING - PLAN CHECK - ELECTRICAL PLAN CHECK, - subject- to the Workers Co mpensatlon.Laws of -California. BATHTUBS SHOWERS TOILETS. - , (,,,URINALS j (�-- - .GENERATOR - 0-1 KW_1-10'KW TRANSFORMER .r Signature • .Date NOTICE: If after making this declaration, you should become subject to the Workers' Compensation of the tabor Code, provisions you must forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS`—• _ _ _-_ APPLIANCE 30-50'KW_50•+KW. - _ - revoked..- _-__ -. - _ __i __ -_ __ __— . _ -_�-. KIT.SINKS DISHWASHERS _ _ ._ -.MOTORS 0-0 HP 1-10 HP' - CONSTRUCTION LENDING AGENCY .I hereby affirm that [here is a construction lending agency for the per- SERVICE SINKS t `SUMPS -' — -- TINC. SOLAR) -- 10-50 HR= f -50 * HP - -�•-- - - - formance of the work forwhich this permit is Issued (Section 3097 ' FLO-OR DRAINS FIXT0RES - ` OUTLETS SWITCHESFLOSINKS\.LeNder,is,Name -which Civ.. C.). -- _ - - r Lender's Address -' - •"v •' z -^• - • OaINKING.FOVNTAINS' -7P - _ - _ S GATUBE SIGNS'" - "- , ', - rINTERCEPTORS CLARIFIERS - jPOLE LIGHTS' OW NEy DER O EC exempt ON'' "Y. - ' f affix addr3.Liesslo Law lar- I hereby affirm that I am exempt from the SWIMMING POOL - P TRAP - - - -" - - -- - -" ' - - POLES METERED SUB •-r :n-' 703Y5 Business Business ,Code:' folityd 'Any ,theAn or countywhit(Section city or county- which requiresnce r permit to construct, alter, t to construct, improve, repair any structure, Prior to its Issuance, also re- WATER SERVICE .a LTE RATION - ,- 'PANELS _ MAIN SUB - - - - ap,li ant f lice the ap,looant for such permit to file a signed statement that he -GASSERVICE OUTLETS - SERVICE _ - - '_ — AMP'—_ - - - is the provisions of the Contractor's License Law is licensed p(com en (Csiness _9 (commencing with Scolio 7000) of Division 3 Of the ' _ _ -WATER HEATERS -BTU OUTPUT, \ - _ f: ,f •.j — - - --- _ _ - -q — - Business antl and031.5 the nempti) or that he inion of Section b- �s for the alleged exemption. Any violation of Season 7031.5 by alleged _ ' SEWER CONNECTIONS -- - ,p a -permit applicant 'lo a civil penalty" ,t mor¢ than Live hundred tlo Ila rs 1$500). mo more than ed dollars_( SOLAR TANK COLLECTORS - - Y- - -- - - - - ' - - - - so ,, as owner of the property, or employees with wages at their' , a the structureofes is not compensation, will do the work, and - - - - - - s de: The or offered for sale. (Section 7044, Business and Professions Code: The or SOLAR PIPING SVS. ISSUE FEE- Contractor's License Law does not owner - - - d who es r himselfor r thereon, and who tich such were who builds or ISSUE FEE �_�, APPLICATION APPROVED BY-- DATE' n,emplet provided are through hos own.em poo that such improvements are enl. MECHANICAL PLAN CHECK .. ,._ SUMMARY OF FEES sale. howe Intended or offered for sale. It, however, the building or Improvement Is.sold-within.ono year of .completion, the owner will have.the burden of proving he did not build or Improve for the purpose of sale). B'1','as-owner of the property, -am exclusively contracting with HEATING SYSTEM 0-100.000 BTU C - - -- - - - ; I JI - _ .- ,_- TBUILDING- PERMIT E - _. _ -�•, _ ,-- - _ `SMTP E_-. licensed contractors to construct the project (Section Business 300,000, BTU' 1 - / (PLAN CHECK E PERMIT es not and' Professions Cotle:"The Contractor's License Law does apply to - - -- - - - - an owner of property who builds or Improves thereon, and who con- REFRIG RATI N 0-100,000 BTU �' iPLUMBING $ ,ISSUANCE tracts from such projects -with a' contractor(s) Ileesned -pursuant to SYSTEM - - --' - - _ --'-' - - - - -' IPLANCHECK GRADING the Contractor's License Law). ❑ Tam exempt unser Section - B.6 P. C. for this 100,000+BTU BOILERS BTU s $ •ELECTRICAL E ,, E reason" ' - - -' - - ' -- ' - " SYSTEM REPAIR, A_LT_ERATION 'PIAN-CHECK $ /� ;;� .MICROFILM b •, - rTOTAL FEE E. Date � - — Owner- - __ MECHANICAL $-//.>� I hereby certify that 1 have application ah that the aunty EXHAUST SYSTEM MULTIPLE LESS AD- agreeread-this Information is correct. I agree to comply with all city and county all PLAN CHECK -E _ VANCE PC $_ ortl inances,a ntl slaty laws.rel Ing to construction, antl hereby authorize � } _ repr Ctentativys f Is ai n Pon the above mentioned property fo Ion p /yin - •/�/ FINAL FEE E� $IgnalurC�Dale ISSUE FEE - - � - - - Drivers' Licon se or GMF 0865.46 White -Building; Canary-Applicant;Pink-Accounting; Goldenrod -Assessor TL I CONSTRUCTION AND PLANNING APPROVALS Permit �rJ I Date Inspector I POOL & SPA - 0 ' APPROVALS - Permits Date r Inspector' 1. Temporary Electrical Service or Pole 43. Pool '& Equipment Location` '-- - - - •- 2. SoilPipe-Undrgrn 44. Steel Reinforcement • - - 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding '- _ Steel Reinforce 47. RoughPlumbing& Pressure Test 6. Electrical LIFER_ Grn _ _ _' - - 48. APPROVAL TO COVER-GUNITE - _ 7 Footings - 49. Electrical Conduit-Undr rn' -6. Foundation _ _ 50. ,. Gas Pipe ❑ Undr rn, Test - 9. Water Pipe-Undrgrn _ _ 51. Backwash Lines P- ra -[D UAdrctrn 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 _ 13. Rough Plumbing _ - -55. Plumbina System _ Final- -- - - --' - - ` - - 14. Rough Electric-Conduit --- - - :-. --56. -Electrical-Final - 15. Rough'Electri6Wiling --- "- - - - -_ --'57. Solar System-Final 16. Rough Heating & Air Conditioning - 58. _ Fencing& Access Approval 1.7: Ducts in Structure APPROVED FOR PLASTERING 18.- Ducts, Ventilating + 60. POOL/SPA SYSTEMS FINAL - - 19. Gas Pipe-Rough & Test _ - 20: Roof Framing 21. Roof.Sheathin NOTES:' - 22. Frame-and Flashing --' _ _ _ _ _ _ 23. Insulation 24. Lathing & Siding 25._ Drywall Nailing 26. -Plaster Brown Coat _ 27: Electrical Power Meter-Final -. 28.- Final Electric _ - - 29. -Final,Heating & Air Conditioning 9t2 30. Final Gas Pipe-Test .31. Final Plumbing- 32. Water Service-Final - 33.- Gas Service-Final 34. Solar DomestiF-Final' • �• 35. Landscape Sprinkling System ' 36: Sound Attenuation 37. Handicap Regulations ',• j o- ; - •• 38. FINAL STRUCTURE & BUILDING 39. Special- Requirements Completed t "� 40. Electric Release to Edison - 41. Gas Release to Southern California Gas Co. - 1 42. CERTIFICATE OF OCCUPANCY No Date - - - „r to fill in all spaces within heavy border lines and sign all appropriate declarations. ' OF -COSTA MESA PERMIT NO. TRACT NO. LOT NO. G ` BC G. NO. - - _ 6719. .8/25/82 - 13.00 TL TRUCTION PERMIT QAddress r TYPE OF CONSTRUCTION 7AhApplicant Phon¢Sj ❑NEW - ❑ADD ❑ALTERATION - -5 2 �� - - - O REPAIR ❑CONVERSION ❑DEMOLISHZONING REGULATIONSg: - - - - --; - License No. - ❑ OTHER' -A:P.` - "-__ - - - - ' - '-- - - - - _ -- .. _ .. DESCRIPTION OF WORK _ '� - - 'ZONE PLNG, REF. �-- - Contractor - u / Phone TYPE PERMIT. - -.- _ -- - - _ - - TOBUILOING Address - - - - {�Eo p GRADING ❑ FOUNDAT O - ❑ STRUCTURAL- - SETBACK C ST. - ID YARD- PRO PE RTV UNE - -_ 'LICENSED CONTRACTOR_DECLARAYION "' 1 hereby affirm thct I am licensed under of Charter 9 (tom- �'❑-TENANT- ❑ELECTRICAL PLUMBING ❑MECHANICA 5EppF 'I provisions mencing with section- 7000)- of ' Olvislon -3 of the Business and. . ❑ OTHER. I RIIGHTA Professions Code, a d my license is in full force and effect. _ 'REAR YARD (TO P/L) - rn License Class y" -3 �- -'- License Ne.,3^� � PROJECT DESCRIPTION _ I _ __ -^' - i _-_ _ --- 'PKG-.SPACE REQ '� - _ _ - PROVIDED - -'-_ Date - -' _- -"'Signature. _i_ _ _ _ _ _ '_.'r_ . _ SQ. FT. ------..__- r . 1 _, _ _ - jSTREET'WIDTH-- - -PARK FEE i WORKERS'N- - . _ WORKERS' CO N.DECLate 'OCCUPANCY__ CONSTRUCTION TYPE Of c :I hereby affirm that I have a certificate of consent to self -Insure or a that I have VALUATION ZONE -,ZONING-APPROVED BV-- ' - _' -DATE oh Workers'- Compensation insurance,. or .a <ertifietl. copy.. - _ _ _ - '-" O 1 thereof (S ,thereof (Section 3800, Lab. 0.). C.). GRADING CV. UOS. ACRES SPECIAL CONDITIONSi P-`•cy No. _- +_- ..Company_' _ _ - _ _. - _ artified.copy Is hereby furnished... �. -REMARKS: 'i'•: ,citified copy Is filed with the city Building Division. EXEMPTION-FROM'WORKERS'"COMPBNSATION"DECLARATION - - This section need not be completed if the permit is for one huntlretl ($100) or less). ^i - - _-- - I certify that in the performance of the work for which th' permit IS i Issued, I shall not employ any person in an anner so o'become PLUMBI N(a r PLAN CHECK �- - ELECTRICAL - "' 'PLAN - _ CHECK -- -- -' -' s subjeto j�ie�l r eS:: Compen5 on o _ • 'BATHTUBS - -SHOWERS - -'-' -- - - - - - - ^' Date Signature C�wII 'NOTICE: If after making this ec lo S Id become zubjecI -jTOILETS;. , URINALS- '--' - _ GENERATOR- -- 0,1 KW -1-10 _ KW Workers' Compensat io vizi0 bor Cotle, yod must forthwith ,TRANSFORMER forthwith comply with suc vision t permit Shall be deemed LAVATORIES DOUBLE L`AVS •^' -- - - '.APPLIANCE - - 10-50-KW=50+KWL revoked.- "'KIT. SINKS- - -DISHWASHERS - -- - MOTORS r- - 0 -1 -HP - - _ .. 1-10'HPs - -- - -- - _ _ CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the per. SERVICE SINKS -- -- !SUMPS - -- - - -- I(INC..SOLAR) _ 10-50.HP 50- - formance of the work for which this permit is issued (Section 3097 j. _ FLOOR SINKS- - -----FLOOR'DRAINS - - - - -OUTLETS - SWITCHES - - --- - - Civ. C:).-- I Lender's Name jFIXTURES Lender's ACtlress DRINKING FOUNTAINS' GAS TUBE SIGNS- - - - - - - - OWNER BUILDER DECLARATION -" 1 hereby affirm that I am exempt from the Contractor's License Law for INTERCEPTORS --CLARIFIERS— -' - _ ---POL•E•LIGHTS- - - --- -- - - - - - -� the following reason• (Section -7031:5 -Business and Professions-Cotle: Any to - SWIMMING POOL - `P TRAP - - .POLES - _ - 'METERED' --.SUB- - -- city or county which requires a permit construct, alter, improve, demolish or repair any structure,' prior to its Issuance, also re- 1 -WATER 'SERVICE -ALTERATION'-`' - - MAIN- - -$UB-- -- - - - quires the ap.licam for such permit to file a signed statement that h¢ }PANELS- GAS SERVICEOUTLETS- - - SERVICE- -- - - - --AMP- - --- --- is licensed -pursuant to the provisions of tine Contractor's License Law i (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS - BTU OUTPUT' - -- - - - ---- - - - - - - -- - -- - - Business -and -Professions Code) -or that he is exempt therefromandthe ba<s for the alleged exemption. Any violation of Section 7031.5 by -SEWER CONNECTIONS - ^• -- - - - - ---- - -- -- - - - - - -- - - +-;' tpplica n4 for a permit subjects the applicant to a civil penalty _'•-""�t more than five hundred dollars ($500). - 'SOLAR TANK ' - - OLLEC-ORS ' - - - -- - - - -- - - -- - - - - - L�-,i. as owner of'theproperty, or -my employees with wages as their sole compensation, will do the work, and the Structure is not Intended _ SOLAR PIPING SYS. - - - i e>14 ISSUE FEE _ or offered for said. (Section 7044, -Business and Professions Code: The Contractor's License Law does not apply .to an owner of a property 'ISSUE FEE - -- - - - -�" - =APPLICATIONAPPROV ED BY - -- DATE who builds or improves thereon, andtl-who does such work himself or through his own employees, provided that such improvements are not MECHANICAL PCAN CHECK - � - $UMMA RV OF FEES _ Intended or offered for sale. If, however, the -building or Improvement' is sold within of the owner will have the burden one year completion, of proving lie tlitl not build -or improva -for "the 'purpose of sale). -' - - - - - - ' 'BUILDING1I . ._ _ - ❑ I, -as owner of the property, am exclusively contracting with HEATING SYSTEM 0-100,000 BTU !PERMIT $ SMIP,t •' .• E, '^ licensed contractors to construct the project (Section 7044, Business AND -DUCTING- 100,000'+ BTU _ _ _ ) - - _ CHECK $ PERMIT, - and Professions Code: -The -Contractor's License.Law does.not apply to. builds Improves thereon, ,PLAN � _.ISSUANCE_ $.' an owner of properly who or and who con- tracts -.from -Such projects with a. contractor(S) llcesnetl. pursuant .lo REFRIGERATION 0-100,000 BTU .SYSTEM- _. (PLUMBING E GRADING ' $ s the Contractor's License Law). 100,000 + BTU PLAN CHECK $ ❑ I am exempt under Section - B.6 P: C. -for this' E BOILRS BTV ELECTRICAL $ reason- -- --- -- - - 'PLAN CHECK $ ' MICROFILM $' Date. Owner SYSTEM REPAIR, ALTERATION - 'MECHANICHL - .TOTAL PEE $ 1 herby certify that I have read this application and slate the aunt¢ EXHAUST SYSTEM MULTIPLE $--- - --- LESS ADC - - Information y a carrell. I agree to comply with an city and county PLAN CHECK` -S- - -VANCE PC E d ordinances and state laws relating to construction. antl hereby authorise _ t represenlali ves'of lhi5'dty to u on the' above mentioned - 1 property f r i ion p /X� FINAL FEE $,13-00 signal ure Date's - _ Drivers' - s r - ( '- ISSUE FEE____ CMF 65- hite-Building; Canary-APPlicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit# �(1(0/0 Date Inspector' PODL-&SQA APPROVALS - Permit# Date Insper,%r 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - - - .2. Sod Ripe:Undrgrn. - __44. Steel Reinforcement - - - - - _777f. -- Electrical Conduit Utility-Undrgrn 45. Forms 4.. Electrical ConduitUndrgrn _ •_ 46. Electrical.Bonding, - - - Steel ein orce -' _ 47. Rough Plumbing & Pressure Test .6. ElectricalUF-ERGrn- _ - 48. APPROVAL TO COVER-GUNITE- 7. ,Footings_ 49. Electrical Conduit-Undr rn - 8. _ - Foundation - - 50. • Gas Pipe_ 11,Undr rn, Test - -- 9. -Water Pipe-Undrgrn._.,._ 51. Backwash Lines P-Tra _. ❑' ndr rn .10. Strumural.Floor.System. 52. APPROVAL TO DECK 1.1. -.Property Sewer. Line & House Connection. - .53. Backwash & Receptor -Final -• 12. _ _ Street Sewer Connection.. _ -- - -- 54- Heater &Vent -Final - 13. Rough Plumbing _ 14. Rout Electric -Conduit _ - - -- - ^ - '56. - Electrical -Final- -- ' 15. Rou h Electric -Wiring - - '•' -57. -Solar System -Final- - - - 16: -Rough Heating -& Air Conditioning- - - _787 -Fencing encing & Access Approval 1�7-: -Ducts, in Structure,. - � � - - - APPROVED -FOR PLASTERING -' ' --18' - Ducts, Ventilating- - 61). _ _.. POOL/SPA SYSTEMS FINAL., 19. Gas pipe=Rough&Test 4 - - - 20. - Roof Framing 21. Roof Sheathing NOTES:.' ...."' 22:-Frame-and Flashing ' 23. Insulation- - - - --- !-- ! -- - -•- - __ _. _. _ _ ___ _ _ __ _ 24:---Lathing-&Siding --- - - - •-- - 25. Drywall Nailing- i- 26. Plaster Brown Coat - - - - -- -^' - - - --27: -Electrical Power Meter -Final - - �- - 28: Final Electric- - - - - - - -- - - - -- ' - ---- - 291 Final Heating & Air Conditioning - --- - - ' 30. Fina)'Gas Pipe -Test- - --- -. -- 31: -Final 'Plumbing- - --- - - _ - 32. WaterService-Final- --- �• 31- Gas Service -Final 34. Solar Domestic-Firial 35. Landscape Sprinkling System - 36. Sound Attenuation 37. Handicap Regulations -• - - - 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. t 42. CERTIFICATE OF OCCUPANCY No. Date Applicant to fill in all spaces within heavy IS6r`�der mes and sign all appropriate declarations. F070 COSTA MESA PE MIT NO. TRACT NO. LOT NO. BLDG. NO 6394 5/26/82' .,CONSTRUCTION PERMIT 294 37G5� 1 I _ • I s?•52 Project Address - 51 - - � TYPE OF CONSTRUCTION - ..- I Owner - O U' - Phon ., Z 2, J NEW 0 ADD ❑ ALTERATION Addressr7Z - a U '- ❑MMM REPAIR ❑CONVERSION-DEMOLI-, - - Arch/Eng. - - j - License No' - - OTHER ZONING REGULATIONS, j Address - - - - - - - • - - - - _ DESCRIPTION OF WORK ,- - - _ A.P. �P- REF, iF IE Contraptor �'� -- -- -Phone,- - - _ 'ZONE i`'�---- -- PLNG _BUI DING• •- TVP,E OF PERMIT, ' SETBACKL ST. -11NOPEWTY IN '`% 'AddressI ' �- ,_ -,-; ��❑yyy GRADINGy,.'❑ FOUNDATION 0STRUCTURAL- EDp YARD-�I- LICENSED CO NT RACTOR'DECLARATION �t TENANT /g1 ELECTRICAL-XPLUMBING' �MECHANICA MIGHT _• _- ... I hereby affirm ths.t I am licensed under provisions of Charter 9�(com• ,. mencing with section -7000) of Division -3 -'of the "Business and _KT TA --- --' ---- - - - - -- Frofesslons Code, and my license is In full force and effect. •' - REAR YARD (TO P/L) .,, Licens_e_Class - License No. - -- PROJECT DESCRIPTION -1' - -- `- L. _ C/ 1 'PKG. SPACE REQ. ROVIDED- - - - Date a Signature '- s ,aeTOO - -I ,STREETWIDTH - .,-- ,,PARK FEE $ WORKERS•'COMPENSATION DECLARATION - -- - -- --OCCVPANC. •1" CONST' ONSTRl1CT.lON.TYP _ - I. herebyaffirm that I have a certificate of consent to self -Insure or a ' ' .ZONING APPROVES BV DATE - certificae of -Workers' Compensation Insurance, or a certified -copy VALUATIOZONE _ ' 'SPECIAL CONDITIONS: -•eof (Section 3800, Lab_. C.). 1 _ _ _ GRADING CU.:YDS. ACRES '.y No. � Company - - - -- _ --'-- - - - " dertifleci copy is hereby furnished. - -- - -- - - - REMARK4 - _ - ✓ s ❑ Certifletl copy_Is tiletl with the city Building Division.tv 3 r/ �I - •EXEMPTION FROM WORKERS' COMPENSATION DECLARATION -- - 'i1f (-/a --- - - - - - - - (This- section need not be -completed -If the permit Is for one hundred. ($100 or less). - ,• I cert♦'fy that IR the -performance of lhe�work.for which this.permit Is - ____ �__ _ _ issued, I shall not employ any person in any manner so as to:become PLUMBING J -•,PLAN CHECK - �sE LECTRICAL - PCAN,CHECK - subject -to the Workers' Compensation Laws of California. = - - - - Date -Signature BATHTUBS SHOWERS FT -- - - r - NOTICE: If atter making this declaration, you should become subject •yTOIEETS'.„. ,),C 1 r"URINALS - I GENERATOR ----0-1 - -- 1-10 KW - a to the Workers' Compensation provisions of the Labor Cotle, you must TRANSFORMER I orthwith comply with such provisions or this permit shall be deemetl LAVATORIES DOUBLE LAV$ - - • -/ 'APPLIANCE 10-50'KW=50-+ KW'- ” -' -' •'�- -' KIT.SINK$ DISHWASHERS . - 'MOTORS'--"-- _- 01HP_1-10HP CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the per. - I} SUMPS � - - (INC. SOLAR)-- 10-50-HP=50 + HP - - - - - formance_of-the work fpr Whi<h_this permititIsIs Issuetl (Section 3097 SERVICE SINKS _ jr- Civ. C-). L Lender -'s Name FOOR'SINKS FLOOR DRAINS t FIXTURES -OUTLETS 'SWITCHES _ •_ _ `s• Lender's Address -,DRINKING FOUNTAINS - _ GAS TUBE SIGNS - - "- - - - - - � � � �� OWNER BUILDERDEC_LARATION - -- - •-• rINTERCEPTORS CLARIFIERS r POLE EIGHTS - -- - - "" --- I hereby. affirm that I'am exempt from the Contractor's License Law for - - - - the following reason (Section 7031.5 Business and -Professions Code:- SWIMMING POOL,s t,: PTRAP j - 'POLES METERED -.SUB Any -city. or county --which- requires_ a'permit Acl'Construct, alter, _ _ Improve, demolish dr.repair any structure, prior to iti issuance, also,,¢- WATER SERVICE ALTERATION ;PANELS- MAIN- - SUB (: - Quires the api,licant'Yor•such_ permit tofile a signed statement that he • is licensed pursuant to the provisions o,f the Contractor's License -U. '-. -" ----- - - (Chapter.9- (commencing with Section 7000)•,of Division 3 of the GAS -SERVICE OUTLETS -T SERVICE -' - _-'- -' -'- ' AMP -- - "'siness and Professions Code) or thatrhe is exempt therefrom and the WATER HEATERS--/ CBTU OUTPUT - a - - - -" --" ---- - - - -- -' : for the alleged exemption: Any violation ppli .of Seaton 7031.5 by -_ applicant for a' permit subjects the applicant to a Civil penally NNE --" -- -" - ------ •--- ---- ----- - -- - - ,,. not more .tnanstive•huntlretl tlollars�.($500)'. _ � .SEWER,CONNECTIONS -i - , , ❑'1, as owner of the property, or work, a employees with s not I ae their ^SOLAR TANK - t COLLECTORSor eco offered for sale. will dost he 44,Business santhe.d Profess isnot Intended I "` _ or Offered for sale. (Section Law -does -not Business antl Professions Code: The SOLAR PIPING SVS. it - 1 ISSUE FEE - --- - -- - Contractor's -License es thereon, a apply doeso.an owner work or --APPLICATION'APPROVED'BV' - - DATE•j Who builds or improves thereon, and who such suchmor work himself or ISSUE FEE " I through his -own -employees, provided that Such Improvements are not intended or offered for sale. If, however, the building or Improvement MECHANICAL PLAN CHECKSUMMARY OF FEES 1 ' - is -sold within -one year of -completion, the.. owner -will have the burden f proving he did not build or Improve for the purpose of sale). - !BUILDING _ 1, -as' -owner of the property, am exclusive) HEATINGSVSTEM__0-_100,000 BTU _ .PERMIT $ 7- •-SMIP -$ p P Y. Bono 7044, -contracting with AND DUCTING 1) 1 1 " is nsetl contractors to construct the project (Section es not Business 100,000,+ BTU l 'PLAN CHECK $ ".PERMIT - and Professions Code: The Contractor's License Law does apply to - - - - - - G - - - - ISSUANCE- $ -^ an owner -such property who builds or Improves thereon, and who con- REFRIGERATION_ 0-100,000 BTV ' 'PLUMBING E .rr.. - a� he Cofrom rsLicene Law). a ContrdGtpr(s)'lit¢sned pursuant to- -SYSTEM -- '- - - --- f ^- - GRADING 'E he Contractors License Law)._ _ 100,000+gTV � �_C ' - _ � jPLAN CHECK •E- - ''�� ' 3y,;' I am exempt under Section B. & P. C. for this BOILERS BTU 'ELECTRICAL E-LGG�i� -� E son` - - - - - aPLAN CHECK $ -' - - MICROFILM S ' SYSTEM REPAI R, ALTERATION e' - '- --Ownes(-- - - -- _ -TOTAL• FEE $ a' `M ECHANICFiL $ - - _ tebycertify that Lhave.reatl this application and State that the above. EXHAUST SYSTEM MULTIPLE _ - •' •v - LESS AD- ation is correct. 1 agree to comply with all city and county PLAN CHECK' -S VANCEPC -$_ p�nces and state laws relating to construction, and hereby authorize,- fgnta o['T7Ys c'WEg ter n the above 1mentiooned " - St e r insp ti DatetFINAL FEELicense or SS #ISSUE FEE -- -- - -- - -- - - - - - X35-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor TL SL X35-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor TL SL CONSTRUCTION AND PLANNING APPROVALS Permit # Q ��.1 Date Inspector, -.. - POOL & SPA i t gppROVALS Permit # Date Inspector _ 1. Temporary Electrical Service.or Pole 43. Pool & Equipment Location - - - - -- - a 2. SoilPipe-Undrgrn . <,�:.. .•;} -44.,;. Steel -Reinforcement - - 3. Electrical Conduit Utility-Undrgen '.": 45. Forms 4. Electrical Conduit-Undrgrn _ 46. Electrical Bonding tee m eorce - 47. Rough Plumbing & Pressure Test - _ 6. Electrical UFER Grn - '48. APPROVAL TO, COVER -GUN ITE. 7. _ Footings 49. Electrical Conduit-Undr rn,- - . 8. _ Foundation _ _ "_' ' - - 50. Gas. Pipe, ❑ Undr rn, Test - Water Pipe-Undrgrn 51. Backwash Lines P-Tra ❑ ndr rn ' 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 113..- Rough Plumbing _ _ - 14. Rough Electric -Conduit - -- - -56. Electrical -Final - 15.- RoughElectric-Wiring- --' -" - '57. Solar, System -Final - - - - -16. - Rough Heating & Air Conditioning - _ _ Fencing & Access Approval 17.. Ducts in Structure. - _ - _l58. 9. APPROVED FOR PLASTERING 18. 19: 20. Ducts, Ventilating. Gas Pipe -Rough'& Test - Roof Framing _ _ _ _ _- _ - 60.POOL/SPABYSTEMS FINAL _' •" - 21. 22. ;. Roof Sheathing Frame and Flashing'NOTES: - _ 23:- Insulation Co¢i )-t &'j e 24.- Lathing & Siding _ _ � I / c 25. Drywall Nailing 26. Plaster Brown Coatd, • 27. Electrical Power Meter -Final _ _ - � r (Alr oil 661 28. -Final Electric - \ _ _ _ _ ' ' • - 29. Final Heating & Air Conditioning - •. 30.- Final -Gas Pipe -Test _ _ �_ ' _31:. FinalPlum6ing _ _ _ 32: Water Service-F'nal_ _ _ _ •'- - - " - " 33.. Gas Service -Final ' 34. Solar Domestic -Final' -- ' 35. - Landscape Sprinkling System' 36. Sound Attenuation 37. Handicap Regulations - •Cr 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas.Co. 2,. CERTIFICATE OF OCCUPANCY No - 33 `s/3 Date -9-26-9- A Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITKOF COSTA MESA PE I NO.�/ TRACT NO. LOT NO. BLDG. NO " CONSTRUCTION PERMIT Applicant's Melling Address _7 TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH ❑OTHER It, after making this declaration, you snoula become 'se DJecr zo me Compensation provisions of the Labor Code, you must forthwith with such provisions or this permit shall be deemed revoked., RUCTION LENDING AGENCY affirm that there Is a construction lending agency,for the performance .work for . which this permit Is Issued (Section 3097' Civ. C.) Name s Address [BUILDER DECLARATION - ) affirm that I am exempt from the Contractor's License Law for the kg reason (Section 7031.5 Business and Professional Code: Any city or which reauires a hermit to construct. alter. Improve. demolish or repair +•-'2'1`efrom and the basis for the alleged ex ::"+r:'1.5 by any applicant for a permit -ally of not more than five hundred doll: n I, as owner of the . property or my ei compensation will do the work, and the s for sale'(Se,Ion 7044, Business' and- Prc License Law does not apply to an owner of thereon, and who does such work himself employydes, provided that such Improvemer sale. I/, however, the building or Improven pletion, the owner,wlll have the burden of Wive for the purpose of sale). as owner of the property, am exclusi ..tractorsto construct the project(Section 7( The Contractor's License Law does not al builds or Improves thereon, and who cont tractor(s) license pursuant to the Contract ❑ 1 am exempt under Section Date Owner I -hereby -certify that I have read this apt Informal ton Is correct. 1 agree to comply s and state lidligg constrL sentatives of Is c10 to e t Lipo tl Inspection p see. Signature Drivers' License or SS 1P CMF 086546 rev. 12/82 White -Building; Floor Sinks Sas Service Outlets Interceptors Kitchen Sink Lavatories , e)' or Inas', na sne'ls exempt , Project Address Owner's Name Aoki MEN -21 Phone DESCRIPTION OF WORK Service Sink - Address IP— TYPE OF PERMIT GRADING UNDATION STRUCTURAL 11 TENANT El ELECTRICAL PLUMBING ❑ MECHANICAL . Arch/Eng. '^ License No. - Address' �� ❑ OTHER Contractor's Nama!0aJLW.6r�—Phone se-` party who builds or improves If or through his or her own PROJECT DESCRIPTION SG. FT. OCCUPANCY— Duet -Under Ground Address(mailing) - t License Nd. CONSTRUCTION TYPE VALUATION$ ZONE_ GRADING CU. YDS. ACRFc _ LICENSED CONTRACTOR DECLARATION - Remarks: ontracting! with licensed con- usinest and Professions Code: ' _Standing Sections I hereby affirm that i am licensed under provisions of Charter 9 (commencing . Garbage Disposal with section 7000) of Division 3 -of the Business and Professions Code, and SMIP l my license Is lit full force and effect. PLUMBING $ License Class License No. I Dale ' Signature Bar Sink Sewer Cap - 1 city and county ordinances WORKERS' COMPENSATION DECLARATION Backflow Preventer Sewer Connection ' PLAN CHECK hereby affirm that.l.have a certificate of consent to wif4nsure or a certificate Workers' Compensation Insurance,or a certified copy thereof (Section Backflow Irrigation Solar Collectors $ .00, Lab. C.) I f I Date „ _ Policy No. i Company - ' Certified copy Is hereby furnish ad. r-�� Bathtubs Solar Piping PLAN CHECK Cert fletl copy s leo with [he city�IgWL Itl-ing 8.1,, . Da e�— Applicant Clarifiers Solar Tank _ $ EXE TION FROM WORKERS' COMPENSATION D ELARATION I (This section need not be Completed If the permit Is for one hundred ($100);or Dishwasher Swimming Pool w/Spa , -- ; Drinking Fountains Urinal $ less) l I certify:that In the performance of the work fo ch this er Issue shall not employ any person In an mmf�itner stlr�WylVjo bpcglpps ubj c[ toQyl,]�BI Workers} CoWpenl2tin Laws of Calif9inia. - vj I,�g.j�- - - �// _ Floor Drains Water Closet It, after making this declaration, you snoula become 'se DJecr zo me Compensation provisions of the Labor Code, you must forthwith with such provisions or this permit shall be deemed revoked., RUCTION LENDING AGENCY affirm that there Is a construction lending agency,for the performance .work for . which this permit Is Issued (Section 3097' Civ. C.) Name s Address [BUILDER DECLARATION - ) affirm that I am exempt from the Contractor's License Law for the kg reason (Section 7031.5 Business and Professional Code: Any city or which reauires a hermit to construct. alter. Improve. demolish or repair +•-'2'1`efrom and the basis for the alleged ex ::"+r:'1.5 by any applicant for a permit -ally of not more than five hundred doll: n I, as owner of the . property or my ei compensation will do the work, and the s for sale'(Se,Ion 7044, Business' and- Prc License Law does not apply to an owner of thereon, and who does such work himself employydes, provided that such Improvemer sale. I/, however, the building or Improven pletion, the owner,wlll have the burden of Wive for the purpose of sale). as owner of the property, am exclusi ..tractorsto construct the project(Section 7( The Contractor's License Law does not al builds or Improves thereon, and who cont tractor(s) license pursuant to the Contract ❑ 1 am exempt under Section Date Owner I -hereby -certify that I have read this apt Informal ton Is correct. 1 agree to comply s and state lidligg constrL sentatives of Is c10 to e t Lipo tl Inspection p see. Signature Drivers' License or SS 1P CMF 086546 rev. 12/82 White -Building; Floor Sinks Sas Service Outlets Interceptors Kitchen Sink Lavatories , e)' or Inas', na sne'ls exempt , JnVwen an;Any viola cod of Section is the applicant to a civil 00). Service Sink - ees with wages as their sole Sub Pole I ' re is not intended or offered - net Code:' The Contractor's ' '.Ina Solar 09-15 HP C3 16-15+ Boiler 11' party who builds or improves If or through his or her own F.A.U. Duet -Under Ground not intended or offered for sold within one year of com- lg he/she did not build or Im- • Device Boxes 1 Duct -Structural ontracting! with licensed con- usinest and Professions Code: ' _Standing Sections Duct - Ventilating 7 o an owner of property who 'or such projects with a con- ante taw). Garbage Disposal Exhaust System ❑ Multiple SMIP l Firepl/Fact. Bit. ICBO;W & P . for th reason $ - PERMIT Heating System & Ducting 00.100,000.BTU 13100,000 on and state that the above - 1 city and county ordinances ISSUANCE $ PLAN CHECK Hood or Type 1 ❑ CenO Typ,II ❑' Canopy and hereby authorize repre- rope rty for we $ Registers Date „ _ Y - Applicant; Pink - Accounting; Goldenrod - Assessor Water Heater Water Service _ Reinspection Fee Issue Fee 3 PLNG. REF. els TO BUILDING PRPE Y INE LEFT SIDE YARD PKG. SPACE REG. STREET WIDTH 7594 4/21/83 9a021 T1 PETo nrr l'1l er'- REAR YARD (TO P/L) RIGHT SIDE YARD - PROVIDED - - , PARK FEE $ Automatic Washer _ Mater LJ over 100 amps , Construction Pole - Sub Panel! Cooking Unit Sub Pole I ' Dishwasher - Motors 00-1 HP ❑196-8 Dryers ❑Gas:❑Electric '.Ina Solar 09-15 HP C3 16-15+ Fan - Microwave 1 F.A.U. 'Pole Light I Fixtures ,Range Device Boxes 1 Sign I Outlets _Standing Sections Switches - Trash Compactor Garbage Disposal $ 00-100,000BTU 11100,000BT6 System Repair/Alteration �'�• Reinspection Fee .•�. $15 Issue Fee I '�$ 3 Generator ❑0-5 KW ❑5-15 KW Transformer 1115-SOKW 050+ KIN Reinspection Fee $15' Meter ❑uptot00amps 'Issue Feer l $ 3 Zoning Approved By Date Application Approved By ' Date l Application Issued By Date SUMMARY OF FEES P BUILDING PERMIT $ SMIP l $ PLAN CHECK $ - PERMIT ' 'PLUMBING $ ISSUANCE $ PLAN CHECK $ GRADING - $ ELECTRICAL $ $ PLAN CHECK $ MICROFILM $ MECHANICAL $ TOTALFEE $ PLACHECK $ LESS ADVANCED PC $ / \ FINAL FEE tO C7.:?� r, 7__•• 7GK >�r AND, PLANNING, ? o 1_: .'��: n- POOL: A� :. @•' t-: °-' -CONSTRUCTION _ ' c � �eOate^ Sk 0APPROVA LS Perini;# - .c .Inspector > - - ', APPROVALS Permit # _Date :Inspector - - n i1r. Temporary (Electrical Service o'_r1�Pole ! �' ti •i".- r ' ''52.= Pool &`Equipment Location- i' 2: `Soil Pipe-Undrgrnd. °53.' Steel Reinforcement - 3: Electrical•Conduivl)tility=Undrgrnd N; ` a� '�54_'. Forms - •- .'; - - ;`- - 4: ndrgrAcF. 55. Electrical Bonding 5: Steel• Reinforcement _ ` ' - 56.• Rough Plumbing -& Pressure Test 6. ,Electrical UFER Grfnd.' i I �' = r1. 57c APPROVAL TO'COVER GUNITE 7. Footings' !3 R' j o 581 Electrical'Coriduit-Undromd.. - I'^ c , - 8. Foundation i= •" °" " "• �� ' O Undrgcnd., Test - _ ._ r'`• _! ^ ,59.Gas'Pipe, 9. Water Pipe-Unilrgrnd. Backwash Lines, P-Trap, O Undryrnd._ 10. Structural Floor System 'o - _ _ F- •.61. APPROVAL TO-DECK 11. Property Sewer Line &'House'Connection' 62. Backwash & Receptor-Final c i. 12. Sev er.Cap V 63. Heater&-Vent-Final 13. RoofiDrains ' ' I �• _ -64. Plumbing-System:Final -g Y 14. Rouyh'Plumbing • �� ' X65. Electrical-Final - - - - 15. Roughtlectriml-Co`riduitT ''�, j ,-" 66, Solir,System-Final ---- - •- - - I ,- s16. Rough Electric Wiring, H ; E t -{- •ii'-� ; _ {'- 67. Fencin & AccesrA - - - - - - ry 17: Rough WiringSign ` j ) ;I j ' ___--., '68, APPROVED FOR PLASTERING ' . I 181 Rou9FlElecttical-T:Ba'r Ceiling j4 I, ' ,69. POOL/SPA SYSTEMS FINAL , - i 19,. Rough Heating & Airibonditioning i .' :- FIRE DEPT.,REQUIREMENT- APPROVALS, Permit # i 20: Rough Factory Fireplace ! ". ! I a 21.;Ducts, in Structure'- ; r' ! I i 70. Underground Hydro I 1'-22. Ducts, Ventilating _ j '71. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test I ! I 72. Underground Flush _ , 24. Roof Framing{ �o I ,'; .'•�','-•�_ s1 I+.I. X73. Undergrnd.Storage Tank ' , ,.OGas,OOil 25. Roof Sheathing ; I �. ` ' : '' - 174. Overhead Hydro - - ' 26.'T-Bar Ceiling`(Structural). & Monocoat I ! ''' ` '- i ! 75: Dry Chemical - - _27.}Frameand Flashing] -: I •' i ` 176. Dry Standpipe 28. Lathing &Siding' •„,77. x- FIXED SYSTEM FINAL ' " 29.. Insulation =t I 1 1 I •78: FIRE PREV. FINAL ' '30.'Drywall Nailing ' ` I'. it I I I j ' i ]Notes:4011r?aP I dL ja ill, 31. 'Plaster Brown CoatI '1 - • 32.-Electrical: Power MeteFinal jl �' �. �� _ ZA ' 33.•'Final Electric_ f34. Final Heating&•Air Conditioning 35. Final Ga's Pipe-Test ' 21 36. Hood r'banoPy=', - 37. Final Factory Fireplace - +' *• .- 1 ! .' _ 38. Final Plumbing' 39. Water Service-Final 40. Gas Service-Final I I ii j i j 41. Solar Doiriestic-Final I , 42. Backflow Preventei n ' I ; ' ^;_ 1 ' • - __r. _ _.. _ _ 43. Backflow Irrigation �_ I I 1 ,.;_, - I _•' 44. Landscape Ir rigation•Systeml ' _- _• = I . .; - - 45. Sound -Attenuation;.. I j j ! `.• - - - ,. -' , I I v _ 46. Handicap Regulations •� 47. FINAL STRUCTUiRE;& BUI'LDINGi i I j,. { _ 48. Special Requirements Completed 49. Electric Release to Edisoni I II , J __ -r { i 50. Gas Releaselto Southern California Gas Co 51. CERTIFICATE_OF OCCUPANCY No " j Date I I I I j , 4��' �� Applicant 7- OF COSTA MESA a CONFRyCTION PERMIT to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 7593 4/21/83 16g0� II PERMIT NO. TRACT NO. LOT N0. BLDG. oµS � Applicant's Mailing AddressAAQ.TYPE Project Address Owner's Name /SL6�r �y�L�=�s� phone .7GT�l� OF CONSTRUCTION U ❑ CONVERSION ❑ DEMOLISH DESCRIPTION OF WORK NEW U ADD U ALTERATION U REPAIR ❑ OTHER -ZONING REGULATIONS TYPE OF PERMIT GRADING 'FOUNDATION STRUCTURAL CITE NANT I� ELECTRICAL UMBING ❑ MECHANICAL [],OTHER _ PROJECT DESCRIPTION SO. FT. - OCCUPANCY A. P. tW ZONE Address Arch/Eng. License No. '� BUILDING PLNG. REF. qM+. QP Address � / Contractor's Nam>C'�( zx'L�miolejogm phone TO BUILDING PROPERTY INE REAR YARD (TO P/L) LEFT SIDE YARD RIGHT SIDE YARD Address(rilailing) License No. CONSTRUCTION TYPE ZON J= GRADING VALUATION$ CU.YDS. ACRES PKG. SPACE REQ. PROVIDED __ LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: STREET WIDTH PARK FEE $ SPECIAL CONDITIONS: _ with section 7000) of Division 3 of the Business and Professions Code, and my license It In full force and effect. PLUMBING 6canse Class' License No. Date Signature, r "IRKERS' COMPENSATION DECLARATION 'say affirm that I have a certificateof consent to self-insuie of a certificate vorkers' Compensation Insurance, or a certified copy thereof (Section aed0, Lab. C.) I I Policy No. Company Certlfied co DY li hereby furnished. I Bar Sink Sewer Cap - - - ELECTRICAL ' Backflow Preventer - Se war Connection -! _ Automatic Washer Meter Uovqr 100 amps -' _ - Backflow Irrigation' Solar_ Collectors - Construction Pole 'Sub Panel 1 Bathtubs - Solar Piping Cooking Unit ' - { .Sub Pole Cdr iftey oD I fllttl with the cityslain -' // e�•2.t�'j t APPliwnt/•'- X - •�1�� Clarifiers Solar Tank Dishwasher - .Motors 00-1 HP ❑l X$ ' EXEMPTION'FROM WORKERS' COMPENSATION LIECLARATION (This section need not be completed if the permit Is for one hundred ($100) or Dishwasher Swimming Pool w/Spa - Dryers ❑Gas ❑Electric' 'Inc. Solar, E19-15HP ❑ 16-15+' ' ( Drinking Fountains Urinal Fan, ;Microwave less). ! - less). that In the performance of the work for which t s permit Is issued I shall not employ any person in dny pea 5 ' `to OTB jest. to he Worker ' C enj;tj9n, La Ws of Calif n a.' ( Iri Date e' %cry Signature NOTlfter making -this tleclarat on, you should become subJeCt to the Workers' Compensation provisions of .the Labor Code, you must forthwith comply With tush provlslons'or this permit Shall be deemed revoked.. Floor Drains, - Water Closet' F.A.U. ' ,POIB LI ht g Floor Sinks L. - Water Heater Fixtures Range _ Gas Service 'Outlets Water Service DiBoxes Device Sign CONSTRUCTION LENG-AG ENCU - - I hereby affirm that there Is a construction len tling agency for the performance of the work for which this- permit is . issued _(Section 3097 Civ. C.), Lender's Name i Interceptors Outlets Standing Sections ' ' Kitchen Sink % Switches Trash Compactor Lender's Address - OWNER BUILDER DECLARATION "' ' Lavatories .. Garbage Disposal I hereby affirm that I am exempt from the Contractor's License Law for the•Generator following reason. (Section 7031-5 Business and Professional Code: Any city or county which requires a permit t0 construct, alter Improve, demolish or repair any structure, prior to Its'Issuance, also requires the applicant for such permit to file d Signed Statement that he/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (Commencing with Section 7000) of 'Ion 3 of the Business and Professions Code) or that he/she Is exempt from and the bails for the alleged exemption. Any violation of Section 5 by any applicant for a permit subjects the applicant to a civil enalty of not more than five hundred dollars ($500): I 1, as owner of the•property or my employees with wages -as their sole compensation with do the Work, and the structure Is not Intended orofferedMECHANICAL ' for ns a Law dionoe of apply of apronal- Code: The Contractor's ' owner if a grope or throDui ids or Improves ly to an andowner License Law does not apply work or through his or her Own employees, provided than such improvements are not within o or offered for employees, provided the tush work hirnove elms are sale. It however, the will hav ng a Improvement is sola within one year of cpm- pletion, the ownerrpose 11 have the burden of proving he/she did not build or im- .r o for the purpose of sale). p_Tra p E10-5 KW 05-15 KW 1 ' Roof Drains - 7 Transformer Ell 5-50 KW ' ❑50+ KW ' Reinspection Fee l - - - Showers - - Reinspection Fee - $15 - - Meter ❑up to 100amps I Issue Fee' $ 3 - _ Service Sink Issue Fee - $ 3 Zoning Approved By Date Application Approved BY ate t Application 1 Issued B ' Date - i Boiler ' Refrigeration System / -' U Duct -Under Ground ❑0.100,000 BTU ❑100,000 BTU rY - SUMMARY OF FEES .BUILDING PERMIT $ SMTP $ Duct -Structural System Repair/Alteration WI. as owner of the proporty, am exclusively contracting. with licensed con- Wtraclorsto construct the project (Section 7044,. Bu siness and Professl ons Code: The Contractor's License law does not apply to an owner of property who builds or Improves thereon, and who contracts for such projects with a con- PLAN CHECK $ PLUMBING $ PERMIT —yq—�� ' ISSUANCE $ _ Duct -Ventilating - f Exhaust System ❑ Multiple ❑ •'"' tractor(s) license pursuant to the Contractor's License law). ❑ 1 am exempt under Section B.LIP. C- • r this reasonFirepllFect. -� PLAN CHECK I $ GRADING $ _ Bit. ICBG dk - ELECTRICAL $ PLAN CHECK $ MECHANICAL $ I I PLAN CHECK' $ ,•/ . 00 MICROFILM TOTAL FEE LESS ADVANCED PC I FINAL FEE $ $ $ $ /y $ "Do Date owner YjLA I here y certify that I have read lhip ysop I with all and state that rdi abo Information Is ceratin. I agree to comply with all city and county ordinances and state laws relating to puiltling construction; antl hereby authorize repro- santatives o his ciq to enter pen a ab-mantlonatl property Derty for Inspection rases. I Signature Date 4- 21-' 3 Drivers' License or. 55 - Heating System & Ducting ❑0100,000 BTU ❑100,0006 -- - r l a= f �- Hood or T e I ❑ yP Reinspection Fee. Cano T e II ❑ .575 Registers Issue Fee ',$ 3 CMF 0865-46 rev. 12/82 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor ;60_NSTkUCTIbN AND PL:AiNlr�cr j T "� '. , � -, ;�nsp`i " I. , - -POOL IPA �". -, %� ., : - -4 - w... i : -.� Zite,- APPROVALS Permif4#- t Inspector APPROVALS Pit .... t+* Pate Aiispector 52? Pool & Equip m-ent Location Z 2. Soil Pipe-Undrgrnd 5,3° Steel Reinforcement �3 d. Ei;ctrtcal 63nduit Utility-Uhdr _drnd. 4'* * 54. Forms.. 4. Electrical Cbnduit-Un&grncP. - z- r! 55. E lectrica 1. Bonding SiH!Rbinforcement 5j 513.1 Rough Plumbing & Pressure est --i.- _jElbctrical LIFER 'Grr4d. 57:: APPROVAL TO COVER-GUNITE 7-• Footing� 17 t 758:' Electrical cal Con.duit-Undrcrnrl: u; 8. Fdil atiori 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pip ndrgrnd. Backwash,Lines,:P-Trap, 0 Undrgrnd. 1,10. Structurbi Floor System 61. APPROVAL TO DECK 1. - ProO*ty Sewer Line &:House*C6nnection' Back.wash.& Receptor -Final _j P 7 .62 12. Sewer Cap '•63. Heater & Vent -Final a 13. Roof Dr iri� 64. Plumbing S�stern Final 14. Rough,Plumbing 1 •65. Ele6trical-Final '?'15 -Rough Electrical:Conduit--------r--'�-1 66.. Sbiar,System-Fifial "Y&.• Etectric Wiring::" 5 j-. 467 -Fencing & Accesi Approval Rough Wiring'Sign, Ff 168.' APPROVED FOR PLASTERING libugh-Electri6al'-'T,78a"`r Ceiling 66.1 000 L/SPA SYSTEMS FINAL 19.. Rough�Heating &'AirConclitioning FIRE DEPT. REQUIREMENT • vlace 20: li;ugh,Fattory Firei APPROVALS Permit q#- ' 21' Ducts; in Structure 170. Underground Hydro 22. Duets, Ventilating 71. Product Piping 0 Gas 00il 23.,Gas Pipe -Hough & Test 72. Underground Flush' c24. Roof Frarni . ng ; 173. Uncle rgmd. Storage Tank 0 Gas o Oil 25,Roof Sheathing I 74.. Overhead Hydrb Bar _26. 'Bar Ceiling IStrLeturaf), I�onocoV T' i 75: Dry Chemical �ar�ieand+lash iing, d 176. D�y Stan pipe 28.;Cathing &Siding '77: FIXED SYSTEMFINAL ,_29., Insulat.ion 78. FIRE PREV. FINAL 30. Drywall N ling at Notes: -jl j'.V' 31. Plaster,BroWn Coat 32.11 Electrical, Power Meter-Fmal 33. Final Ele6tric 34. Final Heating,gi!,Air Conditionin$ Z? I I I , ; �g j" 35. Final Ga's, PiiFe-'Te. 36. Hood Pr I, 37. Final Fa6tody'Firiqtl"aces, 38. Final P16rribing 39. Water.Ser'vice-Final 40. Gas Siry ice -Final 41. Solar b66stic-Firial 42. Backflow" Preventet 4 43. Backf low Irrigaii8n j 44. Landscape frrigation, System, 45. Sound =Attenuation" ^ 46. Handicap Regulations; I 47. FINAL sTRu&rU_RE-& BUILDING 48. Special Rect'Arements Completed' I 49. Electric Release' tolEdison 50. Gas Release!to Sou[hern California Gas bD 51. CERT�IFI OF OCCUPANCY 1!10A�TEI No- Date T I A �� Applicant to fill in all spaces except those within heavy border lines and sign all appropriate tleclantions. CITY OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. BLOT NO. CONSTRUCTION ER_MIT -- 6 p • Project Address, r TYPE OF CONSTRUCTION LJ NEW LJ'ADD ALTERATION, LJ REPAIR Applicant's Mailing Address7�'rs'Sr''-��CUG=-I•� ❑CONVERSION ❑DEMOLISH ❑OTHER: Owner's Name -POLI,UM FQT>�_' Phone DESCRIPTION OF WORK Address' - TYPE OF PERMIT GRADING FOUNDATION 0 STRUCTURAL Arch/Eng. License No. ❑ TENANT I ELECTRICAL ❑ PLUMBING ❑_MECHANICAL Address '_❑,OTHER .S Contractor's Name�iLIE�LN G'LICG �r•.�phohe� PROJECT DESCRIPTION SG. FT. OCCUPANCY Address (mai l i ng) Z S'r ^ISFUC L,/ _e> •On/T1i/CI C� CON STRUCTION TYPE VALUATION$_ IX /(„Iris lj - ZONE GRADINGCU.YDS. ACRES_ City License No. ' C -- LICENSED CONTRACTOR DECLARATION - Remarks; ' Thereby affirm that I am licensed under provisions of Charter 9 (commencing •refrom and the basis for the alleged exemption. Any violation of Section 11.5 by any applicant for' a permit Subjects the applicant to a civil salty of not more than five hundred dollars ($500)., . with section 7000) of Division 3 of the Business and Professions Code, and my Iicense,is In full f c and effect. Ucens /lass � a ' II - PI & • T7' Date ��- S'g t (-� Bar Sink WORKERS' COMPENSATIO DE LARATION Backflow Pre Venter - - ' hereby affirm that I have a cert iCdte of Con50nl to self -insula ora <erliflcdl¢ Workers' Compensation Insurance, or a certified copy thereof -(Section 00, Lab. C.) Backflow Irrigation Policy No. Company Bathtubs eCertified copy is hereby furnished. Certified copy is filed with the city Building Division. i Date Applicant Clarifiers I EXEMPTION FROM 'WORKERS' COMPENSATION DECLARATION need not be completed if the permit is for one hundred ($100) or Dishwasher less). I certify that In the performance of the wor or hick this permit Is issued I shall employ any person in any man . b�cvm�,�ypject to t e Sha'Iomp i ws of Ca \ /� -�7 Drinkin Fountains 9 Floor Drains Date Signat I Floor Sinks " NOTI Ifaftermakingthistllara n, you shoultl become subject [o the WoCom penution provisions the Labor Code, you must forthwith comply with such provisions or 'this permit shall be deemed revoked. Gas Service Outlets CONSTRUCTION. LENDING -AGENCY- ! ' Interceptors I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is Issued ,(Section 3097 Clv. C.) Kitchen Sink Lender's Name - Lender's Address. OWNER BUILDER DECLARATION Lavatories I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional Code: Any city or P—Trap ' p Roof Drains ' •refrom and the basis for the alleged exemption. Any violation of Section 11.5 by any applicant for' a permit Subjects the applicant to a civil salty of not more than five hundred dollars ($500)., SUMMARY OF BUILDING PERMIT $ PLAN CHECK $ PLUMBING $ PLAN CHECK $ ELECTRICAL $ PLAN CHECK $ MECHANICAL $ PLAN CHECK $ ans picoon Fee Pe S25 L] I, as owner of the property or my employees with wages as their sole $ ENERGY,P.C. • cd in pensation, will do the work, and the structure is not Intended or offered for sale (Section '7044, Business and Professional Code:- The Contractor's License Law doesnot 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 $ 3 Duct - Under Ground pp''I employees, pro vltled that such Improvements are not in dr offered for sale. If, however, the builtling or Improvement Is sold within ono year of cam- pletion, the owner wl 11 have the purden of proving he/she did not build or Im- - rove for the purpose of sale). - $ _?'I Duct -Structural I, as owner Oi the property, am exclus lve ly cc nt ract l ng with Il tensed con- tractorsto co nst ruts the project 15ecti on 7044, Business antl Professions Cotle: The Contractor's License La w.�des not apply to an owner of property who builds or Improves thereon, and who contracts for such projects with .Con- tractor(s) license pursuant to the Contractor's License law). Duct -Ventilating Exhaust System ❑ Multiple ❑. Firepl/Fact. Bit. ICBO # ❑ 1 am exempt under Section B. & P. C. for this reason Date Owner, Heating System & Ducting I hereby certify that I have read this application and state that the above Information Is corre gree to comply with -all city and county ordinances and state laws rel ng building construction, and hereby authorize repre- sentatives of lhi o eQSe1�+Pon tt}eabove-mentionetl property for inspection p s, • / ••7 - .7// - I ❑0100,000 BTU 12100,000 BTL Reinspection Fee $25 SignatDriverur �J LL�� Date Driver se or 55 - - 5- CMF 0865-46 rev. 7/83 'White - Builtll g; Canary - ADDlitant; Pink -Accounting; Goldenrod _Assessor Showers Service Sink_ Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Water Closet Water Heater Water Servic 0 Issue Fee Hood or Type 1 ❑ Canopy Type 11 ❑ Refrigeration System 1:10100,000BTU ❑100,000 System Repair/Alteration Issue Fee FEES A.P. # S Main Building: _ E T Frorit - ARear C Right S Left Ping. Ref. # Parking Req./Provided Use of Building: Planning Notes: Automatic Washer 2594. 1/17/94 Zone Accessory Building: Park.Fees $ ELECTRICAL Transformer El 15-50 KW ❑ 50+KW Cooking Unit - Meter ❑up to 100 amps 100 Dishwasher Meter ❑over 100 amps Dryers ❑Gas ❑Electric Sub Panel Fan; _ Motors ❑61 HP Ell h - B F.A,U. _ Inc.Solar 09-15 HP ❑16-15+ Fixtures - ''Microwave Device Boxes Pole Light Outlets Range Switches Sign Garbage Disposal Standing Sections Generator El 0-5 KW 05-15 KW Trash Compactor $'3 Reinspection Fee FEES PUBLIC SERVICES REG r Zoning Approved By Application Approved By Application Issued By_ Issue Fee s.0u TI. O N I N G R E I R E M E N T S FEES $'3 FEES SUMMARY OF BUILDING PERMIT $ PLAN CHECK $ PLUMBING $ PLAN CHECK $ ELECTRICAL $ PLAN CHECK $ MECHANICAL $ PLAN CHECK $ $ PERMIT ISSUANCE $ ENERGY,P.C. • GRADING $ MICROFILM $ 3 s.0u TI. O N I N G R E I R E M E N T S FEES $'3 FEES SMTP $ PERMIT ISSUANCE $ ENERGY,P.C. $ GRADING $ MICROFILM $ pp''I TOTALFEE $ _?'I CONSTRUCTION AND PLANNING APPROVALS, Permit # Date Inspector POOL 'A 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 .4.1Electrical Conduit-Urclrgrnd. ' 55. Electrical Bonding ' ;5.' Steel Reinforcement 56. Rough Plumbing & Pressure Test 6.• -Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7:;Footings 58. Electrical Conduit-Undrgrnd. 8.' Foundation 59. Gas Pipe, O Undrgrnd., Test 9." Water Pipe-Undrgrnd. 60. ,Backwash Lines, P -Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12 Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65.' Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring - 67. Fencing & Access Approval 17. Rough Wiring Sign - 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOUSPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑Gas OOil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing - 73. Undergrnd. Storage Tank ❑ Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat ' 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric r 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 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. 'Date .lob Address: 245 FISCHER AV Suite: D008 Vicinity: Parcel Number: 93898015 Applicant: BOB SANDERSON Address: 3159 REDHILL AV Issued: COSTA MESA, CA, Owner: 245 FISCHER LLC Address 245 FISCHER AVE, �- 'COSTA MESA, CA. Contractor: SLATER BUILDERS INC Address: - 3159 RED HILL AV ' COSTA MESA CA Zip: 92626 - BUILDING PERMIT Zoning: Phone: 714-615-9079 CELL -_-- Zip: 92626 Phone: Zip: 92626 Phone: (714)434-4887 License: 675832 Status: ISSUED Applied: 09/20/2004 Issued: 11/12/2004 i Arch : STEVEN P GAFFNEY Eng: Address: 305 WEST FOURTH ST, _ Address: Phone: 714-571-0500 - Phone: SANTA ANA, CA Zip: 92701 License: C19676 - License: SCOPE OF PERMIT 8,000 S.F. INTERIOR TENANT IMPROVEMENT FOR -CLARKE MARINE INSURANCE- STE 0008. ALSO INCLUDES 116 SF METAL CANOPY AT FRONT. FEE SUMMARY Plan Check: $1,009.94 Calc Valuation: $200,000.00 Permit: $1,553.75 — — - Claim Valuation: 5200;000.00 SMIP Res: $0.00 'SMTP Com: $42.00 Other: $0.00 _ Inspection: ,$0.00 ,Total: , $2,605.69 PLANNING &ZONING SETBACKS MAIN STRUCTURE`Front .0-'0 . ; Ream -0-.0 "' Left -0-0_.._ Right. :0=0_, ACCESSORY Front , 0- 0 ' Rear 0-0 - Left 0-0 _ Right -0- 0 PARKING Exis9n : 1 -0- Required: 0 - Proposed: o NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 9248, § 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 vt:fhis permit. FOR INSPECTIONS CALL: (714) 7546628 wawa taw) I F DECLARATIONS WORKERS' COMPENSATION DECLARATION: 1 hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self -Insure for wo(kers' compensation, as provided for by section 3700 of the Labor Code, for the performance o1 the work for which this permit Is Issued. I have and will maintain workers' compensatlen Insurance, as required by section 3700 of the labor Code, for Ne performance of the work for which LAVs permit is Issued. My workers' compensation Insurance carder an/tl� pd Icy number are: /nQ _Carierp�Zfnr _enAS yrG+tfG \O. Polity Number: TU seclidn-need not be completed it the permit is valued atone hundred dollars ($100) or less.) ❑ 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 o1 California, and agree that it I should became subject to the workers' compensation provisions of Section 3700 01 the Labor Code, I shall forthwith comply with these provision . AAMNGFA7LUR�TOSECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML PINES UP TO ONE HUNDRED THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OE THE LABOR CODE, INTEREST, AND ATTORNEYS FEES, LICENSED CONTRACTORS DECLARATION: -I.hereby affirm1mbfl errl'fibense uM�¢c visions of Chapter 9 (commencing with Section 7000) of Division 3af4he-Business and Professions Cade, and my license Is In full Jcrcr-and'effecf�Lu p,— 1 � Z L-Cfass"N� .� Corran75SignamreY -- t e��„ _Date. / 1, -12--0 11 CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there Is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Cade). Lenders Name: Lender's Address: Signature: Date: OWNER -BUILDER DECLARATIONS: 7� I hereby affirm that under penalty of perjury that 1 em EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any clry 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 civil penaltyof not more than five hundred dollars ($S00).): ❑ 1, as owner of the property, or my employees witli 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 elRployees, 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.). ' ❑ 1, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to canstmct 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 contractors) license pursuant to the Contractors License Laws.). ❑ 1 am exempt under sec. li Business and Professions Code for this reason: Signature: y Date: Owner ID verified by drivers license. ❑ Yes ❑ No Driver's License No. Expires: Verification of Ownership by (type of document, i.9. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 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 B, California Administrative Code). ❑ As owner -builder, 1 will 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: Data; Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will 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? ❑ Yes ❑ 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 areported 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 feet. of compressed, gas at. standard temperature and pressure). ......._......_._.____................................................._._._._............................................................._�.................. ........_............._.......... _........... .............. ....._.... 2 Does ar will the applicant or present or future builtling occupant need to file a registration torte far acutely hazartlous metenels7 ❑Yes ❑ No (Section 25533 of the California Health and Safety 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 s will ih❑e applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? (Section 25534 Toff 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. .........._..............._................................_......._�....................................................... a-111,11a......................_....................._..............b'o'........................................._._..__.........._...............__�......._............._.........__. 4 If an RMPP is presently required, hes Section 25534 of the Calitomie Health end Selery Code been fully complied wiN? ❑Ves ❑ No -5Does or will the applicant Air or present or future building occupant require for the work which is the subject age of this a plication aggermit for such construction or modlllcatlon from the South Coast Air Quality Management District or from any other air pollution control district or agency? � Yes LJ No (Section 65650.2 of the California Government Code requires that the requested Infornatlon 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? ❑ Yes ❑ No (If yes', the facllity must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). _....................a1'r.lpoIIJ6ti....__.._.....__................_..........................._._.___......._...............wa.rk'......—...........__..........................__.. 7 If a permit from the South Coast Air Quality Management District or other, err pollution coon 4 district or agency is required for the work which is the subject of this application, have all at the disclosures Proscribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No B (It 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 COMPLIANCE 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 all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Masa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signatur 1 Le al Owner(s) Date pq cant a1 CODE E. ge]f, gNTMAL$ CODE INSPECTION TYPE gd¢. II{TITIAL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical ' 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 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 .lob Address: 245 FISCHER AV Suite No D008 Vicinity: D008 Parcel Number: 93898015 Applicant: MARTINEZ, RAUL Address: Owner: 245 FISCHER LLC Address: 245 FISCHER AVE COSTA MESA, CA Contractor: MARTINEZ, RAUL Address: MECHANICAL PERMIT Phone: Zip: Phone: Zip: 92626 Phone: Zip: License: 675832 SCOPE OF PERMIT REF B04-01637. PACKAGED HEAT SERVING UNIT D008. ISSUE FEE $23.50 Inst FAU <100 k BTU $14.80 Inst FAU >100 k BTU $0.00 Repair/ Alt Cooling/Heat $0.00 Inst / Rep. Recess Wall Htr $0.00 Refdg Sys <100 k BTU $14.80 Refdg Sys >100 k BTU $0.00 Gas Piping $0.00 Factory Fireplace $0.00 Hood w/Mech Exhaust $0.00 VAV Box $0.00 Vent Fan / Single Duct $0.00 Appliance $0.00 Fire Dampers $0.00 Smoke Dampers $0.00 Inst or Relocate Appl Vent $0.00 Air Handlers < 10000cfm $0.00 Air Handlers> 10000cfm $0.00 Floor Fumace $0.00 Floor or Suspend Heater $0.00 Quantity Status: ISSUED Applied: 12/10/2004 Issued: 12/10/2004 ISSUED BY: 100000 FEE SUMMARY Quantity Repair / Alt Absorbtion Unit $0.00 0 Repair / Alt Refrigeration Unit $0.00 0 Ventillafion System $0.00 0 Evaporative Cooler $0.00 0 Commercial Incinerator $0.00 0 Domestic Incinerator $0.00 0 Compressors / Absorption Systems Upto3hp/100k BTU $0.00 0 37c, 15 hp / 500 k BTU $0.00 0 15 To 30.hp / 1,000 k BTU $0.00 0 30 To 50 hip /:1.750 k BTU $0.00 0 Over 50 hp / Over 1,750 BTU - $0.00 0 Boilers Up to 3 hp - "$0.00 0 3 To 15 hp $0.00 0 15 to 30 hp $0.00 0 30 to 50 hp $0.00 0 Over 50 hp $0.00 0 Other Mechanical Fee , Investigation Fee $0.00 Plan Check Fee $0.00 ' Reinspection Fee - $0.00 TOTAL CALCULATED FEES $53.10 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Californla 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 withln 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) 7545626 244646 (6f00) I% Cl DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to sell -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the w6rk for which this permit is issued. I he maintain workers' oompenswon Insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this penult Is issued. workers' ompensatlon Insurance carder and policy number are: — G ;arT!er:f' I l—�l� M G ,n11nR PoliE7rNDmller: o section nee a completed if the permit is valued atone hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit Is Issued, 1 shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, end agree that if 1 should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith ' ions. �` —� U plicant Slgnatuie� \ Dete'� Z �— \ O SECURE WORKERS' COMPENSATION COVERAGE IS UNUW FUL AND SHALL SUBIECi AN EMP CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE (51 00,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3105 OF THE LABOR CODE, INTEREST, AND ATTORNE rs FEES. LICENSED CONTRACTORS DECLARATION: qd under�rovl;Ions oChapter 9 (commencing with Section 7000) of Divislon 3 of the Business and Professions Code, and my license Is in full Oc (o Class p n #A A I-- Y -42! --et, CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirn that there is a construglion lending agency for the performance of the work for which this permit Is Issued. (Sec. 3097, Civil Code). Lender's Name: Lenders Address: Signature: Date: OWNER -BUILDER DECLARATIONS: I hereby attire that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Profssslons 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 o1 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 civil penalty of not more An live hundred dollars ($5DO).): ❑ 1, as owner of the property, a 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 doeinot 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 LiceDse Laws.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑ Yes ❑ No Drivers Uoense 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-slx (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of IndusMal Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Per ill Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and comfy, a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ 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 feet of comprassed gas et etantlard temperature antl pressure). ........__......................_._....._........................................................_............................................................................. ............................................................... ....................................,........ .... ............................................................................ 2 Does or will the applicant or present or fUture building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mese Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials eque 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 acutel. ._................. __........................................................................ _............. .........................._.................___............_. 4 II en RMPP is presently required, has Stiction 25534 of the California Health and Safety Code been fully Compiled with? ❑ Yes ...❑ No ......................................................................................................................................................................................................................................................................................_....................................................................__._................. 5 Does or will the applicant or present or future building Occupant require for the work which is the subject of this a pllcation ayP mit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes U No (Section 65850.2 of the California Government Code requires that the requested Information be furnished on applications for non-residenllal building permits). ..................................................._............................................ .�_.._..............................-....................._............_..._............_.............................._______.... ....................... s Will an ry ...................................___'____...... y pert of the facili to be constructed under this permit be within 1000 foot from the outer boundaries of a school? ❑Yes ❑ No (It yes', the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). .......__._...................._............._.................................................................................................................offi.._..............___...................................................................................__._'___..............................._._................__.........._ 7 a a permit from the South Coast Air Quality Management District-- or other elr pollution control district or agency is required for the work which is the Subject of this application, have all of the disclosures preu betl by Califomia Health and Salary Code Section 42303 been metle7 ❑Yes ❑ No 8 (If yes', attach certificate of compliance from the appropdete air pollution control officer). CERTIFICATE OF COMPLIANCE: I cerity that under penalty of perjury the information given above Is Correct. I agree to Comply with all state laws and dry ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I cattily under penalty of perjury that I have read this application and state that the Information given is correct. I agree to comply with all state laws and dry ordinances relating to building construction, and authorize representatives of the City of Costa Mass to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signal Its Of Legal Owner(s) Dal 1' D" n rAuthon ' nt Date 400E E. a1SPECTONTYPE 2&U ISL$ CODE INSPECTION TYPE gaff. Qg rrTA 1616 Fixed System Final Fire Prevention 206 Final Mechanical - C. - O S I s]I 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 210 Final Electrical 201 Final BlocktRetelning 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 (714) 754-5273 • Fax (714) 754-4656 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 PLUMBING PERMIT Job Address: 245 FISCHER AV Suite No D008 Vicinity: Parcel Nunmber: 93898015 Applicant: RAUL MARTINEZ Address: 3159 RED HILL AV Phone: (714)134-4887 COSTA MESA CA Zip: 92626 Owner: 245 FISCHER LLC Address 245 FISCHER AVE Phone: COSTA MESA, CA Zip: 92626 Contractor: MARTINEZ, RAUL Address: Arch / Eng : Address: Phone: Zip: License: 675832 Phone: Zip: License: Status: ISSUED Applied: 11/23/2004 Issued: 11/23/2004 ISSUED BY: SCOPE OF PERMIT 8,000 S.F. INTERIOR TENANT IMPROVEMENT FOR'CLARKE MARINE INSURANCE' STE 0008. ALSO INCLUDES 116 SF METAL CANOPY AT FRONT. REF.: B04-01637 PLUMBING TO INCLUDE: 3 COMMERCIAL SINKS, 1 SEWER CONNECTION, 1 WATER RE -PIPE, 3 WASH BASINS, AND 5 WATER CLOSETS. - 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 vold 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 p n FOR INSPECTIONS CALL: (714) 7545826 244646 (6=) FEE SUMMARY AMT QTY AMT QTY - �. AMT QTY ISSUE FEE $23.50 Laundry Tub/ Washer $0.00 0 Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P -Trap $0.00 0 Trap Primer $0.00 0 Bathtub $0.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System $0.00 0 Process Piping (per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect (Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0 - Septic Tank - $0.00 0 Wash Basin $29.40 3 Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain, Floor $0.00 0 Sewer Connect $24.65 1 - Waste and Vent System $0.00 0 Drain, Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet (Toilet) $49.00 5 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 vold 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 p n FOR INSPECTIONS CALL: (714) 7545826 244646 (6=) DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 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. • t7gr s and will maintain workers' compensation Insursrlco, as required by section 3700 of the Labor Code, for the pertomtance of the work for which this permit is Issued. y workers' comperlsatlon Insu rice carder and polity number are: ,o action need not be completed it the permit is valued at one hundred dollars ($100) Orissa.) ❑ 1 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 Califom and agree that If I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these, provisions tz -� WARNING: FAILURE E W RS' COM NPE SATI� ERA LAWFUL AND SHALL SUBJECT AN EM LOYER Ta,— gIMINAL ENA TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DDUARE ($100,ODo), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES, LICENSED CONTRACTORS DECLARATION: I her affirm that I am licensed uglier provisions of Chapter 9 (commencing with Section 7000) of Divisio the Busirin and Professions Code, and my license Is in full ITIEfOlIft-t- _. - ' iid'affacCt— ic!" lb 1 II-1L -T ria:—' I6: ( ) -O-( CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there Is a construction lending agency for the performance of the work for which this permit is Issued. (Sec. 3097, Civil Code). Lenders Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEFROM 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 penult subjects the applicant to a c7'vil penalty of not more than We 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 a,' loyees, 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 owneixuilder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ 1, 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.). ❑ 1 am exempt under sec. (r Business and Professions Code for this reason: Signature: Date: Owner 10 verified by drivers license. ❑ Yes ❑ No Drivers License No. Expires: Verification of Ownership by (type of document, Le. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation live (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 B, California Administrative Code). ❑ As owner-builder, I will 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: 1 Will 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? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be tiled 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 feet of compressed gas at standarri temperature and pressure). .........._............................................._...........—prea..........................................................................d.t-.-fil..............................._._............_...._..................__._........_...__............ ................_._...._............. _................. ..........._ 2 Does or will the applicant or present or future building ocoupant need to file a registration lortn for acutely hazardous materials? ❑Ves ❑ No (Section 25533 of the California Health and Selery 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 acatery 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? ❑ Yes ❑ No ..._........._..........._................_......._._.._.._._...___..............................___._____.............................._...__.__..__..._.....................__.....__...................._...................._.............._......__.......................................... 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application ayormit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes U No (Section 65650.2 Of the California Government Code requires that the requested information be lumishod on applications for non-residentlal building permits). 6 Will any pan of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Ves ❑ No (11 "yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Selery Code). .............. _.......... .............. -................................ __....................................... ............................................................ ......... .......................................................................... __.............................. ..................... ................ .._........................................ 7 If a permit from the South Coast Air Quell ty 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 prescrlbed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No ..............._................................... ........ ............... __............................................................................................................................... ..................................................... __..............._...................................... _..........__........................................... 6 (II 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 COMPLIANCE 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 all state laws and city ordinances relating to building constmctlon, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to Occupy or allow occupancy of any building authorized by this permit until final inspection. 17 eture Of Legal Owner ) Date L� 1 Cly.. r d10r ADthon plicant...,y..:,.- D'at� COPE E. INSPECTIONYPE IRAN INIMAL5 CODE,E INSIySPECTI?yYEg ON PEE gAIE INTTIIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 206 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Well 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 (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: 245 FISCHER AV Suite No D008 Vicinity: Parcel Nunmber: 93898015 FEE SUMMARY Applicant: BOB SANDERSON Address: 3159 RED HILL AV- Quantity ISSUE FEE $23.50 _ Phone: (714)134-4887 _ 0- COSTA MESA CA =; Zip: 92626 Busway,/100 It - ,$0.00 0 ; Res. a/c package, Owner: .245 FISCHER LLC Standing Section $0.00 Address �' 245 FISCHER AVE, $0.00 0 •,, "` Misc Electrical Equipment - - Phone: _ New Res (3+units) - ,COSTA MESA. CA Zip: 92626 Contractor: MARTINEZ, RAUL 0 ` .. � ..........�.'.up to 10 kva/kw ` Address: 0 Lighting Fixts ,, 72 ' " .....0p to 50 kva/kw Phone: _ 0 Recept Outlets- ... Zip: , $0.00/ 0 - License: 675832 Status: ISSUED Applied: 11/122004 Issued: 11/122004 SCOPE OF PERMIT 8,000 S.F. INTERIOR. TENANT IMPROVEMENT. FOR'CLARKE MARINE INSURANCE' STE D008, ALSO INCLUDES 116 SF METAL CANOPY AT FRONT. REF.: 804-01637 ELECTRICAL TO INCLUDE: 72 LIGHT FIXTURES, 8 SWITCHES, AND 1 SUB PANEL TO 200 AMPS 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 thissppermR%' FOR INSPECTIONS CALL: (714) 7545626 246646(6/00) FEE SUMMARY Quantity Quantity ISSUE FEE $23.50 Temp Dist System / Lighting ,$0.00 0- Temp service test $0.00 Busway,/100 It - ,$0.00 0 ; Res. a/c package, $0.00 Standing Section $0.00 ' 0I New Res (1-2 units) $0.00 0 •,, "` Misc Electrical Equipment $0.00 "'o' _ New Res (3+units) '$o.00 0 ,� �;r. Transformers up to 1 kva/kw $0.00 �',0 Pool / Spa -$0.00 x$59.96 0 ` .. � ..........�.'.up to 10 kva/kw ` $0.00" 0 Lighting Fixts ,, 72 ' " .....0p to 50 kva/kw ,$0:00 _ 0 Recept Outlets- $0.00. `. 0 .................up to 100 kva/kw $0.00/ 0 Switches �� - /-$8:80`: 8 ......... ........over 100 kva/kw "$0.00 0 Non Res Appl ` - " $0700 " � �'�0 -Low Voltage Equipment = $0.00 ' ' - 0 Res Appl - .. $0.o0, .Low Volt Wiring System I Ckt $0.00 �.-0 Service to 200a _. $0.00" 0 '`��c Mist. Conduit' ` , " _ - $0.00 j 0' Service to 1000a 1� -A $0.00, '0 - Mises Conductor-- , $0.00' ,' 0 Service over 1000a$0.00 . 0 , Circus ( gen or ride) - /0"' Motors to the _- , $0.00 �:' 0 / `, - Circus (meth'ride or lights) _$0.00 $0.00 Motors to 10hp x$0.00 -- 0,. , - �; Christmas Tree Stand $0.00 0 Motors to 50hp $0.00'' _ 0 �_ �, AFireworks Stand - ` $0.00 0 Motors to 100hp $0.00 ��_-- '0-' _ - Other Electrical Fee, - — " $0.00 Motors over 100hp $0.00 '0� Communication drops $0.00 0 - — "_ -'Investigation Fee $0.00 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 thissppermR%' FOR INSPECTIONS CALL: (714) 7545626 246646(6/00) IN NO DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 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:hsve and will maintain workers' cOmpensti insurance, as required by section 3700 of the Labor Cade, for the performance of the work for which this permit Is Issued. My workers' tom enation Insurance carrier and poli�1f number are: Carder _V 9 "11 C,O . Polley - S SOCaor'need not he completed d the permit Is valued atone hundred dollars ($100) or less.) ❑ 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 California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these prov�i ' ) Applicant -Signature! - �slt,.Wfi� +— ,Date:._.-. WARMNG:.FAILURE TO'SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN ENPLOVERTO'CRIMINAGPENALTIES AND CIVIL FINES UP TO ONE HUNDRED "THOUSAND DOLLARE (5100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hererehy.affirm theYl,am'ncensed under rdylslons of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license Is in full farce, antl. sffecleUcFa'""'""'"`""��7 Sg 2 - Contractors Contractors Signature:_ 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, Civil Code). Lenders Name: Lender's Address: Signature: Date: OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of penury that I em 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 toAfristruct, 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 Iicensed;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 shells exempt therefrom and the basis for the alleged exemption. Any violation o1 Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five 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:a 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 fiei'o n 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.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. 0 Yes ❑ No Drivers License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 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 B, California Administrative Code). ❑ As owner -builder, I will 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: 1 W III 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? ❑ Yes ❑ 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 feet 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 forth for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety 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 ar 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 Costs 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 Ii en RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No ..................................__................................................................ _..__...... .................................................................__..._............................................... ............................ ............ _........................ .................. ............................................... .. 5 Does or will the applicant or present or future bullding occupant require for the work which is the subject of this a plication eppermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes LJ 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 constructetl under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (it "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? ❑ Yes ❑ No ..............................._............................................................__.__......_._............................................................................................................................................................._.................._._............-..................................__.............__........_..... 8 (If'yes', ahach 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 COMPLIANCE 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 all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. $jpaatreOf Lea n&s) Date ) tl1Or AMonzed can ,a Date— "R"` CODE r. INSPECTION TYPE ATE INTITIALS CODE INSPECTION TYPE 2r,M INTITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 11 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 210 Final Electrical `'- 71 201 Final Block/Retaining Well 212 Final Fire Prevention , 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition ' 250 Final BuildinglOccupancy City of Costa Mesa _ Development Services Department Building Safely Division CERTIFICATE OF OCCUPANCY No. `� P. O. Box 1200 Costa Mesa, California The Building located at 24-i FT,SMfT-,R AVF.l1ITF: TWW hpi-7 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group 7L? Occupancy. Use of Building nrpTCF; Legal Description 427=03R—()7 (See reverse side for Metes and Bounds) Building Permit No r-ltind7 Electrical Permit No. r;l rnd7 Plumbing Permit No, r 14nA7 Mechanical Permit No.^� Ae� *+�_�« Number of apartments and/or guest rooms ISSUED TO: Building Official k/ Xr P1J1X?DA4 PRDFa 181 b-1 ; L 1/ i/�- 245 FISCHLR AVE. t.0-4. (X)SA MESA. CA. Date // pac'- /7 xy 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. 1/93 White - Owner; Canary - Numerical File; Pink - Bldg. Permit File Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA' .g -. PERMIT NO. TRACT NO. ;. LOT NO. BL CONSTRUCTION PERMIT PBZ Project Address _ - _ Applicant's Mailing dor SS r n a Owner's Name e L Pho%` � L Address Arch/Eng. /iLicense No. Address Contractor's Name 'vim hone , Address (mailing) �'/� City License No. iFlle l LICENSED CONTRACTOR DECLARATION 1 hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and My license is In f 11 Ira an effect- 1 Ucen lass / L' nse No Da to ll��%' 519 I �If L_lJ� WORKERS' COMPENSATION DECLARATION I'/e,//-,' `lereby affirm that 1 have a certificate of consent to self)nsu or a Certificate Workers' Compensation Insurance; -or a certified copy thereof '(Section Polk Lab./�� n ,, d Policy No. 4� 3� Company �-Y-f-tl/Yla%7.L/']5• Certified copy is hereby furnished. Certs led pY . iletl with the city II ng D Isi n. t Date ��/�/n'(-Lj' Applicant g/u ps e .' EXEMPTION FROM WORKERS' COMPENSATI N DEC�ON- (This section need not be completed if the permit Is for one hundred (5300) or less). i 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 t110 Workers' Compensation laws of California. Data Signature NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the labor Code, you must'foi'thwith comply with Such provisions or this permit shall be I deemed revoked. CONSTRUCTION LENDING AGENCY i" I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097 Civ. C.) Lender's Name Lender's Address _ OWNER BUILDER DECLARATION - I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct, alter, improve, demolish or repair _ the basis for the alleged exemption. Any violation of Section y applicant for a permit subjects the applicant to a civil more than five hundred dollars ($500). , of the oronerty or my emolovees with wanes as their sole License Law does not apply to an owner or a property wno Ulilias or improves thereon, and who does such work himself/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 Com- pletion, the owner will have the burden of proving he/she did not build or Im- rovefor the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con- 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 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 exempt under Section B. & P. C. for this reason Date Owner 1 hereby certify that I have rea. information is correct. I agree to and state laws relating to buildin sentatives Of this clty to anter Inspection purpos Signature �� i 1 Drivers' License or SS upon 5 23 TYPE OF CONSTRUCTION LJ NE ❑ CONVERSION ❑ DEMOLISH DESCRIPTION OF WORK J ADD LJ ALTERATION LJ REPAIR OTHER TYPE OF PERMIT 'L-1 GRADING LJ FOUNDATION LJ STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION SG. FT. OCCUPANCY_ CONSTRUCTION TYPE VALUATION $ ZONE GRADING CU.YDS. ACRES_ Remarks: A.P. # S Main Building: E T Front A Rear - C Right 8 Left Ping. Ref. # Parking Req./Provid Use of Building: Bar Sink Showers $ 3 ' Backflow Preventer _ Service Sink Backflow Irrigation Sewer Cap �. Bathtubs Sewer Connection Reinspection Fee1$251 Issue Fea 1 Automatic Washer Clarifiers - Solar Collectors $ 3 -Construction Pole Sub. Dishwasher Solar Piping - CookingU nit Drinking Fountains Soler Tank Date Date Date "_ Dishwasher Floor Drains'. Swimming Pool w/Spa Dryers ❑Gas ❑Elec Floor Sinks ' Urinal - _ Fan ' Gas Service' Outlets Water Closet SMIP PERMIT ISSUANCE ENERGY P.C. GRADING MICROFILM TOTALFEE F.A.U. Interceptors Water Heater System Repair/Alteration Fixtures Kitchen Sink, Water Service ,- := Device Boxes Lavatories. t - - Outlets P—Trap - _ Switches Roof Drains Garbage Disposal _ Issue Fee Generator 130.5 KW C Reihspection Fee S25 - Under Ground Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact. Bit. ICBO # Heating System & Ducting 00700,000 BTU 0100,000 Fee I $25 0865-46 rev. 7/83 - White - BuilOing; Canary v APPlicanp Pink -Accounting; Goldenrod -Assessor 0438 10/1'7/84 Zone Park. Fees $. Transformer ❑ 75-50 KW ❑ 50+KW Meter -❑up to 100 amps Meter ❑over 100 amps Sub Panel -Motors 110.1 HP 01 X - 8 Inc. Solar 09-15 HP ❑ 16-15+ Microwave Pole Light Range Sign Standing Sections 5 KW Trash Compactor 17,37 TL Z O N I N G R E I R E Issue Fee $ 3 Reinspection Fee1$251 Issue Fea $ 3 iANICAL FEES PUBLIC SERVICES REQUIREMENTS: Zoning Approved By Application Approved By Application Issued By �YJAAP Date Date Date Hood Canopy Typel ❑ . Canopy Type 11 ❑ - 4 Refrigeration System ❑0.100,000 BTU 11100,000 BTU - 0 SUMMARY OF FEES BUILDING PERMIT $ ✓ PLAN CHECK $ PLUMBING $ PLAN CHECK - $ ELECTRICAL $ PLAN CHECK $ MECHANICALr PLAN CHECK $ SMIP PERMIT ISSUANCE ENERGY P.C. GRADING MICROFILM TOTALFEE $ $ $ $ $ $ ^ / / `37 System Repair/Alteration t _ Issue Fee $ 3 PONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POO, ;PA APPROVALS Permit # I Date Inspector .i. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test t 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. t 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 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. POO USPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning S Log FIRE DEPT. REQUIREMENT APPROVALS Permit# 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas 0Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O 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 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:///Z 4"f Uh M ON ROOF OIL . 1_Z,_) 34. Final Heating & Air Conditioning % o l I Lrr- r //7 �7t 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 ,- 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. - Date r — -—nvvncuva-.vmm..rau ayacerenceyr...vac w, nm-neavy' border lines and sign all appropriate tlecla rations. VfT OF COSTA MESA_ CONSTRUCT,L��N PER IT /T!/E'/ ..i Project Address 2115 ,v Applicant's Mai Address. O �� Owner's Name .` LC I Qm f -CO e `-P one �6 Address 1 Arch/Eng.bah w / .u' ,) 'a'rt 'License No. 1% Address Contractor's Name Phone Address (mailing) City License No, LICENSED CONTRACTOR DECLARATION 1 hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class License No. Date ' Signature WORKERS'COMPENSATION DECLARATION; 1 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' olicy'Lab. P30 364 CompanyCertif�� Policy No. Certified Copy is hereby furnishh the ctY a�d�n9 vv 1 Date Applicant (�/J—`,6"v'! EXEMPTION�KERS' COMPENSATION DECLARATION (Thissection need not be completed if the permit is for one hundred ($100) or - less). I 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner sous to become subject to the Workers' Compensation, Laws of California. Date - Signature 'NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit" shall be deemed revoked. 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 (Section 3097 Civ. C.) Lender's Name Lender's Address ' OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/she is licensed pursuant to the provisions of 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 1031.5 by any applicant for a permit subjects the, applicant to a civil enalty of not more than five hundred dollars ($500). ' 1, 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 (Section 7044, Business and Professional Code: The Contractor's 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 employees, Provided that such improvements are not intended or offered for 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- pr ve fol the purpose of sale). 1, as owner of the property, am exclusively contracting with licensed con- 1 ractors to construct the project (Section 7044, Business and Professions Code: he Contractor's License Law does not apply to an owner of property who 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 proof of their Worker's Compensation insurance should be provided to me. ❑ 1 am exen{pt under Section B. & P. C. for this reason Date I . I — la• ' Owner 1 hereby certify that I have real Information is correct. I agree t0 Signature ted—'—= Drivers' License or SS CMF 0865-46, rev. 10/84 above I -SC) FEES Bar Sink Showers TYPE OF CONSTRUCTION LJ NEW U ADD 11 ALTERATION REPAIR ELECTRICAL FEES ❑ ❑ ❑ S 3 CONVERSION DEMOLISH OTHER A P # DESCRIPTION OF WORK/USE OF BLDG. Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps S Main Building: TYPE OF PERMIT GRADING ❑FOUNDATION STRUCTURAL T Front ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL' B ' ❑ OTHER A Rear PROJECT DESCRIPTION SO. FT. OCCUPANCY C KLeft Right CONSTRUCTION TYPE—VALUATION$ S SUMMARY OF FEES BUILDING-P03MIT $ 4::). 49 0 PLAN CHECK $ ' PLUMBING $ PLAN CHECK 25%. $ ELECTRICAL .$ PLAN CHECK 50% $ MECHANICAL $ PLAN CHECK 25% $ ZONE GRADING CU. YDS. ACRES Ping. Ret. # Remarks: --a �� Planning Notes: 2010 11/09/94 Zone Accessory Building: Parking Req./Provided 15.00 TL Z O N 1 N G R E Q M T S - I PLUMBING FEES Bar Sink Showers ELECTRICAL FEES Backflow Preventer- ' Service Sink S 3 Automatic Washer Transformer 1-115-50 KW - Construction Pole Sub. ❑ 50+ KW Backflow Irrigation Sewer Cap Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps Clarifiers Solar Collectors Dishwasher - Meter El over 100 amps _ Dishwasher Solar Piping' FEES Dryers ❑Gas ❑Electric Sub Panel - Drinking Fountains I Solar Tank Fan Motors 00-1 HP ❑l % - 8 Floor Drains Swimming Pool w/Spa F.A.D. Inc. Solar 09-15 HP ❑16-15+ Floor Sinks: Urinal Refrigeration System ❑0-700,000 BTU Ell 00,000 BTU Fixtures Microwave Gas Service Outlets Water Closet SUMMARY OF FEES BUILDING-P03MIT $ 4::). 49 0 PLAN CHECK $ ' PLUMBING $ PLAN CHECK 25%. $ ELECTRICAL .$ PLAN CHECK 50% $ MECHANICAL $ PLAN CHECK 25% $ Device Boxes Pole Light Interceptors' Water Heater �Oe% Outlets Range Kitchen Sink Water Service Switches Sign Lavatories 'Auto -Wash - Garbage Disposal Standing Sections P -Trap '- Laundry Trays - Generator ❑0-5KW❑5-15 KW Trash Compactor Roof Drains Reinspection Fee $15 Boiler Duct - Under Ground Duct -Structural Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact. Bit. ICBG# _ Heating System & Ducting 00-100,000 BTU ❑100,000 Reinspection Fee I $15 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Issue Fee S 3 Reinspection Fee $15 Issue Fee $ 3 iANICAL FEES Hood or Type 1 ❑ Canopy Type 11 ❑ DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Building Approved ByDate Application Issued By— Date Dat Refrigeration System ❑0-700,000 BTU Ell 00,000 BTU SUMMARY OF FEES BUILDING-P03MIT $ 4::). 49 0 PLAN CHECK $ ' PLUMBING $ PLAN CHECK 25%. $ ELECTRICAL .$ PLAN CHECK 50% $ MECHANICAL $ PLAN CHECK 25% $ SMTP PERMIT ISSUANCE ENERGY P.C. GRADING MICROFILM TOTAL FEE $ $ $ $ ' $ $ �Oe% System Repair/Alteration Fire Dampers Registers E$3 - Issue Fee " CONSTRUCTION AND PLANNING ; (. - APPROVALS - Permit # Date - Inspector POOL _ SPA APPROVALS Permit # - Date Inspector I` Temporary,Electrical Service or Pole - 52. Pool-& Equipment Location 2. -Soil _Pipe-Undrgrnd. '!� 53. Steel Reinforcement , 3.. Electrical Conduit Utility-Undrgrnd. 54. Forms 4, Electrical Conduit-Undrgrnd. 55. Electrical Bonding ,5. Steel Reinforcement - 56. Rough Plumbing & Pressure Test 6. Electrical -UFER Grnd. 57. APPROVALTO COVER-GUNITE -; 7. Footings � 58. Electrical Conduif-Undrgrnd. .8r Foundation 59. Gas Pipe, 0 Undrgrnd., Test •9. Water Pipe-Undrgrnd. - " I '• i 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. Structural Floor System 1 - , 61. APPROVAL TO DECK - 11. ,Property Sewer Line & House Connection , 62. Backwash & Receptor -Final - 12: Sewer. Cap I 63. Heater & Vent -Final _ .. 13. Roof Drains 1 - 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final .. 15. Rough Electrical -Conduit 66. Solar System -Final " A0 Rough Electric Wiring 67. Fencing &Access Approval 17: Rough Wiring Sign 68. APPROVED FOR PLASTERING 1, 8.1 Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 16. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS. Permit# 20, Rough Factory Fireplace 21. Ducts, in Structure. 70, Underground Hydro 22. Ducts, Ventilating /1 71. Product Piping 0Gas EI Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O 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 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 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 48. Special Requirements Completed - 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::,ASTA MESA CpONSTRUCTIONI BOCCI RAITp ^� PERMIT NO._ — TRACT NO.� LOT NO. UNIT NC. . PFoject Address Zr 1,AXkQ n' 7 Applicant's Mailing Address -I Sp1,s7,��Ai. {cif- (Qur S.A Owner's Name i_s_QVBAM S—Phone G Address_N. (5 d V I Pxr A'tI'Q- Arch/Eng..LCJri 11`94 License No. Address Contractor's Nan« dla±IJC/L-r gat _Phone Address Imailing)lS'I? �. FAr1211(QaS' �'Cr2 SSA City License No. %D LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed u der prom*$Ions of Charter 9 (commencing with Section 7000) of Dlvlsio� o t BUSlness and Professions Code, and my license is in full force antl a t. License Class License No. Date Signature WORKERS' COMPENSATION DECLARATION hereby affirm that I have a certificate of consent to self -Insure or a certificate t Workers' Compensation Insurance, or a certified copy the Leof (Section .800, Lab. CJ P "",�)O-yt,4 - Company e Policy No. Certified cap . hereby furnished. iltlin 9 Si q tl with'the city i n Date 1 Applicant EXEMPT40N FIROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit is for one hundred ($100) or ass). 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 Ike Workers' Compensation. Laws of California. I Date Signature NOTICE: if, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. 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 (Section 3097 Civ. C.) Lender's Name _ Lender's Atldress _ OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the County which requires a r any structure, prior to Its to file a Signed statement the Contractor's License L Dlvlsion 3 of the Busing wherefrom and the basis I "a�031.5 by any applican 'penalty of not more than bU I, as owner of the p cc m pensalion, will do the for Sale (Section 7044, License Law'd OCs not app thereon, and who does S employees, Provided that Sale. If, however, the bull pletion, the owner will h: r ve for the purpose Of s I, as -owner of the pro [f ctorS l0 Construct the 0 The Contractor's License builds or Improves therei tractor(s1 license pursuao' proof of/ their Worker's ❑ 1 am exempt under Sec 11.5 Business and Professional Code: Any city or It to construct, alter. Improve, demolish or repair lance, also requires the applicant for such permit I he/she Is licensed pursuant to the provisionsof (Chapter 9 (commencing with Section 7000) of no Professions Code) or that he/She is exempt he alleged exemption. Any violation of Section n a permit subjects the applicant to a Civil hundred dollars ($500). :rty or my employees with wages as their sole irk, and the Structure is not intended or offered nes$ and Professional Code: The Contractor's a an owner of a property who builds or improves work himself/herself or through his or her own N Improvements are not Intended or offered for or Improvement is sold within one year of earn. he burden of proving he/she did not build or lm - y, am exclusively contracting with licensed con- ct (Section 7044, Business and Professions Code: N does not apply t0 an owner of property who Intl who contracts for Such projects with a con. the Contractor's License Law). I am aware that 1pensatlon Insurance should be provided to me.. B. & P. C, for JbiS reason Date Ownert 1 1, cartily that have read Information is correct. 1 agree to c and state.laws relating to building sentatives O this city to enter . Inspection p ores. Signature Drivers' License or SS 9P CMF 0865-46, rev. 4/84 the above 3rdinances rize repre- ,party for TYPE OF CONSTRUCTION LJNEy./7sryLJ ADD ❑ CONVERSION ❑ DEMOLISH X OTHER DESCRIPTION OF WORK/USE OF BLDG. — u c v 75.1.7 8/31/84 Zone Accessory Building: _ TY OF PERMIT, LJ GRADING JJ FUUNUAI IUN Trig TENANT ELECTRICAL(J['-f PLUMBI NG V MECHANICAL B -OTHER A C PROJECT DESCRIPTION 5 FT. OCCUPANCY K CON STRUCTION TYPE VSSI_ VALUATIONS - ataII1%r� S ZONE M P GRADING CU. YDS. ACRES Ping. Ref. qfs Parking Req./Provided Remarks: IT!) .Ik a IG, 19i!_ A Planning Notes: Preventer eking Fountains Ir Drains v Sinks Service Outlets Kitchen Sink Lavatories P—Trap Roof Drains Showers Service Sink ,r Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service I I Reinspection Fee I $151 I Issue Fee I $ 3 Boiler Duct- Under Ground Duct - Structural Duct . Ventilating Exhaust System Multiple Firepl/Fact. Bit. ICBG# Heating System & Ducting 0.100,000 BTU 0100,000 — T� I I Reinspection Fee r— White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor $15 Hood or Type ❑ Canopy Type 11 ❑ Refrigeration System Ko-100,000BTU 11100,000 BTU System Repair/Alteration Issue Fee 1 $ 3 Automatic Washer Construction Polg�Sub. Cooking Unit Dishwasher Dryers ❑Gds ❑Electric Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generator 00.5 KW ❑ ELECTRICAL .Transformer ❑ 15-50 KW ❑ 50+KW- Meter ❑up to 100,amps Meter Kover 100 amps Sub Panel Motors ❑0.1 HP ❑V6-8 Ina Solar ❑9-15 HP 1116-15+ Microwave Pole Light Sign Standing Sections KW Trash Compactor 365.6E Tl, FEES Z O N 1 N G R E Q M T S. Reinspection Fee rI $15 Issue Fee $ 3 DEVELOPMENT SERVICES REQUIREMENS: Zoning Approved By DY�C; h1 Date �- Building Approved By _ _ _ 1 .% - Data r - Stlfj'1fvk F FEES I`"'��jj 7 2.10 `. 1 O BUILDING PERMIT $ SMTP $ PLAN CHECK $ 31 PERMIT PLUMBING $ 13.00 ISSUANCE $ PLAN CHECK 25% $7 ENERGY P.C. $ ELECTRICAL $ I GRADING $ PLAN CHECK 50% $ MICROFILM $ MECHANICAL $ �Z'Fj,�OS'1 rf TOTALFEE $ PLAN CHECK 25% $ 7 GONSTRUCTION AND PLANNING .. APPROVALS Permit #- Date Inspector - POOL .PA `1. APPROVALS Permit# Date Inspector 4; Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pjpe--,Undrgrnd. - at 1240f- LW 53. Steel Reinforcement 3.�ElectricahConduit•Utiiity-Undrgrnd. 54. Forms 4; ElectricahConduit-Undrgrnd. /` �!'G/ 55. Electrical Bonding, 5. Steel Reinforcement'. Reinforcement. .• .r .• s V� 56. Rough Plumbing & Pressure Test ii: 6.1•glectricaPUFER Grrld. - 57. APPROVAL TO COVER-GUNITE 7."Fcotin`gs' ; r-� -::=� 58. Electrical Conduit-Undrgrnd. ' ' i •• 6. F.qundation j r 59. Gas Pipe, O.Undrgrnd., Test 9. V,Yaier;Pipe-Undrgrpd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10.=SteucturalFloor System 11., Property Sewer Line& House Connection `' ate- 61. APPROVAL TO DECK 62. Backwash & Receptor -Final ? r• 12 i$ewei.(ap ^ 63. Heater & Vent -Final f 13:1ROQf.6rains 64. Plumbing,System Final 14. RougWPlumbing i 10f7lot r7V 65. Electrica6FinaI 15. Rough Electrical -Conduit _ 66. Solar 6ystem-Final , 16. Rough Electric Wiring _ �1� 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 APPROVALS Permit �k 20It Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 221 Ducts, Ventilating -` 71. Product Piping O Gas El Oil 23. Gas Pipe -Rough & Test - 72.•iJnderground Flush 24. Roof. Framing r 73. Undergrnd. Storage Tank 0 Gas OOil- 25. Roof Sheathing 74. Overhead Hydro ,26 T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Fame and Flashing )t &ell 76. Dry Standpipe 28. Lathing &-Siding •77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing (� 06/ HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coal!, 79. FINAL INSPECTION 32. Electrical Power Metet-Final /Lv 80. FOOD CERTIFICATE ISSUED 33. Final Electric / Notes: 34. Final Heating & Air Conditioning p i`"• 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace ' 38. Final Plumbing I2 /,9Y roo/) 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 i 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING /�//� 48. Special Requirements Completed 49. Electric Release to Edison / 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY NO. ff 7-3. Date m rY�% L C COQ-• Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITYOF COSTA MESAt-�'- C�0NNSTRUCTION PERMIT 2 Project Address 7_4o- Fu-ne -ER SU[T �^ J Applicant's MailingI Address %6F Owner's Name •Yll .e Po UE2 ZJ45S7 Phone Address Arch/Eng. License No. Address Contractor's Name Phone 137 -%CZ Address (mai ling) City Licensea No. _zo: a -T7 LICENSED CONTRACTOR DECLARATION 1 hereby affirm that I am licensed.under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full,fo ce a r effect. License Class LicoMe No.- Date Signature WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure or a certificate d Workers' Compensation Insurance, or a certified .copy thereof (Section - 3800, Lab. C..) _ Policy No. Sf-6 61!24_g etCompany /i -SF ,Q Certified copy is hereby furnished. `0; -Certified copy is filed with the city Bu I g Dlvisi Date Applicant[- „�✓^/Q+-� EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit is for one hundred ($100) or less). 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 California. Date Signature NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be .deemed revoked. 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 (Section 3097 Civ. C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/she is licensed pursuant to the provisions of the Contractor'sLicense Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt herefrom and the basis for the alleged exemption. Any violation of Section 031.5 by any applicant for a permit subjects the -applicant to a civil enalty of not more than five hundred dollars ($500). . I 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 (Section 7044, Business and Professional Code: The Contractor's 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 employees, provided that such improvements are not intended or offered for 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- prove for the purpose of sale). .- I, asowner of the property, am exclusively contracting with licensed con- 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 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 proof o/ their Worker's Compensation insurance should be provided to me. ❑ 1 am exempt under Section S. & P. C. for this reason Date Owner I hereby certify that I have read this application and state that the above information is correct. I agree to'comply with all city and county ordinances and state laws relating to building construction, and hereby authorize repre- sentatives of this to enter, upon the above-mentioned property for inspection purposes Signature Date Drivers' License or SS yf ✓ . III P -7j 10/29/84 6�'4e4 i:6 - 7 TYPE OF CONSTRUCTION . LJ NEW U ADD LI ALTERATION LJ REPAIR _ ❑ CONVERSION 1:1DEMOLISH 1:1OTHER A.P.# • �7 0-53 —p Zone DESCRIPTION OF WORK/USE OF BLDG. S Main Building: Accessory Building: E Z TYPE OF PERMIT El GRADING ❑ FOUNDATION ❑ STRUCTURAL T Front -O ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL BRear N ❑ OTHER A PROJECT DESCRIPTION SO. FT. OCCUPANCY C Right - N CONSTRUCTION TYPE VALUATION$ ZEZ9Z S Left - R ZONE GRADING CU. YDS: ACRES Ping. Ref. # Parking Req./Provided E Q Remarks: 'Planning Notes: - M T S. PLUMBING FEES Bar Sink Showers ELECTRICAL FEES _ Backflow Preventer Service Sink Automatic Washer - - Transformer ❑ 15-50 KW ❑ 50+KW Construction Pole Sub. Backflow Irrigation 9 Sewer Ca P Bathtubs Sewer Connection Cooking Unit - Meter ❑up to100 amps Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel Drinking Fountains Solar Tank Fan Motors 00-1 HP ❑ 1 % - 8 Floor Drains, Swimming Pool w/Spa F.A.U. Inc. So lar 09-15 HP EI 16-15+ Floor Sinks - - - Urinal Fixtures -Microwave Gas Service Outlets Water Closet Device Boxes Pole Light Interceptors Water Heater Outlets Range Kitchen Sink Water Service Switches Sign Lavatories - - - Garbage Disposal - " Standing Sections P -Trap Generator 1:10-5 KW 115-15 KW Trash Compactor ' Roof Drains - - Reinspection Fee • $15 Issue Fee $ 3 Reinspection Fee $15 Issue Fee $ 3 • MECHANICAL FEES DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By / Date Building Approved By 6 Date L Y' Application Issued By Dat zo Boiler Hood or Type ❑ Canopy Type 11 ❑ - _ Duct - Under Ground Duct - Structural Refrigeration System ❑0.100,000 BTU ❑100,000 BTU Duct - Ventilating SUMMARY OF FEES BUILDING PERMIT $ -3 a it> SMIP $ is PLAN CHECK $ Z.fcYt._ PERMIT PLUMBING $ ISSUANCE $ PLAN�CHECK 25% $ ENERGY P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK 50% $ MICROFILM $ MECHANICAL $ TOTAL FEE $ _�o', PLAN CHECK 25% $ Exhaust System ❑ Multiple ❑ System Repair/Alteration Firepl/Fact. Bit. ICBG# Heating System & Ducting El 0-100,000 BTU 1:1100,000 BTL 7 Reinspection Fee $15 Issue Fee $ 3 CMF 0865-46, rev. 4/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor CONSTRUCTION AND PLANNING - APPROVALS Permit# Date Inspector POOL SPA 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 LIFER 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 APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping OGas .0Oil 23. Gas Pipe -Rough & Test 72. Underground Flush -24. Roof Framing 73. Undergrnd. Storage Tank OGas 0Oil 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 �f 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 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 ' 48. Special Requirements Completed ' 49. Electric Release to Edison - 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY o. ' Date N City of Costa Mesa Development Services Department Building Safety Division CERTIFICATE OF OCCUPANCY No. 001270 P. O. Box 1200 Costa Mesa, California The Building located at 14r PTCY474ID At IF TP TjWM 4A—A has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group R--7 Occupancy. Use of Building y7AAEHa1S .. Legal Description e27-033-01 (See reverse side for Metes and Bounds) Building Permit No. Ugt—Arl19RTtir,00 Electrical Permit No. P—A!90 Plumbing Permit No. o—r*)oz Mechanical Permit No. "^�"^� ^"n G�^r1 Number of apartments and/or uest rooms e_v3P 9 ISSUED TO: Building Official Vol' /6 l Nr1RM PTTr.T.TAM y �! by 4�, C 4tDwi,rA�,'rN—` )ARQM'�R!'Re'Wmm�Tamemo rnFca r"a Date This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 lel U.B.C. CMF 1015-46 rev. 1/83 White -Owner; Canary - Numerical File; Pink - Bldg. Permit File City of Costa Mesa Development Services Department Building Safety Division CERTIFICATE OF OCCUPANCY No. 001499 P. O. Box 1200 Costa Mesa, California The Building located at 245 Fischer Avenlm B-4 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group X=2 Occupancy. Use of Building Office Legal Description 427-033-09 (See reverse side for Metes and Bounds) Building Permit No r-21`1601 Electrical Permit No. 620603 Plumbing Permit No.1120603 Mechanical Permit No. 120603 Number of apartments Fire Permit No. F21780 ISSUED TO: Building Official Pill lialnyrrrnarti P.- 1517 N. Fairview Avenue Y Tanta Ara, CA 92707 This Certificate of Occupancy SHALL BE posted in a conspicuous place on the 11 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 and/or guest rooms and SHALL NOT BE removed except by the Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PER IT NO. TRACT NO. LOT NO. BLDG. NO CONSTRUCTION PERMIT INio-5 3 _ , J\12 l\Address -.. " : , - P rr�w Arch/Eng. - - - License No. Address - Contractor %/.fig IIIW AnA A1, - Phur affirm that I am licensed under provisions of Ch with section -7000) of Division- 3 of the I is Co tl ;a my license is In full ford TYPE OF CONSTRUCTION 0 ry NEW 4rADD ❑ ALTERATION 0 REPAIR 0 CONVERSIONt.O DEMOLISH ".D.OTHER DESCRIPTION OF WORK TIZW TYPE OF PERMIT ❑ GRADING, O FOUNDATION - O STRUCTURAL 9 (corn- ; 0 TENANT -;D -ELECTRICAL OPLUMBINGiIECHANI ass -'and - 0 OTHER - - - - etett.. PROJECT DESCRIPTION CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor •'5336 3/08/83 A.P. 9� ZONE iW& K L ST. EF YARD - - - S5IDE VR - RIYARD REAR YARD (TO PIC) PKG. SPACE REQ. TIONS: -NG. REF. 9F " 7.00 TI-' PROVIDED -- - ,PARK FEE $ DATE ' - License Ci��as ice s No. Signature'-- _. r. Date --+ • - FO•' - --- SQ. FT. WORKERS'COMPENSATION DECLARATION- _ I OCCUPANCY— CONSTRUCTION TYPE ,1 hereby affirm that I have a certificate of consent to self -Insure o5 a certificate of Workers'-Compensa ce or a certified copy thereof (Sec h 3 ,.LAb. C.j, - - ' VALUATION ZONE _ GRADING CU. YDS Ir ACRES - - ELECTRICAL - Policy No. SII•+/i/'s.Z'C any 1•' ertified copyds hereby turn fished. _- S/Ue WAS . Certified copy is filed with the city Building Division.- se .REMARKS:'u.+ '-- 77 - - UAR.Ula EXEMPTION FROM'WORKERS' COMPENSATION DECLARATION - 'GENERATOR--- (This section need not be completed if the,permit Is for one hundred TRANSFORMER ($100) Or less). - 'IAPPLIANCE':-`- 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 o t e ers' Compensation Laws of. California. - _ Date I 1 Signature ' PLUMBING. ,S -� .PLAN CHECK' - BATHTUBS - SHOWERS - TOILETSq- 1;.,, - URINALS- -- - - NOTICE: If after making this tleclaration, you should become subject HPC--- - -- to the Workers' Compensation provisions of the Labor Cotle, you must forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS ---'- revoked._--_ _ ! -- . _ CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS -" SERVICE SINKS SUMPS—- 1 hereby affirm that there is a construction lending agency for the per- formance of the work for which this permit is issued (Section 3097 - FLOOR SINKS -- FLOOR DRAINS METERED- .SUB - Civ. C.).- ' - -' -'---"' -- - ' - -'- - Lender's Name '•PANELS'--- --MAIN— Lender's Address T DRINKING FOUNTAINS- INTERCEPTORS CLARIFIERS 1 - - -•^ -- - AMP-- •- --- OWNER'BUILDER'DECLARATION I hereby affirm that I am exempt from. the Contractor's License Law for - SWIM MI NG'POOE" 'PTRAP'^" the -following -reason -(Section 7031.5 Business -and. Professions -Cade: Any city or county which requires a permit t0 construct, alter, Improve, demolish. or -repair any structure, prior to-its'Issuance, also re- quires the apr1rumt for such permit to file a signed statement that he WATER SERVICE- "` -ALTERATION' GAS SERVICE _ OUTLETS ' is-licensed'pursuanbto the'provisions of -the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS- BTU OUTPUT eusiness•and ProfessionsCode) or that he 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 -penalty of not more than five hundred dollars ($500). SEWER CONNECTIONS" 1 SOLAR TANK -' ' -COLLECTORS"' I, as owner of the property, or my employees with"wages -as their El- " ;APPLICATION APPROVED BY sole compensation, will do the work, and the structure is not intended or offered for sale. (Section 7044, Business and Professions Code: -The _ _ SOLAR PIPING SVS. - -I- - - - SUMMARY OF..FEES Contractor's License -Law -does not apply to an owner of a property, _ ISSUE FEE •'� 1' - - --• - --- - I who builds or improves thereon, and who does such work himself or ;PERMIT $ ;PERMIT through .his own.em poo sees, provided t such improvements are not MECHANICAL PLAN CHECK 1 'PLAN CHECK $ howe however, Intentletl th offered for sale. It, however, the building lg or Improvement intended o sprovi g one year of completion, the owner will have theburdensale) of proving he tlitl not oro rt imm-exclus'the purpose of with 0-1, as owner mf -the property, am -exclusively contracting. licensed contractors to construct the project (Section es not Business antl Code: -The Contractor's License Law do, apply to: sof ANDHEATINGDUCTINGSYSTEM 0-10-- : -TU -- -AND DUCTING-" 100,0001+ BTU r REFRIGERATION 0-100,000 BTU - ISSUANCE- $. -- - \" or Improves thereon, and who con- owner of property who and caner p -$•-'-I•� with a tracts from such -projects with -a contractor(s)-licesnetl.pursuant to. tr PLAN CHECK the Contractor's License Law). 100,000+ BTU .ELECTRICAL 0 I am exempt'under Section B: & P: C for'this- reason- - '.-•_- :_ _ - BOILERS BT V Date Owner - _ - _ . SYSTEM REPAIR, ALTERATION PLAN CHECK $ 1 hereby certify that I, have read this application and state that the above EXHAUST SYSTEM MULTIPLE irmation is correct. agree to comply with all city and county nfo MECHANICAL -$'� ordinances and state laws relating to construction, and hereby authorize representatives-of'this cit to enter upon the above mentioned a NO An 007 PLAN CHECK' -E p(operty_(o pe99tion /!f A3 i - ISSUE FEE Signature --Date34 .__c_ _, r - • .. ✓ CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor •'5336 3/08/83 A.P. 9� ZONE iW& K L ST. EF YARD - - - S5IDE VR - RIYARD REAR YARD (TO PIC) PKG. SPACE REQ. TIONS: -NG. REF. 9F " 7.00 TI-' PROVIDED -- - ,PARK FEE $ DATE ' - ELECTRICAL - - ' PEAN CHECK DWELLING UAR.Ula - 'GENERATOR--- 0-1'KW=1-l0�KW - TRANSFORMER -+• •+ ) f I 'IAPPLIANCE':-`- 10.50'KW_50+KW- - - -" MOTORS'- --'-" 0=1 HP---- 1-10 HP - - '- _ !(INC. SO LAR)-'30-S0.HPy--50-1 HPC--- - -- FIXTURES"' `OUTL'ETS-"'SWITCHES- -:GAS TUBE SIGNS --- - }! - POLE LIGHTS-" • POLES METERED- .SUB - '•PANELS'--- --MAIN— -- -SUB ISERVICE - "'- - -•^ -- - AMP-- •- --- f - '- t` -ISSUE FEE ;APPLICATION APPROVED BY SUMMARY OF..FEES BUILDING -- - - --• - --- - I ;PERMIT $ ;PERMIT .,SMTP ,$'T v 'PLAN CHECK $ PERMIT 00 .PLUMBING - ISSUANCE- $. -- - \" -$•-'-I•� GRADING '.$•°ts I PLAN CHECK .ELECTRICAL MICROFILM -i!' ` + PLAN CHECK $ NOTAL FEE $1 • MECHANICAL -$'� _ LESS AD- PLAN CHECK' -E VANCEPC $" FINAL FEE 5 CONSTRUCTION AND PLANNING M��/�,�, APPROVALS Permit # �I Date POOL & SPA Inspector - 'a tDate - Inspector APPROVALS. Permit# �`:•'.`��: �•:.y, 1. Temporary Electrical Service or Pole 43. Pool &'Equipment Location 2.Soil Pipe-Undrgrn _ 44. Steel Reinforcement 3._ Electrical Conduit Ut lity-Undrgrn , . 45. Forms • - 4.- .Electrical Conduit_Undrgrn _ 46. Electrical Bonding 5. Steel em orce 47. Rough Plumbing & Pressure Test - 6. Electrical UFER Grn i 48. APPROVAL TO COVER-GUNITE '- - - - -••• 7. Footings _ _ _ _ _ _ 49. Electrical Conduit-Undr rn ' ' 8. - Foundation _ _ _ _ 50..• Gas Pipe„ E Undr rn, Test . 9. Water Pipe-Undrgrn. 51. Backwash Lines P-Trap''0` ndr rn :t ` 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?�, ' 13. _ Rough Plumbing. -' 14. Rough Electric -Conduit - -- - X56. Electrical -Final 15. Rough Electric-Wirin - - - - 57. SolarSystem-Final-- 16. Rough Heating & Air Conditioning - encing & Access Approval 171- Ducts, in Structure. _' _ __ - _ APPROVED FOR PLASTERING 18. 19. ;. 20. Ducts, Ventilating Gas Pipe -Rough & Test --Roof!Framing - 60. - .POOL/SPA SYSTEMS FINAL - - 21. 22. Roof Sheathing- - Frame and Flashing -.- - _ '� • �•n NOTES: 23. -Insulation 24. Lathing & Siding - - - - - - - - 25. - Drywall. Nailing - - - - - 26. Plaster Brown at : - - 27. Electrical Power Meter -Final: 28: -Final Electric - - 29. Final Heating & Air Conditioning -- - - - - - 30. Final Gas Pipe -Test - 31: .Final Plumbing 32. Water Service -Final C 33. -Gas Service -Final - - - 34. Solar Domestic -Final ' 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUI LDING 39. Special .Requirements Completed - - - -- 1 40. Electric Release to Hdison` • - - - 41. Gas Release to Southern California Gas Co. X42. CERTIFICATE OF OCCUPANCY --No Date r ,r'CI4OF CO ' CONSTRUI ' Applicant to fill in -all spaces withinhe--order lines and sign all appropriate o.ma._— •^` -+•—�' ! f ` ( MESA P MIT jja�yy/ TRACT NO, LOT NO.-„ BLDG. NO. ��y `�) --+. ON PERMIT - y602 i �' 6"f S' OA -19 Z.r9/20J82'- cb7t, I'7:UII -�l TYPE OF CONSTRUCTION 'i _ . :ifn'l. 2J.'. .A99A Phon ❑ NEW D ADD= D ALTERATION _ -- u) 93,kl? IBOI:fSo,_ 416"n Address 1517; AJ.-)54srX❑ REPAIR D-CONVERSIONI,❑DEMOLISH ,__ Arch/Eng. "+ Address - License NO. V OTHER DESCRIPTION OF WORK- .EIQTRICAL_1" . •1:"airJ36t31"b'9 3r e - Phone PE OF PERMIT 'Q- - -' -- .,.IURlNApS Address -- i "'- "" - ❑ GRADING D FOUNDATION D STRUCTURAL- — tracts from. such -projects with_a_contractor(s) Iicasned .pursuant_to the Contractor's License Law). TENANT ❑ ELECTRLCAI. ORLUMBING_0MECMANIC. LICENSED CONTRACTOR DECLARATION _.. DOUBtE LAYS - I hereby affirm that I am licensed under provisions Of Charter 9 (com,� men<ing. with section- 7000) -of 'Division 3 of the-Busings; and . �' ❑.OTHER Date ` 1i O Professions Code, land my license is in full force and effect. Class-"Llcanse No - PROJECT DESCRIPTION 'aarl�yO` DISHtt!ASHERS - ,License - Date - Signature SO = Y ordinances arr��d state laws relating to construction, and hereby authoriz3 represenlat W€!s of'M� cit y-jL1 enfpf•"�rporV`(he -a bove mention¢ WORKERS'.COMPENSATIONMEC LARAT.ION CON 'OCCUPANCY STRVCTION_TYF_' O1 hereby affirm that I have a certificate of consent to selt•Insure, or a�' 50 + jiP� die' — - certificate of Workers'. Compensation Insurance, or, a certitle8 .copy .VALUATION 7— thereof(Se�j�9�j Policy 'No.i�`-7 Ll�p mpanY- GRADING,CU. YDS. ACRES --- SUMMARY OF REFS �'- r '^rtlfied.copyis REMARKS: e FLOOR'aRA!NS-- -_ hereby, furnished. - �. rtifietl copy Is filen with the city Building Division.-MPTION - - — - - - - - 'ERMIT g OO-. SM IP §. WORKERS' COMPENSATION DECLARATION -Gq$TVBE SLC N$ - - need n (This section need not be completed i( the pep mit is for one hundred - OWNERiBUILDER'DECL'ARATION� affirm that-l'am exempt'from the -Contractor's License law, for (5700) or less). -_— _ .. _. _ _ _ POLE LIGHTS "'-- ' - I certify that in the, pe rformance of the work for which this permit Is -^ - - - -- - 7031.5tBusiness--%.a.nd-Professtons C_ggj.I' issueil, f shall -not employ any perAn_in'an�Lmanner so as to become QLl/MBtNG _, +PLAN SMfiCK , .EIQTRICAL_1" . •1:"airJ36t31"b'9 3r e NOTICE: If after making this decl3ratlon, you should bacopy, subfgct i 'TOILETS ,� - .,.IURlNApS - -- ''GENERATOR-- 0.1-KW"—"-1-10'KW' TRA FOR MBR NS an owner of property who builds or Improves thereon, and who con. tracts from. such -projects with_a_contractor(s) Iicasned .pursuant_to the Contractor's License Law). Workers' n ti f to the o eri' Compe sa on provisions O the Labor Cotla, you must forthwith comply with such provisions or this permit shall be deemed .. LAVATORIES. _.. DOUBtE LAYS - - APPLIANCE 10,W KW t 1' 1G11` S50+11W - - - Date ` 1i O reyokCd. 1 J CONSTRUCTION LENDING AGENCY - KIT. SINKS DISHtt!ASHERS - MOLORS -co HP 1-14 HP'' ordinances arr��d state laws relating to construction, and hereby authoriz3 represenlat W€!s of'M� cit y-jL1 enfpf•"�rporV`(he -a bove mention¢ I hereby affirm -that there is a construction lending agencyy for the per- - SERVICE SINKS - - 5UAVRS. •- - _ VNC..SOL,ARj 40,50 HP 50 + jiP� die' — - formance of -the work �torF whit This per mlt,is Issue (Sectlon.3097 E -- iAPPLICAT.ION-APPROVED BY ' -=-DATE. 7— PLAN PLAN CHECK - --- SUMMARY OF REFS �'- Civ: C.). N•/`•'` `. \ - (: LOOR SINKS e FLOOR'aRA!NS-- -_ .. FIXTURES 4VTlETS-'.•SWITCMES- �. BTV „Lender's'Names. Lender'sAddress 'ERMIT g OO-. SM IP §. -Gq$TVBE SLC N$ - - -- IPLAN CHECK $ PERMIT -`,i .8E OWNERiBUILDER'DECL'ARATION� affirm that-l'am exempt'from the -Contractor's License law, for INTERCEPTORS vrC - POLE LIGHTS "'-- ' - -- -.'t_e-fol.bWing-reason.,:.(Sec_t..i_o._n 7031.5tBusiness--%.a.nd-Professtons C_ggj.I' SWIMMING POOL `•PTRAP_ _ _ --_�` - ... ��--'-...-��.-., �..-_.•--... ..,-_�- thrOUgh hislown em IOyeeS,-provided that suCn" Improvements are not intended or offered for sale. If, however, the building or Improvement' is SOId`wlthin one year -of completion, theownerwill have.the burden. of proving he did'nol build or Improve for the purpose -of sale). I as_owner .of the .property, am -exclusively contracting with contractors to construct the project (Section 7044, Business -' $AECHANICAL - - HEATING SYSTEM - _AND DUCTING - 1 and Professions,Code: The Contractor -'s Llcanse Law does not apply to and REFRIGERATION an owner of property who builds or Improves thereon, and who con. tracts from. such -projects with_a_contractor(s) Iicasned .pursuant_to the Contractor's License Law). SYSTEM' - ❑ 1 am exempt under5ection - - B. d P. C. for this - BOILERS reas0 Date ` 1i O .. SYSTEM REPAIR. AL EXHAUST SYSTEM I hereby Certify that I have read this application and state that the above Information is Correct: I agree to 'comply with all City and county ordinances arr��d state laws relating to construction, and hereby authoriz3 represenlat W€!s of'M� cit y-jL1 enfpf•"�rporV`(he -a bove mention¢ - --- - - - ' Drivers' LiEanseor SS � ISSUE FEE - CMF 0865-46 White -Building; Canary -Applicant; Pink-ACCOunting; Goldenrod -Assessor ,a1_,,C M1I1rI41x 0.100.000 0-100,000 100,000'+BTU i �MIv PI_> IVlgtly ->V5 OUTLETS - - _ .SERVICE- --- —' -- -- AMP— --- -'BTUOUTP4T -- �u'COLLECTORS— ' - -- ISSUE FEE--- - -- -- - _ -- _ — - - -- - -- iAPPLICAT.ION-APPROVED BY ' -=-DATE. 7— PLAN PLAN CHECK --- SUMMARY OF REFS �'- BUILDING _ _ _ -•C F_ O Or S'f7 BTV 'ERMIT g OO-. SM IP §. 00000+BTU IPLAN CHECK $ PERMIT -`,i .8E - ' - -ISSUANCE _$^I BTU •PLUMBING $ 'GRADING - 'PLAN -CHECK $ —" '-E JY I' ��L�Ii :E `l BTU -- _I. - ELECTRICAL - $ -- § -- L. ,MICROFILM $' 4'Y '^ 'PLAN TERATION - - CHECK —$— -- - ----� -'FEE lgi'i4 n's 1 --- ---- :MECHANICAL.$-- - _ +}•'TOTAL MULTIPLE rl 10 LESS AD- 1 7 )f'L ^ 4 PLAN CHLKKL$ VANCE PC E ----- '� - - - I, E• _, FINAL FE€ $._J � ✓� CONSTRUCTION AND PLANNING/_ APPROVALS Permit # - (p0a' Date POOL & SPA Inspector APPROVALS Permit #' -Date , Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2.- SoilPipe-Un rgrn _ - 44., Steel Reinforcement - - - ' - -- 3. Electrical. Conduit.Utility-Undrgrn _ . _ - 45. Forms 4. Electrical Conduit-Undrgrn-. -. _ 46. Electrical Bonding -- Steel Heinforcel-,,_ _ �,- •_ 47. Rough Plumbin-&-PresureTest - '- " `` ' '• -` 6,_ Electrical UFER-Grn -. 48. APPROVAL TO,COVER-GUNITE 7. - Footings.. _ 49. Electrical Conduit•Undr rn ' -- 8. Foundation - " _ _.- - . _. 50. Gas Pipe, El Undr rn, Test • 9,- Water Pipe-Undrgrn-'-51. •:51:- _Backwash Lines P-Tra - ❑ Undreirn - - - 10. - Structural Floor. System 52. ,.APP.ROVAL TO DECK - - - '. 11. Property Sewer Line.&.House Connection - �` 53: Backwash & Receptor -Final - 12. StreetSewerConnection. - -- - - - 54. Heater & Vent -Final' - 13, _ Rough Plumbing __ _ - "- 14. Rou ll Electric -Conduit ' - - 56. Electrical -Final 15. Rou Electric -Wiring 57: Solar System -Final 16. Roug Heating & Air Conditioning- = - - - - Fencing & Access Approval _ 17: Ducti in Structure - - - - -APPROVED-FOR PLASTERING 18. ' 19. 20.- Ducts -Ventilating - - Gas PI e'- Rough&Test- "' Root. aming -- - - --- - -- - - - - - -_ •� - .• _ _ -'60. POOL/SPA SYSTEMS FINAL '•"• - - _ •'•'. 21, • 22: Roof, eathin .. -' Frame And Flashing _ - - - 7. - ' NOTES: 3_��,��• , .,•r- 23: Insulation -- - •Ale 24. Lathin& Siding - - - I- - - - - - 25. Drywal Nailing - -- - - -- -•- - - .- 26. Plaster Brown Coat 27. Electrical Power Meter -Final, - 28. Final, Electric 29: Final'Heating & Air Conditioning- -- - - 30: Final Gas Pipe -Test - -- ' -31. Final Plumbing- -" - 32. - Water Service -Final .- - •-- - - - "" - 33:,,,Gas Service -Final - Solar b0mestic-Final 35. Land ca e Sprinkling System - - 36. Sounh Attenuation ' -3/-_ Ste_ ' 37. Han Icap Regulations - 38. FINAL STRUCTURE& BUILDING 39. SpeClal Requirements Completed 40. Eledtric Release to Edison 41. Gas Release to Southern California Glias C�o.�..�. , 42. NEot RTIFICATEOCCUPANCY IZ�ODa"t_'!" pQ� ' ' Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA - •- PER,�uT NO. --- . - TRACT NO, LOT NO. BLDG. NO. - - - - - -- - - - - - CONSTRUCTION PERMIT / �' f La TYPE OF �C,.O,(NSTRUCTION J •• ':❑ NEW'- T61 -ADD ❑ ALTERATION - ❑'REPAIR/ ❑ CONVERSION []DEMOLISH, _ ❑OTHER -_' _ 56Q6 W05/62 .17e QQ - - --- - - - - _ 1 �I ZONING REGULATIONS j Project Address yS Owner Phone _ Address _ .� �,�„� _ _ _ Arch/Eng. License No. _ DESCRIPTION OF WORK � - - - - - S'' A.P, 4a 7 ZONE - _ PLNG. REF. # _ r Address - - Contractor L' C7 0�' Phone TYPE OFPERMIT- - - - - r B .. SETBACK CIL, T. _ ❑GRADING - ❑ FOUNDATION ❑STRUCTURAL- bE EYARD S _ _- '_❑'TENANT'❑_ELECTRICAL ALUMBING 5p a� BPuI LDING O E R 'T�'LINE _ Address 3 y,-� rjl �,c - LICENSED CONTRACTOR DECLARATI •• •' I'� _� t hereby affirm that Fa m licensedunderproLisloris of Charter 9 (com- _❑MECNANICA !, 1 _ _ ! RIIGHT meneing with section Division 3 the Business and' OTHER ' • -7,000) .of -of, Professions Code, and my license Iz In full force and effect. _❑ .REAR YARD (TO P/L) ! _ LI PROJECT DESCRIPTION' -fie License Class -' - License No,l -_ - -- - -_ - - PKG. SPACER EQ. - PROVIDED �/-2.2.- SQ. FT.- Date Signature 1saw5 sj. ,R.,...E - -. _ - - --�- •- - STREET WIDTH - - - PARK FEE WORKERS' COMPENSATION DECLARATION OCCUPANCY—" CONSTRUCTION TYPE _' ,I hereby affirm that I have a certificate of consent t0 self insure or, a ..� VALUATION 1&0 a• OZONE -, -ZONING APPROVED BV_— •- - certificate of Workers' Compensation Insurance, or a certified,_ copy.,VALUATION- _ _ _.. - • - - "- _ - -- thereof thereof (Section 380 b C . 1 ✓A PoII<y No. O'Z'^'r.��-��CompanY GRADING CU YDS. ACRES ;SPECIAL CONDITIONS. ' ❑ Certified copy is hereby furnished. --- ^ REMARKS: - 1 - ; - - --- - - - - - - - - - - - - '- --- - - - -- �- Certified copy is filed with the city Building Division. •"r 1 1 - :EMPTION-FROM WORKERS' COMPENSATION DECLARATION _ This section need not be completed if the permit Is for one hundred - .j7. „�} ($too) or less):. 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 ''+�r ., PLUMBING: - a�-� - -, PLAN CHECK--- - - - '- • -' ;ELECTRICAL - - •-PLAN CHECK -- subject to the Workers' Compensation Laws of California. 1 I -BATHTUBS--- ._ SHOWERS �.�- _�_ __ -. _ _ __ _ _ _. _. - '_ .•_ _ _" _-orn_.__ .. Date i Signature NOTICE: If after making this you should .TOILETS ..,URINALS- - - - + GENERATORS--- 0-1 KW_1-1 ... _.. _ O;KW' - - �- - Labor Code, you to the Workers' Compensation provisions of the Labor Code, you must Provisions - ,TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE -CANS - - -- -- - - - APPLIANCE-10-50KW_50-+.KW-revoke- 6ONStl. _ • _ _ CONSTRUCTION LENDING AGENCY �. -' - KIT -SINKS - - - -DISHWASHERS----,k - -MOTORS - - -1-10-Hp-:-- ---O-LHP=1-1 : - - --- OHP '•-- II hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS - _.__ 4(INC. SOLAR) -,-30-50"HP 50.+.HP formance of the work for which this permit is Issued (Section 3097 FLOOR SINKS-'-' - '-FLOOR DRAINS- --•-i^- -- --' -;FIXTURES ----OUTLETS --SWITCHES--- •- ---- - Civ. C.), _ . - .. _ .- -. __ _ -_._ . . , - Lender's' Name L"entlei's Adtliess'"'•` -- _--` '� -" - - -_ -'" -DRINKING-FO UNTAINS-„-- --- - - - - -i----- - ' GAS TUBE SIGNS - - OWNER .BUILDER.DECLARAT.ION `-INTE RCERTO RSy - CL'ARIFIE RS POLE LIGHTS- I hereby affirm that I am exempt from.the Cootrac[or's License Law for '-SWIMMING POOL PTRAP- -- - ... _ _ __- - - ___ - _ the -following -reason -(Section 7.031.5 Business and.ProfessionsCode:_ Any city or county which requires a permit to construct, alter, POLES- METERED SUB" - WATER -SERVICE---' - ALTERATION - - --- - -fPANELS- ------ MAIN- - SUB - - _ Improve, demolish or -repair any -structure, prior to its.issuance, also re- quires the ap, licant for such permit to file a signed statement that he '1. -GASSERVICE --'" -` -OUTLETS- SERVICE------ --- ^-- -- ----AMP - ---- - Is -licensed Pursuantlo"the provisions. of -the Contractor's License -Law- E1Chapter 9 (Commencing with Section 7000) of Division 3 of the Business Prolessions_Code) that therefrom the .WATER -HEATERS- --BTU OUTPUT - - - - - - - -- - -- -^-- - - --- - - -- and or he.is exempt and basis for the alleged exemption. Any violation of Section 7031.5 by _SEWER -CONNECTIONS - - - - -r- - - -- -----------•- ------ -- - - - -- an_y_applicant-for.a•permiL subjects the. applicant to a civil penalty_ f �ot more than five hundred dollars ($500). SOLAR TANK - --- --COLLECTORS - - �- - - - - --- ------ - - -- - - - - - - as owner of -the -property; or my -employees with wages as their 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.- ' - -' - -”' y - --I SSU EF E E' - - - - - ---- -_---- - - - - Contractor's License Law does not apply to an owner of a property - -'ISSUE FEE"- - -- �' '- ,_,_ .:qPp LIGATION APPROVED BY - _- - -` DATE - ' who -builds or-improws-thereon, and -who does such work himself -or- through his own employees, provided that such improvements are not "MECHANICAL -- - PLAN CHECK -- i"'- - _ `SUMMARY OF FEES, - - intended or•offi red for -sate. 11, however, the -building -or improvement is sold within one year of completion, the owner will have the burden of - proving -he -did - not - build or improve for the -purpose -of sale).- - 1 /D+ •• HEATING SYSTEM 0-100,000 BTU -s PERMITBUILDINE ' SMIP�,: ., �$' El 1, az owner of the property. "am_exclusively . contracting with contractors Business _ANDA VOTING-- - _ _, -Sa 6 - -- - - construct the project (Section and not 100,0001+ BTU -PLAN CHECK E ' PERMIT - Firtl es antl, Professions Code- Contractor's License Law does not apply t _ _ : _ _d 1pertThe - an owner of property who builds or improves thereon, and who con- licesned to REFRIGERATION 0-100,000 BTU -IPLUMBING _ $ li -$ �G hafts fromac Such projects with_a contractor(s) pursuant - the Contractor's License law): -� .SYSTEM _"- _ II -- 100;000,+BTV-- -� - -- _ _ 'PLAN CHECK $-' -� RADING' $�'-"c R'AbI G .. ❑ l am exempt -under Section B.L&-P.'C. for this- - - - - -- - - _ -- - - BOILERS BTU �' �.. '- ELECTRICAC-$� -_� - $. reason _, _ - _,-, --____ - �- - - SYSTEM REPAIR, ALTERATION _- - - _ PLAN CHECK -$-- - MICROFILM$_ - Date Owner TOTAL FEE E _ I hereby this application state that the above certify that I have readagree EXHAUST SYSTEM MULTIPLE ICAL-S _ MECHAN- - ! - •f 'r _. -- b ma information• is correct. 1 a ren to •comply wRh-all cit and count -comply 9 Y Y- � - - - - PLANCHECK- $ - VAN E - - -' - VANCE PC S_ ordinances and state laws relating to construction, and hereby authorize t• „ ,tom representatives of coon -city 4o enter -upon the above -mentioned property far mzp� Ctlon purposCs. •r ` /-GJ/� _/, „� -. _ - Signature,Hdt„ Dale U"ar _ _ __ _ _ - - - FINAL FEE $-.(._/_/ - Drivers' License or'S5' -_ _ISSUE FEE / gym. White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor TL J CONSTRUCTION AND PLANNING APPROVALS Permit # POOL & SPA, Date Inspector APPROVALS Permit#' Date, Inspector 1. Temporary Electrical Service or Pole 43.. Pool & Equipment Location 2. Soil ipe,Undrgrn _ -- _ 44. Steel Reinforcement- 3.-_.Electrical.Conduit Utility-Undrgrn .. 45. Forms _ - - - -4. _ Electrical Conduit-Undrgrn _ - 46. Electrical Bonding5._ 5t(Lel Reinforce 47. Rough Plumbing & Pressure.Test-'- -6 _.Electrical-UFER Grn_ 48.. APPROVAL TO COVER=GUNITE"- - .7._ .Footings _ , 49. Electrical Conduit-Undr rn., - -- 8._ _ Foundation - _ . _ - - . 50�• n. Gas Pipe, ❑Undr rn, Test ' -9.- • Water Pipe-Undrgrn. _ 51. Backwash Lines P-Tra ❑ Un@Fqrn 10.. .Structural. Floor System,. 52.' APPROVAL TO DECK :..•ti : -•. n -11. PropertySewerLine..&.House..Connection - -- 53;- Backwash & Receptor -Final 12. -Street.Sewer Connection ""' ' ' - - - - 54: Heater & Vent -Final 1.3.- .Rough Plumbing__. 55, PlumbFno System- - 14. Rough Electric -Conduit f --- 56. Electrical -Final 15. Rough Electric -Wiring -" _ - " 57. Solar System -Final r 16._- Rough" Heating -&-Air Conditioning- SS - - encing:& Access Approval: 17. Ducts; in Structure - - - - - APPROVED FOR -PLASTERING -1 - 18. 19. 20. Ducts, Ventilating -- Gas Pipe -Rough & Test - "' Roof Framing -_ _ ._ - - - - - 60. - ._ - POOL/SPA SYSTEMS FINAL o ' •. ,. - .. .- r 21. 22. Roof Sheathing - Frame and Flashing - - • - -- - - - - - - - - - . ' . • . ..' - . - i NOTES: 23. Insulation - - - 24: Lathing&Siding - ---- -- - r- -- -- - -- --- -_ - _- - - - . 25. Drywall Nailing 26. Plaster Brown Coat - - • 27. Electrical Power Meter -Final - - -- - - - - -- - 28. Final Electric 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. FINAL STRUCTURE & BUILDING - 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. - i 42. I CERTIFICATE OF OCCUPANCY No. Date -- , - Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations ' CITY OFCOSTA MESA PERMIT NO.. .TRACT NO, LOT NO. BL' 1 ' CONSTRUCTION PERMIT ; r' — Applicant's.Mi ling '" - TYPE OF CONSTRUCTION ADD LTERATION- REPAIR �- 34�J' ;�ai4�E-.'' 1%a ••. T• /ddd�rr�ess' _ •' 1:11:1.NEW ❑ CONVERSION DEMOLIS OT ER - - • - �_ ' 7``--- Prolmt Addreu^-s/�� - - Owner's Name �h hone I DESC RIP ION;OFWO _f-75111QyL� ZONING REGULATION S oiZ vis` TYPED ERM�IITry' G ADING FOULI NDATION• '.STRUCTURAL A. P. gW� s I 20NE � _ Arch/Eng. License No. . ❑!TENANy J�tLECTRICAL ❑ PLUMBING ❑ MECHANICAL -PLNG. RE F. qIs- - BUILDING I _ • Address ❑:'OTHER I TO BUILDING - Contractor's Name. hone Q�->7�%D6 Contractor's PRO'JE'CT DESCRIPTION' SGS FT.' ` - OCCUPANCY I E' -PROPERTYLINE- REAR YARD LTE'riO P/LI'. Address (mailing) CON STRUCTION TYPE VALUATION LEFT SIDE YARD - RIGHT SIDE YARD _ •��' R ZON$!'-' GRADINGCU.VDS. ACREc _ _PKC. SPACE•REO. i PROVIDED - . - . License No. �� LICENSED CONTRACTOR DECLARATION Remarks: �` �' STREET WIDTH ' PARK FEE $ - I hereby affirm that I am licensed under provl6lons of Charter 9 (commencing - with section 7000) of Division 3 o/ the Business and Professions Code, and ../ 4;- ) Q 3' 0/ L71 (/Z SPECIAL CONDITIONS: _ ' _ 1 my Iicenw-Is In / II force ane ef/ rt. a �9GOo�f+ 1 I Class Liu o F PLUMBING , , - ♦ ' Dae ' Data '12-�S �s519nature r . r Bac Sink Sewer Cap' ' ELECTRICAL ' .."RIMERS' COMPENSATION PATION reby affirm that I have a cate of consent -to self -Insure or a.certifirate_ Bkkflow' Preventer - -.' --` - - Sewer Connection —%- - --- - Automatic Washer, _ ,Meter ❑over 100 imps j__ _ _ a Workers' Compensation uranca, orcertified copy thereof (Section - - _ Construction Pole I Sub Panel, , idOO, Lab. C.) I Backflow Irrigation - Solar Collectors . Policy No. ' ' Company ' 1 Cooking Unit ' Sub Pole Certified copy Is hereby furnished. , I B Bathtubs Soler Piping , Certified copy Is filed with the city Building Division. I ( I Clerifierr ' 1 Solar Tank Dishwasher I .Motors 00-11 HP [11%-8 ' Dela ,Applicant - - !EXEMPTION'FROM WORKERS' COMPENSATION DECLARATION ` 1 , Dryers ❑GW❑Electric"' 'Ina Solei'❑9-15H! ❑16-153"-�-` '. Dishwasher f ' ; - Swimming Pool w/Spa , (Thisseclion need not be completed if the permit is /or,one hundred ($100) or ' - t Fen I 1 t 'Microwave less).: s 1 certify,that In the performance of the or for which t ermit is Issued I Drinking Fountains I Urinal i j ( I ' shall not employ any person In any anner so as to me. subject to llm ! I I F.A.U. ! j { I Pole Light Workers Co 0psa0o SS Laws of Cal or 5J : Floor Drains I Water Closet , 'Date S •6� Slgnature 1 , , -- Floor Sinks -� - -- - , - - -I - •Water Heater, ----, -- +_,, ' Fixtures I ' _I '_ _ % -- - --1- - -- 'Ran a �i ` - . g t . _1.- i •'-NOTICE: if, after -making thls'tlecla on; you Should become subject to -the -� Workers', Compensatloni provl6l f the Labor, Code,.you .must forthwith %Com ply ,with, Such Drov)sion vthl5 :permit 'snot's be ,deemed, revoked:; -,j Gas Servlce.I 'Outlet6�.. 'Water,Service p',� ' i t Device 80x¢5 ,- } i Sign , •C ONSTRVCT,ION'LENDING AGENCY ! i , ' ' r' I 4 ' Outlets ( ! Standing $actions p ' I hereby affirm that there Is, a:constructlon•lendin9 agencyfor the parlor mantel -Issued e i Interceptors ! -I I -) - • 1 - i _ 1 tt - j I O of the work for whlth^ this- permit Is (Section 30871 Civ. C:,, I 1 t -' i, - h - !�' Switches ( � I Trasb Com actor P f 1 r I . Landel=s• Name ' { - Lentlerw -Address ( I - ! - " ' KrtchenlSiiik , �• I Garbage Disposal ) ; y I Lavatories" 1 in, "1 � iY - ) OWNER BUILDER DECLARATION', • •• I rl 1 1 I hereby affirm that I am exempt' frm the Cc ntractor's 'Llcense L.aw for the i , + - , ,� - Generator ❑0-5 KW ❑5-15 KW I following reason -(Sect lonr7031.5 Business and Prolessional'Code: Any city or ' l P �Trapj I ti ! 1 r s, , i county which requires a permit to construct after Improve; demolish or repair any structure, Drlor to Its;issuanu,.also requires the applicant for such permit ' i '-I Roof Orcins 1 s ; 7 I - : 1 t I ' Transformer ❑ 15.50 KW ( { , t to file a signed statement that he/she Is licensed pursuant to the provisions of -• 1^ , - , El 50 f KW Reinspection Fee I $15 t e con tractor's'lJconse Law (Chapter 9 (commencing,with Section 7000) of - t C_ 1 _ ' ShoWer6 .^s _ I 1 - - �� Reinspection, Fee• $15 ; I ( -1sion.3'of the Business and- Professions Code)-or;that he//she Is -exempt ^rr ".`'•e/rpm 'and the' basis for the alleged axampllon:Any viola tiono/1 Sectl on , 1'yi .1 : I _ ' - Meter ❑up to 100'amps ' Issue Fee: I ' i - $ 3 is ; :5 by?any applicant for -a'. permit subjects -the •applicant to a civil • anally o/ not more than five Hundred dollars (5500j. i -- i l :. ' ' ' 1 i Service Sink _ j ' . , i Iss-a Fee ; $ 3 Zoning Approved BY - i Date _ ,2 LLJJ I, aslowner of the property or my employees With wages;as their sole comDensaif n' w1111do the work, and the structure Is not Intended or offered _ +.%; { `' { °t. j MECHANICAL: 1 ;_ ! Apphication Approved By ' - —Date . for sa le r(Sec(Ion 7044; Businessi and i Professional. Code: The, Contractor's builds Im -' ' ' 1 Refrigeration System License Law does not apply to'an owner of a property who or prows { Boiler_ ' I Application Issued By ' �i 1 Data thereon„ and ;who'doesl such work himself/herself or through his or her own empl0yeat, provided that such Improvements are;not Intended or offered for - i I 1 I ❑0-100,000BTU ❑100,000BTU � - , Ia. It, however, the building or Improvement Is sold within one ear o! com- g y Duct: Under Ground II , I 1 SUMMARY OF FEES I i ! pletlon, the owneriwlll have the burden of proving he/she did not build or im- prove for the purpose of sate). I i 1 - , i I i Duct - Structural , , System Repair/Alteration iBUILDING PERMIT $' - f 1 SMTP I $ LJ I, as owner of the property, am exclusively contracting' with, licensed con- -tractors to.construct.lhe project (Section 704a, Business and.Prolasslons Code:_ _ ._!.. Duct - Ventilating ; - 4 _ _ - ._ . - - ,PLAN CHECK; $, ! I 1 PERMIT �- The Contractor's License Law dons not apply to an owner of property who 'builds or Improves thereon, and who contracts for such projects with acon- Exhaust System ❑ Multiple ❑ o , I 1 I PLUMBING , $ ISSUANCE i $ 1 ( L j tractor(s) license pursuant to the Contractor's License Law): 1 j I ,PLAN GRADING $ i ❑ i am exempt under Section - B. & P. C. for this reason 1 1 Firepl/Fact. Bit. ICBG+ { 1 ( CHECK $ 7�y—� i , $ i ' 'ELECTRICAL $ < ( ' Date ' Owner. 1 ' ' this state that tne-above <- ' - Heating System &Ducting 1 ❑6100,000'BTU'❑100,000 - '- - - - k 7PLAN CHECK $ �. MICROFILM $ �' 1 , I'hereby-certify1'have-rea0' application and Information is rrect. 1 agree [o c ly with all city and county ordinances c , I i , t $ 'MECHANICAL ' I TOTA L'FEE $ and -state la rate In; t0 bulltlIf nstructlon,•and hereby authorize relive- , sentatives ot•thl y to ant pop the above-mentioned property for � Hood or T e i ❑, YP { ) - Rei ¢tion Feel papa $15 I 1 PLAN CHECK $ LESS ' Inspection urpo Q� I Cano T e II ❑ ! 1 ADVANCED PC $ Date Drivers' Licepte"RI S5 i Registers 1 ! i Issue Fee $ 3 1 1 FINAL FEE; $ CMF 0IW-46 rev. 12/82 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor ;:CONSTRUCTION AND PLANNING' r, " -` • r' - ' - --' ` _, - _ , " POO I. I'A _ - - : Date •-.APPROVALS 'Permit# l nspector - - - - - ."APPROVALS � Permit$ Date Inspector - 1; TemporaryElectrical Service or Pole I . ... c- - 'E2 Pool & Equipment, Location - n Soil Pipe-Undrgrnd: 1 ' - I I -: _ _ ' t ' 53.• Steel Reinforcement 3. Electrical Conduit U'rility-Undrgrnd. I '• - i 54.' Forms • 4: Electrical Conduit•Uhdr!grnd) 62 Electrical Bonding _ 5. Steel Reinforcement _ 56., Rough Plumbing & Pressure Test 6. Electliral_UFER Grnd., i f 57.; APPROVAL TO COVER-GUNITE I 7. Footings ! •i _ - I �_ - I -58t Electrical-Conduit-Undrarnri. 8. Foundation I -_ `_ 'S9. Gas Pipe,-❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. 1 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. Struciural 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. RougR Electrical:Conduit , - 't - r 'I ---� � - - " - i 66.I Solar System -Final - - - - 1pi )Rough Electric Wiring .� '• - -=i'' 67.`Fericing &'Access Approval 17.1R6ugh WiringSign,' I I ' �.- -_ '68,' gppROVED FOR PLASTERING 18' Rough.Elecirical-T.Bar,Ceiling' 69!POOL/SPA SYSTEMS FINAL 19..:Rough.Heating &Air Conditioning .. - -FIRE DEPT, REQUIREMENT APPROVALS ' Permit # ' 20. Rough. Factory Fireplace 21. iDucts; in Structure I I t X70. Underground Hydro r22. Ducts, Ventilating 1 71.1 Product Piping 0 Gas El Oil ':23. GasPipe-Rough &Test - 72. Underground Flush 24. *Roof Framing - 73.1 Undergrnd. Storage Tank 0Gas 25.,Roof Sheathing •' I - • - - _0Oil 74.Overhead Hydro M. T -Bar Ceiling (Structural)l & Monocoat I 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe r 28. Lathing & Siding, �� I 77. FIXED SYSTEM FINAL. - 29. Insulation .� - I 178.' FIRE PREV. FINAL 30. Drywall Nailing I Notes: 31. Plaster Brown Coat 4 32. Electrical Power Meter -Final • 33. Final Electric 34. Final Heating &'Air Conditioning ' I i •� i -. ' 35. Final Gas Pipe --Test • r' 1 i 36. Hood or'CanoPY• _. r ` • r , 37. Final Factory Fireplace 38. Final Plumbing' - 39. Water Service -Final 40. Gas Service -Final I + - •' �* 1' _ 41. Solar Domestic -Final ' • - ' , ' 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation.System; 45. Sound:Attenuation . t ;`• 46. Handicap Regulations' - { 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed I , 49. Electric Releaseto,Edison I 50. Gas Release to Southern California Gas Co - 51. CERTIFICATE OF OCCUPANCY _._ _ _ ' _ _ I, No I Date ,•., , Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CfTY OF COSTA MESA CONSTRUCTION PERMIT - Project Address -2415 4- !Applicant's Mailing AddressNp��1�}'I��1�Q1r J��'�'�rrs1 Owner's Name K_�'I+U04.4 PROPPIRc1.$FSPhone55C—(A = Address �'5a�s11�-7 NJ-�s aig-VLOjr,/oma o Arch/Eng. LW 21IhL4lsi�dl�L�#41iV` License No. C-15 Address 51 QLU,AA4JW S ' Contractor's NamF''Z@] Phone 22Z Address (mailing) 1--,/1-1 0:FA City License No. 1 LICENSED CONTRAC+OR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Busln ss and Professions Code, and my license is in full force and effect. [//I1� _ License Class iNeye No. Date SignatureVVY WORKERS' COMPENSATION DECLA RATIO ' hereby affirm that I have a certificate Of consent to selftinsure or a certificate (� if Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. ) �(/"�� ZClr" Policy No. �s71Q-I Company G ? Certified copy is hereby furnished. s tits c y is filed with the city B ildi vis DatexQ_L� Applicant�� EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit is for one hundred ($100) or less). 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 California. Date Signature NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with Such provisions or this permit shall be deemed revoked. 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 (Section, 3097 Civ. C.) Lender's Name ' Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/she is licensed pursuant to the provisions of the 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 herefrom 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). 1, as owner of the property ormy employees with wages as their sole Compensation, will do the work, and the structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's 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 employees, provided that such improvements are not Intended or offered for 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- p pe for the purpose of sale). as owner of the property, am exclusively contracting with licensed con-' ,act o is to construct the project (Section 7044', Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a con- tractor(sl license pursuant to the Contractor's License Law). I am aware that proof o11 their Worker's Compensation insurance should be provided to me. D Lam exempt under Section B. & P. C. for this reason Date 110!1 -W !!K Ownera&/-a V.WJ I hereby certify that I have read this applicat' information is correct. I agree to comply with a 9716 10/09/64 111.92 TL. TYPE OF CONSTRUCTION LJ NEW LJ ADDIXI ALTERATION LJ REPAI R ❑ CONVERSION ❑ DEMOLISH E] OTHER, ` DE ISO OF ORK/ F glD /V BoilerHood or Type I U Canopy, Type I I ❑ OF FEES A.P.S �� O'3'3 �C� Zone JV S Main Building: Accessory Building: Duct - Structural Refrigeration System 00-100,000BTU 0100,000BTU TVL�.or PERMIT LJ GRADING LJ FOUNDATION XSECTURAL _ .C_YTENANT ❑ ELECTRICAL .❑ PLUMBING ❑ ECHANICAL !.❑ OTHER PROJECT DESCRIPTION S FT. 's OCCUPANNCY�-__a CONST VC ION TYPE N'�G CU. VA ION$ ZONE Y GRADING CU.YDS. � ACRES E T Front Duct - Ventilating 2f, Z 0 BA Rear PLUMBING N C Right $ N S Left $ G - ef Ping. Ref. # Parking Req./Provided E Remarks: C -14;-60 MNUZr Planning Notes: GRADING $ M E4A4_1 E L. CL 50% $ MICROFILM $ S. PLUMBING FEES $ TOTALFEE Bar Sink Showers QQ ,,'''' '' PLAN CHECK ELECTRICAL FEES Backflow Preventer - Service Sink Automatic Washer Construction Pole Sub. Transformer D 15-50 KW ❑ 50 + KW Backflow Irrigation Sewer Cap -. Bathtubs Sewer Connection Cooking Unit ' Meter Dup to 100, amps Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps Dishwasher Solar Piping Dryers DGas ❑Electric Sub Panel " Drinking Fountains Solar Tank Fan Motors 00-1 HP 01%-8 - Floor Drains Swimming Pool w/Spa F.A.U. Inc. Solar 09-15 HP 016.15+ - Floor Sinks Urinal' - Fixtures - Microwave Gas Service Outlets, Water Closet - Device Boxes Pole Light Interceptors - Water Heater Outlets Range Kitchen Sink - Water Service Switches Sign Lavatories Garbage Disposal Standing Sections P -Trap - Generator DO -5 KW D5-15 KW Trash Compactor Roof Drains - I I- Reinspection Fee I $15 I I Issue Fee I $ 3 I Reinspection Fee 1 $15 1 1 Issue Fee 1 $ 3 inspectionu ose 'O ,5 Q/1� Signature •� AQ Date D� Drivers' License or SS :P F2 9f] 47% Reinspeetion Fee $15 Issue Fee CMF 0865-46, rev. 4/84 White - BJlding; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor $ 3 DEVELOPMENT SERVI Zoning Approved By_ Building Approved By BoilerHood or Type I U Canopy, Type I I ❑ OF FEES JV Duct - Under Ground Duct - Structural Refrigeration System 00-100,000BTU 0100,000BTU $ PLAN CHECK Duct - Ventilating 2f, Exhaust System D Multiple D System Repair/Alteration PLUMBING Firepl/Fact. Bit. ICBG # ISSUANCE $ PLAN CHECK Heating System & Ducting 1:10.100,000 BTU D 100,000 BT $ ENERGY P.C. $ ELECTRICAL inspectionu ose 'O ,5 Q/1� Signature •� AQ Date D� Drivers' License or SS :P F2 9f] 47% Reinspeetion Fee $15 Issue Fee CMF 0865-46, rev. 4/84 White - BJlding; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor $ 3 DEVELOPMENT SERVI Zoning Approved By_ Building Approved By SUARV OF FEES JV BUILDING PERMIT $ SMIP $ PLAN CHECK 2f, y2 PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK 25% $ ENERGY P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK 50% $ MICROFILM $ MECHANICAL $ TOTALFEE $ QQ ,,'''' '' PLAN CHECK 25% $ CO N�TRUCTION AND PLANNING APPROVALS Permit # Date Inspector POO, -SPA 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•OFER Grnd. 57. APPROVAL TO COVER-GUNITE .7. Footings, r - 58. Electrical Conduit-Undrgrnd. - 8. Foundation 1 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 r 63. Heater & Vent-Final 13. Roof Drains I `' .1 - 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 1,8. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20-Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating •- 71. Product Piping 0Gas 0Oil 23. Gas Pipe-Rough &•Test 72. Underground Flush 'Roof Framing - 73. Undergrnd. Storage Tank 0 Gas 0Oil 25. Roof Sheathing - 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing/vArApy 76. Dry Standpipe 28. Lathing & Siding _ 77. FIXED SYSTEM FINAL ' 29. Insulation 78. FIRE PREV. FINAL 30: Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat -" .' 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes:• 34. Final Heating & Air Conditioning 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 48. Special Requirements Completed 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'COSTAMESA S� PERMIT NO. TRACT NO. LOT NO. BLD Construction Pole CONSTRUCTION PERMIT Dish washer - j Solaf Piping Cookin Unit _ 9 less): ( certif that in the p Y' y person In of the work fso as to this permit ect t Issued 1 shall not employ any person In any manner so as to become Subject to file Workers' Compensation Laws of California. - Drinking Fountains 9 Solar Tank Dishwasher Project Address TYPE OF CONSTRUCTION NEW ADD 'ALTERATION _ REPAIR SignatureNOTICE: If,'after making this declaration, you should become subject to the Floor Sinks UrinalFanWorkers' 11 CONVERSION ❑ DEMOLISH ❑ OTHER Compensation provisions o1 the Labor Cotle, you must forthwith Applicant's Mailin ddress tractor(s) license pursuant to the Contractor's License Law). ❑-I am exempt under Section B. 8 P. C. for this reason A: P. qE Owner's Name ho a DESCRIPTION OF WORK S Main Build Address' TYPE OF PERMIT GRADING' FOUNDATION STRUCTURAL - T Front Outlets nnI�// Arch/Eng. � License No: '❑ 1:1❑ TENANT ELECTRICAL ❑ PLUMBING MECHANICAL B Signature 7ZL %77 Date Drivers' License or SS mf,�� / / Address ❑ OTHER - A A Rear _ f - - Right Contractor's Nam P one PROJECT DESCRIPTION 50. FT. OCCUPANCY' K Address(mAlingl �!� �i(0 /�/ CON STRUCTION TYPE VALUATION S Left /''// 0 3 ZONE - GRADING CV. YDS. ACRES - PI ng. Ref. # City License No. •yf'y�a LICENSED CONTRACTOR DECLARATION Remarks: - - Parking Req./Pr I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and Use of Building my license is in II a antl,'effect.Plannin Licens las - L e se No. PLUMBING FEES g. 'Notes: Date Signature ttle 9P 4 —' Bar Sink Showers WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selftinsure or a certificate BdCkfIOW Pr¢vep[er SefVIC¢ Sink m of Workers' Compensation' Insurance; or a certified copy thereof (Section - - - 3800, Lab. T P Backflow Irrigation Sewer Cap 22„/ Policy No. ((� C Copany ('L,JI m ertified copy is hereby furnished. , Bathtubs Sewer Connection Automatic Washer Cer eq �yiiletl with the city quJl�}+} Diy�ig9, Date:/` Applicant [/y/� /O/(' E moi. Clarifiers Solar Collectors Construction Pole EXEMPTION FROM WORKERS' COMPENSA�CLARR'AtIION (This section need not be completed if the permit is for one hundred (E100) or Dish washer - j Solaf Piping Cookin Unit _ 9 less): ( certif that in the p Y' y person In of the work fso as to this permit ect t Issued 1 shall not employ any person In any manner so as to become Subject to file Workers' Compensation Laws of California. - Drinking Fountains 9 Solar Tank Dishwasher , Floor Drains. SwimmiMw/SpaDryers ❑Gas. ❑Date SignatureNOTICE: If,'after making this declaration, you should become subject to the Floor Sinks UrinalFanWorkers' The Contractor's License law does not apply to an owner of property who' builds or Improves thereon, and who contracts for such projects with a con. Compensation provisions o1 the Labor Cotle, you must forthwith Gas Service Outlets. '•Water CF.A.U. tractor(s) license pursuant to the Contractor's License Law). ❑-I am exempt under Section B. 8 P. C. for this reason comply ,with such ' provisions or this permi1.t shall .be, deemed revoked. CONSTRUCTION' LENDING -AGENCY . . •• Interceptors, Water HFixtures Date Owner - I hereby certify that I have read this application and state that the above Information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize repre- I hereby affirm that there is a construction lending agency for the performance of the work for 'which this permit is Issued (Section 3097 Civ. C.) Kitchen Sink Water S Device BoxesLender's Lender's Name ' AddressLavatories.OWNER BUILDERDECLARATION ' - �- - Outlets I hereby affirm that I am exempt from the Contractor's License Law for thep—Teafollowing reason (Section 7031.5 Business antl Professional Cotle: Any City or 1p Switches Roof Drains r ' a herefrom and the basis for'the alleged exemption. Any vlol ation of Section SUMMARY OF FEES ' /031-.5 by any applicant for a permit.subjects the applicant to a civil enalty of not more than five hundred dollars ($500). I; as owner of the property or my employees with wages as their sole Comwill do the work, and the structure is not Intended or offered for sale (Sectlon 7044, Business and Professional Code: The Contractor's License Law does not apply to an owner of a property who builds or ImprovesBoiler thereon, and who does such work himself/herself or through his or her own employees, provided that such Improvements are not Intended or offered for 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- rove,for the purpose of sale). $ 'gems etion. Fee $ 3 Pe $25• Issue Fee $ MECHANICAL FEE $ Hood or Type I ❑ - Duct -Under Ground Canopy Type II' Elsale. PLUMBING - Duct - Structural Refrigeration System I, as owner of the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044, Business and Professions Code: Duct - Ventilating . 0-100,000 BTU C1100,000BTU PLAN CHECK The Contractor's License law does not apply to an owner of property who' builds or Improves thereon, and who contracts for such projects with a con. ENERGY P.C. Exhaust System ❑ Multiple ❑ System Repair/Alteration tractor(s) license pursuant to the Contractor's License Law). ❑-I am exempt under Section B. 8 P. C. for this reason $ Firepl/Fact. Bit. ICBG+ Date Owner - I hereby certify that I have read this application and state that the above Information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize repre- Z H ting System & Ducting 0-100,000 BTU 0100,000 _ _ _ , e4 - MICROFILM $ sentatives of this ity to enter upon the above-mentioned property for Inspection purpo 1 Reinspection Fee $25, Issue Fee $ 3 Signature 7ZL %77 Date Drivers' License or SS mf,�� CMF 0865-46 rev -7/83 ' White - Building' Canary - Applicant; Pink '- Accounting; Goldenrod =Assessor 0 :Iectric Garbage Disposal Generator ❑0.5 KW 05.15 KW 1 Reinspection Fee 1 $ PUBLIC SERVICES REQUIREMENTS: Zoning Approved By Application Approved By Application Issued By f B471' 9/19/84 Zone Park.Fees $ 23,00 TL 11CAL FEES 'Transformer ❑ 15-50 KW ❑ 50+KIN Meter Cup to 100 amps Meter ,❑over 100 amps' ,Sub Panel Motors 00-1 HP❑1YS-8 _ Inc.Solar ❑9-15 HP 016-15+ Microwave ' Pole Light Range Standing Sections Trash Compactor Issue Fee 1 $ 3 Z 0 N I N G R E 1 R E N E N T SUMMARY OF FEES ' BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK $ ENERGY P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK $ MICROFILM $ MECHANICAL 1l�.l TOTALFEE $ PLAN CHECK $ a% CONSTRUCTION AND PLANNING APPROVALS Permit # -Date Inspector POOL _ SPA - APPROVALS Permit z# 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 5y'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, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 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 APPROVALS Permit # 20: Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0Gas 0Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank OGas 00il 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 Notes:f6•Z-?-i KOP 2�Aa� •l..fLA 34. Final Heating & Air Conditioning 16/2 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 r 48. Special Requirements Completed 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' TRACT NO., LOT NO. + BLD ' "CONSTRUCTION PERMIT Applicant's Mei ling Address T/PE OF CONSTRUCTION_ :NEW- ADD. ALTERATION ,REPAIR I I + ❑ CONVERSION ❑ DEMOLISH ❑ OTHER � - - Project Address- - Owner's Name Phone �'• DESCRIPTION OF WORK ,/r/V•C�fyj _-��GL/!1/z /' l7 Address -"y TYPE OF PERMIT ,GRADIN FOUNDATION STRUCTURAL A. P. +1Z ONE ' Arch/Eng. - _ License NO., ❑ITENANT, ELECT RACAL PLUMBING 1:1 MECHANICAL PLNG. REF. sIv - - BUILDING - Address - - '❑,,OTHER r ' - TO BUILDING' - 1 _ 1 •' f3�/✓ hone Contractor's Nam PROJECT DESCRIPTION. SD. FT. OCCUPANCY V I E REAfl YARD (TO P/U , tea, Address jrnalling)� �sV' //l�.C�.� �%, �zlpa CONSTRUCTION TYPE VALUATION - LEFT SIDE YARD I RIGHT SIDE YARD ", I •30�-5-7 License No. ZONJ3 GRADING CU. YDS. ACRES - PKG. SPACE RED. PROVIDED LICENSED CONTRACTOR DECLARATION Remarks: ' STREET WIDTH , ' i,PARK FEE $ 4hereby.affirm that I am licensed under provisions of Charter 9 (comrnandng with section 7000) of Division 3. of the Business and Professions Code, and ' SPECIAL CONDITIONS: my license is in f I_f a and effect. � - L'Jcense CI'a ice N /✓1`-�70 PLUMBING Date Signature I Bar Sink , Sewer Cap ELECTRICAL WORKERS' COMPENSATION D lit. I hereby affirm.Mat 1 have a cern��iicate at' nsegRtt o selNneure.or a certificate -Backflow %eventer' . - Sewer Connection' - _ _ _ - Automatic Washer -Meter ❑over 100 amps - - of Workers' Compensation IwsGrance, it Cebrtified Copy thereof (Section - 1 - - Construction Pole Panel 3800, Lab. C.) I Backflow Irrigation Solar_ Collectors +� Sub • Policy No. - Company eCertified copy Is hereby furnished. �', Bathtubs r - Solar Piping Cooking Unit - Sub Pole ' ' Certified copy is filed with the city.Building Division. I 1 "I Clarifiers Solar Tank Dishwasher Motors ❑0-1 HP [11/.-8 ,Date Applicant ,.� EXEMPTION FROM WORKERS' COMPENSATION DECLARATION �: be If the Is for hundred ) r _ Dryers ❑Gas, OElectric • - Inc Solar Og-15 HP 016-15+ -� Dishwasher I Swimming Pool w/Spa ' (This section need not completed permit one ($100) or less) - r ' I - less).. in the performance of the work for which this per R Is Issued 1• ,' Drinking Fountains Urinal Fen /p' I 'Microwave shali.not employ any person In any manner s as to beco subject. to the- , 'Compenaat ' , - - F.A.U. ; r Pole Light ' Worker Laws of Calif -X( i I Fluor Drains + i Water Closet r .Ar Date / 519na[ur i '-NOTICE: If, after -making this det rata vpW ecome subject -to the I - Floor Sinks �• - %----, - %- - Water Heater - - -- - - a . _ T; Fixtures .F _ _ •Range- _ _ -_i• _-_ _ - Workers', Compensation provisi s o he (� tla, you must.forthwith. I comply .with) such provisions or' his �p gt nail be deemed: revoked, l _ _ Gas $Cfvit2i� 'Outlets' - Water Service" ',+ s Device Boxes i ; Sign � 9 I , CONSTRUCTION ILENDING ENCV . 1 r - '•' Outlets I hereby affirm that Mere is lending agency for t3097-fCIv: 1 Interceptors _ LL r r _ I r Standing \ 9 Sectio05 this; permit - C.e of the .work for which. this; permit -ii Issued ' (Section 3097- Clv: C.)• - + ^ ' ' + ' , mak. Switches , TrashCom Lender's' Name - -- - Kitchen•Sink _ - 1 , 8CI0r _P i ' Lender'sl Address i '" I OWNERIBUILDER DECLARATIONLavatories: r = �;. Garbage Disposal I ) 1 hereby, at Ti rm that 1 am exempt Trom the Contradtor's License Law for the reason.(SectlonrJ 031.5 Business antl Professlonal,Cotle: Any city, or , P -Trap, r - • s17. V, Generator ❑0-5 KW 05-15 KWfollowing cnty which req piresrmittoconstruct; alter Improve; demolish'or'repair'Transformer structure; prior10isIssuan ce, also requires tRe applicant far such permit' '- i ROOf Drains ' 1 (-. I �' '- i ' .So Q 15-50 KWany filea tigntlStatementthathe/sheIsuant to ethe .1 ntSgnrsLJcen- L.aw(Chapterwith Section.7000) of cti ovisions of,�-,❑5U i = 1 r '- i I t KWRains I etion Feethe pe 1 $16' Dlvisin3-ofthe Businessad Professions Code) or'that, he//sheIsiexempt therefromantl the' basis forthe al legatl ekemptlon. Any -violation' of Section I ShowersReinspection'Fae I - ' • $15 ''Meter Oup t0 100ampsissue Fea r'$ 37031-5 by%any aDPnt forpermthe applicant to a civil styof than five'huntled dollars I = I r " i 't Servide Sink I ; _ i ( . laua Fee '$ 3ing �7 notmore ($500). - r lJ I, or their sole Approved By Date ' as owner of�the Dro Darty my simployees ,with wages;as compen sat i anI will do the work, isntl,the structure Is not Intended or offered for Sale (Sec(ion 7044, Busi nest. antl: Professional Code:'The! Contractor's _ _ j f 'T. - i I MECHANICAL i - r'. AppliotiOn Approved By I I ate License Law does not apply to'an owner of a property who builds or Improves i Bailer ! Refrigeration System 1 1' , Application Issued By 'nate tharson,land who does such work himself/herself or through his or her own employees, provided that such Improvements are'not Intended or offered forputt'- - Under Ground OO'10Q000BTU 0100,000BTU t sale. If, however, the building or Improvement is sold within one year of com- ( I _ SUMMARY OF FEES % pletion, the owner,will have the burden of proving he/she did not build or im- rove for the purpose of sale)'- ( - , Duct - Structural - Sy_ stem Repair/Alteration r .--BUILDING PERMIT $! SMIP $' I, at owner of [he Dro party, am exclusively contracting with licensed con- I 7044, Professions Code:- - Duct -Ventilating r 7- 1 PLAN ' I tractors to.construct.the�project.(Sectlon Business and The Contractor's License law Edoes not apply to an owner who _ __ _. -_ _ _ �+ CHECK $+ PERMIT of property i ISSUANCE ' $ % 1 builds or Improves thereon, and who contracts for such projects with a con- , Exhaust System ❑ Multiple O, ; „PLUMBING $' I tractor(s) license pursuant to the Contractor's License Law): O ,am exempt under Section ' B. & P_ C. for this reason Fiiepl/Fact. Bit. ICBG+ ', -PLAN CHECK $ I j GRADING $ ) ,I I I 'ELECTRICAL $ , I $ I Heating System &Ducting � ' � owner' � - ,Date 1 hereby certify that-Phave`•read this application -and -state that the -above' -:El ~ 0-100,000 BTU 0100,000 BT' --. *--•' -- -- PLAN CHECK $' , MICROFILM $ ; ;Information is correct. I agree to comply with all city. and county ordinances I t - ++ MECHANICAL $ i TOTAL FEE $ I and,state laws relating to building construction, and hereby authorize repro- for Hood or Type I ❑' 1 1 sentatives of this ,ci y,, to enter po the above-mentioned property 'Inspection I Cano T II O( I '( Reinspection Fee $15 PLAN CHECK $� 1 LESS r purpos ( 'd✓ r e I i ADVANCED PC $Sig r Date_ Drivers. ) 1 Drivers' Ltrxl e c 55,E Register 1 (1 , ( I I Issue Fee ' _ $ 3 !/•' I p _ _ FINAL FEE I $ CMF 06-46 rev:12/81� White - Building;Canary -Applicant;Pink -Account Ing; Goldenrod - Assessor _ I } �%CONSTRUCTION'AND�PLA ING ' - O �.m,r-c-'- a - - �- �., - o e-.POOL&SPA- ,r O - '. - -- - -'� "rool/� ..Date,' , Inspector 3- Y. E� - - Permit# 'Date 1'rispector� • APPROVALS ,}; Permit#i'L - ;APPROVALS - - rt1-'-.. Temporary,Electncal Service orPole 52:; Pool &:Eguipmerit'Location s� _ n Y? 'Soil Pipe-Undrgrnd" e 53`.' Steel Reinforcement- z I 3! Electrical Conduit Utility.Undrgrnd A i 54-''-Forms < r 4: Electrical Conduit-Undrgrnd L-, i Y' 4 1"55.'Electncall,Bondin _ ' ; 5; Steel;Reinforcement I ; n u ' 56, Rough Plumbing & PressurelTest r r -`,.: _ i 6. iElectrical LIFER Grnd., ' a = `� I• `-+ -?^ 57`APPROVALTO.COVER-GUNITE" _ 7. Footings � ' i � "� , a cm � ` � � rpt I, .58:- Electricals,666duit=Uridiarr;r1._ r:1 ,�•� 8..Foun6tion =e _ ,' ,`c . ! t9.Gas(Pipe,El 'd rnd:,Test�.,_: 9. Water Pipe-Undrgrnd.(60. Backv�ash Cines, P,-Trap, O Undrgrnd. - a 10. Structural Floor System.61. APPROVAL-,TO DECK - 11. Property Sewer Line &;House. Connection _ v' W !;62.Backwash &�Recepfor-Final • "; - 12. Sewer CaP ,. I !� i •. j - -' ='63. Heater &-Vent-Final 1 _ _�" _ _ - .9. 13. Roof'Drain`s I j �`• 1 I �; 1^ I ;' 64. Plumbing System r Final 14. Rough Plumbing'x-65. Electrical-Finall�°-''� "A15:^,Rough"Elect-rical-Conduits �" -t - 'i --f `'`j 66.E SSIJT ystem-Final , c- ^6.;'Fiough.ElectricWirang 1,.j� i''67:iFeracing&Access.Appin4al,.r_' __ •• ( : '17r:RougKWiring;Sign` I" -_ ; ' _ ' I r 68.! APPROVED FOR PLASTERING a, ,• Rough Electrical-T'Bar Ceiling i{ ;' '= !'� ' `_ X69.. POOL/SPA SYSTEMS FINAL _• 1 19` R_ough�Heating &Air Conditioning o I 1 (; I j 1 FIRE DEPT. �REQUIREMENT' , j APPROiVALS1 Permit# 20. 'Rough;Factor�n Fireplace 1 'j 'i t ! ! i f 21 in Structures •`. ! } ,I I 170.E Underground Hydro JDucts, i spuds, Ventilating _ I I l I 7Ll Product Piping ❑ Gas O Oil ,22. T x(23. ;I as"Pipe-Rough &Test ,`, •i - 1 r �' 72�Under round Flush 9 't24.,Roof Framing; j • '� li �' !' I �,! �• - ! .-_ i- •7.3.1 StorageTank'O'Gas' ❑.Oil, ' l f I (� •I J'� �J ; , �Undergmd. 1 1 25. ,Roof Sheathing , j - ' �, I - ' i - I �74.i Overhead Hydro •'• - t t ,. -26 T Bar Ceiling (Structuralli & Monocoat _ r l A.1 Dry'Chemical- ! , - . �27. Frame and Flashing, I ,j i , ' I !!' f X76.! DryyStandpipe i. i .28. Lathing 8i-Siding' �,� I ;; ' I I`,rJ-'+ ;77.I FIXEDSYSTEM.FINAL q `' ,� 29_!llnsulation - `-, i '' I ! i ' i i FIRE PREY. FINAL • . i, ! I I 1781 `t30..DryWall Nailing ! ` '! ' i q i ; ' ! l : 1 Notes:! r: '31:-PlasterBrownCoat- !Electrical Power Meter;Final I! i j G4itil ! 1 i' "M! .I 33. Electric I l i i i Llv -Final C' _ , _ 4_ '34. Final'Heeting &;Air, Conditioning L 35. FinalGaslPipe-Test'-' j :i ;`, i•', e i� !>i.=' i"'r c - 'y. - 36. Hood or CanoPY F , F;:c l r; I ' „' i ' _ ' i : t l i - 37. Final Factory'Fireplace 38. Final Plu}'nbing- • lService-Final „` 39. Water i i 1 Imo. 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Pre'venter 43. Backfl w� Irrigation i I I - �'"• • ` ; o c ;'I ' ' 1 - ..a I I 1 44. Landscape Irrigation--SYmm 45. Sound!%Attenuation y I 46. Handicap Regulations ; 47. FINAL STRUCTURE & BUILDING'' 48. Special Requirernents Completed ; y { ! t t , ! i I+' ;i '• ,. I t 49. Electric Release to Edison] I_ _.�._c_ -T-) I ___•-�� 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY -i L4 -•J-�- - ' II ?l I Date -'- Applicant to fill In all spaces except those within heavy • C+.TVOFiCOSTA MESA CONSTRUCTION PERMIT I Project Addr_esi Z4--7 Elf?4nYag- ANE. Applicant's Mallin Addr ss : Z • Owner's Name . ,IoXt� NA). one Address Arch/Eng. 4License No. Address - ' - Contractor'sNam /N ^^ f4& h�9qn�e �() �' Address (mailing) LSI 1A/- IM1�fAA'L r W A"'A LA- cka City License No. 1704-47 LICENSED CONTRACTOR DECLARATION Thereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. CI License tats$ C �I Date 11M. e�L Signature " 0RKERS'COMPENSATION DECLARATIO reby affirm that 1 have a certificate of consent to self -Insure or a certificate workers' Compensation Insurance, or a certified copy thereof (Sect]0n x800, Lab. C ) Policy No. GAJ/07 R$-7-1 Company IHAIA677414 ertif]ed copy is hereby furnished. Cerj� Op cypy is filed with the city B D' on. Date �/, Applicant EXEMPTION FROM WORKERS' COMPENSATIO D R ION (This section need not be completed If the permit is for one hundred ($100) or less). ' 1 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 California. Date Signature NOTICE: If,lafter making this declaration, you should become subject to the Workers' Compensatlon provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a const r act lo lending agency for the performance of the work for which this permit is issued (Section 3097 Civ. C.) \ Lender's Name Lender's Address OWNER BUILDER DECLARATION O I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of 'cion 3 of the Business and Professions Code) or that he/she is exempt -from and the basis for the alleged exemption. Any violation of Section ,1.5 by any applicant for a permit subjects the applicant to a civil enaRy of not more than five 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 (Section 7044, Business and Professional Code: The Contractor's License Law does not apply to an owner of a property who builds or Improves thereon, and who COe$ such work himself/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 com- pletion, the owner will have the burden Of proving he/she did not build or Im- reve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con. 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 builds or Improve$ thereon, and who contracts for such projects with a con- tractor(s) Iicen se pursuant to the Contractor's License Law). ❑ I am exempt under Section B. & P. C. for this reason Date Owner' that.] have read this application and state that the above comply with all city and county ordinances g construction, and hereby authorize repre- Stlpon the above-mentioned p opr�erty for TYPE OF CONSTRUC ❑ CONVERSION TYPE OF PERMITL ❑ TENANT ❑E 7 ,1OTHER PROJECT DESCRIPTION CON STRUCTION Ty ZONE Remarks: Bar Sink Backflow Preventer Backflow Irrigation GRADING Bathtubs Clarifiers Dishwasher Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets lines and sign all appropriate declarations_. OT NO.BL y- I, ADD la ALTERATION FOUNDATION LJ'STRUCTU LUMBING ❑ MECHANICAL FT. OCCUP VALUATION $ GRADING CU. YDS. A( Kitchen Sink Lavatories P—Trap Roof Drains Reinspection Fee $25 Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Issue Fee Boiler Hood or Type 1 ❑ Duct - Under Ground Canopy Type If ❑ Duct - Structural Refrigeration System Duct -Ventilating 00-100,000BTU 0100,000BTU Exhaust System ❑ Multiple ❑ System Repair/Alteration Firepl/Fact Bit. IC80 # ' Heating System III Ducting A; 00.100,000 BTU 0100,000 BT' Signature rCe±SJ Date ' Drivers' License or SS I I Reinspection Fee I $25 CMF' 0865-46 'rev. 12/83 'White - Building; Canary - Applicant; Pink -'Accounting; Goldenrod - Assessor -- REPAIR $ 3 Issue Fee $ 3 A.P: # S Main Building: E T Front B Rear A. C Right SLeft Ping. Ref. # Parking Req./Provided Use of Building: Planning Notes: -I ; •. ,_ 4656 I I /2/85 - 3 ZZ TL Automatic Washer Construction Pole Sub. ' Zone Cooking Unit Accessory Building: Z Meter ❑over 100 amps Dryers ❑Gas ❑Electric O Fan Motors ❑ 0-1 HP ❑ VA - 8 N Inc.Solar 139-15 HP 1116-15+ Fixtures N G Device Boxes Pole Light Outlets R Switches Sign E Q U Standing Sections Park. Fees $ Trash Compactor $ MICROFILM Reinspection Fee 1 $25 I PUBLIC SERVICES REQUIREMENTS: Zoning Approved By_ ate Building Approved By . —te Application Issued By net D, TOTALFEE R E M N T ELECTRICAL FEE; Automatic Washer Construction Pole Sub. ' Transformer ❑ 15-50 KIN .. El 50+KW Cooking Unit Meter ❑up to 100 amps Dishwasher Meter ❑over 100 amps Dryers ❑Gas ❑Electric Sub Panel Fan Motors ❑ 0-1 HP ❑ VA - 8 F.A.U. Inc.Solar 139-15 HP 1116-15+ Fixtures Microwave Device Boxes Pole Light Outlets Range Switches Sign Garbage Disposal Standing Sections Generator ❑0.5 KW 05.15 KW Trash Compactor $ MICROFILM Reinspection Fee 1 $25 Issue Fee $ 3' PUBLIC SERVICES REQUIREMENTS: Zoning Approved By_ ate Building Approved By . —te Application Issued By net D, PLAN CHECK 25% $ SUMMA Y OF FEES BUILDINGPERMIT $ rte_ . SMIP $ PLAN CHECK $_ PERMIT PLUMBING .$ ISSUANCE $ PLAN CHECK 25% $ ENERGY P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK 50% $ MICROFILM MECHANICAL $ TOTALFEE $ PLAN CHECK 25% $ -CONSTRUCTION AND PLANNING Date ., APPROVALS Permit # Inspector POGi _1PF,� APPROVALS Permit 4b _ Date Inspector) ' 1, Temporary Electrical Service or Pole- 52. Pool &Equipment Location Soil Pipe-Undrgrnd. 53: Steel Reinforcement _ -- `. 3. Electrical Conduit Utility-Undrgrnd. 54. Forms ' 4. Electrical Conduit-Undrgrnd. 1 55. Electrical Bonding 5. Steel Reinforcement - 56. Rough Plumbing & Pressure Test 6. Electrical UFER Girnd. 57. APPROVAL TO COVER-GUNITE , 7. Footings ; 58. Electrical Conduit-Undrgrnd. 8. Foundation ti 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. S wer Cap ei-.. 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/SPASYSTEMS FINAL 19r Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Perm it 20. Rough;FactoryFireplace 21. Ducts; in Structure, 70. Underground Hydro 122. Ducts, Ventilating _ 71. Product Piping O Gas . OOil - 23. Gas Pipe-Rough & Test 72. Underground Flush ,-24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical- ' 27. Frame"and Flashing - - 76. Dry Standpipe - 28. 'Lathing & Siding - - 77. FIXED SYSTEM FINAL 29. 'Insulation - 78. FIRE PREV. FINAL •- (J 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. FinalHeating & 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 r 41. Solar Domestic-Final 42. Backflow Pre'venter' i 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 , 1 51. CERTIFICATE OF OCCUPANCYNo Date Applicant t0 /ill in all sy..— CITY•OF.COSs Q-45 - �CO�IS �qa— PERMIT •PrOjext Addr+iss `T/'�` f-�-+ Applicant's Mailing Address ,Z%�2%J1 PP&CA., 5• Owner's Name F13" Am i`ti��sP'Q2"R•151 PhoneS�Z. Address—I.e_(� t3r �'A't Z11aA_%i 15 -Al r Arch/Eng.T,ZLicer No. 13774-1 Address Contractor's Name!RAJW a il t I-il Phcm Address (mailing) City License No. LICENSED CONTRACTOR DECLARATION I hereby affirm that 1 am licensed under provi�ns'of Charter 9 (commencing with section 7000) of Division 3 of ,the uslne55 and Professions Code, and my license Is in full force and effect License Class License No. Dal@ ignature WORKERS' COMPENSATION DECLARATION 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 3800, Lab. C.) - Polity No.Company BCertified copy is hereby f ffhed. Certified copy is file I h the city Building Division. Dat@ Applicant EXEMPTIO ROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit is for one hundred ($100) -or less), 1 certifythatin the performance of the work for which this permit is issued, I shall not ¢plplo any person in any or as to eco sub---/rse jyct 10 the Worjr''IRTF n Laws of Cali 1/✓J (Y/ Data Signature 'NOT CE: f, a er making this declar tion, you should become subject to the' Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. 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 (Section 3097 Civ. C.) Lender's Name 12 Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional Code; Any city or county which requires a permit to construct, alter Improve, demolish or repair any structure, prior to its issuance, also requires tfle applicant for such permit to tile a signed statement that he/she is licensed pursuant to the provisions of 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 enalty of not more than five 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 (Section 7044, Business and Professional Code: The Contractor's 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 ¢m pl If, o ever. th that such improvements are not within o or offered for Q. If, however, the building a Improvement is sold within one year of r im- pletion, the owner will have the burden of proving he/she tlitl not build or im-, Prove for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed con- 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 builds .or Improves thereon, and who contracts for such ,projects with a con- tractor(s1 license pursuant to the Contractor's License Law). I am aware that proof o their Worker's Compensation insurance should be provided to me. D 1 am exempt under Section n H 1 ,B. &'P,�, for tffilt reason Dale Owner x I her by c rtif that I have read' InfOrmatlon is correct. I agree to c and state laws relating to building sentatives of his y toer Inspection P ses. ®� Signature -1 Drivers' License or SS # bp CMF 0065-46, rev. 10/84 White - du'� d state that the above and county ordinances lereby authorise repre- antlonedr ppe3ert////yyppppfor-0 Date �T free y border lines and sign all appropriate declarations. JO. LOT NO. UNIT NO. - I -4 0126 ' 9/13/i35 . 631051 TL TYPE OF CONSTRUCTION LJ NEW ADD El CONVERSION 1:1 DEMOLISH OTHER DESCRIPTION OF WORK/USE OF B DG. _Se TVP OF PERMIT��//� LJ GRADING TENANT VI ELECTRICAL [:],OTHER PROJECT DESCRIPTION 5 CONSTRUCTION TYPE ZONE GRA Remarks: •� rf��7 G. S Bar Sink Backflow Preventer Backflow Irrigation Bathtubs/ sP Clarifiers - Dishwasher Floor Drains ' Floor Sinks ' Sas Service ` Outlets Interceptors Kitchen Sink Lavatories P—Trap Roof Drains Reinspection Fee, $15 Boiler Duct Under Ground. Duct - Structural Duct - Ventilating Exhaust SVstem Multiple ❑ Firepl/Fact. Bit. ICBG # Heating System & Ryting C3 0-100,000 BTU Vkl00,000 BTI 1' Reinspection Fee x$15 Pink - Accounting; Goldenrod-- Assessor FOUNDA- _UMBING UN - VALUATION $ _ CU. YDS. ACR Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet - Water Heater Water Service �'fs Auto -Wash Issue Fee: CHANICAL Hood or Type ❑ Canopy Type I I ❑ Refrigeration System 0-100,000 BTU A,� System Repair/Alterati Fire Dampers Registers Iswe Fee RAL =AE M-, all _ll 1 $ 3 P. # 4_zL S Main Building: E T Front - A Rear C Right S Left Ping. Ref. # Planning Notes: V, o Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Electric Fan F.A.U. Fixtures - - Device Boxes Outlets Parking Req./Provided ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+KW Meter ❑up to 100 amps Meter Xpve,r 100 Sub Panel Motors ❑0-1 HP km -S Inc. Solar 09-15 HP El 16-15+ Microwave - Pole Light Range Garbage. Disposal 1 ; Standing Sections Generator 00-5 KW 05.15 KW Trash Compactor 1 1 Reinspection Fee 1 $15 11 1 Issue Fee 1- $ 3 1 1 DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Building Approved By BUILDING PERMIY"�$I PLAN CHECK $ PLUMBING $< PLAN CHECK 25% $ ELECTRICAL PLAN CHECK 50% MECHANICAL $' PLAN CHECK 25% $ FEES SMIP $ PERMIT ISSUANCE $ ENERGY P.C. $; GRADING $ MICROFILM $ TOTAL FEE $ Ul.J II ,CgNSTRUCTION AND PLANNING , '' APPROVALS Permit Date Inspector POOL &SPA APPROVALS Permit# Date Inspector 9. .Temporary Electrical Service or Pole - 52. Pool & Equipment Location 2:"Soil Pipe-(jndrgrnd. P 6W 53. Steel Reinforcement 3. Electrical'Conduit/Utility-Undrgrnd. 54. Forms 4.:E1ectrica' l'Conduit- Undrgrnd. 55. Electrical Bonding r 5.'Steel Reinforcement /o/a ByL� 56. Rough Plumbing & Pressure Test - -I 1 6 Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 'i 7.�Footings. '� :t" - 58. Electrical Conduit-Undrgrnd.. ' 6. 'Foundation' 59. Gas Pipe, 0 Undrgrnd., Test i •.:; 9. VaterPipe-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:'ho oieDrains -�=! 64. Plumbing System - Final •• 14: Rough Plumbing ; /t/J�� eV) 65. Electrical -Final 15. Rouges Electrical -Conduit 66. Solar System -Final ' 16. Rough Electric Wiring / 67. Fencind & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18.' Rough Electrical -T Bar Ceiling J j3 CIL 69. POOL/SPA SYSTEMS FINAL 19. ;Rough Heati4g & Air Conditioning (J (� d$�aq FIRE DEPT. REQUIREMENT APPROVALS Permit# 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0Gas 0Oil .23. 'Gas Pipe -Rough & Test '' 7Z., Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank OGas ❑Oil , 25. Roof Sheathing - 74. Overhead Hydro 26. T -Bar Ceiling (Struct4al) & Moriocoat : 75. Dry Chemical 27. Frame and Flashing /� z Yr 76. DryStandpipe 28. Lathing &Siding •• 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing /a j g=f-- HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coa( j,ly 79. FINAL INSPECTION 32. Electrical Power Meter -Final L 80.. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: O ( Y1 t��- 34. Final Heating & Air Conditioning I - I (e'.- 'lam.. , T Q 35. Final Gas Pipe -Test 36. Hood or Canopy - ` a7 ` 37. Final Factory Fireplace n _ / `, _ Ni. �2i't- - 38. Final Plumbing /Z/ j r (zo 'T 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final 42. BackflowPreventer 43. Backflow Irrigation , ;R - 44. ,Landscape Irrigation System - I45. Sound Attenuation `'46. Handicap Regulations 147. FINAL STRUCTURE & BUILDING _3 148. Special Requirements Completed - 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co I51. CERTIFICATE OF OCCUPANC -' ,No. �� Date r - - " PROJECT ADDRESS: 245 FISCHER AV UNIT: B-4 OWNER'S NAME: ROXBURGH AGENCY ADDRESS: SAME ARCH/ENGINEER: REG.NO.: ADDRESS: _ UNIT: PERMITTEE:A,S.A:P. FIRE PROT. (213)327=0160 ADDRESS: 113 E SAVARONA WAY CARSON CA 90746 LICENSED CONTRACTOR 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. _ CrTYUC.:041998 STATE UC.:00 C Date: 1-3 7'5Signature: WORKERS' COMPENSATION DECLARATION: thereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. Q. POUCYNO.:785795-89 EXP.DATE: 12/07/89 caMPa y: STATE Certified copy is hemoy fumished. Certified copy is filed with the Building Division. Date: ��3�4� Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the permit I$ for one hundred ($100) or less). 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 California. Date: - Signature: - - NOTICE: If, after making this declaration, you should become subject''to the Workers' Compensation provisions of the Labor. Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. 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 (Section 3097, Civ. C). LENDER: ! ' ...- ADDRESS:' OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct. alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for suchpermit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State 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 penalty of not more than five hundred dollaW(5500). . . , I, as owner of the property or my aIloyees with wages as their sole compensation, will do the ,work„and the ❑ structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State 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 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 will have the burden of proving he/she did not build or improve for the purpose of sale). r ' I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code: The Contactors' State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s) license pursuant to the Contractors' State License Law). I am aware that proof of their -Worker's Compensation, Insurance should be provided to me. ❑ I am exempt under Section: B. S P. C. for this reason: ' Date: Owner 1 do hereby artlty that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that I or any future building Occupant W IVWll not (circle one) need to comply with said state codes and the requirements for a permit for construction or modification from the Air Ouality Management District. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and sate laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. Date: Signature: Driver's License or Social Security 164146 White—GLaIduig; Green—Cade Enforcement; Canary—Applicant; Pink—Revenue; Goldenrod—Assessor '-'- CITY OF COSTA MESA'— BUILDING.PERMIT PERM NO: F 045571 .PERMIT NO: F 045571 PLAN CHECK NO: 01839-89,S GO.VT:. N SUPP: N'.' CONSTRUCTION TYPE:.V—N PERMIT -TYPE: FIR. PURPOSE: OTH JOB DESCRIPTION : FIRE SPRINKLERS INST SQ FT CLAIM VALUE: 3,000.00 CALL—VALUE:GROUP OCC -,,B,2 1 COMMENTS:' *+:�•��r�*+r+r*+r�6SE�E��+r�r�616�EE*+ESE**�e�*+E�*+riE*�6�6��E**�6�rE6*a6+r*Skits**�+r�r*��***+E*��**+E**�* Z O N I; N G R E Q,U I E' M,E N T S S E T B A C K S ----- MAIN BUILDING ----------- --------- ACCESSORY BUILDING --------= FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT. IN RGHT; FTI IN PARKING REQ: PROV: PARCEL: 00000000 ZNE: AEF NO: PLANNING NOTES>' > _ kkkkkikkkkk k kk k k k k k kkk k k N kk k k kkkkkkkkk kkk k kkk kkk kkk kkkkk kkkkkkkk kk kkkkkkk kkkkkk k D E V E I. O P M E N T. S E R V I C E S R E Q U I'R E M E N T S ; h I � ZONING APPROVED BYDATE: _ BUILDING -APPROVED BY : 5 E�_ DANE: APPLICATION ISSgED BY:FA�FT ,DATE: APPLICATION kkkk'akkkkkk FiF � Fkkkkkkkkkk icii kkkkkkkkkkkkkkkkkkkkkkkikk4k,kkNik46kkk kkkk kkkkkkkkikkkkkkkkkkkkkkkkkkkkkkkkkkkkkkk LEGALIZATION:N F E S U M M A'R Y. STRUCTURAL SEGMENT:N `1 BLDG PMT- PLUMBING. ELECTR C MECHANIC FIRE SMIP/RE'S GRADING PERMIT 54.00 , 658 'SMTP/NON—RES PLAN 35.10 ISSUE FEE r BUILDING=DIV—> PERMIT ISSUE PLAN—CHECKi TOTAL PAID -DUE .TOTALS ---> 54.00 0.00 35.10 89.10, 89.10 ,.00 l REVENUE DIVISION TOTALS--> COLLECTED; 54.00 OVER/SHORT: 1.00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE -SMIP/TOT GRADING PLAN'—CHECK • 54.00 kkkkkkkkkkkkkkkkkkkkkNaEkkkkkkkkkkkkkkkkkM-kkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkk I N D. I'V I D [JAL F E E B R E A K D O W N TYPE QTY D E S C!R IP' T I ON UNIT COST TOTAL COST FIR 54 FIRE EQUIP FEE (FROM BLDG VAL TABLE) 1.00 54.00 END OF FEES t ) 01 00050887-00050887 TOT 54.00 DATE: 01/03/90 TIME: 09:51 1 - CONSTRUCTION AND PLANNING POC SPA_ =Datector Permit# APPROVALS Permit # Date Inspector -APPROVALS 1. Temporary Electrical Serviee'or Pole Cu 52. Pool & Equipment Location �•1. mr+ Soil Pipe-Undrgrnd ,Z:;,n :; 1' �. F; •� 53. Steel Reinforcement «73.�:lectrical Conduit-lktility-Undrgrnd'Y- _ 54. Forms' 4. Electrical Conduit-64drgrnd. n - 55. Electrical Bonding - �T'. Steel Reinforcement X 56. Rough Plumbing & Pressure Test o `LL Electrical UFES,:6rnd. - ` 57. APPROVAL TO COVER-GUNITE �. 1. Footings ::.-: 58. Electrical Conduit-Undrgrnd. �'$`. Foundation Sa �i �� 59. Gas Pipe, 0 Undrgmd., Test , 9. Water Pipe-UndrgBnd.�% '„ 60.' Backwash Lines, P -Trap, ❑Undrgrnd. - _ tC� 10. Structural Floor System :;;� ''t"-�'� 61. APPROVAL TO DECK 11. Property Sewer Linaj& House Conriection 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 m; 67. Fencing & Access Approval ;17. Rough Wiring �J'gn 68. APPROVED FOR PLASTERING - 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heatiog &.Air Conditioning _ ...,FIRE DE�,T. Q.EQUIRF�MENT T t, x r� ,�, S -,, x - i' - #J -� �•+• T c - �f 20.Roagh FactoFy Fireplace - - �; s 7777 - Y :.;APPRQVALS;,-tEPermtt 21:'_Du�ts, inPStructu " " = E " - C r K - X70. Wndergro "QW, ;Hyifro _ r- ; ;,. n x - 22.-0uds,'4nt oat i n"; � i _ Ye 9 � .•. ;; � C .� �fi :� -w x r'� �,•.` -�. X71. Product_Ptping ❑Gas O:OiI _ 23 'Gasgipe^=RoPh & Testr '•` '_ * ,72, Underground. Flush= �'" _ 245-Ro6f Frainin • •`� 9 ',> ` x !" X _ •J3nUndergrnd.StoragE_7ank:0Gas 0Oil r p- r. !-.x 25. Ro6f Sheathing '« "•4 x 74�Overhead HydroO _ r-1fix F, 26.`7 -Bad Ceiling (Structural) &'Mprwcoat a rr-,•M * 75EDry Chenjcal rxc ,,� - 27: -Frame and Flashings 76. Dry Stand-ptpe ='m ` t=• -Lathing_& 728. SWing r,. ca 7 �; x S .x _x - x rn 77. --FIXED SyS,TEMiF:INAU; "-i..• C, y29. t; ;x. x -, r1 Insulation =' ! }t^' 78M:FIRE PREV. FIN41- ^ _ 3-11C-40 QM .Y. T 30. DrywalhNaiPin g �; �; x t- ! i i ;R�; •r HE-,ACTH=DEPT„ REQUIREMENT C31. Plaster Browfi,Coat+:S ws fi -79.JFINAL INSPECTION y F'325171ectrik Povber W,IPY 1nal; f ` `-l' j 1-+ 1"' �' 'K _80.�'_'--TFOOD CERTIFI£ATE ISSUED, -- Q x ti 2:33, --Final Electrib C T. Noes: ?, �f^-7 *'= G .. N34TFina`+I Heating& AiiCpn`ditiomng- r,* I '10 4C`- _ : `H,',= -ku 35{Final Gas Pipe -Test« , J-. •• * r+. , :I L,�k-xi • • .^v �. x �.• X36 Hood or Canopy x -1 Cl Factory Fireptac_ex _37.Fina1 -38 Final Plumbing ' �' ! o tr` " S "c �' a S 39. _Wafer Service -Final;; g g M x* N c o x: Gas Service -Final x=m['^ S - i -• CW "cul x _40. :,41:Solar Domestic-Fin21 - :y ,J � iy; y, -.2, �C - � ,R•, 42. Backflow Preventer, CU I I -C x •� "•�-+ x :� - CtSS 43. Backflow Ir`tgation;; I Y ;, ;; ,; i x C• - t 44. Landsca p r, C xx' N OZ "'rd .tC _* _ 245;Sound Attenuation• ... x m -•x �; L7' 46.•Handicap Regulations C7 f:11V STRtJCTUO.E & BUILDING x ,47.-'FlIal_ 48 .::FIPfAL PLANNING -� * ; r✓{ '-�F x T x •= 049!�_Elearic Releise totdison a k C ,,=. ;; -,t " . L+n %505Gas_Release to Southern California Gas Co I =51. CERTIFICATE OFVOCCUPANCY x E! No. Date n i/ City�of Costa Mesa ' ` Building Safety Department P.O. Box 1200 Costa Mesa, California CERTIFICATE OF OCCUPANCY i P2 3209 The Building located at 23J Pit wzz ii:J'.`3 4 has been inspected and found to comply with1he provisions of all City of Costa Mesa Ordinances applicable thereto l for a Group 1-2 Occupancy. r Use of Building t1pnImt Il;rornye':`.t?h'c Legal._ Description , 447,033-07 t - ` (See reverse side for Metres and Bdunds) tt ' E-4827 —4195 A Building Permit No Electrical Permit No. RF'P-.Ali,; Plumbing Permit No. rl Number of apartments and/or guest rooms ISSU ED'TO: Building Official by bbral PaL limn p Data ( This Certificate of Occupancy SHALL BE posted' in a conspicuous place on the premises"and SHALL NOT BE removed except by the . Building Official of the City of Costa Mesa under Sec. 306 lel U.B.C. I r Form BU 34 Rev. 11/70 I Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA - P R I �j-- _ TRACT NO. _ LOT NO. BLyr CONSTRIUCTi ON PE MIT JN- Pject ddress T E OF CO STRUCTION _ 7II9�BG IOaOD nnOwde _•-PhOn EW �DD ❑ALTERATION3�6% ❑ REPAIR ❑ CO NYE RSIOfJ: ❑DEMO - Address - - - - ❑ OTHER - ZONING REGULATIONS Arch/Eng. - - --- -License No. - DESCRIPTION DESCRIPTION OF WORK _ _ __ __ _ . _ _. . 1 TYPE OF PERMIT - - '❑.GRADING ❑ FOUNDATION -'❑ STRVC t1RAL"'- - - - A.P. 9F 'ZONE - PLNG. REF. $ s, - - X� BPM GING - SETBACK C/L ST. O R V'LINE IDF YARD _ _ . _ _ ... _ _ '-Address "' - Contractor - Phone 'Addltas --- LICENSED CONTRACTOR DECLARATION - I hereby thLt I licensed Charter 9 (com- ❑TENANT ❑ELECTRICAL ❑PLUMBING CHANICA ,g1 Eyq - -- I - -- - - - -- affirm am under provisions of . , i , -- I RIGHT mencing With section 7000) of;Division- 3 -of -the Business and Professlons Co Q my license Is in full fort n (f t. �• :- u ❑OTHER -- --- PROJECT, IPTION- - .. REAR YARD (TO P/L) _ _ •, r .. . LICOOfe dif O. 1 1 1 .SQ., 1 PKG.SPACE REQ. PROVIDED .1 - • �' ignatura' \-/�/�7 _ FT . _ _ _ _ - _ Date �7�f WORKERS' COMPENSATION DECLARATION - _ (/ OCC UPANCV •`_CONSTRUCTION TYPE ,STREET WIDTH .r- .PARK FEE$• . I hereby affirm that I have a'certificate of consent to self-insure,or a , VALUATION - ZONE - ZONING APPROVED BY. _ 1 7 - OATE - - -- - r SPECIAL CONDITIONS: certificate of rkers'-Compensation- I ur ce,-or a certified copy ,[Hereof (Se b. C. I •GRADING CU UDS. 'ACRES Company Jertlfied copy.ls hereby furnished.-- '.REMARKS:'.'•. rl6certified copy Is flied with the pity Building Division. `EXEMPTION FROM -WORKERS' -COMPENSATION DECLARATION - (This sectionneed not be completed if -the permit_is,for_one hundred- SE100) or less). cert(((y 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 • P -I. _ .i PLAN CHECK .` ,SHOWERS ! - - ELECTRICAL' _ " _ 'PLAN CHECK, •� subject to.the.Workers' Compensation Lawsyf _" California.` - _ - BATHTUBS - `- - Date l SignatureFT NOTICE: If after making this declaration, you should become -subject 'TOILETS-: r^,,,, URINALS-" "' -GENERATOR 0-1 KW_1-10-KN/ to the Workers' Compensation provisions of the Labor Cotle, you must- TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE L'AVS- - '-f - -- _ .APPLIANCE- '10-50'KW 50 + KW - revoked._ _ %_ - KIT. SINKS- - DISHWASHERS '-'- _ MOTORS 0-1 HP 1-10 HP^ _ ___ __ _ CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the per- SERVICESINKS-; s'I'•-, SUMPS `--' - - -' '(INC. SOLAR) - 10-50 HR 50 + HP--•'=- - - - formanceof the work for which this permit is issued (Section 3097 FLOOR SINKS - FLOOR DRAINS 'FIXTURES' _ '-OUTLETS- `SWITCHES - Civ. C:)7.`-- --- _ -�' - -- - '---- -� -' - Lender's Name_ _ Lender's Address - DRINKiNG•FOONTAINS' " -- -- -r` }GAS TUBE SIGNS'- OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for INTERCEPTORS .CLARIFIERS POLE LIGHTS '• -" -` "' " 'SWIMMING' POOL- - PTRAP -"'- - '---- - - _- - - --- the•fallowing -reason (Section -7031:5 Business -and Professions Code: Any city or county which requires a permit to construct, alter, I POLES METERED .SUB a WATER 'SERVICE ALTERATION' - --� -- ';PANEL'S- " -MAIN-' ' "� -SUB-- � ; ' Improve, demotlsh or -repair any structure, -prior -to its issuance, also re- quires the ap,. Ilcanl for such permit to file a signed statement that he - -• - k "GAS SERVICE �� OUTLETS - I -,SERVICE ' -' '-' - - ^ —' ' •AMP -- - " - -r-t is -licensed pursuant to the provisionsof-the-Contractor's License -Law- V((Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS--- --BTU OUTPUT' •: •• .' lsiness'and^Professions-Cotle) orthat he is exempt -therefrom and the for the alleged exemption. Any violation of Section 7031.5 by SEWER ' y _ _ _ rpplicznl-for apermit the applicant -to civil -penalty- Ol more than five hundred dollars ($500). SOLAR•TANK- -`- COLLECTORS" � "'I ❑ I, as ovwnei of the property, or my employees witS' wages as their' sole,compensatlon, will do the work, and the _structure -is not Intended _•_I•r. ^' ^ or offered for sale. (Section Business antl Powneriof The _ _ SOLAR PIPING SVS. y - _ - _ "ISSUE FEE _ ,s d es -n o anowner a pro Contractor's -License Law tloeon, _- _ - _ -__.._ ISSU E.F EE jl - - - • APPL'ICATION-APPROVED-BV--'• -- `- h i mselerty or who builds or -Improves thereon, aritl who does such work himself or and who Ihrough- his -own, employees, provided that such improvements are not ! -H MECHANICAL PLAN CHECK ( s I - SUMMA RV OF,. FEES .. ' •- Intended or offered for sale. If, however, the building or Improvement is Sold.within one year -o/ completion, the owner will have the burden of proving he did not build or improve for. the purpose of -sale).' ❑ HEATING SYSTEM 0-100,000 BTU 1 •BUILDING- - -- - rPERMIT $ - --^- --- ------ - - SMTP-.-' $ r ' contracting. i,sed AND'DUCTING-' - -'- "- - "'"-�- �'- - 7044,Business IlCens¢tl cOntraclprs to construct the Orol¢Ct (Section 7044, Business contractors o construct t project ]00,000,+ BTU 1Y PLAN CHECK E • PERMIT•. and Professions -Code: The ContraCtor's-License Law does not apply to builds Improves thereon, REFRIGERATION ) - --- - -- •ISSUANCE E an owner of property who or and who con- 0-100,000 BTU PLUMBING' E -• �'• • tracts from -such -projects -with a-contractor(s)- licesned pursuant to- the Contractor's License Law). 'SYSTEM-- - -- -- ---- - 100,000•+BTU - - 1 - J. - � - - JPLANCHECK E-' GRADING' E �_',J"!,,� r� •; 0-1 ani exempt-untler Section' -- '- ' - _ - -B. & P. C. for this -- - YELERICAL E ECT reason - - - - - -- BOILERS BTU SYSTEM REPAIR, ALTERATION PLAN CHECK- -$ f MICROFILM S' _ - Date Owner' ,MECHANICAL $ 1. TOTA L,FEE E' , certify that I have read this application and state that the above information EXH UST SYSTEM MULTIPLE I -�- ILES$ AD- - Information is correct. I agree to comply with all city and -county _ -PL"AN'CHECK-�E' - _' _ �LESSANCE S- ordinances and stale laws relating to construction, and hereby authorize -6 l ,� " ' , • - ' ' representatives this city enter an the above mentioned 'I - •' property for spur b'R . FINAL FEE $Lj�r� Signature Daley 1 Drivers' License or SS $ - ISSUE FEE - - .- - - - - - - -- --- , CMF 0865-36 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor SL CONSTRUCTION AND PLANNING APPROVALS Permit# M4�3� Date Inspector' POOL & SPA .APPROVALS• ,: t Permit#_� ,Date •'. -Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipm nt L'ocation - - - • • - Soi ipe-Undrgrn• '- _ _ 4. Steel Reinforcement - - •-• - -- 3.-- Electrical Conduit Utility-Undrgrn_ - 45. Forms _ 4. Electrical_Conduit-Undrgrn Electrical Bonding �- -- - • -- - 5. Steel ReinforceI __46. 47. Rough Plumbing & Pressure -Test - - 6. Electrical LIFER Grn_ _ _ _ _ 48. APPROVAL TO COVER-GUNITE-�--- - - - _ -- -- - 7. Footings - 49. Electrical Conduit-Undr rn- 8.- Foundation_ _ _'''• 50.. Gas Pipe, 1:1Undr rn, Test - 9. Water-Pipe-Undrgrn 51. BacKwasti Lines P-frap. ❑ Wdrgrn 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 - :-•, 13. Rough Plumbing _ _- ° - - - - "- 14. Rough Electric -Conduit - - - - •- -56: Electrical -Final 15. Rough Electric -Ming-- -` - - - - - ---- -57: Solar System -Final - 16: Rough Heating &'Air Conditioning b8. -,Fencing & Access Approval ' 17. Ducts, in Structure 59. APPROVED FOR PLASTERING -18.. 19. 20: Ducts, Ventilating Gas Pipe -Rough &Test .Roof Framing_. - y .. --' '60. -POOL/SPASYSTEMS'FINAL .. r •. '. y 21. 22. Roof Sheathing - - Frame and -Flashing - ... -' - -. •^ NOTES: 23. Insulation- 24. Lathing & Siding --- -25. Drywall Nailing - - - - - _ - - _ 1 - -- 26. �_ Plaster Brown Coat �. - - - - -• 27. Electrical Power Meter -Final - --- - - - - - - - _ - -- - 28. Final Electric - ' 29: Final Heating.& Air Conditioning 0 L - - - -«• 30: - Final Gas Pipe -Test 31. Final Plumbing 327- Water Service -Final • - X33. Gas Service -Final - 34. Solar Domestic -Final -• •�"+� •' 35. Landscape Sprinkling System - - 36. 'Sound Attenuation ' 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING - - 39. Special Requirements Completed - i 40. Electric, Release to Edison * ;-._I, I- - - - - - -- - - -- 41. Gas Release to Southern California Gas Co. •��` ' 42. CERTIFICATE OF OCCUPANCY • Not Date - -_ ��• - Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CLTY 0PCOSTA MESA PERMIT NO. TRACT NO. LOT NO.. SLOG. - - - CONSTRUCTION PERMIT C— - e? �OF CONSTRUCTION3D3q NEW ADD ALTERATION' -❑ REPAIR ❑ CONVERSION-LDEMOL.. I-SH=771; L OTHER - 7/16/82 9.25Owner •- - ZONING REGULATIONSArch/Eng. ProjectAddress Phone Address - - - - - isNo. - DESC RI PTION OF�WORK _ _ .P. ' -" - 'i 'Address`-- ---- - - -- .. -. - - .ZONE PILING. REF. 91A, Contractora-2. - hone / TYPE OF'PERMIT -' - - '- 1BUILDING ❑GRADING ,L -FOUNDATION -L STR VCTU RAL- -L TENANT ❑ELECTRICAL ❑PLV MBING LMECHANICA - �� BUILDING - - - SETBACK C L T. OPERTY LINE' ' IDE YARD- - ,�'•-. - -- Addr s� - -/ - LICENSED CONTRACTOR.. DECLARATION..._ I hereby affirm that I am licensed under provisions of Charter 9 (com- RIGHT mencing -with- section 7000) of Div' ' - 3- of the Business--antl L OTHER - Professions Code and my license is n full force antl effe -REAR YARD (TO P%L)- .� ' ( PROJECT -DESCRIPTION' License Class Licens - r i SOFT: _ OCCUPANCY '_lt CONSTRUCTION TV PE _ __ PKG. SPACE REO. „PROVIDED ` - _ 'STREET WIDTH -..PARK FEE,$., Date Signature -" ar (WORKERS' COMPENSATION LARATION_.- _-___ - ,I hereby affirm that have itificate of consent to self -insure or a VALUATION 'ZONE ZONING APPROVED.BY" DATE- certiflute of -Workers' Co ensationInsurance, oor.acertified. copy thereof (Section 3800, Lab. C.). I GRADING CU.1YDS. '' ACRES SPECIAL CONDITIONS; •a ` � yNo. ._ ... Company _•__.. _ .._ _. _._. .____- - __.. ,. .-_. _ __ .__ .. -__ ._ :ertifie0.copy is.hereby furnished.. .. -. __.... �.._ -._ _. - '1 '• :-REMARKS: .'.• '.' . ' k. _-1._•_s q. r U Certified copy is filen with the city Building Division. 0. -EXEMPTION FROM WORKERS' COMPENSATION' DECLARATION - .. A. - `- ^- _ `-•- - - - - - -- (This section need not -be completed If the permit,is_for one hundred - - - ,• t .. s.- t - i.✓t ; ($100) or less). - 1 certify that In that performance oft ork for which this perit, Is, issued shall not employ any pe rs i ny mann so as to PLUMBING 'n .PLAN CHECK 7 y - iE LECTRICAL " ` "PL'AN CHECK - - -- roma subject to th pokers: C.pepsat' n; ws of Cd r .--- _ - - - BATHTU85 SHOWERS' SHO _ 1 Date Signature ' NOTIC If after niakl ng this a'atio o, you should become sub!ec[ LETS ••• ;URINALS �' "' -a" - - - ;GENERATOR- -01 KW'to the Workers' Co mpensa ovisio ns of the Labor Code, You must ,;tTOI - 'TRANSFORMER forth.I th comply with soro vi si ons or this permit shall be deemed LAVATORIES DOUBLE LAVS - - - - - - ;APPLIANCE- -10-50 KW�50`+-KW--- -_ -revoked. _ J_._ - KI T. SINKS -- '--DISHWASHERS MOTORS- - - -0-1 HP_1--10 HP- _' ' 1 1[ CONSTRUCTION LENDING AGENCY - 'I herebyaffirm that there is a construction lending agency for the per. g g y p ..__.-. - SERVICE SINKS i(-• SUMPS'- "' __. I" "' , )H S r(INC..SOLAR)� 10-50 HP=-50+HP - - - - - -formance of the work for which this permit is issued (Section 3097 -FLOOR SINKS _ 'FLOOR DRAINS-- - t•- i '!FIXTURES ' 'OUTLET 'SWITCHES Civ. C.): La- er's;Name - _ _ • -'- " - -' -' Lender's Address "DRINKING FOUNTAINS "•' ?�'--"—• -'--" - "-' - -'GAS-TUBE'SIGNS----- '-'-' --"" - OWNER BUILDER -DECLARATION- - '- - - ---" --- I hereby affirm that I am exempt from the Contractor's License Law for _INTERCEPTORS --' 'CLARIFIERS -' - POLE L'IGHTS"' •'-" �' -' - '-"' - - _ the following reasom(Sectlon 7031.5 Business and Professions Code; SWIMMING POOL' PTRAP- -' -- - - -lu- _ - .Any. city or county which requires a permit to construct, alter, POLES METERED SUE- WATER -SERVICE- -"AL'TERATION-'- -- - PANELS '---- -MAIN-- -"SUB^' - -- improve,-demolish-orrepair`anystructure, prior to its -issuance, -also re- quires the api-licant for such permit to file a signed statement that he i v, I SERVICE OUTLETS _-"` a- •.�-•-AMP- - is licensed pursuant -to the provisions of the Contractor's, License LawGAS (Chapter 9 (commencing with Section 7000) of Division 3 of the t\ .'SERVICE'- t _1 _ WATER HEATERS- BTU'OUTPUT" `•'- - - - " - `- ^ - - -' - --- - - B-iness and Pro/essio ns- Code) or -that he is,exempt therefromand the for the alleged exemption. Any violation of Section 7031.5 by - - --SEWER CONNECTIONS"' - -•--' -- - --- ----- - applicant -for -a permit subjects the applicant to -a -civil penalty of more than five hundred dollars ($500). If I 7 ❑ I; as owner o! the property, or employees"with-wages their- SOLAR TANK "` '"COLR LECTOS sole Compensation, will do the work,, and the structure i5 not intended or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SVS. ISSUE FEE' - Contractor's License Law,does not apply to an owner of a property -ISSUE FEE -,I --' ` - APPLICATION APPROV ED•BV - -' - '- --•`DATE -- who builds or improves thereon, antl who does such work himself -or w through, his own employees, provided that such improvements are not MECHANICAL PLAN CHECK _ SUMMARY OF, FEES mprovement intended or offered for sale. If, however, the building or improvement- Is sold within one of completion, the owner will have the burden Is year of proving he did not build or improve for the purpose of -sale).' HEATING SYSTEM 0-100,000 BTU - - - IBUIL-DING-- -- - --- - - _.-- - - - - - L 1, as owner of the property, am exclusively- contracting -with _ - -- _- _ AND 'DUCTING -""' _ _ _ ,PERMIT- .- - - - _ ---_? - - I - ',n•$-' - - - -- -- - - licensed contractors to construct the project (Section 7044, Business 1Og000,+BTV - �pLAN CHECK $ PERMIT. n,; and Professions Code: The Contractor's•License -Law does not apply to r _ _ T�. _.-_- _ ISSUANCE-$ an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU -- I PLUMBING $ "$' s tracts from such -projects with a contractor(s) licesned pursuant to SYSTEM` -- - - - -'- - __ GRAOIN6 the Contractor's License Law). -ram 100,000,+ BTU ! $•$ 'PLAN CHECKr `I .if • , i t. L exempt under Section BC& P. C. for this- BOILERS BTV ELECTRICAL reason- - - _ SYSTEM REPAIR, ALTERATION MICROFILM $ PLAN CHECK- $ - TOTAL'FEE$•-'' L'h ,MECHANICAL--,$ ' - - -ESS -; Date. Owner _ I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE v$1 � D. - information is r,ecC I agree to comply with all city and county 'PLANCHECK _ VANCE PC'$ -_- VANCE ordinances a s to laws rata ng to cons tion, an tl hereby authorize repfese't at es f this o ent pon'the above' men ned properly or pspec[io poses. /}p, Signature -FINAL FEE $ Driv tense or 55 �' ISSUE FEE - - -• -. .- -. _. _ White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor TL C 0865-46 5 CONSTRUCTION AND PLANNING APPROVALS Permit- # Y-�� Date - POOL & SPA .. . -inspector Date - -Inspector .APPROVALS � .`7 I . -.Permit # 1. Temporary Electrical Service -or Pole _ _ 43.' Pool & Equipment Location - - - •- - _ 2. SoilPipe-Undrgrn• - v _ _ _ 44. Steel Reinforcement - - - -- - -- - - - - 3. Electrical,Conduit.Utility-Undrgrn _ _ 45.- Forms - -- - - - - - - ' 4.. -Electrical ConduitUndrgrn , _ 46.. .Electrical Bonding -- - -- - - - Steel. Reinforce orce 47. Rough Plumbin I & Pressure Test - - 6.- ^Electrical UFER Grn _ 48. APPROVAL'T.O COVER-GUNITE '- - 7.. Footings _ _ _ _ 49. Electrical Conduit-Undr rn - .8. Foundation 50. Gas Pipe, ❑-Undr rn,-Test ' -_9. Water.Pipe-Undrgrn 51. Backwash Lines P-Tra - ❑ Undrqrn • -' - -' _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 - .13. Rough.Plumbing, - _ _ _ -- - - -- - -- -- -- 14. Rough Electric -Conduit - - -- - - - - - -:56. -Electrical-Final - 15. Rough Electric -Wiring •57.'- Solar System -Final - ,`- 16. ' Rough Heating & Air Conditioning : - --- - - - -Fencing &- Access -Approve l " 17: - -Ducts in -Structure- - -� _ --- __59. APPROVED FOR PLASTERING ' • 18. 19. 20. . Ducts, Ventilating . Gas Pipe -Rough & Test Roof'Frarning -60. POOL/SPA SYSTEMS FINAL 21. -22.Frame Roof Sheathing- and Flashing- _ NOTES: - ' 23. Insulation - - - = -' '�- z 24. Lathing & Siding - - - -- --- - - - -----" - 25. Drywall -Nailing 26:- Plaster Brown Coat - 27.. Electrical Power Meter-Fi al -28. Final.Electric - o $S 29. -Final:Heating & Air Conditioning- 30. -Final Gas Pipe -Test - - - 31.- Final Plumbing 32'.= Water -Service -Final l 33. Gas. Service -Final .- - - 34. Solar Domes -tic' -Final - • - ' 35. Landsca e Sprinkling System 36. Sound Attenuation • - -- 37. Handicap Regulations I 38. FINAL STRUCTURE & BUILDING ' 39. Special Requirements Completed' " - -- - - �- •- { 40. Electric, Release to Edison - - - - __ 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No. Date - - - J Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. ,,CITY OF COSTA -MESA -' ) PERM NO. _- - - TRACT NO:'-LOT'NOL -,BG-NO. � LO6- CONSTRUCTION PERMIT `' l i+'r..l<I 140: ' ;• TYPE OF CONSTRUCTION q •` -, i ❑-NEW' ADD' '❑ ALTERATION ..�_ - j. (•❑ REPAIR ❑ 'CONVERSION ❑DEMOLISH. - ❑:OTHER] - �!• - I „• , ,}r,� 3. ,. 6/05/ + y 5607 88 _ '' - - - _ . l u(,.. .r •y- l .,.. _t- r ,- ., -_- 2 ZONING REGULATIONS ' Project Address a �• ,Owner "_' -- ��j='�'�1 Phone -"" Address - -� yf `f�-- .. F .., _ .._. - - +Arch/En -License -- -•- {- --- Nor -- - ' - S - - DESCRIPTION' OF WORK ••�' ! - "A -.. ,:+ S' L IA.P. X03 'rO _ _ ;ZONE' NG'. PL- - Address '__ ,_.,.-_ .__.� __-.._. __.. ._.^._... . , Contractor)Q: - .' ---- ---Phone me3'-JYPEIOFPERMIT--' .e f -"_ "-"'- --_--"-B -El 0-F66ND4TION--❑STRUCTURAL-- '-❑ TENANT--❑ ELECTRICAL-PLUMBING-❑MECHANICA DN --- _ -_ BILDING _- Tp �/ 'SETBACKC L T. PROPERTY LINE SIDE-VARD --- - -- _ SEDE-VAR _ :Address] ' �T7 S� /L_- - - -','. LICENSED CONTRACTOR DECLARATION - :2 ;I hereby affirm that I am licensed under provisions of Charter 9 (com- -3 f -I - t ,.i , }.�! a I ❑ ` -• -- __. _ _ .- RIGHT - mencing with-sectlon ]000) -of Division of -the-Business and Professio ns Cotl e, nd y license is in full fort antl ffect. Prof t. • - ---- • - '— -- -- --�� -- OTHER - - s ' C PROJECT_DESCRIPTION'_ ; ; REAR (TO P/L)-`- ,` •Lltense Cl • License No. Date_ �'LZ-Signatu7e'�il _n--. ',.!=� r f ?i` '--"""'-' '-- - SQ:`FT: PA _ - r +PKG: SPACE REQ.--' PROVIDED -- - � ._ - I STREEY WIDTH" PARK'FEE $ WORKERS' -COMPENSATION DECLARATION - - - --.- -__:l --_'OCCUPANCY -z CONSTRU_CTION TYPE r ereby affirm'that 1 have a certificate Of consent to self-msure.or a ofietl copy 3 - i- - - VALUATION ZONE "ZONING APPROV Ep BV - DATE - tificzte-of-Workers•-Compensation-Insurance,-or-a-c reof (Section 3800 b. CJJ 3�O: .,'� VDS -ACRES !SPECIAL CONDITIONS Nd. /^lG %��•; kcomPant M �•'�� - _GRADING,CU kEREMPTICiN ertihetl copy Isheraby furnished... -- -- ---._ ... .-.. ,..:- Division. Certified copy is •filed with the REMARKS. ,--- cityBuiltling + "•' ^- -' FROM'WORKERS'-COMPENSATION-DECLARATION"T- '- '-- --- -+.i�vOF This-section need_not- be.completed,if,the permit -is ,for one_hundretl ___ -_ I j •'.na_ri '. •17�) t+ti; �p Fl ((1$1000) o less). _ _ _ __ _ _^ _ - -f _. - T '; PLUMBING=siZ_ j' "•"PCAN'CHECK - - -"- "' ' - - '_ _ {ELECTRICAL'- ^-^PLAN'CHEC K�- -^ -- .the Performance of the-wor k,for ,which this y. ,permit'is issuetl, I shall not employ an y manner so-as.to;become p y y person In an subject to the.Workers' Compensation-L9ws.of California. ;,,--,- _ - - BATHTUBS -' SHOWERS' � --.� - I 'Date � ! Signature � (NOTICE: If after making this declzration, you should become subject ;;TOILETS - '(URINALS-•-- " ' - 'f -- -'GENERATOR-- - 0 1 KW" " 1-10 KW' - - to the Workers' Compensation provisions of the Labor Code, you'must - TRANSFORMERr qr r ,forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBCE'L-AVS^ - - { --- - -- -' ,APPLIANCE - •^ 10 50 KW_50-+ KW. -- -_ revoked.... --__-_.L -,,. •-__.. _`_. u-.--�...__-._ _ __- 'CONSTRUCTION LENDING AGENCY -. —"'--"'-'- '-'- - - KIT -t DISHWASHERS" SINKS 'M 'MOTORS '•-- - •' S --- t --•- 1 '- 0-1-HP=y 1-10 HP !I hereby affirm that there is a construction lending agency for the per- SE RV ICE SI NKS ^• SUM( PS'--""'--•-^^-' ' -_ __.... 1 _l�ri. .• - �---_ J(INC..SO LA R)..._,_10-50,NP 50 _HP formance of the work for which this permit is issued (Section 3097 _..-_._-. _{..-. __ - ._-.. -'-FLOOR SINKS-" FCOO R'DRAINS "" - 'FIXTURES- _---OUTL-ETS- SWITCHES--'-- 'ICInder' e w_-..-.....�-- __.. _ _,_•^_ _-.. •..-____. - _ - - Name__ .Lender's ____ _ _ _ _ _ v 3 -- 1+ � "-' !Lender's Address _ " DRINKING FOUNTAINS' --'i .-__-- "^"'^• - --- -^ -GAS-TUBE SIGNS -»- ------ -- _ _ OWNER BUILDER "DECLARATION- - INTERCEPTORS"-----CCARIFIERS'-- "--^-_"-...__-'POL•E-LIGHTS•----r----•----=--__ I hereby affirm that (S exempt 31.5- a Contractor's License Law for the'f Business the -(Section -SWIMMING"POOL-""'P'TRAP—•-- '• �Y" "POLES -"`--METERED-""SVB' ` it to construct, t, alter Any city or `county ',which requires a permit to construct, alter, city requires - WATER SERVICE -" _'A L'TE RATION" '- _''-'- - - MAIN !PANELS- -- 'MAIN - improve,- demolish'or-repair-any structure, -prior to its issuance, also re- quires the ap'.licant for such permit to file a signed statement that he quires + -- OAS SERVICE `-'—"OVTL'ETS"�--'"' -SERVICE---•---- - - • - pursuant to'the-provisions of'the-Contra ctor's-License-Law- (Chapter 9'(commencing with Section ]000) of Division 3 of the -WATER HEATERS "' - STU'OUTPUT ------ -' -^ -- - x_ - _ _-- �• •' -- _ __ ---- --•_- - - _ _ Business'and Professions Cotle)*or-that he is'exempttherefrom and the- t for the alleged exemption. Any violation of Section 7031.5 by - --_ _ .. - - _ -'^' - '- "' "c•'••^,.T' SEW ER'CONNECTIONS '�r" ••`� �' - F-' -' -- ^ E--^ -------• -------- .-. --- - - - -_- - - ' ppllcant'for-a 'permit -subjects, I Me -a ppli cant to -a- civil -penalty- L A m_ ore than five hundred dollars ($500). '. '-SOLAR-TANK-- -^"' COLLECTORS•^ }----- - ---- - --^---_--,... _-'• , - - i❑ 1, as owner of the pr'oper'ty, or my employees -with -wages as'their' sole.compensation, willdo the work, and„the structure is not intended or offered for sale. (Section 7044_136sipess and Professions Code: The _ `SOLAR PIPING SVS.' _ '`�'" "-" --'-"' I'^-'"- - ISSUE— I _ ISSUE FEE- ---- ---- •+------ r-- -'-+,:•=-.-!-_- - - -" Contractor's- License_Law_does-not-apply-to-an owner. of a property who builds or improves thereon, and who does such work himself or _ ISSUE FEE +-'- - ""'"-- - - --- ;APPLICATION -APPROVED BY---'--"-- .-':-. DATE.Y�:... through, his,own.employees,-provided, trial such improvements are not ---"" -^ -- --- -- MECHANICAL PLAN CHECK - + , -^- ---- -- ----- - - -- RY,OF� FEES, ;l'•'^r,_i"; _; ,._"'_"'-' -SUMMA � intended or offered for sale. If, however, the building or improvement- of sold within o of completion, the owner will have the burden of proving he dltl not builtl or improve for the purpose of sale). did not 1� h-as•owner- -of - the -property, -am- exclusively -contracting. with_ - _ - - --- -- - -- HEATING SYSTEM 0-100,000 BTU - ! -AND'D UCTING'-- - ---- -BUILDING •--- S"0 PERMIT $_ SMIP - licensed' contractors'to construct the project Section ]044, Business p ( "antl- 100,G00,1 BTU IPLAN CHECK $ '0 z PERMIT,•, , f Professions -Code: -The Contractois-LicenseLLaw does notapply.to_ _ _ '- _ : - _ ISSUANCE'_'$` "• •�'� � _1 an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU ' PLUMBING f $ arn�G - ^'.11 tracts -from -such -Projects -with-a-contractor(s)»•licesned-pursuant Ao Contractor's License Law). - SYSTEM _ �.J. 100,000 +`BTU' - RR1IJING�'�$' PLAN CHECK ,the '❑ 1 am exempt under Section'-" " B.`& P: C: for this" BOILERS BTV ELECTRICAL '$'-' ,I treason ( ':07a ,q1^✓ MICROFILM$ •' SYSTEM REPAIR, Date- Owner ALTERATION FPLAN --- - EXHAUST SYSTEM 'MULTIPLE I ': �-} UTOTA L'FE E;$'+ ,MECHANICAL-$- -- - --- "''� +I-' I i„'� b LESS AD-•. II hereby certify that (pave read this application and state that the above -to with information is correct. 1 agree comply all city and county ordinances laws to and hereby _ ;PLAN -CHECK'"$` - and state relating construction, authorize representatives -this -city- to upon the -above- mentioned - - `'1.''i+l%r 'i"'. r, ;: �•' '-'•"'Z of enter in ins ection I ( property ur pos s. ..��+ �• -D �', -j - I. FINAL FEE $� Signature to L-rT - ...-__ _-,. .v ,. -._ I I - - --- Drivers' License or SS ISSUE FEE •-. -' -- - •-- ^- ---- _-._.__.. ..._ _^. _ _ __, - -. _ CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING,!• - -_ 1 APPROVALS 1:' Permit�y�( Date ,--Inspector-, _ POOL & SPA '- - Date r Inspector-. :APPROVALS • , Permit 1. Temporary Electrical Service or Pole_ _ - 43. Pool & Equipment Location - - - ---- ---- -- -- ._. SoilPipe-Undrgrn 44. Steel Reinforcement -- ---- -'•- - - = ` - 3. Electrical Conduit•Utility-Undrgrn _.,,.- _• - - 45. .Forms. _,---- -- - 4. Electrical_Conduit-Undrgrn. ._ 46.. .-Electrical Bonding-- --- - --- - - - 5.Steel Reinforce' - _ 47. Rouh-PlCmbin- & Pressure Test— - - - gre es - 6. ,Electriral.UFERGrn 48.- APPROVAL TO COVER-GUNITE-- J.__Footings.. - _�-- .. _ _ _•� � 49. Electrical Conduit-Undr rn �- -8:--Foundation 50: • Gas Pipe, Undr rn, Test 5=' •�=-s. •9.- Water Pi a=Undr rn 51. Backwash Lines P -Trap, �: ndr rn• 10.--Structural.,F.IborSystem,. .__--.._'..t<'. _:•.._ '... „_-- �. ,.,. •;-, 52. _ APPROVALTODECK- `"-"'_"'--" `'"' --•�• - -1.1.. -Property-Sewer Line & House -Connection - •-.53. . Backwash & Receptor -Final •- 12: - Street Sewer Connection _ - 54. Heater & Vent -Final '. .13.- Rough Plumbing_ - -' -- - 4irial"" - - • ' 14. Rough Electric -Conduit -- - - -- -- - - --56. Electrical -Final - -J -.� '�• - 15. Rough Electric -Wiring '-• - - - -57. Solar System -Final" •' - n, 16. Rough -Heating & Air Conditioning =' - _ Fencing & Access Approval - 17: Ducts in Structure - - ----- - APPROVED PLASTERING'' - ` 18.-- Ducts, Ventilating--•- 60. POOL/SPA SYSTEMS FINAL = 19. Gas Pipe -Rough &Test- - 20: --Roof Framing 21. Roof,Sheaitiin - - - ----------- - - - -- - -�' - NOTES; - - - --' 22: Frame and -Flashing ---- -- - - - - 23. -- Insulation - - - - -- -- - -- - / _ 24. Lathing &Siding- --- - . -__-_ - - - - - - - - -- - -- -- - 25. Drywall Nailing -- - - - -- n- - -- - •' • ' 1 26. Plaster Brown Coat -27'.- -Electrical Power Meter -Final - - -- - •- o ' ' 28': - Final Electric- -- - - ------- - - - - - - '' ' 29. Finall,Heating-& Air Conditioning -• - !- - -- - - - - - 36: Final'Gas Pipe -Test 31. Final Plumbing - -- 32. Water Service -Final - -- - -- - - - • - - -- - -- --- • ... .. - - --- - - :., .. •,. .. '- ,. -. , . f'- 33. -Gas'Service-Final -- -- - - L __ --_._ - • . ,., ,; 34. Solar Domestic -Final ' 35. Landscape S rinklin System" -- stem" -36. 36. Sound Attenuation 37.. Handicap Regulations - - -- - - - 38. FINAL STRUCTURE&BUILDING 39. Special Requirements Completed 40. Electric Release. to Edison - 41. Gas Release to Southern California Gas Co. - 42. CERTIFICATE OF OCCUPANCY ' 'No Date Applicant to fill In all spaces wittfin heavy border lines and sign all appropriate declarations. ', 7CO A MESA PERMIT NO. TRACT NO. - LOT NO. BLDG. NO. CWJSTRU ON PERMIT $E. Q- 5 Project Addr TYPE OF CONSTRUCTION ypQ ❑-NEW ❑ ADD ❑ ALTERATION Lv ❑ REPAIR ❑O CCO��./{VERST�pN ❑ EE/M�p/L,IIS %��/OTHER /F/V�/ �gf[iS"�•�� r DHSC RIPTION OF WORK Owner Phone `:-'L Address r _ - - - Arch/Eng. License No. Address - _ ' Contractor c-taf, Phone _ TYPE OF PERMIT ❑ GRADING El FOUNDATION ❑ STRUCTURAL TENANT ID ELECTRICAL USPLUMBING ❑MECHAf Address Or LICENSED CONTRACTOR DECLARATION I hereby affirm that 1 am licensed under provisions of Charter 9 (cOm- 7000) Division 3 ❑OTHER mencing-with section of of the Business an Professions Code, and my license Is In full force and affect. SWIMMINGPOOLPTRAP License Class - License No. PROJECT ES RO ¢ IPTION - " j - Z-5-- SQ. FT. - Z � Date � Signature D WORKERS' COMPENSATION DECLARATION OCCUPANCCONSTRUCTION TYPy I hereby affirm that I have a certificate of consent to self -Insure or a VALUATI ZONE certificate of Workers' Compensation Insurance, or a certified copy - thereof (Section 3800, Lab. C.)- GRADING CU. YDS. ACRES .y No. Company - - .ertlfied copy Is hereby furnished. _ REMARKS: copy Is filed with the city Building Division. _LRr-71 XEMPTION' FROM WORKERS' COMPENSATION DECLARATION is Section need not be completed li the permit Is for one hundred [ECertified LESS AD- VANCEPC $_ 00)orless).rtlifythat _ In the performance of the work for which this permit is PLUMBING •- -PLAN CHECK ed, 1 shall not employ any mVpn in p.,y�mar+ner so asfq become Date A ✓ ( !t - O r Signature NOTICE: If after making this declaration, you should become subject to the Workers' Compensation provisions of the tabor Code, you must forthwith comply with such provisions or this permit shall be deemetl revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the per- formance.of the�work-(orwhlchsth�sper�mit'l issue�(Seclion vi�097 Civ. C.). -7 - - - - - - Lender's Name Lend is Atldress - 4 - OWNER BUILDER DECLARATION I hereby atiirm that 1 am exempt from the Contractor's License Law for :he following reason (Section 7031.5 Business and Professions Code: Any city or county which requires a Permit to construct, alter, mp r0 ve, demolish or repair any structure, prior to Its issuance, also re- auires the apFliw nt for such permit to file a signetl statement tN[ he s Iicensed'oursuantto the provisions of the Contractor's License Law BuSInese and Professions COCO) or that he Is exempt therefrom and the r - for.the. alleged exemption. Any%violation of; Section,7031.5 by I ppllCant for a- Permit subjects the'appli Cant to a civil penalty A more than five hundred dollars ($500). LJ I, as owner of the property, or my employees_ with wages a5 -their sole 00 mpensatlon, will do the work, and the structure Is not Intended or offered for sale. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of a property who OuildS or Improves thereon, and who does such work himself or through his own employees, provided that Such improvements are not intended or offered for Sale. D, however, the building or Improvement Is sold within one year of completion,. the owner will have the burden oof roving he did notbuildor Improve for the purpose of sale). I, as owner of the property, am exclusively contracting with nse0 contractors to construct the project (Section 7044, Business an Professions Code: The Contractor's License Law does not apply to an owner of properly who builds or Improves thereon, and who con- tracts from such projects with a contractor(s)-IiCesned pursuant to the Contractor's License Law). ❑Tam exemptunder' Section .� jJ ".r—,• B. & P. C. for this Date 1:114-nr Owner -929A BATHTUBS SHOWERS TOILETS URINALS LAVATORIES DOUBLE LAVS KIT. SINKS '- DISHWASHERS ` SFZRVICES1,NKS SUMPS - FLOOR SINKS, FLOOR DRAINS DRINKING FOUNTAINS " INTERCEPTORS CLARIFIERS SWIMMINGPOOLPTRAP -- WATER SERVICE ALTERATION GAS SERVICE OUTLETS SEWER CONNECTIONS/'II SOLAR TANK - COLLECTORS SOLAR PIPING SYS. DATE _/ -.g ISSUE FEE OF FEES MECHANICAL PLAN CHECK HEATINGSYSTEM ANO DUCTING 0.100.6OOSTU— 100,000+BTU _ REFRIGERATION SYSTEM 0-10010\00 BTU_ 100,000 +BTU •�_ BOILERS BTU r SYSTEM REPAIR. ALTERATION I hereby certify that 1 have read this application antl State that the above EXHAUST SYSTEM MULTIPLE Information is correct.' I agree to comply with all city and county ordinances d state laws relating to tonstructl on, antl hereby authorize r¢preienta s his i to er u on the above mentioned property or ins it pose ¢ Signature Date 1, V7— - Drivers' License or SS -- / - -ISSUE FEE - CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor 21661 7/14/k A.P. ZONE NG SETBACK S . SI YARD A LLRIIGHyAHUT REAR YARD (TO P/L) PKG. SPACE REQ. ;iz EET WIDTH ZONING APPROVED B` SPECIAL CONDITIONS: asse ELECTRICAL REGULATIONS PLNG. REF. gp F(R6V IOED PARK FEE $ ATE PLAN CHECK - PANELS MAIN. .-SUB SERVICE - - AMP ase 127.47 TL 1, �l NMI RIN�I MEWAFM 0�0 N®m E�w E® • e ISSUE FEE GENERATOR 0-1 KW_1-10 KW DATE _/ -.g TRANSFORMER OF FEES PERMIT G 00 APPLIANCE 10.50 KW_50+KW qq,-a ' 'MOTORS- 0-1 HPC -1-10 HP -t -.(INC: SOLAR) -10-50 'OUTLET HP y 50 + HP - FIXTURES 1 y PLAN CHECK ITCH GAS TUBE SIGNS - - PLAN CHECK - POLE LIGHTS $ ' TOTAL FEE $ K 7 'MECHANICAL PANELS MAIN. .-SUB SERVICE - - AMP ase 127.47 TL 1, �l NMI RIN�I MEWAFM 0�0 N®m E�w E® • e ISSUE FEE - - _ - s 010 APPLICATION APPROVED BY DATE _/ -.g OF FEES PERMIT G .(S--U��MMARRY $ 2E�]i/; SMTP $ ��v= _ qq,-a r PLAN CHECK $ 1 L PERMIT' ISSUANCE $ PLUMBING § r OO.,: - GRADING $ 1 y PLAN CHECK $ ELECTRICAL -$ • tMICROFILM PLAN CHECK - $ ' $ ' TOTAL FEE $ K 7 'MECHANICAL $L-' _ _LRr-71 PLAN CHECK $ LESS AD- VANCEPC $_ • 1 _ �t _ FINAL FEE $ 1�2.7.y7 CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL&SP.A-'. ,�. .- -• - - Dat APPROVALS Permit #`- a �.`. inspector ; 1. Temporary Electrical Service or Pole . • 43. Pool &Equipment Location 2. SoilPipe-Undrgrn 7 - :, �. 44\ .Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding b. bteel Reintorce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVALTO COVER-GUNITE - 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. . Water Pipe-Undrgrn 51. Backwash Line P -Trap,❑ Undrqrn 10. Structural Floor System '" 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection • 53)'` acOwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing 55. Plumb4no System - Final 14. Rough Electric -Conduit- 56. Electrical -Final 15. Rough Electric -Wiring 57. Solar System -Final 16. Rough Heating & Air Conditioningencing & Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING - 18. 19. 20. Ducts, Ventilating Gas Pipe -Rough & Test Roof Framing '" • 60. _., __ , , . - y , POOL/SPA SYSTEMS FINAL '{'• t �, 21. ,, 22._% Roof Sheathing- C/1•¢ Frame and Flashing .,-s.._ 1DZ QCy-.42-$'� - NOTES: • _ a. 23. Insulation - W.a.,Q-Q 24. Lathing & Siding 25. Drywall Nailing ProJkt 26. - Plaster Brown Coat 27.` Electrical Power Meter -Final ' ',-{{. ',L- C- �Ec_ 28. Final Electric - - 7-3,) -$Z- 29. Final Heating & Air Conditioning - .1 _ O .- 30. Final Gas Pipe -Test 31. Final Plumbing 7/ - 32.; Water Service -Final, '33. • Gas Service -Final - - 34. Solar Domestic -Final "- 35'. Landscape Sprinkling System 36. Sound Attenuation' 37. Handicap Regulation's 38. FINAL STRUCTURE & BUILDING - $'• _$'� 39. Special Requirements Completed -k(,U - - a -.' 40. Electric Release to Edison l 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY .3� " : ,t• Date a_� , City of Costa Mesa. r 'Building safety Department C E R'T I F I. C A T E OF-,OCCUPANCY i- 3389' P.O:. Box 1200 - - :' . ,Costa Mesa, California The Building located at 245 F:isehxr Avenue.. unit 4B-6' has been inspected and found to comply with the provisions of all City of Costa Mesa, Ordinances applicable thereto -for a Group P-WA ccupancy.. • • - -Use of Building 7fi+cririr al+craf•intla 'Legal Description 497_n4i_n7 w t (See reverse side for Metes and Bounds) ]''"4412 M-4458 'Building Permit No IDr. _nnao Electrical Permit No, tttw_.444R Plumbing Permit No. RT?t>-4453 Number of apartments - _n_ and/or guest rooms -n- - •ISSUED TO: Building-Official Pulliam Properties V. 'C . Ncwtt�ti, Builduq Division Direc:Wr, Date /—�� /0' A 2 .This Certificate *of Occupancy SHALL BE, posted in`a'conspicuous place on the premises and SHALL NOT.BE removed except by the Building Official of the City of Costa Mesa under Sec. 306 (e)-U.B.C. r- 'Form BU,34 Rev. 11/70 ' - t - - - Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CIT9 OF -COSTA MESA-- •,•'^- PEPMT NQ. - TRACT NO. - LOT NO. - BLDG. NO.- . " CONSTRUCTION PERMIT 7 TYPE OF CONSTRUCTION `• ❑'NEW �• ADD O'ALTE RATION - v_�� - _ (_ ,. -1 ^ , JR IF +.9e47 Project Address a ..i Ike - 4,yrgr Owner w _ 04- Phone - '^ /j --J 1•� -Address-74i ❑REPAIR EICONV ERSION ❑DEMOLISH 0 OTHER DESCRIPTION OF WORK _._ .. _ ZONING REGULATIONS rA.P, "Arch/Eng:- - - License No. - -Addreu - _ _. -_ _ __ - - S S - ZONE PLNG. REF�.�-- --Contractor XL + - �p Phone y6/ -TYPE OF PERMIT - - - ❑GRADING .',y0 FOUNDATION ❑STRUCTURAL"- .0 TENANT❑ ELECTRICAL XPLUMBING-OMECHANICA 'B - 'SET ACK T. , - LID 'YARD' - Ep RIGHT To et/I LpINC --- - PRO PE RTV LI NE'• 'Atldle55- - - -I ' _ 'LICENSED. CONTRACTOR DECLARATION I hereby affirm thkt I am licensed under provisions Of Charter 9 (com- 7000). 3 I -. (].OTHER- •- - ' mencing- with- section- of Division -of -the Business .antl'. Professions Code'and my license is In full force and effect.., 1 - -- REAR YARD (TO P/L) - - - 'PROJECT DESCRIPTION- - _ License Class - License No:_ _ _ _ _ _ - -- 9q. FT. 'PKC. SPACE REG. - _ IST REET WIDTH PROVIDED, - �.. PARK FEE$ . �Date -LL-` Signature - =:Z__.. ,WORKERS:.COMPENSATION DECLARATION _ OCCUPANCY_ CONSTRUCTION TYPE - - - T '1 hereby affirm that 1 have a certificate of consent to self -Insure or a �- s•�'t ZONE ZONINGAPPROVEDBV 1 •� DATE t certificate -of. Workers' -Compensation. l nsurance,_or a.cortifled-copy- b. VALUATION• ---- -- - -- - - - -- -- - - - - SPECIAL CONDITIONS: •- - - - ---, thereof (Section ?g800 C. I / , GRADING CU.tV DS. ACRES, " ,cy'No. OLWG%I 39/frompany - h1'/O A" _ _ _ _ _ -. _- _ _ '..REMARKS! ertified,copy.is hereby_furnished. -. ' 4 . ertified copy is filed with the city Building Division. L , WORKERS' COMPENSATION -DECLARATION E%EMPTIONction becompleted if themit is (This section neetl not b0 completed if the permit is for one hundred need - - -' 1 "'. :�'f '- _ .- .. $100) or less). •- -- •.-- ..__ __ _. _ - _ •P _. __ _- _ -_. __ - ^ _ 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 _ 9 f-. PLAN'CHECK' - - - - - ' ' ' ' ' " ' ')ELECTRICAL PLAN CHECK-. ` subject to the,Workers- Compensation Laws of Califor nla.� .11, c . '�._ •BATHTUBS �.. .. SHOWERS._ _.. _- -' . -- .t _ _ Data Signature NOTICE: If after making this declaration, you should become subject :,TOILETS -,7. - URINALS - - - "1-_ -!GENERATOR 0=1-KW_1-1to the Workers' Compensation provisions Of the tabor Code, you must forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS -- - - TRANSFORMER +APPLIANCE - '10.50 KW_50'+'KWrevoke eY • - - CONStl.KIT.'SINKS CONSTRUCTION LENDING AGENCY - _ - -DISHWASHERS' - - -' 'MOTORS ---0-1-HP_1-10 HP' - affirm that rhes iw ch permition lending SERVICE SINKS. .. •,'}DMP$ ^--^ -}' -'- - ^ '(INC. SOLAR) _ 10 -50 -HP=- SO+HP -� - --- � • formaby this Issuedagency (Section formance of the work for which this permit is Issued (Sectlon 3097 FL-OOR'SINKS'- -' FLOOR -DRAINS 1FIXTURES - - " OUTLETS- SWITCHES -- - "- Civ. C.). -- ---••---- - ----• --- -- - -' Lender's.Name "• ._;;d _-`-"-'-'-- Lend ex's Atldress _ DRINKING FOUNTAINS -' --' ""-' 1 '�GAS'TUSESIGNS l - - _ _ ----•- ----- i- -- INTERCEPTORS CLARIFIERS POLE'L'IGHTS'" -'"-^ _ - -- - - OWNER-BUILDEROECLARATION------- ---'•----- I hereby affirm that I am exempt from the Contractor's License Law for ' - '- - -- - PTRAP SWIMMING POOL"f�,POLES METERED - - __SUB_. - the following reason (Section 7031.5 -Business -ane -Professions Code: Any city or county which requires a permit to construct, alter, WATER SERVICE ' -ALTERATION '1 -' '" iPANELS'- -MAIN - -SUB- improve, demolishorrepair any -Structure, prior to its issuance, also re- quires the api licant for such permit to file a signed statement that he GAS SERVICE 'OUTLETS-_ - - - -SERVICE --' - - - -AMP- -- - - • - is -licensed pursuant -to the -provisions -of-t he. Contractor's License.Law ((Chapter 9 (commencing with Section 7000) of Division 3 of the 2-' 'WATER HEATERS- -"- BTU OUTPUT- -'- " ^ 'F -'` -' -'•' -• - - - -^- - -•� usiness a no- Prolessio ns- Code) or that -he Is exempt therefrom and the bxcis for the alleged exemption. Any violation Of Section 7031.5 by •-SEWER CONNECTIONS '�• jam^ - '- - - - "'- -" - _ _ - - ' c applicant for -a -permit subjeCls-the applicant -to a -civil -penalty- ,t more than five hundred dollars ($500). SOLAR TANK ' - '- -COLLECTORS "" `-' '- t -- -' - - - -'-' - -"- - • -- - - � .,'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. (Section 7044, Business and Professions Code: The SOLAR PIPING'SVS.- -- -- `- - -- - - ISSUE FEE Contractor's License Law does not apply to an Owner of a property who builtlz'or improves thereon, and who does -such work himself -or _ _ - ..__._ _ �_ - "ISSUE FEE _ �, I APPLICATION APPROVED BY - - - - - DATE - - through his employees, provided that such improvements are not ----' - - - '- - - ' '- ---'-' MECHANICAL PLAN CHECK .s SUMMARY OF,F EES _own intended or offered for sale. If, -however, the building or improvement is within one year of completion, the owner will have the - - Pr f sale). of- proving not Improve for purpose of sale). - - - - HEATING SYSTEM 0-100,000 BTU 1 >, -\ BUILDING - IPERMIT' '•-$, r •— ,�,SMIP. ' ,.�.. $'' iS� ' ❑_I, as- owner-. of the property, am excl usiv¢ly_ contrac[inq. with n -. o pro rt excl'theusively- AND DUCTING •' _ "-" - - licensed contractors l0 Construct the project (Section 7044, Business 100,000;1 BTU I PLAN CHECK E % /X and Professions Code: The -Contractor's License Law does not apply to improves - _ ,PERMIT ISSUANCE $ an owner of property who build$ or thereon, and who con- REFRIGERATION 0-100,000 BTU 1 -PLUMBING $ ,! � -•. -r tracts from -such .projects with. a.. contractor(s), Iicesned, pursuant -to SYSTEM - -• L -- _ _ -- _ 'RLAfJ _GRADING _E" the Contractor's License Law). 300,000+ BTU• CHEEK'$ 0.1 am exempt'under'Section--- - - - - --B.-& P. C: for this -BOILERS BTU ( ELECTRICAL $ -'''IMICROFILM reason - - _ _ - _ _ - __ _ _ SYSTEM REPAIR, ALTERATION ! 1' IPLAN CHECK t: $- - 1 Date Owner EXHAUST SYSTEM MULTIPLE t • 'MECHANICAL '$ TOTAL FE - - LESS AD - I hereby certify that 1 have read this application and state that the above information isd all tete and county I agree to 'complyactio .� PLAN CHECK --$ - ^VANC E'PC $_ ' statecorrect.- ordinances and stale laws relating [e construction, and hereby authorize law , f j - , - representatives- t reprezentatives"of this- to 'enter upon the above mentioned ••� property for inspection par s¢s - Z in.Iore - DateI t ISSUE FEE FINAL FEE $i CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNIN 4N�2Date APPROVALS Permit � Inspector POOL & SPA .APPROVALS'. r• Permit# Date - _ Inspector 1. _ Temporary Electrical Service or Pole _ _ - -- - 43. Pool & Equipment Location- . 2... -Soil Pipe-Undrgrn + ' _ _ 44. Steel Reinforcement ...- 3. Electrical Conduit Utility-Undrgrn _ 45. Forms I - - - - 4... Electrical Conduit.Undrgrn 46.. Electrical Bonding. - - _ tee Reinforce orce _ _ - 47. Rough Plumbing & Pressure Test -•'�' '- 6. Electrical UF_ER Grn _ _ _ _ - 48. APPROVAL TO COVER-GUNITE- 7. Footings _ _ _ 49. - Electrical Conduit-Undr rn - _-8. Foundation L.° 50. Gas Pipe, ❑ Undr rn,Test _.9..,_Water.Pipe.Undrgrn_. - 51. Backwash Lines P-Trap•Q ndr rn _ '- 10. _StructuralFloor. System,_ 52. APPROVAL TO DECK' -- _ _ 11. -P.roperty.Sewer Line& House•Connection- ;_ 53.. Backwash&iRece tor -Final' ' 12. --.Street. Sewer Connection,.""" - - - - - - - - 54.- Heater & Vent -Final - 13. ,Rough Plumbing_ - - - - - - - 14. Rough Electric -Conduit - - - -56. - Electrical -Final- - 15. Rough Electric -Wiring - - - -- -- - '� - - -- -- 57. - Solar System -Final -. - - 16. Rough Heating & Air Conditioning=_ - - encing& Access -Approval" - 17. Ducts in Structure,..' APPROVED'FOR PLASTERING - - 16: 19. 20, Ducts, -Ventilating Gas Pipe -Rough'& Test Roof Framing - '-- _ = 60. POOL/SPA SYSTEMS. FINAL --' 21. 22:. Roof -Sheathing Frame and Flashing--- - � _ NOTES:,` •' ' - - i ' ' ';.. 23.- Insulation- 24. Lathin -& Siding 25; Drywall Nailing - 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric - 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 i 35. 4myAoswe Sprinkling System RRE AWA4. 36. Sound Attenuation - - ' 37. Handicap Regulations -- - - - - - 38. FINAL STRUCTURE &BUILDING - - 39. Special Requirements Completed`.1, 118Zun_ i 40. Electric, Release to Edison - - 41. Gas Release to Southern California Gas Co. 42. - CERTIFICATE OF OCCUPANCY No Date - - - - 0 d 4 A C< 1 Applicant to fill in all spaces withirl� eavy border lines and sign all approbi late declarations. '-' CLTY OF'COSTA"MESA PE T NO. TRACT NO. LOT NO. BLDG. NO: - - 5648 - 8/11/82 -"' -- -'I I CONSTRUCTION P MIT 4�' ' TypE OF COJJSTRUCTION W 957D El ALTERATION - ❑ REPAIR ❑.CONVERSION.ODEMOLISH ❑ OTHER -' .00 -- ' + I ' . - - I. .2. - - -- ZONING REGULATIONS i 'Project Address41 54= ,Owner Phone "" ,Address - -- - ArchlEng. License No. - D ESCRIPTION OF WORK .. __.. R - ---- - - --- VPE OF; PERMIT 1 ;,•(],GRADING O FOUNDATION -O STR�U-CTU�RAL- _ - _ ' _' -• r - A.P. T _ ZONE - - PLNG. REF. $:-•; - - - - - �WrpBtL��ILDING-- r- SET ACK C ST. TROPE RTY LINE SEI EYARD- -- - - - -- Address a Contractof - i-- "Phone Address _ -___ LICENSED CONTRACTOR. DECLARATION. -' - - �0 TENANT ❑ ELECTRICAL I]PLUMBING'�aiECHANICA I hereby affirm that I am licensed under provisions of Charter 9 (com. - ' „- P - glpE V -- - - - - - --- - - ' RIGHT inencing-with section 7000) of Division 3 of the Business and ❑OTHER'- THER - Professions Coo an license is In full for If ct. !P1 �._ _,56y PROJECT DESCRIPTION _ I REAR YARD (TOP/L)- Licens$.�lajs ticeFlse/{v� _. _ -_' (_ - _SQ. FT. :r.. .. PKG. SPACE REQ. -- PROVIDED- �• /'/n --D - I - ��[J� Date signature .__�J. 'TYPE• 'QCC - •�' CONST-VCTION � ._ _ STREETWIDTH PA'RK�FEE,$-:" WORKERS'COMPENSATION.DECLARATION_ "_ - _ _�--_ I hereby affirm that I have a certificate of consent to self -insure or a _ I- ___ _ - h -- '" (ZONING"'APPROVED;BY" 'DATE certificate of orkers' Compensation Insurance, or -a certified.copy >ALV ATION' _ _ZONE _ _-'_ thereof (Set' Ms.. GRADING CU YDS. ACRES 'SPECIAL CONDITIONS:' _'by'No.--CompanyQ %l14n _ -'_ - - _-- -. -- .- aaaaaaaaaaaaaa ertifletl copy Is hereby furnished. _ REMARKSi 171 �rXrertifled copy Is filed with the city Building Division. _ E%EMPTION FROM WORKERS' COMPENSATION DECLARATION -. .. -- - - - - This section need not be completed if, the permit, is for one hundred _ - -- - I � l •�_ 'J 100 or less $100) In T-- . C _• certify that the performance of the work for which this permit is -it,PLAN - -' ' - Issued, I shall not employ any person In any manner so as'to-become .'PLUMBING tl, cCHECK'- ' - •BATHTUBS -,ELECTRICAL: PLAN CHECK subject to the Workers' Compensation Laws of California. _ -- - SHOWERS -- -- U NU }-"'-"'- Date I Signature NOTICE: If after making this declaration, you should become subject TOILETS ,.p URINALS' - -"' -` - - -GENERATOR ' 0-1 KW_;1-l0 KW to the Workers' Compensation provisions of the Labor Cotle, you must ,TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS - -` .APPLIANCE -- -10-50-KW_50-+KW- --- - - -- !evoked.-- I _ .- .-_ _ _ _ CONSTRUCTION LENDING AGENCY 'KIT: SINKS '- - -- DISHWASHERS'- - - - MOTORS I hereby affirm that there IS a construction lending is agency for the per- SERVICE SINKS. -' ,-) SUMPS -' ^"�" `- - 77 - , �(INC.SOLAR) - 10-50 HP- 50 � HP--- - - - - forman<e of the work for which this permit is issued (Section 3097 FLOOR'SINKS - FLOOR'DRAINS _ ^ - - _ 'FIXTURES -- OUTLETS- 'SWITCHES -- Civ. C.): -' - - `- Lender's Name 'Lender's n " - .- - - :--'�: _-' ,t- - - ' AtltlresS' � '_DRINKING FOUNTAINS -' --' ' ---^" -," - - _ :GAS TUBE SIGNS -- - _ OWNER BUILDER'DECLA RATION ¢ - - _ ---- - — INTERCEPTORS CLARIFIERS '•' POLE'L:tGHTS•`- - I hereby affirm that I am exempPfrom the Contractor;s� License Law for. •'SWIMMING'POOL— '-P'T RAP •' ---^ -•�--- - - - - -- - -- - - the -following reason -(Section 7031.5>61usiness and Professions Code:- Any -city or county which requires a permit to construct, alter; POLEB METERED SUB -WATER-SERVICE '--- -'ALTERATION --' -- -i '-"-' PANELS _-- ' -MAIN SUB - --- - - - improve, demolish or -repair any structure; prior to -its -issuance, also re- quires the ap, licant for such permit to file a Signed statement that he GAS SERVICE- OUTLETS' -- - --- '- -SERVICE - ,-- -- - -- AMP -- Is licensed -pursuant -to -the -provisions of the Contractor's- License Law Chapter 9 (commencing with.Section 7000) of Division 3 of the Chapter WATER HEATERS - BTU OUTPUT' - '• ' - -• - - ^ - - -- - - - •- - - - - - and Professions Code) or that he is exempt therefrom and the h-4 for the alleged exemption. Any violation of Section 7031.5 by - SEWER CONNECTIONS- - - applicant for a permit subjects the applicant to -a -civil - penalty A more than five hundred dollars ($500).- '-SOLAR TANK -'COLLECTORS +- • - - 1 ^-�-• - - -- - - -- - -- --- - t_. I; as pwne"r or 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. (Section 7044,'8 usiness antl-Professlon5 Cotle: The _ _ . SOLAR PIPING SVS. - •';) _ - - 'I" -'ISSUE FEE— EE-Contractor'sLicense Contractor's LicenseLaw tloes not apply to an owner of a property who builds or Improves thereon, and who does such work himself or _ _ _ _ _ _ - ISSUE FEE •- - - 'f - - - '- - -jAPPLICATION-APPROVED BY - - - - - --' DATE throughhis own employees, provided that such improvements are not "-'' �' MECHANICAL PLAN CHECK -' �-MMARY OFFEES; - SU tt -,,f• I •• I intended or offered for sale. If, however, the building or Improvement' the have the burden is sold within one year of Completion, owner will of proving he did not, build or improve -for the purpose of 'sale)- - HEATINGS TEM ' cps r „� IrU C .1 .BUILDING ------ - ----- - - .-•---_^ SMIP$: ❑ I, as.owner-of the property,-arn-exclusively. contracting. with N _ _'..p -.. __ __ s[J_ ,PERMIT E - -` licensed contractors to construct the project (Section 7044, Business to 100,000'+ BTU " / PLAN CHECK E PERMIT: '1 I and -Professions Code: The Contractors -License Law does not apply an owner of property who builds or Improves thereon, and who con- licesnetl to REF RIG ERATI 0-100,000 BTU _ _ _ -_-... ISSUANCE- ;PLUMBING E - - nGRAO1NG'_ tracls-from such projects with a contractor(s) pursuant. the Contractor's License Law). SYSTEM - _ ]00,000'~ BTI( -__ (PLAN CHECK E _ . ❑ I am -exempt' under Section' '-` -- -- B.-& P: C. for thisBOILERS BTV ' "- -- L $ ELECTRICAL E - - reason- - - - - - - - _I SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE MICROFILM E _' PLAN CHECK - E �/ 'TOTAL' FEE $' t •MECHAN�CAL-E -- " ,LESS AD-, •' ' Date Owner ( hereby certify this application and state that the above that I have readagree ts information is correct. ('agree to comply with -all city antl'counry ,PLAN CHECK E VANCEPCordinances and state laws toting to construction, antl hereby authorize .� representative�a( hl ty 1 enter upon the above mentioned property f�t / VVV ,,, ^ Signature Dale 'D FINAL FEE $J1 -License ISSUE FEE - - -3-JIM - - _ - Drivers' or SS CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor TL I CONSTRUCTION AND PLANNING APPROVALS Permit 4A _ Date POOL & SPA - +" --• Inspector APPROVALS .- . r o Permit 4# - '- r Date -, • :Inspector 1. Electrical Service or Pole _ _ ry 43. Pool'& Equipment Location - - - - • - - - - - _Temporary Soilpipe-Undrgrn_ - _ 44. Steel Reinforcement - - - 3.,_Electrical.ConduitUtility-Undrgrn 45. Forms I---- - -- �- 4.. Electrical Conduit-Undrgrn - 46.. Electrical Bonding-- 5._Steel Reinforce 47. Rough Plumbing & Pressure Test - - - �• ' - 6.- Electrical UFER Grn_ 48. APPROVALTO COVER-GUNITE--"-'-; - - - 7. _Footings 49. Electrical Conduit-Undr rn -• 8.. Foundation._ _ 50. Gas Pipe, ❑Undr rn, Test ' 9., Water Pipe-Undrgrn - 51. Backwash Lines, P-Tra- ❑ Undrarn - - -- - -- ' -10._Structural,FloorSystem _ 52. APPROVAL TO DECK" -- -- -- --'-'---' i. 11. Property -Sewer Line & House Connection: _ - _ 53. .Backwash & Receptor -Final - •'' 12. - Street Sewer -Connection_ •''' - - - - - - - 54. Heater &Vent -Final- 13. Rough Plumbing- _ _ _ _ __ - 14. Rough Electric -Conduit' - --- ,-56:- Electrical -Final 15. Rough Electric -Wiring 57. Solar System -Final -16. Rough Heating-& Air Conditioning - =_-- - - encing.& Access Approval,, 17. Ducts in Structure. - _ APPROVED.'FOR PLASTERING '- 18: 19. 20. - Ducts, Ventilating GasPipe-Rough-&Test - - - Roof Framing- --- - - - - 60.. - - - POOL/SPA SYSTEMS FINAL ' 21. ' 22. RoofSheathin - - -- - - Frame and Flashing - - - - - - - -. - - - - '. -. .'J:::'. NOTES; ' • . ' 23:- Insulation -- -� --_ - 24. Lathing-& Siding- - - -- - r - - Z-efwtj 25. Drywall Nailing _ I - , 26. Plaster Brown Coat - + 27. Electrical Power Meter -Final ----. - - 28. -Final,Electric -- - - -- - - -- - 29. FinaPHeating & 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. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY - •No Date - Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. 6•TXY Of`COSTA'MESA - P R NO. TRACT NO. 'LOT NO, BLDG. NO. - CONSTRUCTION PERMIT TYPE OF CONSTRUCTION �,[] NEW 1:1 NEW - ❑ALTERATION - ❑ REPAIR El CONVERSION' ❑ DEMO LISH. XOTHER - 15782, 8/j O/82 67.75 - - - - - ZONING-REGULATIONS - - Project Address T OWD¢f Phone 'Address' - ^- - -- •_ "Arch/Eng. — License No: - �'- DESCRIPTION OF WORK - A.P.'ge • ZONE PLNG. REF,. 9F PE OFPERMIT,. -- - -- -- - ppeL1IL IrvG- SETBAC C T. �ROPER�V LINE EIGRADING ,.•O'FOUNDATION''❑STRUCTURAL - SIEF YARD-' -' --- •- _ -_ ,TENANT" -O ELECTRICAL( OPLUM13ING -OMECHANICA LLWII6D VA - - - - 1 - -- --- -\ - .Address _ - Contractor Phon Q •Address- - -' - - - LICENSED CONTRACTOR DECLARATION - - I hereby affirm that) l am licensed under provisions of Charter 9 (core- _ --- RIGHT b mencing-with section --7000)- of -!Division -3 of- the -Business and O. OTHER �� - - ___ _ _,. _- Professions Code, and my license is in full force and effect. _.. _ _ • - "PROJECT DESCRIPTION__ _ 'REAR YARD (TOP/L) ' .r License Class License No. �, ` _ _ - PKG. SPACE REQ. PROVIDED Data '' Signal lire- '' - s SQ. FT.' K/ r� 1 ��/ - _ _ _ 'STREET WIDTH [, PARK,,FEE $-. jli. WORKERS' COMPENSATION DECLARATION _ r OCCUPANCV4''��d�w�C��OsNS'�TR CONSTRUCTION TYP _ - I hereby affirm that I have a certificate of consent to self -insure ora *copy ._ VALUATION-f+—ZO_NE 'ZONING"APPROVED B DATE ,I Q .11,11, certificate of - Workers' -Compensation- Insurance, or a certified I _r - - 'SPECIAL thereof (Section 3800, GRADING CU. YDS. ACRES CONDITIONS r i y'No. rl _.. "-ComPanY _-- - - - _._ -. -__ - ._.- - -"_.- __ _ -_-•. atified copyls hereby furnished.-. ._ - _..__- �'i REMARKS:F- �Z '- _ -_ --- - _ _ - _ n_ s -ertified copy is filed with the city Building Division. E EMPTION-FROM WORKERS'COMPENSATION DECLARATION - - ---' - --- - - - --- - - (This section need not be completed. if the.permit_is for one hundred _- _�_ � -,;- - '1 -. ,t -- t ., I '�t^.�i f S$100) or less). r -.r •� certify that -in the performance of the work for which this permit Is Issued, I shall not employ any p son Iryw�y�ner so as to become f PLUMBING I ; - PLAN CHECK - �' ELECTRICAL "' '-- PLAN CHECK - subje gthe-Vrhers'-Compens,1 nLdw f fornl,-� - - _... _ ATHTU85 SHOWERSFT,FT _ -_ _ -----GARAGE Date ' Signature �� .4i NOTICE: If after making this declaration, you shouid become subject SOILETS,, 1, ,-URINALS' -" -• - t- 0 GENERATOR 0=1 KW -- KW' - - - - 1.7 to the Workers' Compensation provisions of the Labor Code, you must TRANSFORMER x• Iorthwith comply with such provisions or this permit shall be tleemed AV ATORI E$ DO UBLE'LAVS --' '-- "-'O[7 'APPLIANCE- '-'10.50'KW=-•-50'+-KW--' _ revoked.. _ .- - KIT.SINKS" - -- - 'DISHWASHERS '- -'" --- "'u MOTORS' '-.-- 0-1-HP_1<10 HP _ - _ _ _ _ _ CONSTRUCTION LENDING AGENCY I herby affirm that there is a construction lending agency for the per - SERVICE SERVICE SINKS - (p $VMPS - - c • = - T --- - (INC. SOLAR)._ --10-50 HP --50-+.HP-'r1 •t - )C --- forniance.of`the_work.for which this permit.is-issued (Section 30971 SINKS FLOOR DRAINS•' ';FIXTURE56q "SWITCHES ' a— Lentler'sfJame �y, .7"•FLOOR Lender's Atldress - DRINKING FOUNTAINS •• - --- '- .1"-" - �GAS'TUBE SIGNS ----'----•----- OWNER ' BUILDER DECLARATION --'�- I INTERCEPTORS CLARIFIERS - '- - -�POLE'LIGHTS—"-'-"^' -- - - I-hereby.affirm that 1 am exempt from the Contractor's License Law for I -SWIMMING POOL' - PTRAP '-" - 717 - --:-SUB'- - - - the -fol (Section 7031.5 Business antl-Professions' Cotle:' Any.dty, or 'county which requires a -permit to construct, alter, METERED _ WATER3ERVICE - ALTERATION" '- -.PANELS-1--7- MAIN-_-: `SUB-'- " improve, demolish -or r repair any. -structure, prior to itsissuance, also re- quires the ap.lieent for such permit to file a signed statement that he f7 -GAS SERVICE - OUTLETS "` -� -i - �`-- r,- -{SERVICE - - "--- - - - - - AMP -- - -_-- Is licensed pursuant twthe provisions of the Contractor's License Law- ((Chapter 9 (commencing with Section 7000) of Division 3 of the 9usiness'a -Professions ' that he is therefrom the -WATER HEATERS -/BTU OUTPUT-' - - rid Code)�or exempt and b- for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS- ' 'Y - '-' ^" -- ''-""-"-"'-'--'- `-'---• ••-•- _ - - - - - - pplicant for -a permit -subjects -the- applicant -to -a' civil. penalty. t more than five hundred dollars ($500). -SOLAR TANK '- '-COLLECTORS-- - { •-_ -- -"--- -. --- - - -- - �_ - -- - --- L i, as owner of the property; or•my employees with wages as their sole compensation, will do the work, and thestructureis not Intended _ " - or offered for sale. (Section 7044, Business and Professions Code: The _ _ SOLAR PIPING SVS. '„- •` -- ISSUE FEE' ' Contractor's_ License -Law. does -not apply to an, owner of a property- - _ _ _ _ __ ISSUE FEE -•APPLICATIOMAPPROVEO BV- - who builds or improves thereon, and who does such work himself or through. his own employees, provided that such improvements are not MECHANICAL PLAN CHECK - 1 - SUMMARY OF, FEES. •_ BUILDING-'---- - -- -- - SOO'J d• rr So' intended or offered for sale. If, however, the building or improvement is sold.within one year of completion,_ the owner will have the burden -f roving he did not build or improve for the purpose of sale).- HEATING SYSTEM 0-100,000 BTU (PERMIT am -exclusively n 7044, with -1; -as -owner-of-the. property, - g Il nsed contractors to construct the project (Section 7044, Business - 300,000 1 BTU + -$ _ _ - -J - PLAN CHECK . PERMIT, ' - and. Prof ass io ns-Code:—The, Contractor's License Law tloes not apply to- owner of property who builds or improves thereon, and who con- REFRIGERATION 0.100,000 BTU 1' $ ---ISSUANCE- $,�an �PLDM BING $ tracts from -such -projects -with a contractor(s) licesned pursuant to SYSTEM - - - --�� _-GF]_ .r; , ., S'I - __ _-_ _. _GRADING_'$ the Contractor's License Law). 100,000,+BTU - i �•� - �- PLAN CHECK $.' '� ,t l.,i-,� ,1••{ _ a`. O -I am`exempt untle,'Section- B. & P: C. for this BOILERS BTU $ t ELECTRICAL' $, reason - - - - ---- - ' -_ SYSTEM REPAIR, ALTERATION - EXHAUST SYSTEM MULTIPLE _ K _ �•1'� _MICROFILM•$ 1' '1PCAN CHECK"$' '- - - _ _ -TOTAL"FEE$ MECHANICAL' -$-' - - - - ' "LESS `•1 n,. - -- d 1-� - - Date Owner I hereby certify that have read this application and state that t e above information is correct I agree Yo comply with all city and county E P '(PLAN CHECK $- - •- - "VANCE PC"' - Ordinances and state laws relatingto construction, and herebyauthorize -pon -„ •, .- l,l ' 1 .(, representat s o IS t�p mer the above entionetl , j"•f' r proPertY_ f r, ins io Po�9. _ - - S (� A2 VVVVj, - '� �. - �1• �,f NAL FEE �7 7 _ Signature a • .tea Date >' �� •r:.' _ $ Drivers' License or SS � ISSUE FEE -_ _ _I'. -- "'--' - - - CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor TL CONSTRUCTION AND PLANNING APPROVALS Permit 4 OiL�� Date Inspector -'POOL&SPIA,- APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole770=, 43. Pool & Equipment L66atio6 2. Soil Pipe-Undrgrn 44. Steel.Reinforcement 3, Electrical Conduit,Litility-Undrgrh .45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel Reintorce 47. Rough Plumbing & Pressure Test 6. Electrical.UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undrgrn 8. Foundation 50. Gas Pipe, F-1 Undrgrn, Test 9. Water Pipe-Undrgrn., 51. Backwash Lines. P-Trap, 0 Undrqrn 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' 13. Rough Plumbing 55- Plurnhino System - Final 14. Rough Electric-Conduit 156. Electrical-Final 15. Rough Electric-Wiring- 57. Solar System-Fina 16, Rough Heating & Air Conditions 7 ng encing & Access Approval 17. Ducts, in Structure --0. -APPROVED FOR PLASTERING- LASTERING18. 18. 19. 20. Ducts, Ventilating Gas Pipe-Rough &Test Roof Framing - 60. . POOL/SPA SYSTEMS FINAL 21. 22. Roof Sheathing Frameand Flashing ,Z" NOTES: 9,A92- 23. Iniulatio6 24. Lathing & Siding Of' 25. Drywall Nailing tv!�t544 26.- Plaster Brown Coat. 27. Electrical Power Meter-Final 28. Final'Electric 29: Final Heating & Air Conditioning 30. Final Gas Pipe-Test 31- Final Plumbing 32: Water Service-Final t 33. Gas Service-Final 34. Solar Domestic-Final 35. Landscape Sprinkling Sjst6m-- 36. Sound Attenuation 37. Handicap Regulations A. 38. FINAL STRUCTURE & BUILDING NG 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY 'No- Date 3 a Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations CITY OFCOSTAWESA CONSTRUCTION. PER/MIT Project Address -Z-4S • E(�_e� !7 G Applicant's Mailing Address 1517 K. F,A IR-U'��.4T x`5,/72 PERMIT NO. �o .9 TRACT NO. I 8 LOT NO. UNIT NO. 7520 8/31/84 _ 550.44 TL TYPE OF CONSTRUCTION WW ADD ALTER�ATIOON REPAI ❑CONVERSION ❑DEMOLISH �OTHER7EKA�l` �L`P A.P. —�7J �O� Zone p �V Owner's Name S17 �s� � U1 �1� Phonal Address �37.i�V DESCRIPTION OF WORK/USE OF LIG. �(z S Main Building: Accessory Building: /�� 2.t Arch/Eng. -��✓t 5(il +JL License No. C• 1 *75L Address �I ILLA4� �rff) TYE&OF PERMIT GRADING LJ FOUNDATION TRUCTURAL IIf3_�Q'I` TENANT ELECTRICAL .PLUMBING 54WECHANICAL OTHER - r PROJECT DESCRIPTION .N . —OCCUPANCY CONSTRUCT ON TYPE VALUATIONS%.T O'Qa ZONE h� GRADING Cu. YDS. ACRES �' T Front Z O B Rear - 04L N t�5`r17,`�r�' y„��^�n/ A� Contractor's Name A `L' 4 1)tL.C^_Phone l-✓S��.Z. Address (mailing) 1,5f-7 t . �td.i��Qiir City License No. LICENSED CONTRACTOR DECLARATION 1 hereby affirm that I am licensed under provisions of Charter 9 (commencing A C Right - N g Leh G R Ping. Ref. # Parking Req./Provided �„D E Remarks: 5� — Planning Notes: M I \ with section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and eff ct. OL T S. �n `J Ucense Class License No. Date Signature - PLUMBING FEES Bar Sink Showers 2, ELECTRICAL FEES I WORKERS' COMPENSATION DE to RATION - hereby affirm that I have a certificate Of consent to self4nsure or a certificate - Backflow Preventer Service Sink - - A.itomatic Washer Construction Pole Sub. Transformer ❑ 15=50 KW 11 50 + KW - Workers' Compensation Insurance, or a certified copy, thereof (Section eeoo, Lab. c.{ Policy No. t" �.N0� Company I ^Certif ietl copy is hereby furnizhetl. e "fl z ilea with the city slat isl Backflow irrigation Sewer Ca P Bathtubs Sewer Connection ZEZ5 Cooking Unit Meter ❑up to 100 amps Date Applicant MP INN WORKERS' COMPENSATION DE ARATION (This section need not be completed if the permit Is for one hundred ($100) or less)- I certify that in the performance o1 the work for which this permit is issued 1 shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Clarifiers Solar Collectors Dishwasher Meter over•100 amps7 5D Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel . - 1 Drinking Fountains Solar Tank Fan Motors ❑61 HP 1%- 8 (� Floor Drains Swimming Pool w/Spa F.A.U. Inc. Solar ❑b-15 HP El 16-1 Date Signature NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions Of the Labor -Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I I hereby affirm that there is a construction lending agency for the performance Of the work for which this permit, is Issued (Section 3097 Civ. C.) LandersName Floor Sinks Urinal Fixtures Microwave - IL 17T Gas Service Outlets 2 Water Closet 4'IQS Device Boxes Pole Light ) I Interceptors Water Heater 2 Outlets Range 00 Kitchen Sink Water Service - S Switches- Sign 2 Lender's Address OWNER BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of caisson 3 of fhe Business and Professions Code) Or that he/she is exempt - iere_from and the basis for the alleged exemption. Any violation of Section 31.5 by any applicant for a permit subjects the applicant to a civil e natty of not more than five hundred do -liars ($500). • .� 1, 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 (Section 7044, Business and Professional Code: The Contractor's 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- employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sola within one year of com- pletlon,'the owner will have the burden of proving he/she did not build or im- ve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con- ra tors to construct the project (Section 7044, Business and Professions Code: The COntractor's License Law does not apply to an owner of property who 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 proof of their Worker's Compensation Insurance should be provided to me. ❑ 1 am is under Section P. C. this reason 2 Lavatories - Garbage Disposal 'Standing Sections P—Trap Generator ❑0-5 KW El 5-15 KW Trash Compactor Roof Drains - Reinspection Fee $15 - Issue Fee _ $ 3 Reinspection Fee $15 Issue Fee $ 3 MECHANICAL FEES DEVELOPMENT SERVICES REQUI E Zoning11�1� Approved By Date Building Approved By U -J t 1 ALIAS Date Application Issued By Dat -t 8 Boiler Hood or Type I El Canopy Type II ElZoning Duct - Under Ground Duct -Structural Refrigeration System 100,000 BTU 0100,000BTU / 4 Duct - Ventilating BUILDING PERMIT • PLAN CHECK PLUMBING PLAN CHECK 25% ELECTRICAL PLAN CHECK 50% MECHANICAL PLAN CHECK 25% S MARY OF FEES $ 00 SMIP $ 9 , $ 4-40 PERMIT $ Iq •e ISSUANCE $ $ 4. Cc) ENERGY P.C. $ $ ��.7�i GRADING $ $ MICROFILM $ $- TOTALFEE $ $ 5. Ott 7 Q 3 • 1� 550 Exhaust System ❑ Multiple ❑ System Repair/Alteration I Z Firepl/Fact. Bit. ICBG # NInfor}nation Date Owner I hA[[eby certi y that I have read this application and state that the above i5 correct. agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize repre- eentatives o this city to ante on th a -in nod pr perty for Inspection oses. O r� q Signature ate�j,Q. l Heating System &Ducting 6100,000 BTU El 100,000 BT " Reinspection Fee $15 Issue Fee $ 3 Goldenrod - Assessor Drivers' License or SS rev. 4/84 Pink - Accounting; CONSTRUCTION AND PLANNING ,`� APPROVALS Permit # Date Inspector POO- . SPA. APPROVALS Permit # -Date Inspector 1. Temporary„ Electrical Service or Pole t,� 52. Pool & Equipment Location 2. Soil Pipe-.Undrgrnd. ' 53. Steel Reinforcement 3::Electr cal-Cond_uit'Utility-Undrgrnd. ``'` 54. Forms 4i'Eleot[ical ConduWUndrgrnd. 55. Electrical Bonding 5; Steel Reinforc`ement>' -56. Rough Plumbing & Pressure Test 6•r:Electrical.UFER•,6cntl. : 57. APPROVAL TO COVER-GUNITE 7.-footiagsl'" - - 58. Electrical Conduit-Undrgrnd. 8.: Toundation ;., y - - - - 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water=pipe-UndrgCnd? 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. Stiucturbi Floor System '� j, 61. APPROVAL TO DECK •:" .a 11•.'"Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. SewerCap'-� ' i 63._�Heater & Vent -Final - 13. RoofDrairiS i 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 APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure _ 70. Underground Hydro 22. Ducts, Ventilating ? 71. Product Piping ❑ Gas ❑ Oil 23. G- i Pipe -Rough & te'st 72:.Underground Flush 24.'rgofFraming _ X73. Undergrnd.Storage Tank OGas ❑Oil-." ' 25. Roof Sheathing - 74. Overhead Hydro , 26. T -Bat 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. Orl-vall Nailing "HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coaty!.' 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: ilel -7 34. Final Heating & Air Conditioning •° - `'"' ; _- ' 35. Final Gas Pipe -Test 36. Hood or Canopy _ 37. Final Factory Fireplace ' 38. Final Plumbing 39. Water Service-Fihal 40. Gas Service -Final 41. Solar Domestic -Final _ 42. Backflow Preventer 43. Backflow Irrigation 44. ,Landscape Irrigation System 45. Sound Attenuation i µ 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison) 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No, Date _ Applicant to fill In all spaces except those within heavy border tines and sign all appropriate declarations. CITY OF COSTA MESA t CONSTRUCTION PERMIT Project Address Applicant's Mailin cidress Owners Name_ no •Z Address Arch/Eng. A License No. I Address _ Contractor's Name fit one Address Imail'ngl ..X 111 �- �110 �/!0 /'1121160. City License No •/J-(/I(i�Un LICENSED CONTRACTOR DECLARATION I hereby affirm that 1 am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is In fu fro" sf ��nd effect. Licetenl Day/= % Signature YORKERS' COMPENSATION DECLARATION hereby affirm that I have a certificate of consent to sell -Insure or a c rt I(Icate of Workers' Compensation Insurance, or a certified -copy thereof (Section 3800, Lab. C.)��nn��ff ^�'�1�s��.�� Policy No. /V.1�A4/Z q35 Company �+�,Q �••�n,.S Certified copy is hereby furnished. Certlf `ed Opy�rI d with the city Bpifdin9 Dive r Dale y/l �[ Tom' Applicant Il/ //� y / EXEMPTION FROM WORKERS' COMPENSATION DECLARARA ION (Thissection need not be completed If the permit is for one hundred ($100) or losse) I certify that in theof the work for which this permit is Issued 1 shall not employ anyy person In In any manner so as to become Subject to the Workers' Compensation Laws California. Data --Signature NOTICE: Compensation doer making this Declaration, you r-Cod,¢come sub7ett to the Workers'ithsuchprprovisions of the Labor -Code, a deemed forthwith' comply .with such provisions or this, permit shall be daemetl revoked. CONSTRUCTION LENDING AGENCY, I hereby affirm [hal there is a cis permit s Issue agency for the performance7Ci v. of the work 'fpr which this permit Is Issued (Section 3097 Civ. CJ Lentler'z Name Lender's Address – OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct, alter Improve, demolish or repair any structure, prior to Its Issuance, also requtres the applicant for such portnit to file a signed statement that he/she Is licensed pursuant to the provisions of /U41.p by any appncans or a permit subects-Ine applicant to a civil anally of not more than five 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 (Section 7044, Business and Professional Code: The Contractor's License Law doesnot 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 ample Cos, provided that such Improvements are not Intended or off ored for sale. W. 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- ELJve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con. 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 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 exempt under Section B. & P. C. for this reason Date Signature A—' Drivers' License or SS CMF 0865-46 rev. 7/83 . Owner have rea I this application and state that the above comply with all city and county ordinances g construction, and hereby authorize repro. upon // �the above-mentioned /property for /n7 �4Ci�i DZJal- 2 -� TYPE OF CONSTRUCTION LJ NEW LJ ADD LJ ALTERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P. j(6 DESCRIPTION OF WORK S Main Buildi ELECTRICAL • FEES Sewer Connection TYPE OF PERMIT GRADING FOUNDATION STRUCTURAL T Front ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Cooking Unit -- ❑ -OTHER ' A Rear - Dishwasher Meter Clover 100 amps Right PROJECT DESCRIPTION SO. FT.C OCCUPANCY KLeft -' Dryers ❑Gas ❑Electric CONSTRUCTION TYPE VALUATION $ $ Urinal _ ZONE GRADING CU.YDS. ACRES Ping. Ref. + Remarks: Parking Req./Pri / Use of Building: - PLUMBING FEES Planning Notes: Fixtures Microwave 3ackflow Preventer 3ackflow Irrigation 3athtubs Clarifiers Dishwasher Drinking Fountains ' Floor Drains Floor Sinks _ Gas Service .Outlets Interceptors Kitchen Sink - Lavatories P–Trap Roof Drains. - Reinspection Fee $25 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. ICBO # Heating System & Ducting ❑0-100,000_BTU El 100,000 BT Reinspection Fee White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - '$25 0437 10/17/84 Zone Accessory Building: Park.Fees $ 23437 TL O N I N G R E Q U I R E E N T Sernce Sink Sewer Cap _ ELECTRICAL • FEES Sewer Connection Automatic Washer •Construction Pole Sub. Transformer ❑ 15-50 KW ❑ 50+KW Solar Collectors Solar Piping ' - " _ Cooking Unit -- Meter ❑up to 100 amps Solar Tank Dishwasher Meter Clover 100 amps ' Swimming Pool w/Spa' -' Dryers ❑Gas ❑Electric ;Sub Panel Urinal _ Fan _ Motors 00-1 HP 01'6 - 8 Water Closet F.A.U. Inc.Solar 09.15 HP 016.15> Water Heater Fixtures Microwave Water Service Device Boxes Pole Light Outlets Range - - Switches Sign Garbage Disposal Standing Sections Generator 1:105 KW 05.15 KW Trash Compactor Issue Fee $ 3 Reinspection Fee S25 Issue Fee $ 3 1ANICAL FEES PUBLIC SERVICES REQUIREMENTS: Zoning Approved By Date Application Approved By Date Application Issued By � � Det /7 Hood or Type ❑ Canopy Type I I ❑ Refrigeration System - 110.100,000 BTU ❑100,000 BTU SUMMYRY OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK $ ENERGY P.C. $ ELECTRICAL $ GRADING $ /J n®I $ ''// � MICROFILM S PLAN CHECKN-106 MECHANICAL N•vTOTALFEE $ PLAN CHECK - $ 4 3.o System Repair/Alteration • - - ' Issue Fee $ 3 CONSTRUCTION AND PLANNING APPROVALS Permit# Date Inspector POG, & SPA 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 LIFER 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 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 APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping El Gas 0Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O 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 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 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 48. Special Requirements Completed 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 _CONNSSTRUCTION PERMIT 1 Project Address ,e'A /v/�enfr/tIil Applicant's Mailing Address ��,�✓1E(.e% J��//•�� ,Owner's Name 15C06LWr- �' ��✓_ eX•r.2 Address 1517 f9l 591K`ll/Eej 2W 9a?06 Arch/Eng. License No. Address Contractor's Name Phone Address (mailing) City'License No - LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed uhtler provisions of Charter 9 (commencing with section 7000)'of Division 3 of the Business and Professions Code, and my license is in full force and effect. Ucense Class License No. Date Signature WORKERS' COMPENSATION DECLARATION I hereby affirm that 1 have a certificate of consent to self -Insure or a certificate ` Workers' Compensation Insurance, or a certified copy thereof (Section 300, Lab. C.) Policy No. Company 8 Certified copy is.hereby furnished. Certified copy is filed with the city Building Division. Date Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit is for one hundred ($100) or less). I certify that in the performance of thew k for which this p � Nssued shall not mploy any person in any er so as to b o ubjec to t(le Workers' om ratio ws of Calif Date Signature NOTICE: if, after making this tlecla ti ou shout become subject tc the Workers' Compensation provisions of Labor Code, you must forthwith comply with such provi5ion5 or t Permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097 Civ. C.) Lender's Name Lender's Address - - OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the followingreason (Section 7031.5 Business and Professional 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/she is licensed pursuant to the provisions of 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 herefrom and the basis for the alleged exemption. Any violation of Section 0315 by any applicant for a permit subjects the applicant to a civil eryaity of not more than five hundred dollars ($500). 1, as owner of the properly -e6me6w5aEien, will do the work, and the Structure is not intended or offered for sale (Section 7044, Business and Professional Cotle: The Contractor's 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 m eployees, provided that such improvements are not Intended or offered for '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- rove for the purpose of Sale). ' 1, as owner of the -property, am exclusively contracting with licensed con- tractorsto construct the project (Section 7044, Business and Professions Code: The ,Contractor's License Law does not apply to an owner of property who 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 proof of their Worker's Compensation insurance should ��be�p7r�ovided to me. ❑ 1 am exempt under Sect [on .q B. &,ljrq-fo laic reason,' Date 11 I hereby informatio and state sentatives. inspection Signature Drivers' Li CMF 0865-46, Owner ,4 TYPE OF CONSTRUCTION LJ NEWsr��LJ ADD LJ ALTERATION LJ REPAIR El CONVERSION L1 DEMOLISH 9,OTHER DESCRIPTION OF WORK/USEOF BLDG.' ArX/}77Ne7- TYPE OF PERMIT LJ GRADING LJ FOUNDATION L-1 STRUCTURAL ❑ TENANT ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION SQ. FT. OCCUPANCY_ CONSTRUCTION TYPE VALUATION $ ZONE GRRAOINGCU.yDS. ACRES_ Remarks: I� _ ..•. Gp._ ia•s n ...-.e ...n FE A.P. # S Main Buildi E T 6ront B Rear A C Right K S Left Ping. Ref. # Planninq Notes: Zone Accessory Buildinq: _ Z O N I N G R Ig Req./Provided E I Q M T Bar Sink Showers - - ELECTRICAL I FEES Backflow Preventer Service Sink iANICAL _ _ Automatic Washer Transformer ❑ 15-50 KW -r Construction Pole Sub., ❑50+KW Backflow Irrigation Sewer Cap - - Bathtubs Sewer Connection Cooking Unit _ Meter/8-P to 100 amps ' Clarifiers - Solar Collectors _ Dishwasher Meter Dover 100 amps 1 Dishwasher Solar Piping Zoning Approved By Date Building Approved ByDate_/1.=5L'RiL`7� Application Issued By ate ' 11—.29i$k Dryers ❑Gas ❑Electric - Sub Panel ' .8 Drinking Fountains Solar Tank I Fan Motors 1-10-1 -HP 01M. ' Floor Drains Swimming Pool w/Spa F.A.U. Inc. Solar ❑9-15 HP 016.15+ Floor Sinks Urinal Fixtures Microwave Gas Service• Outlets Water Closet Device Boxes Pole -Light Interceptors Water Heater Outlets 1 Range Kitchen Sink - -- Water Service - * Switches Sign - - - Lavatories Auto -Wash Garbage Disposal Standing Sections P—Trap - Laundry Trays Generator 00-5 KW ❑5-15 KW I Trash Compactor Roof Reinspection Fee. 1 $151 Issue Fee I. $ 3 Duct- Under Ground Duct -Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Bit. ICBO # Heating System & Ducting. ❑ 0.100,000 BTU ❑ 100,000 BT Reinspection Fee Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor $15 Reinspection Fee I $15 Issue Fee - $ 3 iANICAL FEES Hood or Tyl5eI ❑ DEVELOPMENT SERVICES REQUIREMENTS: •- Canopy Type 11 ❑ Zoning Approved By Date Building Approved ByDate_/1.=5L'RiL`7� Application Issued By ate ' 11—.29i$k Refrigeration System 00-100,000 BTU ❑100,000 BTUSUMMARY OF FEES BUILDING PERMIT $ SMIP I$ PLAN CHECK $ PERMIT - System Repair/Alteration Fire Dampers PLUMBING $ ISSUANCE $ I PLAN CHECK • 25% $ --�I�— .ENERGY P.C: $ ' ELECTRICAL $t��-/(') GRADING $ - PLAN CHECK '50% $- MICROFILM $ Registers 9 • - MECHANICAL $ TOTALFEE $ v ap Issue Fee $'3 PLAN CHECK - 25% $ - CONSTRUCTION AND PLANNING APPROVALS Permit '# .Date + Inspector I' . POOL & SPA APPROVALS Permit# Date I , 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 APPROVALS Permit # _ 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0Gas 0Oil '. 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank OGas 0Oil 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 /l 80. FOOD CERTIFICATE ISSUED 33. Final Electric 6 - 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 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date i CiCosta Mesa ®� a �51 Developmentent Services Department Building Safety Division CERTIFICATE OF OCCUPANCY No. b P. O. Box 1200 Costa Mesa, California The Building located at 245 Fischer #C1 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group 132 Occupancy. Use of Building 427-038-07 Office Legal Description 427-038-07 reverse side for Metes and Bounds) Building Permit No G13829 Electrical Permit No. G13829 Plumbing Permit No, G13829 Mechanical Permit No. G13829,M15630 Number of apartments /0// and/or guest rooms 0 ISSUED TO: Building Official Pull.izn Properties —. by 1517 North Fairview road, SaintanAna, CA Date This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 lel U.B.C. CMF 1015-46 rev. 1/93 White - Owner; Canary - Numerical File; Pink - Bldg. Permit File City of Costa Mesa 1 Development Services Department CERTIFICATE OF OCCUPANCY No. Building Safety Division 000139 P. O. Box 1200 Costa Mesa, California The Building located at 245 Fischel Avenue OC -1 - has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group R—? Occupancy. Use of Building Tntarinr Alt•crAtJong — Off3cp Legal Description d27—nl I-5826 (See reverse side for Metes and Bounds) BPE-4"g2 BPE-452 BPE-4552 Building Permit No BEE 8J2 Electrical Permit No. BEP -48 3 Plumbing Permit No. —4843 nf_F174. D"554, F-4413 _B_ F-5374 Mechanical Permit No. Number of apartments and/or guest rooms ISSUED TO: Pulliam Properties Building Official by 1517 Fairview, Santa Ana, CA Date !//�e�l/Lc�( /'�7 f � This Certificate of Occupancy SHALL BE posted in a conspicuous place on th4 premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. CMF 1015.46 rev. 1183 white - Owner; Canary, Numerical File; Pink - Bldg. Permit File Applicant to fill in all spaced itnin heavy border lines and sign all appropriate declarations. !• CIV OF (STA MESA - PERMIT NO. TRACT NO. LOT NO. BLDG. NO. - - - - '' c ' STRUCTION PERMIT B.PE y s L3 G—� TYPE OF CONSTRUCTION ❑ NEW ❑ ADD ❑ ALTERATION ❑REPAIR ❑CONVERSION ❑DEMOLISH v./ 77B0- 9/1-67B2 245.50 + Project Address S Owner Phone •6Z2' Address OTHER - ZONING REGULATIONS Arch/Eng. License No.-- 1)0 DESCRIPTION OF WORKONE - - TYPE OF PERMIT "- - - (] GRADING ❑FOUNDATIIO�N El STRUCTURAL ASCI TENANT ELECTRICAL IbIP LUM13ING ❑MECHANICA A _ Z PLN F. - B - - a� BUILDING - SETBACK T. OPERTY LINE S! YARD • Address ---' - - - - Contractor Phone- Address '-- - -' - LICENSED -CONTRACTOR DECLARATION. _ I hereby affirm I am licensed under provisions of Charter 9 (com- (((�A_ � ' ` thLt W114 HT men ting with section .7000) of Division 3 of the Business and ❑ OTHER _ Professions Code, and my license Is In full force and effect. REAR YARD (TO P/L) PROJECT DESCRIPTION License Class - � License No. _ y - SO: FT. - - ON TVP �er� JJ. 216 PKG. SPACE REO. PROVIDED - STREET WIDTH -- PARK FEE $ -$• Date - - Signature' - - -- '- WORKERS' COMPENSATION DECLARATION OCCUPANCY CONSTR VCTI ZONING -APPROVED BY DATE -• ')S - I hereby affirm that I have a certificate of consent to self -Insure or a VAL'VATION ZONE - - certificate of Workers' Compensation Insurance, or -a certified .copy SPECIAL CONDITIONS: -' thereof (Section 3800, lab. C.). GRADING CU. YDS. ACRES -•tics No. - _,__ .: ___ Company Certified copy -is hereby.turnished. _. .. _ _ l REMARKS: _" _ _, _ _ -., -- _ -_ _ _ _ _ - '' - . _ _• . {{Certified copy is filed with the city Building Division. ,-EJ EMPTION FROM WORKERS' COMPENSATION DECLARATION /• ((This section -need not be completed if the permit Is for one hundred (E300) or less). ( I certify that in th_e performance of the work for which this permit is Issued, I shall not employ any pe S m manner,$o aj to becog�e PLUMBING I•-,� , - _ PLAN CHECK - - 'ELECTRICAL '-"" PLAN CHECK - -_ sabject]gtlSexWQ7r,.k'ers/ComPensaLawk of CaJ`L�({Xa /) _ _. BATHTUBS SHOWERS-' _ .. - _ _- -_ Date C�,f 1/ �- (/ -/{)�`(-..J�Signature Sw/L—\61' NOTICE: I after making this declaration, you she ultl become sbject TOILETS - URINALS '- - - -GENERATOR '0;1 KW— 1-10 KW' RAN to the Workers' Compensation provisions of the lvbor Code, you must forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS' T SFORMER- -,APPLIANCE 30-50 KW -50 +. KW- - - revoked.-. - CONSTRUCTION 'KIT. SINKS - - DISHWASHERS - -IMOTORS - 0-1 HP HP - LENDING AGENCY -1-10 +_ rl hereby affirm that there is a construction lending agency for the per. _ _ SERVICE SINKS SUMPS-' _ _ _i(INC. SOLAR) -10-50 HP 50 + HP." _ , •formance of the work for,which.this permit-is'issued.,(Section_ 3097 - FL'OOR $INKS-- FLOG R'DRAINS'' - "� •- TLETS SWITCHES FIXTVRES - - Civ. 'C. -- -' - - - " •- - - - - - Lender's Name�OU Lender's Address - -DRINKING FOUNTAINS j'-' - .GAS TUBE -SIGNS t- - 'INTERCEPTORS CLARIFIERS r- -•'jPOLELIGHTS --- - - - - — OWNER BUILDER DECLARATION - - ---- - hereby affirm that I am exempt_from the Contractor's License Law for SWIMMING POOL " P TRAP UU - _ POLES ' METERED SUB the following -reason (Section 7031:5 Business and -Professions Code: Any city or county which requires a permit to construct, alter, WATER SERVICE ALTERATION' 'PANELS - MAIN - SUB - Improve, demolish -or repair any structure,- prior to its issuance, also re- quires the ap.licant for such permit to file a Signed statement that he SERVICE - OUTLETS-' - - - }SERVICE - -- - - - - AMP - -- - Islicensedpursuant,to the provisions of the Contractor's -License Law 1Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATER- BTU OUTPUT EG'AS Business and Professions Code) -or -that -he is exempt therefrom and the ',tis for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS' '---� -- - - - -• - •'•- - - applicant for a -permit subjects the applicant to -a civil penalty 'of more than five hundred dollars ($500). SOLAR TANK -- COLLECTORS' - - - - -- -' - -- - - - .� I' as owner -of the properly, or'my employees with'wages as'their' Sole compensation, will do the work, and the structure is not Intended or offered for sale. (Section'7044, Business and Professions Code: The SOLAR PIPING -SVS.--` - - -'- - - ' - -ISSUE FEEwho License Law not apply owner of a property ISSUE FEE - - __ . y _ _ _ _. -^7 J APPLICATION APPROVED BY �p DATE ---' eyes _to es who builtls or improves thereon, and who does such work himself or builds through his own employees, sale, prohovve that such Improvements are not ntende offered for sale. If, however, the improvement intended ill MECHANICAL PLAN CHECK SUMMARY OF FEES owner have sold within one year of completion, the Owner will have chef within - sale) of proving he tlitl not build Or improve for the 'purpose of edl¢). o - - - - HEATISYSTEM 0-100,0008TV - BUILDING - - iPERM1T S 134�so r .Erp p p y, .am exclusively contracting with. -has-owner-of. the ro ert Scontractors to construct the project (Section 7044, Business AND DUCTING _ - - AND DUCTING 100,000+BTU „SMTP &9r��- PERMIT antl Professions -Cotle:-The Contractor's License Law.does not apply.to improves thereon, REFRIGERATION 0-100,000 PLAN CHECK b—®.1 t.i- _ __ GB. ISSUANCE -' 'i �PLUMBI NG an owner of property who builds or and who con- tracts from. such projects with a -contractors) licesned pursuant -to BTU SYSTEM _ _ $ ..1; - _ - _ - �GRliDING,- $ the Contractor's License Law). ❑' - -7O¢¢. - B"& P. C. for 100,000,+ BTU r _ _ 'PLANCHECK $ - I am exempt under Sec on this BOILERS BTU ELECTRICAL $ - reason- /2IAA-19 i - SYSTEM REPAIR, ALTERATION MICROFILM S .PLAN CHECK -E Owner _' Date _ EXHAUST SYSTEM MULTIPLE TOTAL FEE $ ,MECHANICAL E' - -$' LE55AD- t a, 1 hereby per ifs that I have read this application and slate that the abC Information is correct. I -agree [o complystru with all county _ PLAN CHECK VANCE PC $.' hereby a ordinances and state laws relating ro construction, and hereby authorize ' I representali o ii Ct o entyf�uPon the above mentioned property f ns on os�. - S� % , .O 2 FINAL FEE $ �'• Signature �✓ Date�.19-4 - Drivers' License or SS ISSUE FEE CMF 0865-46 Wnite-Building; Canary -Applicant; Pink-ACCOunting; Goldemod-Assessor TL CONSTRUCTION AND PLANNING APPROVALS Permit # t3P£ yY�Y Date Inspector POOL & SPA APPROVALS Permit # Date Inspector - 1. Temporary Electrical Service or Pole _ 43. Pool & Equipment Location 2. SoilPipe-Un rgm - ' 44.. Steel -Reinforcement - - - - - - • - 3. Electrical Conduit Utility-Undrgrn.. 45. Forms - - .. 4. Electrical Conduit-Undrgrn 46. Electrical Bonding - - - - - 5._ -Steel ein orce _ _ _ _ _ 47. Rough Plumbing & Pressure Test - - - . 6. Electrical UFER Grn _ _ - - - 48. APPROVAL TO COVER-GUNITE - - - 7. - Footings 49. Electrical Conduit-Undr rn' r- 8. Foundation-. - .- 50. GasPipe, O Undr rn, Test ' 9. -Water Pipe-Undrgrn 51. Backwash Lines P-Tra •❑ Uncrqrn 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 13. Rough.Plumbing_.-_ '" - - 14. Rough Electric -Conduit - _ --�- . 56:.. Electrical -Final . •i 15. Rough Electric -Wiring - 57.' _Solar'System-Final 16. Rough Heating & Air Conditioning- - _ -- =- - - - -- . _ encing & Access' Approval 17. Ducts; in -Structure- - •_ _ _ APPROVED FOR PLASTERING 18. Ducts, Ventilating - ._ _ - - _ 60. -POOL/SPA - SYSTEMS FINAL 19. Gas Pipe -Rough &Test "+ = 20.-Roof,Framin9 21. Roof Sheathing- NOTES: 11_ I• iA _ o _ - 22. Frame and Flashing - - - - - 'p- ''-_ _ _ 23. Insulation - - •- - -- - -I - -- - 24. Lathing & Siding 25. Drywall Nailing 3ge21n- - - - - 26. Plaster Brown Coat 27. Electrical Power Meter -Final - - - 28. Final Electric 29. Final Heating & Air Conditioning - -- • - - - - -- - - - 30. Final Gas Pipe -Test - • - - - • ' 31. Final Plumbing - ---- - r. 32. Water Service -Final 33. Gas Service -Final - - - - 34. Solar Domestic -Final �'° '• 35. Landscape Sprinkling System - 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE &-BUILDING - (�.,Z!_q,t (j _ 39. Special Requirements Completed 40. Electric Release to Edison - 41. Gas Release to Southern California Gas Go. 42. CERTIFICATE OF OCCUPANCY No Date - - - - - of Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. CITY W. COSTA MESA P MIT NO. �. TRACT NO. LOT NO. BLDG. NO. coNSTRUCTION PERMIT " 1:5-1 51 _1 —f Project Address 245 Fi Scher Ste. C-1 TYPE OF CONSTRUCTION _ Owner •(ps Phone 0 NEW -2 ADD 0 ALTERATION ' Address;1517 N. Fairview Santa Ana 0 REPAIR 0 CONVERSION 13 DEMOLISH Arch/Eng, n/A License No. 0 OTHER 1 Address •-jNIERe0tdRS CLARIFIERS- ` Contractor- 'r Cond. Phone 528-82 TYPE OF PERMIT -�t1 0 GRADING O FOUNDATION ❑ STRUC URAL O TENANT!O ELECTRICAL PLUMBINs CHANU O 'Address.11fiq r -' LICENSED CONTRACTOR. DECLARATION--. �I hereby affirm lhLt I am licensed under provisions of Charter 9,(com- usiness. and Professions Code) or that he Is dxompt-therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by mencing with. section 7000) of Division 3 of the. Business and 0 OTHER, - Professions Code, and MY license is In full force and effect. r License 51 s - Lic No: PROJECT DESCRIPTION - - - Date' -+" Sigdature- SO. FT. _ WORKERS'_COMPENSATION DECLARATION V- rOCCVPANCY_ CONSTR UCT ION TYPE_ I hereby affirm that I have a certificate of consent to self -Insure or a VALUATION ZONE certificate. of -Workers' Compensation Insurance, or a certified copy _ thereof (Section 3800, Lab. C.).1 Goodman Ins. GRA DINGrC U. YDS. ACRES rnlicy No. GOG -Company _ - Certified copy is hereby furnished. _ -REMARKS: -- - - Cert ifietl copy is filed withthe city Building Division. - - - - 72 - EXEMPTION -FROM WORKERS' COMPENSATION DECLARATION (This section need not be com_ pletid if the permit is for one hundred - - 1$100'othatsln - - -- - -- - E• - - certify the of the work for which this Permit is 'PLUMBING - - PLAN CHELSKS`-\„ ' ,performance issued, I shall not'emptoy any person in any manner so as to become subject to the Workers' Compensation Laws of California. - a. -BATHTUBS -' SHOWERS Date Signature - NOTICE: If after making this declaration, you Should become subject TOILETS s ....URINALS - - - to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS - revoked. I "KIT. SINKS - --- DISHWASHERS - _ CONSTRUCTION LENDING AGENCY - - 1 hereby affirm that there IS a construction lending agency for the per- SERVICE SINKS SUMPS - - - formance of the work for which this permit Is Issued (Section 3097 n-. 1� FLOOR SINKS -"; FLOOR-ORAINS" -- ' •`s - Civ. G).-. _ --'--' - -"- - - Lender'slName, -�v - - _ L-eoder'sAdtlress �e•S .S 4> �� -- - DRINKING FOUNTAINS'' -'.i- "--- '- O'WNERrBUIC15ERDECLAR'AiWN��`•V� �� :S �'�� `••1\ 1 hereby affirm that I amexampt from the -Contractor's License Law for the following reason (Section 7031:5 Buiiness• and.PrOtesslons Codo ` ,Any. city oL. county, whICh,requiryyS a per mitr.•to. construct, alter, improve'.demolish ocrepai7 any strutlbreiprlOr to Its issuance, aim re--' quires the ap:licant for such permit to file a signed statement that he •-jNIERe0tdRS CLARIFIERS- ` -SWIMMINGO POttIlLY =' P TRAP - - .- C ♦.i .Y- WATER-SERVICli ALTERATION ' is licensed Pursuant to the provisions of the -Contractor's License Law 2(Chapter 9 (commencing . with Section 7000) of Division 3 of the GAS SERVICE �< OUTLETS ' ' WATER HEATERS BTU OUTPUT usiness. and Professions Code) or that he Is dxompt-therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by -SEWER CONNECTIONS - - - applicant -for -a permit subjects the applicant.to-a Civil. penalty :ot more than five hundred dollars ($500). SOLAR TANK - - COLLECTORS ' r-.as'owner of the property, ormyemployees with wages as•thetr sole compensation, Will do the work, and the structure is not Intended or offered'for Sale. ISection 7044, Business and Professions Code: The SOLAR PIPING'SYS.' 'Conlraclor's License Law does not apply to an owner Of a property ISSUE FEE-` '- - - - " Who -builds -or -Improves thereon, and who -does Such work•hlmself or through his own employees, provided that such Improvements are not (Mended or offered for safe. 11, however, the building or Improvement is sold within one year of completion, the owner will have the burden of -proving he did not build or Improve for the purpose of Sale).' ❑,I,., as -owner _of lh<_prpperty, dm exclusively .contracting with licensed contractors to construct the project (Section 7044, Business and. Professions Code: The Contractor's License Law. does not apply to an owner of property who builds or Improves thereon, and who con- tracts. from such.projects with a contractor(S) licesned pursuant -lo. the Contractor's License LaW)- MECHANICAL PLAN CHECK HEATING SYSTEM 0-100,000 BTU ' ANDDUCTING- I - 100,000)+ BTV REFRIGERATION 0-100,000 BTU SYSTEM 100,000 + BTU I am exempt under Section B. d P.•C. for this BOILERS BTVDate�easo- Owner SYSTEM REPAI R, ALTERATIONI hereby certify that I have read this application antl state that the above EXHA ST SV M MULTIPLE %13 intormation-is-correct. 1 agree to comply withallcity antlcountyordinances - 1 and state lawn rela Ing to construction, antl hereby authorizerepresentatives 1 -this Cies to enter upon the above m<n[ionedpropertyfor Lon pu Date 1J•Drivers' License or SS ISSUEFEE_ Ine CMF 0865-46 White -Building; Canary -Applicant? Pink -Accounting; Goldenrod -Assessor ZONING REGULATIONS ' A81 9P. ZONE ' i PLNG. REF. # REAR YARD (TO P/L) PKG. SPACE'REO. PROVIDED r STREET WIDTH - - PARK FEES' ZONING APPROVED BY I DATE' ' SPECIAL CONDITIONS: - - es 'I ELECTRICAL' '- -'PLAN CHECK77 - aUWLLL.NG_. GENERATOR 0-1 KW— 1=10 KW TRANSFORMER APPLIANCE 30.50 KW_50+ KW MOTORS 0-1 HP-_1-10'HP - (INC..SOLAR) --10-50.Hp-_-- 50+HP - - 'FIXTURES-- 'OUTLETS - SWITCHES 7- GAS TUBE SIGNS -- - -- - - - - 1 -,POLE LIGHTS POLES -METERED SUB-, PANELS- 'MAIN - -SUB - - SERVICE-- - - - AMP ISSUE FEE- -APPLICATION APPROVED BY - - -DATE - SUMMARY OF FEES I BUILDING— - - PERMIT E I.•SMIPI 1 -- PLAN CHECK $ PERMIT --- - ISSUANCE $ ti PWMBING E -PLAN NG GRADING E' rCHECK E R, _. 'ELECTRICAL $ - -$ _ y r' "-'MICROFILM $ •• '� �`• - - $- PLAN CHECK' _ MECHANICAL' $ TOTAL FEE $ ' -E PLAN CHECK - - LESS AD-. VANCEPC FINAL FEE $ CONSTRUCTION AND PLANNING��-•••�� ,..,, APPROVALS Permit # _adz2L_ � POOL & SPA - Date Inspector APPROVALS Permit # Date Inspector `+ 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - 2. SoilPipe-Undrgrn 44. Steel Reinforcement " 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel Reinforce 47. Rough Plumbing & Pressure Test - - - 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE - - - 7. Footings 49. Electrical Conduit-Undr rn ' B. Foundation. 50. -Gas Pipe, ❑ Undr rn, Test ' 9. Water.Pipe-Undrgrn 51. Backwash Lines P-Tra • ❑ Undrqrn - 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' - 13. _Rough Plumbing -" 14. Rough Electric-Conduit •- 156. Electrical-Final 15. Rough Electric-Wiring - - • - 57. Solar System-Final - 16. Rough HeatinQ & Air Conditioning encing & Access Approval 17. Ducts in Structure - - _ APPROVED FORYLASTERING - 18: 19. 20. "Ducts, Ventilating " Gas Pipe-Rough & Test - Roof Framing - -_ "60. POOL/SPA SYSTEMS FINAL' 21. 22: Roof Sheathing- Frame and Flashing - - -- - NOTES: 23. Insulation - - - - jp--/® =!O' JErYO"LE' 24. Lathing & Siding "" - - -PZATe-3 7, 25. Drywall Nailing - T ` 26. Plaster Brown Coat ACSO V,9 .v 27. Electrical Power Meter-Final- - - - 26. 29. Final Electric -- - Final Heating & Air Conditioning - 7-••gL 30. Final GasPipe-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. FINAL STRUCTURE & BUILDING ' 39. Special Requirements Completed .40. Electric Release to Edison �11 ' 41. Gas Release to Southern California Gas Co. - 42: CERTIFICATE OF OCCUPANCY No Date f'` r :, 1 '•p.t (1V e Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. ' CITY OF COSTA MESA PERMIT NO. • TRACT NO. LOT NO., BLDG: N0- - 9817 10i2T/d2 , �54.p2 �CONSTRUCTION PERMIT , %{_�' TYPE OF CONSTRUCTION 1 ❑NEW ADD ❑ ALTERATION I_ C ❑.REPAIR ❑CONVERSION ❑DEMOLISH GV ❑OTHER , ! r, - - ZONING REGULATIONS Project Address � s OGJa (Owner (�• T• Phone' - -Address - - I Arch/Eng. License No. DESC RIPTION OF WORK - A P � - - - ZONE' - - PLNG. REP. 9F - .Address _- - •Contractor Phone �_ .CO - - - TYPE OF PERMIT �, - GRADING �� FOCIN DATION ❑STRUCTURAL -O TENANT❑ ELECTRICAL! OPLUMBING ❑MECHANIC SETBACKARD T_ _ - I ING XRt 016 , - - Y LINE Address - -✓B LICENSED -CONTRACTOR DECLARATION - I heaffirm that I dm Iicensetl under provisions of Charter 9 (com- 'with 7000) 3 - s ., + _ ,, 0 9I V RIGHT - mendng section• of Division of the Business and Professions CO and my license Is In full force and effect. OTHER - - REAR YARD (TO P/L) License Class r�L _ y License No. PRO JECT-DESCRIPTION. "' -' -" - - SQ. FT' .: �. — _ _ !_._ '. PKG: SPACE -REQ. - - -PROVIDED - - ��'/Y/ �:Z'i ' �^^Ov 7Q�0-6 Date Signature _ - _ _ _ .. STREET WIDTH` _ _ "PARK FEE $ - 'WORKERS' COMPENSATION DECLARATION- - OCCVPAIVCy_ CONSTRUCTION TYPE I hereby affirm that I have a certificate of consent to self -insure or a e0 VALUATION�SL(� ZONE ZONING APPROVED'BV - - DATE - certificate' of -Workers'' Compensation Insurance, or -a erUfled copy 5) 'thereof (Section 8 0 ). - I icy N�.��ComPany- %��L5:S �a10. GRADING CU. -YDS. ACRES _ _ -. _ _1 .SPECIAL- CONDITIONS: Certified copy.is hereby furnished. _ _ _ _ - _ __ _ .. seee.._. REMARKS:_ L. copy is,filed with the city Building Division. -- -A�ertlfietl EXEMPTION -FROM WORKERS -COMPENSATION DECLARATION (This section need not be completed,i/ the Permit IS for- one. hundred '_: s 1. - _ ��• ($100) or less). ( --, - - I certifythat in.theperformance of the work for which this permit is Issued, I shall not employ any person in any manner So as to become PLUMBING f PLAN"CHECK" -'-' VSHOWERS SELECT RICAL ' - - PLAN CHECK-- - - subject tothe .WorkerSLCompeniation Laws of -California.'__-: -. BATHTUBS -• -'-" '" - "' - -'-'-- -' _ 'Date Signature t NOTICE: If after making this declaration, you Should become subject gTOILETS-y URINALS' -'-' - -- - - 1GENERATOR- - 01 KW_ _ 1:10 KW - .to the Workers' Compensation provisions of the Labor Code. -You must TRANSFORMER .. ,pr „--i * forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBL•E'L•AVS -- - - -'IAPPLIANCE'`-- 10-50 KW_ 50+-KW- rONSTRUCi _t.___'KIT. -CONSTRUCTION LENDING AGENCY - SINKS' ""-"DISHWASHERS- --'•7- - � 'MOTORS '0-1 HP_1-30 HP=- I hereby affirm that there is a constructionagency for n per. SERVICE SINKS•^ !SUMPS --'-� -"'� �• - -- SOLAR) 30.50.HP 50 + HP" " :formance of the work for which this It Is , ( ' ,(INC. FLOOR'SINKS-` -'FLOORDRAINS` -"'^ 'FIXTURES —OUTLETS 'SW ... ._ ITCHES -�-------_ - iCiv. C.).- �_.. _. -.... _- _..._- -_. .. 1 (Lentler's Name _ ,Lender's Address •DRINKING FOUNTAINS -•��- '-' •- - GASTUSE SIGNS--- - ---- --- - - - -- - INTERCEPTORS' CLARIFIERS ^-^ �-- POLE -LIGHTS - -^ -- --- - - OWNER BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for the following-reasow(Section• 7 03 1.5 Business and -Professions Cotler SWIMMING POOL '-` -P-TRAP" -"`-'�•''.' tPOLES METERED UB---'- - - _ Any city or county which requires a permit to construct, alter, Improve; demolish or'repalr any structure, prior to Its issuance, -also re-- WATER SERVICE --ALTERATION- _ ' - !PANELS - - MAIN - - -'SUB- - -- quires the ap, Ilcant for such permit to file a signed statement that he - GAS SERVICE bUTLETs"',SERVICE - •- - -- - - 'AMP - Is licensed ' pursuant to'the provisions of -the Contractor's -License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS- BTU OUTPUT - - — - - --- -�- - --- - _ _ Business antl' Pro/essions-Code) or that he Is exempt therefrom and the- `__+FIs for the allegotl exemption. Any violation of Section 7031.5 by 1 SEWER CONNECTIONS •-' - -`- -- 1 - -- 1 - - -•---- ---- - - --- - ....... --- applicant for a permit subjects -the -applicant -to' a-clvll penally ."hot more than five hundred dollars ($500). ' SOLAR TANK - "COLLECTORS - --- - - - -- -- - - - L, 1, as owrier of'the property, or my employees with wages as lhelr- sole.compensallOn, will do.the work, and the structure Is not Intended or offered for sale. (Section 7044, Business and Professions Code: The _ SOLAR PIPING SVS. - -"" ' - "' - ISSUE FEE - - '- - -• - - -• - Contractor's .License Law does. not apply, to an owner. of a property. _ } _ - - 'ISSUE'FEE - --' --- -' APPLICATION APPROVED BY - b -x7- DATE/" 'ca .'wh0 bulids or improves thereon, and who does Such work Himself or through.his. Own employees, provided that such Improvements are not _ _ MECHANICAL PLAN CHECK - SUMMARY OF FEESr _ 1 Intended or offered for sale. If, however, the bus Idling or improvement IS sold within one-year Of completion, the owner will have the burden ne improve for the of - - -- -' - - BUILDING r„, of proving did not build or purpose Sale). ❑-I, as owner of -the property, -am -exclusively rt contracting with p Y.-dmroject HEATING SYSTEM 0_100,000 BTU AND DUCTING- - - - - ,'.gyp �r�� --_ -- f� jPERMI1 f ,3� - SMIP - the project (Section Business licensed contractors construct (Section 100,000 +BTU � PLAN CHECK f aS.1T �s PERMIT - : heContractor's es not Code: The Contractor's License Law does not apply to andowner -ISSUANCE of p or Improves thereon, and who con- owner property who a REFRIGERATION 0-100,000 BTU 'PLV MBING E I tr - with a ,the Conrom-such with a cont ractor(s) Ilcasno0 -pursuant to -SYSTEM - - - - - - - _ _ _ GRADING�••$f •; the Contractor's License Law). scene La 100,000+BTU , PLAN CHECK - - 0 1 am exempt under'Section '- -- B. 6 P. C. for this BOILERS BTU ,'ELECTRICAL IS •- -' -$ - reason'- -- - - - _ _ SYSTEM REPAIR, ALTERATION - PLAN CHECK-$ MECHANICAL -f � '•MICROFILM$ - TOTAL 'FEE $ r' - Date Owner _ r .I hereby Certify that Icorre have read this application and state [hal the above EXHAUST SYSTEM MULTIPLE I LESS'AD-_ is correct. I agree to comply with all hereby tluthori y 'PLAN CHECK E - $-- - VANCE PC- $- ' ordinances ordinances antl state laws relating to ruction, and hereby authorize .. - Y ter representatives of this city to anter upon the above mentioned ( - - i _•' property for i edign.p po s. -_ Signature � - Date., I - ISSUE FEE _ FINAL FEE $ a - CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor 'TL CONSTRUCTION AND PLANNING APPROVALS Permit # F S3lHS3lH Date Inspector POOL & SPA - - - APPROVALS_ _ Permit # Date Inspector 1. Temporary Electrical Service or Pole _ - 43. Pool & Equipment Location2.. Soil Soi ipe-Un rgrn - 44. Steel Reinforcement - - - - ' -3. -Electrical Conduit Utility-Undrgrn'. '. 45. Forms - - 4.. Electrical Conduit-Undrgrn _ .46. Electrical Bonding - - - 5. -_Steel Reinforce " _ _ 47. Rough Plumbi66 & Pressure Test 6- Electrical UFER Grn _ _ 48. APPROVAL TO COVER-GUNITE - - r 7. -Footings _ _ 49. Electrical Conduit•Undr rn + 8. - Foundation-- - - - 50-:.; Gas Pipe, 0 Undr rn, Test L- 9. Water Pipe-Undrgro._ _ - 51. Backwash Lines P -Trap_ -D" ndr r -' "- - 10. Structural Floor.System _ 52.. APPROVALTO DECK - - - - 11. Property Sewer Line &.House Connection.--. 53. Backwash & Receptor -Final -12. Street Sewer Connection- -_-- 54. Heater & Vent -Final '. 13.- Rough Plumbi ng- _ _ - -- _ - -"'- - '- 14. Rough Electric-Conduitf - -- -- -- - 56. -Electrical-Final 15. Rou h Electric -Wiring '-- - - " - 57. Solar System -Final" - 16. -Rough Heating &-Air Conditioning -- - - - - --- encing & Access Approval ' 176• Ducts -in Structure- APPROVED FOR PLASTERING - 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL ; •' .,j` 19. Gas pipe -Rough &Test• - - _ -- 20.- Roof Framing - - -- - -- - -- - 21. Roof Sheathing- _ - _ - '-. _ ..r - -tt i.r• :. NOTES: - 22.- Frame and Flashing - _ _ 23. Insulation- 24. Lathing & Siding - - - • - - - - = _ y -- - - -•- - 3 - 25: - Drywall Nailing - - - - " - • / 26. Plaster Brown Coat- - - -- - - 27: -Electrical Power Meter -Final - - - - -- - -- - - -- - - 28: Final', Electric -- - - -- - : - ' 29. -Final Heating & Air Conditioning - - - -- - - - - - - --- _ " ' - - - - 30. Final Gas Pipe -Test - - --- -� - - - 31'. Final,Plumbing 3 32. Water Service -Final - - -- - - - - ' , 33. Gas Service -Final 34. Solar Domestic' -Final __ • ' • •+' , + 35. Landscape Sprinkling System 36. Sound Attenuation - 37. Handicap Regulations I 38. FINAL STRUCTURE & BUILDING 39. Special, Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date rApplicant to fill In all spaces within heavy border lines and sign an ..�_-� rte •C13; OF COSTA MESA PEJyIT NO. TRACT NO. ,,LOT NO. BLDG. NO. rONSTRUCTION PERMIT ' I Gr TYPE OF CONSTRUCTION ❑ ❑ � t. _. 7 �I5I6 c �2/I]/Bre. �� Qjt e Project Address _ /' % Owner Phon XL ` 2 ,$ NEW ADD ALTERATION -❑ REPAIR 11 CPVVERSION ❑DEMOLISH v - 1:1OTHER0SAeTZo ZONING REGULATIONS "Arch/Eng.'License No. - DESCRIPTION OF WORK - A.P. 9P ZONE PLNG. REP. 4' Address - Contracto`66 f,'• �,��5-v�rN Phone TYPE OF PERMIT ❑ GRADING ❑ FOV NDATIO ❑STRUCTURAL ❑ TENANT ❑ ELECTRICAL LUMBING EIMECHANICAL •' N SETBACK C L ST. LIDE YARD FT wAt VAR ��P I .D\IJ•IGNE Address - LICENSED CONTRACTOR DECLARATION - that I licensed Charter 9 I hereby affirm am under provisions of (com- -me section 7000) Division 3 of the Business ❑OTHER RIGHT ncing with of and Professions Code, and my license Is In full force and effect. REAR YARD (TO P/L) PROJECT DESCRIPTION - - - Li cense Class yh cense ♦ice?� PKG.SPACE•REO. PROVIDED - OaleZ2 •/ G Signature - SQ. FT. - WORKERS' COMPENSATION D RA'fi�N - OCCUPANCV_CO NSTRUCTION TYPE STREET WIDTH PARK FEE E ' I hereby affirm that 1 have a ce flt consent to self -Insure or VALUATION ZONE ZONING APPROVED BY DATE certificate of Workers' Compensatlo nsurance, or a certified copy - thereof (Section 3800, Lab. C.). GRADING CU. YDS. ACRES SPECIAL CONDITIONS: policy No. Company -' J Certified copy is hereby furnished. -- REMARKS: Ss J 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 _ - ($300) Or Ie551. ' 1 cert((fy that n the performance of the work for which thi permit is issued, I shall not employ any person in any nner so o become PLUMBING PLAN CHECK " ELECTRICAL "PLAN CHECK subject to thee Workers Compensation Lawb Iiforn" BATHTUBS SHOWERS SUO- - Dat¢'-�`�Ignatura' NOTICE: If after making this d tion hould become subject iTOILETS URINALS GENERATOR 0-1 KW_ 1-10 KW - to the Workers' Compensation Islon he Labor Code, you must TRANSFORMER forthwith comply with such p ovl5lons his permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE 30-50-KW_50+KW revoked. -- - - - - -�. CONSTRUCTION LENDING AGENCY - KIT. SINKS DISHWASHERS - MOTORS 0-1 HP_- 1-10 HP' - - I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS. SUMPS - - - - (INC. SOLAR) 10-50 HP 50 + HP - formance of the work for which this permit I5 Issued (Section 3097 - FLOOR SINKS FLOOR DRAINS 1 - -'FIXTURES - OUTLETS SWITCHES ' Civ. C.): "- - -' ---- Lender'; Name Lender's Address DRINKING FOUNTAINS - L • - -- '- GAS'TUBE SIGNS -- - INTERCEPTORS CLARIFIERS - - POLE LIGHTS' OWNER'BUILDER'DECLARATION '"� -' •--- herebyy affirm that I am exempt from the Contractor's License Law for -SWIMMING POOL PTRAP "'" POLES METERED'- SUB: - ' 'the'following reason"(Section 7031:5 Business and Professions Coder Any city or county, which requires a permit to construct, alter, improve, demolish or repair any structure, priortoIts'Issuance,'also re- -WATER SERVICE -ALTERATION PANELS "" '-MAIN' SUB' - quires the applicant for such permit to file a signed statement that he GAS SERVICE OUTLETS- '"SERVICE -'" - - AMP - - - 'is" I ieensed-pursuant to'lhe provisions of -the Contractor's License Law- (Chapter 9 (commencing with Section 7000) Of Division 3 of the WATER HEATERS ''BTU OUTPUT' - 'Business and Professions Code) or that he -is exempt therefrom and the basis for the alleged exemption. Any violation Of Section 7031.5 by SEWER CONNECTIONS -• - - _ '" - _ -- - „ ,y applicant for a permit subjects the applicant to a civil -penalty not more than five hundred dollars ($500). SOLAR TANK - -'74COLLECTORS, . I, as owner of the property, or my employees with wages is their sole compensation, will do the work, and the structure is not intended. _�• or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SVS. O - ISSUE FEE - '- - .Contractor's License Law does not apply to an .owner of a property_ who builds or improves thereon, and who does Such work himself or ... ISSUE FEE -APPLICATION APPROVED BY DATE')J through his own employees, provided that such Improvements are not, MECHANICAL PLAN CHECK SUMMARY, OF FEES intended or offered for sale. If, however, the building or improvement i5 sold.within one year of completion, the owner will -have the burden of proving he did not build or Improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU - 'BUILDING PERMIT $ $ ❑ I, as owner of the property, am exclusively contracting with AND DUCTING .SMIP licensed contractors to construct the project (Section 7044, Business 100,000 +BTU PLAN CHECK $ PERMIT and Professions Coder -The Contractor's License Law does not apply 4o -- - 'ISSUANCE $ 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) Iloesned-pursuant to SYSTEM- - - - - - - - - GRADING '$ ' the Contractor's License Law). 100,000 +BTU PLAN CHECK - $ ❑ 1 am exempt under section* - • B.& P. C. fo9this BOILERS BTU ELECTRICAL $ E reason ^ - SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE PLAN CHECK' $ - MECHANICAL $ MICROFILM E' TOTAL FEE $ - - - LESS AD - AD - Date �� -�G v+wner "I 1 hereby certify that 1 have read this ap ication and, state that the above information is correct. I agree to omply with all city and county - PLAN CHECK 5 'VANCE PC S t and state d6 to c upon t and hereby authorize representatives City to 4epresentati ves of t Is city to a upon the above mentioned '- property, r i -I n urpos /Z�/ - FINAL FEE S CC Signature •�� Dare " _ _ _ _ Drivers' se 5 - . . ' ISSUE FEE • - - - - - - - - - -• - CMF 0865-46 ✓White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor :A CONSTRUCTION AND PLANNING APPROVALS Permit # r Jr Date Inspector POOL & SPA APPROVALS Permit #� Date Inspector \� 1. Temporary Electrical Service or Pole 43. .Pool & Equipment Location -- 2. SoilPipe-Undrgrn - 44. Steel Reinforcement - - - - 3.. Electrical Conduit Utility-Undrgrn 45. Forms - - .4. Electrical Conduit-Undrgrn 46. Electrical Bonding' 5. Steel em orce 47. Rough Plumbing & Pressure Test - _ 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. - Gas Pipe,. ❑ Undr rn, Test 9. Water Pipe-Undrgrn- _ 51. Backwash Lines P-Trap.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 13. Rough Plumbing ._ _ _ - - - - 14. Rough Electric -Conduit - - - ^ - - '+56= Electrical -Final - 15. Rough Electric -Wiring - -- -- - - • 57. Solar System -Final' - 16. Rough Heating & Air Conditioning - • -Fencing &Access Approval 17.-- Ducts in Structure _ APPROVED FOR PLASTERING 18. - Ducts, Ventilating. - 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough &Test s' •-20." Roof Framing 21. Roof Sheathing NOTES: ' -22. Frame and Flashing 23. Insulation 24. Lathing & Siding 25. Drywall Nailing, - 26. Plaster Brown Coat 27: Electrical Power Meter -Final' 28. Final Electric 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. FINAL STRUCTURE & BUILDING /d- /- Y✓% ' 39. Special Requirements Completed - --- 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY _ No Date Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PERMIT NO TRACT NO. LOT NO. BLD . NO. - - - ,CONSTRUCTION PERMIT /L--/ TYPE OF CONSTRUCTION s. ❑ NEW - � ADD ❑ ALTERATION :/fes ❑.REPAIR ❑CONVERSION ❑DEMOLISH ❑OTHER 5609 B/p5/82 . .26-90 - - _ _ r ZONING REGULATIONS,;' - • Protect Address ;L _41 le- Owner Phone Address -1-C- - _ Arch/Eng. ! � - License No. DESCRIPTION OF WORK A P # - Address- - - ___ _ _ ZONE PLNG. REF: # ' Contractor/t - e. - G Phone TYPE OF PERMIT - SETBACK C T. ❑ GRADING ❑ FOUNDATION - ❑ STRUCTURAL IOE YARD - -- - ❑-TENANT'❑ ELECT.R ICAL IPLUMBING ❑MECHANICA S5EppF YA - TTop ggLL111�p G PROPERTY'LwINE. - - - 17- - Address !aC s LICENSED CONTRACTOR DECLARATION I hereby affirm tm•t I am licensed underprovisions of Charter 9 (com• ,r I' �! rW,I61 mencing -with -section 7000) of Division - 3 of the Business and- El OTHER-' Professions Code, and my licenseis in full force and affect. - _ REAR YARD (TO P/L) - - --Llconso - PROJECT DESCRIPTION'- _ - " License Class No. .3d/�A/ .. Is ,1. . �PKG.-SPACE REO: - PROVIDED - "' '• Date '"Z" L % Sl9nature _a.� �_e� /�0.-i'i.,l - SO.;FT. , _ .._ _ _ ! TYPE I_n'n _ _ - - 1 _ _STREET WIDTH ..:'PARK FEE",$ .- WORKERS'.COMPENSATION DECLARATION- _ _ - 1 hereby affirm that I have a certificate of consent to self -insure ora OCCUPANCY CONSTRUCTION _ - - - ZONING -APPROVED BV' - - - •- -- certificate of Workers' Compensation. insurance, -or a.certified copy -.d 6, , VALUATION ZONE t rDATE r. thereof (Section 38 0 b. ,). ) GRADING CU..YOS. ACRES SPECIAL CONDITIONS: •Ilcy"No. Company 'Av2AX%9�- - Certified copy.Is. furnished. . _ REMARKS: -- .. _ filed w ��••ttCertified copy Is filed with the city Building Division. _ - - - - _ _ __ _ _ ' 'EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - - -- -- -'_- -a,-- - - - ♦- - rt s (This section need not be completed if the permit is for one hundred 1 •'? 7 '_ SE30t if or less)- .. _ _ _ _ ... _. _ _. certify that In the,performance of the work for which this permit Is , Issued, I shall not employ anyperson in any manner so as to become - -PLUMBING;- `- -"' -PLAN CHECK -'subject r-"'-"-' to,the Workers' Compensa Hon Laws of California. BATHTUBS- SHOWERS'--_-- - - - - - - - - - t , - - Date Signature 'NOTICE: If after rtiaking this decldration, you should become subject TOILETS r,4URINALS - -GENERATOR 0-1"KW_1.30'KW to the Workers' Compensation provisions of the Labor Code, you must - !TRANSFORMER - �.. �• •-,I ' forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE L -AVS - - -APPLIANCE --10-50 KW_ 50 F -KW 7, - KIT. SINKS - '- 'DISHWASHERS - - ---- MOTORS - 0.1 HP -1-10 HP-• - - -- - .revoked., _ CONSTRUCTION LENDING AGENCY lending is agency for the per. I hereby affirm that there IS a ch this SERVICE SINKS r Y(- SUMPS - - - - . (INC..SOLA R)__ ._30.50 HP_50.* _- HPC perm lormance Of the work for which this permit is issued (Section 3097 -FLOOR SINKS —FLOOR DRAINS •FIXTURES - - OV TIoETs SWITCHES - - - - Civ: C.).' -- -- -- - - - - - - - Under's Name r . .- _ L . . entler's Atltlress DRINKING FOUNTAINS "-- -' -- - GASTUBE SIGNS OWNER BUILDER DECLARATION-- - '-CLARIFIERS - - - - ' "' -.POLE LIGHTS --- ---- - - - - - iINTERCEPTORS- re hebyy m alfirthat I am exempt from the Contractor's License taw for SWIMMING POOL' PTRAP-- he folio wing reason (Section 7031.5 Business and -Professions Code: Any city or county which requires a permit to construct, alter, POLES METERED-' UB WATER SERVICE - -ALT,ERATtON - - - 'PANELS - - - MAIN -SUB - improve,,-tlemo llsh or repair any structure, prior to its issuance, also re-- quires the ap, liwnt for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License law .-GAS SERVICE OUTL-ETS_- - - - - - AMP - - - - (Chapter 9 (commencing with Section 7000) of Division 3 of the .SERVICE WATER HEATERS --BTU OUTPUT - -- - - - -- •- -'- - Business and Professions Cotle) or that he is exempt therefrom and the `-Sts for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS - -- s -- - - - - - l -- applicant for a permit subjects the applicant to a civil Penalty tot more than live hundred dollars ($500). , SOLAR TANK - COLLECTORS - - -- --- --- --- -- .. _ _ - 1, as owner of the property, or my employees with wages as'thelr sole,compensalion, will do the work, and the structure is not Intended or offered for sale. (Section 7044, Business and Code: The SOLAR PIPING SYS.: - - ISSUE FEE- - FEE - _ - Contractor's License Law does not apply to an owner of a property ISSUE FEE ' -' - - - -APPLICATION-APPROVED-BY - ---GATE-- who builds or improves thereon, and who does such'work himself or through his own employees, provided that such improvements are not intended - MECHANICAL PLAN CHECK -- SUMMARY OF FEES • or offered for sale. If, however, the building or improvement' Is Sold within one year of completion, the owner will have the burden ,r f f.'.' of proving he did not build or improve for the purpose of sale).- --- '- - :BUILDING-- W _ -- _ _ Cl -i, -as owner- of. -the -property, am exclusively contracting with HEATING SYSTEM 0-100,000 BTU'•. . ,C PERMIT .$ , SMTP, licensed contractors to construct the projectSection 7044, Business ( AND DUCTING 100,000 t BTU �p 5 PLAN CHECK $ PERMIT and Professions Code: The License Law does s not apply to Off' 'ISSUANCE. builds or i owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ 1 -$'r '- tracts with.a contractor(s) Ilcesnetl pursuanl_to. tracts from sus SYSTEM - - _ _ _ _ ':PLAN -CHECK GRA DIfJG $ License the Contractor's License Law). � L � 700,000;. BTU $---;-- ❑ 1 am exempt under Section B. & P. C. for this - "ELECTRICAL - $ BOILERS BTV E - - _ SYSTEM REPAIR, ALTERATION PLAN CHECK -Is MICROFILM'$ - - .reason- Dale Owner EXHAUST SYSTEM MULTIPLE TOTALFEE$'" LESS AD- 1 t I hereby certify that I have read this application and state that the above Information is'correct.'I agree to comply with all city and county' PLAN CHECK _$ - VANCEPC ordinances and state laws relating to construction, and hereby authorize , representatives of this city to enter' upon the above mentioned property for ins ectlon r9pj� 5. pu f 6 9� Signature �� a /..5_a -f' ; ate 7 �' e - - ISSUE FEE las FINAL FEE E Drivers' License or SS # CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor TL; CONSTRUCTION AND PLANNING, APPROVALS Permit #l__L Date Inspector - POOL'& SPA _ , • - Date Inspector APPROVALS' Permit # 1_ Temporary Electrical Service or Pole - 43. Pool & Equipment Location - 2. .Soil ipe-Undrgrn - -- _ __ 44. Steel Reinforcement - - - - - - 3. Electrical Conduit Utility-Undrgrn 45. Forms - - 4. .Electrical Conduit-Undrgrn 46. Electrical Bonding - - - Steel ein orce 47. Rough Plumbing & Pressure Test _.6.- Electrical OF R Grn _ 48. APPROVAL TO COVER-GUNITE t .7... Footings _ 49. Electrical Conduit-Undr rn ' - 8. Foundation - - 50. Gas Pipe, ❑ Undr m, Test. ' _-9. Water Pipe-Undrgrn 51. Backwash Lines P -Trap -0 ndr in • - - -' ' 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 13... Rough Plumbing - 14. Rough Electric -Conduit - - 'W - Electrical -Final - 15. Rough Electric -Wiring ' -'-- - - - - 57. - - - Solar System -Final Z. 16. Rough Heatin -& AirCoriditioniug b8. -Fencing & Access -Approval ' 17. Ducts; in Structure. 59. APPROVED FOR PLASTERING 18. 19. 20. Ducts, Ventilating- Gas Pipe -Rough & Test' - - - - Roof Framing - -' 60. POOL/SPA.SYSTEMS FINAL ' 21: 22' Roof Sheathing Frame and Flashing NOTES: ' 23. Insulation - - - -- - - - 24. Lathing & Siding - -- - - - - -- - -- -- - --- - 25. Drywall Nailing - - - '- - 26. Plaster Brown Coat - - - - - 27. Electrical Power Meter -Final - - 2B. Final Electric - - - - - 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. 4oadseawSprinklinq System 2 36. Sound Attenuation - - 37. Handicap Regulations - - -' 38. FINAL STRUCTURE & BUILDING _ 39. Special Requirements Completed _ 40. Electric Release to Edison 41. Gas Release to Southern California Gas Go. - 42. i CERTIFICATE OF OCCUPANCY No Date Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PIT NO.' TRACT NO. LOT NO., BLDG. CONSTRUCTION PERMIT ,N. C TYPE OF CONSTRUCTION 1 CSD- ❑ ALTERATION REPAIR ❑ CONVERSION ❑DEMOLISH Ll OTHER _ 6389' 8/19/82 - _I �• '- . - ZONING REGULATIONS - ' Project Address _ + I •e `. Owner1pi I Phone Address - - ^ - . Arch/Eng: License No. - DESCRIPTION OF WORK • - Q.P. - - •- „ .. , -'- - - - ZONE PLNG. REF:,O r'Address - - - _ _- _- Contractor Phone TVPE,OF PERMIT - - '-' - - 1 ❑GRADING. ❑ FOUNDATION - ❑STRUCTURAL - - - 'SETBACK LST. - YARD -' Tp gU1 INC PROPER Y' 4:I NE. ' "Address- - - _ LICENSED -CONTRACTOR -DECLARATION- T❑ TENANT ❑ ELECTRICAL ❑PLUMBING tj>4ECHANICAL c - I -hereby affirm th;.t I am licensee under provisions of Charter 9 (com-, r 5I VA RIGHT L mencing with -section -7000) of , Division -3 -of- the Business and ❑ OTHE0. - - - Professlons Co e, my Ilcense is In full fore a tl of fgg��l( PROJECT DESCRIPTION-._- REAR 'FA (TO P/L) Licen las - �) -- _ -tJc /'i set , PKG. SPACE REQ. PROVIDED Date •-;• Z' Signature -�a-r"/� __$Q �: t _ -- '�OCCUPANCV' . t , CONSTRUCTION TYPE- STREET WIDTH .PARK FEES - WORKERS' COMPENSATION DECLARATION hereby affirm that I have a certificate of consent to self -insure ora ZONE ZONING'APPROVED BY " - - DATE ' I"VALUATION certificate of -Workers' Compensation Insurance, or a- rtill ed copy C�Nr - - -- - _ 'thereof (Secj 0 b.. C.). I an_lysr. f N GRADING CU.•VDS. ACRES SPECIAL CONDITIONS: COrrlpdnY ' rtified copy.is. hereby.furnished._- ____ _ REMARKS: J. _ _ - _ ,- .__• - _ _ r. .r+' ' rtified Copy is filed with the city Building Division. FROM WORKERS' -COMPENSATION DECLARATION • -' _ - - -- - -- -- -_ - - - -- - ,EXEMPTION (This section -need not be completed if-.the.permit Is for one hundred - - - ' 1 ($100) or less,1. - - _ ''f-' - - t _ _ _ _ '� '- '- ' I- Certify that In the, performance Of the work for which this permit IS , PLUMBING-- 7: •, , _PLAN CHECK �" - - :ELECTRICAL- --- PLAN CHEC K,� issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California._, _ _ BATHTUBS SHOWERS - y '- Date Signature f NOTICE: If after making this declaration, you should become subject, TOILETS, •� � , ,URINALS- -' I _ - -GENERATOR-- - 0-1 KW_1-]0 KW = - - to the Workers' Compensation provisions of the Labor Code. -you must'- TRANSFORMER _ forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOt18L'E LAYS APPLIANCE -- '10-50 KW_ 50'+ KW'- - - revoked. _ -_ t - _ KIT. -SINKS-" -"'-"'DISHWASHERS-- 'MOTORS- - 0-1"HP_1-30HP' - - - - _ _ _ _ �CONSTRUCTION LENDING AGENCY �I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS, .,,SUMPS - --" "' - - (ING.SOLAR) -30-50 HP= --50 +-HP-:- - - - - formance of the work for which this permit is Issued (Section 3097 FLOOR SINKS -. FLOOR DRAINS - ',FIXTURES- - OUTLETS_ --SWITCHES -- - Civ: C.). - - - - - -- - ---,' - - -- - iLerideCs_NamG _ _ _ Lender's Address DRINKING FOUNTAINS.--;"-•' "- 'f- 'GAS TUBE SIGNS -- --4 - IOWNER BUILDERDECLARATION- ---- -- -'-- -- - 'INTERCEPTORS 1-hereby affirm that I am exempt from the Contractor's License Law for CLARIFIER$• - 'POLE'LIGHTS-- SWIMMING POOL' - - PTRAP' -- - - - ,- - - the'following reason -(Sect ion- 7031-.5 Business -and Professions Code: Any city or county which requires a permit to construct, alter, POLES METERED -SUB' WATER SERVICE - —ALTERATION- i"-_-" ;PANEL -5' -MAIN - '- _ improve,' de molish-or-repair- any structure -prior to Its issuance; also re- quires the ap,licant for such permit to file a signed Statement that he • ,SUB- - -G - -GAS SERVICE - - OUTLETS SERVICE - --� --' -'--- ••AMP is'Rcea5e0 pursuant provisSection the Contractor's Law- nci g (Chapter 9 (commencing with Section 7000) of Division 3 of the - WATER HEATERS ' '- BTUOUTPUT.-- Business and- orthat he ibex opt therefrom and the- ex Code) -is for the alleged ptio alleged exam pilon. Any violation of Section 7l by _ SEWER -CONNECTIONS a subjects s pen applicant for a -e pelicant to -a -civil penalty hundred .rot more than five huntlretl t1011ars ($500). ($5 - SOLAR TANK COLLECTORS -- L� 1, 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. (Section 7044, Business and Professions Code: The SOLAR PIPING _ __ -SVS. - - -- l' ISSUE FEE _ ' Contractor's License -Law does apply to an owner of a property _ _ _ ISSUE FEE-v' - iAPPLICATtON APPROVED BV--•- - - - - 'DATE - - -not who builds or improves thereon, and who does such work himself or through.his own -employees, provided that such improvements are not MECHANICAL PLAN CHEC - SUMMARY �- OF,FEES intended or offered for sale. If, however, the building or Improvement- burden is sold within one-year of completion, the owner will have the improve for the v BUILDING - -- -- - - ---- - - - of proving he did not build or purpose of sale), ❑ 1.n as owner of- the property, -with ; HEATING SYSTEM 0-100,000 STV _ 7 / N - -• - .- _ ' FJ SPE RM IT $ _ _ - _ -. SMTP -,s _. - 1. - e p ject (Section 7 licensed contractors to construct the project (Section 7044, Business 100,0001+BTU "RIG 'PLANCHECK $ PERMIT•"', -and Professions -Code: The Contractor's License Law does not -apply to - -- -- - -ISSUANCE $ an owner of property who builds or improves thereon, and who Con- RE N 0-100,000 BTU ! .PLV MBING E tracts -from such -projects with a contractor(s)-llcesned pursuant -to SYSTEM- - -- -- - - - -- GRADING- $ the Contractor's License Law). 100,000 4 BTU t PLAN CHECK ,$ ❑ I am exempt under Section - B.'&-P.'C.'for this' -- --- - BOILERS BTU •- - - 'ELECTRICAL $ - - - -- - $ reason - --- - -- --- -' - - -MICROFILM EXHAUST SYSTEM MULTIPLEESS SYSTEM REPAIR, ALTERATION4.3-, PLAN CHECK" $ - ((,J(-�- $ ;TOTAL FEE EtMECHANICAL.$ AD-informationis Date Owner I hereby certifythat I nave read into apPlication and state that the aunt¢_ correct. (agree to complywitN all city antl county Sn 'PLANCHECK E "-VANCEPC "$ordinances antl state laws relating to construction, antl hereby authorize22 representatives (-this Ify to enter upon the above' mentionetl N1 7M n propertystl�..6Signatue ' „ FINAL FEE $ Date J_YL "'ISSUE FEE- CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # Date POOL & SPA Inspector APPROVALS Permit #. - Date. Inspector . 1. Temporary Electrical Service or Pole 43. Pool-& Equipment Location '� - - - - •'' •' 2._ _SoilPipe-Undrgrn - 44. Steel Reinforcement- 3. Electrical Conduit Utility-Undrgrn 45. Forms -- _ 4.- Electrical Conduit-Uridrgrn _ 46. Electrical Bonding i----- - - - 5. _ Steel Reinforce - _ _ _ -; 47. Rough Plumbing & Piessure�Test - h6. _ Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7._� Footings _ _ _ _ _ _ 49. Electrical Conduit-Undr rn -.8.- _ Foundation. _ 50. . Gas Pipe ❑ Undr rn, Test 9.. Water_Pipe-Undrgrn 51. Backwash Lines P-Trap. f" n r rn 10. Structural, Floor System - _ -- 52. APPROVAL TO DECK "- •' - " - - -- -' - .11.- Property Sewer Line & House Connection - _ .. 53. _Backwash &.Rete tor-Final 12. Street Sewer-Connection. - 54. Heater•& Vent-Final 13.-. Rough, Plumbing.-- - _ _ _ _ .•_ -55` - - - ----- -^-- - - 14. Rough Electric-Conduit - - - - - - -56: Electrical-Final - •' 15. Rough Electric-Wiring -57-.- ' Solar System-Final -16.-- -Rough Heating & Air Conditioning Fencing,& Access Approval ' 17. Ducts, in Structure" . �� 9. APPROVED FOR PLASTERING _ 18. • 19. 20. Ducts,Ventilating_ Gas Pipe-Rough & Test '' Roof Framing. _ - I _ - - _ , -_ __60._ POOL/SPA SYSTEMS F INAL"; 21. RoofSheathing_ 22. _ Frame and-Flashing "= r ._ •c • .... - - - - ,-,'NOTES: - 23.- 24. Insulation-- '- - - - - Lathing & Siding - -- ' '� r- - ev - - - H -- -- 25: Drywall Nailing - - - 26. Plaster Brown Coat 27. Electrical Power Meter-Final _.1 28. Final Electric- , 29. Final•Heating & Air Conditioning 30. Final .Gas Pipe-Test -.4 - - 31. Final Plumbing 1 32. Water Service-Final 33. - Gas Service-Final i 34. Solar Domestic-Final •� - " ` 35. Landscape Sprinkling System 36�Z.Saund Attenuation 37. Handicap. Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed - 40 ase to E. Electric Reledison . - - - 41. Gas Release to Southern California Ga's Co. i 42. CERTIFICATE OF OCCUPANCY No Date - '- �`- �• _ - Applicant to fill in all "s •t-C!T,Y OT COSTA MESA PERMIT NO. ONSTRUCTION PERMIT 4, ' •Project Address /� 11 -owner- 1- Arch"Eng, +-+ - License No. s Address •--� - - Contractor A1I1LIAQ t]1LAF_,. Phone ss wlmi-� BLDG. YPE OF CONSTRUCTION 4 (oZZ © NEW ❑ ADD ❑ ALTERATION ON OF WORK Address ❑ GRADING ❑ FOUNDATION C1 STRUCTURAL LICENSED CONTRACTOR DECLARATION .TENANT)( ELECTRICAL 1.}L'LUMBING ❑MECHA. I hereby affirm th4t I am licensed under provisions of Charter 9 (com- menting with section 7000) of Division 3 of the Business and ❑ OTHER Professions Code, and my license Is in foil force and effect. PROJECT DESCRIPTION 4100 �!�, J-.�(��a✓�,�� License Class License No. Sq. FT,wl7lsc.E.,C.� Date Signature —.-- WORKERS' COMPENSATION DECLARATION OCCUPANCu1',�•�CONSTROCTION TYP`r�.�s ►w I hereby affirm that I have a certificate of consent to self -insure ora VALU ATI -��+` ZONE certificate of Workers' Compensation Insurance, or a Certified Copy _ thereof (Section 3800, Lab, C,). GRADING CU. YDS. ACRES licy No. Company Certified copy is hereby fur f[Shed. REMARKS: ��CCJI Certified COPY Is flied with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit is for one hundred 1$100) or less). I certify that in the performance Or the k for which this Permit is issued, I shall not employ any PeVqn In n man er as eco ' PLUMBING PLAN CHECK stablea r• Compensat o taw f Cali r, MECHANICAL \ PLAN CHECK DateSi9nature BATHTUBS SHOWERS NOTICE: if after making this dec ration, you sho Id become subject TOILETS URINALS to the Workers' Compensation provislons of the labor Code, YOU must - ,I 'FIXTURES forthwith comply with such provi90ns or this Permit shall be deemed LAVATORIES DOUBLE LAVS MULTIPLE sly With all City and County POLE LIGHTS ' C - - ONStl. CONSTRUCTION LENDING AGENCY KIT. SINKS- DISHWASHERS 1 hereby affirm that there is a cons traction lending agency, far the per- SERVICE SINKS SUMPS fufmance of .the work for whicn this, permh'isassued (Section 3097 - "t Ci V. C.). - '. FLOOR SINKS FLOOR DRAIN! Lender'sName Lender's Address DRINKING FOUNTAINS INTERCEPTORS 'CLARIFIERS,, SWIMMING POOL P TRAP WATER SERVICE ALTERATION GAS SERVICE OUTLETS WATER HEATERS BTU OUTPUT J 1, as owner of the property, or my employees with wages as their SOLAR TANK - Sole compensation, will do the work, and the structure is hot intendetl or offered for sale. (Section 7044, Business and Professions Cooe: The SOLAR PIPING SVS. Contractor's License Law does not apply to an owner of a property _ who builds or improves thereon, and WhO does such wOrlc himself or ISSUE FEE Q is sold Wnhln one year of completion, t proving he did not puiid or impr 1, as owner of -the property, am I used Contractors to construct the 0 and Professions Code: The Contractor's an owner of property who builds or in tracts from such projects with a cont the Contractor's License Law)gthisappl� ❑ 1 "am exempt under Section reason (SNI Date Owner 1 hereby certify that t have read Information is correct. I agree to Cort ordinances and stale laws relating to con! e owner will nave the burden MECHANICAL \ PLAN CHECK ve for the purpose of sale). exclusively contrattin9 with affect fSection 7044, Business -(cense Law does not apply to HEATING SYSTEM AND DUCTING 0-100,000 BTU_ 100,000 1 BTU REFRIGERATION SYSTEM - 0-100,000 BTU_ 100,.00 .. BTU proves thereon, and who con- actors) licesned pursuant to r B. & P, C. for this BOILERS BTU 'FIXTURES SYSTEM REPAIR, ALTERATION anon and state that the above EXHAUST SYSTEM MULTIPLE sly With all City and County POLE LIGHTS ' �� ruction, and hereby authorize PERMIT S _slS2-"r • upon the above mentioned DriISSUE FEE vers' -License ar SS 5* ' CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Gotdenrod-Assessor 6356 8/, 94.02 PLNG. 92.02 TL PKG.SPACEREQ. 1w, ',1pRb<JIDED I FEE $ SPECIAL ELECTRICAL C�. PLAN CHECK SO FT. So FT. GENERATOR TRANSFORMER APPLIANCE 0.1 KW.__ 1-10 KW — 10-50 KW_50+KW_ MOTORS (INC. SOLAR) 0-1 HP 10-50 HP -1-10 HP — so. HP _ 'FIXTURES OUT LETS &SWITCHES GAS TUBE SIGNS BUILDING POLE LIGHTS ' �� PANELS / MAIN: ISUB C�. ISSUE FEEof 00, '3 O APPLICATION APPROVED BY DAT SUMMARY OF FEES BUILDING �� PERMIT S _slS2-"r • SMTP $ PLAN CHECK §... L.�.' PERMIT �r _ ISSUANCE § PLUMBING §� , GRADING § PLAN CHECK $ � , ELECTRICAL S 1 ?, oQ $ PLAN CHECK is MICROFILM $ MECHANICAL $ TOTAL FEE $ PLAN CHECK Is LESS AD- VANCEPC $_ l „ \�\a•; y.�c\,", FINAL FEE b �'� CONSTRUCTION AND PLANNING APPROVALS Permit 4# ! OL & SPA .�~+ Date Inspector APPROVALS Permit# _ iDate : Inspectoia ` •' 1. Temporary Electrical Service or Pole 43. P.00l.& kquipment- i Locaton'" 2. Soil Pipe-Undrgrn ; - -."t' , i '44.,; Steel Reinforcement"• - 3. Electrical Conduit Utility-.Undrgrn 45. Forms r - . 4... Electrical Conduit-Undrgrn 46. Electrical Bonding5. Steel ein orce 47. Rough Plumbing & Pressure Test •-= 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE - 7. Footings ' 49. Electrical Conduit-Undr rn - 8. Foundation_ 50. -Gas Pipe, ❑ Undr rn, Test 9.. Water .Pipe-Undrgrn51. •' Backwash Lines P-Trap,Elndr rn - - 10. Structural Floor System �'��;'. 52. +AP.PROVALTO DECK 11. Property Sewer Line & House Connection .53.' '•Backwash & Receptor -Final 1.2. Street. Sewer_ Connection - 54. Heater & Vent -Final 13. Rough Plumbing - _ - - 14. Rough Electric -Conduit - '56. Electrical -Final 15. Rough Electric -Wiring - 57. Solar System -Final - 16. Rough Heating & Air Conditioning bts. _ Fencing & Access Approval 17. Ducts, in Structure - APPROVED FOR PLASTERING' 18. 19. 20. Ducts, Ventilating -- Gas Pipe -Rough &Test Roof Framing- 60.'POOL/SPA - - .. •� _ -_- SYSTEMS FINAL 21. _22. Roof Sheathing- Frame and Flashing - - =$A I _ - - - - " NOTES: _ _ w _ 23. Insulation - 24. Lathing -& Siding - - - 25. Drywall Nailing .at 26. Plaster Brown Coat 27. Electrical Power Meter -Final'- t ' 28.:7, Final Electric - //�l6•'T)y !/ - 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. FINAL STRUCTURE & BUILDING f-S.Z - 39. Special Requirements Completed - 40. Electric Release to Edison _ 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY /J�6 No 0(Z 4; f �� Date & '''�/ 3 /i e . i' Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. TRACT NO LOT NO CITY OF COSTA ME8A CON�EYCTION PERMIT Project Address Z�� .5�2r PNt ERMIT3O5L14 �i ELECTRICAL FEES _ • U • NIT NO. G . A.P. # S Main Building: _ TYPE OF CONSTRUCTION NEW LJ_ADD L1 ALTERATION LJ REPAIR El CONVERSION El DEMOLISH ❑ OTHER - Applicant's Mailing Address - E T Front Owner's Name TtsG_iY.� F LA'$C Phone DESCRIPTION OF WORK/USE OF BLDG. - = ' A K Rear Address - q^ Arch/Eng: �+% Fi0' License No. 1 TYPE OF PERMIT GRADING FOUNDATION STRUCTURAL ❑ TENANT 1:1 ELECTRICAL PLUMBING ❑ MECHANICAL Right -$ Left Address Contractor's Nam - . _ - ❑ OTHER . - Ping. Ref. # 9Notes: �1Phone / Address (mailing) �� 'C'�`v��^-� L-a�- en. �4 �S PROJECT DESCRIPTION SQ. FT. OCCUPANCYPlannin CON STRVCT,ION:TYPE -VALUATION$ y� 1 Cit License No. ZONE GRADING CU. YDS. I ACRES LICENSED CONTRACTOR DECLARATION - I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and MY license is in fu.0 force and effect. -A4ez, License Class C. 4067 C Date �-tr�•1-19-eR Signature_ - WORKERS' COMPENSATION DECJJ\RAT 1 hereby affirm that I have a certif}" ate of c sent to self -insure or a certificate of Workers' Com pensationInsu ance, o certifled copy thereof (Section 3800, Lab:- C.) —. "" ' Policy No. Company ' 8 Certified copy is hereby furnished. Certified copy is filed with the city Building Division. Date - Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit is for one hundred ($100) or less). 1 certify thaLin the performance of the work r w 'ch th' p �rmit is issued, I shall not emplo�f any rson in any maT o o b e su act to the Workers' Co p do ��v s of Califo la. Date '"��S'i gnature - NOTICE: If, iter ma <in9 this declaration, ou s d become subject to the Workers' Compensation provisions of the La ode, you must forthwith "comply with such provisions or this , 1 shall be deemed .revoked. 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 (Section, 3097 Civ. C.) Lender's Address OWNER BUILDER DECLARATION - I hereby affirm that I am exempt from the Contractor's r, improve, demohsn or the aoolicant for such p to file a signed statement trial ne/sne Is licensed pursuam in ine prwumna v. 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 ,MC,of not more than five hundred dollars ($500)., �� I; as owner of the property or my employees with wages as thelr.sole .compensation, will do the work, and the structure Is not intended or offered . for sale (Section .7044, Business and Professional Code: The Contractor's 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 employees, provided that such improvements are not intended or offered for 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.. 5 rove for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con., 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 builds or improves thereon. and,who contracts for such oro iects with a con- ) ' tractor(s) license pursuant to the Contractor's License Law). I am aware that proof oftheir Workers Compensation insurance should be provided to me. ❑ 1 am exempt under Section S. & P. C. for this reason Data - Owner — 1 hereby certify that I have read in information is correct. I agree to con and state laws retail cling s sentatives of in y ter up inspection purIMses. Signature - G Driver$"License or Ss Remarks: Sink Preventer Irrigation Drinking Fountains Floor Drains Floor Sinks Gas Service Interceptors Kitchen Sink Lavatories P—Trap Roof Drains - Accessory Building: " 2 O N I N G R Parking Req./Provided- E Q M T S. Reinspection Fee oiler " Not - Under Ground )uct- Structural , _ r $15 Issue Fee, -, .MECHANICAL Hood or Type ❑ Canopy Type 1.1 ❑, Exhaust System ❑ multiple F irepl/Fact. Bit. ICBO * Heating System & Ducting ❑ 0100,000 BTU ❑ 100,000 BTi Reinspection Fee I $15 086546, rev. 5/88 pvhite - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Refrigeration. System ❑0t00,000BTU 0100,000,6 System -Repair/Alteration Fire Dampers Issue Fee I, Reinspection Fee ' $15 Issue Fail $ 9 DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By FEES Building Approved By. Application Issued By' I Set, • ELECTRICAL FEES PLUMBING FEES Automatic Washer Transformer ❑ 15-50 KW' ' Construction Pole Sub.' ❑50+KW Showers' - Service Sink - - - . _ Cooking Unit _ Meter ❑up to 100 amps ' ' Sewer Cap Dishwasher Meter Dover 100 amps Dryers ❑Gas ❑Electric Sub Panel Sewer Connection Fad Motors�l HPV 8 Solar Collectors F.A.U.- - - Inc Solar 09:15 HP ❑16-15+ - Solar Piping Solar Tank Fixtures Microwave Swimming Pool w/Spa Device Boxes Pole Light ' - Urinal ...... - _. ..._ Outlets Range - Outlets '. Water Closet Switches Sign Garbage Disposal Standing Sections Water Heater Water Service - Generator 00.5 KW 05-15 KW Trash Compactor Auto -Wash - Reinspection Fee oiler " Not - Under Ground )uct- Structural , _ r $15 Issue Fee, -, .MECHANICAL Hood or Type ❑ Canopy Type 1.1 ❑, Exhaust System ❑ multiple F irepl/Fact. Bit. ICBO * Heating System & Ducting ❑ 0100,000 BTU ❑ 100,000 BTi Reinspection Fee I $15 086546, rev. 5/88 pvhite - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Refrigeration. System ❑0t00,000BTU 0100,000,6 System -Repair/Alteration Fire Dampers Issue Fee I, Reinspection Fee ' $15 Issue Fail $ 9 DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By FEES Building Approved By. Application Issued By' I Set, $ 3 01 00015367-00015368 TGT 56.63 DATE: 08/26/88 - TII'IE: 11:08 BUILDING PERMIT PLAN CHECK PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK MECHANICAL PLAN CHECK 25% 50% 25% SUMMARY OF FEES $ $ $ $� $�� $ $ SMIP I PERMIT ISSUANCE ENERGY P.C. GRADING MICROFILM TOTAL FEE $, $ $ I . $ $ $ $ 3 01 00015367-00015368 TGT 56.63 DATE: 08/26/88 - TII'IE: 11:08 CONSTRUCTION AND PLANNING APPROVALS Permit# Date Inspector POOH a SPA APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe:Undrgrnd. 1'i- iI 53. Steel Reinforcement •,3: Electrical Conicuit-Utility-Undrgrnd. - 54. Forms 4. Electrical`Conduij-Undrgrnd. 55. Electrical Bonding , 5`Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER.Gcnd. 57. APPROVAL TO COVER-GUNITE J.) Footings (I 1 58. Electrical Conduit-Undrgrnd. 8. Foundation •*• '� 11 0" A ;. f ��_ 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe -U irgrnd. " 60. Backwash Lines, P -Trap, O Undrgrnd. _ }. 10'.^Structural Floor System %! 61. APPROVAL TO DECK ` 11.)Property Sewer .Line &House Corinection 62. Backwash & Receptor -Final 12( Sewer Cap 63. Heater &Vent -Final ' 13. Roof Drains sJ ;•. i 64. Plumbing System - Final 14. Rough Plum bjng i i 65. Electrical -Final 15. Rough Electr'i'cal -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 APPROVALS Permit# 20. Rough Factory Fireplace ' 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0Oil 23. Gas -Pipe -Rough & Test 72. Underground Flush " 24. Roof Framing 73. Undergrnd. Storage Tank OGas 0Oil 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 PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31 t. Plaster Brown Coat ." - 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric_Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test ' 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final .V 42. Backflow Preventer 43. Backflow Irrigation ,,-,♦Sl 44. Landscape, Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING r 48. Snecial Requirements Completed 49. Electric. Release to Edison ' 50. Gas Release to Southern California Gas Co I ' 51. CERTIFICATE OF OCCUPANCY No. Date f% ' Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declar CITY OF COSTA MESA • PERMIT O. TRACT NO. LOTINO. B eG. NO CONSTRUCTION PERMIT S :herefrom-and the' basis for the alleged exemption. -Any vlolation-of Section _ - $ 3 Sink Issue Fee 7031:5 by •any applicant for.a'permit- subjects the , applicant to a: civil - Applicant's Mailing Address ' TYPE OF CONSTRUCTION; LJ NEW LJ ADD LJ ALTERATION; U REPAIR . �G—'I G> M: ! ❑ CONVERSION ❑ DEMOLISH ❑ OTHER. - Project Address -45 Boiler Refrigeration System ! GRADING 1 Owner's Name A %O f-Vs'� pL'al A:M. • Phone . --. - DESCRIPTION OF WORK - - - AddressL$I� �%H (VIFH1� ::5,4 car/_ :TYPE OF PERMIT GRADING FOUNDATI STRUCTURAL sale. It however, the bulltlfng or improvement sold within one year. of com- letfp 0, the owner will have the burden of proving he/she did not build or Im- Arch/Eng. ' License No., ❑ TENANT ❑ ELECTRICAL tp�r�(. ❑ PLUMBING' Sl MECHANICAL _ • I Address"OTHER - PROJECT DESCRIPTION SG. FT. ' - - OCCUPANCY CPpfraLlpl's Nam hone Addrew(mailing) Sfimf-`��S A at'� , CONSTRUCTION TYPE VALUATION$ ` ZONJ= GRADING CU. YDS'. IACREc - ' License No. __ LICENSED CONTRACTOR DECLARATION ( Remarks: - I Lhereby affirm that tam Ilcensetl under provisions of Charter.9 (commencing 1 tractor(s) license pursuant to the Contractor's License Law). with section 7000) of Division 3 of the Business and Professions Code, and my license Is In full force and effect. i 1:1 Cam axempt untler Section B. & P. C. for this reason .. ' '' I Date ' I J Owner ' ! i PLUMBING , Ocense Class I '—Ll—cense No.'! Date Signature I I - Bar Sink Sewer Cap WORKERS' COMPENSATION DECLARATION I 00-100,000IBTU 0100,000BT - - - - -- --, V - -• information is correct. I agree to comply with all City and county ordinances i Backflow Preventer- - Sewer Connection - - - I hereby affirm that I have a certificate of consent to self -Insure or a.certNlcate of Workers' Compensation Insurance, or a certified. copy thereof (Section Backflow Irrigation Solar Collectors- t 3900, Lab. C-) ' ! I , Policy No. Company CaT a II ❑ Certified copy IS hereby furnished.BathtUbSCertified I I � Registers Issue Fee ' copy Is filed with the cityBuilding Division.ate % Signature Data 47 •SS i Drivers' Ucenso or 9f Applicant Clarifiers EXEMPTION FROM WORKERS' COMPENSATION DECLARATION Dish Washer I w/Sp (This section need not be completed if the Permit is for one hundred ($100) or Drinkin FountainsI 9 Pica ess). Certify Shat In the performance of the work for,which this permit Is Issued, I shall not employ any person In any manner so las to become subject to the Workers" Compensation Laws of California) ! Floor Drains:et 1Date I ' Signature NOTICE: If, after•making this declaration, you should become subject to the FloorSinks-� - erWorkers' Compensation provisions of the Labor, Cotle, you, must llorthwithcomply Gas Service'' 'Outlets' . j J • - with' such ; provisions or_this-permit shall be'deemed revoked.' CONSTRUCTION LENDING AGENCY - Interceptors I hereby affirm that there Is alconstruction lending agency fdr the performance i of the work for which - this permit is Issued (Section 30 7• Civ: C.) KitchemSink! I Lender's' Name ^ ' Lender's Address _- - Lavatories OWNER -BUILDER DECLARATION 1 heraby,a/firm that I am exemptlfram the Cont ractor's,License Law for the t II I reason Sectl - -7031.5 Business and Professional Code: An cit or ' - ' P -Trap) 0 ow n9 0 ( on - u y y 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 Roof;Drains , to file a signed statement that he/she is licensed pursuant to the provisions of - Reinspection, are $15 Showers r '� 1 r the Contractor's License Lnw,(Chapler 9 (commenCing with Section.7000) of Division .3 of the Business' antl' Profess ons Code) or that, he//she`is,exempt :herefrom-and the' basis for the alleged exemption. -Any vlolation-of Section _ - $ 3 Sink Issue Fee 7031:5 by •any applicant for.a'permit- subjects the , applicant to a: civil penalty of not more than five hundred dollars ($500): ••• , I a I 'as or Service _ r .PLUMBING ' LJ 1, owner of the property my employees with wages,as their sole compensation wl 11, do the work, an tit the structure is not in tend ad or oflaretl - :- MECHANICAL PLAN CHECK( l Boiler Refrigeration System ! GRADING 1 for sale (Section 7044, Business, and :Professional. Code: The' Contractor's License Law does not apply town owner of a property,who builds or Improves thereon, and who does;Suth work himself/herself or through his or her own employees, provided that such Improvements aretnot Intended or offered for Is -- Duct - Under�Ground 1 00-,100*OBTU 0100,ODOBTU $ j 1 sale. It however, the bulltlfng or improvement sold within one year. of com- letfp 0, the owner will have the burden of proving he/she did not build or Im- I Duct -Structural j r System Repair/Alteration ,ELECTRICAL; ( PLAN CHECK! P gr�qve for the purposo of sale). t - Id 1, as ownei of the property, am exclusively contrattinglwlthlllcensed con. the Business Code: ', Ventileting_. Duct.: : $ tractorsto,construct project,(Section.7044,. and.ProfessionS _�_ The Contractor's License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such projects with a con- $ I PLAN 1CHECK ' $� I Exhaust System 0 Multiple ❑ i I J t 1 tractor(s) license pursuant to the Contractor's License Law). 1 Firepl/Fact. Bit. ICBO'As - i 1:1 Cam axempt untler Section B. & P. C. for this reason .. ' '' I Date ' I J Owner ' ! i 1 Heating System & Ducting ('herebyy certify -that-lrhave-read this application 'and -state that'ttie above- r - 00-100,000IBTU 0100,000BT - - - - -- --, V - -• information is correct. I agree to comply with all City and county ordinances or e I ❑� ' YP Rat Tno $15 and state laws relating to building construction, land hereby authorize repre• iHood sentatives of lthis'city to a tart pon the above-mentioned property for Inspection Purposes. I - Inspectionh i CaT a II ❑ I I � Registers Issue Fee ' - $ 3 % Signature Data 47 •SS i Drivers' Ucenso or 9f PLNG.REF. "LEFT SIDE YARD PKG. SPACE REG. STREET WIDTH: F.A.U. is Washer tion Pole Unit Boxes Generator ❑O-5 KW ❑ Transformer 015-50 KV 1350 + KW Meter Oup to 100 amp! u83ti 4/11 i'/ 33' L-eG. REAR YARD (TO P/L) RIGHT SIDE YARD - . PROVIDED , •PARK FEE.$ amps Sub Pole (Motors L.10-1 HP Ll1 X$ c 'Inc.Solar'09-15 HP 015-15+ Microwave j Pole Light ' Range Sign Standing Sections ! j Trash Compactor 5-15KW I :Reinspection Fee Issue Fad: Application Approved By —Dote Application Issued By v "Date ®m MN [M= MF 086546 rev. 12/82 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor /I SUMMARY OF FEES ` .BUILDING PERMIT $ ! ' ( SMIP f $ PLAN CHECK. $i • i PERMIT I .PLUMBING ' $I I I ISSUANCE $ I PLAN CHECK( l $f ! GRADING 1 $ J $ j 1 $ 1 I ,ELECTRICAL; ( PLAN CHECK! $ i MICROFILM $ - :MECHANICAL $ LS'— TOTAL,FEEi. $ I PLAN 1CHECK ' $� f LESS ADVANCED PC $ 1 1 i FINAL FEE $ MF 086546 rev. 12/82 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor /I r, - „ .lof POOL'aSPA;.,'._-. ��CONSTRUCTION,AND;PLANNING 'APPROVALS = Permit# -;.Date - 'I nspector ..'APPROVALS." .-`•' Permit#- Date � Inspector - ' t' Temporary,Electrical Service orPole ��' - ?!' '52' Pool & Equipment Location 3 t� V 4 n I n _o' ', i- 2: Soil Pipe Undrgrnd' - ' i �o' �" °•: ' ` cy,,... 53t' Steel Reinforcement j » i - �. 1 Electrical.Conduit Utiliiv-Undrgrnd! is 54='Forms, t; 4: Electrical Conduit-Undrgrrid. : = - 5 n. ' �: � I 55°'Electrical?Bonding+'` I _ , t: . 5: Steel Reinforcement } �� - I n N' 56 Rough Plumbing& PressuWfest 6. Electrical UFER Grndl u = P1 ,. c: - ,57` APPROVALTO COVER-GUNITE I , 7. Footings , i - ^� i , �; -u a 158. Electrical Conduit-Undrornrl _'- '- 1Pipe,' _ B. Foundation • ai' o, '59. Gas D Unilr' d:; Test 9. Water Pipe-UAdrgrnd. I , _ S;, '`60. Backwash. Lines,jP Trap, Undrgrnd.' ,0 10. Structural Floor System , L ` i 9 ` ;, , •61. APPROVAL- TO,DECK '" • ' _ - 11. Property Sewer Line&'HouseConnection:•X62. ash'Receptor;-Final: Backw& _ •? l i - ¢. n _ _ 12. Sewer Cap I i �• i ' �" _ , 63. Heaters &-Vent-Final`_ 13. Roof Drain's j ! i I _ :64. Plumbing7Systein, Final - 14. Rough Plumbing' I .. -' i - -'65. Electrical=Final- - - 15. Rough -Electrica l -Conduit'- 56._.Solar`S stem:Final'-T�- - 1'6I Rou h.Electric Wirin I 9 9 I '+ r ' ¢ 1 �,"'_i =� = 1r' - '- -' '- - ' . X67." Fencing &'Access,ApprovaUl ' - T" -- i ---t.- n , n 1 I , 4 17. FRdugh.Wiring.Sign�' i ! ^ ,I II,_- }' _; - `r 1 '- X68.'APPROVED EOR -PLASTERING_ _ t 18: Rough-Electrical-TBar,Ceilingl 69.1 POOL/SPA SY.STEMSFINAL I ' _ 19. Rough Heating & Air Conditioning �I i ; } 1 I I FIRE DEPT. REQUIREMENT: u APPROVALS` Permit'# ' 20.�Rough Factory Fireplace) I I ti i t I. , f > I. t I I 21. Ducts, in Structure, I I 'i } i } ! 1 70.� Underground Hydro •' ' ,- 22. Ducts, Ventilating '. j ') II } + I ! `n ' X71.1 Product Piping 0 Gas 0Oil 23. Gas Pipe -Rough & Test i I r i I 72., Underground Flush i 11 . '24. Roof Framing • _ tib f' ; } �> ,ctrl o, I -{! ,73.1 Undeigrnd. Storage Tank•_© Gas 0'0iI' j 1 • ,_' , : • I ' 25. Roof Sheathing ` i jIS„ - 4V-� • (� I p'I:•; , . r_ ; _, ' �. i74. Overhead Hydro i-26. T -Bar Ceilirig (Struciural), & Monocoat' 75.1 Dry Chemical 27. Frame and Flashing • 6 } (''• : I �?' 76.' Dry Standpipe- I, .' 26. ,Lathing 8( Siding ;� i^ I I 'I iI i ( I 4r; 1^T� I 177.', FIXED SYSTEM;FINAL i.29. 'Insulation I� Ij I } I �} X78., FIRE PREV,. FINAL 4, j 30. Drywall Nailing ' ? i j II i .. I �I I 'Notes: , 31. Plaster Brown Coat • i ' r i I i ' t r , } 32. Electrical Power Meter;Final 33. _;Final Electric _-r•-; ' i _ I_ I _ I _ _ 34. Final Heating &Air Conditioning 35. Final GaslPipe-'Test'' j 36. Hood or Canopy_ r � ' •' i,� i T- I r, , I Y ` I �_ _ - - -'I l . I, f' = � I I �• I 37. Final Factory Fireplace; 38. Final Plumbin 39. Water Service -Final' 40. Gas Service -Final I i 41. Solar Domestic -Final_+ �- Imo• •' ' ' +_� _ _� -.t __-- 42. Backflow Preventer' 1 43. Backflow Irrigations 44. Landscape Irrigation,System 45. Sound. Attenuation i I ^ I T i ? ! '� • I I �; I I �_ I �' I ' ; i ,� ' '_ �+ - " 46. Handicap Regulations, j j: }� ' I I ! , � , r �•� � _ n 47. FINAL STRUCTURE & BUILDING 48. Special Requirer�nents Completed) I j • I I j, I ! i - ' 49. ElectricReleaselto Edison) I F t_i '-I-- _A 50. Gas Release to Souti hem California Gas Co , 1 I 51. CERTIFICATE OF'.00CUPANCY i _' _I__I -_I_-•__ I_ r_ )�j._j,-_ L _'__} 1) I , No - Date ' •^� j ( ,", a_ -ter Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. -CITY QF COSTA MESA' CONSTRUCTION PERMIT-;P�,/�/7/ Project Address Applicant's Mailin/gAddress /J - 172 /1( Owner's Name rr�� a!ee4z —pho e Address ,�Jr//`�/!////P///� /-) . Arch/Eng. License No. Address. Contractor's Naff,PVJIIUhone 3-i• Address (ma"ling)/3l/ 9//E City License No L(0710(n LICENSED CONTRACTOR DECLARATION I'hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in f y fp cy and effect. LJcenansa No. Dat $ -g l t//M / ( 'ORKERS' COMPENSATION DECLARATION ereby affirm that I have a certificate of consent to wIf-insure or a certificate Workers' Compensation Insurance, or a certified copy thereof'(Sectlon 3800, Lab. Cf -7 Policy Nol(/ �?.__)') Company mnn %2C. ❑. Certified copy is hereby furnlshed. �Q Cerci ]a c y iy filed with the city it i Div e Date /� -/ r'� Applicant EXEMPTION FROM WORKERS' COMPENSATION EC LARATI - '`(This section need not be completed if the permit is for one hundred ($100) or less). 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 California. Date Signature NOTICE: It, after making this declaration, you should become subject to the Workers' Compensation provisions of,the Labor Code, you must forthwith comply with such provisions or this permit - shall be - deemed revoked. 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 (Section 3097 Civ..C.) Lender's Nam.' Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct. alter. improve. demolish or repair ' TYPE OF CONSTRUCTION LJ NE ❑ CONVERSION ❑ DEMOLISH DESCRIPTION OF WORK J ADD OTHER ALTERATION LJ REPAIR TYPE OF PERMIT LJ GRADING LJ FOUNDATION LJ STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION SO. FT. - OCCUPANCY_ CONSTRUCTION TYPE VALUATION $ ZONE GRADINGCU.YDS. ACRES_ Remarks: 3ar Sink 3ackflow Preventer 3ackflow Irrigation 3athtubs Clarifiers Dishwasher Drinking Fountains Floor Drains Floor Sinks 1 Sas Service -Outlets Interceptors, Kitchen Sink Lavatories P—Tran any structure, prior to Its Issuance, also requires the applicant for such permit Roof Drains to file a'signed statement that he/she is licensed pursuant to the provisions of r 'se 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 erefrom and the basis for the alleged exemption. Any vlolat ion -of Suction pains etion Fee Pe $25 /031.5 by any applicant for a' permit subjects the applicant to a civil enalty of not more than five hundred dollars ($500). 1, as owner of the property or my employees with wages as their sole $ ENERGY P.C. compensation, will do the work, and the structure Is not intended or offered for sale. (Section 7044, Business and Professional Code: The Contractor's $ Boiler t 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 Duct -Under Ground employees, provided that such improvements are not Intended or offered for sale. If, however, the building or Improvement Is sold within one year of com- pletlon, the owner will have the burden of proving he/she did not build or im- Uve for the purpose of sale). Duct - Structural u I, as owner of the property, am exclusively contracting with licensed con. 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 builtls or Improves thereon, and who contracts for such projects with a con- Duct - Ventilating Exhaust System ❑ Multiple ❑ tractor(s) license pursuant to the Contractor's License Law). ❑ 1 am exempt under Section B. & P. C. for this reason Firepl/Fact. Blt. ICBG Vh Date Owner Heating System & Ducting hereby certify that I have read this application and state that the above Information is correct. I agree to comply with all city and county ordinances ❑0.100,000 BTU (]100,000 BT " and state laws relating to building construction, and hereby authorize repre- sentatives of thi$, it to enter upon the above-mentioned property for inspection purp0 eb. Reinspection Fee $25 Signature Date Y'YT� Drivers' License or 55 — CMF 086546 rev. 7/83 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod -Assessor Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Issue Fee AANICAL Hood or Type 1 ❑ Canopy Type II ❑ Refrigeration System 00.100,000BTU 0100,000 System Repair/Alteration Issue Fee FEES A.P. # S Main Building: E T Front B Rear A C Right K Left Ping. Ref. -0 Parking Req./Provided Use of Building: Plannina Notes: �. Automatic Washer Construction Pole Cooking Unit r Dishwasher Dryers ❑Gas ❑ Fan; - F.A.U. Fixtures Device Boxes Outlets 9754 10/09784 Zone Accessory Building: Park. Fees $ ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+KW Meter 0 u to 100 amps Meter ❑over 100 amps. Switches Garbage Disposal Generator ❑65 KW ❑5-15 KW Sub Panel Motors C30-1 HP ❑1'f.-8 ' Inc. Solar ❑9-15 HP ❑ 16-15+ Microwave Pole Light Range Sign Standing Sections Trash Compactor $ 3 FEES Reinspection Fee $25 1. Issue Fee PUBLIC SERVICES REQUIREMENTS: Zoning Approved By 1 Application Approved By APolitation Issued By BUILDING PERMIT / PLAN CHECK PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK MECHANICAL $ 3 PLAN CHECK O N 1 N G R E 0 U R E N FEES $ 3 SUMMARY OF FEES ' $ SMIP $ $ PERMIT $ ISSUANCE $ $ ENERGY P.C. $, $ GRADING $ - ——�M,ICROFILM $ -G-.1 2iip.:F SICAL FEE $ $ e �• CONSTRUCTION AND PLANNING APPROVALS. •Permit# Date_ Inspector - POC SPA APPROVALS Permit Date Inspector 1. Temporary Electrical Service or Pole - 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. - 51 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, 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 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 I p/124x'-( co FIRE DEPT. REQUIREMENT APPROVALS Permit 4#- 20. Rough Factory Fireplace 21. Ducts, in Structure 21. 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0Oil 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 29. Insulation 78. FIRE PREY. 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 35. Final Gas Pipe -Test- r - 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 48. Special Requirements Completed 49. Electric Release to Edison - i - 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 _CIT-vk-OFCOSTA MESA p MIT NO � � TRACT NO. L CONSTRUCTION PERMIT •roject Address esls_ ter}' TYPE OF CONSTRUCTION NEW ADD Applicant's Mailing Address Z S1• 'rc) - CONVERSION ❑DEMOLISH ❑OOTTHER Owner's Name DESCRIPTION OF WORK TF4 rA'6/ 1 1•L Address Arch/Eng. surp_ IceTns'e/1 0. Address 7 p µ% LOU lt Contractor's Name Address (mailing) p¢kyA e City License No. LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license Is in full force and effect. Llcen se Class - License No. Date Signature WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -Insure or a Certificate if Workers' Compensation Insurance,' or a certified copy thereof (Sectlon `s 3800, Lab. C.)' 1 Policy No. Company Certified copy Is hereby furnished. rrr�� /s - Ce t led o y s filed with [he citItlDi¢Lsj411! /i O Date Applicant l: Ls sr'.' • (J_ '. E)(EM l0 FROM WORKERS' COM NSATION DEC LA 0.ATI )N M(This section need not be completed If the permit is for one hundred ($100) or,' less). II I cart ify that in the performance of the work for which this permit is issued 1 shall not employ any person In any manner so as to become subject to the Workers' Compensation Laws of California. Date Signature NOTICE: If,iafter making this declaration; you Should become subject to the Workers' Compensation provisions of the Labor Cotle, you must forthwith comply with such provisions or this,,permit shall be deemed revoked. 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 (Section 3097 Civ. C.). Lender's Name Lender's Address - _ OWNER BUILDER DECLARATION 1 hereby affirm4hat I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional Code: Any city or and sign all appropriate declarations. ALTERATION LJ REPAIR T P OF PERMIT LJ GRADING LJ FOUNDATION LJ STRUCTURAL TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL OTHER PROJECT DESCRIPTION S T.T. ��p��,� OCCUPANCY-135- CONS CCUPANCY CON ST,RUC�ION TVPE�' ' - `_6 VALUATION $ ZONE �11•� r GRADING CU. V S. ACRES Remarks: P ( _ - n 0 h / - 9 9 rfA� C Bar Sink Backflow Preven Backflow Irrigati Bathtubs Clarifiers ' rinking Fountains loor Drains loor Sinks as Service Outlets Iterceptors itchen Sink avatories. 1 any structure, prior to Its Issuance, also requires the appllcint for such permit Roof Drains, :to file a signed statement that he/she Is licensed pursuant to the provisions of �- ' the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Hvision 3 of the Business and Professions Code) orthat he/she is exempt ierefrom and the basis for the alleged exemption.' Any -violation of Section Reinsction Fee ^ pe $.25 /031[5 by any applicant for a permit subjects the applicant to a ci Of enasty of not more than five hundred dollars ($500). , r 1, as owner of. the property or my employees with wages as their We compensation will do the work, and, the structure Is not Intended or offered for sale (Section 7044, Business and Professional Code; The Contractor's License Law does not apply to an owner of a property who builds or Improves thereon, and who does such work himself/herself orthrough his or her own employees, provided that such -improvements are not Intentletl or offered for sale. If, however, the building or Improvement is sold within one year of com- the owner will have the burden of proving he/she did not build or im- $r, va for the purpose of sale). Cooking Unit Boiler Under.Ground Duct -Under Ground Duct - Structural .Pit 1, as owner of the property, am exclusively contracting with licensed con - r tors to construct the project (Section 7044, Bus lness antl Professl ons Cod 0: The Contractor's License Law does not apply to an owner of property who 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 exempt under Section . 6 P. .for Is real n Duct - Ventilating Exhaust System Multiple ❑ Firepl/Fact. Bit. ICBO # Date Owner Heating System 4 Ducting I hereby cart fy that I have read this application and state that the above Information Is correct. I agree to comply with all city and county ordinances r' 100,000BTU ❑100,0008-P and state laws relating to building corUtruction,,and hereby authorize repre- Motors❑41 HP❑1ya-BZ- santatives of upth Is city, to a bov entloned propertyfor Inspection p ses. ' Reinspection Fee •$25 Signature Ica Dategt2 Drivers' License o SS 9 �%J-Ip—.-. _ CMF 0865-46 rev. 12/83 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod -Assessor PLUMBING Showers Service Sink Sewer Cap Sewer Connectiori •- Solar Collectors 1 Solar Piping Solar Tank Swimming Pool w/Spa Urinal 11, Water Closet Water Heater / Water Service Issue Fee Hood or Type 1 ❑ Canopy Type I (, ❑ lefrigertl ion System 4100,000 BTU ❑ 100,000 System Repair/Alteration Issue Fee - A.P. +-'Z-7— Ping. Z —Ping. Ref. # Parking Req./Provide Use of Building: FEES Planning Notes: 2913 6/26/84 04.Ej: 11 d - O 7 Zone 0 V Accessory Building 2 UJ E $ D U R E M E ELECTRICAL FEES Automatic Washer Construction Pole Sub. Transformer ❑ 15-50 KW ❑50+KW Cooking Unit Meter ❑up to 100 amps - Dishwasher - Meter over 100 amps Dryers ❑Gas ❑Electric Sub Panel y, Fan Motors❑41 HP❑1ya-BZ- f F.A.U. Inc. Solar 09-15 HP ❑16-15+ 2 fixtures Microwave 2 O Device Boxes Pole Light Zo O Outlets Range Switches Sign n Garbage Disposal Standing Sections ' Generator 00-5 KW ❑5-15 KW Trash Compactor $ 3` - Reinipection Fee $25 Issue Fee i ,$ 3• FEES PUBLIC SERVICES R IR Zoning Approved By -BuildingiApproved By Application Issued By ME T / L% at I Datella Data 2 / moi, ___ -�sv BTU BUILDING PERMIT '$ PLAN CHECK �$/Q•� PLUMBING l PLAN CHECK 25%� ELECTRICAL) PLAN CHECK - 50% MECHANICAL) PLAN CHECK 25% SUMMAFLY OF FEES Z Op SMIP $ �r66 PERMIT ISSUANCE $ ENERGY P.C. $ GRADING .$ MICROFILM $ $ 2. oc TOTALFEE $ $ ' — © $ 3 X 2 COTISTRUCTION AND PLANNING Date . t;. APPROVALS Permit # Inspector POOL SPA APPROVALS Permit # Date Inspect or 1. Temporary Electrical Service or Pole --------------- _ ' 52. Pool & Equipment Location - �i 2. Soil Pipe-Undrgrnd. q/s�G(i� LCO 53.. Steel Reinforcement - 't, 3.' Ele'ctri+'I Cond uit.Utility-Undrgrnd. ,. - 54. Forms - 4. Electrical Conduit-Undrgrnd. 55r Electrical Bonding 5. Steel Re 56.f Rough Plumbing&Pressure Test-. 6: Electh6a'l.,UFER.Grnd. '' 57. APPROVAL TO'COVER-GUNITE 7. Fo ,tings; :i.. - -.. 58. Elect'riul.Conduit-Undrgrnd. ' 8. Foundillion, 59. Gas Pipe,.❑ Undrgrnd., Test - 9. Water Rp¢;Undrgrnd. _ 60. Backwash' Lines, P -Trap, O Undrgrnd.. 10. Structuraf Irior Sysiem 61. APPROVAL TO.DECK T1". Propert,7 Sewer Line & House Connection 62. Backwash & Receptor -Final , ' 2. Sewer �, '�1P 63. Heater & Vent -Final - 13. Roof. • aini rs r ,- 64. Plumbing System - Final `. - - 14. Rough ,p( uinbing. q/5t?Y (EO 65. ElectricaPFinal ' 15. Rough Electrical -Conduit 66.. Solar System -Final _ 16: Rough Electric Wiring 9 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 I(�%( ( FIRE DEPT. REQUIREMENT APPROVALS. Permit;# t. 20. Flough Factory Fireplace 21. Ducts, in Structure : ; 70. Underground Hydro ' 22. Ducts(Ventilating 71. Product Piping O Gas .❑ Oil 23, Gas Pipe -Rough & Test' - 721 -Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O Gas' •0 Oily 25. Roof Sheathing 74. Overhead Hydro• 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry.Chemical ' 27. Frame and Flashing // C 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL .,. 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing �,i (� - `. HEALTH DEPT. REQUIREMENT ' 31. Plaster..Brown Coat-' .:-'- 79. FINAL INSPECTION 32. Electrical Power Meter -Final / RG 80'.F000CERTIFICATE ISSUED 33. Final Electric - 7� Notes: 34. Final, Heating & Air Conditioning 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factoryl Fireplace '- - - 38. Final Plumbing (1 � exe 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer - -, ',+• 43. Backflow Irrigation i '• t' '+ r• 44. Landscape Irrigation System - . • - 45. Sound Attenuation -- !• 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 3101 48. Special Requirements -Completed 49. Electric Release to Edison r 50. Gas Release to Southern California Gas Co ! • �. •\51. CERTIFICATE OF OCCUPAON ib. �ZSI Date t 85 r ` . "+, Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA^ CONSTRUCTION PERMIT Project Address - Z -4-r7 FIyz ff age o;U [TIC Applicant's Mail Mailing Address Owner's Name Phone Address Arch/Eng. License No. Address Contractor's Name @ Phone637- 7G?'L Address Imailingl �y��3' City License No. 2!7 aaZl LICENSED CONTRACTOR DECLARATION 1 hereby affirm that 1 am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license Is in full forssa and effect. ense LicCI 5 2- Li se No36 7, Data Signature E 'YORKR 'COMPENSATION DECLARATION tereby affirm that I have a certificate of consent to self -Insure or a certificate Workers' Compen tion Insurance,.or a certified copy thereof (Section 3800, Lab. CC..)I PPolicy No. .1 ,, Company o certified copy is hereby furnished. l .Certified copy is filed with the city Build g Djvyslor�.�. Date Applicant i\IV jx `11V EXEMPTION FROM WORKERS' COMPEN A ION DECLARATION (This section need not be completed if the permit is for one hundred ($100) or less). I certify that in the performance of the work for which this permit Is Issued, Shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Signature NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit Shall be deemed revoked. 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 (Section 3097 Civ. C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License .Law for the following reason (Section 7031.5 Business and Professional 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/she Is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of ivision 3 of the Business and Professions Code) or that he/she is exempt •erefrom and the basis for the alleged exemption. Any violation of Section - .031.5 by any applicant for a permit subjects the applicant to a civil enalty of not more than five hundred dollars ($500). I, as owner of the property or my employees with wages as their sole to m pen Sa tion, will do the work, and the structure Is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's License'Uw 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 employees, provided that Such improvements are not intended or offered for 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- rove for the purpose of sale). 1, as owner of the property, am exclusively contracting with licensed con- tractors t0 Construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such projects with a con- tractor( license pursuant to the Contractor's License Law). I am aware that proof of( their Worker's Compensation insurance should be providetl to me. ❑ 1 am exempt under Section B. & P. C. for this reason Date Owner I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize repre- sentatives of this ity to enter upon the above-mentioned property for inspection purpo Signature ,. 49,,� Date TYPE OF CONSTRUCTION LI NEW LI ADD r!!j'ALTERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A,P-# DESCRIPTION OF WORK/USE OF BLDG.` S Main Buildi E TYPE OF PERMIT GRADING 0 FOUNDATION 0 STRUCTURAL T Front �❑ILTENANT El ELECTRICAL El PLUM BING 1:1 MECHANICAL B pear _�OTHER ILC ��IZIcI/GLFILI A PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right K' CONSTRUCTION TYPE VALUATION$SCDL7 S Left ZONE GRADING CU.YDS. ACRES Ping. Ref. # Remarks: Planning Notes: 0297 10/16/84 p Zone Accessory Building: Parking Req./Provided 41.70 TL Z O N I N G R E Q M T S. PLUMBING FEES SUMMARY OF FEES Bar Sink Showers - ELECTRICAL FEES Backflow Preventer Service Sink' - - - Automatic Washer Transformer ❑ 15.50 KW ❑50+KW Construction Pole Sub. Backflow Irrigation 9 Sewer Ca P Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps Clarifiers Solar Collectors Dishwasher Meter ❑over 100 amps Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel Drinking Fountains Solar Tank Fan Motors 001 HP 01'/, - B Floor Drains Swimming Pool w/Spa F.A.U. Inc. Solar 09.15 HP 016-15+ Floor Sinks Urinal Fixtures -- Microwave -. Gas Service Outlets Water Closet - - Device Boxes Pole Light Interceptors Water Heater - Outlets Range Kitchen Sink Water Service Switches Sign Lavatories - Garbage Disposal 'Standing Sections P -Trap TOTALFEE Generator 00-5 KW 05.15 KW Trash Compactor Roof Drains Reinspection Fee 1 $15 Boller Duct - Under Ground Duct -Structural ' Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact. Bit. ICBO # Heating System & Ducting ❑0100,000 BTU 1:1100,000 Drivers' License or 55 # I I Reinspection Fee I $15 CMF 0865-46, rev. 4184 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Issue Fee $ 3 IANICAL FEES Reinspection Fee $15 Issue Fee Hood or Type ElDEVELOPMENT SERVICES REQUIREMENTS: Canopy Type II ❑ Zoning Approved By Building Approved By Refrigeration System 00-100,0008TU ❑loo,000 System Repair/Alteration' , Issue Fee $ 3 $ 3 PLAN CHECK 25% $ SUMMARY OF FEES BUILDING PERMIT $ Z-Sc]o SMIP $ " —6 PLAN CHECK $ I6 "ZS PERMIT PLUMBING $ ISSUANCE ' $ PLAN CHECK 25% $ ENERGY P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK 50% $ MICROFILM $ MECHANICAL $ TOTALFEE $ PLAN CHECK 25% $ i CONSTRUCTION AND PLANNING ' APPROVALS Permit # Dat Inspector POI.- SPA 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 Cold uit-Undrgr nd. 55. Electrical Bonding 5. Steel Reinforcement . _ 56. Rough Plumbing & Pressure Test 6. Electrical UFER Gr6d. 57. APPROVAL TO COVER-GUNITE 7. Footings, 58. Electrical Conduit-Undrgrnd. 8. Fouridation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe.Undrgrnd. - 60. Backwash Lines, P -Trap, ❑ Undrgrnd. ' 10z 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 .r '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 APPROVALS Permit# 20. Rough Factory, Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑Gas ❑Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank El Gas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. NT -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL GG 29. Insulation 78. FIRE PREY. 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 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 48. Special Requirements Completed 49. Electric Release to Edison '50. Gas elease to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY. No. -Date A . ADaRrssaeMLDNc: 245 FISCHER AV UNI C-1 OWNERSN;MEIFMWL CLOUGHERTY, MARGARET M ADDRESS: ;ROBERT B MARUSCIH 27031 SANTA SUSANA CIR MISSION VIEJO,CA 92691 APR. MAILNG ADORM' ARCHITECT OR ENGINEER: M. NO, ARCH OR DIG'S AODREM: UHT: CONTNACTORSNAME: DEL MAR HEATING 6 AIR (714)499-2805 CONTRACTORS MAKING 15 MONARCH BAY PLAZA wonss: MONARCH BEACH CA uc.No.:. 477331 92629 UNIT: 384 LICENSED CONTRACTORS DECLARATION: 1 herby Aim urger pmaly of Perjury that I anal IcMW ndm proaieiarw of Chala.9 (oommenan9 whh Section ]000) of Dhmon 3 of Ne Suainp and Proles sims Cede, ant my Rnrhp b in Iu0 era C"LiC./NO..:0381177/yuOcLASs: C-20 LIC.NO.: 47 31 XP: /00 Dae: /lf Ili "I G Cont. : OWNER BUILDER DECLARATION: I hereby a. anter pmhely of Imply Ihet 19rn exenpl Iron the Comww Licmne Lew lar the Iabwtp reason (Swim 7031.5 Susima. end Proleeaiwu Code: Airy cry or worry wbch raquirm a permd to oohs onss. Mer, bnpome. 'wd'wh. or top" my.audne. poor W IN bauerce, abo requires IM eppimm /a sunt puma to fib a signed stmemera Gua M a she z:3Aiaamed pummel to the Itovbima of the Cohiradon license Lew (Chapter 9 (oommsxaq cash Sealer TOGO) of Dvcbn 3 of the ;'5eihhem and Professions Code) or that he or she is exempt thaehan and 1M basis its the etle9ed exemption. Airy yidmion of Semon 1031.5 by my applicaot la a perms Milha s the apPIi to a tivI penalty of not mere than Fwe hundred do0va ISSOOD ❑ 1, m., althe Property or my employees with castes m thei oda compelstion, will do IM wdk, mW the volissure b not istmded or offered b sale (Section 7041, Sudrnm end Profession. Code: The Contrwan lioams lewdam not e Ophyt.. bwnm of Properly who bold. or inpoyes tMrem. And who does such wwk Fluenta AnelaMwphMaMr own employees,p,d that such bnponemmh me w was a tamed la We. tl, however. the MiMiAg a rope anw b pD wahin me yw of aempbhon, the .w bsilder will hew IM burden of pavaH M a she did w bark or impure tar IM p res . of sale). ❑ 1. As own" of IM property• am mamirely omandiq cash 6smaad amassae to wmoud the pojw (Sw'ah ]OAt, Suable" and Profeaaiolw Code: The Caawera Lianas Lew sop not so* b M owrwr of Property who builds or impwes tMmn and wdw wntrw. for wash K iw. will A oorawhs(.) Ikarus PafIWll to the Contredcrs U.. Lew). ❑ I aln exempt wrier Section: R. A P.C., ler the reason: Data Owner: I do hweby ced4 9w I Am nwane of and u :ancl IM ngdnmema of Calfomin NpMh and Safety Code Sedlme 25505,15533. alhd 2553x, end that I a emy Mun hhdldin9 omryeM wiR / wD w lamb mal Iheed Io comply wIh sed role uses ehd IM nRuvamanm Ea Date: Appl'uM: WORKER'S COMPENSATION DECLARATION: I hereby afbm unto, Peh by of perjury one of IM Idbwi, dedmaliona: ❑ I here and xil meinten a mnifrate d wneenl to cetlirwun hx wakars epnpenaanion, m pwidsd /a by Ssdim 0]004 IM Lobar code, its IM partammrcs of the tack for which this pall b issued. n I hon and N mss plih where'ss. My ion Imurmae. p repu"ved Try scall3]00 oche Lehr Cont, brtM pvMmmwa d the i� wrk for which Ihb pamN u muss. My wrbn' mmpenamion inwranca inner W play camber ms: Cerner: STATE FUND EXPIRES Pa'ry Number 01/01/97 uc scaler need w M omlpbbd y the Peml is Aw me hurdrad ddlera IVOO) or less.) ❑ cooly that in IM pedmpme d the wok 1a which lis penia b loosed, I ss that Uw employ Ars' perean'n ymn Io became subjectsubjectlq 1M workers' aarrtpenWlohh hew. d Celhomie, end Agres m I I shwa toll b ole Ica to h BalsaDale: canpaor 7 � .1 MM 1 calif can r wvlh WATMp: Fe9O"W KKYro woss"' [wmpMYatlpn royMapl Is .1"M, and eIWI eW/ect M Mlployar as CIIIIII�M�p And .h,H Awa rpt N am h.~ Muyammd "h a fafOA=1 M wdldan n Me mal or coapMpdo, danttspsc p mPyMed floor In Swdm 3M of Ms labor Code, Interact, and slromey s less. CONSTRUCTION LENDING AGENCY: I Mlaby allium anter panel)' of Penury that there I, a aoMrudion bndin0 a,mo, ler tlw pedmnmhce of the wrk for which this perms is issued (Seohm 309]. Civ. C). LENDER'S NAME: LENDER'S "DREW: I certify, that I how re24 this application and nue that the above idormalicn is carad.l Agree to comply with ail cly and county mfinarhws ant dale hss retakes m bcldih9 omal,l dicn end hereby sahabe reprasentaivm of this cly to eller upon the ebaemrMioned property la iespadbn puryoesa. WALTER M 42ZPnM Namep� /�/ L (5151_sSMP) Whde-BmWaj A SMety: Gossn-Flo: Carr,-Appfram:Pink-Revenue: OddMroa-Aaasawr CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 078389 PERMIT NO: E 078389 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE.: ADD JOB DESCRIPTION CHANGE OUT A/C UNIT 6 TON SQ FT: CLAIM VALUE: CALL—VALUE: GROUP OCC: B / COMMENTS: CHANGE OUT EXISTING ROOF MOUNTED A/C UNIT / REF M-78386 it*i61E16iE***dE1E**R6***1EiE961ER6dE**RE 1EdE*dE1E*1E REdE*dEiE**i6iE1E16161E1E*161E♦E**1F i6i61E96*1EdE**i6iEiF1E1EiE**1EiEiElErdE♦Fif Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ• PROV: PARCEL: 42729206 ZNE: REF NO: PLANNING N TES> 49.25 1E*1f 1F RE 1E 1E dE♦E**1f 16 RF♦Ek 1F d6 iE 961F dE dE 1E 1E dE dE 1E 1E 1E 1E dE dE SE*dE dE*1E it 1E dE 161E iE 1E 1Ert96 i69t dE iE*iF 1E 1E**iF 1E iE 1E 1E iE 9t RE 1E*1E 1E**d6 i6**161E D E V E L O P M E N T S E.R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY : APPLICATION ISSUED BY: 11. dF♦E 1E 1Ek♦E ♦E*k1E 1E ♦E dE dE ♦F 1E dE**1E*k LEGALIZATION:N F E E S U M M A R Y BLDG PMT PLUMBING ELECTRIC MECHANIC PERMIT 27.25 501 DATE: DATE: 1E * * * * R6 d6 dF 1F 1E�1FiFiF1E 1E STRUCTURAL SEGMENT:N FIRE SMIP/RES GRADING SMIP/NON—RES PLAN ISSUE FEE 22.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 27.25 22.00 0.00 49.25 49.25 .00 REVENUE DIVISION TOTALS--> COLLECTED: 49.25 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 49.25 RE 1E iE 1E*161E 1F 161f 9E Rf iF 1f 961E 1FkklF dEk dF iF 9E 9E kdFR6**9E 1E 161EdE*1E dE 1E 1E 1E*d6 d6k1E 16 iE*if iE**R6*iE iE 1E**1E*1E**dE 1F 1E 3E dE i6lF iE iE 1E*1f 1F I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 1 MOTOR/POWR APPARATUS 1.1 — 10.0 HP 11.00 11.00 ELE 1 MISC APPARATUS NOT LISTED REQ PERMIT 16.25 16.25 END OF FEES i 0 CONSTRUCTION AND PLANNING POOI .PA 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 . ;zg;tElectrlcal Conduit•U�drgrnd. 55. Electrical Bonding �. - =r5- Steel Reinforcement= 56. Rough Plumbing & Pressure Test - - 6. 'EhEctrical UFER�Ynd. 57. APPROVAL TO COVER-GUNIT.E -+ 7:Awings -. ,=sV TR8 58. Electrical Conduit-Undrgrnd. - ;Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9._Water Pipe.Undrgrnd, y- 60. Backwash Linen P•Trap, O, Undrgrnd. ,1_•0. Structural Floor'StiVitem 61. APPROVAL TO,DECK - 91. Property Sewer Lirie, & House _.Connection 62. Backwash & Receptor -Find, . 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing: 65, Electrical-Finalr 15. Rough Electrical-CoCdult ?, 66. Solar System-Far)al. 16. Rough Electric Wiring _ 67. Fencing & Acce !r.Jipproval _ 17. Rough Wiring STP- - 66. APPROVED FFSR'PLASTERING 18. Rough Electricai�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning. r ; _ FIRE DEPT.jtEQUIR.EMENT - APPROVALS J' Permit # =7 20. 1#bu4t Fa tont Fi place t r N IdroY 21. D'uctr in`�tru&urC_ f ,r 70Uaul..nderg 22. Bud`s, Ventilating-'> '- v c=• rpt r' 71. Produb9 P.iping.P,Gas 0Oil _ 23. Gas Pjpe-Rou§h & Test '� - "• 72. Under r nd Flush ` 9 oY _ 24. R'oof'Framing• 73. Undergrrid.StorapTank'OGas ❑Oil 25. Roof Sheathing r-* �" :r '� %� 74; Overhead Hydro, x _.1 26. Y -Bar Ceiling (Structural) & Monoeoat x Cl Ct 75: Dry Chemical 27. Frame and Flashing 76. Dry Starpipe 28. LathmgB Siding ;�zr = * t Tr., FIXEDBYSTEWFINAL- _ 29. Insulatiori�� '? 78: FIRE PREV. FINAL c` 30. Drywall Nailing _ + l- * T-HEALTRDEPT. RE66IREft71ENT " 31. Plaster Brown Coat, ° 5 k •�`', 79, FINAL INSPECT '32. Electrical•Power tgr-FMaI "80.; FOOD CE RTIATE ISSUED-• :•' -33. Final*Electric=_ r r7 ' _ _ <_ �=� /�j Nates: �'- "t`1 •- - -' _ ' 34. final Heafn & Air o `iionin _ * s •r. -" ` 35. Final Gas Pipe -Test"- _ 36. H_ood:br Canopy -37. Flnal•Factory Fireplace - r_ _ 38. Final'Plumbing t. 39. Water Service-FinaT,. _ - z•^ - ' X40. Gas Service -Final 2r " =• '-w -41. Solar Domestic•Firt@E - ;r a. .^ i t 42. Backflow Preventer~ "= r ' r •' -' 43. Backflow Irrigation Landscape Irrigatiof%System 45. Sound Attenuation r r• x - - rm •.x. .. r• 46. Handicap Regulations t r s; •--' ' 47. FINAL STRUCTURE & BUILDING -r 48. FINAL PLANNING - i • • t i_r _ 49. Elecfric Release to Edison j ri 50. Gas Release to Southern California Gas Cn 51. CERTIFICATE OF OCCUPANCY No. Date ADDRESS OF BUILDING: 245 FISCHER AV UNT: C-3 .OWNERS NAME IF KNOW. CLOUGHERTY, MARGARET M ...... %ROBERT B MARUSCIH 27031 SANTA SUSANA CIR MISSION VIEJO,CA 92691 APPL. IWl1N0 ADDRESS: ARCHRECT ON ENGINEER: UC. NO.: ARCH. OR ENG.'S ADDRESS: UNIT: CONTRACTORST :DEL MAR HEATING & AIR (714)499-2805 CONTRACTORS MAILING 15 MONARCH BAY PLAZA ADDRESS: MONARCH BEACH CA urw.: 477331 92629 um: 384 LICENSED CONTRACTORS DECLARATION: I herNy affirm Inger Penalty of perjury Nm I sm licensed SSM« pnvtsions of Chapter 9 (cammancing Wh Section 70001 of Ohvcn 3 of the Business And! Pt *lots Coda, and my 6. u m hA Lor and e0w. cmuc.N/o/.:03817.7 uc.cLAss:C-20 uc.N0.: 477331 XP: 0/00 Daa:1% •o-8. 96 Conoodar: 12 61 OWNER BUILDER DECLARATION: I hmaby dfirm ander peluly of perjvy that I Am ammpl born tM Conmwoon a Law 1« the lot w* neaon (Section 7031 S Bosiree and Professions Code: Am oty or Wu ty W ich scot A paredt to mmPuct, all, improve, mdch, « rapes an, nruclur, prior b u Mloance, also Moves the appbotmt for loch p rma to fib A signed stela Db M or mM icer ed pinnetnt to One prwnsions of del Cwrwon license law (Chww 9 (commemalg with Section ]DOD) of DNMion 3 of IM .telcos and Praaaions Code] or IM M or det M e.empt theamm led tins bens to tlet a0pee exemption. Am vioW ion of Section 7031.5 by Any applicant 1« a plemm sultpects One d okoa A to a IivO pens ty of w mors 0oW Tee humans dollars ($SDDD. ❑ I. as owmr of the pnalny«my employee ebh mgeo m their gds comp«mMn, wig do Na work, and But amionm; enot Wended «dlandheek(Section)O4. and ce And Ptaeaeick Cass:Tr Cwrwola Lianas Lew employees. ilwrleraP anh wM buida a tam M Ummon. o wile dons lot 1 work h'vnsel «Mrig or gaalgh M or tee ownlunons tat, plaided Nn loch oemer meNe ens w Wended I,td «dlleea in ale. E, bowavle, t l l dNvp or tw Ins M wU wind cm later d cerllpistvn. Ns awmreadd.r wig hay.IM dvden a proving M « cols ed w bee «imFmw 1« iM wmale a.w). ❑ I. m owmr of One *Went. am ma®vay mmrwig wnh ficeme l antra. to construct Ne project (Section 704. Bmirlse. end Plae4kns Cove: The Cont ww Licame law dose w Apply to an Carlo d iawinoapwy wIsdMm or W;xmas th; on and efio mnlracn b soon pmjads won to ocone d q.) Imwtl W Wct to tM CooWcon Uoenoa Lew). ❑ I am eeempl under Section: B. s P.C., tea Uis roman: I do Immby torah DIe1 I are swan. of end Ildlem9lld Na mammae. of CaMorm. Ilaah and SAW, Code Sedicm 25505. LSSD3. end 25531, and Nn I or Wry Mum budding oomped ail I wO w (circle «et) need to comply Mh ams glee N' and tM repukentente kr apanMl«mrlauwionanndRtutionbamtMAi w anglmrm GiWw. RaddWaWlmMlwion aPpEcetbman eumpt icons tMr Pr— Date: Applicant: WORKER'S COMPENSATION DECLARATION: I Mraby all Indle pmnetly of papa, one of Ns lollowkN daoMraiom: ❑ I haw. and Ail net"vinn a of ft .which maalleva i. warkai mriparrolion, n lsawidM lor G'section 0700 a IM talar Cada, la tM palomuWm a Ne sotto la which tlo pans, u mllmd. I have and W mammon amrken• Wmperetnion bmnarlce, As nalead by Swim 3700 of D1e labor Cods. Lor 1M p omance of Nm worth la wMN Nie pemW ls Mmund. MY wvYen' eompruanipn'vmrtarca mrile and D00ry nrnlber ane: Conn.: STATEFUND EXPIRES Policy Number. 07aoa 5— 01/01/97 .mire season need ler M «mpMral d rM perm! M AA• Dal huldM dasw /Stool «kuJ ❑ I Dann 0etl M Ne Dadarmanca a 1M work Lor ehicN tie pelma M Mwad, I Nal w slnploY erry paraan " v m r an m to become lobjed to the ecdcle" oalriparetnipn toes a Cabom". ed agnea ded 1 I mhauM beWrlet ubjmd l0 1 corriDemnicn praviacns a Swian 3700 d tM lobar CMm, I Neo taNekh m loth alp mddons. Got.: 11; 2 ' 9/n APPIW d: - Wam/ng:FM. Wsmcun.&.'Wnipmeaatlpn emmrapm la unraayay, Wd slim e1e(411an arRCloyWrocd pmrultlm and clvg floW W n ons hundred tho m datan (11100,DD0j An aCWLbn b tM call of WmpleetadCR damages m pmddmd for In secdon 37M CI Ne Lao, Cob, Willett and .Morns,', N CONSTRUCTION LENDING AGENCY: I hereby Mum oder Fleetly of alrjlsy Nn ten u a Wrnemaipn Hindi, agamy W me alrhmlanxe of tins work M M tWi peml c could (Salon ooh. Civ. C). LENDER'S NAME LENDER'S ADDRESS: I ceddY thn I ham nee Nil appficetian And nate IMI the AbUw bdlmediOn M comic.I Agree to Comply loth a City and 00«dY od'vwcm e tttana tows misting to buddi, Wnmwion and Mraby sulh«ba repemerKNivm of rtescly to aleupon the ebows+Ilerltiarled propend Ia inepedkn ptuposse WALTER M KI Pwz ?6 ole.: O Sp aro a OwnadApenU rwor (515146.WP) WMo-8uideq S SAW Gmer-File: CWlary-APpitad; Pink-Mmens;(bWaaod-Asmu« CITY OF COSTA MESA — BUILDING PERMIT --j—PERM NO: E 078388 PERMIT NO: E 078388 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N - PERMIT TYPE: ELE JOB DESCRIPTION CHANGE OUT A/C UNIT 2 TON CLAIM VALUE: CALC—VALUE: PURPOSE: ADD SQ FT: GROUP OCC: B / COMMENTS: CHANGE OUT EXISTING ROOF MOUNTED A/C UNIT / REF M-78387 tE tE*dEk/E dE dEk*kdE iEkiE sit*dE iErtkdE kdt*dE iE dE dE4**dfrtiE iE dE dE dE dE dE d6 dE irk iE*test sit sit sit sit*lF dE site ib dt iEitdE*dl d9*ltt*dE dF*dE dE dF dF iE dE it lE* Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ• PROV: PARCEL: 42729206 ZNE: REF NO: PLANNING N TES> 49.25 dE df dE*iFkdE dFdE dF IE*gE dE dl dE irk ib lE iE iE dl*iE irk it stirE**iE IE iE dE 1E*dE■de*dE dE*dE dF****iE fE lin dF lE dtlF lin dE iE iE lb dE*dE dE d41E*iE sit dE iE*sit■irk 4dt lE > V I D U A L F E E B R E A K D O W N dE dE if lE irk iE iE iE iE iE dE dE dE♦E dE sit dE irk**iE dr sit dE dE lE dE dE sit dE db dE dE*ltE*dE**irk dE dE iE dE dEkiF dE lE dF*dE dE dE♦E lE if dE***dE*kiE*4dE dF l!*if site*dE iE**k D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: LEGALIZATION:N F E E S U M M A R Y BLDG PMT PLUMBING ELECTRIC MECHANIC PERMIT 27.25 50% DATE: DATE: 9 �iF1E ♦E*lE 1E iE 1E dE iE iE dE iE STRUCTURAL SEGMENT:N FIRE SMIP/RES GRADING SMIP/NON—RES PLAN ISSUE FEE 22,00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 27.25 22,00 0.00 49.25 49.25 .00 REVENUE DIVISION TOTALS--> COLLECTED: 49.25 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 49.25 dE df dE*iFkdE dFdE dF IE*gE dE dl dE irk ib lE iE iE dl*iE irk it stirE**iE IE iE dE 1E*dE■de*dE dE*dE dF****iE fE lin dF lE dtlF lin dE iE iE lb dE*dE dE d41E*iE sit dE iE*sit■irk 4dt lE I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 1 MOTOR/POWR APPARATUS 1.1 — 10.0 HPC 11.00 11.00 ELE 1 MISC APPARATUS NOT LISTED REQ PERMIT \ 16.25 16,25 END OF FEES CONSTRUCTION AND PLANNINGDate POO ;PA APPROVALS Permit # Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. Z, 53, Steel Reinforcement -3.�E4ectrical Conduit Utility-Undrgrnd. 54. Forms =47 Electrical Conduit-thStlrgrnd. 55. Electrical Bonding - •S..Stgel Reinforcemeotc 56. Rough Plumbing & Pressure Test �lebtr'mal UFEFEEG%ritl. 57. APPROVAL TO COVE R-GUNITE - 58. Electrical CondulPUndrgrnd. e8' rbundation =' 0 59. Gas Pipe, 0 UridYand., Test Maier Pipe-Undrgrq`d. _- 60. Backwash Lines; P -Trap, 0 Undrgrnd. 10. Structural Floor`Sy3tem 61. APPROVAL T6LIECK 71, P.toperty Sewer Lips & House7Connection 62. Backwash & Receptor -Fina 12, Sevier 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 & Acce-WApproval 17. Hough Wiring Sign _ y 66. APPROVED FO,RjPLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOLJSPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning_ - . Ft_RE, OEPT.,REQU1REMENT y VAL--_8-j- Pei'init# �• .. 20. Rough FactorypFir�jace 5p• 4 _ -, ,,APPA- 21. Ducts; in Stru`sture_ " •' " - ' - 70. '�]ndergrollgd Hydro ,".. 22. Duct3-.; Vent ilatng` 71. Produc-Pping2- OOiI 23, Gas Pipe -Rough & Test - r "- J ; 72. Underground Fr'tlsh 24. Woof!Fra'Ming" r_ - - 73,' Undergrnd. StoraI;7u*Tank"0 Gas 0 Oil 25. Roof�6heathing •• - !_• 74:' Overhead Hydro-.'_ 26. T:,Baf`_Ceiling (Structural) & Montisbat x - 756 Dry Chemical" - =, 27, frame and Flashing-, x , : �: R r- 76. Dry Star�dipe r- Lathing&,Siding "; ` `r77 FIXED SYSTE1a;hINAL--`.29. jr, ..,��--ttS28. Insulatio r:r _ ' 78.i FIRE PREV. FIN�L `{ 30. Drywall tailing F- ;MEALTFFDEPT,. REQUIREMENT X31. Plaster Brownt"t _ '* !-' -79. FINAL INSPECTf_ON r ' :n c r32. Oectiical�ow�T tv�aier`Final _ 80, FOOD CERTIFICATE IS*$l{ED. �J -33. Final-ElectricC •' <' �� r No`test u '7 r_ -q _ 34. F(nal`Hearing $e Aritopditionin6.=• `"' __ c- ~ .•1 t,' :x " t„ 35. rural Gas Pipe -Test- x -%36. Hpodr Canopy = ` I. M �' x • xo r .. t-•: 37. Final Factory Firepla e x 38. Final -Plumbing J �` _ c' It- ' -39. Water Service -Final r_ � ' _ 40. Gas Service -Final �• � � , J. � � � •'� , F• 41. Solar Domestic-Finalne ^ 42. Backflow Preventer ' x F- 43. Backflow Irrigation; >.'- :r r •-: 44. LandscapE Irrigation System ; '; '' Cl -11 x• ^„ - < _ 45. Sound Attenuation 46. Handicap Regulation -' D .Y m •- r'r`' n 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING' "" r ` t a' 49. Electric Release to Edison 1 Y ` +• - - 50. Gas Release to Southern California'Gas Co t _ a 51. CERTIFICATE OF OCCUPANCY No. Date L\ 0DRESSOPH0UM: 245 FISCHER AV UNIT: C OWNERS NMIE IF IDS]MN: AIRPORT WEST BUSINESS PAR ADOp 245 FISCHER AV COSTA MESA, CA 92626 APPi MMIlNO AGGRESS: 556-4990 ARCHITECT OR ENGINEER: UC. NO: IRON.OR ENG.'S ADOREM: UNIT: CONfPACTom'RAw- PETRONELLA ROOFING (714)548-1645 CONITIACIORSUMM 2626 NEWPORT Am'COSTA MESA CA mw- 00460707 92627 u.T: 201 LICENSED CONTRACTORS DECLARATION: I hwaby tlDm unlder paruly of perp., that I am rowllsd under providers of Chapter 9 (commmdiq with Section )000) d Direion 3 at the BIr@MO ted p Code. mrd my license I. m hA form end whop. c��D.No.:032605 u`'`u`4" C 39 u`'N 00460707 EXP: 07/96 DWNE DECURATION: I hovels, dfurn order tl iMt I watt estenq Irm the Catrrlas lirtwe few la Ow Id reason (Seaman 70315 Bus. ted Prcleedam Arry c a aarmY which expees a Permit to con.NCY, der, improve. mallsh, or repair"sincMe. prior b b awaace, also r.. fa suit panni to Ne a a gom awtrwd that M a she licensed pursued to the provitiorw of the Ca rsaors firm_.. Lew [Chapter 9 (oannaning with Section )000) of Dbbion 3 of the .ownews end Pr "moms Coda) or that he or ata at wwrapt tharalmn erd IM baso for the alleged wempticn. Arq vbblion of Section 10]1.5 by m Yapphc la a pared mOj ted apphced to a dvg pwwby d nct mos Nen IXa huedred do0ars jSv00D. I. m owow d led popany or my emgo/em with wagm m their sob wmpemtevt, waT do ted work. erd tlw wuqun ls nal vuwded r offered b eels (Swdon )OIs, Bus'uwm end Prlembw Cade: The Crandon Littera law does ml apptyto m bwmrd property who bui Is or knprvm therm. old who doas such work lined or MreN or Morph he or her cram anWryam, pmided that such imprwwneds re m unwed.! or dbnd for eels, 0, howenr, the buildup a ung ad u sold witldn row year d mmpld'on. the ownar-0 Ww win have ted burden of prwirp M or she dW tel bugd or improve for the purine of sale). 0 I, as ower of IM IroDeny, stn sadva a omtra]kp with batter al cmirec m n t.mruct the project (Section 70U, Bmirwas aM Pal. Cod.: The Craradm L. law der not apply w m ormw of property who builds or impwm thwaon and who wnvada for sued propos with a opdratlar(s) liceased pawed to the Corurmaa licrme law). I watt exempt .M Section: S. & P.C.. for this reason: Det.: Owaw: I ed hereby cmity that I am aware of ted underwrd the tepuirmend of California Heath etld Salm Code Seaioas 25505. 25533, wW 25531. and Mel I or any Move humin, oowper will I wD m (dab row) need to campy with said nate codas and the nOdremmM for e pe.R loroo_atmction or n tcatbn homtMA, = 7 ._agement Diwiq. RaaideMul mnpntlun eppEtNiruar memp Mm them prwisiom. Data: Appllism: WORKER'S COMPENSATION OECLARAnON: I hereby affirmu pwaaty of pwpey one d the Idbwirp dwdeatbns: IhatseMsoftmaitre_a of the wriodwIsdLwrs forwrkwi canperwtbn.m provided In by5wbn ])GOdiM labor Cede.la the pedprmans d saw soak la which Mb game h blued. flava and wil main_ worMre' cotnpened'on imur.nm, as rewind by Beavon 3700 of the labor Code, ler the padprmmce of the —\soak for which this pend) b mutl. My waken' aompemdiai Mwrmcs m n r and pogc r camber we: Carrier: ARG17)NAUT EXPIRES P014 Number: 21570115 595 01/01/97 .his sedfart need _d bw coa*cwt s ow ow rk u bar tl.Id/ed data. /Stool a bm.1 0 I mniy Pat In ted pwlonmrce d tM soak b whch Ills pwma b issued, I shat ex emgoY my pram'm wry me m w as to /-A.. wbject 1. IM wakes' wravented bws of sad agna that a I would became wbjecl to the workers' dmparent. F awe. d len 3700 d the Labor J`C dlfd hw4h mrr"";= ms. 1 II 4-)-t _IT,[_ ) , W.41W: Flgpn r .stun wo*ws'rorryww td.. row Is ter sold1, Id tublect m mployr m cdminal pm.Mes and chell firm up to ore hwtdnd flntumN Wows ($104 A In _fj n m ted cwt of corttPerreeNar4 demsgm as "Oded At, In S.D. 3)05 of Me Labor Cotta IafwwsL and srtom Ylass. CONSTRUCTION LENDING AGENCY: I hereby affirm of Pwimy that rhsre I. a caMrudion leadup aprvR ler the pedormanca d IM wrk tar which IM prmb is owed (Section 3091. CN. C). LENDER'S NAME: LENDER'S ADDRESS: I codify that I have reed this spoicatim ted elan that the abws uaorowlion b correct, l agrsa to owl* with d cdy rd county ord'utmma and dd.lewe rehom to b.liM cawM.tion text hereby uthorbs rapremnmives of this dry b eater upon the abon tmmiawd property for impecticn punpmes. t\ LOID WATTS Wed.-Buidap A Sway. Gere.-%; Ctewry-App4sr: Rnk-Mwas: Oddw.od-Asaemar CITY 0£ COSTA MESA — _BUILDING,PERMIT PERM NO: B 078187 PERMIT NO: B 078187 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: STR, PURPOSE: 0TH JOB DESCRIPTION T/OFF BUR S REROOF W/SAME SQ FT: 17,000 CLAIM VALUE: 17,000.00 CALC—VALUE: 17,000.00 GROUP OCC: B / COMMENTS: REROOF 17000SF COMMERCIAL BUILDING W/BUILT—UP ***MMMMMMMMMMMMMMMMMMMMrraFratoE�E�E*****r�E�E*�Ew�EiE*�x*iE*�E��*�E�r�*�E*�r*�E�r�*�EiE*�P�**iE�E*x Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT:. FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RIGHT: FT IN LEFT: FT IN RIGHT: FT IN PARKING REQ: PROV: PARCEL: 00000000 ZNE: REF NO: PLANNING NOTES> MMMMMMMMMMirkMMMMMMMMMMirkMMMMirkM MM MMMMM MMMMMMM MMMMMMMMMMMMMMM MMMMMM M M MM M M M MM M M M MM MM D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY DATE: APPLICATION ISSUED BY: DATE: Hjg MMMMM MMirk irkMM MM MMMMMMMMM MMMMMMMMirkM Mirk LEGALIZATION:N F E E S U M M A R Y STRUCTURAL EGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES' GRADING PERMIT 249.75 SMIP/NON—RES PLAN 3.57 ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 253.32 0.00 0.00 253.32 253.32 .00 REVENUE DIVISION TOTALS--> COLLECTED: 253.32 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 249.75_ 3.57 MMMM MMMMMMMMMMMMMMMMM MMMMMMMMM MMMMMMMMIidM MMirkM MMMMMMMMMM MMMMMMM MMMMirkM MMirkM MlidMMMMMM I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST SFC 17000 REROOF BY VALUE COMMERCIAL NOZONE 1.00 17,000.00 END OF FEES CONSTRUCTION AND PLANNING P•00 3PA APPROVALS Permit # Date Inspector APPROVALS Permit# Date Inspector t.. emporary Electrical Service or Pble 52. Pool & Equipment Location• 2. Soil Pipe-Undrgrnd. 53- Steel Reinforcement t �3?-U#Mrical Cond U�, ity•Unccprnd. 54. Forms z�Aegrical Condu UArgrnd. 55. Electrical Bonding ^f6:�ffi%al Reinforce rvarIIS 56. Rough Plumbing & Pressure Test fr�ectrical UFER 57. APPROVAL TO COVER-GUNITE t F:,f v'Footings ^cc 58. Electrical Cond 9l%Undrgrnd. - FSundation 59. Gas Pipe, 0 Und., Test ,.W' _ater Pipe•Undr�nd. ,i 60. Backwash Lines' -Trap, Q Undrgrnd. 9. tuctural Floor System 61. APPROVAL TO ICK i1. Property Sewer Line,8f House,xonnection 62. Backwash & Receptor -Final Y2. Sewer Cap 63. Heater & Ven[ -Final 13. Roof Drainso s 64. Plumbing System -Final ' 14. Rough Plumbing2 � 65. Electrical -Final 15. Rough Efectrica or2uit ?. 66. Solar System-F� 16. Rough Electric 1Afirinfle t C 67. Fencing & Acces tpproval n 17. Rough Wiring Si S 0" 68. APPROVED FLASTERING 18. Rough ElectricahT Bar Ceiling- 69. POOUSPA SYSTEMS FINAL 19. RQugj1 Heating& ,�r Conditioning_ 9 r t� a, F'tt D T. EQUI ME � t: Kg , e r _ i7 �•� �r ^' 00 :-t * jtPPtf19V�.y Pe(:mit# y t� r C` 20. F orYtFir ace y� * S t -i r`J•k, -ug S'" ti r•, _T�F 21. TTctP�•,n ruFur'!' eSz r. x S v : -r 70. nderrjrt}I�nd Hj1ro t•, tz S r• O r• �: y 22. DucpJVe Lila ngN rt CJ n.% .71. Pro duar,Elping O as doil 23. Gas I e•P,buc &Text [*t SX' 72. Undergr4gr)�1 Fl;�s9Y4 n F� * cr ,J 24. f�oof Fra t ng. czx -..., x = p r ,.,. • 73- Undergrnd. Ston tgsT•ankTO Gas OO,I 25. ROoof'9hea"ihing r�z 16��U/ C �, •,y 74?werheadHydra. rr' M 26. %Ba Ceil�gg (StruC2 Tal) & tv'�goc`�•oat . 00 ` p x 7��ry Chemical F,=1 4 _ v r, 27. FrartGrand-Flashings* ^_�^S * =' mX R1. F11 76. Dry Stan�f4pe F -'H * n N 0 F28. Lathi g 8 Sito904 r �tr. 0 g * 77Pj FIXED 3YSTEIU' INAb rt _ 29. Insulation, • S 'h 7t -oz PREV. FLDI�L G t 30. Drywall t ri g g 1: �IE-ALTItf;DEP4 �E61RA•MENT t 031. Plaster BrCWn•Coal1*S i t * 79. FINAL Iq7 P,ECT�iN x m C F <32. P,yctricalt Dw,aj M j� rPiAal x N I �K '80YF000 CERTIFFCA_TE I SUED. t 33. al�HlettBie: "'�* t*: i K Y • • �, N s: s•S 34. F,jhal7HeaTng X AgC4p�iioning S * G v 35. f nal Gas Ape-7est7* p� j36. F ootP.br (;anoPYS4 , Gr c t I s m xo e m ;_37. Final gactory Fire�ljerx Vic- 0t • I _ ru it M S r38. FAnaIFPlumbinc 04 n * !-� ti :.:r� W y rr 39. Water Service-ijna * F r tv K : # S m M'40. Gas Service -Final f -4m Crm S M ' - r It, ,.:A1. Solar DomestZFirylR ' ;,j .* r ?T -jcn tr K : ^ - 42. Backflow PrevEter * N " t; 43. Backflow Irrigation > z x �• + s�i 4 . f, andscapgrrigationtystem �r•.r' t .T. WIT! It O a, C74 �'. Cu;U J. "• �, g ry O� x S t• C 45. &und Attenuation �, -, ,.`. a t'f v c^ aIt ••�` LL' 48. HFa cljnSap RegUtationt: '-' �-` * M -S 7•'' -- 4 47--. F1 NALSTRUC7UR&BUILDING cc y * O 48. fR4AL PLANNING ' m t r T• r -,X GSL' S X 49. Etectrif Re�eafe to Edison 59. Gas Release to Soutltjrn CaliforasCo 51. CERTtFICATE OF OCCUPANCY so 11 1 No. Date r- 5tp MF,p CITY OF COSTA MESA BUILDING DIVISION F _ DEVELOPMENT SERVICES DEPARTMENT _ PERMIT 754-5273 • Fax(714)754-4856 / Job Address: 245 FISCHERAV Suite: Vicinity: IN FRONT OF UNIT C-2 Parcel Number: 93898001 BUILDING PERMIT Zoning: Applicant: KYLE ESSE Permit:' $38.75 Address: 701 NORTH PARKCENTER DR' SMIP Com: $0.00 Other: Phone: (714)560-8200 Total: SANTA ANA, CA Zip: 92705 Owner: HITTNER, GLENN W Address 245 FISCHER AVE #A-1 - Phone: COSTA MESA,"CA' - - Zip: 92626 11 Contractor: ,TAIT ENVIRNMENTAL MANAGEMENT INC Address: 701.NORTH-PARKCENTER DR " Phone: (714)560-8200 " SANTA -ANA, CA ' Zip: 92705 License: 588098 PERMIT NUMBER B00-00155 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 02/07/2000 Issued: 02/07/2000 ISSUED BY: Arch : - Eng: TAIT ASSOCIATES Address: '- y Address:, 701 NORTH PARKCENTER DRIVE Phone: - Phone: (714)560-8200 SANTA ANA, CA Zip: - / License: 92705 License: ' INSTALL MAXIMUM 25 REPUBLICAN CENTRAL COMMITTEE. Plan Check: $25.19 Permit:' $38.75 SMTP Res: $0.00 SMIP Com: $0.00 Other: Inspection: $0.00 Total: $63:94 SETBACKS MAIN STRUCTURE Front 0-0 ACCESSORY Front- 0-0 PARKING Existing: 0 'at urr Vr rCKN11I , )T HIGH FLAG POLE INCLUDING FOOTING IN. FRONT OF BUILDING "C" FOR THE FEE SUMMARY . - _ Calc Valuation: ' 1 Claim Valuation: PLANNING & ZONING Rear 0-0 Rear 0-0 Required: 0 Left 0-0 Left 0-0 Proposed: 0 Right 0-0 Right 0-0 $1,000.00 $1,000.00 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) 7545626 DECLARATIONS WORKERS' COMPENSATION DECLARATION: - I hereby affirm under penalty of perjury one of the fallowing 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'ped0hTarice of the work for which this permit is issued. ' �I have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which tMs permit is Issued My workers' compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not he completed i/ the permit is valued of one hundred dollars ($100) or less.) ❑ 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 worker.. compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith, comply with these provon isi Applicant Signature: Date: (J2--��--Ute WARNING: FAILURE TO E WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOULARE (S100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS 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, end my license is in full tome and effect. Lic. # Class # R AS liT9 } Gf0 Contractor's Signature: Date: J CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit I$ issued. (Sec. 3097, Civil Code). Lender's Name: Lenders 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 stiff 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 penalty of not more than five hundred dollars ($500).): ❑ 1, 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.). ❑ 1, 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. ❑ Yes ❑ 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 will 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: 1 Will 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? ❑ Yes ❑ 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 feet 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? ❑ Yes ❑ No (Section 25533 of the California Health and Safety 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 Callfomla Health and Safety Code been fully complied with? ❑ Yes ❑ 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 ppermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 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? ❑ Yes ❑ No (if "yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ality-.__--_.._..._____— —....— -.___trio orequired 7 a a permit from the South Coast Air Quality Management District or other air pollution control district or agency la requiretl 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? ❑ Yes ❑ 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 COMPLIANCE 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 all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Sig re Of Legal Owner(s) Date y i-off-� nd/Or Authorized Applicant - Date CODE A, INSPECTION TYPE DATE INTRIALB CODE 1 INSPECnONTYPE QA¢, INTITIAL 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 210 Final Electrical 201 Final Block/Retaining Well 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Builtling/Ocoupency 2446-46 City of Costa Mesa- - - - - B.uilding safety Department C E R T I F I'C A T E O F O C C U P A N C Y r - '"P.O. Box 1200 - T�.ie - M5 — Costa Mesa, California The Building located at 245 Piarhar Tlnii• C-R has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicab4thereto - for a Group � n-7 Occupancy. v Use of Building TOM•arinr Tmr�wxvxnon}c ' Legal Description a n en7n_nzz_n� - - .- (See reverse side for Metes and Bounds) - 4: <, Building Permit No r: lAc;`+ Electrical Permit No. r 1'R55 Plumbing Permit N0.n-79'7r/M_171^ " 49282 Number of apartments -0- and/or guest rooms —0— ISSUED T0: Building Official by PullmanProperties Victor C.�Newton—Huilding'Division Direci]the Date �6 �'�r3 /�lS✓L This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except Building Official of the City of Costa Mesa under Sec. 306 lelU.B.C. Form eU 34 Rev. 11/70 —no M- MESA BUILDING—SAFETY DEPARTMENT r P.O. BOX 1200 Costa Mesa, Califomia �N0 z On7 cinOi'.]l_ VSM,; , F , . ' E , ' I kI �P� ELECTRICIAN •� a 11 xrWR TRACT NO. LOT NO RECD BY/ ' -4444�&F/ PE Q ) �V DATE ISSUED ADDRESS pT 13• 0.T BUILDING USE 3 TEM CITY M. No. — M STATE LICENSE NO. 2.12 1 CLASS (t—j C DINGElse .L '/ ENIDRESS -'2 S J$'/7 •G lrL CITY LICENSE NO. R 3 W p-? NO. ITEM EACH FEES COSTA MESA, CALIFORNIA Dwelling,NEAREST Sq. Ft. S CROSS ST. Garage, Sq. Ft. • OWNER L %ii �/ 0)? First TO Outlets, each MAIL_ a y ADDRESS j��yl / /(!%{v V / iT W/ Outlets, Additional TEL. NO. 63 CITY �J�N/'�� ! /L//EIAA7T �•22' js�CATION First TO Fixtures, each ` I HEREBY ACXNOWLEDGE THAT I HAVE READ THIS APPLI• AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO(6?,MPLY WITH ALL CITY ORDINANCES AND STATE LAWS REG. gill, ELECTRICAL WIRING. �1 CERTIFY THAT I POSSESS THE ABOVE VALID STATE OF CALIFORNIA CLASSIFICATION OR I AM THE LEGAL OWNER OF THE SINGLE FAMILY RESIDENTIAL PROPERTY DESCRIBED ABOVE. of PERMIT Fixtures, Additional Dryer /p M.L. . Fan �D•_ Heatert 4yyI A� Oven, Domestic .d �� 1 No. ITEM EACH FEES Pole, Construction Sign b 1 Trans. 2.00 Range, Domeiti< Transformers KW Gerwrators IDM Motors ISes Schedulal HP HP Sub -Total Fee, HP APPROVALS Meter,, ea. INS"CTOE __ DATE TEMP. POLE I Permit Fee 3 00 UNDERGROUND CONDUIT ROUGH Sub -Total Fees FIXTURES POWER Total Fees UTILITY CO. NOTIFIED FINAL CMF 0313-46, rev. 7/75 I_ For items not listed refer to Fee Schedule BLDG. PERMIT NO. TL :+v Applicant t0 fill in all ipat-.� Ry border lines and si--�-_(gn all appropriate declarations. '`, CITY -OF COSTA MESA" PER NO. �"' TRACT NO. LOT NO. •BLDG. NO. � 870L 11/25/81 � 1 16e 1 7 COP° TR. TION PERMIT / S \`3S3 j 3 TYPE OF CONSTRUCTION NEW ❑ ADD ❑ ALTERATION ❑ REPAIR ❑ CON_VERSION ❑DEMOLISH ❑ OTHER _ _ "— "" + _ - ZONING REGULATIONS Project dress Owner Phone Address Oleltd 57' License No. Arch/Eng , (f DESCRIPTION OF WORK E OF PERMIT El GRADING ❑ FOUNDATION ❑ STRUM TURAL ❑ TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHAN11 A.P.'q-Z-7— ^ ZONE P PLNG.. gR CEP.. p:. UlTi LD I NG C T. RO PEIRTV , Nr SIDE YARD Address 2;6V Contractor Q ry( [/ Phone 4-6 Address LICENSED CONTRACTOR DELLA ATI N I hereby affirm that I am Icons u er rovl t (com- SI E YARD RIGHT mencing with section 7000) of vis n e mess and ❑ OTHER Professions Co n m Iice e' i I f II f r and effect. REAR YARD (TO P/U PROJECT DESCRIPTION License ClassLI e a PKG. SPACE REQ. PROVIDED Date Signature SQFT9SLJ . . OCCUPANCY CONSTRUCTION TVP A), STREET WIDTH PARK FEE E WORKERS' COMPENSATION DEC LARATIO I hereby affirm that I have a certificate of consent to self -Insure ora VALUATION r ZONE ZONING APPROVED B OATE,t I+�O{ certificate of Workers' Compensation Insurance, or a certified copy GRADING CU. YDS. �— ACRES SPECIAL CONDITIONS: thereof (Section 3800, Lab. C.). _ No. Company _ REMARKS: - - - PPolicy I +rtifled Copy is hereby furnished. rlifled copy is filed with the city Building Division. E.._MPTION FROM WORKERS' COMPENSATION DECLARATION q - (This not be completed if the permit i5 for one hundred ))section ))need or lethatsln S§cart(fy the performance of the work for which this permit 15 issued, I shall not employ any person in any manner so as t0 become PLUMBING i PLAN CHECK ELECTRICAL PLAN CHECK Subject to the Workers Compensation Laws of California. BATHTUBS SHOWERS Date Signature NOTICE: If after making this declaration, you should become subject TOILETS URINALS GENERATOR 0-1 KW_ 1-10 KW 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 LAYS APPLIANCE 10-50 KW -50 + KW revoked. KIT. SINKS DISHWASHERS MOTORS 0-1 HP -140 HP CONSTRUCTION LENDING AGENCY 1 hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS SUMPS (INC. SOLAR) 10-50 HP 50 + HP formance of the work for which this permit is issuetl (Section 3097 ., _ I,' -, ; FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES Civ. C.). Lender's Name Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS _ OWNER BUILDER DECLARATION I hereby affirm that I am exempt from.the Contractor's License Law for INTERCEPTORS CLARIFIERS' - '� s' POLE LIGHTS SWIMMING POOL PTRAP POLES METERED SUB the following reason (Section 7031.5 Business and Professions Code: Any city or county which requires a permit t0 construct,' alter, WgTERiSERV ICE 'ALTERATION PANELS MAIN SUB - Improve, demolish or repair any.struct We prior [o.i[s issuance, also re- quiresthe applicant for such permit to file'a signed statement that he GAS SERV ICE, •. J� SERVI AMP is licensed pursuant to the provisions of the.Contractor's, License Law (Chapter 9 (commencing with .Section 7000) of -Division 3tof•the OUTLETS Business and Pro/essions Code) or that he is exempt therefrom and the .WATER HEATERS'- • c BTU OUTPUT'� - '-I ,basis for -the alleged exemption. Any violation of Section 7031.5'by. SEWER CONNECTIONS anv. applicant for a permit subjects the applicant to a civil penalty o,.aa,^4,1f-' more than five hundred dollars,(E500).-- Lt.;*'I,s the with wages as their SOLAR TANK 'COLLECTORS'.-- owner of property, or,my'employees Spi f the pen Sat Ion, will tlo the work, and the structure ii not intended ;'I or offered for sale. (Sectionw7044, Business and Professions Code: The SOLAR PIPING SVS. ISSUE FEE Contractor's License Law does not apply to an owner of a property ISSUE FEE ' APPLICATION APPROVED BY DATE who builds or Improves thereon, antl, who does such work himself or through his own employees, provldetl that such improvements are not MECHANICAL PLAN CHECK $UMMARV OF FEES Intended or offered for sale. If, however, the building or improvement Is sold within one year of completion, the owner will have the burden .. f cuing h¢ tlltl not build or improve for the purpose of sal¢). BUILDING I, a5 owner of the property, arts exclusively contracting with HEATING SYSTEM 0-100,000 BTU AND DUCTING PERMIT § •S� SMTP E_adL ICG nsed contractors to construct the project Section 7044, Business P ( 100,000 +BTU PLAN CHECK § PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE E an owner of .properly who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING E tracts from such projects with a contractor(s) Iicesnetl pursuant toSYSTEM GRADING E the Contractor's License Law). 100,000 +BTU' - _-� PLAN CHECK § ❑ lam exempt under Section B. & P. C. for this BOILERS B7U _ ELECTRICAL E J.C�2_ E reason PLAN CHECK § MICROFILM E Date w SYSTEM REPAIR, ALTERATION MECHANICAL E TOTAL FEE E I hereby cert y hat I v ea ppl' ion and state that the above EXHAUST SYSTEM MULTIPLE LESS AD- in(ormatlo Is 'come a to ply With all city andcounty PLAN CHECK E VANCEPC E Ortl In antes no state I ale 'ng t omstructic antl hereby authority¢ representatl of 15 city o nter upon the above mention¢ for —J - ,... �.`T>.L - c•`t t Property so O purp S. _ Signature -- ISSUE FEE .) Jsaa :�'. .te FINAL FEE 'E - Drivers' Licens SS CMF 0865-46 White -Building; CanarY-Applicant; Pink -Accounting; Goldenrod -Assessor TL CONSTRUCTION AND PLANNING APPROVALS Permit #4LZArvs Date - '- Inspector • !POOL & SPA . APPROVALS Permit # -F� Date 1VLAS *" 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. SoilPipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility.Undrgrnr - •, 45. Forms A) 1 4. Electrical Conduit-Undrgrn t.�t ; �, �•�,-�; - 46. Electrical Bonding5. ' "- • ' ' Steel em orce 47. Rough Plumbing &-Pressuie Test A0 � ' 6. - Electrical LIFER Grn! 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr en B. Foundation - 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. _Backwash Lines P -Trap.❑ Undr rn 10. Structural Floor System '1" 52. APPROVAL TO DECK 11.,, Property Sewer Line & House -Connection 53:`tlBackwash & Receptor -Final 12. - Street Sewer Connection - 54. Heater &Vent -Final 13. Rough Plumbing j a - - 14. Rough Electric -Conduit _ _ -56. Efectriraf-Final 15. Rough Electric -Wiring - 57. Solar System -Final _1.6. Rough Heating & Air Conditioning bd. Fencing & Access Approval 17. Ducts, in StructureAPPROVED FOR PLASTERING 18. Ducts, Ventilating - 60. POOL/SPASYSTEMS FINAL 19. Gas Pipe -Rough & Test - ,� 20. Roof Framing 21. Roof Sheathing- NOTES: - _ - , 22. Frame and Flashing /. j,$ ✓' -c123, ,'Insulation. C \ - o / ` 24, Lathing & Siding A[ " Lrr. I d 41 25, Drywall Nailing-/ - 2 L' .'� jouG 26, Plaster Brown Coat r ,'AA 22--• 27, Electrical Power Meter -Final _ -S-sJ2j4r.v L GJe<,<eC 5' f Co a," .• ' -28." Final Electric -06Lt • 29, Final Heating & Air Conditioning _8 a 30, Final Gas Pipe-Test(1,9,7- - -- 31, Final Plumbing 6'1 /,. /LO •32.?'tWater Service -Final M, -C,4 ri .7 - Y- ff.R R:O • 33. Gas Service -Final - = f1-tG �� /--'1 9-.�Z ''=.: G C - 34. Solar Domestic -Final 35°.,Landsca e Sprinkling S "steml�l •� 36. Sound Attenuation i .' : 31 �` 37. Handicap Regulations 38. FI NAL STRUCTUR E & BUI LDING- 39. Special Requirements Completed - 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42, CERTIFICATE OFOCCUPANCY Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PE IT NO. - TRACT NO. LOT NO. BLD NO. - 1694 - CONSTRUCTION PERMIT d�S %J~ �� 2/04/84 7.00 TYPE OF CONSTRUCTION I �D NEW D ADD '❑ ALTERATION ❑ REPAIR El CONVERSION ❑DEMOLISH - ❑OTHER _ _ •� - - - ZONING REGULATIONS Project Address - -/ GiY <f— 3 Owner UL / Phone Address /452 7 p'/��! Address g.- License NO. DESCRIPTION OF WORK -. A'P'B - -.Address - - - ZONE PLNG..REFc yF -- ContractorcOj-� r� r - PhdneJ167og3,3 -TYPE OF PERMIT "- -� - •D GRADING ID FOUNDATION ❑STRUCTURAL D_TENANT❑ ELECTRICAL OPLUMBING ❑MECHANICA - - STETBACK C/L ST. YARD TTQ E6 Lp"TI _ P^OPE RTY `INE [ ! - j Address t p . /� ,-%/Q !LICENSEO CONTRACTOR DECLARATION •1 hereby affirm thLt 1 am Ilcensetl under provisions of Charter 9 (tom- menctng-with section 7000) of I Division 3 O6 the- Business and. I E V 55I HT D OTHER" R -_ .Professions Code, antl my license Is In full force and effect. 'REAR YARD (TO P/L) --' - - i PROJECT DESCRIPTION- ;License Cldis 'license O _ t 1' •' �`-- - 'PKG. SPACE REO-' '"' - "PROVIDED - - -;-PARK-PE Signature ,r J - - WORKERS'.COMPENSATION A - _ - OCCUPANCV_CONSTRUCTION TYPE- , STREET WIDTH' --- E'$.n.-- 11 hereby affirm that have a Lift f sent to self -Insure ora _ -VALUATION ZONE "ZONING APPROVED BY- • - - --- -DATE-- -- certificate of Workers' Compensatio Ins ante, -or a certified Copy _ :thereof (Section 3800, Lab. C.)•GRADING CU. YDS. ACRES SPECIAL CONDITIONS:' - - - - 'policy No. ` Company REMARKS: - r-artified Copy I5 hereby. furnished. _ _ srtified copy Is filed with the city Building Division. 4_.. MPTION FROM WORKERS' COMPENSATION DECLARATION I - - - - ((This -section need not be completed if the.permit is for one hundred ' x($100) or lessl.,i certify that in the performance of the work for which this permit Is Issued, I shall not employ any person in an anner so become PLUMBING .PLAN CHECK - - - ` ' ELECTRICAL ' ---- •' PLAN CHECK' — - subje to the Wo kers' Compensation CaMor ;^ _ _ -- -BATHTUBS SHOWERS-- -_ - , FT _ J - Dat Signature NOTICE: If after making this ration, ud become subject TOILETS - 1... URINALS -- -+ -- -'GENERATOR. - .O-1 KW=P-]0 KW - - - to the Workers' Compensatio ovislon labor Cotle,-you must (TRANSFORMER forthwith comply with such ovislon t permit shall be deemed LAVATORIES DOUBLE L -AVS - - APPLIANCE - -]0-50 KW_SO+KW - revoked... I -KIT. SINKS - -- 'DISHWASHERS-- - _ - ,MOTORS -- '0-1 HP -_I-30 HP _ 'r ICONSTRUCTION LENDING AGE CV - I hereby affirm that there is a construction lending agency for the per. SERVICE SINKS SUMPS - - - _ (INC. SOLAR).-.10.50.Hp 50.+HP' Jormance of the work for which this permit Is Itsued (Section 3097 , ' FLOOR SINKS - - FLOOR DRAINS'- - FIXTURES - OUTLETS^ - SWITCHES' Civ. C.).- - - - - - - - - -' Name `Lender's _ _ Lender's Address DRINKING FOUNTAINS GAS -TUBE -SIGNS - - - - -- _ OWNER BUILDER DECLARATION INTERCEPTORS- 'CLARIFIERS"''- POLE -LIGHTS - -- - - - -- ' I herebyy affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business -and -Professions Cotle: SWIMMING POOL - PT�RAP - - 'POLES - - METERED - SUB -- - - ' Any city or county which requires a permit to construct, alter, WATER SERVICE 'ALTERATION -- - - ;PANELS - MAIN SUB - - - Improve; demolish orrepairany structure, -prior to its issuance, also re- quires the an, licant for such permit to file a signed statement that he -GAS SERVICE- - OUTLETS' - I ySERVICE -- - - -- AMP .. - Is licensed pursuant to the provisions of the Contractor's License -Law (Chapter 9 (commencing wills Section 7000) of Division 3 of the Chapter WATEWHEATERS BTU OUTPUT - - - - - - - - `- --- ' and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by SEWER'CONNECTIONS• •' ' - - -- - _-- _ -. - _- �. _-. ev"applirant for a- Permit ' subjects the applicant to a civil penalty ' -1-rdl more than five hundred dollars ($500). � ' .. _ SOLAR TANK - COLLECTORS - - s as owner of the property, or. my.employees with wages as that, s o compensation, will do the work, and the structure is not Intended 'Or offered for sale. (Section 7044, Business and Professions Code: The' SOLAR PIPING SVS. ), -' - -ISSUE FEE - - - - - - 'Contractor's License Law doe, not apply to an Owner of a property ISSUE FEE- - •-" - �- APPLICATION APPROVED BY - -_DATE who builds Or Improves thereon. and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or Improvement Is the have burden MECHANICAL � PLAN CHECK � - - -- - � -'SUMMARY SUMMA RV OF FEES, sold within, one year of completion, owner will the bl Droving he did not build or improve for the purpose of sale): - - HEATING SYSTEM 0-100,000 BTU -BUILDING - PERMIT - - exclusively-contractingwith 0-1,—as—owner of the property, AND DUCTING - ~PLAN SMIP �E towner n7044, Il lcensed contractors lO construct the project (Section es not apply ss p antl-Professions Code: The License Law does not apply to 100,000;+ BTU t CHECK E $ PERMIT : ISSUANCE 'E or Improves thereon, and who con- owner o/ property who builds or i REFRIGERATION 0-100,000 BTU PW MBING $ • � � from such- Projects -wills a contractor(s). Iicesnetl pursuant to tracts itis a SYSTEM - _ .._ ' GRADING -tracts -the Contractor's License Law). 100,000 +BTU `PLAN CHECK f (] I am exempt under Section' S. S P. C.'for this (reason- - BOILERS BTU - - -- _ - _ _ _ _ ELECTRICAL E - .PLAN CHECK $' _ , -$ MICROFILM E- - -- bate Owner _ SYSTEM SVSTEMREPAIR,ALTERATION _ - �MECH ANICAL E TOTAL'FEE-$'_ I _ I herebycertify that 1 have read this application and state that the above Y- EXHAUST SYSTEM MULTIPLE LESS AD. information is correct. 1 agree to complyWithall <ity'antl'tountY 'PLANCHECK $- VANCEPC 8-'- - ordinances and state laws relating to con uCtin n, and hereby authorize 4apresenlatives'of t city to en p n the -above mentioned property or n purpos ?1 'Signature -� Date - '• FINAL FEE $ u/ Ori v¢r5' •nsc or 5 -' - - - ISSUE FEE CMF0865-J6 W'Jfit`Bwtding; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor TL- CMF-0865-46 L' CONSTRUCTION AND PLANNING APPROVALS Permit# Date Inspector POOL&SPA APPROVALS Permit 4# Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. - Soil Pipe-Undrgrn 44. Steel Reinforcement 3.. Electrical nnduit Utility-Undrgrn 45: Forms, 4. -Electrical Conduit-Undrgrn . 46. Electrical Bonding 5.- -Steel. Reinforce 47. Rough Plumbing & Pressure Test 6. Electrical.UFER Grn-.- 48. APPROVALTO COVER-GUNITE -- _7.- Footings. 49. Electrical Conduit-Undrgrn 8, -Foundation 50. ., Gas Pipe, 0 Undrgrn: Test 9. -Water Pipendrgrn_ 51. Backwash Lines - P -Trap-, El UnMorn 10.- Structural steiiT loo ST 52. APPROVAL TO DECK 11.- Property -Sewer Line.&.House.Connection 53. Backwash & Receptbr-Final 12.- Street Sewer- Connection. 54. Heater & Vent -Final 13.... Rough Plumbing 55 Plumbine System - Final 14. Rough Electric -Conduit -'56.--Electrical-Final 15. Rough Electric -Wiring 57. War System -Final 16. Rough Heating & Air Conditioning- W -Fencing & Access Approval 17. Ducts, in Structure J _79FA_PPROVED FOR PLASTERING 18. Ducts, -Ventilating- - - - - - - - ucts, Ventilating - - 604- _ - . _ . _ _. POO L/SPA.SYSTEMS FINAL - 1 .1 - . •I 19. 19. Gas Pipe -Rough &Test 20. -Roof�Frarning - - 21. RoofSheathing NOTES: 22. Frame and Flashing - 23. Insulation 24. Lathing,& Siding 25;- -Drywall Nailing 26. Plaster- Brown Coat 27. --Electrical Power Meter -Fina( 28. -Final Electric 29... Final Heating & Air Conditioning- 30. Final:Gas Pipe -Test 157) 31. -Final Plumbing -32. Water Service -Final 33; Gas Service -Final 34. Solar Domestic Fin'dl 35. LandscaSprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison i 41. Gas Release to Southern California as Co. 42. CERTIFICATE OF OCCUPANCY No Date M .��.-Cpllcan: ns -„n ural) spaces within neav bora r lines and sign all Y 9 appropriate declarations. CITY OF COSTA MESA PE IT NO. TRACT NO. LOT NO. BLDG. NO. - - CONSTRQUION PERMIT �a-1 � L' - 3 TYPE OF CONSTRUCTION ❑ NEW E ADD ❑ ALTERATION ❑REPAIR ❑ CONVERSI ON ❑DEMOLISH ❑ OTHER �t /�s� /Ob/ _ ,. .r 0464_ I / I I /B2 17.00 ZONING REGULATIONS Project Address - 'Phone Owner I Address 1r Arch/Eng. License No. DESCRIPTION OF WORK A P Address ZONE PLNG. REF. 9F _ Contractor I 4 - i �' -Phone Z TYPE OF PERMIT - ❑GRADING ❑ FOUNDATION ❑ STRUCTURAL RAL ❑TENANT ❑ELECTRICAL ❑PLUMBINGyI'JMECHANICA BUILDING SETBAC T. SIDE YARD LSfEDFE p gt�I DIrvG - �RO PERTY LINE Address LICENSED CONTRACTOR- ECLARATION I hereby affirm that I am licensed under of Charter 9 provisions (com- ,fencing with section 7000) of Division 3 of the Business and ❑ OTHER TY RIGHT ' Professions Cotle, and my license is In full or n ef( Ct. REAR YARD (TO P/L)^� 31 -PROJECT DESCRIPTION ” License Liceys No. , PKG. SPACE REQ. PROVIDED Date 44)s Signature _' ' SQ. FT- OCCUPANCY— CONSTRUCTION TYPE - STREET WIDTH . PARK FEE$ ER WORKERS'COMPENSATION DECLARATION COMPENSATION C 1 hereby affirm that I have a certificate of Consent to salt -insure Or VALUATION ZONE ZONING APPROVED BY DATE certificate of Workers' Compensation Insurance, or a certified Copy thereof (Se n 0 Lab. C I SPECIAL CONDITIONS: K,, �.Q (#&]I f'Q� 1cCl GRADING CU. YDS. ACRES Policy No. Company copy Is hereby furnished. - REMARKS: f s ertifled copy is filed with thoIty Building Division. VIPTION FROM WORKERS'OMPENSATION DECLARATION ' section need not be completed if .the permit is for one hundred f..0) or less). \ Certify that in the performance of the work for which this permit is _- PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK Issued , I shall not employ any person' of any manner so as to become subject to the Workers' Compensation Laws of California. BATHTUBS SHOWERS _ Date Signature NOTICE: If after making this declaration, you should become subject TOILETS URINALS - GENERATOR 0-1 KW KW to the Workers' Compensation provisions of the Labor Code, you must -1-10 TRANSFORMER forthwith Comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE 10-50 KW -50 + KW revoked. KIT. SINKS - DISHWASHERS MOTORS 0-1 HP_ 1-10 HG., CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS (INC. SOLAR) 10-50 HP 50 , HP formante of the work for which this permit Is issued (Section 3097 FLOOR SINKS FLOOR DRAINS FIXTURES "OUTLETS SWITCHES Civ. Lender'sName er's _ Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for INTERCEPTORS CLARIFIERS POLE LIGHTS - - the following'reason (Section 7031.5 Business and Professions Code: SWIMMING POOL PTRAP ' Any city Or county which requires a permit to construct, alter, POLES METERED SUB WATER SERVICE ALTERATION PANELS MAIN SUB improve, demolish or repair any structure, prior to its Issuance, also re- quires the applicant for such permit to file a Signed statement that he GAS SERVICE OUTLETS SERVICE AMP is licensed pursuant to the provisions of the Contractor's License Law I Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT 6 usiness and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). SOLAR TANK COLLECTORS ' ❑ ' as owner of the property, or my employees with wages as their sr mpensation, will do the work, and the structure is not inlendetl o red for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE - Cu. actor's License Law does not apply to an owner of a property ISSUE FEE ;APPLICATION APPROVED BY - DATE who bullas or improves thereon, and who does such work himself or through his Own employees,, provided that such improvements are not intended or offered for sale. If, however, the building or improvement Is sola within one year of completion, the owner will have the burden MECHANICAL PLAN CHECK SUMMARY OF FEES of proving he did not build or improve for the purpose of sale). SYSTEM 0-100,0006TU UILDINHEATING PERMIT G F1 I, as owner of the Property, am exclusively contracting with AND DUCTING $ $MIP E licensed contractors to construct the project (Section 7044, Business 100,000+BTU -PLAN CHECK $ PERMIT and Professions Cotle: The Contractor's License Law does not apply to ISSUANCE $ an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ ' tracts from such projects wltn-a contractor(s) llcesned pursuant to SYSTEM GRADING $ the Contractor's License Law). 100,000 +BTU PLAN CHECK $ ❑ I am exempt under Section B. & P. C. for this BOILERS BTU ELECTRICAL $ $ reasonSYSTEM PLAN CHECK $ MICROFILM $ Date Owner REPAIR, ALTERATION - MECHANICAL $� TOTAL FEE $ I. hereby certify that I have read this application and state that the abovePEXHAUSIT SYSTEM MULTIPLE LESS AD - Information is correct. I agree to comply with all city antl county PLAN CHECK $ VANCEPC $_ ordinances and state laws relating to Construction, and hereby authorize representatives of Wis city 1 enter upon the above mentlonetl o(J property -for � ec n pu / FINAL FEE E 17, Signature Date % FEE W Drivers' License or SS jr CMF 0865-46 White -Building; Canary -Applicant: Pink -Accounting; Goldenrod -Assessor TL CONSTRUCTION AND PLANNING APPROVALS Permit # Date% Inspector POOL & SPA APPROVALS Permit # .Date Inspector 1. Temporary Electrical Service or Pole - 43. Pool & Equipment Location 2. SoilPipe-Undrgrn 1 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn _ 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel em orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE ' - •- -• - 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Tra ` ❑ ndr rn - 10. Structural Floor System 52. _ APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection _ 54. Heater & Vent -Final ' 13. _Rough Plumbing -55. Plumb'nu System - Final 14. Rough Electric -Conduit •56. Electrical -Final 15. Rough Electric -Wiring - - - - 57. Solar System -Final 16. Rough Heating & Air Conditioning W. Fencing & Access Approval 17. Ducts in Structure - APPROVED FOR PLASTERING ' 18. Ducts, Ventilating. 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test 20. Roof Framing 21. Roof Sheathing NOTES: 22. Frame and Flashing 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric - 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. FINAL STRUCTURE & BUILDING ' 39. Special Requirements Completed 40. Electric Release to Edison, 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date ' I City of Costa Mesa Development Services Department Building Safety Division CERTIFICATE OF OCCUPANCY No. 000621 P. O. Box 1200 Costa Mesa, California The Building located at 7dS FT—c*R;F?R (1-4 - has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group n..1 Occupancy. Use of Building Legal Descriptio (See reverse side for Metes and Bounds) Building Permit No 0=13204 Electrical Permit No. G-13204 Plumbing Permit No. "G-13204 Mechanical Permit No. —t Z,>nd Number of apartments - and/or guest rooms ISSUED TO: Building Of ficial NORM PULLIAM by 1517 N. FAIRVIW AVE.. SANTA ANA, CA. t This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. CMF 1015-46 rev. 1/03 White - Owner; Canary - Numerical File; Pink - Bldg. Permit File City of Costa Mesa Building Safety Department - CE RT I F, I C A T E O F OCCUPANCY 3253 P.O. Box 1200 Costa Mesa, California - I' - -The Building located at 245 Fische:- Aypnpi . Crti f -p r -A has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group R-2 Occupancy. Use of Building CommprniAl T»t•orinr-nt;-a.- +;....� y - - - Legal Description A•13.#427---033'-00- (Seeaverse side for Metes and Bounds) - 'Building Permit No 52f)9�7 Electrical Permit No, �Acl )fn Plumbing Permit No. Number of apartments -�' 'and/or guest rooms -0- , 1 I'.. ISSUED TO:Building Official--�/� PULLIAM PROPERTIES, INC. Victor C. Newton—Director Building "13,v Date:`Aanuary-a This Certificate of OccupancySHALLBE. posted in a conspicuous place on the premises and SHALL NOT -BE removed except by the i f' Building Official of the City of Costa Mesa under Sec. 306 lel U:B.C. , ��. `} Form BU 34 Rev. 11/70*' ' PPPPP7` , f 826 //074 JSTA MESA BUILDING—SAFETY DEPARTMENT. ' / P.O. BOX 1200 �y Costa Mesa, California ' Contractor lr_ Cond. TRACT N0. LOT NO. REC-D BY PERMIT NO. rn —S DATE ISSUED 7-7-J7i Address 3369 E.Miraloma Ave. BUILDING USE City Anaheim zip Code 92806 State License No. 289588 Class. C-20 BUILDING _ ADDRESS 245 Fischer, Bld . �� City License No. 0660-6 Tel. Na. N0. ITEM EACH I FEES �J COSTA MESA, CALIFORNIA,\� FAU, Wall, or Gray. Furn. Incl. Ducts and Vents t0 100 000 BTU over 100,000 BTU NEAREST �rt. CROSS ST. i OWNER Airport West MAIL ADDRESS !� r CITY t\ \\/ \y TEL. NO. Vent (if not incl. above) I hereby acknowledge that I have read this application end stateithet the above is correct and agree to comply ,.�0 , wl all ity Ordinances and State Laws regulating Heat - ging; Ventilating, Refrigeration and Air -Conditioning. I certify that I possess the above valid State of Calif - ornia classification or I am the legal owner of the single family residential property described above. Signature of nU Permittee (�(,(, UL Suspended Heater Alter or Replace A liance PP r Over feet o gas Piping � BOILERS OR COMPRESSORS 1`,' �' y' 3 H.P. or less ' ,q 9 j�� Over 3 H.P. to 15 H.P. % q ,\ \ W Vent Fan—Sin I d.D t' - �44 'C l4'61t�ing,Hocd'egisters C. 1ti'REMARKS: � 1.00 4.00�� APPROVALS INSPECTOR DATE X5 C Ducts Underground 111COMP'l ancel Ducts in Structure K�e Ducts Ventilating — Rough 44rHeating Hoods Refrigeration Lines Pressure Test al 4.00 Air -Gond. Final Ventilating Final Heating Final DO Refrigeration Final Final Gas Test FEES Utility Co. Notified CMF 0449-46 BLDG. PERMIT NO. _t -5 -AS A4117 Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. ' CITyY, OF COSTA MESA PERMITINTRACT NO. LOT NO. .® G. NQ. Lr CONSTRUCTION PERMIT C/7� 7/T/ OF CONSTRUCTION 'vrg�� NEW ❑ ADD ❑ ALTERATION t�REPAIR 71 CONVERSION ❑DEMOLISH • ❑OTHER ', r ' 6I 42 7/06/81 . 93.72 ONING REGULATIONS Project Address ZZ C v�r.�9-4TYPE Owner ik OR 1 L - Phone Address/51 I ✓lbw RJB .0.32_ Arch/Eng.S�;ViAr q.,v�j A 1.1 F=License No. DESCRIPTION OF WORK / A.P.' � T 0'j �"4060 — _ Address - ZONE PLNG. REF. # Contractor ALL S G Phone TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL ❑TENANT ❑ELECTRICAL❑PLUMBING ❑MECHANICA BUILDING SETBACK C T. LIDE YARD SIEDFE VAR To BUILDING - PROPE LDI LINE RTY - - _ _ _ Address / C�,q ,V?G,U CAL, LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (com- RIGHT mencing- with section 7000) of Division' 3 of the Business and ❑ OTHER Professions Code,• and my license Is in full force and effect. REAR YARD (TO P/L) Q. �.( F�{-3! TIO PROJECT DESCRIPTION _ License Class License No?5 PKC. SPACE REQ. PROVIDED xx Date7— Sig not urq --" - " 50. FT.' WORKERS' COMPENSATION DECLARATION - - - - OCCUPANCY CONSTRUCTION TYPE STREET WIDTH . PARK FEE $ ' -77 I hereby affirm that 1 have a certificate of consent to self -Insure ora 00 0 ZONE ZONING APPROVED BY DATE certificate of Workers' Compensation Insurance, or a certified copy (iV�'ALUATION thereof (Sec'on 3800, Lab. C.). I-• „cY NOWF'l/7gi ltOs Sl CompanYl 121�11litUs GRADING CU. YDS. ACRES SPECIAL CONDITIONS: :w:ertlfid ecopy is hereby furnished. - - - REMARKS:' - - - L l:ertified 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). 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 PLUMBING PLAN CHECK ELECTRICAL - _ PLAN CHECK Subject t0 t Orkers' Compensation Laws of. California. _ BATHTUBS SHOWERS . Signature NOTICE: If after making this declaration, you should become.subject TOILETS URINALS ' - - GENERATOR 6-1 KW 1-10 KW 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 LAYS APPLIANCE 10-50 KW_50+KW revoked.. KIT. SINKS DISHWASHERS MOTORS 0-1 HP -1-10 HP - CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS - - - (INC. SOLAR) -10-50 HP 50 + HP - - formance of the work for which this permit is issued (Section 3097 FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES - Civ. C. . Len er' Name - Lender's Address -- DRINKING FOUNTAINS GAS TUBE SIGNS "- OWNER BUILDERDECLARATIONiINTERCEPTORS CLARIFIERS POLE LIGHTS hereby affirm that I am exempt from the Contractor's License Law for POOL' PTRAP he following reason (Section 7031.5 Business and Professions Code:•.SWIISIMING Any city or county which requires:a permit tUleq nstruct; alter; POLES METERED SUB Improve, demolish or repair any structure, prior to its issuance, also re- WATER SERVICE ALTERATION PANELS MAIN - SUB quires the applicvnt for such permit to file a signed statement that he .GAS SERVICE OUTLETS SERVICE -AMP ' is licensed pursuant to the provisions of the Contractor's License Law Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT - - - - lisiness and Professions Code) or that he Is -exempt therefrom and the h - for the alleged exemption. Any violation of Section 7031.5 by SEWER-CONNECTIONSit spplicant'for a permit subjects the applicant to a civil penalty more than five hundred dollars ($500). SOLAR TANK COLLECTORS' - - - L 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. (Section 7044, Business and Professions Code: The SOLAR PIPING SVS. ISSUE FEE ' - Contractor's License Law does not apply to an owner of a property ISSUE FEE APPLICATION APPROVED BY -DATE who builds or improves thereon, and who does such work himself or through his own employees,.provided that such improvements are not MECHANICAL PLAN CHECK SUMMARY OF FEES intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner will have the burden of proving he did not build or improve for the purpose of sale). BUILDING' - ,r _ C Sli HEATINGSYSTEM 0-100,000 BTU PERMIT $ �..7y SMTP $ • ❑ f, as owner- the property, exclusively contracting with AND DUCTING ' / •51 - licensed contractors to construct the project (Section rs p Business 100,000 +BTU PLAN CHECK $ 7 .�4 ,PERMIT and Code: Tho License Law does not apply to ISSUANCE $ ,-not wrier of p builds owner of property who builtls or improves thereon, and who con- REFRIGERATION 0-100,000 BTU 'PLUMBING $ $ tracts from such proied a contractor(s) lite5netl pursuant to tracts SYSTEM "' - GRADING $ the Contractor's Lic w). ). 100,000 +BTU PLAN CHECK $ ❑ I am exe nicer Section B. & P. C. for this$ BOILERS BTU ELECTRICAL $ reaso SYSTEM REPAIR, ALTERATION PLAN CHECK $ MECHANICAL $ MICROFILM $ TOTAL FEE $ - ' - Owner -- -- - - ,Date I hereby certifythat I have read this application and state that the above EXHAUST SYSTEM MULTIPLE LESS AD.- information is correct. I agr to comply with all city and county PLAN CHECK $_ VANCEPC ordinances antl sl laws rel ng to construction, and hereby authorize - representatives this ci to enter upon the above ntioned property for s, - n ' 2 Signature_ Da eX FINAL FEE $ Drivers' Licen or SS # / ISSUE FEE - - _ CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor T L• 19, CONSTRUCTION AND PLANNING n I APPROVALS Permit # 6 _L_L-� "' POOL & SPA Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. SoilPipe-Undrgrn 44. Steel Reinforcement - 3. Electrical Conduit Utility_Undrgrn - 45. Forms - 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. bteel Heinforce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. -Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P -Trap,❑ Undrqrn - 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection - 53: Bapkwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing - 14. Rough Electric -Conduit 56. Electrical -Final 15. Rough Electric -Wiring - 57. Solar System -Final 16. Rough Heating & Air Conditioning b8. Fencing & Access Approval 17. Ducts in Structure APPROVED FOR PLASTERING 18. 19. 20. Ducts, Ventilating Gas Pipe -Rough &Test Roof Framing 60. POOL/SPA SYSTEMS FINAL 21. Roof Sheathing - . ` 4°`4 22. Frame and Flashin NOTES : 23. Insulation 24. Lathing & Siding 9, 7r 25. Drywall Nailing _ - 26: Plaster Brown Coat L k .11.a�F! 27. Electrical Power Meter -Final 28. Final Electric 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 Srinklin System 36. Sound Attenuation - - ' 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison - 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date Tract Block Lot BUILDING PERMIT NO. O �.5� C/.( Electrical Permit No. D ulltl in9 9//6 �r%�. Atltlress Gf�' Plumbing Permit No. Cross y��^ Area C-/�- street /�G/L Metnaniral Pormlt No. ��s Owner a— / /-/�I� 7/ G r_ Type of Project: El New ❑Alter ❑ Addition '/ Address 5/77 A/ F�r-s1 ❑ Repair ❑ Convert ❑ Demo ❑ Occupancy Pmt. �!% //( City �.� L��-: ZI�`7_rPM1One /L A-P• Ssp. Area Architect' 'AltAleP Desl9 nor G _ ___ _ Zone \ SPI. Pmt. No. Address 1. ,! 7 `7 lm-IAL '7 t AL oT, Setbacks P/L Front C/L St. Street Width City /4A-45 Zi�77 Phone n Vi Yartls Lill 19ht ear ave ol. a Ig Engineer License No. Parking Spaces Required Oyl a Overe Address Struct No. of No. of Cit Zi Phone Y P Height Stories Family / LICENSED CONTRACTOR'S 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 Cod! antl cense is in full force and s t) Park Fees Ve Requiretl NO C.T. Fee Receipt Zoning Approved By: Date / License la C - ce sg N�� Date Contractor L� Misc. G Adtlress 21_a-4j-W �C6 Proposed Use of Structure \ / City and Zip %Q(o Phone/ %j 2 \ 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, Civ. C.). Oct.Type Glass Const. Cotle Year Lender's Name USE/OCCUPANCY / SIZE SO. FT. Lender's Address s 1 \ OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law 2. for the following reason: 0 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. Cl I, as owner of the property, am exclusively contracting with 3 \ 4' \ licensed contractors to construct the project. ❑ I am exempt under Sec. , B&PC for this reason Data Owner Total Valuation / \ WORKERS' COMPENSATION DECLARATION Encroachment Permit Requiretl ❑ Yes \ ❑ No I hereby affirm that I have a certificate of consent to self-insure or acertificate of Workers' Compensation Insurance, or a Certified copy Ihereol. Policy No Company Certified copy is hereby furnished. ,PiCer fl to la filed with nvle E /�ZdA Grading Pmt. Required ❑Yes 0N Grading Pmt. No.\ Rouyn Grading Approved py: Dale ) Data Applicant f CERTIFIC E OF EXEMPTIO FROM WORKERS COMPENSATION INSURANC (This section head not be completed if permit is for $100 or less). 1 certify that in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. PERMIT FEES \ Data I Applicant NOTICE TO APPLICANT: If, after making this Certificate of Structural $ Plan Check S Exemption, you should become subject to the Workers' Compensation Electrical $ Special is Invest. provisions of the Labor Code, you must forthwith comply with such Provisions or this permit shall be deemed revoked. Numbing $ 1 CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS Mechanical Is RELATING TO BUILDING CONSTRUCTION, AND HEREBY RUTH- ORIZE REPRESEtJTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE M N ZONED PROPERTY FOR INSPEC lON PUN- PO gnature of Applicant or Agent 61 Data Re-Graife inspection $ Re-Grade Rec. No. $ Permit Issue $ Print Applicant's/Agent's Name All st Spaces within this box must be completed to process Plan Check By: Issuance Approvetl: CMF 0335-46 (13U-28) rev. 6/80 v' CITY OF COSTA MESA CONSTRUCTION PERMIT ' Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. Project Address - ' –n�N Applicant'sMaili 330 ml /A�OffIC4 l-ll/K �1yiiVjM Owner's Name Q -d Ualn Prnor-4IPS�nPhone a Address 111 �,� 1(VIQjJ) .5(jnjj Ow Arch/Eng. An License No. Address Contractor's Nam --4Phan �Ee,�1.,�1C Address (mailing) —D31F(I 1o0C1Ll. I SLW-.IM City License No. .aoNa 3 LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in II force and effect. 1 Licenla L ense N Date j Signature VOR KERS'COMPENSATION DECLARATION . hereby affirm that I have a certificate of consent to selfgnsure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C.) �s Policy No. S/�`/�O Company �Certifiedy[copy IS billreby ed with thehcitt 1tlpin� �ws�°n Date Applicant V !'I{LF13S{— (r nNY� EXEM TI N FROM WORKERS' COM PE NSATIO DECLARATI N (This section need not be completed if the permit is for one hundred ($100) or less). , 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 California. Data—Signature NOTICE: If. after making this declaration, you should become subject to the Workers' Compensation provisions Of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCV I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is Issued (Section 3097 Civ. C.) Lender's Namn Lender's Address OWNER BUILDER DECLARATION I hereby, affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/she Is licensed pursuant to the provisions of he Contractor's License Law (Chapter 9 (commencing with Section 7000) of )IVISIOn 3 of the Business and Professions Cotle) or that he/she is exempt herefrom 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, 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 (Secilon 7044, Business and Professional Code: The Contractor's 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 employees, provided that such Improvements are not intended or offered for 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- fOve efar the purpose of Salo). I, as owner of the property, am exclusively contracting with licensed con. tractors to construct the projectSection 7044, Business and Professions Code: The Contractor's Llcenso law Aes not apply to an owner of property who builds or Improves thereon, and who contracts for such projects with a con- tractors) license pursuant to the Contractor's License Law). ❑ I am exempt under Section B. 6 P. C. for this reason Date Owner I hereby certify that I have read this application and state that the above Information Is correct- I aaree to comply with all city and county ordinances TYPE OF CONSTRUCTION U NE ❑ CONVERSION ❑ DEMOLISH DESCRIPTION OF WORK J ADD U ALTERATION IJ REPAIR OTHER TYPE OF PERMIT ❑ GRADING' ❑ FOUNDATION ❑ STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION SO. FT. OCCUPANCY— CON STRUCTION CCUPANCYCONSTRUCTION TYPE VALUATION $ ZONE GRADING CU.VDS. ACRES Remarks: Bar Sink Backflow Preventer Backflow Irrigation Bathtubs Clarifiers Dishwasher - Drinking Fountains Floor Drains ' Floor Sinks Gas Service Outlets Interceptors Kitchen Sink Lavatories P" Trap Roof Drains Reinspection Fee S25 Boiler Duct- Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. ICBO+ Hating System & Ducting D7 00,000 BTU ❑ 100,000 BITi Reinspection Fee 1 $25 CMF 0865-46 rev. 7/83 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor FEES Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Issue Fee 1-31 FEES Hood or Type I ❑ Canopy Type 11 ❑ Refrigeration System 00-100,000BTU 0100,000 System Repair/Alteration Issue Fee 1 $ 3 -4-6051 6506 3/19/84 45.OJ TL A.P. $ I Zone S Main Building: Accessory Building: Z E 0 T Front N B A Rear I N C Right G K Left R S E Ping. Ref. # Park.Fees $ 0 U Parking Req./Provided I Use of Building: R E Planning Notes: M E N T S ELECTRICAL FEES Automatic Washer Transformer ❑ 15-50 KW ❑ 50+ KW Construction Pole Sub. Cooking Unit Meter ❑up to 100 amps Dishwasher Meter Dover 100amps Dryers ❑Gas ❑Electric Sub Panel Fan Motors 00-1 HP 01%-8 F.A.U. Inc. Solar 119-15 HP 016-15+ Fixtures Microwave Device Boxes Pole Light Outlets Range Switches Sign Garbage Disposal Standing Sections Generator 005 KW 05-15 KW Trash Compactor Reinspection Fee S25 Issue Pee $ 3 PUBLIC SERVICES REQUIREMENTS: ' Zoning Approved By Date Application Approved By Date Application Issued ByDate 3 SUMMARY OF FEES BUILDING PERMIT $ SMIP $ ' PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK $ ENERGY P.C.. $ ELECTRICAL $ GRADING $ PLAN CHECK $ MICROFILM $ MECHANICAL $ TOTALFEE - $ _iI6 PLAN CHECK $ CONSTRUCTION AND PLANNING APPROVALS Permit# =Datlor .. S POtSPA APPROVALS Permit q# 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 LIFER Grnd. 57. APPROVAL TO COVER-GUNITE > 7. Footings 58. Electrical Conduit-Undrgrnd. IL 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 & Houso 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. POO USPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning 7fj7l+'z7 LFV FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas []Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing ' 73. Undergrnd. Storage Tank OGas 00il 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 PREY. 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: 1_'6FrC41Z6 34. Final Heating &,Air Conditioning �%((q/y7t.� ( ) [i��ai" NJ fMs%9LwgVON $7-'qzi 0 GEE 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 48. Special Requirements Completed 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` ,GUNS I h V I IUIV rrnlvII I Project Address' r s 4' Applic*i's Mailing Address S-7-574044 s �'f% " Owner's Name Pin I 'Phones—T—WAV", I^ Address /= A,' QVC im" V 1 Arch/Eng. License No. Address CP Contractor's Nam �tI s Phon I Address (mailing) / City License No. 15 SOZ LICENSED CONT RA,, OR DECLARATION 1 hereby affirm thy° I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 o1 the B mess and Professions Code, and my license. In fuyffar2prid a ffec(� n �►7_=.2 i p...e Signature _WORKE S' COMPENSATION DECLARATION 1 hereby ffirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a certified copy thel f (Section 3800, Lab. Ca,O,� I ( I Policy No. ``''''II Company tified copy is hereby furnished. Cer ' i tl c y is filed with the city B 9 Dlvi Date .NOE App EXEMP licant CLA RATIONRS'CO (This section need not be completed If the permit is for one hundred ($100) or less). 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 California. Data Signature ' 'NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply ,with such provisions or this permit shall be deemed revoked. 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 (Section 3097 Civ. C.) Lender's Name _ Lender's'Address _ OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/she Is licensed pursuant to the provisions of 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 �nalty of not more than five hundred dollars ($500). LJ 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 (Section 7044, Business and Professional Cotle:. The Contractor's 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 employees, provided that such improvements are not intended or offered for 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- prove for the purpose of Sale). ❑ I, as owner of the property, am exclusively contracting with licensed con- . 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 i builds or improves thereon, and _who contracts for such projects with a can. tractors) license pursuant -to the Contractor's License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ -I;am exempt under Section B. & P. C. far this reason Date Owner. I hereby certify thi If have read this app icati on and state that the above information is corre L agree t om ly h all city and county rdinances and state laws tela n to buil tr tion, antl hereby auth ize repre- sentatives of thi i to en above-mentioned ope for inspection pu os AI Signature - Date Drivers' License Or SS # TYPE OF CONSTRUCTION LJ NEW LJ ADD L'J ALTERATION a REPAIR ❑ ❑ ❑ CONVERSION DEMOLISH OTHER A.P. # DESCRIPTION OF WORK/USE OF BLDG. S Main Buildi TYPE OF PERMIT GRADING FOUNDATION STRUCTURAL T Front ❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL B ❑ OTHER A Rear C Right PROJECT DESCRIPTION SQ. FT. OCCUPANCY KLeft CONSTRUCTION TYPE VALUATION $ $ ZONE GRADING CU. YDS. ACRES Ping. Ref. # Remarks: _ Planning Notes: Sink <flow Preventer_ kflow Irrigation Clarifiers Dishwasher Drinking Fountains Floor Drains Floor Sinks 1 Gas Service Outlets Interceptors Kitchen Sink - Lavatories P—Trap, Roof Drains ' Reinspection Fee 1 $15 Boiler. • Duct- Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑' F irepl/Fact. Bit. ICBO # Heating System & Ducting I ❑ 0100,000 BTU Ell 00,OOOBTL 0 Reinspection Fee I $15 CMF 0865-46, rev. 10/84 White - Building; Canary Applicant; Pink - Accounting; Goldenrod - Assessor Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto -Wash Laundry Trays Issue Fee 1 $ 3 Hood or Type ❑ Canopy Type I I ❑ Refrigeration System 00-100,000 BTU ❑100,000 System Repair/Alteration Fire Dampers Registers 1562 II/2Q/84 Ca^Q TL Zone Accessory Building: Z O N I I N ' G R Parking Req./Provided: E O M T S ELECTRICAL Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Electric Fan F.A:U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generator 1:10-5 KW 05-15 KW -❑- 15-50 KW ❑ 50+ KW Meter LJup to 100'emps Meter ❑over 100 amps I ,Sub Panel ' Motors 130-1 HP ❑1'/x-8 Inc. Solar 09-15 HP 016-15+ Microwave Pole. Light Range Sign Standing Sections Trash Compactor � FEES Rainspection Fee ' $15 Issue Fee I $ 3 DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Date Building Approved By Date II Application Issued By Date UI Z4 Issue Fee 1 $ 3 SUMMARY OF FEES BUILDING PERMIT $ SMIP, $ PLAN CHECK $ PERMIT PLUMBING $ 7L.1 ISSUANCE $ PLAN CHECK ELECTRICAL $ GRADING $ PLAN CHECK 50% $ MICROFILM $ MECHANICAL $ TOTALFEE $ S`SO PLAN CHECK 25% $ fi COJtJSTRUCTION AND PLANNING APPROVALS - Permit# r-- ? Date Inspector POOL & SPA APPROVALS Permit # Date - Inspector 1. Temporary Electrical Service `oPole Pool & Equipment Location "2.-Soil..Pipe-Undrgrnd. 53. Steel Reinforcement •-3. Electrical Conddit.Utilityjdndrgrnd. 54. Forms , 4. Electrical Conduit=Undrgrnd. 55. Electrical Bonding - 5: Steel- Reinforcement - - - 56. Rough Plumbing & Pressure Test "6. Electrical LIFER Grind. 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 62. Backwash & Receptor -Final 12•: SeV42f Cap - 63. Heater & Vent -Final 13. Roof Drains f - 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 APPROVALS. Permit # 20' Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro •-22.' Ducts, Ventilating 71. Product Piping 0Gas El Oil -23. Gas Pipe -Rough & Test a 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank OGas OOil 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.•Electriml Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating,& Air Conditioning 35. Final Gas Pipe -Test f/��j1� GIgg 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 48. Special Requirements Completed 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, LCONSTR�/UCTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT Nn Project Address 2� J �I�r/ �I� C s Applicant's Mailing Address ��'f7 Owner's Name �(�UCLIV M Y QC%F'• Phcm,_5y- z 6 ZZ Address Z_/ `rG Z 7 Arch/Eng. License No. Address Contractor's NamMI%/I,Z% I /✓S ELC�M1C phone 62 Address (mailing) '`�I ICUlf—L/ J'','ONT/� IZI, City License No. (T t110 LICENSED CONTRACTOR DECLARATION - I hereby affirm that 1 am licensed under provisions of Charter 9 (commencing with section 700300) of Division 3 of the Business and Professions otle? my license is in f or a f t. t I License Clag Y C • �' .Lice se N�of. Date �' / SI9 n a t WORKERS' COMPENSATION D RATION hereby affirm that I have a certificate of consent to self -insure or a certificate if Workers' Compensation Insurance, or a certified copy thereof (Section ' 3800, Lab. C I Policy No. RSc>q7 / Company eCertified copy is hereby furnished. Certifie co ij fit ith the city B ivisi Date 6 APplican EXEM TION FROM WORKERS' P SATION DECLARATION (Thissection need not be completed 1 e permit is for one hundred ($100) or less) 1 certify that in the performance of the work for which this permit is issued 1 shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Signature NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. 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 (Section 3097 Civ. C.) Lender's Name • Leader's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/she is licensed pursuant to the provisions of ...the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Nvision 3 of the Business and Professions Code) or that he/she is exempt I rierefrom and the basis for the alleged exemption. Any violation of Section '5031.5 by any applicant for a permit subjects the -applicant to a civil enalty of not more than five hundred dollars ($500). 1. as owner of the property or my employees with wages as their sole mrr, nnaatlnn will tln the walk. and the Structure i5 not intended or offered License Law does not apply to an owner or a property wno ouups or lmproven thereon; and who does such work himself/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 com- pletion, the owner will have, the burden of proving he/she did not build or im- rove for the purpose of sale). 1, a5 owner of the property, am exclusively contracting with licensed con- 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 builds or improves thereon, and who contracts for such projects with a con- tractor(s) license pursuant to the Contractors License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I'am exempt under Section B. & P. C. for this reason Date Owner certify, that 1, Q read this )n is correc agrap to comp Driver( Li�ehse or SS #,•j CMF 0865-46, rev. 4/84 White -Building; above u TYPE OF CONSTRUCTION LJ NEW J ADD LJ ALTERATION LJ REPAIR Showers Backflow Preventer ❑ CONVERSION ❑ DEMOLISH ❑ OTHER- A.P. # DESCRIPTION OF WORK/USE OF BLDG. Bathtubs Sewer Connection " S Main Buildi TYPE OF PERMIT GRADING ❑ FOUNDATION STRUCTURAL E T Front ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Floor Sinks ❑ OTHER A Rear Interceptors C Right PROJECT DESCRIPTION SO. FT., OCCUPANCY- K a CONSTRUCTION TYPE VALUATION $ I $ Left ZONE GRADING CU.YDS. ACRES Ping. Ref. # Remarks: - Planning Notes: Bar Sink Showers Backflow Preventer Service Sink Backflow Irrigation Sewer Cap Bathtubs Sewer Connection Clarifiers Solar Collectors Dishwasher - Solar Piping Drinking Fountains Solar Tank ' Floor Drains Swimming Pool w/Spa, - Floor Sinks Urinal Gas Service Outlets Water Closet Interceptors Water Heater Kitchen Sink Water Service Lavatories a P—Trap F.A.U. Roof Drains Inc. Solar 09-15 HP 016.15+ vj D Reinspection Fee 1 $15 1 Issue Fee Duct- Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact. Bit. ICBO # Heating System & Ducting ❑0100,000 BTU 0 100,000 Reinspection Fee 1 $15 Applicant; Pink - Accounting; Goldenrod - Assessor Hood or Type I ❑ Canopy Type II ❑ Refrigeration System ❑0100,000BTU ❑100,000 System Repair/Alteration Issue Fee 1169 7/16/94 Zone Accessory Building: Parking Req./Provided 60.1111 T;— Z O N I N G R E Q M T S. ELECTRICAL FEES Automatic Washer Construction Pole Sub. .Transformer ❑ 15-50 KW ❑ 50 + KW Cooking Unit ' Reinspection Fee Meter ❑up to 100 amps ' Dishwasher t FEES Meter Dover 100 amps zev 7 S Dryers ❑Gas ❑Electric Date Data Dotal Sub Panel z00 O Fan Motors ❑0-1HP❑1X-8 a O F.A.U. SMTP PERMIT ISSUANCE ENERGY P.C. GRADING MICROFILM TOTAL FEE Inc. Solar 09-15 HP 016.15+ vj D Fixtures Microwave Device Boxes Pole Light 0.0 Outlets Range 924 Switches Sign 6 Garbage Disposal Standing Sections Generator ❑05 KW ❑5-15 KW Trash Compactor $ 3 Reinspection Fee $15 Issue Fee $ 3 t FEES DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Building Approved Application Issued Byy Date Data Dotal U BUILDING.PERMIT . PLAN CHECK PLUMBING PLAN CHECK 25% ELECTRICAL PLAN CHECK 50% MECHANICAL PLAN CHECK 25% SUMMARY OF FEES $ $ $ $ $ -!Q $ S $ SMTP PERMIT ISSUANCE ENERGY P.C. GRADING MICROFILM TOTAL FEE $ $ $ $ $ $ — $ 3 CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector PG & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole I 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement r, 3. Electrical Conduit Utility-Undrgrnd.,, ,� 54. Forms 4. Electrical Conduit-Undrgrnd. - y 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, O Undrgrnd. 10. Structural Floor System - '' 61. APPROVAL TO DECK - 11., Property Sewer Line & House Connection 62. Backwash & Receptor -Final - 12! •Sewer Cap - 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval' 1.7. 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 APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating _ 71. Product Piping 0 Gas OOil 23: Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank OGas OOil 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 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 48. Special Requirements Completed 49. Electric Release to Edison �. 50. Gas Release to Southern California Gas Co ., , �� •� 51. CERTIFICATE OF OCCUPANCY No. Date '•� .� .^ �' / •�� ' ~ r '�• r • _ - - - - Applicant to fill in all spaces except those within heavy border lines and sign all appropriate CITY OC COSTA MESA P RMIT NO. TRACT NO. LOT NO. BLD CONSTRUCTION PERMIT - � I ?J // 3 � / l % Project Address " Applicant's Mailing Address Owners Name�.Phone 2 Address / !7- Arch/Eng. /704"!27WAA 41U0 License No. /.379/ Address' y - Contractor'sName OW�� p/"_0Z- Phone 5 627' Address(mailing) /617 A-'• �1%We�E� '(&- S%A City License No. LICENSED CONTRACTOR DECLARATION 1 hereby affirm that I am licensed under provisions of'Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is In full force and effect. License Classicense No. Cele Signature - -,_s4RKERS' COMPENSATION DELL RATION ' ' '?ieby affirm that I have a certificate of consent to self -Insure or a certificate d: Workers' Compensation Insurance, or'a certified copy thereof (Section. 3800, Lab. C.) ' Policy No. t Company ,II•�71�-Certified copy is hereby furnished. x C if- oP with the city VNltlioivN/ Date r ")� Applicant Y . EXEMPTION FROM WORKERS-COMPENSATION,DECLARATION : I (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 h shall not employ any person In any manner so 'as to become subject to the Workers' Compensation Laws of Californla: Date Signature NOTICE: If;iafter making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, -you must forthwith comply with such provisions .or this permit shall be, deemed revoked.' CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is i ue (Section 3097 Civ. C.) tender's Name' Lender's Address, OWNER BUILDER DECLARATION I hereby affirm .that I am exempt from tl a Contractor's License Law for the following reason (Section 7031.5 Business ane Professional Code: Any city or refrom and the basis for the alleged exemption. Any violafion 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). 1, 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.(Seclion 7044, Business and Professional Code: The Contractor's License Law tloes 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 employees, provided that such Improvements are not Intended or offeree for 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- r rrve for the purpose of sale). '. as owner of the property, am exclusively contracting with licensed con - tors to construct the project(Section 7044, Business. and professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a con- tractors) license pursuant to the Contractor's License Lawl. ❑ 1 am exempt under Section _ B. & P. C. for this reason Date -.7 -It IJW,'— Owner information certify that I have read.,this application and state that the abo e Info, motion is correct. I agree to comply with all City antl county ordinances and statelaw relating to building construction, and hereby authorize repre- sentatives is cl*Nto eYter, upop the above-mentioned property for TYPE OF CONSTRUCTION LJ IX -EW LJ ADD AALTERATION U REPAIR ❑ CONVERSION ❑ DEMOLISH ❑OTH-'EIR/' DESCRIPTION OF WORK - �M A iW. T E F PERMIT LJ GRADING LJ FOUNDATION U STRUCTURAL TENANT ❑'ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ OTHER - o PROJECT DESCRIPTION 5FT. ��{�/ OCCUPANCY_ - CONSTRUCTION TYPE 4914' VALUATION $ ZONE M� GRADINGCU.YOS- �—' ACRES Remarks: Reinspection Fee $25 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact. Bit. ICBO # Heating System & Ducting 00100,000 BTU Y100,000 Drl vers' License or SS I I Reinspection Fee :I $25 CMF 0865-46 rev. 12/83 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor / Transformer ❑ 15-50 KW ❑50+KW Cooking Unit ons. Dishwasher Meter Ixover 100 amps Dryers ❑Gas ❑Electric 050:1 5/17/04 404.15 TI, A.P. $ '3 b Zone M t2 Inc.Solar 09-15 HP 016-15+ S Main Building: Accessory Building: Pole Light. Z Range Switches- Sign Garbage Disposal Standing Sections TFront Trash Compactor N ARear PLAN CHECK 25% $ N C Right G K Left R E' Ping. Ref. # Park. Fees $ O Parking Req./Provided - U 1 Use of Building: R E Planning Noes: - • M E EZ Automatic Washer Construction Pole Sub. Transformer ❑ 15-50 KW ❑50+KW Cooking Unit Meter ❑up'to 100 amps Dishwasher Meter Ixover 100 amps Dryers ❑Gas ❑Electric Sub Panel Fan Motors ❑0-1 HP 01%.8 F.A.U. Inc.Solar 09-15 HP 016-15+ Fixtures. Microwave Device Boxes, • Pole Light. Outlets Range Switches- Sign Garbage Disposal Standing Sections Generator 00-5. KW 05-15 KW Trash Compactor S -FEES- Issue Fee ,. I S 3 I A I- IANICALFEES Reinspection Fee $25 i Issue Fee $ 3 Hood or T PUBLIC SERVICES REQUIREM NT - f { ' Type ❑ Zoning Approved B s t• Canopy Type II ❑ 9 � Y l�fh►-�� Date .71 -Building Approved By _ Date 130100,000 BTU A00,000 BTU 9'- BUILDING PERMIT PLAN CHECK PLUMBING PLAN CHECK' 25% ELECTRICAL - PLAN CHECK 50% SUMMABY OF FEES $ $PERMIT $- $ ^� ^O $ $ SMIP ISSUANCE ENERGY P.C. GRADING MICROFILM $ $ $ $ $ '57, System Repair/Ateration S - ' MECHANICAL $ / 7r TOTAL FEE $ 6 '1 -Issue Fee _ $ 3 PLAN CHECK 25% $ `: OFONSTRUCTION AND.PL'ANNING '- y�:. -, - -POC SPA . Date' -APPROVALS - Permit'#' Inspector - APPROVALS Permit # Date ° Inspector .- ('�femporary Electrical Service or Pole - - - 52. Pool & Equipment Location - - - - - _ Soil Pipe-Undr'grnd._ Z]/� .: 4_A4 53. Steel Reinforcement s 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. APPROVALTOCOVER-GUNITE 7. Footings• 58. Electrical Conduit-Undrgrnd. - 8. Foundation; _ 59. Gas Pipe, 0 Undrgrnd., Test 9. Water'Pipe=Undrgrnd.• %ply]/�y; Lei/i 60. Backwash Lines, �P-Trap, 0 Undrgrnd. - 10. Structural Floor System 'r• 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection-+� 62. Backwash & Receptor -Final ' 12. Sewer Cap , - `• 63. Heater &Vent -Final - --- 13. Roof -Drains ; 1, 69. Plumbing System = Final -- ,•i 14. Rough Plumbing ' ?/[� C�rj - 65. Electrical -Final , 15. Rough Electrical -Conduit " - '- -- 66. Solar System -Final - - - - - 16: Rough Electric Wiring / 67. Fencing & Access -Approval 17i,Rough Wiring Sign;-' 68. APPROVED FOR PLASTERING , i6."1 Rough Electrical -T Bar Ceiling - -, 69.E POOL/SPA SYSTEMS FINAL 19-. Rough Heating & Air Conditioning( 7,/� 9�L�p FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace "? 21. Ducts, in Structure _; 70. Underground Hydro - 22:.Ducts, Ventilating •-i, �• ' - •71. Product Piping O Gas D Oil - I 23,�G�js Pi -Rough & Tesi. 7.2'. •Uhdefground Flush 24�+`1400t Framing ;l-.; 1 73. Undeigrnd. Storage Tank' 0 Gas 0Oil ' 25., Roof Sheathing ! - ! 74.. Overhead Hydro - - 26'.`T -Bar Ceiling (Structural) &.Monocoat - + 75. Dry Chemical -27. Frame and FlashingA* 76.E Dry Standpipe 76�, 28. Lathing & Siding i ,i 77. FIXED SYSTEM FINAL + 29. Insulation - _ I -13i 7: 78. FIRE PREV. FINAL 30. Drywall Nailing -% I HEALTH DEPT. REQUIREMENT 31'. Plaster Brown Coat'. -b ' .2 79. FINAL INSPECTION 32. Electrical Power Meter` -Final 80' FOOD CERTIFICATE ISSUED 33. Final Electric +' Notes: ]V/&t( _ 34. Final:Heating & Air Conditioning ]��( [, V. • _ / / v 35. Final GasPipe-Test 36. Hood or Canopy 37. Final Factory FireplaceAef 38. Final Plumbing - 39. Water'Service-Final 40. Gas Service -Final ' '• ' 41. Solar,Dorr'estic-Final - -- -, 42. Backflow Preventer I 43. Backflow Irrigation 44. ,Landscape Irrigation System 45. Sound Attenuation' i•. _ 46. Handicap Regulations ,. 47. FINAL STRUCTURE&BUILDING' Z. s 48. Special Requirements Completed' 49. Electric Release to Edison' 50. Gas Release to Southern Califor4Gas51. CERTIFICATIEOOE CCUPANCNo. 2.5/ .SCI .Date Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA CONSTRUCTION PERMIT. Project Address 7-45 rid, �6C ^ �� tF C-4 Applicant's Mailing Address 181215 I,J.s...l%aa�,�(,�t - O it Owner's Name ,� Cq&- weer mss"""�"`"`f'hone _ Address 7-45 figaFR- IyLP e --F- ` cDow4 P469A Arch/Eng. License No. Address p' Contractor's Name-& one �' =,L M Address (mailing) lPL,3 N. Lei 012601AIGEfes" "Mr.65 City License No. LICENSED CONTRACTOR DECLARATION I hereby affirm that I-amlicensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full force a}qd effect. Licen �Cl�' -rd Li %No. p L Date Signature 'vORKERS' COMPENSATION DECLARATION ereby affirm that I have a certificate of consent to self -insure or a certificate Workers' Compensation Insurance, or a certified copy thereof (Section 5800, Lab. S' �,�./� s Polley No. 4D^CWIi-Be-4 Company 0151fice a6(e jLr-,tified copy is hereby furnished. Certified �(S }pletl with the city Budding DIvi51 Date Fpy 4 Applicant EXEMPTION FROM WORKERS' COMPENSA�ARATION (This section need not be completed if the permit is for one hundred ($100) or O lescs). ertify that In the performance of the work fpr which this permit is issued, shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California., Date Signature NOTICE: If, after making this declaration, you Should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith" .I comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance 1 of the work for which this permit is issued (Section 3097 Civ. CJ Lender's Name - Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law forthe following reason (Section 7031.5 Business and Professional Code: Any city or rn,mty which renuires a Dermit to construct. alter. Improve. demolish or repair a slimed statement that he/she Is licensed pursuant to 'Z ':refrom and the basis for the alleged exemption. Any violation of Section by any applicant for a permit subjects the applicant to a civil enalty of not more than five 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 offeree for Sale (Section 7044, Business and Professional Code: The Contractor's 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 employees, provided that such improvements are not Intended or offered for 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- rove for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con- 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 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 proof of their Worker's Compensation Insurance should be provided to me. ❑ I am exempt under Section B. & P. C. for this reason Date Owner I hereby certify that 1 have read this Information is correct. I agree to comp and state laws relating to building con sentatwes of this city to enter upi Inspection purposes. Signature Drivers' License or SS 9P n and state that the above city and county ordinances and hereby authorize repre- ve-mentioned 7-1(-A4 property for _ Data P R I O. TRACT NO. _ _ LOT NO. UNIT NO. 4896 7/26/84 93072 TI TYPE OF CON RUCTION LJ NEW LVADD L1 ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF B DG. d� F/� SP A.P.# �� Zone S " Main Building: Accessory Building: TYPE OF PERMIT GRADING FOUNDATION ❑ STRUCTURAL II ❑-I /TTENANT 1:1ELEC RICAL ❑ PpLV�MB'I N`G ❑ MECHANICAL S?CTHER SrGWrls--C.� T Front O A Rear - N C Right - - N PROJECT DESCRIPTION SO. FT. OCCUPANCY CONSTRUCTION TYPE VALUATIONS __i� �1 ZONE GRADING CU.YDS. ACRES $ Left - R Ping. Ref. # Parking Req./Provided E Remarks: Planning Notes: Q M T S. _ PLUMBING FEES Bar Sink Showers ELECTRICAL t FEES Backflow Preventer -- Service Sink - Automatic Washer Construction Pole Sub. Transformer ❑ 15-50 KW - ❑ 50+ KW Backflow Irrigation Sewer Cap i Bathtubs Sewer Connection Cooking Unit ' Meter ❑up to 100 amps Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel Drinking Fountains Solar Tank Fan Motors 00.1 HP 0 %- 8 Floor Drains Swimming Pool w/Spa F.A.U. Inc. Solar 09-15 HP El 16-15+ Floor Sinks t -Urinal Fixtures Microwave .. - Gas Service Outlets Water Closet - Device Boxes Pole Light Interceptors - Water Heater Outlets Range Kitchen Sink Water Service Switches Sign Lavatories Garbage Disposal 'Standing Sections P -Trap Generator 00-5 KW 05.15 KW Trash Compactor Roof Drains' Reinspection.Fee $15 Issue Fee $ 3 Reinspection Fee $15 Issue Fee $ 3 MECHANICAL FEES DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Date Building Approved By Date Application Issued By- Data Boiler Hood or Type ❑ Canopy Type II ❑ Duct - Under Ground Duct -Structural Duct - Ventilating Refrigeration System ❑0-100,000 BTU ❑ 100,000 BTU BUILDING PERMIT PLAN CHECK PLUMBING PLAN CHECK 25% ELECTRICAL PLAN CHECK 50% MECHANICAL PLAN CHECK 25% $ $ $ $ $ $ $ $ SUMMARY OF FEES 5CWAIL iMac C .6• SG SMIP $ - --3�c PERMIT ISSUANCE $ ENERGY P.C. $ GRADING $ MICROFILM $ 13, TOTALFEE $ 13a?Z Exhaust System ❑ Multiple ❑ System Repair/Alteration Firepl/Fact. Bit. (CBO # ;�• Heating System & Ducting ❑6100,000 BTU 0100,00067 - -- r-% Reinspection Fee $15 Issue Fee? $ 3 CMF 0865-46, rev. 4/84 White - Hulloing; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor J CONSTRUCTION AND PLANNING- APPROVALS Permit # Date Inspector PO( SPA APPROVALS Permit # Date Inspector •). 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 - •' I ' 6. Electrical LIFER Grnd.' ' 57. APPROVAL TO COVER-GUNITE 7.'Footings t , 58. Electrical Conduit-Undrgrnd. " 8. Foundation i 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 Cohhection 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 r - 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 APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro " 22. Ducts, Ventilating - 71. Product Piping El Gas 0Oil -. 23. Gas Pipe -Rough,& Test - 72. Underground Flush 24. Roof Framing ! 73: Undergrnd. Storage Tank OGas 0Oil . 25.dRo6f 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 '• 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 48. Special Requirements Completed 49. Electric Release to Edison -_ 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY - - No. Date, I hereby affirm that I am licensed under provisions of Charter 9 (com- -' MAIN mencing- with section 7000) of Division 3 of the Business and .❑'OTHER Applicant to fill in all spaces within heavy border lin e1sign all appro Cdale declarations. License ass License No. Cl Date Signature - - - CITY OF COSTA MESA PERMIT NO. --TRACT NO. LOT NO. BLDG. NO. - - �•- - i CONS2RUCTION PERMIT - �' 1�3 S3 c'S Policy No. - Company eroject Address (— TYPE OF CONSTRUCTION Certified copy Is filed with the city Building Division. Owner Phon NEW ❑ ADD ❑ ALTERATION ' - -- -- - - Address - - r ZJ ❑ REPAIREIDE- PLUMBING -• PLAN'CH ECK -'- BATHTUBS SHOWERS - Date Date Signature -❑�.�CONVERSION /}ry7/IOLIS•,H URINALS - - Arch/Eng.- - License No.- '� OTHER T `PAZpJ� -KIT.SINKS - DISHWASHERS - -' CONSTRUCTION LENDING AGENCY SERVICE SINKS SUMPS - DESCRIPTION OF WORK A.P. "Addre55 _ Lender's Address -DRINKING FOUNTAINS - - - ZONE Contractor Phone TYPE OF PERMIT - WATER SERVICE- ALTERATION '^ -Address - - - - -' - ❑GRA DINGLE El FOUNDATION FOUNDATION ❑STRUCTURAL •SIO LICENSED -CONTRACTOR DECLARATION - TENANT ELECTRICAL�LUMBING ❑MECHANICAI pQ �,ErF.c I hereby affirm that I am licensed under provisions of Charter 9 (com- -' MAIN mencing- with section 7000) of Division 3 of the Business and .❑'OTHER Professions Code, and my license is in full force and, effect. - _ - � ';h..KAvV PROJECT DESCRIPTION o�i 7 License ass License No. Cl Date Signature - - - SQ. FT. -:0 If WORKERS' COMPENSATION NATION DECLARATION u ser. OCCUPAIVCV CONSTR UCTION�T VAP Ewa hereby affirm that have a certificate of consent t0 seer -Insure ora certificate Compensation Insurance, or a certified copy. VALUATION 'ZONE t`2( (Section 3 00, thereof (Section 3800, Lab. C.). GRADING CU. YDS. ACRES Policy No. - Company - - 1 Certified copy Is hereby furnished. REMARKS: ' Certified copy Is filed with the city Building Division. - - - - - -)i!EMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit Is for one hundred - -- -- - - SS100) or less). i r ZJ certify that In the performance -of the work for which this permit is Issued. 1 shall not employ any pe n in y mann q50 to bete a subjec to. he W rkers',Compensa lz s)f Calf hid 1 PLUMBING -• PLAN'CH ECK -'- BATHTUBS SHOWERS - Date Date Signature NOTICE: If after making this dec aration, you should become subjectTOILETS URINALS - - to the Workers' Compensation provisions of the Labor Code, you must' forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS - 3 revoked. -KIT.SINKS - DISHWASHERS - -' CONSTRUCTION LENDING AGENCY SERVICE SINKS SUMPS - I hereby affirm that there is a construction lending agency for the per- formance of the work for which this permit Is issued (Section 3097 .'FLOOR SINKS --'-- -FLOOR DRAINS' Civ. -C.). Lender's Name _ Lender's Address -DRINKING FOUNTAINS - - - OWNER BUILDER DECLARATION -- - I hereby affirm that I am exempt from the Contractor's License Law for -INTERCEPTORS - CLARIFIERS - the following reason (Section 7031 -.5 -Business and Professions Code:- Any city or county which requires a permit to construct, alter, improve,- demolish or repairanystructure, prior to Its issuance, also re- quires the apoicant for such permit to file a signed statement that he SWIMMING POOL "- 'PTRAP - - - WATER SERVICE- ALTERATION '^ SERV ICE - - OUTLETS - is licensed pursuant to the provisions -of the Contractor's License•Law-GAS (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS- -- BTU OUTPUT - Business and-Pro(essions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by SEWER'CONNECTIONS -^ l' ^nv' applicant for -a permit subjects the applicant to a civil penalty T: riot more than five hundred dollars ($500). SOLAR TANK COLLECTORS -' 1, as owner 01 the property, or my employees with'wages as their' compensation, will do the work, and the structure is not intended -PLAN CHECK or Offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SVS. --' Contractor's.License Law does not apply to an owner of a properly ISSUE FEE - who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not _ MECHANICAL PLAN CHECK intended or offered for sale. If, however, the building or improvement Is sold within one year or completion, the owner will have the burden HEATING SYSTEM .0-l0o,000 BTU n AND DUCTING 100,000+13TU i of ing he did not build or improve for the purpose of -sale): I, as owner of -the property, am exclusively contracting -with is setl contractors to construct the project (Section 7044, Business and Professions -Code: -The Contractor's License Law tloes not -apply to REFRIGERATION 0-100,000 BTU -SYSTEM- - 100,000 + BTU an owner of property who builds Or improves thereon, and who can- tracts from -such projects with. a contractor(s) licesned. pursuant to the Contractor's License Law). ❑'I -am exempt under Section B. & P. C. for this - BOILERS BTU reason - Date _ - Owner SYSTEM REPAIR, ALTERATION I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE informationiscorrect. I agree to'comply with allcityand county ordinances iS�QQd state laws relating to construction, and hereby authorize representat(v4% otp khis gtyl to epft upop-%the above' mentioned Signature Oatc&F IIII � � U - Drivers' License or S5 9p -- ISSUEFEE ---- CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor ., 5780 8/10/82 -,ti ZONING REGULATIONS s - PLNTC1gG.. REF. � - L NT. PRPElRTY GIN REAR YARD (TOL 7 �J- PKC:SPACE REQ.� P VIDED STREET WIDTH o '-t I -PARK FEE $ CONDITIONS: - -- - -- 68.50 TL PANELS -' MAIN S -UB' - - -S ELECTRICAL- - - - PLAN CHECK - 50. FT- ING----- - -- GENERATOR-- TRANSFORMER APPLIANCE - 0.1'KW_1-30 10-50 KW_50I KW' ' lkW - - MOTORS (INC. SOLAR)- '0.1' HP 10-50 HP—So -1-10 HP - + HP FIXTURES 'OUTLETS SWITCHES GAS TUBE SIGNS - IGNS-POLE'LIGHTS APPROVED By POLE LIGHTS - - -- -- - - - BUILDINGO�� r ZJ , ---- rn - O.J✓ PANELS -' MAIN S -UB' - - -S SERVICE - - - - - AMP- - -- - ISSUE FEE' APPLICATION APPROVED By DAT 6 SUMMARY OF FEES. - BUILDINGO�� r ZJ , ---- rn - O.J✓ PERMIT $ . SMIP' iE PLAN CHECK $ '9.2" PERMIT4 - PL•UMBING g .DO - ISSUANCE $ !PLAN GRADING $ CHECK-,$ ELECTRICAL $ 'MICROFILM-$ PLAN CHECK $ - - TOTAL FEE $ MECHANICAL E' - -PLAN CHECK $- 'LENSED- - `r VANCE PC-$_ FINAL FEE $ O "r6 CONSTRUCTION AND PLANNING`' APPROVALS Permit # Date Inspector=.. - '" -� POOL& SPA •' _- APPROVALS Permit �\, �•-,.� , Date In p ctor 1. Temporary Electrical Service or _Pole -': ` 43. Pool &Equipment' Location`'`- '•``'� ' '" -� 2. SoilPipe-Undrgrn _t y'._, ; '�, S: '• 4�c; ;Sttiel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms - - 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel ein orce 47. Rough Plumbing & Pressure Test - - 6. Electrical UFER Grn 48. APPROVALTO-COVER-GUNITE 7. Footings - 49. Electrical Conduit-Undr rn 8. - Foundation 50. Gas Pipe, ❑ Undr rn, Test -9. Water Pipe-Undrgrn "' 51. Bac vd sh Lines P-Trap.❑ Undrqrn 10. Structural Floor System 52. -APPROVAL TO DECK - 11. Property Sewer Line & House Connection 532 =Backwash & Receptor-Final 12. Street Sewer Connection 54. Heater &Vent-Final 13. Rough Plumbing 55, Plumbina System- - 14. Rough Electric-Conduit 56. Electrical-Final 15. Rough Electric-Wiring / 57. Solar System-Final - 16: Rough Heating & Air Conditioning encing & Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING - 18. Ducts, Ventilatingr 60., 1.- - - _ _, _' POOL/SPA SYSTEMS FINAL 19. Gas Pipe-Rough & Test - 20. Roof Framing- 21. Roof Sheathing NOTES: _ - 22. Frameend Flashing - "23. Insulation 24. Lathing & Siding - - 25. Drywall Nailing - - - 26- - Plaster Brown Coat- 27. • Electrical Power Meter-Final - - - - - 28. Final Electric - - 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 Srinklin .S`sterh�I 36. Sound Attenuation ` 37. Handicap Regulations - - 38. FINAL STRUCTURE & B I DING 39. Special Requirements Comp Med 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. - CERTIFICATE OF OCCUPANCY No. Date _ -r 4" - - Anplieant to fill in all spaces within heavy border lines and sign all appropriate declarations. 404 OflIIad II.UU TL ' CITY OF COSTA MESA FPEIVIT„a TRACT NO. LOT NO. BL'QQG. '•- . 'CONSTRUCTION P RMIT 441 C. TYP OF COPSTRUCTION l,�L�'''�'D- - ALTERATION REPAIR.D.CO NVERSION'D.DEMOLI SH ❑OTHER-` � - - - - -- ' ZONING REGULATIONS ^ '-A Project Address r ._ _ Owner - - - Phh;neNEW ,Address ani. -- - ��' Arch/Eng. - � License No. DESCRIPTION OF WORK , c 1. I _ TYPE OF PERM IT.±- - ”' -' - � .* .__._ - -- - P $ - - - .ZONE'_ .•� PLNG'. REF.# - - - - - - a� BUI LDIrvG WE 'SET OPE RTV LINE' !Address 'I __ ._ _ • Contractor j -- Phone • • - -' - -0 GRADING - O FOUNDATION-�-O STRUCTURAL--- - ACK •YARD _- LICENSED -CONTRACTOR DECLARATION.- "` I' ' w a ' ❑TENANT 0 ELECTRICAL ❑PLV MBING MIECHANICA .51 L 91 EVA f i • - I hereby affirm thsP I am licensed under provisions of Charter 9 com- P ( I •-„ - - C 'RIGHT mencing with section 7000) sof Division 3 the Business and - [:]OTHER _ .I ll Professions Coe,. my license is in full force ff�t.. � (( PROJECT•DESCRIPTION,- Ii REARVARD(TO P/L)„- Llcensef la 'cen o. � � r PKG. SPACE REQ. - � — ;PROVIDED - Date- •-/'�” J% -'Sig at - 67/il /fit--Si9 -Signature- . A7A; /� SG FT.. .. '. STREET PARKIFEES WORKERS'COMPENSATION DECLARATION +OCCUPANCY_ CONSTRUCTION TYPE _. I hereby affirm that I have a certificate of consent to self -Insure Or a VALUATION' ' ZONE _ ZONING APPROVED BY - _ - - 'DATE' certificate of -Workers'- Compensation, Insure n e, -or a -cert ltletl copy. _- rt - - thereof (Sec b. C_) j i GRADINGyCU. YDS. ACRES SPECIAL CONDITIONS: POIICY No.- Co mPanY Q / : _ - _ 11,>ertitietl copy ls.herebY furnished..✓.REMARKS:: `'.,.'i-. .. � CONSTRUCTION AND PLANNING APPROVALS Permit 46 Date Inspector POOL & SPA - - - Date t% Inspector APPROVALSPermit# Temporary Electrical Service or Pole _ 43. Pool & Equipment Location'-` _1. 2._ -SoilPipe-Un rgrn•- 44. Steel Reinforcement �- 3.-. Electrical. Conduit Utility-Undrgrn 45. Forms - - - - - - . -4. Electrical.Conduit-Undrgrn 46. Electrical Bonding -:---- - - - - - _5. Steelem orce 47. Rough Plumbing ` & Pressure Test - - ' 6. Electrical UFER Grn. _ - 48. APPROVAL TO COVER-GUNITE- - - _7._ Footings - _ _ 49. Electrical Conduit-Undr rn ' ' r- _ .8. _ .Foundation. - 50. ,Gas Pipe, ❑ Undr rn, Test-' ^ . 9. Water Pipe-Undrgrn:_ �. - 51. Backwash Lines P -Trap' 0' ndr rim "' ` ':+"'" ' '- +.4'r. 10. --Structural Floor System_ 52. APPROVAL TO DECK . 11.. Property -Sewer- Line_& House Connection 53.._Backwash &'Rece for-Finah •'- + . 12. Street Sewer Connection.- -_- - 54 - Heater & Vent -Final '• 13._ .Rough Plumbing _- _ _ _ - -- - "` 14. . Rough Electric -Conduit . - "- -- - ' -56. Electrical -Final- 15. Rough Electric -Wiring 57. Solar-Sy4tem-Final �+" -16:-=Rough Heating & Air Conditioning - - - - encing.& Access Approval 1.7.1 Ducts in Structure - _59. APPROVED FOR PLASTERING ' 18: Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test - (- ' -- •- - - -= 20.- Roof Framing -- - --- -. '- -. 21. Roof Sheathing - - - '''- NOTES: '' . • • 22. Frame and Flashing 7 - 23' Insulation - 24. Lathing & Siding _ - - - -_ _ 25:. Drywall Nailing - _ "' _ • - 26! Plaster Brown Coat - - 27. Electrical Power Meter -Final -- - - - - 287- Final Electric -- - - -- - - - - - - 29. Final Heating -& Air Conditioning 30. Final Gas Pipe -Test - - - - - - 31. Final Plumbing_ - 32. - Water Service -Final - - - - 33. --Gas Service -Final ._ -- - _ _ - - _R - 34. Solar Domestic -Final "' ' -' _ ' _ "' '= .• ' 35. Landscape S2?inklinq System 36. Sound Attenuation 37. Handicap Regulations - - 38. FINAL STRUCTURE & BUILDING ; _ - - _ _ - r' •- 39. Special Requirements Completed" _ V 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co.• 42. CERTIFICATE OF OCCUPANCY No: ' - Date - --- - 1 V Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESAONSTRUCT/,ION PERMIT _ Project Address '24'D ,SC Id tt-� AyP J i 1375% Se Ikvt-llK talUa .Applicant's Mailing gA4ddress kl or Owner's Name �I'K V R 5711 L- LO RS Phone Address Arch/Eng. License No. Address Contractor's Name '—WVIYZOU krrll_>Zl�h e 1 541-17ti Address (mailing) X27 na . Dr- if ' p / City License No. LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of 'Division 3 of the Business and Professions Code, and my license is in full force and effect. 'L ZZJ License Class C �} No.� D Date Signature WORKERS' COMPENSATION DECLARATION I hereby affirm that 1 have a certificate of consent to self -insure or a certificate -`,Workers' Compensation Insurance, or a certified copy thereof (Sectio 10, Lab:/�C�/gp p C �j { icy NoY�'�LLd7 _Oom ' Copan>N 'd 1'L Certified copy Is hereby furnished- / I CertifMytjViled with the city I.din Division. Date 7 U Applican EXEMPTION FROM WORKER MPE ATION DECLARATION (This section need not be comp to if th ermit is for one hundred (8100) or less). I certifythat 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 California. Date Signature NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of,lhe Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. 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 (Section 3097 Civ. C.) Lender's Name Lender's Address _ OWNER BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/she is licensed pursuant to the provisions of 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 Merefrom and the basis for the alleged exemption. Any violation of Section „1.5 by any applicant for a permit subjects the applicant to a civil _a <dty of not more than five hundred dollars ($500). ; . a, 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 (Section 7044, Business and Professional Code: The Contractor's 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 employees, provided that such improvements are not intended or offered for 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- prove fl the purpose of sale). ❑ I, asoowner of the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to anowner ofpropertywho 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 proof of/ their Worker's Compensation insurance should be provided to me. ❑ 1 am exempt untler Section B. & P. C. for this reason Date Owner I. hereby certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relatin o buil n onstruction, and hereby authorize repre- sentatives of this Pon he above-mentionedope(ty-(yrs Inspection purpose, �j�G�1+lX Signature Date Drivers' License or SS 35 y3 _S A.P. # S Main Buildi TYPE OF CONSTRUCTION N NEW LJ ADD LJ ALTERATION U REPAIR E ❑ CONVERSION ❑ DEMOLISH ❑ OTHER T Front DESCRIPTION OF WORK/USE OF BLDG. -A Rear TYPE OF PERMIT GRADING 0 FOUNDATION STRUCTURAL C Right K ❑ Left TENANT ❑ELECTRICAL El � MECHANICAL � S ❑ OTHER Ping..Ref. PROJECT DESCRIPTION SQ. FT. OCCUPANCY planning Notes: CON STRUCTION TYPE VALUATION$ ZONE GRADING CU. YDS. ACRES Remarks: PLUMB G FEES Automatic Washer Bar Sink Showers Construction Pole Sub. Backflow Preventer Service Sink - - Cooking, Unit Backflow Irrigation Sewer Cap PLAN CHECK Dishwasher $ PERMIT .+ Dryers ❑Gas ❑Electric Bathtubs Sewer Connection $ ISSUANCE:, $ Fan Clarifiers Solar Collectors $ ENERGY P.W.. Dishwasher. Solar Piping ELECTRICAL F.A. U. - - - Drinking Fountains Solar Tank - Oil GRADING 1. Fixtures Floor Drains Swimming Pool w/Spa 50% Device Boxes Floor Sinks Urinal - - - - MECHANICAL Outlets _ Gas Service Outlets Water Closet . - TOTALFEE_� Switches PLAN CHECK 25% Garbage Disposal Interceptors -" Water Heater. .. Generator ❑0-5 KW ❑5-15 Kitchen Sink Water Service - Lavatories'. _Auto -Wash P—Trap Laundry Trays Roof Drains - Reinspection Fee I $15 Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple 1:1 Firepl/Fact. Bit. ICBG # Heating System & Ducting ❑ 0.100,000 BTU ❑ 100,000 BTI Reinspection Fee 1 $15 0865-46, rev. 5/88 White - Building; Canary - Applicant; Pink - Accounting: Goldenrod - Assessor Issue Fee IANICAL - Hood or Type I ❑ Canopy. Type 11 ❑, i}ef-rigeration System Art -' /-100,000 BTU � ❑ 100,000 6 System Repair/Alteration Fire Dampers Registers Issue .. ., . I Zone' Parking Req./Provided ELECTRICAL Transformer ❑ 15.50 KW ❑ 50+KW Meter ❑up to 100 amps Meter ❑over 100 amps Sub Panel ' Motors ❑ 0-1' HP ❑ 1 % - 8 Inc. Solar 09 -15 -HP 016.15+ Microwave Pole Light P.— Sign I Standing Sections Trash Compactor FEES O N 1. N G R E O M T S. I Reinspection Fee I $15 I I Issue Fee 1 $ 3 1 1 $'3 DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By FEES Building Approved fay Application Issued IS 'p SUMMARY OF FEES BUILDING PERMIT' $ SMIP $ PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE:, $ PLAN CHECK 25% $ ENERGY P.W.. $ ELECTRICAL . $ Oil GRADING 1. . $ PLAN CHECK 50% $ MICROFILM- $ MECHANICAL $ TOTALFEE_� PLAN CHECK 25% $' - - _. 0100015289-00015259 TOT 33,00 DATE: 09/23/88 TIME: 11:39 - CONSTRUCTION AND PLANNING r Daie APPROVALS Permit # Inspector POOL'A APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. r 53. Steel Reinforcement 3 Electrical Conduit Utility-Undrgrrid' .- : 54. Forms _ 4�Electrical Conduit-Uniirgrnd. 55. Electrical Bonding 5! Steel�Reinforcement ', 56. Rough Plumbing & Pressure Test 6" Electrical UFER=Grndt 57. APPROVAL TO COVER-GUNITE T- Footings, 58. Electrical Conduit-Undrgrnd. 8. Foungation - � ;:, � y ` 59. Gas Pipe, 13 Undrgrnd., Test 9;, Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. ti .�Sfructural Fl000,system 61. APPROVAL TO DECK 1 �:1 Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12.Sewer Cap "� 1� 63. Heater &Vent -Final 1'3. 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 - - ,1.7- Rough Wiring Sign 68. APPROVED FOR PLASTERING IT* Rough Electrical -T Bar Ceiling~', 69. POOL/SPA SYSTEMS FINAL 79'. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20! Rough Factory Fireplace 21'. Ducts, in Structure 1,, _ 70. Underground Hydro 22. Ducts, Ventilating- _ v. 71. Product Piping 0 Gas 00il 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing' -1. 73. Undergrnd. Storage Tank DGas ❑Oil..{ 25.' Roof Sheathing - '-"'" -f-"' i - - 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 i 78. FIRE PREV. FINAL 30. Drywall Nailing - HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat - 79. FINAL INSPECTION 32. Electrical Power Meter -Fina?- 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test 36. Hood or Canopy 37- Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final - - 40. Gas Service -Final 41. Solar Domestic -Final :} 42. Backflow Preventer 43. Backflow Irrigation - - 44. Landscape Irrigation System J 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING ' 48. Snecial Requirements Completed 49. Electric Release to Edison �• 50. Gas Release to Southern California Gas Co 1� , 51. CERTIFICATE OF OCCUPANCY=• No. Date ,,�j City of Cost* Mesa , Development Services Department Building Safety Division CERTIFICATE OF OCCUPANCY No. 0001k® P. O. Box 1200 Costa Mesa, California The Building located at 245 Fischer Avenue 1#C-6 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto fora Group B=2_0 cc up an cy. Use of Building Tntarior Ali-xrations — Office Legal Description 427-033-07 BE -5895 (See reverse side for Metes and Bounds) I 5l1 BE -5895 P-6292 Building Permit No BEP1370 Electrical Permit No. AFP -4370 Plumbing Permit No. BEP -4370 F-5875, I-5788, Mechanical Permit No. F-4415, M-4547, M-57881 Number of apartments —0— /<-/, and/or guest rooms —0— ISSUED TO: Building Official `T1 /Can , CX Pulliam BMngKtjes by 1517 ,Santa Ana, CA_ Date This Certificate of Occupancy SHALL BE posted in a conspicuous place on the p%mises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. CMF 1015-46 rev. 1/83 White -Owner; Canary - Numerical File; Pink - Bldg. Permit File Applicant to fill in all spaces within heavy border lines and sign ]II appropriate declarations. CITY;OF COSTA MESA PE$[v11= NO.� NO: LOT NO. BLDG. NO. - ? " I '1' 7 R r��' ��'�r f E13. 3C TI CONSTRUCTION PERMIT LLQQXX�� SS /TRACT G Project Address TYPE OF CONSTRUCTIOPI •. Owner (% Phon NEW ❑ ADD 'ALTERATION - _ Address �(,(f^^ ❑REPAIR ❑ ONV ERSION ❑DEMOLISH ❑ ZONING REGULATIONS Arch/Eng. •� - License No. OTHER 1 DESCRIPTION OF WORK A P # 'p 'Address - - - ZONE 44,0 PILING, REF. -P I , Contractor0tkr/(•/ej& ( Phone - __B_=ING- - Tp Bt�I INCi TYPE OF PERMIT SETBACK C ST. PROPS RTY LINC- kip 'Address - - "' ARADING ❑ FOUNDATI ❑STRUCTURAL TENANT ELECTRICAL MBING ❑MECHANICA SIDE YARD -- -' IDE VA LICENSED CONTRACTOR DECLARATION. I hereby affirm i I am licensed under provisions of Charter 9 (com- RIGHT l man clog with section 7000) Of Division 3 of the Business- and ❑ THER Professions Code, and my license Is In full force and effect. REAR YARD (TO P/L) - - - _PROJECTD S IPTION License Class License No. _ _ PKG. SPACE REO. PROVIDED Date � - � Signature -SQ. FT. >>�� _ OCCVPANCI�R.lL CO NSTRUCTIO N TYPE. _ g%J E&T WIDTH -_ - PARK FEE $ - DECLARATION WORKERS' COMPENSATION I hereby affirm that I have a Certificate of consent to soli -Insure ora 'ZONING APPROVED BY DATE Z- 7 2 _r y_ cert lfl Wte of Workers' Compensation Insurance, ora certified copy ,VALUATION ZONE thereof (Section 3800, Lab. C.). GRADING CU. YOS. ACRES 'SPECIAL CONDITIONS: - MPolicy No. Company" - - - ' - -- - - - I rtlfled copy is hereby furnished. . REMARKS: rtified copy is filed with the city Building Division. E-. MPTION FROM WORKERS' COMPENSATION DECLARATION L� - ' (This section need not be completed if the permit IS for One nun Dred . ._• F or less). - ._.' - - O($100) I certify that In the performance of the work for which this permit Is o issued,.) shall not employ any pars Ina manner so as beco PLUMBING • -PLAN CHECK ELECTRICAL PLAN CHECK subje t Ot eW rker Co mpensati Laf Id. - -SHOWERSSO, DateSignat ure _ BATHTUBS =L ING_ F57L_ ' _ n NOT CE: If after making this declaration, you sh uld become 5ubj act TOILETS URINALS `" z GENERATOR- 0-1 KW to to the Workers' Co mpensatlon provisions of the Labor Cotle, you must •TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVs' APPLIANCE 10:50 KW_ 50 + KW revoked. _ _ CONSTRUCTION LENDING AGENCY KIT, SI INKS - DISHWASHERS" -' - MOTORS 0.1 HP 1-10 HP I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS "' 'UNC. SOLAR) -10-50 HP 501 HP - .s formance of the work for which this permit Is issued (Section 3097 ,.,SUMPS Civ. C.).' �'.A- - T FLOOR SINKS v FLOOR DRAINS .,FIXTURES OUTLETS SWITCHES Q Lender's Name w Lender's Address r-1. DRINKING FOUNTAINS - '•' '- •GAS TUBE SIGNS' ' OWNER'BUILDER DECLARATION INTERCEPTORS CLFiRIFIERs.� IGHTS ;POLE LIGHTS- I hereby affirm that I am exempt from.the Contractor.'s License Law for the following reason (Section 7031.5 Business and Professions Code: the SWIMMING POOL "P TRAP - - Any city or county, which, requires a. permit to construct, alter, POLES METERED SUB -' i'.' Improve, demolish or repair any structure, prior to its issuance, also re- WATER. SERVICE ALTERATION - PANELS - MAIN SUB quires the ap, licant for Such Permit to file a_signed statement that he - A Is licensed pursuant to the provisions of the Contractor's License Law GAS SERV ICE OUTLETS SERVICE - - ' '-" AMP OQ (Chapter 9 (commencing with -Section 7000) of Division 3 of the, E- , - ueineis and- Professions Code) -or that he is exempt therefrom and the WATER HEATERS BTU OUTPUT - - -t basis for the alleged exemption. Any violation of Section 7031.5 by -�. anv •oplicant for a permit subjects iapplicant to a civil penalty SEWER CONNECTIONS -' -- - - of more than five hundred dollars ($500). - s E S owner of the property, or' my employees with wages as their SOLAR'TANK - ' -COLLECTORS Sole compensation, will do the -work„and the structure is not Intended or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SVS. ISSUE FEE - - Contractor's License Law does not apply to an owner of a property _ who builds or improves thereon, and who does Such work himself or _ _ ISSUE FEE APPLICATION APPROVED BY DATE 23 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 't IS sold within one year of completion, the owner will have the burden _ a of proving he did not build or Improve for the purpose of sale). 1, the am exclusively contracting with HEATING SYSTEM 0-100,000 BTU BUILDING ,�QQ//�� 'y�� 'PERMIT. $SLIL>—�gS! - SMTP $ as owner of property, lite etl contractors to construct the project (Section 7044, Business AND DUCTING' 100,000+BTU PLAN CHECK $ PERMIT. and rofeisions Code: The Contractor's License -Law does not apply to - ISSUANCE $ 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) Iicesned pursuant to SYSTEM - -- - GRADING $ the Contractor's License Law). _ 100,000 + BTU PLAN CHECK $ ❑ 1 am exempt under Section B: & P. C. for this BOILERS BTV7- 'ELECTRICAL $ $ reaso - SYSTEM REPAIR, ALTERATION PLAN CHECK $ MICROFILM $ ']/ s Dafe Owner . - _ MECH ANICAI. $ - _TOTAL FEE $ I hereby certify that I have read this application and state that the above E HA_UST SYSTEM MULTIPLE LESS AD - information is correct. I agree l0 comply with all cit and count 9 P Y Y y PLAN CHECK $ VANCE PC $_ ordinances a d state laws relati to construction, and hereby authorize represenlat of cit f ant up0 a above mentioned property f r inso, n ses. -' PH S 2`32 1^I'- �`' FINAL FEE $_—�z "SSG ,y / ISSUE FEE - 62 Z 7/1//49 /-le - 10.3.3d) ",d -Assessor CONSTRUCTION AND PLANNIN APPROVALS Permit M87J Date Inspector POOL &SPA: APPROVALS Permit Date Inspector 1. Temporary Electrical Service or Pole 43. ,Pool & Equipment Location 2. Soil Pipe-Undrgrn - . .. I 1 44. Stidl Reinforcement 3. Electrical Conduit LWity-Undrgm 45. , Forms 4. Electrical Conduit-Undrgm •46. Electrical Bonding Steel Reinforce 47. Rough Plumbing & Pressure Test 6.1 -Electrical UFERGrn 48. APPROVAL TO.COVER-GUNII'E 7. Footings 49. Electrical Conduit-Undrgrn -8. Foundation 50. Gas Pipe, El Undrgrn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines, P -Trap- El Undrqrn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53.. Backwash & Receptor -Final 12. Street Sewer Connection 1 .7 54- Heater& Vent -Final' 13. Rough Plumbing 55- Plumb'na System - Final 14. Rough Electric -Conduit 56. Electrical -Final. 15. Rough Electric -Wiring 42-90d,562- (17 -C-, 57. -Solar System -Final .-16. - Rough Heating & Air Conditioning- 58. Fencing& Access Approval 17. `.Ducts , in Structure APPROVED FOR PLASTERING 18. 19. 20. Ducts, Ventilating Gas Pipe-Rough&Test- Roof Framing 60. POOL/SPA SYSTEMS FINAL 21. -22. Roof Sheathing Frame and Flashing NOTW -23. =Insulation, n, -:2-4 4z� 24. Lathing & Siding 25. Drywall Nailing /-6-V-3 279OW 26. Plaster Brown Coat 27.. Electrical Meter -Final 29. -Power -Final Electric e_ 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing 32: Water Service -Final 33. -"..Gas Service -Final 34. So Domestic -Final 35. -lar -Landscape Sprinkling System-' 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUI,LDING 1y- S3 39. Special Req i reEjen s t! d �'t 40. _ Electric Release [o Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY 6- Date ' Applicant to fill in all spaces within heavy border. lines and sign all appropriate declarations. CITY -00 -COSTA MESA PERM NO. - TRACT NO. - LOT NO. BLDG. NO. - - - - - - - ,CONSTRUCTION PERMIT � C- • ^c093 12/ �YBv;:; ':.34,32 TL Project Address - �+ io -, TYPE OF CONSTRUCTION ., �� ? _..� ~ 1 .. '•>ti•';, Owner - �j - Phone - -❑ NEW ADD ❑ ALTERATION --- -Address , 0EPAIR ❑CONVERSION ❑DEMOLISH !7 - ZONING REGULATIONS -Arch/Eng. - License No. - ❑ OTHER DESCRIPTION OF WORK A P .-. Q ' Address -' - - - -- _ _ _ _ O L F S G _ ZONE PLNG.•REF. T - COntrac[or' Phone I Q. - -TYPE OF PERMIT - - - Tp g�/ILLpDING- SETBACK PROPS RTV.LI NE Address - - - ,b GRADING' .. ❑ FOUNDATION ❑ STRUCTURAL T YARD - - - - LICENSED CONTRACTOR DECLARATION. ' ❑ TENANT ❑ ELECTRICAL UlPLUMBING ❑MECHANICA 'SI LLSIDE I horeby affirm Inst 1 am licensed under provisions of Charter 9 (Com- -with 7000) I ❑OTHER' Y ARD RIGHT Section of 1 Division 3 of the -Business and. oenchins PrCo , antl my license Is In full force Ind effect., ofessio /tl18 - PROJECT DESCRIPTION REAR YARD (TO P/L) ILICenS9 Class `'�� cense No. '- PKG. SPACE REO.- PROVIDED- i>-N/-.(� - .50. FT. � _ _ .. �Date - Signature _s��Lt�cli_ r _ - -_ WIDTH PARK FEE E' WORKERS' COMPENSATION DECLARATION " S'CO OCCVPANCV CONSTRUCTION TYPE .STREET I herebyORKE that 1 have a certificate o/ consent to Self -Insure Ora p%�Jry 7, ZONE ,ZONING APPROVED BY DATE - - _^n ;certlfipate of -Workers' Compensation Insurance, or a• certified .copy. !I+VAL•VATION'9 'LSPECIAC - - thereof(Section � 8 C�. GRAD G'CU/YDS. '' ACRES CONDITIONS:- --- - Py:;Y No.�CompanY /aLdL_ V5 ..h•rtifieCOPY IS,hereby fur .._ _.._..REMARKS. A�4arlifi¢d COPY IS,filed with the city Building Division.- EXEMPTIONFROM WORKERS' COMPENSATION DECLARATION - -- - '-- - -'- ) - •- - -- -- „_ - • '(This Section, need not be completed if the permit is for one hundred�- ,�• "' 1;,q (5100) or less). r , . - -_- _ _ __ _ ,r -_ _ _. ._ __ _ _ _ _ ._ `I, ter I, y that In the performance of the work for which this permit is Issued; 1 shall not employ any person in any manner so as to -become -PLUMBING - ., PLAN CHECK --- I - - ELECTRICAL - PLAN CHECK ' - subjl to the Workers' Compensation Laws of California. r'_rr_-'_-_ - ' _-GARAGE I 'Date Signature ' BATHTUBS- - SHOWERS _ - "'-' - -- -'-- -- a J ,NOTICE: If after making this declaration, you should become Subject -TOILETS. f - , .URINALS - - - ,GENERATOR- -0:1-KW_1-10 KW' - TRANSFORMER 'to the Workers' Compensation provisions of the Labor Cotle, you:m ust forthwith comply with such provisions or this permit Shall be tleemetl LAVATORIES DOUBLE LAYS- 'APPL'IANCE10-50 KW_50 t KW� - revoked.. CONSTRUCTION LENDING AGENCY KIT. SINKS- - -" DISHWASHERS' - MOTORS -- 0 -1 -HP 1-10 HP 'I hereby affirm that there IS a construction lending agency for the per. SERVICE SINKS - SUMPS -- -- 4(INC. SOLAR) 10-50 Hp_ -50 -+-HP 4ormance of the work for which this permit is issued (Section 3097 1 l Civ. C.I.- - '- - - ` - - - 'FLOOR SINKS' ----_---FLOOR DRAINS' - FIXTURES- -- OUTLETS --'SWITCHES- -- - ,L¢ntler•s Name Lenders Atldress -' DRINKING FOUNTAINS' ' -'- - ' 'GAS TUBE SIGNS -- -- - - - - - OWNER BUILDER DECLARATION- 1 herebyaffirm that I am exempt froni Contractor's License Law for folowings INTERCEPTORS' - CLARIFIERS- POLELIGHTS " - - - --- - -•- the reason (Section 7031.5 BusinessandProfessions Cotle: SWIMMING POOL'-' ' PTRAP - - - - - - -$LIB - Any city or county which requires a permit to construct, alter, POLES Improve, demolish or repair any structure, prior to its issuance; also re- WATER SERVICE- _ -ALTERATION- PANELS - ----MAIN - --� - - r U li nt for such permit [ file a i statement h h the w o u m o signed a ecen at e q Pr P 9 ,SVe to Ga ctor's License Law the provwith p(com •'GAS SERVICE- 'OU+LETS "- .. _ rSERVICE------� --•-- .-AMP- - - (Chapter en (commencing with Section 7000) of Division 3 of the Sectionthe 7000) - Business9 therefrom -and the S and Professions Code) or that he Is opt BTcJs WATER HEATERS - BTU OUTPUT' - - - - - - - - - - - -- - - f exemption. Any violationapof SetUon 7031.5 by Section bai.' for the afar a ?' '.-;gppliW nit for fi permit applicant to -a -Civil penalty �y. SEW ER'CONNECTIONS _ r more than five hundred dollars (5500). ed dollars 1 „ Li',Co owner of the prop mane with wages their -SO CA R'TANK'-'--'- 'COL CECTO RS' -' .I •- - - uet he work, tile, will do the work, and the Is not intended the structure P ' ! .% _ 1 for offer etl for sale. (Section 7044, Business and Professions Codes The or Offered d ofes de -The SOLAR PIPING SYS.— -{ " "-'- - 1 - ISSUE FEE - -- - - - --- - - - - - ;ContrauildstorLaw not ply owner of a property 'C im who builtls or improves thereon, and who or r thereon, d who es sucti woik himself or' _ - - ISSUE FEE - -- - - +APPLICATION APPROVED BY Such ,intendh his own employees, Provided that Such improvements are not intentletl or offered for sale. If, however, the building or Imp m p vemenl is MECHANICAL PLAN CHECK - SUMMARY OF FEES"-, Sold within One year of completion, the owner will have he burden of proving he tlitl not build or improve for the purpose of 'sale). - - -- BUILDING q�, -• ❑ 1, -as-owner-of the property, am -exclusively with HEATING SYSTEM 0-100,000 BTU o I no SMIf?,� .S_✓f/^ PERMIT E-6L1siCL .contracting licensed contractors to construct the project (Section 7044, Business gND DUCTING- 0- .. - 100, OO+BTU - r. 'PLAN CHECK E �.3' fS PERMIT s and Professions Code: The -Contractor's LiCensti does not apply to 'property - _ I _ - .ISSUANCE En an owner of who builds or Improves thereon, and who con. REFRIGERATION 0-100,000 BTU r IPLUMBING E tracts from such projects with . a. cont factor IS),_. Iicesned pursuant to SYSTEM - - - - _. GRADING' E" --•T the Contractor's License Law). 100,000'+ BTU . PLAN CHECK E dL - ❑ 1 a exempt'untler Section - - 'B'. & P, C. fpr this , E' 'E - BOILERS BTV ,ELECTRICAL ° - reason -- _ - MICROFILM En - PLAN CHECK E ---- Dale Owner SYSTEM REPAIR, ALTERATION r TOTAL FEE Er- MECHANICAL, E - - - I herebycertify that I have read this a y application and State that the above EXHAUST SYSTEM MULTIPLE ! LESS'AD- • - Information is correct. 1 agree to comply with all Nty"and'county - 1 .PLAN CHECK E - - VArvCE PC ordinances and slate laws relating to con,t,uclloo, and hereby authorize representatives' of this city '"lo enter 'upon the above mentioned properly for Inspection \I - - •' �� apo5/as. _ -/>-��,,�� Signature�� `�"'��-+ 1- ISSUE FEE CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNINGf APPROVALS Permit # Date POOL & SPA Inspector APPROVALS - Permit# -Date Inspector 1._ Temporary Electrical Service or _Pole 43. Pool & Equipment Location 2. Sol . ipe-Undrgrn 44. Steel Reinforcement - - -- 3.. Electrical Conduit Utility;Undrgrn 45. Forms - 4. Electrical-Conduit-Undrgrn„ 46. .. Electrical Bonding - - - _5. _ tee ein orce 47. Rough Plumbing & Pressure Test- - 6. Electrical UFER Grn _- 48. APPROVAL TO COVER -GUN ITE - - - - - 7.. Footings _ 49. Electrical Conduit-Undr rn- 8. - ,Foundation 50.. Gas Pipe, ❑ Undr rn, Test 9. - Water Pipe-Undrgrn -_.. ' 51. Backwash Lines P-Tra-p. ❑ Uncirclin .10..-Structural.FloorSystem. 52. APPROVAL TO - - 1.1. _Property. Sewer Line.&.House Connection__ -53.. Backwash:& Receptor -Final 12. Street Sewer Connection "' ' "'•' ---- - -_- 54. Heater &Vent -Final 13.. .Rough Plumbing _ - - ` 14. Rough Electric -Conduit "- - _--- - - •56. - Electrical -Final - 15. Rough Electric -Wiring - - - 57. Solar System -Final 16. Rough Heating & Air Conditioning W.- encing.& Access -Approval 17. Ducts in Structure. 59. APPROVED FOR PLASTERING - 18. 19: 20. Ducts, Ventilating •- - - Gas Pipe -Rough & Test Roof Framing - - - 60. - - ... _ POOL/SPA SYSTEMS FINAL., 21! t 22. Roof Sheathing- -Frame and Flashing- - - - - - - - NOTES: 23r Insulation - - - 24: Lathing & Siding 25. Drywall Nailing -- •� •-(ti-�., _ e!5� D - 26. Plaster Brown Coat- -- - / - 27: Electrical Power Meter -Final - - •-; V • . • 28. --Final, Electric - - - - - - - 29: Final;Heating & Air Conditioning 304 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. FINAL STRUCTURE & BUILDING ! 39. Special Requirements Completed _ _ - • 40. Electric Release to Edison 'r' • - - 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PE3C^IT NO '' // �T TRACT NO. LOT NO'. - B G. NO. e-� •- "-• - - - -- - - CONSTRUCTION PERMIT /"� TYPE OF CONSTRUCTION + ❑ NEW ADD- ❑ ALTERATION ❑ REPAI ❑CONV ER SIOrv, ❑DEMOLISH ❑,OTHER I - 561.1. 8/05/82 , 2Q:97 - " f ' - ZONING REGULATIONS i Project Address 2yy _ Owner _ _ Phone - - 'Address �," -�' -- --• "Arch/Eng. No. -- License DESC RIPTION OF WO RK ...L S'rw - A-P-C --0 '-'0 ZONE PLNG. REF. $ 'Address - - ---- -•' - Contractor' "tC .T - Phone 4TYPE OF PERMIT " - - SET AC T. ❑GRADING'- ❑ ❑STRUCTURAL IO YARD' - ❑TENANT -E] E LV MBING" ❑MECHANICA .SIDE Y a'CI BUILDING RO PE RTV LINE .-AddressV,4,,72_-1- - - - -FOUNDATIONI /B/- .fit' :LIC ENSED-CONTRACTOR-DECLARATION. - .I hereby that I licensed under of Charter 9 (Com- affirm am provisions mencing - with - section 7000) -of Division 3 of the -Business and - ❑-OTHER _ RIGHT Professions Code and my license is in full force and effect. -REAR V.ARD (TO P/L) - - - "C-�G - - R/l PROJECT LlcenSe CIasS - License No. 1�/ _i - �i - + + + 'I, • PKG. SPACE REQ. - 'PROV IDED IOCCUP tOCCVPANCV s CONSTRUCTION TYPE ' STREET WIDTH ., PARK FEE-$. COMPENSATION DECLARATION ;WORKERS' -- _: _ ___7T9 - _ EO BY - - --DATE I hereby affirm that 1 have a certificate of consent to self4risure, or a VALUATION' _ 20NE .20NING'AI I . certificateof-Workers' Compensation Insurance, or -a certified copy ,._ 'hereof (Section 38800 l� ti C.LL / GRADING CU. YDS. ACRES SPECIAL CONDITIONS: - Ilcy No-. Da_ lJC %/AD.39/9.. in pang- J Certified copy is hereby -furnished. _ _ -_.__ _ ., REMARKS:. Certified copy is filed with the city Building Division. IeX '"--- t E EMPTION'.FROM-WORKERS'"COMPENSATION DECLARATION - - -'- -' -•-' --'-• -- - --- t (This section need -not be completed if the permit is far one hund retl - -- - __. (E100I or less(. ) .. ) _ - 1 certify -that in the performance of the work for which this permit is issued, 1 shall. not employ any person in any manner so -as to become � ,'PLUMBING'. •'- i ; PLAN CHECK "-- ' - ' - - - .ELECTRICAL= -'- - PLAN CHECK __ -- "' subject to the Workers', ompensation_La Ws of California.' C BATHTUBS '- -SHOWERS-"--" "' GARACiL - --'- -' FT '-"- - - - -- Date iSignature I NOTICE: If after making this declaration, you should become subject 7TOILETS,URINALS'--- - -- -� - - GENERATOR " -0-1 KW_ 1-30 KW - to the Workers' Compensation provisions of the Labor Code, you must' TRANSFORMER ' 1" forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS--- - - APPLIANCE -10-50-KW_50+KW - revoked.. KIT. SINKS -' - '-' DISHWASHERS - MOTORS -0-1 HP =1-10 HP -- ENCU CONSTRUCTION LENDING AGENCY il hereby affirm that there is a construction lending agency for the per- SERVICE SINKS. -' - - - -- ,(INC. -- .'(INC. SOLAR) 10.50 HP 50 - HP. formance of the work for which this permit is issued (Section 3097 FLOOR SINKS s,-"FLOOR'DRAINS -' FIXTURES 'OUTLETS- -SWITCHES-1 -- ._"--- t -y ' - `• - :Lender's Name- �Lender'S Atldress DRINKING FOUNTAINS-- .r '- - -- - - GAS -TUBE SIGNS-- - -- OWNER BUILDER DECLARATION' - -•^' - - I hereby affirm that I am exempt from the Contractor'Sl License Law for 'INTERCEPTORS- CLARIFIERS - - '•POLE LIGHTS - - SWIMMING POOL '-'•P'T RAP- •"-- - J POLES - METERED-' SUB the following- reason "(Section 7031.5 -Business and Professions Code: Any to Construct, alter, City or County which re0uire5 a permit Improve, demolish or repair any structure; prior -to its issuance, also•re- WATER SERVICE -- '-"'A L'TERATION"- - - - - :PANELS -'--' MAIN - quires the ap, Ilcxnl for such Permit to file a signed statement that he 'GAS SERVICE"- '^ _OUTLETS`---' 'i - 'SERVICE-- - - AMP- - - is licensed -pursuant to the -provisions of the Contractor's -License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the f WATER HEATERS BTU OUTPUT - - - - - - -- - - •' . 8ustness-and-Professions {ode) or that he is exempt therefrom and the - %;+515 for the allegetl exem ptlon. Any violation of Section 7031.5 by SEWER'CONNECTIONS-' �- -- - - - - - -- - - -- -- - - - - y-appliranl ora-subjects the applicant to a civil Penalty ?-1 r 'tif not more than five hundred dollars ($500). SOLAR TANK - - COLLECTORS ❑ 1 -,-as owner of the property. or my employees with wages as their solecompensation, 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 - ISSUE FEE - ' -" APPLICATION APPROVED BV- - -- DATE - - who builds or improves thereon, and who doeli such work himself or through his Own employees, provided that such improvements are not MECHANICAL PLAN CHECK - ' SUMMARY CF, -+_ Cr• `p Intencied-or offered for sale. If, howe3er, the building or improvement is sold within one year of completion, the owner will have the burden of proving he tlitl not build or improve for the purpose of Sale). ❑ - -- _ HEATING SYSTEM 0-100,000 BTU : -- •'ah f- - BUILDING :PERMIT - E` �7v -"--- -- - •SMIP' _.$ • -rn" I, as -owner oL the. property,. am exclusively- contracting -with licensed contractors to construct the project (Section 7044, Business AND DUCTING - ii - - '` 100,000+BTU i ,PLAN /y, 97 - -r - ^PERMIT and professions - Code: -The-Contractor's License taw does not apply to CHECK -E 'ISSUANCE E an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU j 'PLUMBING S tracts from -such.projects with a -contractors) Ilcesned pursuant to. .SYSTEM -- -__ _ ' _ _ _GRADING $ the Contractor's License Law). 100,000 �+ BTU } tPLAN CHECK S El am exempt under Section - - 'B. & P. C. for this I $ BOILERS BTU 1 +ELECTRICAL $. reason- - - - - - - --- - - - SYSTEM REPAIR, ALTERATION - - ', PLAN CHECK E - - MICROFILM E - Date. Owner EXHAUST SYSTEM MULTIPLE _ MECHANICAL E . TOTAL FEE V_ - -"- - - - - LESS AD - hereby certify that I have read this application and state that the above information +s correct. 1 agree to comply with all city -and county yPLAN CHECK VANCE PC $ ordinances and state laws relating to construction, and hereby authorize _ representatives of- this city t0 enter' upon' the above mentioned' fo_r s. property �lr{spection purpo _J1- � � - _7-2 FINAL FEE S �I Signaturn��L!<6. Date ell - Drivers'License or 55- - - --ISSUEFEE - •- ._ _.- - .- _ .L. - _ - _ _ , CMF 0865-46 White -Building; Canary -Applicant: Pink -Accounting; Goldenrod -Assessor TL CONSTRUCTION AND PLANNING r' ' Date Inspector APPROVALS Permit # / Y� POOL& SPA Date - Inspector APPROVALS . ' . Permit # _ _ 1_. Temporary Electrical Service or Pole 43. Pool & Equipment Location - - - - • - 2. Soil Pipe- ndrgrn• _ 44. Steel Reinforcement -- - - - - 3. Electrical Conduit.UtilitycUnclrgrn 45. Forms •- - - - _ 4.. Electrical Conduit-Undrgrn 46.. Electrical Bonding - - - - - -5. Steelem orce 47. Rough Plumbing & Pressure Test - .6. .Electrical LIFER Gr,n 48. APPROVAL TO COVER-GUNITE - - - Z.Footings _ _ - 49. Electrical Conduit-Undr rn 8. Foundation - 50. Gas Pipe, ❑ Undr rn, Test ' F 9. - Water-Pipe-Undrgtn 51. Backwash Lines P-Tran0' ndr rn 10. Structural.Floor System 52. APPROVALTO DECK- - 11... Property Sewer Line & House -Connection. 53.'-.Backwash& Rece for-Final -.12. Street. Sewer. Connection - - -_ - - - -54. Heater & Vent-Final 13.. Rough Plumbing _ __ - - 14. Rough Electric-Conduit - -- - - •56. -Electrical-Final 15. Rough Electric-Wiring - 57. Solar System-Final - - 16. Rough Heating &-Air Conditioning '- - -' _ - -- encing & Access Approval ' -17. Ducts in Structure _ APPROVED FOR-PLASTERING 18. 19. 20. Ducts, Ventilating Gas Pipe-Rough & Test - • - - - - Roof.Framing - - - - ._ 60. _ POO USPA SYSTEMS FINAL _ - 21. 22. Roof Sheathing_NOTES: Frame and Flashing-- - - - - ' 23. Insulation 33 - - 24. Lathing & Siding - - - - - - - - - - - 25. Drywall Nailing - - - 26. Plaster BrpWn Coat - -- - -- - - -- - - 27. Electrical Power Meter-Final- 28. Final Electric 29'. Final Heating & Air Conditioning - - - - - -- -- - - 30.- -Final Gas Pipe-Test - - -- - - - - - - 311 Final'Plumbing - - 32. Water Service-Final - --- ' 33. Gas Service-Final -- - - 34. Solar Domestic-Final' 35.' Sprinkling System 36. Sound Attenuation 37. Handicap Regulations - 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison - - 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. cngR p i pAa 10.00 TL' CITY OF COSTA MESA PE MIT O. TRACT NO. LOT NO. CONSTRUCTION PERMIT TYPE OF CONSTRUCTION NEW ❑ADD ❑ALTERATION 11 REPAIR ❑CONVERSION- ODEMOLI SH - ❑OTHER 1 ZONING REGULATIONS ProjectAddress 'S Owner - lit Vhone_rJ Address' (py.`, Arch/Eng:-. - License No. DESCRIPTION OF WORK - - -- - Q.P. ZONE PLNTGp. REF, Address - - Contractor -Phone TYPE OF PERMIT - -- -CILST. O GRADING' .O FOUNDATION 'O STRUCTURAL O TENANT O ELECTRICAL PLUMBING OMECHANICA SETBAC ID YARD 5I E Y pp� PROLILPYIJLINE Address - '" - - LICENSED CONTRACTOR DEC LARATION I hereby affirm that I am licensed under provisions of Charter 9 (tom- ,RIGHT mencing with section ' 7000) of Division 3 of the Business and •. O OTHER Professions Code, and my license is In full force and effect. REAR YARD (TO P/L) PROJECT DESCRIPTION Licehso Class License No. _ SQ. FT. PKG. SPACE REQ. _ PROVIDED - - Date Signature STREET WIDTH PARK FEES ' WORKERS' COMPENSATION DECLARATION - OCCUPANCY—CONSTRUCTION TYPE -APPROVED ;I hereby affirm that I have a certificate of consent to self -Insure or. a VALUATION ZONE ZONING BY - - -' DATE certificate Of Workers' Compensation Insurance, or a certified copy - -- •reof (Section 3800, Lab. CJ- GRADING CU. VOS. ACRES SPECIAL CONDITIONS: icy No. Company- - - - - - - -- - - - d Certified copy is hereby furnished. - - REMARKS: 737777773-77 ❑ Certified copy is filed with the city Building -Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section_neetl-not be. completed if the permit is for one huntlre0 (5100) or less). I-certlfy that in the,performanra of the work for_whlch this permit is issued, I shall not employ any person in any manner so as to become PLUMBING q PLAN CHECK' - - - ELECTRICAL - - PLAN CHECK - subject to the Workers! Compensatlon.Laws of California.. . .. __ - _ BATHTUBS SHOWERSUWLL • - - " -qrs FT- Dale I Signature NOTICE: If after making this declaration, you should become subject TOILETS • ,URINALS ' - '- I'. -' GENERATOR 0-1 KW_1-1O;KW 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 CAVS -' - 1APPCIANCE - 10-50 KW_50 + KWrevoke- - -- - - -- - � - - - - -- 'CONSTRUCTION CONSTRVCTION LENDING AGENCY KIT. SINKS - 'DIS,HW A$ RS' - -MOTORS - 0-1 HP - - -- - 1-10 HP' I hereby affirm that Mere Is a construction lending agency for the per - SERVICE SINKS ' .,,SUMPS - "-' — (INC.,SOLAR) ,_ 10-50 HP=- 50+ HP fOrmance of the work for which this permit is Issued (Section 3097 FLOOR SINKS FL AINS- ? - FIXTURES- -OUTLETS- SWITCHES- Civ: C.). -- - _ - '- - _ Lender's Name Lender's Address - DRINKING FOUNTAINS- - - -- - GAS TUBE SIGNS INTERCEPTO IFIERS I POLE LIGHTS OWNERBUILDER-DECLARATION" - - I hereby affirm that I am exempt from the Contractor's License Law for -SWIMMING PP'T P - -' - - - - •- -- - 'POLES METERED L - - Me following -reason (Section 7031.5 Business -and Professlons-Code: Any city or county which requires a permit to construct, alter, Improve, demolish or repair any structure, prior to -its Issuance, also re- WATER SER I - ALTERATION - Y -" - ,PANELS MAIN -- SUB - quires the ap411cant for such permit to file a signed statement that he GAS SERVICE OUTLETS ^ -- - .SERVICE AMP- Is 'licensed - pursuant td -the prevISIOne-of the-ContractorY License Law rChapter 9 (commencing with Section 7000) of Division 3 of the -WATER HEATE S BTU OUTPUT _ easiness and Professions -Code) or that he -is exempt therefrom and the its for the alleged exemption. Any violation of Section 70 31 .5 by SEWER' CONNECTIONS- '- - -^- "' -- --- - - - - - - l,"'y applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (1500). - SOLAR TANK - - COCL'ECTORS-.' .0 I, as owner of the properly, or my employees with wages as their sole tion, will do the work, and Ma. sir ucture Is Viol _ - de: The or offered for sale. (Section 7044, Business and Professions Code: Tho feted for _ _ SOLAR PIPING SVS. I -ISSUE FEEwho License not apply to owner property ISSUE FEE - -APPLICATION APPROVED BY - - • - -DATE - boor's who builds or Improves thereon, antl who does such work himself or es thereon, es work through his own employees. provided that such Improvements are MECHANICAL PLAN CHECK SUMMARY OF FEES ,$ or improvement for sale. If, however, the improvement ntende forle. Intended owner ill Is sold withih ono year of completion, the Owner will have the burden n one within G _ _ , proving he Oltl not build or Improve for the purpose of Sale). HEATING SYSTEM 0-100:000 BTU PERMIT $ s SMTP •� tio) �J. I -as-owner of -the property, am exclusively contracting with -AND DUCTING ' _ ' nsel contractors to construct the project (Sectlon 7044, Business 100,000+BTU .PLAN CHECK E -PERMIT ' and Professions-Code^TheContractor's License Law does not apply to- •-- Ll .ISSUANCE S" an owner of property who builds or Improves thereon, and who con- -projects licesned to REFRIGERATION 0-100,000 BTU ,PLUMBING $ -` V tracts from such with a contractors) pursuant the Contractor's License Law). SYSTEM - -- 100,000. BTU r IPLAN CHECK $ _ .GRADING .5 ❑ -I am exempt under Section - B. & P. C. for this BOILERS BTU - ELECTRICAL $ E reason--' - -' '-" - -' - - I - SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE 'PLAN CHECK E -I - 'MECHANICAL'$-' - _ MICROFILM g" - TOTAL FEES -' LESS AD- 1 Date _ •'-� -Owner I hereb certif that I have read this application and state that the above y y PF Information is correct. I agree to comply with all city and county PLANCHECK $ 'VANCE PCrepresentatives and State laws relating to construction, and hereby authorize representatives of t Is city to enter upon the above mentioned propert or s ec pur '' - /v- $Ignatur ate SSUE'FEE - . FINAL FEE $ Drivers' License or 55 6, CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # t �l5 I Date POOL & SPA Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or. Pole 43. Pool & Equipment Location - 2. SoilPipe-Undrgrn 44. Steel Reinforcement - - - 3. Electrical Conduit Utility-Undrgrn. 45. Forms . 4._ Electrical Conduit-Undrgrn 46. Electrical Bonding - _5. SteelReinforce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn _ _ 48. APPROVAL TO COVER-GUNITE _ - 7. _Footings. _ _ _ _ 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test .9.. -Water Pipe-Undrgrn 51. Backwash Lines P - Trap, ❑ Undrqrn - - 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 .13. Rough Plumbing ' - - - - - - 14. Rough Electric -Conduit r - - -56. • - Electrical -Final 15. Rough Electric -Wiring - - 57. Solar System -Final - ' 16. Rough Heating & Air Conditioning bB. Fencing & Access Approval 47: Ducts in Structure APPROVED FOR PLASTERING - 18. 19: 20: Ducts, Ventilating Gas Pipe -Rough & Test Roof Framing - - - - 60. POOL/SPA SYSTEMS FINAL .• - 21. -- 22: Roof'Sheathin Frame and Flashing - - - _ - _ NOTES: _ - • 23. Insulation - _ '• • _ 24. Lathing& Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final' 28. Final'Electric - - 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. FINAL STRUCTURE & BUILDING - - - 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY - No. Date Applicant to fill in all spaces within heavy laorder lines and sign all appropriate declarations. 6360 6/19/82 13.00 CITY"OF'COSTA'MESA"`- PERMITNO._-- '" - TRACT NO.-- 'LOT NO.'j' BLDG'. NO I 1 -- -- --- --- -•-- - •CONSTRUCTIONPERMIT '1 TYPE OF CONSTRUCTION '� '•,_ 01 NEW r�DD ' 'El ALTERATION TI REPAIR. ❑.CONVERSION, ❑.DEMOLISH - El J "' ?< ':'-'1""'+:'�'''.•. 'lli �l ;r -' f t,•,a';re. ' - --"ZONING-REGULATIONS - i Project ddress 7+„ Owner' (' '- -Phone -- I Address ) - Ir+ ___ _ �' - I - -- - --•�-- -- License No.----- OTHER: DESCRIPTION OF WORK - . A.P. .. , - )"Arch/Eng: ,'Address_ _ _ - _ _ _ -,ZONE.--'^ - PLNG'.,REF. Tf:i 1 � _ ... h Contractor -(- ' '- --- Phone TYPE OF'PERMIT,' -'ir ""-- -- - -': -- - .t .. I + .g D - _ -� _-_ _� BUILDING 1- 'SETBACK CIL T. OPE RTV LINE3,J - • . _ Addres - I -- '" _ ' ❑ GRADING-'rO`FOUNDATION O STRUCTURAL- - - .SIDE YARD- - - -- - -' -- - - - - -- --- LICENSED CONTRA TOR_DECLARATIO "' r', �' ' -O TENANT- ❑ ELECTRICAL- ❑PLUMBINGC�IECHANICA LEFT 'SIDE YARD•- -- -- -- - -- - - - -- d hereby affirm that I am licensed under provisions of Charter 9 (com- 7000) -" - 9,-1 b 11- ❑OTHER • RIGHT mencing with section of Division -3 Of --the- Business- and Professions Co a nd my license is In full force d e ct - - + - 1 REAR YARD (TO _P/L) 1. _�.� - 'PROJECT DESCRIPTION _- Licen��/}�s Lic N _ _ PKC. SPAC E'R EO ---'PROV IDEDY Z 5.9 t _S �t FT' 4 CONSTRUCTION TYPE _ 1 STREET WIDTH , -`PARK-FEE,$ IWORKE RS' COMPENSATION DECLARATION_ __. .._ 11 herebyaffirm that I have a certificate of consent to self insure or a, 3,OCCU PANCY - )+VALUATION 1 ZONE -'+ZONING APPROVED BY - "DATE - - - •>• •+ - :certificae �of Workers' Compensation -Insurance, or -a certified copy "•ereof nn _ : '- - - - SPECIAL CONDITIONS" (Se �./I��1�//��L___a�b.��C�J. I GRADING CU YDS. ACRES 2Y-No'L/�3.IG—CompanY�M�/mar)-inc -. -_. _ li _REMARKS.+.,t,I_i _ _ 1 _... _ - i- _ _. Certifi------y is hereby.furnishetl.._ _...,�.-__....___..., _,Or' _- - tified copy is filed with the city Building Division. COMPENSATIONDECLARATION ,�.. - - --- - - a •.- - (EXEMPTION'FROM'WORKERS' (�.� •f. 'i (T histsection need notbeif the permit. Is fur one huntlretl - - - •- L'":''i ,:(+f. _f+ (8100) or less). 'I certify,) that m the performance of the work for which this permit is Issued, I shall not employ any person in any manner -so as tobecome-PLUMBING -' - - • Is e-'PLAN'CHECK�- '-' - - jELECTRICAL'- - - PLAN'CHECK. - subject.to.the Workers' Compensation_Laws of_ California.' -" c"- - ' _ _ BATHTUBS -"-' -SHOWERS• -` - _ _ _ _ + - _."' iDate I Signature - (NOTICE: If atter making this declaration, you should become subject -^- iTOILETS;- ;r. •) --- - GENERATOR-- ---01 KW `1'10 KIN -" - to the Workers' Compensation provisions of the Labor Code, you'mustI ,forthwith comply with such provisions or this permit shall be deemed ,7{IURINALS- LAVATORIES DOUBLE'LAVS '- TRANSFORMER :: ,e - .f i : - 'I'APPOIANCE - --10-50 KW. -50 + KW-- - "t - .revoketl._ __ .,-{,__.-__--_ _t__._..-- SINKS" DISHWASHERS- !MOTORS1.10 HP ---- P ''- _ !CONSTRUCTION LENDING AGENCY _ - --KIT. :1I hereby affirm that there is a construction lending agency for the SERVICESINKS -SUM I tl _Z .(INC..SO LAR). a10-50HP_50 +HP f �formance of the work for which this permit is issued (Section 3097 FLOOR'SINKS-'--"-FLOOR'DRAINS "-' ":'-"T"' '" jFIXTURES "'-•OUTLETS-^SWITCHES- --- - rCiv.C:)T--^--- ---_----'--. -•- - -- -- -�--- - '•Lender's Name _ 1Lentler's Address �- - --DRINKING-FOUNTAINS - ,1 4- _ -• "1GAS TUBE SIGNS ---^-^-•--------•--.--.--- - •Y - 'INTERCEPTOR$"• "' -' CLARIFIERS" """', -"""-tPOL'E IGHTS' - - LIGHTS- ,OWNER 'BUILDER -DECLARATION- - ----- ------ •'--- I hereby affirm that I am exempt from the Contractor's License Law for -'SWIMMING POOL'---"'--P'T,RAP"'--"-'�'^" - D `- - - -" --- - - _ •IPDLE$ -� METERED' '_SUB �.': ` - - the -following reason -(Section• -7031.5 Business and -Professions -Cotler 'Any city or county which requires a permit to construct, alter, improve, -demolish or -repair -any -structure, prior to -its issuance; also re-- ----- 'WATER SERVICE ALOE RATION""" "I"- "--- "-' iPAN ECS'--'-'--' MAIN'--- _- -SUB .....'-- -SU .r. the for such permit to file a signed statement that he90 -GAS SERVICE' '-"� OUTLETS"'-"`--`"- "- - -- """"- --' - - - -)SERVICE - -AMP - ' pursuant is lice provisions -of tractor's -License -Law- ( licensed (commencing with 000) (Chapter 9 (commencing with Section 7000) of Division'3 of the - WATER HEATERS -'---BTU' OUTPUT-, 7,- - •- -- - ---7-- - •- t-_ _ " 9ysiness-and-Pro4essions•Code) or -that he•is exempt therefrom and the - exemption, Any violation of Section 7i ,bis- for the by -SEWER CONNECTIONS— '-" - -- { - -- - nt-for a^permit- subjects the-applicant4o-a-civil-penalty- appli -for- -pen __ 'not more than five hundred dollars ($500). - more SOLA R'7ANK^ - COL`CECTO R$_--•"- - - ----`- ---- --- ---- ------ -- _ a ole as owner of -the prophe woYmy is of intended tion, will do the work, and the structure is not intended Sole compensation, the Structure _ or offered for ion 7044 -, Business and Professions The for SOLAR PIPING SVS.`-"""- yam. -(')SSU E'FEE--' ------ - License La a pro tpuilds _r impe Law does not apply ohne_, of a property who or eon, and who does work M1s "or" 'wrough ��`-. -ISSUE FEE ' '- 1( - ' ,_- ? 'APPLICATION APPROVED BY----" M _ ' eme arelf employees, provided that such improvements are not through his owned his n employees, mpr _m _ _ _ _ _ _ _ MECHANICAL PLAN CHECK _ _ , -'- SUMMAR _I SUMMARY for sale. If, however; for is the will have theburl nt` thin have the hurtle. owner will o sold unth_in one year - completion, owner sold one Df proving"he-tlio not build or Improve"fol the purpose of"'sale).` (]-I,-as HEATING SYSTEM ,69 4_-6 .. - - - BUILDING ---- :PERMIT n^ SMTP,, $- - --' owner-of-.the-property,_am_exclusively..contractmg with_ owner- ,_ NiiN N ~10000 `..$ - licensed contractors to construct the project (Section ]044, Business and.Professions-Code: The License Lew.does.not.apply.to- i+gTU )PLAN CHECK $ ,PERMIT, I - 3 -Contractor's an owner of property who builds or improves thereon, and -who con- tracts to RE RIG ERATION 0-100,060 BTU - ISSUANCE..$ -- +PLUMBING $ I �"'r'�GRADINGt' .. -from- such-projects.with- a. contractor(s)-licesned -pursuant the Contractor's License Law). -SYSTEM - - - - - _ . _ 100,000 i+ gTU __ '( _ ._ 1'PLAN CHECK - El lam"exempt'untler'Section--'-- B. &'P. C:'for this BOILERSBTU r ECTRICAL , EL $ _" I - - .-_ - ..- _ ___ . . __ - SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE 1 i I ' : MICROFIlM $ _ ,1 '"''tk -PL-AN'CHECK-$ --- - ( II' -J rTOTAL FEE MECHANICAL--$r(Q__- -^ u . ,.+ .:'-+ r-VANC -_ ner 'II herebycertify that I have read this 5 y application and state that the above ioformation'is" correct.s - comply MiadkPL-AN ICHECK - $ - - - --- -- VANCE E'PC' ,agree I t n, and y authunty ordinances and state laws relppti ng [o construction, antl hereby authorize `upon 'the -above "mentioned er.,�?� - -il - representatives of this DIY to enter property fo s tion /)-�� S s - W :_ 11 hd s _ _ .__ Signature • Date __ _ _--- - _s _ s] ISSUE FEE rr -i FINALFEE$ t - - -- ----- Driver' License or 55 i_c CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor TL 1 CONSTRUCTION AND PLANNING Date APPROVALS Permit # L�� - POOL & SPA C + y, '• Inspector "-' = - - "-Date. APPROVALS Permit<' Inspector 1. _Temporary Electrical Service or Pole 43. _Pool &Equipment Location --- ' - - - - - .2. SoilPipe-Undrgrn_ - _ _ 44. Steel Reinforcement -3._ Electrical Conduit UtilitycUndrgrn_ _ 45. Forms - - --- ._.4. .Electrical_Conduit-Undrgrn . _ 46. Electrical Bonding_; -- - - - --- --- - - -- - - - - - - --� -- = - - _ _§teE�l Reinfome. 47. Rough Plumbing & Pressure Test-. - -- - - :6..- .Electrical UFER Grn _ _ _ _ _ _ _ - 48. APPROVAL TO COVER-GUNITE=- `-=. _- _ --i��-'• - _--- _ _ 7. Footings___-_ _ _ _ _ __ _ _ • 49. Electrical Conduit-Undr rn B. _-Foundation 50...7 GasP.ipe, EJ Undr �n,Test '- •' -' -'- ' _9. _.Water Pipe-Undrgrn. _ 51. Backwash Lines P-Trap- f7llJridr6n .10._ Structural_Floor System . 52. _ APPRO.VALTO,DECK -` 11,. _ Property.Sewer Line.& House Connection _ ' 53.. -Backwash.& Rece tot-Final 12-Street Sewer Connection.. _ . -- � - - � ----- - - � � 54. Heater-& Vent-Final -13. Rough Plumbing55. - pFinail - 14. Rough Electric-Conduit_- - - - -- - ' - - -•56: Electrical-Final-i1 '- •- - - + •• - 15. Rough Electric-Wiring - -- - -- -- - -4 - 57.' 'Solar •" """" -'' - '" "" ' 16... Rougfi Heating &Air Conditioning-- =-_-- '- - ~_y_ - -_ - _- encing.&:Access Approval -17:- Ducts,-inSteucture - - - - APPROV,ED.FORPLASTERING' --" 18._, Ducts, Ventilating- 19. Gas Pipe-Rough -& Test-" 20. -Roof'Framing- L _._ _' -4 -:.. __. . -- _ 60. • POOL/SPA SYSTEMS FINAL '" "• • __ -. -' 21; Roof: Sheathin -22:- Frame and Flashing- - - - ' -- ' - NOTES: _ ... ..• ' 23. -Insulation - - --- - - - - - - - ' 24.- Lathing & Siding 25. Drywall Nailing - - - -- 26� -Plaster Brown Coat - - - - -= - "'• •-` - - - - 27. Electrical Power Meter-Final --" - . - • "_ '_ _ ., _. _ _ _. _ _ _. '•• - - -- + - -• " ' 28:--Final,Electrio- ---- -- - - --- -- --- - - ._ _ . - - - -- - -- 29. Final, Heating &Air Conditioning ' 30.-FinaliGas Pipe-Test- 31:. Final:,Plumbing.- 32'. Wate; Service-Final-- - 33. Gas-Service-Final 1i 34. Solar Domestc-Final inal • ' _ J.3-Vil u.l � 4'.. ' • .. • •. 35. Landscape Sprinkling S stems - '• - "' "'" ' I 36.' 'Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE&BUILDING 39. Special Requirements Completed ' 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. i " • 42. CERTIFICATE OF OCCUPANCY Not Date 4-�,•�-t A _ s1. 'T Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. I GO'z 17 / 11. an•i � 'CI f`d"OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. BLDG. 0 4.U,f ONSTRUCTION PERMIT j %C3 TYPE OF CONSTRUCTION NEW �f�,4DD El ALTERATION ❑REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER , , - ZONING REGULATIONS Project Address Owner Imp j2 ne Pho Address r Arch/Eng. License No. DESCRIPTION OF WORK - - - TYPE OF PERMIT - - - -❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL ❑-TENANT ❑.ELECTRICAL ❑PLUMBING_,6ECHANIC, A.P. - ZONE PLNTGo. RlE1FL. � BUILDING - PROPEIRT NG _ SETBACKC LST. V LINE. LI OE YARD. ,SI DEY " Addrei5 s Contractor �+ - Phone Address - - Q LICENSED.CONTRACTOR DECLARATION 9 I hereby affirm that I am licensed under provisions of Charter (com- meneing with- section -7000) of Division .3 of the Business and - ❑ OTHER RIGHT- Professions Code, land my license Is In full for antl ft Ct. - REAR YARD (TO P/L) - - - - PROJECT DESCRIPTION License lass LI No. -- - -• - ' PKG.-SPACE REQ. - -- PROVIDED - - . Y -Signature' - SQ. FT. Oate 'WORKERS'COMPENSATION DECLARATION iOCCUPANCY_ CONSTRUCTION TYPE STREET WIDTH-- PARK FEE $- - ',I hereby affirm that I have a certificate Of Consent to self -Insure ora - '- _ - l - -' VALUATION ZONE ZONING APPROVED -BY EDBV --- .DATE _ _ _ certificate of Workers' Compensation.. Insurf T -' --- - thereof (Sec 8 b- C I GRADING CU. YOS. - ' ACRES SPECIAL CONDITIONS: - - Iicy No. Company' - - -- - - - - I- - Copy Is hereby furnished._ _. _ REMARKS:1 `Certlfied Certified Copy is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATIONDECLARATION_ (This section need, not be Completed If the permit is for one hundred - r •'. (5100)or less). _ l _- _ _ - - _ _ _ _ _ I Carlffy_t hat n 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 ,yr.j �- - PLAN CHECK - -- --- - _ ELECTRICAL --- - - PLAN CHECK subject to the Workers' Compensation Laws of California._ BATHTUBS - - - SHOWERS- ^ -- - LL --SO - FT.!" - - -- - - t Date Signature 'NOTICE: If after making this declaration, you should become subject- TOILETS, , URINALS-- - 4 - - GENERATOR O-1 KW_ 1-lO KW - - to the Workers' Compensation provisions of the Labor Code, -you must•. ,forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE-LAVS---- TRANSFORMER (APPLIANCE 30-50 KW_50+KW' r °_ revoked. l _ r _ _ _ __ _ _ _ CONSTRUCTION LENDINGAGENCY- KIT:SINKfr - - DISHWASHERS— - - !MOTORS _ .0-1.HP_3-lO ; HP :' -._ I hereby affirm that there is a construction lending agency for the per -SERVICE SINKS,�y-,. ,.-SUMPS- 1050 HP 50+HP''3�'•t _ - - formance of the work for which this permit is issued (Section 3097 FL'OORSINKS- - --FLOOR'DRAINS- OUTLETS- SWITCHES Civ,C.)r ' '------ --- - ---- -- - - - - Lender'sName •Lender's Address DRINKING FOUNTAINS- - - - - T---- - --- 7.GA5 TUBE SIGNS _ _ _ •'I,• ^'_ -INTERCEPTORS" '"CLARIFIERS"--- _ -- POLE.LIGHTS OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for - - -- _ SWIMMING POOL-- - P -TRAP' -v the following reason -(Section 7031.5 Business and -Professions Code: Any city or county which requires a permit to Construct, alter, _ POLES- - --- -METERED - - SU, - - WATER SERVICE ALTERATION- -•.1' __ PANELS MAIN _ -_' SUB: Improve, demolish or repair any structure, prior -toils Issuance, also re- quires the aptlicanl for such permit to file a signed statement that he GAS -SERVICE - OUTLETS' - - -- - 'SERVICE __. ___ ._ AMP_' is-lieensed pursuant totheprovisions of the Contractor's License Law- ' Chapter 9 with Section 7000)' of ONision 3 of the BTU -OUTPUT, -WATER HEATERS - BTVOUTPU 1•- - - " - _ �usiness and Professions Code) Or that -he Is exempt therefrom and thUe Isis for the alleged exemption. Any violation of Section 7031.5 by _ - SEWER.CONNECTIONS "�I'y applicant for a permit subjects -the -applicant to a civil penalty 2Y'( not more than five hundred dollars ($500).- SOLAR TANK- - —COLLECTORS - - .❑ 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. (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 --ISSUE FEE -' if- -- - - - -- - - .APPLICATION APPROVED BY_ _ t 'v DATE who builds or Improves thereon, and who does -such work himself or through,hls own employees, provided that such improvements are not -"MECHANICAL -- PLAN CHECK - - -` "'-' '- - -- - - _--- SUMMARY OF FEES intended or offered for sale. If, however, the building or Improvement- is sold within one year of completion, the owner will have the burden , '_I_` '�E- ( of proving he did not' build or improve forthepurpose of sale). - - - ----- - -- HEATING SYSTEM 0-100,000 BTU -j BUILDING. _ _ PERMIT $ SMIP;. - -_ -''-- IQ 1, -as owner of. -the property, -am-exclusively contracting with AND DUCTING- _ __ _ - - - - L - i licensed contractors to construct the project (Section 7044, Business 100,000]+BTU - -- 1 PLAN CHECK' $ --- - - PERMIT ' and Professions Code: -The Contractor's - License. Law does.not.apply to _ _ __ I -'ISSUANCE l$_ an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU - "PLUMBING ---$"'""'_"' ' - - --- - Itracts-from. such -projects with. a contractor(s) _ licesned pursuant to SYSTEM - r� 1 - -' '1_. I •.GRADING the Contractor's License Law). 100,000 + BTU- -PLAN CHECK :$ - - -_ - ` - - - ❑ I am exempt under Section- - B. & P. C. for this BOILERS - BTV-` - s - -- - - ELECTRICAL $ - - - .• - - .. _ _ SYSTEM REPAIR, ALTERATIONl� _ EXHAUST SYSTEM MULTIPLE _PLAN CHECK. $ •" "MICROFILM.$-' MECHANICAL $�I"_'.TOTAL FEE - LESS AD- ,reason- Dale Owner p hereby certify that I have read this application and state that the above informahon is Correct. I agree to comply' with all city and county _ PLAN CHECK_. $ _LANCE PC $ _ ;ordinances and state laws relating to construction, and hereby authorize _ representatives this city t enter upon the above menlloned _ ' property for i - gcj do pu FINAL GI/l1 Signature Date - - - FEE $ Drivers' License or SS - _ -ISSUE FEE' - CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION ANDPLANNIN _ pG1 APPROVALS Permit # OO Date Inspector POOL&SPA. . APPROVALS Permit # Date Inspector - 1. Temporary Electrical Service or Pole - 43. Pool & Equipment Location - 2. SoilPipe-Un rgrn _ 44. Steel Reinforcement - 3. Electrical Conduit Utility-Undrgrn -- 45. Forms - - 4. Electrical Conduit-Undrgrn - - 46. Electrical Bonding- -- 5. Steel ein orce - _ 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn .48. APPROVAL TO COVER-GUNITE 7: Footings - _. _ 49. Electrical Conduit-Undr rn 8. Foundation "-- - 50. Gas Pipe, ❑ Undr rn, Test " -9. -Water Pipe-Undrgrn - 51. .Backwash Lines P -Trap, ❑ Undrqrn - 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 ' 13. Rough Plumbing - - - - - - - 1 14. Rough Electric -Conduit - -- - ' - 156� Electrical -Final - - 15. Rou h Electric -Wiring • 57. Solar System -Final - - 16. Rough Heating & Air Conditioning - O - Fencing & Access Approval 17.- "Ducts, in Structure -- - - APPROVED FOR PLASTERING " 18. Ducts, Ventilating - - - - 60. -- - POOL/SPA SYSTEMS FINAL - 19. Gas Pipe-Rough"&Test - - -- - 20. Roof. Framing - - - - - 21. Roof Sheathing - -- '- -NOTES: •. ' ' 22. Frame and Flashing- - - 23. Insulation - - - -- -- - 24: Lathing & Siding 25. Drywall Nailing - - - - - - -- - - - -- - 26. Plaster Brown Coat - - --- -- - 27. Electrical Power Meter -Final - - - "- 28. Final Electric - - -- - - - - 29. Final Heating & Air Conditioning - 1 .• �y3 - " - -- - - 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. FINAL STRUCTURE & BUILDING - 39. Special Requirements Completed 40. Electric Release to Edison -%% - 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY _ No Date -- / Ar Applicant to fill in all spaces withinheavy border lines and sign all appropriate declarations. a""- " C7O,F COSTA MESA - PRI,g MIT NO. TRACT NO. LOT NO. BLDG. NO. ,CONSTRUCTION PERMIT , I - tA370 113 1 S3 %'' 5011 8/03/82 87.52 Project Address 13-0 TYPE OF CONSTRUCTION • -\ OwnerL Phon ❑ NEW El ADD 13 ALTERATION — AddrF55 - - - V ❑ REPAIR ❑ CONVERSION ❑DEMOLISH _- ZONING REGULATIONS Arch/Eng. - License No. OTHER Address DESCRIPTION OF WORK A.P. s _ ZONE PLPfG. REF. Contractor V Phon .j 4,ryPE OF PERMIT �'� BPs�I ING SETBACKLS O VLIN Address If ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL SI YARD LICENSED CONTRACTOR DECLARATION - TENANT ELECTRICAL LUMBING ❑MECHANICA 55Ip - I hereby affirm that I am licensed under provisions of Charter 9 (Com- RIIGHT menCing with section 7000) of Division 3 of the Business and ❑ OTHER - Profasslons Code, and my license is In full forte and effect. ce REAR YARD (TO P/ PROJECT DESCRIPTION wr��.-�/ Dtegse Class License No. SO FT. eo WAs }�M �1 - PKG. SPACE REO PROVIDED Date Signature "'^pp� ��ss�� •'" •" � �� v - WORKERS' COMPENSATION DECLARATION OCCUPANCYIG�CONSTRUCTION TYPE (p STREET WIDTH- PARK FEE $ I hereby affirm that I have a certificate Of consent to self -Insure or a VALUATION �)/ ZONE ZONING APPROVED BY DATE g certificate of Workers' Compensation Insurance, or a certified copy SPECIAL CONDITIONS: thereof (Section 3800, Lab. C.). GRADING CU. YDS. ACRES -Oicy No. Company , =,Certified copy is hereby furnished. REMARKS: I�.alCertified copy Is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION g g y (This section need not be completed if the permit is for one hundred ($100) or less). I cert (y that In the performance of the work for which this permit is Issued, I $hall not employ any person Igl t me neer so s to become PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK subjeee9ee rrrrrr��t t Workers' Co mpensa s f a f brnia -l'1 BATHTUBS SHOWERS Date Signature . A - S/ NOTICE: If after making this declaration, IOU Should become subject TOILETS IF URINALS - - GENERATOR 0-1 KW_ 1-30 KW to the Workers' Compensation provisions of the Labor Code, you must TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES f DOUBLE L'AVS J APPLIANCE 10-50'KW_50+KW revoked. e _ CONSTRUCTION LENDING AGENCY - KIT. SINKS DISHWASHERS MOTORS 0.1 HP -1-10 HP I hereby affirm that there Is a construction lending agency for the per. SERVICE SINKS SUMPS— (INC. SOLAR) 10-50 HP 50 + HP /.,mance of the work for which this permit is issued (Section 3097 Civ. C.). Lender's Name AA ..FLOOR SINKS FLOOR DRAINS FIXTURES' UTLETS SWITCHES Lender's Address �'�1- - ��, DRINkING"FOUNTAINS GAS TUBE SIGNS - - OWNER BUILDER DECLARATION- ''y '- - I hereby affirm that I am exempt from the Conlractor's,License taw for �INTERCEPTO R$ CLARIFIER$-: p• POLE LIGHTS the following reasons(Section 7031.5 Business and Professions Code:SWIMMING POOL P TRAP - POLES METERED SUB Any city or county which requires a permit to Construct, alter, improve, dempllsh or repair any structure, prior to its issuance, also re. WATER SERVICE "ALTERATION OJ PANELS - MAIN- SUB quires the apFlicanl for such permit to file a signed statement that he Is IlCensed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS s SERVICE - - AMP (Chapter n (commencing with Section 7000) of Division 3 of the WATE0. HEATERS BTU OUTPUT hasis for and alleged ons Cotle) or that he Is exempt therefrom and the - hav for the alleged exemption. Any violation of Section 7031.5 by v applicant fora permit subjects Me applicant to a civil penalty SEWER CONNECTIONS not more than five M1untlratl dollars ($500). " 1, as owner of the property, or my employees with wages as theirSOLAR 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 SVS. -- - ISSUE FEE QQ Contractor's License Law does not apply to an owner Of a property who builds or improves thereon, and who does such work himself "or ISSUE FEE C7 APPLICATION APPROVED BY DATE 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 of proving he did not build or improve for the purpose of sale). BUILDING 1, as owner of the property, am exclusively contracting with HEATING SYSTEM 0.100,000 BTU PERMIT $ SMIP $ ensed contractors to construct the project Section 7044, Business AND DUCTING I ( 100,000 + BTU PLAN CHECK E 5'. 02 PERMIT ntl Professions Code; The Contractor's License Law does not apply to • ISSUANCE $ tracts - owner of Property who builds or improves thereon, and who con- REFRIGERATION 0-1 00,000 BTU PLUMBING S tracts from such projects with aconlractor(s) licesnetl pursuant to SYSTEMSYSTEM- - GRADING E the Contractor's License Law). 100.,000 + gTU - _ PLAN CHECK $ ❑ I am exempt under Section & P. r this BOILERS BTU ELECTRICAL $ $ reasonPLAN CHECK E MICROFILM $ SYSTEM REPAIR, ALTERATION Date O TOTAL FEE $ I hereby certifythat I have read this apph Cati n and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $_ ,. LESS AD- _ nformallon is correct. 1 agreetocomply with -all city and county PLAN CHECK $ VANCEPC $_ ordinances and slate laws relating to construction, and hereby authorize replesenla s o his cit to ter u n the above mentioned V I • SZ property o in$ tlo ,pose & _`\ FINAL FEE S Signature DataISSUE FEE - H- icense or SS $ 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING ��.'•.- APPROVALS Permit # ' Date Inspector : ' POOL & SPA. APPROVALS Permit'# -Date. Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipmeni Location -- - -• '" SoilPipe-Undrgrn • ; 44., ,Steel -Reinforcement ---- ` - 3. Electrical ConduitUtilityUndrgrn. , 45. Forms - - 4. Electrical Conduit-Undrgrn 46. Electrical Bonding5. - - - Steel, em orce _ 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE - 7. Footings 49. Electrical CondUit-Undr rn .8. Foundation 50. Gas Pipe, EJUndr rn, Test 9. .Water Pipe-Undrgrn - -t .•, •� 51. Backwash Lines P -Trap.❑ hdr rn - 10. -Structural Floor System i . } c,._ 52. .APPROVAL TO DECK ' 11. Property Sewer Line & House Connection - 51" "Backwash & Receptor -Final 12. . Street Sewer Connection - 54. Heater & Vent -Final 13. Rough Plumbing _ _ _55, Plumbina System _ Final 14. Rough Electric -Conduit - --' "' -56. ",Electrical -Final, ' 15. Rough Electric -Wiring 19 98 bi; ,' - '57. '•' Solar System -Final - 16. Rough Heating & Air Conditioning 58. Fencing & Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING - 18. 19. 20. Ducts, Ventilating Gas Pipe -Rough &Test Roof Framing - - 60. POOL/SPA SYSTEMS FINAL 21. _22._ Roof Sheathing- Frame and Flashing IJ._3o ren .• NOTES: 23. - Insulation 24. Lathing & Siding 02 2 - - 25. Drywall Nailing 71A- -6,71-1 •Q - 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning _ 30. Final Gas Pipe -Test -- 31. Final PlumbingL- - 32.` Water Service -Final 33. Gas Service -Final ' 34. Solar Domestic -Final " 35. Landscape Sprinkling System - . - 36. Sound Attenuation - 37. Handicap Regulations, 38. FINAL STRUCTURE&BUILDING - _,Zy.Y3 39. Special Requirements Completed 40. Electric Release to Edison- " 41. Gas Release to Southern California Gas Co. 42. .. CERTIFICATE OF OCCUPANCY ' No OOOZ!;�d Date - ^s J Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESAPERMIT N0. I TRACT NO. LOT NO. -r CONSTRUCTION PERMIT a -lp Date d9nature - NOTICE: If, after making this declaration, you sh d uld become subject to the Workers'Compensation provisions of the Labor Code, you must forthwith comply 'with such ,provisions ,or this permit !shall be deemed revoked. - CONSTRUCTION evoked:CONSTRUCTION. LENDING AGENCY i -j- I hereby affirm that there is a construction lending agency for the:erformance• of the work for, which., this permit -is Issued (Section 30 7 Civ. C.). Landers' Name. - Lender's' Address' - - - OWNER BUILDER DECLARATION - - - I hereby affirm that 1 am exemptifrom thelContractor's License Law for the /uaz:u Dy .any applicant Tor -a permirsuDlecrs the applicant to a avu 'LJpenalty of not more than five hundred dollars ($500). , r ' J , I; as.owner of the 'property or -my employees with wages as that, vele , compensation wlllido the work, and the structure Is not intended or Offered for sale,(Secilon 7044, Business and Professional Code:, The, Contractor's 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 employees, provided that such Improvements are not Intentled or offered for , sale. If, however, the building or Improvement Is sold within one year.of com- pletlori, the owner -will have the burden of proving he/she did not build or im. Ell. 101 the purpose of sale). ) EI, as owner of the property, am exclusively contracting withlllcansed can. 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 builds or Improves thereon, and who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Law)- ❑ -1 am exempt under Section i B. 6 P. C. for this reason j - t 1 Date ' Owner d hereby certify that. I have read -this application and state -that the -above '- Information is correct. 1 agree to comply with all city and county ordinances and stale laws relating to building construction,"antl hereby authorize repro. sentatives of ,this city) to enter upon the above-mentioned properly for ,se or SSS "' NX0q 31YR I MY. 12/82 White - Building; Canary - Applicant; Pink - 'loor-Sinks .- - - - Water. Heater, - - - - SasServicel Outlets' Water Service 050+KW \Contractor's , Applicant's Mailing Address j 3 6 9� if Nsr N ^ LO rt •'q Project Address- Z S A C.A E C.' s Owner's Name W-- 19L,(IIA� On.ggU_(ZCZ ' Addre—sS IS( 7 N . Fc4rt r i Ek) SAAJr.A A 1)/t - TYPE OF CONSTRUCTION ONEw ADD ALTERATION LJREPAIR F-1CONVERSION❑ DEMOLISH ❑ OTHER ' DESCRIPTION OF WORK - <itchen Sink' Meter 13 up to 100 amps _ - TYPE OF PERMIT GRADING FOUNDATI N, STRUCTURAL , 1-1TENANT❑ ELECTRICAL ❑ PLUMBING �M��,,r/u� ANICALn Cl -OTHER I.'- i l `�7��.5�%L�ClTOA PROJECT DESCRIPTION; SG. FT. OCCUPANCY CO NST RUCTION TYPE - - VALUATION $- ZONE GRADING CU. YDS. ACRES Lavatories„ • 1 Arch/Eng. Llcema No. Address - - 7 -Date '-Trap Name lJi leh r/ d •5 .41A Phone 528, �ZoO Address (mailing) 3364 - r'. "I,AeA 1<r,, License No; '342 3) 9' Application Approved By. LICENSED CONTRACTOR DECLARATION 1 -hereby affirm that P am licensed' under provisions of Charter'9 (commencing with section 7000) of Division 3;of the Business and Professions Code, and my license Is In full fol ce and'effect. ; Ucense Class � _ i i Lice se o. ?y 2 3/ y ' Remarks: ' -• Reinspection;Fee ' Service Sink _ 'j PLUMBING ' $ 3 Date 3'y - g 3 ' Signature ORKERS' COMPENSATION DEC LA RAT N ' ereby,affirm that 1 have a certificate of.cohsent to self -Insure or a certificate. . t Workers' Co an Sall n Insurance, or a certified copy thereof (Section 3800, Lab. C- I •`y,%jfo2- (• Policy No. -�I' Company __ ."' "' ZA/j. ertifled copy iz hereby furnished. • 1 , li L!/ SS ' .Certified copy,�S Med with the Gty, Buil,Qjpg Division _ date 2 -9' 6' 3 Applic2nt '/ Wil- T� -* EXEMPTION FROM WORKERS' COMPENSATI N DECLARATION i 1 1!55)3 section need not be completed If the permit Is fortune hundred ($100) or t certifythat In the performance of the work for which this permit is issued I I shall not employ any person in any manner so as to bpcosne subject to the , . Workers' Compensstlon'Laws of CaliforniaV ✓.7!-. 1 Bar. Sink Sewer Cap- Boiler - Duct-Under;Ground Backflow Preventer - t- -�- - - -Sewer COnnectiOn= - • - - i Duct - Structural I Backflow Irrigation Soler Collectors , . 0 _ .. ._ , Bathtuhi , Soler Piping ' Duct - Ventilating__ Clarifiers Solar Tank 1 Dishwasher Swimming POOI W/$pe ' i PLAN CHECK $ Exhaust System ❑ Multiple ❑ ' j Drinking Fountains Urinal ELECTRICAL' $$ Floor Drains Water Closet ' Date d9nature - NOTICE: If, after making this declaration, you sh d uld become subject to the Workers'Compensation provisions of the Labor Code, you must forthwith comply 'with such ,provisions ,or this permit !shall be deemed revoked. - CONSTRUCTION evoked:CONSTRUCTION. LENDING AGENCY i -j- I hereby affirm that there is a construction lending agency for the:erformance• of the work for, which., this permit -is Issued (Section 30 7 Civ. C.). Landers' Name. - Lender's' Address' - - - OWNER BUILDER DECLARATION - - - I hereby affirm that 1 am exemptifrom thelContractor's License Law for the /uaz:u Dy .any applicant Tor -a permirsuDlecrs the applicant to a avu 'LJpenalty of not more than five hundred dollars ($500). , r ' J , I; as.owner of the 'property or -my employees with wages as that, vele , compensation wlllido the work, and the structure Is not intended or Offered for sale,(Secilon 7044, Business and Professional Code:, The, Contractor's 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 employees, provided that such Improvements are not Intentled or offered for , sale. If, however, the building or Improvement Is sold within one year.of com- pletlori, the owner -will have the burden of proving he/she did not build or im. Ell. 101 the purpose of sale). ) EI, as owner of the property, am exclusively contracting withlllcansed can. 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 builds or Improves thereon, and who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Law)- ❑ -1 am exempt under Section i B. 6 P. C. for this reason j - t 1 Date ' Owner d hereby certify that. I have read -this application and state -that the -above '- Information is correct. 1 agree to comply with all city and county ordinances and stale laws relating to building construction,"antl hereby authorize repro. sentatives of ,this city) to enter upon the above-mentioned properly for ,se or SSS "' NX0q 31YR I MY. 12/82 White - Building; Canary - Applicant; Pink - 'loor-Sinks .- - - - Water. Heater, - - - - SasServicel Outlets' Water Service 050+KW Interceptors •� - <itchen Sink' Meter 13 up to 100 amps + Issue Fee Lavatories„ • 1 = ' _ - -Date '-Trap RoofDrains'• ✓ Application Approved By. Det" Showers ,+ c. -_ - -• Reinspection;Fee $15 Service Sink _ 'j , Issue Fee $ 3 -'' MECHANICAL i BUILDING PERMIT $ Boiler - Duct-Under;Ground Refrigeration System I 110100,000BTU ❑100,006BTU i Duct - Structural I System Repair/Alteratioli , .PLUMBING I $' Duct - Ventilating__ $ PLAN CHECK $ Exhaust System ❑ Multiple ❑ ' .$ ELECTRICAL' $$ Firepl/Fact. Bit. ICB05P' ' Heating System & Ducting ❑0.100,000,BTU ❑ 100,000 B I L.• i I - - -. - • 7 MECHANICAL $ TOTAL FEE; Hood or Type I ❑; Cane T e I I C] Reimpection Fee ' $15 Registers _ )ssue Fee $ 3 A. P. -0 PLNG. REF. vY• TO BUILDING PROPERTY LEFT SIDE YARD PKG. SPACE REG. STREET WIDTH SPECIAL CONDITION Automatic Washer ;- Construction Pole Cooking Unit ' Dishwasher Dryers ❑Gas ❑E Boxes REAR YARD (TO P/L) RIGHT SIDE YARD , PROVIDED ,I PARK FEE$ Sub Panel. ; Sub Pole Motors 00-1 HP ❑1'h Inc.Solar ❑9-15 His ❑ Microwave Range_ _ Sign' Standing Section: Trash Compactor Generator 00.5 KW 05-15 KW Transformer ❑ 15.50 KW 050+KW 'Reinspection Fee Meter 13 up to 100 amps + Issue Fee $ 3 Zoning Approved By -Date , Application Approved By. Det" ' Application Issued By /� �'e -Date r� �-IF 3 SUMMARY OF FEES I ( 1 BUILDING PERMIT $ SMIP . - $ PLAN CHECK' $;, ;'PERMIT - .PLUMBING I $' ISSUANCE $ PLAN CHECK $ GRADING , .$ ELECTRICAL' $$ PLAN CHECK $ MICROFILM $ MECHANICAL $ TOTAL FEE; $ - :PLAN CHECK' S LESS ADVANCED PC $ • FINAL FEE, �•• ��---- � $ ONSTRUCTION AND PLAN INGt�•�_'. -Inspector '7 ` "� POG SPA OC ..�.-% - rA�PPROVALSPermit#''' ••Dateh . •�AFPROVALS' -Permit # ;Date Inspector ^emoorery,Electrical SerGice or Pole - �� 0, IT ' " - - ' • 52.. Pool &Equipment Location' _ �! 'Soil Pipe-Undrgrnd:. L o ' `' - j .0 i;, _ `53 Steel ` , �Reinfoicement 3! Electrical Conduit Utility-Undrgrnd: I '-^�,v _ Forms', --- .`•IA7l� .54! '•' ,4. Electrical Conduit-Undrgrnd.= _ I J�� ,� 1 '55; Electrical•Bonding' - - my 5: Steel Reinforcement ^ i ' i ' - j: 56. Rough Plumbing & Pressure Test _ . i !6. 'Electrical LIFER Grnd `• ' _ ` - UNITE-: _ - 7. Footings ,• , .•. - _ _ - 58' Electrical Cpnduit-Undrornr_ 8. Foundation•59. Gas ;Test • - '• lPipe;!f95Undrgrnd 9. Water Pipe-Undrgrnd. -, ! ' t-, . ' 60. Backwash Lines, -P -Trap, ❑ Undrgrnd:' 10. Structural Floor System c k i° 61. APPROVAL TO DECK 11. 'Pr'operty Sewer Line &I -louse -Connection ,_ •� - jl 2• Backwash' & Receptor -Final`. f 12. Sewer Cap; '' • [ - •'' 63. Heater & Vent -Final. 13. Roof Drains • _, .� 64. Plumbing System - Final - - - 14. Rough Plumbing ' ° -- :65. Electrical -Final - - 15. Rough Electrical=Conduit'IT"--Ir, - - „ ;- --� -'t' -' - j66.'S6lanSystem-Final• '1L6.': Rough.Eleciric Wiring 1 , 1 67'..'Fencing& AccessApproval - -17:,Rough Wiring Sign,' , �'• '' ` , c I • - 68; APPROVED FOR PLASTERING I 18l Rough Electrical:T_Bar Ceiling - II :' I -. I = I C. _ ;69. POOL/SPA SYSTEMS FINAL ' 19:�Rough .Heating & Air -bond !• j •_ j FIRE DEPT. REQUIREMENT APPROVALS, ! Permit # 2W+ Rough,Faaor'y Fireplace , ` 21 Ducts, in Structure °� ! i ! I 70. Undergrountl Hydro - ! _ .,22.1Ducts, Ventilating C. i 1 71: Product Piping El Gas 0Oil 23. Gas Pipe -Rough & Test 1 ' ! 72. Underground Flush l I i�24. Roof Framing: I j', - 73._ Undergrnd. Stoiage Tank ❑ Gas ❑ Oil - ,�,, 25.' Roof Sheathing T. I (i:?+ : _ ' ; i I 74. Overhead Hydro 26. T -Bar Ceiling (Structural), & Monocoat _ 75. Dry Chemical .27. Frame and Flashing `28.;,LatHing I 1 76.:Dry Standpipe & Siding; `.> ,I I' j i v ! 77. FIXED SYSTEM -FINAL - ! 29_;Insulation ; ' { 1 j I j ! j j78! FIRE PREV. FINAL i - `30.Drywall Nailing i 1 11 j I Notes: I _ •31.,Plaster Brown Coat 32: Electrical Power Meter -Final 1' •. 33.,Final Electric 34. Final Heating 6 -Air Conditioning 35. Final Gas Pipe=Test 36. Hood ori.°Canopy 'r` ,' �' • i " - i - , :i nl 1 37. Final Factory Fireplace ! :t- 38. Final Plumbing •! 39. Water tService-Final 1 i , i i i I I I 40. Gas Service -Final 41. Solar DomesticFinal 42. Backflow Preventer 43. Backflow Irrigation" ! 44. Landscape Iriigation;System' ! •-' - j _ I - 45. Sound:. Attenuation' • . I �' ` i o -' •, ` ' 46. HandioapRegulationsj 47. FINALSTRUCTU�RE & BUILDING, ; �r 48. Special Requirements Completed 49. Electric Release to Edison' 50. Gas Release to Southern California Gas Co : •� - I i 51. CERTIFICATE OF OCCUPANCY - L __ -' - - L _ - No " I i Date 1- ' ' Oki Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA' i _ PERMIT NO.. I TRACT NO. LOT NO.B •CON$TRUCTION.PERMIT I'= 8. Applicant's Mailing Address �3• '_,' WifeA COM. ` • TYPE OF CONSTRUCTION: NEW ADD . ALTERATION' 'REPAIR ProlectAddress Z43 . /-iSC``eL P C-6 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER Owner's Name IV of YA I•J I I / czw-phone DESCRIPTION OF WORK Address I$I - 0.tyV IF cW '5A.H}4- N-[� i - _ - TYPE OF PERMIT GRADING FOUNDATION STRUCTURAL A. Arch/Eng.—License No.' I 1:1 TENANT El ELECTRICAL PLUMBING' ❑ MECHANICAL PL Address_ 01.OTHER TC Contractor's Name V t11 °- -NP4t j.t q i- lik !Phone Z $_11 Zee PROJECT DESCRIPTION' SQ. FT. OCCUPANCY PA REF. 946 Address (mailing) Liclense No. '3 t ' . ' I,R A (0^.4 1 Aya�.</ps CONSTRUCTION TYPE VALUATION $ LEFT SIDE YARD 3yU 2 3 L7 ZON)= GRADING C.YDS. ACRES PKG.SPACE REQ. __ i ' LICENSED CONTRACTOR DECLARATION Remarks: ._ t "o '-cZ--7,s7P STREET WIDTH I hereby, affirm that 1 am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3, of the Business and Professions Code, and my license Is in full force and effect, 1 , I License Class - Ucense No. -�-3 4 ZZ 30, • - 1 ' SPECIAL PLUMBING ' Data' g- Signature c� /3ly.ef'a.ass 'ORKERS' COMPENSATION DECLARATION Outlets; Standing Sections Bar Sink Sewer Cap' - - - • Backflow'Prerventer - --. - - — Server Connection' - - - •-' - • - - Autom ereby affirm that) have a certificate of wuunt.to Sell -insure or a.certlflcate a. Workers' Compensation Insurance., or a certified copy thereof (Section 360Q Lab. C - b? s47Q2 ��151 �� ES/ Policy No. Company Certified copy Is hereby furnished. 1 I f I e Certified co y Is filed with the city Bullqlag Division 1 is Y-lD-B� Applicant SATI N DECLARATION I EXEMPTION�FROM WORKERS' COM=(Thlssection need not be completed If the permit Is for one hundred ($100) or .' Cans[rl _ Backflow Irrigation - Solar_ Colie_cto_rs 1 ^ Bathtubs I Solar Piping I I Cookir Clarifiers Solar Tank ? Dishwa Dishwasher I Swimming Pool w/Spa Dryers _ ( Drinking Fountains Urinal 1 ,� ,Fan 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 beco subject to the Workers'. Compo ion' Laws of California I I + '• } Floor Drains 1 Water Closet ! ! F.A.U. Date 2'/°'� 3 Signature " -r NOTICE: If, after -making this declaration; you sho Id become subject to the-� - Floor Sinks-' - -- - =j— -�- - - Water Heaters - - :- - - Fixturf Workers; Compensation provislons.of the Labor, Code, you must forthwith comply lwithi such provizlonsor �thisDermlt!shall be ,deemed, revoked., CONSTRUCTION. LENDING AGENCY ' I hereby affirm that there Isa(construction lending agency for the performance, i of the work for, which; this permit Is Tissued (Section 3097Civ: CJ; Lender's Name - Lender's Address OWNER BUILDER DECLARATION 'I 1 hereby affirm that I am,exempt from the•Contractor'S:Ucense Law for [he' following reason -(Section 7031:5 Business and Professional 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'applkant for such permit ' to file a signed statement that he/she Is licensed pursuant to the provisions of I ,v Contractor's.Ucense Law (Chapter 9 (commencing;with, Section 7000) of °tdision;3 of the Business and Professions Code) -or that he/she Islexempt 1•;.,refrom and the basis for the alleged exemption. Any violation' of'Section 31.5 by any applicant fora permit . subjects;the applicant to a, civil. penalty of not more than five, hundred dollars ($500)'. 1 , , compensation will'do the work, and the,structure is not intended or offered for sale (Sec{Ion 7044, Business. and( Professional Cotler The Contractor's , License Law does not apply toan.owner of a property 'who builds or Improves thereon, and who does such' work himself/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 com- 1 pletlon, the owner will have the burden of proving he/she did not build or Im- rove for the purpose of sale). I I1 I, as owner of the property, am exclusively contracting with licensed con- 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 builds or Improves thereon, and who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Law), 0 I'am exempt unser Section B. & P. C. for this reason .1 Date Owner' - i herebyy certify that i'have read lhis'•applicatlon and -state that the above - informatlon is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize repre- sentatives of this ,city Ito enterPon the above -mentioned -property for Inspection Purpo3q, 74- i.s-.. 7 _J_ .1r 7 ' Drivers' License or SS 9K CMF 0065-46 rev. 12/62 White - Building; Canary Outlets ! - 1 ep! r.1 Drains rers I ce Sink; - - ;t r: = Under'Ground l t -Structural D "ct - Ventilating Exhaust System 0 Multiple I Firepl/Fact. Bit. ICBG # Heating System & Ducting 13 0.100,000 BTU 0100,000E Hood or Type 1 El, ' Canopy. Tvoe II ❑' ` 1 1 Registers i + ; Goldenrod - Assessor Unit ZONE BUILDING - cETnnry rr er % .r REAR YARD (TO P/U .-. RIGHT SIDE YARD PROVIDED - o ' - PARK FEE $ 1 'r Sub Panel Sub Pole I I , Motors 00-1 HP 01X-8 ;Ina Solar,I]9-15 HP 016-15+ Light l le.. ;. ,Water Service J. ' f Device Bozes -- - i Sign ' - Outlets; Standing Sections j - - Switches i t Trask Compactor j 1 l - Garbage Disposal r Generator 00-5 KW 05-15 KW I 1 } ' Transformer 015-50 KW ; i I I i I 050 + KW I Reinspection Fel $16 1 Reinspection Fill, Meter ❑up to 100,amps Issue Fee: $ 3 Issue Fee $ 3Zoning Approved By lica Application Approved BY - Application Issued By Datei 1 - I I ' Date I --��• �� 3 - 'Date - l IANICAL Refrigeration System• 00.100,000 BTU 0100,000 BI"U' I ! . 1 i } SUMMARY OF FEES System Repair/Alteration .•BUILDING PERMIT $' I SMTP 1 PLAN CHECK $ ' PERMIT PLUMBING $ /S ISSUANCE I $ I 1 $ _ _ I PLAN CHECK $ I GRADING -. $ ' - ELECTRICAL $ . PLAN CHECK, $ MICROFILM -I $ MECHANICAL $ CHECK; $ i TOTAL*EE Reinspection Feel •$15' ,'PLAN j ADVANCED PC $ ' i Issue Fee , } $ 3 , , I I I FINAL FEE. $ i /S'!7— . f GONSTRUCTI,ON,AND.M�) POO ;PA -,i! :Date -'16 APPROVALS Permit 4' sl� �_A S APPROVALS '-Permit.46 'Date Inspector . �1-. temporary,E1'ectricat Ser vice oir-Pole =V I - &L, ui P9.0 q pment Location 2: 'Soil Pipe-Undrgrnd.- V. 53: Steel Reinforcement 3. Etectr�icil Conduit Utility -Uhdrgrnd :.541 Forms All < 4: El6ctrical Conduit-Un&grncP. Ele6trica- I Bonding , .5. Steel Reinforcement r 'Rough Plumbing,& Pressure Test .66. '6: :Eilectricil LIFER Grnd., 57__ APPROVAL TO COVER-GUNITE 7. Footings ElectricaIb6rid uit-Undrarnri: 8. Foundaiion ` 9. Gas!Pipe'd. 64rgind% Test_.r 9. Water;Pipe-,Undrgrnci. '-,60. Backwash 'Lines,.P-Tra 0A Undrgrnd. T j 10. Structural Floor System 61. APPROVAL`TOIDECK 11. Property Sewer Linb &�House Connection; &' �6.2. itackwash Receptor -Final. 12. Sewer Cap 673. , Heater &.Vent -F inal 13. 'Roof'Drain's f 1 64. Nu m'bin§-Syst6m Final- 14. iRough Plurinbing % .165. Electrical -Final`- `1157 Rough -Electrical -Conduit r --T 66:_SdIir-tSy,st-em-FinaI T 4.16."Rough-Electric Wi�,ing, -1 TI 7- 67:1-Fe�-n-ciii-g-&-A&6ess,App-rova rt -Wirin 7.)RO lg ou�� SignZ� 68 .1 APPROVED FOR PLASTERING 18 %6,6trEIect,icaI',T Rar Ceiling' 166.: POOL/SPA SYSTEMSIFINAL t 19.:AougfNeating &;Air Conjiti8ningFIRE D'EP'T.IREQUIREMENT t APPROVALS* Per. it'4#-. 1 20. 'Rough,Factory Fireplace 21. Ducts,2in StitJaure del 70.. Un rground Hydro 22. Ducts, Veniilaiing [71.f Product Piping OGas 00il 23. !Gas Pipe-I`16ugh'& test It , Underground nderground Flush iRoof Framing- 73., Undergrnd. Storage ank 0 Gas Oil ,=24. A .0 25. 'Roof Sheathing 1 74., Overhead Hydro ro 26. nT (Struciural)� Monoco�t_, T Bar Ceili I 75. Dry Chemical Z - .,27. rane and Fla'shi.gr 1 176.; Dry Standpipe L 28. Lathing& -Siding,* 77� FIXED SYSTEMFFINAL u r; iation S 7" 78. - FIRE PREV, FINAL 0. Drywal,l Nailing INote,:; Brown t C31. !�I�ster Bron Colt 1:_32. '6eciririal Power Meter -Final 33.;Ftnal Electric 34. Final Heating &'A_ it Condi . tioning L 35. Final Gas'Pi 36. Hood or CanopY2t; 7 37. Final Factory FirePla,ce, 38: Final Plumbing 39. Water Service -Final 40. Gas Service -Final i 41. Solar bo'mes_t ic-Final II I 42. Backflow Preventer, 43. Backf low. Irrigat,on 44. Landscape Irrigation -System i I •j!- i E; 45. Sound' -4t t, n R ' uiii ts 46. Handicap, eg a _on - r, 47. FINAL STRUdtUkE& IJ6ILDiNG 48. Special Requirements Completed It 49. Electri'c Releaselto �di'�onj 50. Gas Release t to Southern California Gas Co 51. CERTIFICATE OFIOCCUPANCY + A_ No. Date Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. e . CITY OF COSTA MESA ( PERMIT NO. TRACT NO. - LOT NO., + BLD T 44 [ I I :1I',`_ I Jnu•' TL CONSTRUCTION PERMIT �8. C— w 1 Applicant's Mailing Addre/a-��'3hy M�R� LOisrA TYPE OF CONSTRUCTION .NEW ADD ALTERATION- 'REPAIR ' ' Z. �/J E'Sti1 er' ['-� '_ ❑CONVERSION DEMOLISH El OTHER, ' -.0- ,t/oJ Hf ! PJ II%R a"1 Phone L -bZ27 DESCRIPTIONOF WORK Owner's Name SA/• Fa -1r L11<W S• )VIi 4 Anlh J/ 7 ZONINGL Address TYPE OF PERMIT El ,GRADING -0 FOUNDATION STRUCTURAL A. P.906 ZONE ; Arch/Eng.—License No. - ❑TENANT ❑IELECTRICAL ❑IPLUMBING- ECHANICAL PLNG'. 6EF.'vW. BUILDING I} Address - - - - - - ❑;'OTHER •: OET. ' 1.71 �� Oxi ! TO BUILDING- t , E V *REAR YARD (T0 P/U ALINE OCCUPANCY Contractors Namhone�O 3 69 E mi�eR fa tH v lQA4�Pln Address (mailing) CO NSTRUCTIONT:YPE VALUATION$ LEFT SIDE YARD RIGHT SIDE YARD r ' 33I L �� 5 I ZONE GRADING � CU. YDS. ACRES PKG. SPACE REO. PROVIDED 1 ! , License No. � - _ LICENSED CONTRACTOR DECLARATION I Remarks: I i 1 'STREET WIDTH ; PARK FEE$ n I ereby affirm that 9 am licensed under provisions Of Charter 9 (commencing with'sectlon 7000) of Division 3 01 the Business and Professions Code, antl- : I } I SPECIAL CONDITIONS: my'license Is In full for" andleffect. ' i C LO �(% Z 319 r LI`cenw Class Ucan a , PLUMBING I ; • ,:� Dale 'Z -!S^ 519natura ! • - - 1 Bar Sink Sewer Cap ELECTRICA ; 'sRKERS' COMPENSATION DECLARATI I I Ireby.afflrm that I have a certificate of consent to self-Insure.or.a,cartlRwte _ - Backflow Preventer - - - - Sewer Connection-• - - _ - Automatic Washer. Meter over 1008m _ _Ps w Workers' Compensation Insurance, or a cartlfied;copy thereof (Section I 3800, lab. C.), .(��-75 Backflow Irrigation I Solar Collectors Construction Pole ' ( Sub PanaP 1 I ,,,_, ^;, .,r Ll Q; �1 �1SC /`T` Policy No. Company Cooking Unit Sub Pole _ _Q Certified copy is hereby furnished. 1 Bathtubs Solar Piping • I rtifle oL•," p �f filed with the city BulldIrWX vision. t^ -s Applicant v'�'�'a• �-�"'"-�^'-`1 Clarifiers Solar Tank 1 , Dishwasher Motors 00-1 HP [11%-8[11%-8Date - EXEMPTIONFROMWORKERS'COMPENSATION ECLARATION Dishwasher ' Swimming Pool w/Spa Dryers'- OGas!' OElectrlc �" - .Inc.Shcar',❑9-15HP-❑16-15+' (This section need not be completed If Me permit Is for one hundred ($100j or Test).', - I l — - Fan! i (Microwave I certify that In the performance of the work for which this permit Is Issued I Drinking Fountains I Urinal ( I shall not employ any person in any manner so as to be m subject to the - - F.A.U. 'Pole Light I ' Workers ',Corp pen I • Laws of Californla,� /$ II� Floor Drains - Water Closet ' Date �,5-1'J �3 3' Signature f/`X/Lt+a r"^-'�-^�` - -Floor Sinks - y--- -- - Water_.Heater, - -- - _ _ _ ._' . - _ -, Fixtures I Range -NOTICE: If, after making this tleclaratlon, you sho r1 become subject to the Workers' Compensation provisions,of the Labor Code, you.must forthwith comply twlth; such - rovlSions.or this"- permit be deemed revoked P p } - Gas Service' I tOutle;s I '., j S - - - Water:Servlce ,. 1 Device Boxes I Sign 9 CONSTRUCTION, LENDING AGENCY '- - - I hereby affirm that there Is a construction tending agency for the performance• p '- Interceptors - , � r t t, , 1 - ' Outlets I Standing Sections of the _work for. which this permit -Is lissuetl .,(Sectlon'.3097' Civ. C.). - - _ - _ - :'J Switches I - Trash Compactor Lender's Name - Kitchen Sink - ( Lender's Address' r' - I I • : � ^- Lavatories 1 -• -_ - t _ Garbage Disposal I i I ' OWNER BUILDER DECLARATION' � I � 1 herebylaffirm that I am exempt from the Con tractor's. License Law for the _ , - - - ,ti Generator 0075 KW 05-15 KIN P -Trap i -� _ , , ;` ( _n I following reason (Section7031.5 Business and Professional Code: Any city Or' r __ _ county which requires a permit to construct, alter Improve, demolish -or repair - _ Transformer 015-50KW 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 Roof Drains r- - ❑50+KW 'Reinspection Contractor's License Law (Chapter 9 (commencing with Section -7000) of �'Jsion Showers '. - . _ 1 - Reinspection,Fe l $15' I Fee $15� ! 13 of the •Business antl- Professlons Code) ori that he/she'Is exempt �, efrom and the basis for the.alleged exemption. Any vlolallon'of Section - .I - - '- Meter ❑up to 100amps Issue Feel ' $ 3 31.5 by -any applicant for a; permit .'Subjects 'the applicant to a dvll i ' .. Service Sink - - $ 3 -- i Issue Fee s ' penalty of not more than flue hundred Dollars Y ($500): I i,. n 1 11 I - -- Zoning Approved By Date 1, as owner of; the property or my employees with wages as their sole 1 MECHANICAL T. ' I- compensation wtllao the work, and tha.ilructure is nohintendetl or offered for sale (Section 7044, Business and i Professional. Cotler The Contractor's - I .- -i' Application Approved By , Date "License Law does not apply to'an owner of a property;who builds or Improves I .thereon, and who ldoes such work himself/herself or through his or her own that Improvements are; not Intended or offered for I _ Boiler i 1 1 1 - } Refrigeration System - e ( x ❑0-,100000BTU ❑100.00OBTU I ' Application hued By �- - Data �. - employees, provided such Sale. If, however, the building or Improvement Is sold within one year,of com- I I 1 i Duct -Under Ground 1 w. - 1 I SUMMARY OF FEES ; f pletion, the owner'will have the burden of proving he/She did not build Or im- rove for the purpose of sale). '; Duct - Structural 1 System Repair/Alteration .•i , ;BUILDING PERMIT $' SMIP $ I, as owner of the property, am exclusively contracting wilh'llcansed con- ! - '' I - ` 1 tractors to construct the project (Section 7044, Busin ass a no, Prof esslons-Cotle:, „ Res to _ Duct_ Ventilating _•) , -_ _ _ _ _ _ - IPLAN CHECK' $ ' - i PERMIT The Contractor's License Law not apply an owner. Of property who builds or 'Improves thereon, and who contracts for such projects with a con- Exhaust System ❑ Multiple ❑' I; i i .' j r I ,PLUMBING $ ISSUANCE' ) $ tractor(s) license pursuant to the Contractor's License Law)! j I 4 ❑ Lam exempt under Section B. d P. C. for this rea on Firepl/Fact. Bit. ICBO 5I5 1 I j '.f IPLAN CHECK. $ GRADING I I $ ' I- I ELECTRICAL $ ' 1 $ I Date' '' Owner; ' i Heating, System &Ducting IPLAN CHECK' $. MICROFILM $ ' -I hereby - certify that -I have thls-application and state that the -above - ---t 0'0-100,00dBTU ❑100,00087 - 1 TOTAL FEE' $ Information is correct. I agree to comply with all city. and county ordinances an laws relating to building construction,. and hareoy authorize repro- i -T : ' 'MECHANICAL $ %s— late Sentatives of, this )clty'to enter up0 the above-mentioned property far HOOd or VP a I' ❑' Cano ❑ Reinspection Fee x$15' 1 PLAN CHECK( ! $' LESS ' s : Inspection purp047-5. d Date T e II ADVANCED PC I $ ' Signature ISS Drivers' License or SS Registers i I Issue Fee $ 3 ' FINAL FEE $ CMF 086546 rev. 12/82 - ApPlicant; Pink - Accounting; Goltlenrod - Assessor _ - .. - - - - - ^' ' r• - - 76ONSTRUCTION ANDjPL'ANNI G �' '�� u +. �; ,� ' ; POO- �''PA .. r =, r . r r .'Date ,' . APPROVALS Per # o Inspector . _ ,' ; APPROVALS Permit # -Date • Inspector, •: ,,:52: Temporary.ElectricaJ Service or,.Pole 9 ` '" v, = ": Pool &Equipment Location .' n 21 Soil Pi a-U.ndr rnd: - t p t c _ Fr� .- X53.' Steel Reinforcement - - r• 1 9 n` -, •1 Electrical Conduit Utility-Undrgrnd e. - 54- Forms C e i 4i Electrical Conduit-Undrgrnd'. _ _ • i = 55. Electrical^Bonding - 5S Steel'Reinforcementr = 56. Rough Plumbing &Pressure Test •� 6: !Electrical UFER Grnd. „ = _ r' 577 APPROVAL T000VER-GUNITE. - 7. Footings I 1 _� '- ;' ' , �' , $8: 'ElectricelConduit-Undremd.- B. Foundation _ ; t 59. Gas'Pipe,-O Undrgrnd., Test ' `- 1 9. water Pipe-Uhdrgrnd. _ I 60. Backwash Lines,,RTrap, O-Undrgrnd. _ 10. Structural Floor Systerrt _' I 3 61. 'APPROVAL TO DECK- K•1t. 11.Property Sewer Line & House Conneciionp 'Backwash &Receptor -Final X62. 12. Sewer Cap - _ _ -- '63. Heater & Vent -Final 13. Roof Drains -� '� ! o X64. Plumbing;System- Final,- - ,- 14. Rough Plumbing: X65. Electrical -Final" - • - ' 15:'Rough Electrical=Conduitj`--.�'';--'- r-- 'f".- i66.' Solar Sysiem-Final' "IW6.1 Rough:Electric Wiring, I � � ! r `' ,1-' , .. i � - 1T';-'�: 1674 Fencing & Access -Approval 17.,Rouyh.WiringSign'� ^1 168. APPROVED FOR PLASTERING , 1 18:,'.Rough:Elecirical"TrBar Ceiling '� Ij = ' f I =. ' '69 POOL/SPA SYSTEMS FINAL ' - - 19),Rough,Heating &'AirConditioning ;i I I- I 13 f I FIRE DEPT,{REQUIREMENT APPROVALS; ! Permit # 20. •,Rough'Factory Fireplace ii j +I 21. Ducts;_in Structured " Ii� if II j ( I I 170; Uhdergrounld Hydro !' 'x22 !bucts, Ventilating? ; ' ;lei 1. { I I i '71. Product kping 0 Gas 0611 :23. ,Gas'•Pipe-Rough & Test : + ;moi L. _I_ _i i - ; I de 172: Underground Flush 1_24.alRoofFramin6' 1 � I 73Uhdergrnd.StorageTank,OGas DOil I i , I n .✓� IIS r 25.Roof Sheathingy�� ;:,a !i ' , r, ! I ;- - . .74. Overhead Hydro - •26.1,T -Bar Ceiling°IStructuralli& Monocoat i i E' I !75i Dry Chemical ' - r „ r 27. Frame and lashing, { �, I ' I -;: I l 76' Dry Standpipe _ - 28.hLathing&-Siding; 177! FIXED SYSTEM FINAL 29._ Insulatioh' i' i' n ' I '! r ' , :781 FIRE PREV. FINAL =30.,. Drywall Nailing ' i p r I {Notes i '311APlaster Brown Coat, 32: Electrical Power Meter -Final 33. Final Electric ii l I _ ' I I_ '•-_ 34. Final Heating'&;Air Conditioning 35. Final Gas Pipe =Test ^ I - `_' ,L ` = l ° - - - 36. Hood.orfCa n6py..- , 37. Final Factorly Eiieplace `- 21 T ` i 1 38. Final Plumbing 39. Water Service -Final 40. Gas Service ,Final - l - r 41. Solar Dornestic'Final 42. Backflow Preventer • i 43. Backflow Irrigation , rt 44. Landscape Irrigatioh;$ystem 45. Sound :Attenuation, - ' l , 46. Handicap Regulationsl I 47. FINAL STRUCTURE+& BUILDING 5 ' h- t '• I 48. Special Requirements Completed i' -- 49. Electric ,Release to Edisori 50. Gas Release�to Southern California Gas Co a I I I I l I I I 1. •' 1 I • Iv ' 51. CERTIFICATE OF OCCUPANCY No v II Date. l I I_ -f .I I- ._-t._f I I l ,), Applicant to 1111 In all spaces except those within heavy border lines and sign all appropriate declarations CMF d&e!�'46 re4.-112/62-�'Wnite - Building; Canary - Aiipticant; Pink - Accounting; Goloenrotl :Assessor CITY 95 COSTA MESA _ CONSTRUCTION PERMIT a ER TAO. TRACT NO. LOT NO. BLDG _� r. 4271.1/-'11b..:r,. T•. Applicant's Mailing. �Alddress _ � Project Address�S ��.SC//'/J�/i71� TYPE OF CONSTRUCTION NEw ADO, ALTERATION _ REPAIR - ❑CONVERSION ❑ DEMOLISH ❑ OTHER' Owner's Name .H�.dm �ii�U�� Phone SSW22 DESCRIPTION OF WORK I- ZONING 1 Address -*!5 ��'�� O��ld TYPE OF PERMIT U GRADIN FOUNDATION U STRUCTURAL ❑ TENANT ❑ ELECTRICAL LUMBING ❑ MECHANICAL ❑'BOTHER - - PROJECT DESCRIPTION SG. FT. OCCUPANCY CONSTRUCTION TYPE VALUATIONS ZONA GRADING CU. ACRFc A. P. fW ZONE' - Arch/Eng. - License No. Address PLNG. REF. y BUI LDING -' _ TO BUILDING REAR YARD (TO P/L) PROPERTY LINE • Contractors Name C'�iIZ7.r/ %AZ—`r 13-d'C phone 9�-o&33 • Address(mailing) �� •S/fl�.t�i9 n;eeP o 4f� 710 License No. X36-d-�'0 _ - LEFT SIDE YARD RIGHT SIDE YARD PKG. SPACE REQ. PROVIDED - - LICENSED CONTRACTOR DECLARATION Remarks: D STREET WIDTH - PARK FEE $ - ' I hereby affirm that I eDi licensed prosiness o/ Charter 9 (commencing - 3 of the Business and Professions Code, and 7000) of 3 of the SPECIAL CONDITIONS: - mywithlicense Is a and of my license Is In full farce entl affect. License Class G- 3C 52 LlcenS�a PLUMBING Date 9'5% 4innah,.n i�7`"f"1� WORKERS' COMPENSATION DEC RPtT}ON"/ - I hereby affirm that I have a. cart) to of conseril to Self -insure or a certificate . 'vorkers' Compensation Insurance, or a certified copy thereof (Section . Lab. C,) r .-y No. Company Certified copy is hereby furnished. ' ie Certified copy Is filed with the city Building Division. Data - Applicant I EXEMPTION FROM WORKERS' COMPENSAT I 014-D ECLA RATIO 4 : (This section need not be completed I1 the permit IS for dna hundred ($100), or . less). 1 certify that in Me Performance of the work for which this permit Is Issued I Bar Sink Sewer Cap ELECTRICAL Backflow Preventer - - - Sewer Connection- - - Automatic Washer Meter Clover 100 amps - - Backflow Irrigation Solar Collectors Construction Pole... Sub Panel - -- - - Bathtubs Solar Piping Cooking Unit Sub Pole Clarifiers Solar Tank Dishwasher Motors 00-1 HP Ell % -8 - - Dryers ❑Gas' Electric 'Inc.SOlar ❑9-15 HP ❑16-15+ - Dishwasher r Pool W/Spa _Swimming Drinking Fountains Urinal I 1 - , Fan' - Microwave - I FIOOr Drains - - - Water ClgSet'_ F.A.U. i Pole Light shall. not employ any Person In any manner so as to b e subject to the Workers,', C a U9n Laws of Call Orni �— ryj Date 519nature NOTICE: It, alter making this declare %, o hitg tl becomesubjectto the Workers" Compensation provislorl! Ih oyCc hr _you must lorthwith comply with; such brovi5ion5' . this er C shall be deemed revoked.. ' - Floor. Sinks - --• -.Water.Heater. _ .- Fixtures _ - _ - Range_ _ Gas Service! )Outlets Water Service .- ' Device Boxes i Sign 1 , CONSTRUCTION LENDING AGENCY , 1 hereby affirm that there is a construction lending agency. for the erformanca - of the work for. which., this. permit is issued (Section .30 7 Civ. C.) Lender's Name^ Interceptors - Outlets t Standing Settion5 r ! KitchenlSink' .s �' i ( - - Switches i ,Trash Compactor Lender's Address - OWNER BUILDER DECLARATION - ' I hereby affirm that 1 am exempi from the Contractor's,Liconso Law for the_ following reason:(Section 7031.5 Business and Professional Coda: Any Illy or . county which requires a permit to construct, alter Improve; demolish or repair any structure, prior to Its Issuance, also requlros the applicant for such permit, t0 file a signed statement that he/she Is licensed pursuant to the provlsPons of the Contractor's License Lawr(Chapter 9 (commencing with Section 7000) of Division 3�of the ,Business and Professlons Code) or, that he she Is exempt therefrom and the' basis for the alleged exemption. Any vlolatlon'ot, Section .7 5 by any applicant for a!permit-subjects the •applicant to a. civil ` y of not more than five hundred dollars ($500). 7 ., L as owner of, the property or my employees with wages as their sole con pensation will do the work, and the structure Is not Intended or offerod for Sale'(Sec/Ion 7044, Business and Professional Code: • The Contractor's ; License Law does not apply to an owner of a property who builds or Improves thereon. land who 'does, such work himsoll/herself or through his or her own employees, provided that such Improvements are not Intended or offered for sale. If, however, Me but clog or Improvement Is sold within one year'of <om• i pletlon, the owner;wlll have the burden of proving he/she did notbuild or Im- rove for the purpose of, sale). 1 1 I, as owner of the property, am exclusively contracting with;llcensed con. _tractorsto construct the project (Section 7044, Business and,Professions Cotle:— The Contractor's License Law does not apply to an owner of property who , bullds or Improves thereon, and who contracts for such projects with a con. tractor(s) license pursuant to the Contractor's License Law). i Tam exempt uhtlar Section t B. & P. C. for this reason I _ Lavatories +• - I - - I ' Garbage Disposal ; 1 ! _ 1 P—Trap' '7 ' - - ' Generator 0:5 KIN 13 5-16 KW 1 i _ i Roof -Drains l .; { , Transformer 015-50 KW 1 0 5 + KW Reinspection Fee $15 ' Showers ' 1 ! Reinspection Fee i $15 - Meter ❑up t0 100'emp5 'Issuo Fee '$ 3 I - - :• c Service Sink Issue Fee �' S 3 ..- _ Zoning Approved By Date Application Approved By Date -- l ' I - Application Issued By Data I MECHANICAL Boiler I '.! , ! Refrigeration System Duct -'Under Ground ' LJ0.100,000 BTU ❑100,000 If I LI , ! r , r I - ; 1 SUMMARY OF FEES , 1 IBUILDIN6 PERMIT $; , SMTP $ PLAN CHECK $ { PERMIT ' 1 : , I ISSUANCE $ 'PLUMBING l $ GRADING S ' ! ;PLAN CHECK* $. 1 i 1 $ - ELECTRICALI $ r - L ) 'PLAN CHECK' $ MICROFILM $ TOTAL FEE: $ ' MECHANICAL $ I - , 1 ; i '.PLAN CHECK• $ LESS 1 i ADVANCED PC ( $ . , `�Q(J BLE FINAL FEE, , 8 . t Duct - Structural ( System Repair/Alteiation - Duct - Ventilating �;. _ { g _ _ _ _ _ - Exhaust System ❑ Multiple r ! ' Firepl/Fact. Bit. ICBO dk i j j ' Date — owner - i4 1 'I -hereby certify that I have read [his-apPli catlon-and state that the above Information Is correct. I agree to comply with all hit and county ordinances ' g PY y and state taws relating to building construction. and hereby authorize repro- sentatives of thlS lcI1Y to enter! p n�the above-mentlonatl property for Inspettlon urpos / , Q� � r Signature/ �s�-i,.- - Date '� : Drlvern'�I � ' I i — Heating System & Ducting ; '110.100,0008TU 0160,000 _ _ _ __ __ 1 I+ ' r Hood Or Type I ❑' i � Carso . T e 11 ❑! Reinspection Fee; $15 � , - - Registers 1 i Imre Fee $ 3 CMF d&e!�'46 re4.-112/62-�'Wnite - Building; Canary - Aiipticant; Pink - Accounting; Goloenrotl :Assessor :. i ONSTRUCT10NAND PLA ING I r .-•. 11-- I-,,- ., POOL&O 0 ,: '.APPROVALS Permit # �..te^, Inspector ,'APPROVALS;• Perm,.'.Date Inspector. - I Temporary ;Electrical Service or'Pole c , - '52-. Pool &IEquipmerit. Location' !u 2? Pipe-Undrgrnd,; _ :`� ` ;53" Steel Reinforcement :Soil ',- ` 3! Electrical Conduit Utiliiv-Undrgrnd. 54 Forms -�''i- r 4: Electrical Conduit-Undrgrnd: 9r '55:` E lectrical Bonding , •r 5E Steel Reinforcement ' i { c L 56. Rough Plumbing & Pressure Test - 6. `Electrical UFER Grnd., 57l;APPR6VA0T0 COVE R-GUNITE 7. 'Footings - �:; - '• - ,�: 58.' Electrical Conduit•Undrar„d. - 8. Foundation _ 59. Gas Pipe; O, Undrgrnd.; Test,, 9. Water Pipe-Untlrgrnd. - - Backwash Lines, P -Trap,,❑ Undrgrnd. _ ,160. 10. Structural Floor System 7 61. APPROVAUTO DECK 11. Property Sewer Line &House ConnectionI 1- 11 •:62. Backwash &Receptor -Final - - 12• Sever Cap' i _ 63. Heater & Vent -Final - 13. Roof Drains'64. Plumbing5ystem •Final - - 14. Rough Plumbing - - - '65. Electrical -Final �- ".15`'Rough-Electrical-Conduit . "-, ` - E - � " " �" � "" -' �166.�Solar.Sys4em-Final -- •' - - � RoughElectric Wiring• '671 F ncing & Access-Approval'-:- ,Rough .:17:Wiring•Sign�.-68! APPROVED FOR PLASTERING . - 18.•..RoughElectrical•-T.BalCeiling -t- X69. POOL/SPA SYSTEMS FINAL- 9r,iRough Heating & Air'Conditioning I I FIRE DEPT. REQUIREMENT i c i' APPROVALS Permit # - 20. "Rough, Factory Fireplace i' 21. Ducts, in Structure; I 1 :70i Underground Hydro `22.'Ducts, Ventilating •. i I ,71. Product Piping C3 Gas ❑Oil ' 'i^23. Gas Pipe-Robgh & Test �• i' I 72. Underground Flush '73. 24. Roof Framing'' �' -,! r• 1 -'-_ Undergrnd.Storage Tank ❑Gas ❑Oil , i, ?5.:'Roo. Sheathing a •. ..- r 74 Overhead Hydro - 26. T -Bar Ceiling (Structural). & Monocoat X75.Dry Chemical 27. Frame and Flashing' i 76. Dry Standpipe • - 28.' Lathing & Siding -_ 177. FIXED SYSTEM FINAL 29,.,Insulation .: _ '78.FIRE PREV.FINAL -30, Drywall Nailing ` Notes: . 31.�Plaster Brown Coat; i --_- ' 32.'6ectrical Power Meter -Final ' 1 33. final Electric I ! 34. Final Heating &.Air Conditioning 35. Final Gas Pipe�Test 36. Hood'or1CanonY 37. Final Factory Fireplace• �; •- 38. Final Plumbing; 39. Water Service -Final "! 40. Gas Service -Final i - 41. Solar Domestic -Final 42. Backflow Prevente{ 43. Backflow Irrigation' . , 44. Landscap? Irrigation,System' •` - ; - .' 45. Sound Attenuation' 46. HandicapRegulations 47. FINAL STRUCTURE i & BUILDING � � I I 48. Special Requirements Completed t 49. Electric Release to,Edisor) 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No, Date ' j City of Costa Mesa Building safety Department_, CE R T I F I C A'T E' D F O CC U P A N C Y n 3 3 8 P.O. Box 1200 l - _ Costa Mesa, California The Building located at ,245 FischPtr D has been inspected and found to'comply with the provisions of`all:C.ity of Costa Mesa Ordinances appl!cable �th 1' for a Group - B-2 Occupancy. Use of Building Tei nti T=ixwenent Legal Description' A. P. '4427-033-07 ISee reverse side for Metes and Bounds) ,, Building.Permit No A—t'AAA E lectricalrP,erm it No. —2310 Plumb,iing. Perm it No. P-2875j'�' P-2R4 3. Number of apartments ''-0 and/or!guest rooms ISSUED;TO:, / Building Official by Pulliam Properties V.'C...Nevrton-Building Division Director-. Datei2.��8 This Certificate of Occupancy SHALL BE posted in a conspicuous place o_n the premises and SHALL NOT BE removed except Building Official,of the. City of- Costa Mesa underSec306(e),U.B.C. Form BU 34 Rev. 11/70. 1. all ap Pro piate1 Applicant ... .711 in spattsn..__.=.5vy�s._. __.....,es antl sign all rtleclaratip ns. \J MESA PERMIT NO. TRACT NO. LOT NO. BLDG. NO. - - - - '- - - - - - - - W10;0 UtidTION PERMIT /� A TYPE OF CONSTRUCTION '., � NEW ADD ❑ ALTERATION -O REPAIR ❑CONYERSION ❑DEMOLISH ❑ OTHER • �� .�{ _. .' 0586 I�,I382:�27a24 ZONING REGULATIONS Address {S- t IA -4 zr Phone - TbT77�/`/'r/ EAddre�' '- �" _ /?{v`-�[C W �M - Eng.- --- - - License No. _ DESCRIPTION OF WORK A.P. IF 'ZONE _ �P,LNG::R EFCgp�:',' , Contractor" - 1^ �• 7 �� - -- Phon - TYPE OF PERMIT,. - - •- `-- PTL ❑GRADING,','(]`FOUNDATION-❑'STRUCTURAL - IpE VA EF 0 -TENANT p, ELECTRICAL PLUMBING-❑MECHANICA IDE VA - •Tp Bt/I LpINGt Ni ..A•PROP.@RTK LINE !u --- -- yyp�i �IS16iliYLICENSED ff . - - _ _ __ I Address (j ` - ---1- '" '- '., _ _OO11 CONTRACTOR -DECLARATION., - I hereby affirm thaf I am licensed under provlslons of Charter 9 (com- mencing - -3 •- '. t.•� � _ •( � � ❑OTHER--- IG HT with section 7000)'- of ;Division of the Business -and Professions Codlicense is in full force effe t. - -- - - - - - EAR YARD (TO Pfd}y'j -. r-, my and License Class � `0 License -/Z I`I PROJECT DESCRIPTION ._. �' - _� KG. SPACE REO. __ rr Eb .. ., SO. FT. _ ,.PR,O�.(D `RK Date FE WORKERS' COMPENSATION DECLARATION- -- - - OCCUPANCY CONSTRUCTION TYPE_ NIN A�, 0,V .y�+�7�P D, E ` D B' {I hereby affirm that I have a certificate of consent to self -Insure -ora ,certificate' of Workers' Compensation ,Certificate ns Ura nee, -or a cern fieticb py ,sV ALUATION ZONE - - - - - - - - IN ECI C - 'tT - Ill l aj /' NS:� �l - thereof (Section 3800, Ub. CJ. ,GRADING CU..V DS. ACRES' �4a _ - Policy No. _ _ �- _- Company - REMARKS: - •! _ -.-_ __ -. ___ _ _ _ _ _ _ _ _ _ _ (]- ertified Copy is -hereby -f urn lshed. - - - --- - -- —I Nertified copy is filedwith the city Building Division. •q>EM PTION FROM WORKERS' COMPENSATION OEC LA RATION 'itis section need not be-completbd if -the permit Is for one huntlretl -_ _� - _. ,� .,,, •_l - _ .` }` I ' ' ($100) or less). I.certify that m.the performance of_the. work. for which this permit is Issued, I shall not employ any person In any manner so as to become _ PLUMBING ('PLAN'CHECK - - ' - '- -1-7 ' ELECTRICAL '- -- ' PLAN CHECK:--.-- -- -' subject to the Workers' Compensation Laws of California. _ ... _ _ -- - BATHTUBS SHOWERS ._ - (UWt _ - LLINU_ _ _ _ UAKAUL - - - Date i Signature ( - NOTICE: If after making this declaration, you should become subject 'TOILETS.: n p: 9URI,NALS - -" "". GENERATOR' 0-1 KW_1-1 O.KW.'. to the Workers' Compensation provisions of the Labor Code, you must "" -,- ;TRANSFORMER . .1 forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS .. 'APPLIANCE"`-' 10-50'KW_50+KW��-- revoketl,-e--.., -- _i, w__--_ --..... __. __ KIT. SINKS- -'- DISHWASHERS-`"' - -'MOTORS-- 0-1'HP '`1-10-HP- LENDINGAGENCY CONSTRUCTION- I hereby affirmthatthat there is a for the lendingis '- - - -' ' -- � - '(INC. SOLAR). - dI 10-50 HP 50 + ' construction per. ssagency formance of the work for which this permit is issued uetl (Section 3097 SERVICE SINKS c SUMPS � HP •- FLOOR SINKS FLOOR DRAINS !' "' IFI%TURES' v'-OUTC ETS LSWITCH ES' Civ: C.).- - -' -` - - . Lender's_Name _ _ _ ILerider's Address " DRINKING FOUNTAINS -'�- -)' 'IG'ASTUB E'SIGNS"-' - "' "^-'-_'-'- - - -- -- - "' -" _ -" -"^ -" �^" INTERCEPTORS CLARIFIERS ---- POLE LIGHT$' - --- - - "-" -"' _ "--- .-�• OWNER BUILDER DECLARATION _ - "' --' "- "- I hereby affirm that I am exempt from.the Contractor's License Law for -SWIMMING POOL — 'P TRAP' - -- _ - "-"' 1. - iPOLES - METERED SUB' v the following`reason'(Section 7031-.5 Business and Prof essions-Code: Any city or county which requires a permit to construct, alter,' --WATER SERVICE- ALT,E RATION `- ' "' PANELS - - ' MAIN -' SUB'" - Vfl improve, demolish- or,repair.any structure; prior to its iSSuance,also're= quires the ap;licant for such permit to file a signed statement that h¢ -GAS SERVICE _OUTLET$ -t ,- - 'SERVICE- ""-'- '--- .. -"'--AMP-- - - - - Is-Iicensed'pursuant to the provisions of the Contractor•s'License Law' (Chapter 9 (commencing with Section 7000) of Division 3 of the -WATER-HEATERS --BTU OUTPUT -- Business and Professions'Code) or'that'he IS. exempt therefrom'and the basis for the alleged exemption. Any violation of Section 7031.5 by -SEWER-CONNECTIONSof _ any"applicant-for a"permiV subjects. theapplicant to-a'Civil- penalty not more than five_ Inundred dollars ($500). SOLAR TANK-COLLECTORS- as owner of the property, or my employees with wages az [heir compensation,_will.do.the work,.and the structure is not intended,.- �ffered for sale. (Section 7044, Business and Professions Code; The SOLAR PIPING SYS. p -' _ _ , '.L- ISSUE FEE -- _ '- '"� �- _' �" -: f'-' QLJ Contractor's -License Law-does_not_apply._to an owner of. a_property _ _,--_.�r--- _ ISSUE FEE ... _ _ , APPLICATION APPROVED BY--- -- - DATE---• who builds -or improves thereon, and who does such work himself or through-his.own.employees,. provided that such.improvements are not MECHANICAL PLAN CHECK ` f - _ $UMMARV O_FIFEESis intended or offered for sale. If, however, the building or improvement sold within one year.of.completion, the.owner-will have the burden of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BT_U ;BUIL'DING' ---""' PERMIT $ • --' --- - -- •SMIP •', $ - Q'nsed owner'of-o with -AND'DUCTING - - - - - '"---- -- - "- '-- -- ---- - - - - construct the prexclusively-contracting licensed contractors to the project (Section Business 100,000.,+BTU- PLAN CHECK S E :,PERMIT' he Contractor's es not and Professions Code: The Contractor•s-License-Law does not apply to l$ ISSUANCE $ - an owner of property who builds or improves thereon, and who con. -from -such. -contractors) joesned to REFRIGERATION 0 -100,000 -BTU --- PLUMBING f - tracts projects-' with a pursuant the Contractor's License Law). SYSTEM - --i+- -- --- - - 100,000 + BTU �. - - - PLAN CHECK $"' - - - -' GRADINGS S ❑ I am exempt untler Section - B. & P. C. for this BOILERS BTU ' - ELECTRICAL -S Jl 1$ -- reason - - - -'-"• '- -- -- - - - - SYSTEM REPAIR, ALTERATION I PLAN CHECK -$-- -- MICROFILM $�i Date - -�- - -Owner - - � - - - - - - - - _ { MECHANICAL: $ v __ _ _ � TOTAL FEE'$ ' hereby certify that.l.have,reatlthis application.and sta to that theabove EXHAUST SYSTEM MULTIPLE- � .c., .•LESSAD-"-' information is correct. I agree to comply with all city and county _ __ PLAN CHECK -$' "--VA_NCE PC $ _-- ordinances and state laws relating to constructionth, antl hereby authorize representatives of this city to enter upon e above mentioned' property_ for . inspection.. purposes. Siqnat usDate ISSUE FEE - -- • -- '- -- --- I - --- --- - - e FINAL FEE - - -- - - - - Drivers'e License or 55 CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING ��]]�� \• '• APPROVALS Permit # G: as..�l& Date Inspector POOL &SPA .APPROVALS . , Permit # "-' - -Date . Iinspe 1. _Temporary Electrical Service or Pole 43. 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 Reintorce 47. Rough Plum[in &Pressure-Tesf '� _ _ _ 6. Electrical UFER Grn _ _ -- 48. APPROVALTOCOVER-GUNITE ---- - ' 7. Footings _ _ _ _ _ _ ' 49. Electrical Conduit-Undr rn- - B. _ . Foundation _ _ _ -_ 50. Gas Pipe, ❑,Undr rn;-Test -F 9.. Water_Pipe-Undrgrn.- 51. Backwash Lines P -Trap." ❑-' nd 'n 10. - Structural F,Ioor.SYstem._ --- �. 52. APPROVAL TO DECK- . 11.. Property Sewer Line -&_House Connection _ 53. _Backwash & Receptor -Final ..12.- Street Sewer Connection -_ 54.- Heater & Vent -Final 13.. Rough Plumbing. . - _- . .:Plumbin _. . ._ . - ----- 14. Rough Electric -Conduit - - - - - - - - •56. -Electrical-Final -� 15. Rough Electric -Wiring - "- - - - 57. - Solar System -Final 16: Rough Heating& Air Conditioning uts. Fencing & Access Approval .17. Ducts, in -Structure _ _ _ APPROVED FOR PLASTERING 18. 19. 20. Ducts, Ventilating Gas Pipe -Rough & Test- Roof Framing - -_ - 60. _POOL/SPA SYSTEMS FINAL • •-• - 21. - 22! Roof'Sheathin -' - --• _ -- - _ - Frame and Flashing- - -- _ .. .. _ �, OTES: N - _ _ •• 23. 'Insulation-' 24: Lathing & Siding-- - - 25. -Drywall Nailing-_ 26. Plaster Brown Coat - - - 27. - Electrical -Power Meter -Final_ 28: Final,Electric - 29. Final,Heating & Air Conditioning 30. - FinalGasPipe-Test_ _ _ - _ - - ;• - 31.- Final Plumbing 32. Water Service -Final 33.- , Gas Service -Final - - 34. Solar Domestic -Final �'�-- •• 35. Landscape Sprinkling System - 36. Sound Attenuation "';• - i 37. Handicap Regulations - - 38. FINAL STRUCTURE & BUILDING - - - - 39. Special- Requirements Completed- - - - - - 40. Electric Release,to Edison 41. Gas Release to Southern California Gas Co'. - • 42. - - CERTIFICATE OF OCCUPANCY - No -= ' Date - - I Applicant to fill In all spaces within heavy border Imes and sign all appropriate declarations. CITY 6F COSTA MESA PrIT NO. TRACT NO. LOT NO. BL G. IN 0. CONSTRUCTION PERMIT , o�(lap I I TYPE OF CONSTRUCTION ❑NEW ❑ADD ❑ALTERATION ❑REPAIR 0CONVERSION '❑DEMOLISH ❑ OTHER f p OQ(I %I�7I®I /1%o QQ ZONING REGULATIONS Project Address- - U Owner Phone Address Arch/Eng. License No. DESCRIPTION OF WORK A.P. iF ' ,ZONE PLNTG.gRlE1F.V Address - Contracs Phtordn S 7VPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL ❑ TENANT ❑ ELECTRICALALUMBING 0 -MECHANICAL SETBACK I YARD pOPEI PF�i NE Address LICENSED ONTRAC OR DECLARATION - I hereby affirm that I.am licensed under provisions of Charter 9 (com- SID RIGHT meriting with section 7000) of Division 3 of the Business and ❑OTHER - Professions Code. aV ripe se is In full for and REAR YARD (TO P/L) �II PROJECT DESCRIPTION (// r/gra License N License Class SD. FT. -- ' OCCUPANCY_ CONSTRUCTION TYPE PKG. SPACE REG. - STREET WIDTH PROVIDED PARK FEES _ Date Signature - WORKERS'COMPBNSATION DECLARATION I hereby affirm that I have a certificate of consent to self -Insure or a VALUATION ZONE ZONING APPROVED BY SATE certificate of Workers' Compensation Insurance, or a certified copy thereof ,(Section 3800, Lab- C.).�,.,.�y1 GRADING CU. YDS.. ACRES SPECIAL CONDITIONS: Policy No. AWDz copy Is hereby furnished. REMARKS: Certified copy Is filed with the city Building Division. .XEMPTION FROM WORKERS' COMPENSATION DECLARATION �7 (This section need not be completed if the permit Is for one hundred - - ($100) or lessl. ' 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 PLUMBING. PLAN CHECK ELECTRICAL PLAN CHECK subject to the Workers Compensation Laws of California. BATHTUBS SHOWERS Date Signature NOTICE: If after making this declaration, you Should become subject TOILETS URINALS DO GENERATOR 0-1 KW_ 1-10 KW 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 p APPLIANCE 10-50 KW -50 + KW revoked. - - KIT. SINKS DISHWASHERS MOTORS 0-1 HP -1-10 HP .CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS SUMPS (INC. SOLAR) 10-50 HP_50 + HP formance of the work for which this permit .is issued (Section 3097 FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES Civ. C.). 'Lender's Name Lender's Address _ DRINKING FOUNTAINS GAS TUBE SIGNS INTERCEPTORS CLARIFIERS POLE LIGHTS .OWNER BUILDER DECLARATION I hereby.affirm that I am exempt from.the Contractor's License Law. for SWIMMING POOL P TRAP the following reason (Section 7031.5 Business and Professions Code: Any city or. county which requires a permit to construct, alter, POLES METERED SUB WATER SERVICE ALTERATION •PANELS MAIN SUB improve, demolish or repair any structure, prior to its issuance, also re- quires the applicant for such permit to file a signed Statement that he GASSERVICE OUTLETS SERVICE AMP - is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT Business and Professions Cotle) or that he Is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS --y applicant for a Permit subjects the applicant to a civil penalty not more than five hundred dollars ($500). SOLAR TANK COLLECTORS ' I, as owner of the property, or my employees with wages as their .tele 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 who builds or improves thereon, and who does such work himself or ISSUE FEE Q APPLICATION APPROVED BY DATE through his own employees, provided that such improvements are not intended or offered for sale, If, however, the building or improvement MECHANICAL PLAN CHECK SUMMA RV OF FEES is sold within one year of <omptetion, the owner will have the burden of proving he did not build or improve for the purpose of Sale). -owner HEATING SYSTEM 0-100,000 BTU BUILDING PERMIT S SMIP E ❑ I, as of the properly, am exclusively contracting with AND DUCTING licensed contractors to construct the project_ (Section 7044, Business 100,000+BTU PLAN CHECK E PERMIT and Professions Code: The Contractor's License Law tides not apply to ISSUANCE S owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING E 00 tracts tracts from such Projects with a contractor(s) Ilcesned pursuant to SYSTEM GRADING $ the Contractor's License Law). 100,000 +BTU PLAN CHECK E ❑ I am exempt under Section B. 6 P. C. for this BOILERS BTU ELECTRICAL $ $ - reason• SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM - MULTIPLE PLAN CHECK E 'MECHANICAL E MICROFILM $ TOTAL FEE $' LESS AD - Date - - Owner 1 hereby certify that I have reatl a 1 tion and slate that the above information is correct. I a r to 0 y with all city and county PLAN CHECK E VAf$C[ PC $ ordinances and state laws relating to s uct ion, antl hereby authorize repre;en of this city o r upon the above ntlo 0 properi$ fa _ coonp \ �� 97. FINAL FEE $ OD Signature Drivers' c S or SS — ISSUE FEE " F 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor TL CONSTRUCTION AND PLANN G APPROVALS Permit #-�R'� Date POOL &SPA - Inspector APPROVALS . , Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. SoilPipe-Undrgrn "- 44. Steel Reinforcement ' 3. Electrical Conduit Utility-Undrgrn - - '- 45.. Forms _ 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel ein orce - 47. Rough Plumbing & Pressure Test _ 6. - Electrical LIFER Grn - - 48. APPROVAL TO COVER -GUN ITE. 7. Footings 49. Electrical'Conduit-Undr rn ^ - 8. Foundation -- - - - ---- - 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Trap.E) Undrqrn- ' 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 - 13. Rough Plumbing} :("/ / _�� - - Plumbing System_ - 1.4. Rough Electric -Conduit -- -.-._ - .- -56. Electrical -Final 15. Rough Electric -Wiring - - -- - - - 57. Solar System -Final _ 16. -Rough Heating.& Air Conditioning b8. Fencing,& Access Approval 17. Ducts in Structure,, .' • �' APPROVED FOR PLASTERING 18. 19. 20. Ducts, Ventilating Gas PiPe-Rough &Test Roof Framing - 60.`POOL/SPA ' SYSTEMS FINAL. s- 21. 22. Roof SheathingI Frame and Flashing --- - '' •' I I ' -- -_ •i r.. . .. ... •c. - NOTES: 23. Insulation �• T o �- >,' 24. Lathing& Siding i 25. Drywall Nailing 26. Plaster Brown Coat - - 27. Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning 30. 31. Final Gas Pipe -Test Final Plumbing - - - ' - - 32. Water Service -Final '- - - 33. Gas Service -Final 34.Solar Domestic -Final 35. Landsca e Sprinkling System - 36. Sound Attenuation 37. Handicap Regulations -- - _ 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co.- ' 42. CERTIFICATE OF OCCUPANCY No Date - - - - Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. +ClfY4F COSTAMESAPERMIT NO. TRACT NO. LOT NO. BLDG. N . - - - CONSTRUCTION CONSTRUCTION PERMIT - 1 p TYPE OF CON TRUCTION EW OF CON ❑ ALTERATION - EPAIR ❑CONVERSION ❑DEMOLISH ❑ OTHER C/� /l) A ✓ 1 1 - , f 9494 J 2/1 4I B I 35.00 '- ZONING REGULATIONS' •Project Address s Phone - Address - •- Arch/Eng. - License No. DESCRIPTION OF WORK - ---BUILDINGTpg TYPE GF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCT AL - s ❑ TENANT ❑ ELECTRICAL' ❑PLUMBING MECHANICA A.P. � ' ZONE - PLNG. REF. � ' ILDING SETBACK L ST. PROPERTY LINE SIEDE YARD - - ' LIDE VA - -- Address - - - Contractor 4 a. 'Phone Addres •' tffi( � LICENSED CONTRACTOR:DECLARATION that I licensed 1 hereby affirm am under provisions of Charter 9 (com- lancingwith section 7000) of Division 3 of the Business and ❑ OTHER RIGHT - - - Professions Code and my license is in full force and effect. REAR YARD TOP ( /L) � .�,., p r— PROJECT DESCRIPTION _ License Class _Se_@LL�'� LiS9pse No } _ _ PKC. SPACE REQ: � � _ -PROVIDED Date I;)- I I Sig nat.ra- 1[ld(v n /�I Q.�./ SQ.. FT. WORKERS' COMPENSATION DECLARATION - f OCCUPANCY=CONSTRUCTION TYPE STREET WIDTH PARK FEE I hereby affirm that 1 have a certificate of consent to self -insure or a VALUATION ZONE ZONING APPROVED BY DATE certificate of Workers' Compensation Insurancecertified copy SPECIAL CONDITIONS:' ' thereof (Sec' 8 b. C.). rN/wl'I/��II{�1�.l. GRADING CU. YDS. ACRES Policy No. Company :. - REMARKS: - - - I Certified copy is hereby.furnished. r ._ Certified copy is filed with the city Building Division. vrAr •, • EMPTION-FROWWORKERS' COMPENSATION DECLARATION (This section. need not be completed if the permit -is for one hundred or less). - - ""- - - -- J.$100) .certlfy that in the performance of.the work for which this permit is issued, I Shall not employ any person in any Tanner so as to become PLUMBING _ PLAN CHECK-- - - - - ELECTRICAL PLAN CHECK subject to the Workers' Compensation Laws of California. BATHTUBS SHOWERS - - Date Signature NOTICE: If after making this declaration, you Should become•subject -TOILETS URINALS GENERATOR -- 0-1 KW_ 1-10 KW 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 10-50 KW -50 + KW revoked. . - _ . ._ __ CONSTRUCTION LENDING AGENCY KIT. SINKS -'_ DISHWASHERS 'MOTORS 0-1 HP -1-10 HP' I hereby affirm that there is a construction lending agency for the per -(INC. SINKS SUMPS — - - UNC. SOLAR) 10-50 HP 50 + HP ' formance of the work for which this permit is issued (Section 3097 S FLOOR SINKS FLOOR DRAIN - "- FIXTURES OUTLETS -SWITCHES Civ. C.). ' Lender's Name Lender's Address -DRINKING FOUNTAINS - GAS TUBE SIGNS - — INTERCEPTORS CLARIFIERS - - POLE LIGHTS - .OWNER BUILDER DECLARATION - - I hereby affirm that I am exempt from.the Contractor's License Law for SWIMMING POOL PTRAP-I lull POLES- METERED -SUB.--- the following reason (Section 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 re- WATER SERVICE ALTERATIONPANELS MAIN SUB quires the applicant for such permit to file a signed statement that he GAS SERVICE OUTLETS - SERVICE -- - - - _ AMP - - - is licensed pursuant to the provisions of the Contractor's License Law- (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT '- - - business and Professions Code)'or'that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS - - any applicant for a permit -subjects the applicant to a civil penalty not more than five hundred dollars ($500). SOLAR TANK' COLLECTORS - - - I, as owner of the property, or my employees with wages as their' .e 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 who builds or improves thereon, and who does such work himself or - ISSUE FEE - APPLICATION APPROVED BY DATE ^ through his own employees, provided that such Improvements are not MECHANICAL AN CHECK SUMMARY OF FEES Intended or offered for sale. If, however, the building or improvement Is sold within one year of completion, the owner will have the burden %} of proving he tlitl not build or improve for the purpose of sale). HEATING SYSTE 100,000 BT �A a py BUILDING PERMIT $ SMIP $ ❑ 1, as owner of the property, am -exclusively contracting with AND DUCTING licensed contractors to construct the project (Section 7044, Business 0,000+BTU �� PLAN CHECK $ PERMIT and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who con- REFRIGERATIO 0- 00 000 BT 7/,� 0 PLUMBING $ ISSUANCE $ tracts from such projects with a contractor(s) licesned pursuant to SYSTEM /Zt- 'GRADING $ the Contractor's License Law). 100,000 +BTU {{{{((((�� PLAN CHECK $ ❑ 1 am exempt under Section B. & P. C. for this ELECTRICAL $ $ reason BOILERS BTU - SYSTEM REPAIR, ALTERATION - PLAN CHECK $ MECHANICAL $ MICROFILM $ TOTAL FEE $ Dale - Owner 1 hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE �— , LESS AD - Information is correct agree to comply with all city and county PLAN CHECK- $ - VANCE PC $_ ' ordinances and State laws relating to construction, and hereby authorize I • • - representatives of �jhis city to enter upon the above mentioned 'f 3 . property for on uses. d FINAL FEE $ '--" Signature Date Drivers' License or SS ISSUE FEE- - - - -Apr CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING " ' APPROVALS Permit - _-Zoll # Date Inspector - POOL & SPA Per �• APPROVALS #� - - Date Inspector - - Pate �•) C� 1. Temporary Electrical Service or Pole 1 ,'.'. iZ 43. Pool & Equipmept Location f 2. SoilPipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-,Undrgrn _ 46. Electrical Bonding 5. Steel ein orce ``� 47. Rough Plumbing & Pressure Test _ '-r_' r t • `f !-I 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE""- -�" "' z! 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation - 50. Gas Pipe, ❑ Undr rn, Test ._ 9. Water Pipe-Undrgrn. 51. Backwash Lines P -Tray 'E1 ndr_rn 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 i 13. Rough Plumbing , _ _ - - _ Final 14. Rough Electric -Conduit - ^56. Electrical -Final - 15. Rough Electric -Wring - - - - 57. Solar System -Final - - 16. Rough Heating "& Air Conditioning - - f --I( - Fencing &.Access Approval 17. Ducts, in Structure _ APPROVED FOR PLASTERING • 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL ' •• 19. Gas Pipe -Rough & Test - 20. Roof Framing - 21. Roof Sheathing- --- NOTES: „p 22. Frame and Flashing - 23. Insulation - No -°•aZ•w`� �� c, -( 24. Lathing & Siding - - - - 25. Drywall Nailing - - -. - 26. Plaster Brown Coat 27. Electrical Power Meter -Final _ 28. Final Electric 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 STRUCTUR E & BUI LD I NG r`• 39. Special Requirements Completed - 40. Electric Release .to Ediso p'_ 41. Gas Release to Southern California Gas Co. 42i-,rCERTIFICATE OF OCCUPANCY No Date "�`,� -r -. vv• r �..t\,.' .. ,,�-,r-� Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. . CJTY,OF�COSTA MESA PE IT QLO✓ TRACT NO. LOT NO. BLDG. NO. 2B0B 3/03/82 5.00 CONSTRUCTION PERMIT _ ve�[6/ cSJ TYPE OF CONSTRUCTION _❑ NEW ❑ADO ❑ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER ZONING REGULATIONS Project Address ;Z 5— �SC/iRQ n-1 Owner ;DZ/s/ Phone Address /5 /j/ / . Arch/Eng. License No. DESCRIPTION OF WORK A.P. ¢ + ZONE PLNG. REF. W- ,Address - Contractor- - ��„�,.�r3 �.; - Phone^J 3 TYPE OF PERMIT t ❑ GRADING --,0 FOUNDATION _D STRUCTURAL " _ ❑ TENANT ❑ EL'ECTRICAL ❑PLUMBING ❑MECHANICA SETBACK I YARD Tp g�/ �p PROPEI RTV LINE - -'- _ Address Q Si -',(1e/' Z/P&O 81f LICENSED CONTRACTOR DEC L'ARATION 1 hereby affirm that I am licensed under provisions of Charter 9 (com- mencing with -section 7000) of Division -3 -of the Business and ETOTHER- Professlons Code,'and my license is In full force and effect. ;I ( REAR YARD (TO P/L) •• 3 PROJECT DESCRIPTION _ -' _ License Class ansa No. SQ_FT. '• '' _ �_ _ - 1, _ PKG. SPACE REQ. PROVIDED ? '3 L Date Si9nat ur- CCVPANCY_ CONSTRUCTION TYPE I STREET WIDTH PARK FEE S WORKERS' COMPENSATION ARATI = - -- - If hereby affirm that I have a iflcate of nsent to self -Insure ora VALUATION ZONE (ZONING APPROVED BY ` DATE certitinate"of'Worker5'"Com nsatlon In once, or•a certified GRADING -CU. YDS. ACRES SPECIAL CONDITIONS: thereof (Section 3800, Lab. C.). - ,�_y No. _ - _ r _. _Company _ .. _ W tltietl copy is hereby -furnished. REMARKS: 0 L rlified copy is tiled with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit Is for one hundred _ _•._ _ .- _ _ _..__.. -. _ .. . _ ^ _ _ "' , SE300) or less). _ certify that in theperformance 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 PLAN CHECK . - subject to the Workers Compensation Laws of California. BATHTUBS SHOWERS Date Signature NOTICE: It after nicking this declaration, you should become subject TOILETS', ^'URINALS - — "!GENERATOR'- - 0-1 KW_ 1-10'KW ' to the Workers' Compensation provisions of the Labor Cotle, you must _ TRANSFORMER s• forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVs APPLIANCE APPLIANCE 10-50 KW -50 + KW - revoked. - -- - • . -- __-.. CONSTRUCTION LENDING AGENCY _. _ KIT. SINKS DISHWASHERS_ _ - MOTORS 0-1 HP_1-10HP - I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS SUMPS - (INC. SOLAR) 10-50 HP 50'+ HP -- - - - formance_ Of the work for which this permit Is Iss uetl (Section 309] FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS" SWITCHES - • Lentler's Name Lender's r's Lender's Address DRINKING FOUNTAINS'GAS TUBE SIGNS OWNEWBUILDER DECLARATIONi -- -- -"'-�A INTERCEPTORS CLRIFIERS --- POLE LIGHTS - - - - hereby affirm that I am exempt from the Contractor's License Law for SWIMMING POOL P TRAP he following reason (Section 7031.5 'Business and Professions Code: Any city or county which requires a permit to construct, alter, POLES METERED ISU13 WATER SERVICE ALTERATION - PANELS MAIN SUB, - inn p rovo, demolish or repair any structure, prior to Its issuance, also re. qulres the ap,.licant for such permit to file a signed statement that he _ GAS SERVICE OUTLETS - SERVICE - -' - "AMP," Is licensed pursuant I-o"the provisions of the Contractor's'License Law- E--_- 1Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT - - - - Business and Professions Code) -or that he Is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by _ SEWER CONNECTIONS - -- -- alz_:S_ nplitanl for a' permit 'subjects -the applicant to a civil' penalty o^--;"-: more than It" hundred dollars ($500). _ _ SOLAR TANK COLLECTORS owner of the properly, or my employees with wages as their sole co m pen Ion will do the work, and the structure is not Intended Or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SVS _ ISSUE FEE - r rr Contractor's License Law does not apply to an owner of a property _ __ _ ISSUE FEE I APPLICATION APPROVED BY - - -- -' DATE -' who builds or Improves thereon, and who does such work himself or through. his own omployee5, provided that Such Improvements are not MECHANICAL PLAN CHECK SUMMARYOF FEES Intended or offered for sale. If, however, the building or Improvement Is sold withln.one year of completion, the owner will have the burden sBUILDING "--- ' of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU - `' - - SMIP $ I, -as owner of the property; am exclusively contracting with 'AND DUCTING - ,PERMIT .$ _ licensed contractors to construct the project (Section Business 100,000+ BTU - (PLAN CHECK $ • PERMIT d es not and Professions Code: The Contractor's' Law does not apply to - - �� ISSUANCE 'S proveso owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU -PLV MBING E deet Itr a contractor(s) Ilceined -pursuant t0 tracts SYSTEM - - 'f - GRADING S actor's censeProjectsLaw).h the Contractor's License Law). 100,000 +BTU .PLAN CHECK E' 91 am exempt under Section ' 8.8 P. C. for this BOILERS BTV$ ELECTRICAL E reason'- - - REPAIR, ALTERATION PLAN CHECK $ •MECHANICAL MICROFILM E - Date- - - Owner O - - SYSTEM EXHAUSTSYSTEM MULTIPLE E TOTAL FEE $ ' •' LESS AD- certify that I have read -this application and state that the above information Intormallon is correct. I agree to comply with all city and county PLAN CHECK E VANCE PC E_ ordinances and state laws rataflog t nstruction, and hereby authorize - representatives of thcity t ter upon the above mentioned property. or .inspe Qn. our _ 1 r t D a Signature ,..,� Date-� ISSUE FEE - ) - - - - FINAL FEE E • - - - • Drivers' Lic CMF 086K.46 ite-Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor TL CONSTRUCTION AND PLANNING ')-i APPROVALS Permit # B`15 Date Inspector Z • .� POOL &SPA APPROVALS Permit # • Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location' • ' -• - ' ' •- - -- - 2._ SoilPipe-Undrgrn 44. Steel Reinforcement ---• -' - - -' - 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn _ 46. Electrical Bonding Steel ein orce 47. Rough Plumbing & Pressure Test - - 6. Electrical UFER Grn _ _ 48. APPROVAL TO COVER-GUNITE --- - -'-••- - 7. Footings 49. Electrical Conduit-Undr rn - _ 8. _Foundation, _ _ _' _ _ - 50.. Gas Pipe, ❑ Undr rn, Test 9. - Water Pipe-Undrgrn 51. Backwash Lines P-Trap.Ej Undrcirn - - 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, 13. Rough Plumbing -- '- - - - - - - 14. Rough Electric -Conduit 1 - --- - 56. Electrical -Final - 15. Rough'Elect6c-Wiring '- - -- - - - 57. Solar System -Final •' 16. - Rough Heating & Air Conditioning - _ - encing & Access Approval 17; Ducts in Structure APPROVED FOR PLASTERING . 18: Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL - - 19. Gas Pipe -Rough & Test _ 20.. Roof Framing 21. Roof Sheathing. , NOTES: 22. Frame and -Flashing _ 23. Insulation 24. Lathing & Siding 25. - Drywall Nailing 26. -Plaster Brown Coat 27. Electrical Power. Meter -Final 28. Final Electric - 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test y2 - 31: FinalPlumbing 32. Water Service -Final ' 33. Gas Service -Final t • - 34. Solar Domestic -Final ' 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations - 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison - - - 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date - --�- Applicant l0 fill in all spaces within heavy border lines and sign all appropriate declaration'. CITY OF COSTA MESA PE IT NO. TRACT NO. LOT NO. BLD . NO. ' CONST/j,UCTIONPERMIT — y-� G•S TYPE OF CONSTRUCTION � NEW 13 ADD ❑ALTERATION REPAIR ❑ CONVERSION ❑DEMOLISH ❑OTHER 1689 2/04/82 83.82 I - ZONING REGULATIONS Project A.0 Owner� Phone Address Arch/Eng. License NO. Qp�sEr-�SCRIPT ON OF WORK n dw 10{.1 � �IG t�� - TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION X.$TRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHANICA - A.P. � ZONE PLNTGp. gRlE1F�. p� BUILDING C 5T. PROPEIRTVNU NE SETBASI OF YARD L$IEpE y Address 7�_ Contract. ffp as Phone '` Address 1 LO j e0Y i LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under Of Charter 9 (com- provisions mencing with section 7000) of Division 3 of the Business and ❑ OTHER RIGHT Professions Code, and my Ii Is In full force an tl elect. REAR YARD (TO P/L) � (0a Vs PROJECT DESCRIPTION Licensey Class 1141 -As !o. PKG. SPACE REO. ED PARK Date u`V SSI Z 51 t F`i g d 50. FT. STREET WIDTH F PARK FEES WORKERS' COMPENSATION DECLARATION OCCUPANCY CONSTRUCTION TYPE I hereby affirm that I have a certificate of consent to self -Insure or a VALUATIONIn C) ZONE ZONING APPROVED BY DATE certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C.). GRADING CU. YOS. ACRES SPECIAL CONDITIONS: Policy No. Company -vtified copy is hereby furnished. REMARKS: :rtlfied dopy is filed with the city Building Division. -. "EMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit is for one hundred ($100) or less). 1 certify that In the Performance of the work for which this permit is PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK Issued. I Shall not employ any person in any manner so as to become subject to the Workers Compensation Laws of California. BATHTUBS SHOWERSSO FT Date Signature NOTICE: If after making this declaration, you should become subject TOILETS URINALS GENERATOR 0.1 KW KW to the Workers' Compensation provisions of the Labor Code, you must -1-10 TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE 10.50 KW -50 + KW revoked. KIT. SINKS DISHWASHERS MOTORS 0.1 HP -1-10 HP CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the per. SERVICE SINKS SUMPS (INC. SOLAR) 10-50 HP 50 + HP formance of the work for which this permit Is Issued (Section 3097 FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES Civ. C.). - Lender's Name Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS - OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for INTERCEPTORS CLARIFIERS POLE LIGHTS the following reason (Section 7031.5 Business and Professions Code:SWIMMING POOL PTRAP Any city or county which requires a permit to construct, alter, _ POLES METERED SUB WATER SERVICE ALTERATION PANELS MAIN SUB Imp rove, demolish or repair any Structure, prior to its Issuance, also re. quPes the ap, Iicant for such permit to file a Signed statement that he Is licensed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS SERVICE AMP (Chapter 9 (commencing with Section 7000) of Division 3 of the usl.ess and Professions Code) or that he is exempt therefrom and the WATER HEATERS BTU OUTPUT - basls for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS ar" applicant for a Permit Subjects the applicant to a civil penalty c ' more than five hundred dollars ($500). SOLAR TANK COLLECTORS L as owner Of the property, Or my employees with wages as their Som Compensation, will do the work, and the structure is not Intended or offered for sale: (Sectlon 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE Contractor's License Law does not apply to an Owner of a property ISSUE FEE APPLICATION APPROVED BY DATE who builds or Improves thereon, and who does such work himself or through his nw. employ..,, provided that such Improvements are not MECHANICAL - PLAN CHECK - SUMMARY OF FEES Intended or offered for sale. If, however, the building or Improvement Is sold within One year of completion, the Owner will have the burden nn of proving he did not build or Improve for the purpose of Sale). HEATING SYSTEM 0.100,000 BTU - BUILDING 50 PERMIT �U SMIP ❑ 1, as owner of the property, am exclusively contracting with AND DUCTING $ $—_ y� licensed contractors to construct the project (Section 7044, Business 100,000 + B $TU PLAN CHECK 3.2 az PERMIT and Professions Code: The Contractor's.License Law does not apply to ISSUANCE Is 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) Iicesned pursuant to SYSTEM - - GRADING $ the Contractor's License Law). 100,000+ BTU - PLAN CHECK_ $ ❑ I am exempt under Section -B. 6 P. C. for this- $ t BOILERS BTU_ - ELECTRICAL $ reason ALTERATION - PLAN CHECK $ MICROFILM $ Dale Owner SYSTEM REPAIR, EXHAUST SYSTEM MULTIPLE - MECHANICAL $ TOTAL FEE $ LESS AD- I hereby Cereat I have read Is ap ication antl state hat the above Informatiorrect. I ree c pl with all ci and county PLAN CHECK $ $representat ordinancesle 1 s tln o c str tion and he by authorizeVANCEPC th i ant on the ab0nt Oetl -- propertyfects n r s - L 83.g,Z, Signal ufe Date - FINAL FEE $ Drivers' License or , ISSUE FEE CMF 0865--16 White -Building; Canary.Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING F-0257 7�� Date APPROVALS Permit # F�coC� `�` Inspector POOL & SPA ', - ,i -' 0,,0 'gate ` - Inspector APPROVALS Permit r 1. Temporary_ Electrical Service or Pole _ ,43. Pool & Equipment'Location - - 2. . Soi ,pe-Un rgrn.'--:_. - . .- _ _ _ 44. Steel Reinforcement- 3.- Electrical Conduit Utility-Undrgrn _ 45. Forms 4.- -Electrical Conduit-Undrgrn -_ - _ _ - - . - _ 46. Electtical Bonding - - - - - - ... tee em orce. .47. Rough Plumbin & Pressure Test-6. Electrical UFER Grn-Y.. _-. _ 48. APPROVAL TO COVER-GUNITE - - - 7. -.Footings - . __ _ - _ 49. Electrical Conduit-Undr rn ' B. Foundation-- - •- - - - •--- - 50. Gas Pipe, ❑Undr rn, Test -- 9.--Water Pipe-Undrgrn- -- _ - 51. Backwash Lines P-Trap.0- ndr-- 10: Structural Floor System - 52. AP.PROVALTO DECK - 11. Property Sewer Line -&.House Connection - - - - 53: -Backwash & Receptor-Final 12:---Sweet Sewer Connection - - 54. Heater & Verit•Final 13. Rough Plumbing- ' 14. Rough Electric-Conduit - " - - 56. Electrical-Final ' 15. Rou h Electric-Wiring i - - 57. Solar System-Final ' 16. R.,ugh Heating & Air Conditioning 513. Fencing & Access Approval 17. Ducts in Structure - - - - -3T APPROVED FOR PLASTERING 18.- Ducts, Ventilating-- 60. POOL/SPA SYSTEMS. FINAL 19. Gas Pipe-Rougti_&Test - -- 20. Rcrof Framing 4 21. Roof Sheathing - e NOTES:' 22c -Frame and Flashing - - - 23. Insuiatfon- 24. 1,4 Siding L jhit-g 25.• DiywatliJailin9 26.` Plaster-B,own Coat - - - - - - - - - ----- •- - • 27! -Electrical Power Meter-Final-- -- --- - - -- - - - - ' 28. Fwal Electric -- - - �• - -- - - -- - - - ,• -29: -Final Heating & Air Conditioning— - --- - - - - - - _ -- - - - - 30. Fina1 Gas Pipe-Test 31: - F nal PPluPlu.nbin9 -- - - '- - - ` 32. Water-Service=Final - - - - - •- - - 33. -Gas Service-Final - - - 34. Solar Do,nestic-;sinal 35. Landsca e Sprinkling System 36. Sound A tenuation - ---- _ - ' 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING- Rt/AIja- S -�•-�- ' 39. Spec ial•Fequirements Completed - _ _ _ I 40. Electric Release to Edison 41. Gs Rele se to Southern California Gas Co. I 42. CERTIF'CATE OF OCCUPANCY N•.- - - Date i, - ..71 Applicant to IIII'rma__- .thin hear' bd ,.as and sign all appro riategaGmfions. CITY OF COSTA MESA -� P¢ IT y �� TRACT NO. LOT NO. BLDG. NO. CONSTRUCTION PERMIT /J � [ l 353 1 9-1 ' 6662 I,O/ 15/81 4O3�o 1,4 7 Prpject„PdRU / • ri TYPE OF CWTRUC�TI9N Owner PhOn NEW DD ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER ZONING REGULATIONS Address 5 Q- KO Arch/Eng. cf4"PV�- 0. DESCRIPTION OF WORK A.P. Address%%ro % �f ��• - " ZONE PLNG. REF. iF —el—kT Contractor -Z) Phone. TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION YSTRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHANICA ACK I YARD a�OePUI IIyG 0k- Y LINE AddressSET Address i}m_c LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (com- 9I yq KU RIGHT �l mencln9 with section 7000) of Division 3 Of the Business and ❑ OTHER Professions Code, .and my license_ Is In full force and effect. REAR VARD (TO P/L) •� PROJECT DESCRIPTION _ License Cled. en No PKG. SPACE REO. PROVIDED ` Date Signature 1 + SQ. FT. - WORK S' M ENSATION DECLARATION OCCUPANCY- ONSTRUCTION TYPE _ STREET WIDTH -PARK FEES - 1 hereby affirm that I have a certificate of consent to self -Insure or a t� � ZONING APPROVE DATE $I certificate of Workers' Compensation Insurance, or a certified copy VALUATION ZONE thereof (Section 3800, Lab. C.). _ GRADING CU. YDS. ACRES SPECIAL CONDITIONS: _ rIlcy No. Company EC [iEQUIREMEPIT. rtifled copy is hereby furnished.— REMARKS: _ --' — - �� copy Is ed with the ity Building `COMPENSATION M �z'VZT —Zp 72 EXEMPTION FROMrtIfIecI WORKERS DECLARATION -- ((This section need not be completed if the permit is for one hundred 151001 or lessl. r V Y T II certiify 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 PLAN CHECK I subject to the Workers Compensation Laws of California. -_ BATHTUBS SHOWERS Date Signature NOTICE: If after making this declaration, you should become subject TOILETS URINALS GENERATOR 0-1 KW_ 1-10 KW to the Workers' Compensation provisions o the Labor Code, you must TRANSFORMER - forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE 10-50 KW_50+KW revoked. ' KIT. SINKS DISHWASHERS MOTORS 0-1 HP -1.10 HP CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agencyY for the per- SERVICE SINKS SUMPS, 'l (INC. SOLAR) 10-50 HP 50 + HP formance of the work for which this permit is Issued (Soctlon 3097 `. , Civ. C.)._ ` FLOOR SINKS G FLOOR DRAINS FI%TURES OUTLETS SWITCHES Lender's Name Lander%Address•-x' N ` , DRINKINGFOUNTAINS GAS TUBE SIGNS OWNER BUILDER DECLARATION 1 hereby affirm that I am exempt from.the Contractor's License -Law for, the following reason, (Section 7031.5 Business and Professions. Code: INTERCEPTORS CLARI'FIERS•1 ' � s :' POLE LIGHTS SWIMMING - TRAP Any city• or county which requires •a permit"tb construct,-- alter; - POOL^. 4P POLES METERED SUB Improve, demolish or repair any structure, Prior to its Issuance, also re- WATER SERVICE ALTERATION PANELS MAIN SUB quires the applicant for such permit to file a signed statement that he GAS SERVICE OUTLETS SERVICE AMP Is licensed pursuant to the provisions of the Contractor's License Law 2Chapter 9 (commencing with Section 1000) of Division 3 of the WATER HEATERS BTU OUTPUT uslness and Professions Code) or that he Is exempt therefrom and the bass for the alleged exemption. Any.vloation of Section 7031.5 by SEWER CONNECTIONS 7.9plira nt for a permit subjects the applicant to a civil penalty five q}^Y�+'•_or. than hundred dollars (5300). SOLAR TANK COLLECTORS Ls owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intendetl or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE Contractor's' Llce Ose Law does not apply to an owner of a property ISSUE FEE APPLICATION APPROVED BY DATE who builds or Improves thereon, and who does such work himself or through his own employees, provided that such Improvements are not I MECHANICAL PLAN CHECK - SUMMARY OF FEES Intended or offered for sale. If, however, the building or Improvement is sold within one year of completion, the owner will have the burden of proving he did not build or Improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU PERMIT G 6 /� ❑ I, as owner -of the property, am exclusively contracting with E347.oe SMIP E licensed contractors to construct the project (Section 7044, Business AND DUCTING 100,000 + BTU PLAN CHECK. E PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE E an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING E tracts from such projects with a contractor(s) licesnetl pursuant to SYSTEM GRADING E - the Contractor's License Law). ,- 100.000+ BTU�\ _j ', t,- ? PLAN CHECK $ , ❑ I am exempt under Section B. & P. C. for thisBOILERS BTU 'i� \ \� ELECTRICAL E $ reason - SYSTEM REPAIR. ALTERATION EXHAUST SYSTEM MULTIPLE PLAN CHECK $ MECHANICAL E MICROFILM E TOTAL FEE S LESS AD- Date Owner I hereby certify that I have r ad this appliwlion antl state that the above informatlon Is correct. I ree to comply with all city and county PLAN CHECK E VANCE PC $ ordinances ccs and ate laws r all ng ro construction an tl hereby authorize ordin ncs r ere the .- of this to enter, upon ab mentioned property or s ec Ion- o s %/ Signatur6 Catd ISSUE FEE FINAL FEE Drivers' License or SS CMF 0865-46 White -Building; Canary-APPlicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNG •. t, ' APPROVALS permit#� _ Date Ilspector �. -POOL & SPA - Date APPROVALS `. Permit# ` . I nrseotor+` 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - - -Soil Pipe-Undrgrn -; -'. - - 44. Steel Reinforcement i 3. Electrical Conduit Utility-Undrgrn 45. Forms _ 4. Electri_cahConduit-Undrgrn j 46. Electrical Bonding 5. Steel em orce - 47. Rough Plumbing & Pressure.Test - 6. Electrical LIFER Grn 48. APPROVAL TO COVER-GUNITE - 't 7. Footings.; - - 49. .Electrical Conduit-Undr rn B. Foundation - - - - - - -- 50. Gas Pipe, ❑ Undr rn Test 9. Water Pipe•Undrgrn 51. Backwash Lines P - Trap. ❑ Undrqrn- 10. Structural Floor System 52. -APPROVAL TO DECK - 11.' Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection 1 41 54. Heater & Vent -Final ' 13. Rough Plumbing _- -55. Plumbina System _ Ainal -14:- Rough Electric -Conduit 56. Electrical -Final" rq - 15. Rough Electric -Wiring-;- - -- - - _ 57. Solar System -Final , 16. Rough Heating & Air Conditioning '- ' _ _Fencing & Access Approval - - - 17. Ducts in Structure ; •i ' ' APPROVED FOR PLASTERING d 18. Ducts,_ Ventilating - 60. ., POOL/SPA SYSTEMS FINAL - 19. Gas Pipe -Rough & Test - 20. Roof Framing _ 21'. Roof Sheathing... a.. NOTES: , 22. Frame and Flashing - _gj / i 23. Insulation - -9-1 /1 f7 IA7, c1 evvS 24. Lathing &Siding ?✓17p C,04 25. Drywall Nling - Lsc cC - 26. Plaster Brown Coat ^/0' $ 2 R - L! +V! i ,. O J'XA OA, 27. Electrical Power Meter -Final 28. Final Electric ' • 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. Landsca Sprinkling System _ 36. Sound Attenuation 37. Handicap'Regulations 38. FINAL STRUCTURE & BUILDING S 82 39. Special Requirements Completed L - -- " 40. Electric Release to Edison - - - - -- 41. Gas Release to Southern California Gas Co. - 42. ' CERTIFICATE'OF OCCUPANCY No�.�r./ g Date 5 r City of Costa Mesa Development Services Department Building Safety Division CERTIFICATE OF OCCUPANCY No. 000274 P. O. Box 1200 Costa Mesa, California The Building located at 245 Fisrhar Wtzitue $D-2 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group 17-7 Occupancy. Use of Building_ Tn*prier Al}oral-i enc — (lfficp Legal Description a97-n't't—n7 .(See reverse side for Metes and Bounds) - I-3532 1-3532 P-6669, I-3532 Building Permit No BL? -3532 Electrical Permit No. BPP -3532 Plumbing Permit No. BIP -3532 Mechanical Permit No. M-6759 Number of apartments -0- anndd//or guestrooms-� ISSUED TO: Building OfOfficial �/rl�/J� dol liam Properties by / m L- 1517 1517 Fairview Road, Santa Ana, CA ' 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 Ono Applicant to fill i�paces within heavy'bdttl er lines antl sign a ppropriate declarations. CfiY OF COSTA MESA - P,� NO. TRACT NO. LOT NO.DG. NO. � �Q-_Ji - - 6333 5/25/82' 388.25 CONSTRUCTION PERMIT LSC 3S37i j TYPE OF CONSTRUCTION NEW ' ❑ ADD C1ALTERATION,5W9 ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER > - - - - ZONING REGULATIONS Project Address . Q/ Owner- Pho Address ! Arch/Eng. - - License No. DESCRIPTION OF WORK - A.P. ,Q l ZONE •PLNG. REF. I Address - - - Contractor Phone - .TYPE OF PERMIT s^ .- ; S , \ c. ❑GRADINGµµµ ❑ FOUNDATION ❑STRUCTURAL IS�TENA.NT ,q ELECTRICAL-,�P LUMBING ❑MECHANIC - - 1 ING - SETBACK - - IMPOFY urvE 51D YARD . Address - - - __ .. LICENSED -CONTRACTOR DECLARATION ,1 hereby affirm lh4t I am licensed under provisions of Charter 9 (com- ,` . ' / ' s, RIGHT " meneing with section 7000)- Of : Division 3 of the Business and ❑.OTHER ` ' ' - s REAR YARD Professions Code. ,and my license is In full force and effect. ,Professions PROJECT DE CR� - (TOP/L) Class Utense No.- ��TION - 1 - PKG. SPACE REO.' Lf PROVIDED, ' - - - ': 50. FT. Date Signature - - ry, TVP STREET WIDTH' PARK FEES. (WORKERS' COMPENSATION. DECLARATION hereby that I have of consent to self-insure,or a OCCUPANCVQ=GCONSTRUCTION ZONING APPROVED BY Loo DATE •Z�J- g 1 affirm a certificate certificate -of Workers' Compensation Insurance, or a. certified . copy VALUATION �/IC260 ZONE -. .. -.... thereof (Section 3800, Lab. C.). GRADING CU., UDS. ACRES SPECIAL CONDITIONS: - - , cy No. Company O.. REMA R KS: P6%l64"Z'Irs-2- RCCC9 ..` -� -- — _ --^ f - .ertifietl copy -is hereby.(urnishetl. .. ... ,�Certified copy Is filed with the city Building Division. .jy EXEMPTION'FROM WORKERS' COMPENSATION DECLARATION -- - - - - - (This section need hot be completed if the permit is for one hundred. ($3001 or less). I Certify that in the performance of the work for which this permit is Issued.- I shall not employ any -person in any manner so -as to become 'PLUMBING - - . PLAN CHECK "' - - - ELECTRICAL - - 'PL -AN CHECK - - subject to the Workers Compensation -Laws of -California. - BATHTUBS - �" 'SHOWERS -- -- UAHAUL - '-SO ' - Date Signature FT 'NOTICE: If after making this declaration, you should become subject TOILETS, .:,URINALS GENERATOR-, 0-1 KW_ 1-10 KIN to the Workers' Compensation provisions of the Labor Code, you must TRANSFORMER - forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS - p' APPLIANCE ---30-50rKW_50 + KW - - - revoked. - _- CONSTRUCTION LENDING AGENCY KIT. SINKS - - - DISHWASHERS - -MOTORS- - 0-1 HP_1-30 HP - J 1hereby affirm that there Isoconslrucper lendingissueentyy fpr'the per:: SERVICE SINKS rr•..SUMPS -f y(INC. SOLAR). 30-$OHP=.-SO+Hp _ - formance'ol'the.work Jor,whlch,lhls permit Is`issuetl.,(Sectlon 309,7 -s't- FLOOR S - FLOOR DRAINS "- SINKS. FIXTS -OUTLETS S WITCH$ -- - �• - - ' ,Civ. CB. -•-. - , • c l11RE Lender's -Name - - - 'Lander's'Address, �• - - f - DRINKING FOUNTAIN , VC1 GASTUBESIGNS --- --- - - OWNER BUILDEf2 DECLARATION ••' -' •� ' '` �' - I hereby affirm that I,am exempt fromSheCo Attactor's License Law for- -INTERCEPTORS CLARIFIERS, - �• - -1 �- POLE LIGHTS - - - - - - SWIMMING POOL `-P'TRAP Ing folfowing.reason (Section 7031:5 Businese and'Professions Cotler Any.,_city7or county which retuire5. a. permit to construct kalter, - POLES METERED SUB SERVICE `t'•'ALTE RATION - 'PANELS 'MAIN SUB "p rove, demolish or repair -any structure,-prlor to Its Issuance, also re• 0WgTER ire$rt i[.to he pi for such pegmlile,a signed. statement thagha is licensed -pursuant to the provisions of the -Contractor's License Law GAS SERVICE`OUTLETS - _ SERVICE -- - - - -- AMP- --- - - ((, Chapter9- (commencing with Section 7000) of Division 3 of the Eusiness 'WATER HEATERS BTU OUTPUT - - - - - - - - - -- antl Pro4essions-Cotle) or that he is exempt therefrom and the •sis for the alleged exemption. Any violation of Section 7031.5 by SEWERCONNECTIONS-- " - - - - - -- "-t' ------ - _-- - - _ e -applicant for a permit subjects the applicant to a civil. Penalty m npl<pre than five hundred, dollars (5500):- . }. ;,v SOLAR TANK - _ -COLLECTORS d 1, as owner of°the'property,'or my employees with wages as their sole,compedsation, Will dolthe work,.and.the structure is not Intended or,offered for sale. (Section -7044,-Business.and Professions Code: The SOLAR PIPING SVS. 1 �- - ' 'ISSUE FEE �Conlractor's License. Law does not apply to -an .owner. of a property( who builds or Improves thereon, and who does such work himself or _ ISSUE FEE -- J � :APPLICATION APPROVED BVti$. DAT - 8 / through his Own employees, pprovltl¢d that such Improvements are not MECHANICAL PLAN CHECK - SUMMARY OF FEES intended or offered for sale. If, however, the building or Improvement Is -sold within one year of completion, the Owner will have the burden 1 roving he did not build or Improve for—the purpose of solo). _ HEATING SYSTEM 0-100,000 BTU _ _ PERMIT G E 3��. oo i.SMIP• ?•,$ I -as ownor_.ol the property, -am .exclusively contracting with - AND DUCTING (used contractors to tothe project (Section 7044, Business 100,000+BTU CHECK $ PERMIT- '. and Professions Code: The Contractor's License Law does not apply to ,PLAN _ _ - ISSUANCE-$ an owner of property who builds or Improve$ thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ • OO tracts from such projects with_a contractor($) licesned pursuant to. SYSTEM - - - - - - GRADING` $ t the Contractor's License Law). 100,006+ BTU' PLAN CHECK S - ❑ 1 am exempt under Section"'- B. 6-P. C. for this BOILERS BTU LECTRICAL ELECTRICAL- season season - .. .. _ _ ._ SYSTEM REPAIR, ALTERATION ( EXHAUST SYSTEM MULTIPLE _ _ . MICROFILM $ _ 'PL -AN CHECK 'E - - - - MECHANICAL ll - - TOTA L'FEE $ LESS•AD- Dat¢ Owner 1 hereby certify that I have read this application and state that the above Information is correct. I agree to comply With all city and county T ;PLAN CHECK E VANCEPC $-' ordinances and state law$ relating to c nsI tion, and hereby authorize- representatl of Wis cit o e r upon the above mentioned property f 1 sped io as _ , / .t ` �j-•� ` J �•` FINAL FEE g �.�r Signature Dat¢3-lZ-�SY ISSUE FEE J b,iwls' License Or SS CMF 0865-46 White -Building: Canary -Applicant: Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # 6 ,�;3 Date Inspector POOL & SPA -Date Inspector APPROVALS.. - Per _ 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location` -- ' - --- - •- ' ' soil Pi -- • . 44. Steel Reinforcement _ - •• -- • - - 3. Electrical Conduit UbUty- ndrgrn. - 45. Forms - - - - 4. Electrical Conduit-Undrgrn _ 46. Electrical Bonding - -- - t-5--. St -eel Reinforcepv��_ �a 47. Rough Plumbing & Pressure Test 6. Electrical UFER._ n _ 48. APPROVAL TO COVER-GUNITE - - - _ 7. Footings _ _ , a,- 49. Electrical Conduit-Undr rn 8.- Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water-Pipe:Undrgrn 51. Backwash Lines; P-Tra - ❑ Undrarn -10. .Structural Floor System 52. APP OVAL TO DECK - - 11. Property Sewer Line & House Connection 53. :Backwash & Receptor -Final - .12. Street Sewer. Connection _ '' _ - 54. Heater & Vent -Final - 13. Rough Plumbing _ _ -' - - 14. Rough Electric -Conduit - - -56. Electrical -Final 15. Rough Electric -Wiring - _If_g" - 57. -Solar System -Final - - 16. Rough Heating & Air Conditioning 58. Fencing & Access Approval - 17. Ducts in Structure - APPROVED FOR -PLASTERING' 18. Ducts, Ventilating 60. -POOL/SPA SYSTEMS FINAL - 19. Gas Pipe -Rough &Test .- • 20. Roof Framing -- - - - - 21: Roof Sheathing - - NOTES:. -. 22.- Frame and Flashing '- 23. 'Insulation - - - - - - - - _ '► 24. -Lathing&Siding - - - -Ir 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power -Meter -Final - - - 28. Final Electric- 3 - • 29.- Final Heating & Air Conditioning 301 Final Gas Pipe -Test - _ - - 1 31. Final,Plumbing 32. Water Service -Final - (,,. 33. • Gas Service -Final - 6-�en 34. Solar Domestic -Final ' 35. Landscape Sprinkling System - 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING _ B 39. Special Requirements Completed - 40. Electric Release to Edison - 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No�17�5 7 .Date. , Z04 /"7 Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PER IT N TRACT NO. LOT NO: BLDG. NO. - 143.55 ,CONSTRUCTION PERMIT TYPE OF CONSTRUCTION 4- ❑ NEW ADD - ❑ ALTERATION f9, ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER - 9I i l 6/23/82 _ - - - - - - ZONING REGULATIONS' - Project Address L'4:rj 000W=__VZ_ Owner [/[-L� " QOR, -Phone '- Address _ _ _ Arch/Eng. t License No. DESCRIPTION OF WORK Si�R/!vK ' Q S -SP GE Z A.P. 9F -Q ' ZONE PLNG. REF. T- Address - -- - 1 -Contractor - f".. one- TVPE'OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL ❑'TENANT -b ELECTRICAL ❑PLUMBING. ❑MECHANIC - Tp BUILDING _ SETBACK T. PROPERTY LINE• - YARD Address G (e LICENSED CONTRACTOR DECLARAT N -, --- _- - I hereby affirm th:f I am licensed under provisions of Charter 9 (com- �' _ 5I E V RIGHT -- mencing- with section 7000) of ,Dl vlsi on 3 .of the .Business and . El OTHER- Professions Code, n) my license Is In full orb apd pfjgc,1 _ / � / - :PROJECT DESCRIPTION' REAR YARD (TO'P/L) _J �`(( License CI ss License N - -' •- - SQ. FT. - •• - - " PKG'. SPACE REQ. " "PROVIDED- - !7 Date� `""Signature - WORKERS COMPENSATION DECLARATION, - OCCUPANCY _G NSTRUCTION TYPE ' -. ST REET WIDTH PARK FEE $ 1 hereby affirm that I have a certificate of consent to Self -insure or a hereby affirm 'Copy _ VALUATION l� ZONE - ZONING APPROVED BY - - DATE - - - - - Workers' Compensation -Insurance,. or.a certified thereof Section 380p ��y ). ..=;r.v r, 2WG//Xr�K�comoanyl"/5$/O/✓ /N� !R GRA DING �CU. YDS. ACRES_ SPECIAL CONDITIONS: - - - - - - - y •entified Copy is hereby furnished. - - -_: REMARKS: •� '- - - - - —' .'Certified copy Is flied with the city Building Division. _ _ _ _ _ - r EXEMPTION FROM WORKERS' COMPENSATION DECLARATION This section need not be completed it the permit IS for one hundred , ... ($100) or less). ' I certify that in the. mance the work for which this permit - - Issued, Io ploy rs not employ any -person in any manner so as to become' e PLUMBING_ c - PLAN CHECK- - ELECTRICAL •- - PLAN CHECK - - - - the subject to the Workers Compensation Laws of California. BATHTUBS SHOWERS - - UWtcLLING UA - - - Date Signature NOTICE: If after making this declaration, you should become subject -TOILETS,,-URINALS-_ ,- - - - GENERATOR . 0-1 KW_1-10 KW' - - 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-- -.f-- - - APPLIANCE--- -10-50 KW_5o+KW _ revoked, KIT. SINKS - - - - -DISHWASHERS--- i -- - MOTORS- -- - 0-1 HP_1-1OHP" - - - CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the per. SERVICE SINKS - .,SUMPS-i(INC.SOLAR)- ---- - .10.50 Hf_ 50 + HP formance of the work for which this permit is issued (Section 3097 ,FIXTURES FLOOR SINKS ,� = - FLO OR DRAINS •-- - - ---OUTLETS- SWITCHES - -- - -- CN. -C.).- Lender's Name - _ Lender's Atltlress rs , ' "'- -DRINKING`FOUNTAINS - ---•• - --- GAS TUBE -SIGNS - -- - -. -,_� .. _ _ _ _ OWNER 96I11DER-DECLARATION--� = r :=`S_.'-�" ' _ •INTERCEPTORS -CLARIFIERS - �y -:POLE LIGHTS -•— - - -- - -- -' I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section. 7031.5 Business and Professlons.Code: 'requires -SWIMMING POOL- ;;P TRAP ---- - ' - - - ,POLES -'- METERED' ' SUB ' Any city or, county which at permit: -to construct, alter; 'WATER SERVICE`'k-' ALTERATION- - PANELS -- - MAIN SUB. - - Improve,' demolish or repair.any structure, prior to its Issuance, also re-- quires.the ap, licant .for such permit to file a signed statement that he.. - I - GAS SERVICE --OUTLETS"` - -' SERVICE- --.-•.. _ _.-'AMP -- ' 1s' -licensed pursuant to the -provisions of -the Contractor's License Law (Chapter 9s.(commencing wlth•Section '°7000) of Division 3 of the WATER HEATERS -t - - BTU OUTPUT !- - - - - s'• Business and Professions Code) -or that he -is exempt therefrom -and. the - 1- - for the alleged exemption. Any violation of Section 7031.5 by t-- SEWER CONNECTIONS --- -- 4 ipplicant-for a -permit subjects.the applicant. -to a_civil. penalty A more than five hundred dollars ($500). I� - SOLAR TANK- - - i^.COLLECTORS - �- -- - -- -- - - -_- ___. L, I', as owner -of the property, or my' employees with wagei•,as their sole compensation, will do the work, and the structure is not Intended or offered for sale. (Section' 7044, Business' and'Professions Code: The- SOLAWPIPING'SYS.' 1 --j; - -' _ i - _ ISSUE FEE - - - - - - - - Contractor's License Law does not apply to an ownerof a property ISSUE FEE -Z - - - _'�r - - --' - '.- _ : APPLICATION APPROVED BY - DATE. - - who -builds -or improves thereon; and who does�Such worWhlmself or through his own employees, provided that such -Improvements are not MECHANICAL - Y-. PLAN CHECK./`� r- 1 -- --` - SUMMARY OF�FEES intendedbr offered for sale. If, however, the;building or improvement Is sold within one year of completion, the owner will have the burden of -proving he did not build or Improve for the'purpose-of sale).''' _ - - -.ti - - 1 t BUILDING. pp/ _ ^: �•^ VIA ❑_I, -as. owner..ol. the property, am..exdusively contracting with HEATING SYSTEM 0-100,000 BTU r •PERMIT $� SMIP '•$� f licensed contractors to construct the project Section 7044, Business ( _ AND DUCTING - - 100,000+ BTU - -- - �' ... - _ - PLAN CHECK `$ PERMIT and -Professions Code: The Contractor's License Law does not apply to .J�• s' - an owner of property who builds or improves thereon, and who con- R REFRIGEATION 0-100,000 BTU I _ -ISSUANCE _$ 'PLUMBING $ tracts. -from such projects with a contractor(s) Ilcesnetl pursuant to SYSTEM - _ - -100,000'+BTU- c. GRADING' $' the Contractor's License Law). _ - 'PLAN CHECK IS -' -- - ❑ I -am exempt under Section- B. & P. C: for this BOI LERS BTU - - 'ELECTRICAL $ - $ reason- _ - - _ _ ' •MICROFILM'$ PLAN CHECK $ - Date Owner SYSTEM REPAIR, ALTERATION - EXHAUST SYSTEM MULTIPLE - TOTAL FEE 8 ' MECHANICAL $ - - - - -- AD - LESS AD- ' Ihereby certify that have read this application and state that the above Information is correct. 1 agree to comply with -all county PLAN CHECK S VANCE PC- $_ a ordinances and stale laws relating to construction, and hereby authorize hereby representstive spechis-city t en -upon the above-mentioned properly fo sspe�ct�l�o/n>o/��{��f(/�}/�s -; �� Signature rr "`•r-'��"��w '�¢~�_ CMF 0865-46 Write -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor TU CONSTRUCTION AND PLANNING APPROVALS Permit # �3I-A5 Date Inspector POOL & SPA,_ APPROVALS - Permit #4 - .Date. Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - 2.. .SoilPipe-Un rgrn - _ 44. Steel Reinforcement - - 3.- Electrical Conduit Utility-Undrgrn - 45. Forms -- 4. Electrical Conduit-Undrgrn _ ._.. _ 46. Electrical Bonding 5. Steel em orce - 47. Rough Plumbing & Pressure Test - - -. 6. Electrical UFER.Grn_ - -. 48. APPROVALTO COVER-GUNITE - - 7._ Footings 49. Electrical Conduit-Undr rn� ' - - - 8. -Foundation - - - - '-- - ..., 50: .Gas Pipe, El Undr rn, Test .9. -Water Pipe-Undrgrn _ - 51... Backwash Lines P-Trap.[I Undrorn - 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, 13. _Rough Plumbing 14. Rough Electric -Conduit _ -- -- - _ "' - 56. Electrical -Final" ' 15. Rough Electric -Wring " - '- - 57. -Solar System -Final _ 16. -Rough Heating & Air Conditioning =-- -- - - - - encing & Access Approval 17. Ducts, in Structure- - -- - - _ 9• APPROVED FOR PLASTERING ' 18:- Ducts, Ventilating 60. -POOL/SPA SYSTEMS FINAL. _. ..•�: •. - 19: Gas Pipe -Rough &Test- - - - - - -- 20: Roof Framing- - - -- - _ _ __ _ . _ - 21: - - - - - - - - Roof Shea thing - -- - - - - NOTES: ••. - _ - -- - - i�� 22. Frame and Flashing - - --- - _ _ _ 23: Insulation - - -- - - - - - -- - - - - 24. - Lathin & Siding - - - - --- -+ - - - - - G •- - - - - - - - & 25. Drywall Nailing - - - - - - - - - •• - 26! Plaster Brown Coat -- - - -- - - 27. Electrical Power Meter -Final - - - - - - - -JAAAA smg� 28: Final Electric - - --- - - 29. Final.Heating & Air Conditioning - - - -- - - 30: Final',Gas Pipe -Test 31. Final Plumbing 32: - -Water Service -Final • - -« - -- - - - --a 33. Gas Service -Final - 34. 35. -I Sol tic-Fina' pri nklin em 61 S st - 36. Sound Attenuation --- �•-_ - ' 37. Handicap Regulations 38. FINAL STRUCTURE&BUILDING - 39. Special Requirements Completed' 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY - No.- Date - - Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations ---CFMOF C9STA MESA ? 1 PERMIT NO. TRACT NO. LOT NO. BL(iB�J /1'/OTId3' i j�%.r(jy ITL - "'CONSTRUCTION PERMIT' ' i Applicant's Mailing Address j sR A : •ar TYPE OF CONSTRUCTION LJ,NEW I.LJ ADD U ALTERATION LJ_ REPAIR - '- •' .. i '. ' _ , SCh e -Z ❑ CONVERSION ❑ DEMOLISH ❑ OTHER, Project Address .S �d lel Aar* Phone Ssy ezLZ DESCRIPTION OF WORK - ING REGULATIONS Owners Neme S 1-7 "A) Fwf ✓ l ew• 54 Ar TA NII t Address, . TYPE OF PERMIT GRADING LJ FOUNDATION LJ STRUCTURAL A. P:=0 ZONE - ' Arch/Eng - ', ' License No. - ❑ TENANT 1:1 ELECTRICAL ❑.PLUMBING Ll MECHANICAL i PLNG. REF. -k- BUILDING ;qg�Rcr Address r El -OTHER PROJECT DESCRIPTION SQ. FT. TO BUILDING - PROPERTY INE • _ REAR YARD (TO P/L) i, L/p iIA: AT3 d A/4- Phone ' 0/j OCCUPANCY ' Contractors Name Address (mailing) �•y✓i/QAC L0 rh y01 IfA:),*he'M _ CONSTRUCTIONTYPF VALUATION $-- I _ LEFT SIDE YARD RIGHT SIDE YARD j/� 3'1 C/ ZONj= GRADINGCU.VDS. ACRES ' - PKG. SPACE.REO. PROVIDED License No. Y ' i - LICENSED CONTRACTOR DECLARATION- Remarks: _ C STREET WIDTH PARK FEE $ C 1 hereby affirm that 1 am licensed, under Provisions of Charter,9 (commencing with section 7000) of Division 3 of the Business and Protessic ns Code, and SPECIAL CONDITIONS: rEy license Is in full force andef/ect. License ClassO Uce o. lq? 3/% PLUMBING Date 4'' 31P - Signature Bar Sink, Sewer Cap ' i ELECTRICAL WORKERS' COMPENSATION DECLARATI N I hereby affirm that) have a certificate of consent to self -Insure or a certificate - Backflow Preventer Sewer Connection - .. - Automatic Washer '_ _ _ 'Meter Clover 100 amps ; of Workers' Co�npq(wygInsyranpe, or a certifi .copy thereof actio of W Lab, e. ( �j �/( is ra7,e ' Backflow Irrigation '- -_ Soler Coliector_s .' Construction Pole Sub Panel Policy No. Company copy is hereby furnished. I 1 , Bathtubs I - - Solar Piping ', Cooking Unit Sub Pole ' 1 ,RCertified uu�ccds1��1�� Cer 1 led op s.11led with the tityyy g DIVISio _ - Clarifiers '� Solar Tank Dishwasher - Motors 00A HP ❑1X$ Date ,. Applicant ' EXEM ION FROM WORKERS' COM ENSAT N DECLARATION I Dryers ❑Gas ❑Electric Ina.S0lar 09-15 HP El 16-15, - -- Dishwasher Swimming Pool w/$pe (ThiSseclion need not be completed If the perm Is for.one hundred ($100) or less): I 1- +.' -- Fan Microwave , I certify that In the performance of the work for which this permit is issued I In so as to become subject, to the Drinking Fountains „ Urinal - i f F.A.U. Pole shall not employ any person any manner Workers' Compensation Laws of California. 1 Floor Drainsy, Water Closet Light Date Signature '- Floor Sinks.' - - - -Water Heater- - 'Fixtures Range _ NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Cotle, you must forthwith comply with' such provisions •or -this, permit shall be deemed revoked. - Gas Service' •Outleis' ' Water Service - i" Device Boxes Sign I g CONSTRUCTION -LENDING AGENCY � Outletsi Standing Sections I hereby affirm that there Is a construction lending agericy for the'performance Interceptors '• ! of the work for which., this, permit is 'issuad -(Section -3097 Civ. C ; ti Switches ,Trash Compactor Lender's Name ` ' f - 'Lentler's Address • - OWNER:BUILDER DECLARATION - . -• Kitchen Sink _ - i - Garbage Disposal - Lavatories - r - •- , I hereby affirm that I am exempt -from the Contractor's License Law for theGenerator P.Trap• 00-5 KW El 5-15 KIN . following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct, alter. Improve, demolish or repair - Transformer 015.5 0 KW 1 _ - i! any Strutt cera' prior to Its Issuance, also requires the applicant for such permit' he/she Is licensed to thelprovisions Roof.Drains - - - 05U+ to file a signed statement -that pursuant of KW Reinspection Fee $15' the Contractor's License Law (Chapter 9 (commencing with Section 7000) of 'of " that. he/she Is i Showers ' Rein eetionlFee • $15- i W - 1 Division :3 the Business and Professions Code) or, exempt therefrom the basis for the Any violationof. Section .� - - - , Meter ❑up to 100 amps Fee $ 3 and alleged exemption: 7031.5 by any applicant fora permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:. r• 'Property 'or f Service Sink. _ _ Issue Fee "$ 3' Zoning Approved By ,Issue _ I Date LJ I, as owner of the my employees with wages as their sole MECHANICAL ' compensation will do the work, and the structure Is not Intended or offered for sale •(Sec/Ion 7044, Business and' Professional. Code: The, Contractor's /•; - Application Approved By 1 _ ' Date 1 ' •Datav Q License Law does not apply to an owner of a property who builds or Improves ed P P Boder - Refrigeration System t'—;(?13 g y Application Issued By ' ' - 1� thereon, and who or through his or her Own , work ove elms are or offered for that such improvements era not employees, that =Under &o-.100,000 BTU ❑100,000 BTU + I within one year of Im- ever,providedthe or Improvement is within o sale- If, however, the Ground Duct r SUMMARY OF FEES , r - pletlon, the owneriwlll have the burden of proving he/she did not build or Im- it havet g h for the Purpose of sale)'. ) i I Duct -Structural y System Rep it/Alteration 'n 1 r : BUILDING PERMIT $ i I SMIP $ F I, as owner of the property, am exclusively contracting with -licensed con- Fl. -. i • / tractors to construct.the,project.(Section 7044,.Buslness and Professions Code:. i. _ _ Duct -_Ventilating _ ` _ l .PLAN CHECK $ PERMIT .. The Contractor's License Law does not apply to an owner of property who I builds or Improves thereon, and who contracts for such projects with a con- - Exhaust System ❑ Multiple ❑ i I PLUMBING $ ISSUANCE, $ tractor(s) license pursuant to the Contractor's License Law). ; - CHECK $ t ' GRADING $ ❑ I am exempt under Section B. 6 P. C. for this reason ,. .. I Firepl/Fact. BIt. ICBO -0 ,PLAN i 1 i �; 'ELECTRICAL $-$ Date ' Owner' '- I I, Heating System &Ducting ' MICROFILM • - $ ' I• r ll -have read this to that -the above- thatorrect )40-100,000 BTU ❑100,000 -- - •PLAN CHECK $ i and comply with all city and county agry with all City Information Is correct, I agree o at on Is/ i !MEC' $ �j� TOTAL'FEE' � $ di riteordinances and state laws rotating to building ltlin9 constructiobove- hereby authorize repro- for Hood Or T e I ❑ $15• -�f— LESS i sentatives of;this'c y'to enters po the above-mentioned property Inspection purpos 1 Canopy. Type it ❑ i i ei cti ee PLAN CHECK i $ I i ' ADVANCED PC $ 579nature Date Registers Issua 3 Drivers' n or!SS . i I ee ,' i FINAL FEE: • • $ CMF 086546 rev. 12182 White - Building; Canary -Applicant, Pink -Accounting; Goltlenrotl -Assessor �- -- --------- -- --- - '.�'-'CONSTRUCTION+ANDPLANNING ------_*`: -----f--'-•-,n POOL.&SPA--- -- - - «. 'APPROVALS .- Permit#. = - -Date 1:'- Inspector - •-Date APPROVALS' 'Permit # - .Inspector _ J. 'r 1. Temporary,Electri6i Service 6r Pole - 2:' Pool &Equipment, Location , - ,off _3 2. boil Pipe-Undrgrnd. - - -,.�; . - _>�53.; SteelReinforcement - - _ c �- 3. Electrical Conduit Utilitv-Undrgrnd. .�• - �' ' 'o ,54 Forms _� '•' 4. Electrical Conduit -Undrgrnd�',J i 7 . 55.; Electrical,Boncli ng •: -- -- 5: Steel Reinforcement = I' _ 56: Rough Plumbing & Pressure -Test 6. ElectricalUFERGrnd. r �'< s_ -_ X57' APkOVALTOCOVER-GUNITE- , _- ;�.,-'y 7. Footings -58. Electrical Conduit-Undrornd. ' 8. Foundation _ - ' `� - _ .59. Gas Pipe; O Undrgrnd., Test - _. o 9. Water Pipe-UnBrgrnd. 60. Backwash Lines, P. Trap, 0 Undrgrnd. 10. Structural Floor System'- g; ; 61. APPROVAL TO DECK 11. Property Sewer Line & House„Connection' _ E' " X62. Backwash &Receptor -Final. 12. Sewer Cap ?63. Heater, & Vent -Final 13. Roof.Drains ., ;'r .-64. Plumbing.System -Final ... - 14. Rough Plumbing ' `- _," - �65. Electrica4inal - - 15. Rough Electrical:Condui£ 66; -Solar System -Final r -- - T" - •+ 16. Rough Electric.Wiring, . - i : '� 9 9 ; _'I' ' -1;� �,i c- n• '+ ' - - '67 Fencing &'Access Approval .1 •, - -- ' _17.,'R6u6h.Wiri6gSign _ ° �.; is , �? '68; APPROVED FOR PLASTERING' _ - 18; Rough Electrical-T'Bar Ceiling '' I E -169.! . PO ' - XOL/SPASYSTEMSFINAL _ . 1- - 19. Rough Heating & Air ;Conditioning ! FIRE DEPT.'REQUIREMENT - APPROVALS Permit # 2Q. Rough Factory Fireplace 1 121.•Ducts, in Structure! I e f I t I 70. Underground Hydro r22. Ducts, Ventilating ;- ' I ! I ! ,71. Product Piping []Gas 0Oil 23. Gas Pipe -Rough & Test . ! ! 72. Underground Flush L 24. Roof Framing: X73. Undergrnd. Storage Tank 171Gas _fl Oil, ' 1_ 7 1 C U 1 25. Roof Sheathing I ,. "- - i ., -' . �. • ± �74! O4erhead Hydro - 26. ,T•Bar Ceiling (Structural), & Monocoat,75: Dry Chernical 27. Frame and Flashing' , I ' ! i I ;76: Dry Standpipe - ' - 28. Lathing & Siding ,� ' ,I i I I i i 177. FIXED SYSTEM FINAL ; . 29. Insulation::- j 1 ) 1 FIRE PREY. FINAL '- 30. Drywall Nailing i I 178. (Notes: r31. Plaster Brown Coati - . + 32. Electrical Power Meter -Final 33. Final Electric 4 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test - 36. Hood orCanopy I 37. Final Factory Fireplace .�i �, 1 `• w I i , ' - i 38. Final Plumbing 39. Water Service -Final 40. Gas Service -Final I I , , 41. Solar Domestic -Final 42. Backflow Preventer I I , 1 ! I I _ _ 43. Backflow Irrigation 1 I I 44. Landscape Irrigation -System' - 45. Sound .Attenuation ;,- 46. HandicapRegulatiori'sl- t + 47. FINAL STRUCTURE!&BUILDING` 1 1 I I 48. Special Requirements Completed ' 1 • I _ , - 1 49. Electric ReleasetolEdison 50. Gas Release •Ito Southern California Gas Co 51. CERTIFICATE''OF OCCUPANCY l _. - - - _ _- __.L No i Date • CITY OF COSTA MESA, CONtTRUCTION PERMIT Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. PE IT NO.[[ // TRACT NO. .LOT NO. B IrrT "Applicant's Mailing Addran, - TYPE OF CONSTRUCTION LJ NEW LJ ADD LJ ALTERATION LJ REPAIR - ❑ CONVERSION ❑ DEMOLISH ❑ OTHER' ' Project Address •. Swlmml ng oo w pa 'Ile a signed statement that he/she Is licensed pursuant to the provisions of _ - - owner's Name Q' hone .DESCRIPTION OF.WORK Fan ' shall not employ any Person In any manner so as to become subject. to the . - - Address TYPE OF PERMIT GRADING FOUNDATION STRUCTURAL Water Closet I A. P.46 _ _ Arch/Eng. License No. ❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL Fixtures REF, ' Address - - ❑OTHER Workers' Compensation provisions of the Labor Code, you must forthwith -PLNG. aW MICROFILM TO BUILDING- Nmne f in �gy�/%6 Contractor's one ' - PROJECT DESCRIPTION SG. FT. OCCUPANCY $ PROPERTY LINE - LESS ! ', ADVANCED PC I. 1 p.r �s� Address (Mailing) n�/y 1) �"'S ^ ✓�' CONSTRUCTION TYPE VALUATION $ _ T LEFT SIDE YARD 1A21° ZONE—GRADING CV.YDS. ACRFc PKG. SPACE REO. License No: _I LICENSED CONTRACTOR DECLARATION Remarks: 3 STREET WIDTH ,-hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and 1 SPECIAL CONDITIONS: my license is In full rc a tl effect. ' �123 Z�' License Cl a s License N PLUMBING Data Signature f Bar Sink Sewer Cap 'ORKE RS' ION DEC RAT m that I ave or a affirm that I nave a certificate co [sent o SeB-ipy - - Backflow Preventer - - - - Sewer Connection - AutomatiE Washer ' , o Workers' Compensation Insurance,' or a cert)/led copy thereof (Settlon Workers t f (Section ' Construction Pole 3880, Lab. C. �1J'SO Backflow Irrigation Solar Collectors Policy No. �S Comet y - - - -- Cooking Unit Y' Ll Certified copy Is hereby furnished- Baihtubi Solar Piping Cer fled c y ,led with the City Bu g Dlvisio Dishwasher ate— Applicant Clarifiers Soler Tank " EXEMPTION FROM WORKERS' CO ENSA N ECLARATION h P I /S Dryers ❑Gas ❑Electric ' (This section need not be completed if a perm Is to one hundred ($100) or Dlsh Was er Swlmml ng oo w pa 'Ile a signed statement that he/she Is licensed pursuant to the provisions of to ss 1 cc 'that in the performance of the work for which this permit is Issued I Drinking Fountains Urinal Fan ' shall not employ any Person In any manner so as to become subject. to the $ - - F.A.U. Workers', Compensatlon' Laws of California.. Floor Drains , Water Closet I $ Date Signature $. ! — GRADING Fixtures NOTICE: If, after making this declaration-; you should become subject to the Floor Sinks Water Heater ' - •-' - - Workers' Compensation provisions of the Labor Code, you must forthwith $ MICROFILM Device Boxes comply 'with; such provisions or this permit •shall be deemed revoked. Gas Service Outlets' Water Service I $ CONSTRUCTION LENDING AGENCY - LESS ! ', ADVANCED PC I. 1 Outlets I hereby affirm that there Is a construction lending agency for the performance Interceptors _ T $ of the work for which this permit -.IS Issued (Section 3097 Civ. C.) "°"'.f AWNA MESA et REAR YARD (TO P/L) RIGHT SIDE YARD PROVIDED PARK FEES Meter LJover 100 amps.- Sub mps.-Sub Panel ' Sub Pole i Motors 00-1 HP 01X$ 'Inc.Solar 09-15 HP 015.15+ ;Microwave Pole Light Sections Lender's Name - _Kitchen,Si_nkl' / - ' I Switches , 'Trash Compactor Lender's Address - ' OWNER BUILDER DECLARATION I Lavatories p,i " '' Garbage Disposal I I ireby,affirm that 1 am exempt from the Contractor's License Law for the owing reason (Section 7031.5 Business ane Professional, Code: Any city or my which requires a permit to construct, alter Improve, demolish or repair structure; prior to Its Issuance, also requires the applicant for such parmlt p -Trap lr Roof. Drains' 'Ile a signed statement that he/she Is licensed pursuant to the provisions of Showers Contractor's License Law (Chapter 9 (commencing with.Section 7000) of ISIon,3 of the Business and Professions Code) or that he/she Is exempt 'efrom and the basis for the alleged exemption. Any. viola lon'o/ Section Service Sink _ 11.5 by any applicant for a permit ' subjects :the applicant to a civil ally of not more than five hundred dollars ($500). j I,' as owner of the'property or 'my employees with wages, as their sole $ t pensatlon, will do the work, and the structure IS not Intended or offered .' License Law does not apply to an owner Or a property writ, Dunes or Improves themon,'and who 'does- Such work himself/herself or through his or her own employees, provided that such Improvements are not intended or offeree for Sale. It, however, the building or Improvement Is sold within one year of com- pletlon, the owner,wlll have the burden of proving he/she did not build or Im- LJprove for the purpose of Sale). I, as owner of the property, am exclusively contracting• with licensed con- tractorsto construct the project'Section 7044, Business and Professions. Code: The Contractor's License law Sees not apply to an owner of property who builds or Improves thereon, and who contracts for such projects with a con- tractors) license pursuant to the Contractor's License Law). 1 ❑ Fam exempt under Section B. & P. C. for this reason I Date s f Owner' -1-hereby certify that 1 It 11 1. read this application antl state that the-above- In/ormation ii c rect. 1 agree to comply with all city and county ordinances. and:state levet ating to building construction ,'and hereby authorise reps santatNes of ,city to enter don int, above-mentionatl property for I inspection Our Signature Dat toiler.. ' )uct - Under Grou nd ' )uct- Structural )uct--Ventilating -- :xhaust System 0 Multiple Firepl/Fact. Bit. ICBO+ lasting System & Ducting , 30-106,00D BTU Ell 00,000 Hood or Type 1 0 Drivers' LI se or f& $ Registers CMF 0865-46 rev. 12/82 White - Building: Canary- Applicant; Pink - Accounting; Goldenrod - Assessor i Reinspection' Fee $15 _ Issue Fee $ 3 NNICAL 00-100,000STU 0100,o0OBTU I Reirrspectiori Fee' $15 Issue Fee $ 3 Generator 00:5 KW 05-15 KW ; Transformer 1315.50 KW ' 050+KW Reinspection Fee 515 Meter ❑up to 100amp5 Issue Fee$ 3 Zoning Approved By Date 1 , Application Approved By ate '/ p Application Issued By Date 3 .29e- -7 • SUMMARY OF FEES BUILDING PERMIT $ SMIP I $ . PLANCHECK $ '---- PERMIT .' 'PLUMBING $ ' ISSUANCE $ PLAN CHECK $. ! — GRADING $ ELECTRICAL $ - $ , PLAN CHECK $ MICROFILM $ MECHANICAL $ TOT A L;FEE j $ PLAN CHECK' $' LESS ! ', ADVANCED PC I. 1 ' $ , FINAL FEE- $ i ''� - r`-CONSTRUCTIOWAND'PL/Ap[�.-N�TN�G� , _ =. :POOL :PA'..-�_ �- -,� = - -- c�>� APPROVALS -Permit.#1---L2-L:-S.-1- -"bate v - Inspector _ - - - - • - ,`'APPROVALS Permit# _ Date Inspector 1: Temporary Electrical Service or?Pole - ` 52 Pool & Equ_ipment, Location �. z! Soil Pipe-Undrgrnd.- �' _:=•_ 1 53:; Steel Reinforcement - `- - - _ .- flT Electrical Conduitl7tility-Undrgind. _ .1...,- - 54.E Forms ° •'?- " . - - - - �) 4: Electrical Conduit-Undrgrndi= •- aZ . �:•;, : 55:. Electrical Bonding• - 5. Steel Reinforcement 56. Rough Plumbing:& Pressure Test- - 6. Electrical UFER Grnd. 57.1 APPROVAL TO;COVER-GUNITE 7. Footings; '= i _! _ Electrical Conduit•Undiorod. - n _-58.' - 8. Foundation •' .. - `' ' 59. Gas Pipe; O-Undrgrnb., Test - , 9. Water Pipe-Undrgind.60. Backwash; Lines, P•Trap, O Undrgrnd. 10. Structural Floor Sy"siem 61. APPROVA--LTO DECK • •t 11. Property Sewer Line'& House Connection r -62. BackwasH'&FReceptor-Final - 12. Sewer Cap ' o 63. Heater & Vent -Final _ 13. Roof Drains 1 . ` ' �: `64. Plumbing System - Final 14. Rough Plumbing .I i .• - '65. Electrical=Final •- - --- - 15. Rough -Electrical -Conduit '- -; •'„ (" i - , - - T' `66: Solar System -Final- - "• - - " 16: 'Rough Electric Wiring, i '. = -n g Access Approval & - - - _ 17. :Rough Wiring Sign;' 68.E APPROVED FOR PLASTERING _ - 1VRoughElectrical-TBar•Ceiling I ;, ';•`- 69. POOV$PASYSTEMS FINAL 19., R6 & Air Conditioning i = 1 I I I I FIRE DEPT.REOUIREMENT- - APPROVALS 1 i Permitl# 20."•R6ug'h_Factory Fireplace j I ! I 21. Ductsjn Structure I I 70.1 Urideiground Hydro ' N 22. Ducts, Ventilating .71. Product Piping Ll Gas C3 Oil 23. Gas Pipe -Rough & Test . r `� !• ,1 4 ; I 1 1 1 72., Undeiground Flush, 24. Roof Framing' ', •� .,:; ' I lro 1 __ j -7-3.1 Undergrrid. Storage Tank (3 Gas O.OiI' 25. Roof, Sheathing , ; I% - " I 1 , = I • 74.t Overhead Hydro 26. T -Bar Ceiling (Structural)'. & Monocok • I 1 1 ; 75. Dry Chemical , 27. Frame and Flashingi76. Dry Standpipe : - - 28. Lathing & Siding' 77. FIXED SYSTEM FINAL - 29_ Insulation,78. FIRE PREV, FINAL - '30. Drywall Nailing I I 1 i 'Noies:l I I • r. , 1 � I 31.'Plaster Brown Coat �.) , - r-'1- .} . - l -•- �- .. _ _ .._� - ' 32.1' Electrical Power Meter"FinalI 33. Final Electric it 34. Final Heating & Air. Conditioning - 35. Final Gas'Pipe-Test, ' ` i , ; - -_ - - - ' i -: %) ,r 36. Hood or Canopy 37. Final Factory Fireplace. �' �_• I I1 j , I' { ° -- ' I'� - 38. Final Plumbing - I �)- 39. Water Service-FinalI`•- 40. Gas Seivice-Final _ - 41. Solar Domestic -Final 42. Backflow Preventer • - 4. BaeItJLlrrjgation ! I I? I n = (- 'F I v j i ., 4 �;L.andscapd, Ligation System I. - 45Aound'_Atte nation 1 I i + ; - •_ _ _ - Handicap;Regulations !- 47:-FINAL.ST9UG7URE & BUILDING- , 48. Specia equiremerits Completed 49.ftlectrig,,Releas to Edison, i.. ' 1 _• �_, _.i-_ __ _ . . _ ._+ .; 50. 6aPfl@fgase to Southern California Gas Po 51. CERTIFICATE OF OCCUPANCY No Date 1 i .1 _ Applicant to fill in all spaces except those within heavy border lines and Ilse all appropriate declarations CIT OFF COSTA MESA TpERM1T NO.. TRACT NO LOT NO. 'BLD r CONSTRUCTION PERMIT -, —. '�j-�S. �i - 5135 - ` 1�%b:/ Gab '1 T Applicant's Mailing Addreu_ • TYPE OF CONSTRUCTION- L11NEW LJADb . LTER�T REPAIR- _ f ! ' El CONVERSION CONVERSION DEMOLISH 1:1 OTHER" - Project Address_' (( "hone DESCRIPTION OF WORK 11 Owner's'Name : , -- ' p c ZONING REGULATIONS - (� Address - 7,YPE OF PERMIT El GRADING 44 - FOUNDATION .STRUCTURAL - ❑MECHANICAL A. P.#. ZONE . . . _ Aich/Eng.' -' License No., - ' El TENANT EJ ELECTRICAL PLUMBING PLNG. REF. 20, - �BUI L D I NGS - Address y ❑,OTHER - '" TO BUILDING' I - - q ' 1 ° �' 1 Contractor's Name ne PROJECT DESCRIPTION SQ. FT. - OCCUPANCY' PROPERTY LINE <' REAR YARD (TO P/U Addreu(mailingl'� V s CONSTRUCTION TYPE VALUATIONS LEFTSIDEYARD"' RIGHT SIDE YARD . y j � - i ZONA= ' GRADING CU -YDS: !ACRES PKG. SPACE'REO..'. PROVIDED .• Licenw.No: - ___ LICENSED CONTRACTOR DECLARATION- Remarks: STREET WIDTH 1`; • "{ _ .PARK FEE $ ' I affirm that 1'am licensed under provisions of Charter.9 (commencing _ - - with•section 7000) of Division 3 of the Business and Professions Code, and ' 1 SPECIAL CONDITIONS: f t - rily license IIs In Tull fRr_ce .effect. ' , . 1 Ucense Class • `� - Licenagq No: I ti •/ j PLUMBING ' .. ( Date �i_� _. Signature 4M � l Bar Sink Sewer Cap ELECTRICAL 'ORKERS' COMPENSATION DE LAR IO ,ereby affirm that I have a.tertificate of onseilt to self4.sure or a.certificI I BackflOw'Preventer -/ Sewer Connection, _ - Automatic Washer . - _ Meter Dover tOG amps • L_ - ) ,l Workers' Compensatlon Insurance, or a certified: copy thereof (Section 2, .� I -' - -- ' Construction Polei'. Sub Panel, I 3900, Lab. cJ I i• ��j .-.vr �,�L�s ,�� i �O - Backflow Irrigation i Solar_ Collectors 1 I Policy No. S Company Sri r' `� s rnt-s'rT' "' - " Cooking Unit ,< Sub Pole rDWyat�e_� fi�!t is herefiled '� Bathtubs ; Soler Piping 1 1 Ll Ca fled cr7Sp T1s filed with the city ItlIISM Ivi ((jr+�T� w th thehea. R9-� Ih 7f 1 � -• , Clarifiers - Solar Tank 1 Dishwasher 1 - 1 -8 Motors DO -1 HP ❑ 1 h Applicant EXEMPTION,FROM WORKERS' comPENSATION I Dryers ❑Gas; ❑Electric- Inc.Solar ❑9-15 HP ❑16-15+ Dishwasher Swimming Pool w/Spa (This section need not be completed if the permit is for one hundred ($100) or less) r' t : I certify that In the performance of the work for which this permit is Issued I any In any manner so'as to become subject, to the Drinking Fountains Urinal , - - Fan '_Microwave shall. not employ person Workers'; Compensation; Laws of California., 1 i , ; Floor Drains' - - Water Closet, F.A.U. ' Pole,Light ' Date' Signature NOTICE: It, after making this declaration; you should become subject'to the I Floor Sinks -' - - -Water Heater, - Fixtures / _ Range. i _ Workers' Compensation provisions of the Labor Code, you. must forthwith "Outlets Device Boxes i Sign ' comply with; such .provisions or this permit shall be ;deemed revoked., Gas Service; Water Service CONSTRUCTION LENDING "AGENCY I 'Outlets ' • I hereby affirm that there is a construction lending agency for the performance Interceptors - - - %Stagding Sections , of the work for, whlch:, this; permit is :issuetl .(Section 3097- Civ. C.) . Lentler's, Name; - ' _ j Kitcben'Sink '.- - 2+. Ci7 j Switches ( - :Trash Compactor'' Lender's Address -. ' --- - r I -, _ - r ' � - Garbage Disposal y„ 4 OWNERBUILOEROECLARATION,.1 1 , g� 1-6atorie5 _ 9 1/• I hereby affirm that I am exempt'. from the Contractor's License Law for the 7031.5 Business Professional'Cotle: _ P -Trap. - , F' Generator �0-5 KW []5-15 KW r following reason'(Section and Any city or county which requires a permit to construct, alter improve, demolish or,repair any structure; prior to Its Issuance, also requires the apptican Dfor such permit Transformer _� 15-50 KW • �= ' Roof DiainS i ;I' ~' to file a signed statement that he/she is licensed pursuant to the! provisions of - - ' OSU} KW ' 'Reinspection Fee $15' the Contractor's: License Law, (Chapter 9 (commencing'with lSect ion 7000) of Division -of the and Professions Cotle)' or'that he/she is' exempt - ! ;-- y Showers 17 ! j • Reinspection Fee' ):' ,�i p3, ,Business MereTrom'antl the, basis for the alleged exemption: Any violation of Section - 4 Meter ❑up to 100 amps 1 /� IWaje Fee, '$ 3 .7031.5 by any applicant for-' a' permit. subjects -the applicant to a civil of not more than five hundred dollars ) ($500.1 - - , Servme Smk.: Issue Fee .$ 3 s• ' Zoning BY" penalty I I .; LJ 1,'as owner of the property or employees with Wages, as their sole compensation wllPtlo the work', andithe structure.is not Intended or offered i i .. i ,. APProved Application Approved Sy - Date �! to Date �• n• { r ; MECHANICAL i for sale i(Secflon 7044', Business .antl, Professlonal Code:;The Contractor's '!' License Law does not apply tolan owner of d prop¢rty lwho builds or Improves BOilet ( " I Refrigeration System / ✓; - •I' Application hued By • dJ �? •` • Data thereon, and who tloes, such work himself/herself or through his or her own i Implores, piovided that such are'not Intended or offered for ' Imployr sale. If, however, the building or improvement Is sold Within one year:of com- Duct -Under Ground , ) ❑ 0:100,000BTU ❑100,000BTU I - - SUMMARY;OF FEES pletion, the ownerlwlll have the burden of proving he/she did not build or lm - prove for the purpose of,sale)'. , - ! Duct - Structural i Sy, stem Repair/Alteration -r • BUILDING PERMIT $ ' SMTP $ ' LJ I, as owner of the property, am exclusively c;ntracting'�wlthMc¢nsed can. _tractorsto. construct.the project (Section 7044, Business and. Professions. Code: J _ Duct - Ventilating .� I : - - _ _ _i -.° ; 'PLAN CHECK r $ PERMIT The Contractor's License Law does not apply to an owner of property who builds Or Improves thereon, and who contracts for such projects with a con- Exhaust System ❑ Multiple ❑ - - ' ! �' 1 ..PLUMBING ' .' $ .�7 -ISSUANCE); �• $ ; .•e+ .l tractor(s) license pursuant to the Contractor's License Law). 1 _ i •' /• ' C' '^ ,', PLAN °fX9 - ` ,'i GRADING $ ❑ lam exempt under Section ,. B. & P. C. for this reason f Firepl/Fact. Bit. ICSO # i 6 ,• CHECK' $�' - I .EL'ECTRICAL, ' X'' - f 11 '• •/ , Date Owners I i i Heating System & Ducting i y MICROFILM $ have reatl this application and -state that the above ' I hereby certi&h' ❑Q100,000 BTU 0100,0008 — - - _ - j f, PLAN CHECK $. - _ Information Is agree to comply with all city and county ordinances .. ' : ' •MECHANICAL $ /" •; TOTAL FEE. '� r q/ . antlstate lawso builtling < nstruction, and hereby authorize repro- ) sentatives of; to enter, n the above-mentioned property fpr HUOd Or Typal ❑' , Reinspection Fee $15 .. 1 '. �. ."{ ,LESS i Inspection 3Cano U_ T e I ❑` PI, I CHECK` : $ rADVANCED �• PC'. $Drivers' Lices .1 Registers ! Issues Fee $ 3' ' f /' i�' FINAL FEE, CMF 0865-46 rev. 12/92 White - Builtling;Canary - Applicant; Plnk- Accounting; Goldenrod' -Assessor Y - i. ,r CO _ •_ �" •'-" - POOL aSPA• - -_ -` - • �, �,'�- _ , u r :_ v: .� r �:.`Da"te ^ =APPROVALS Permit.#: -��Y� - . Inspector -' "' -' :,;.5. � - APPROVALS• `-PermiY# riData 1 :Inspector - - _- ., e_. , -- r_- 1. i emjYorlry Electrical Service or' ole '• ,'52: Pool & Equipment Location 2? Soil Pipe-Undrgrnd:_:' - > = 53`.- Steel Reinforcement '' - 3 Electrical Conduit Utility-Undrgrnd. - _ - -r 54n Forms; 4'.. Electrical Conduit-Undrgrnd: , %7 `" 55. Electrical Bonding , ; . ,•,::• _- . 5 Steel -'Reinforcement 56. Rough Plumbing &Pressure Test ' 6: +EIWrical LIFER Grnd.. = Q : 57.-' APPIROVAL•yO COVER-GUNITE' t 7. Focti,ngs-1 ,: �, t c_ i _ ; ` _.58. Electrical Conduit-Undrar.,d.- - - 7, _ - 8. Fdundation _ ' 59. Gas Pipe, O Undrgrnd.; Test _ 9. Water' Pipe-Undrgrnd. !.60. BackwastrLines;_P-Trap,O Undrgmd.� 10.$tructuralFloor System ' 61.APPROVAL.TO'DECK 11. Property, Sewer Line & House Connection- n Backwash &Receptor -Final-' 12. Sewer Ca p'. 63. Heater &'Vent -Final - 13. Roof,Drainsj;.'64. Plumbing System -Final 14. Rough Plumbing i `•� - 65. Electrical-Final- I�t15£Rough-Electrical:Conduit i ?- ;l ',: -'i I I h '66. Solar'Sysfem-Final - - -` - -- I -ou h Electric Wir'tn 16. R9 9 Fencing1-'_ -67 .j &Access Approval "`1 =- - +- - - - -- c ; r . + _ 17. IRoughtWiHng Sign;- S ' ' I II :' ! - ,- � 1' i ' _ X68.' APPROVED F,OR PLASTERING - - 1� 18,(Rough,Electrical;T;Bar;Ceiling fl II_ I . I �' I r- I -_ I'. '69., POOL/SPA SYSTEMS FINAL! - - 't 19. IRoogh`Heating & Air`Conditioning FIRE DEPT. REQUIREMENT, - I APPROVALS Permit 30. yRough Factory Fireplace. 1' �� I I I I J 21. Ducts; in SCructure,� X70.1 Underground Hydro '.1;22 !Ducts, Ventilating C. I '/' !' II 1 7111 Product Piping 0 Gas 0 Oil 4 _ i,23. :Gas Pipe -Rough & Test ° I j. il_r �- +72. Underground FlushT - SC24. 'Roof Framing I "i I II I f v I 73.1 Undergrnd. Storage Tank t] Gas -❑Oil ' 25.;Roof Sheathing I h' e • I 1 1 " I ' I 74.1 Overhead Hydro , 26. T -Bar Ceiling (Structural), & Monocoat' • _ c . s• -" 1 ` ; , + 75. Dry Chemical 1 27. IFrame and Flashing' ? . j- ' I - i76.. Dry Standpipe , P 28.", thing & Siding, I I j I I ;77' FIXED SYSTEM FINAL c = i X29. Mlnsulation o '. I li ' l ! 78. FIRE PREY. FINAL i 1 ,,-30. Drywall Nailing �' • ; I. I I t Notes: 1 _31.'Plaster Brown Coat Electrical,Power Meter: FinaldQeI �+ •+ I wy32. .I 33. Final Electric_ _ 1_ L 34. Final Heating &:Air Conditioning's 4 . 35. Final Gas Pipe'-Testi +^ i '� r : I'; I `�' I • ., ° I /' k �, 36. Hood or Canopy'" I T -� I ' I I j _ 37. Final Factory Fireplace - I rr 38. Final Plumbing „ - 39. Water,5ervice-Flnall 40. Gas Service -Final 41. Solar Domestic -•Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscaoe lr'rigation'System, ., • ` s' `� 45. Sound :AttenuationAdo l I - •• 46. Handicap Regulations' ° I - -8 - CTE,&BUILDING ;' 47. FINALSTRUUR I I�•I J ('_ 48. Special Requirements Completed it I I 49. Electric Releaselto'Edison' ._ _ I I I I ♦ ... 50. Gas Release to Southern California Gas Co I f j IU. a , 51. CERTiIFICATEIOF OCCUPANCY I No U I Date l j I _ - Applicant to fill In all spaces except those within heavy border Ilnas and sign all appropriate declarations. AIT',JJECOST&MESA PERMIT NO. - ' TRACT NO. LOT NO. I B l 'CONSTRUCTION PERMIT S� Backflow Preventer Applicant's Mailing Address TYPE OF CONSTRUCTION NE �.-4 �sTS�Jn i.rl'nf ❑CONVERSION ❑DEMOLISH Project Address fry,712 Clarifiers Owner's Name . hone DESCRIPTION OF WORK Address LSti4,rVIFu/ S l��'N%}- r C.L1• .7ypE OF PERMIT LJ GRADING • Arch/Eng. License No. ❑ TENANT ❑ ELECTRICAL C - Address' ❑ BOTHER t' - Contractors Name ��p+ Phone PROJECT DESCRIPTION SQ. FT._ �(i ling)-,QH1P- p'�: !}�o UE Addrassnla CONSTRUCTIONTYPE ZONE= GRAC ' License No, _ LICENSED CONTRACTOR DECLARATION Remarks: VC A r I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is In full force and effect. License Class License No. Dater Signature •PORKERS' COMPENSATION DECLARATION ' sereby affirm that I have a certificate of consent to self -Insure or a certificate ,f Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C.) Policy No. Company eCertified copy Is hereby furnished- . Certilled copy Is filed with the city Building Divislon. Date Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed If the Permit is for one hundred ($100) or less). I certify lthat 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 Cal ifornla. Date Signature NOTICE:If, after making this declaration, you should become subject to the Workers' Compensation' provislons,of the Labor Code, you must forthwith. comply withsuch provislons-or this permit 'shall be deemed revoked. ,CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction landing agency for theperformance, of the work for which: this permit is issued (Section 3097 Civ: C.) Lender's Name' P Lender's Address ' OWNER BUILDER DECLARATION - I herebyaffirm that I am exempt from the, Contractor's License Law for the following reason j5ectlon 7031.5 Business and Professional Code: Any city or county whlch'requires a permit to construct, altar Improve, demolish or repair any structure, prior to Its Issuance, also requires the applicant for such permit . to file a signed statementthat he/she Is licensed pursuant to thwprovisions of the Contractor's License Law.(Chapter 9 (commencing with Section 7000) of Division 3 of the Business a ntl'Professions Coda) or that he she'Islexampt therefrom and the: basis for the alleged exon p[lon. Any Ion -of Section _ 7031.5 by'any applicant for Permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). I, -as.owner of the .property n my employees with Intended lholr sole for le , tion will do the work; and the structure is not Intended or offered , for Ule Law 7044', Bu to an o n owner of Proper Cotler The Contractor's Licenw Law does not apply to an owner of a property who builds or Improves or J ADD U ALTERATION U REPAIR OTHER I FOUNDATION U STRUCTURAL ' PLUMBING ❑ MECHANICAL VALUATION $ CU. YDS. A( Bar Sink Sewer Cap Backflow Preventer -Sewer Connection Backflow Irrigation Solar Collectors ' Bathtubs Solar Piping Clarifiers Solar Tank Drinking Fountains ' Urinal I Floor Digins' i Water Closet - - Fldor Sinks - - - Water Heater - - - - Gas Service Outlets Water Service _ . Interceptors Owner t I hereby, certify that It have- read -this -application and state -that the above- ,Information Is correct. I agree to comply with all city, and county ordinances • and state laws relating to building construction, and hereby authorize repre. sentatives of ,this city o enter u on the above-mentioned property .for ! Inspection ourp I . Signature �. r + aS/.�d"'� — Oata 4-7 -4 • Drivers' License prSS a �, j ! I Heating,System & Ducting 0a100,000,BTU 0100,0000T , F.A.U. I ! Hood Or Type I ❑ CanO , .T a it 0 Fixtures • .. I , Regirters 1 ,- CMF 0865-46 rev. 12/82 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor r - Reinspection Fee' Issue Fee , $15 $ 3 PLNG. REF.tP - TO BUILDING PROPERTY LINE LEFT SIDE YARD PKG. SPACE REG. I ' STREET WIDTH SPECIAL CONDITIONS: c,tisi oru%its , REAR YARD (TO P/L) RIGHT SIDE YARD PROVIDED PARK FEE Automatic Washer - - _ Meter LJover 100 amps Construction Pole;'. :Sub Panel Cooking Unit Sub Pole ' Dishwasher - Motors 00-1 HP 01A-8 Dryers ❑Gas I]Elecirid ;Inc.Solar 09-15 HP 016-15+ Fan' ! Microwave F.A.U. I ! Pole Light Fixtures • .. Range -. Device Boxes Sign Outlets ! Standing Sectitins ' Switches - , 'Trash Compactor Garbage Disposal 4 ' Generator 00-5 KW 05-15 KW Transformer 015-50KW - 050 + KW' Reinspection Fee Meter Oup to 100 amps Zoning Approved By _ . Date — Application Approved By Date _ 1 I i Application Issued By nate SUMMARY OF FEES 'BUILDING PERMIT $ SMIP $ PLAN CHECK $. i I PERMIT PLUMBING $, ' ISSUANCE $ } PLAN CHECK $I t GRADING $ ELECTRICAL $ . $ PLAN CHECK MECHANICAL $ $ I MICROFILM ' TOTAL'FEE' $ $ PLAN CHECK' 1 1 $. I LESS t$ i ADVANCEUPC I I I ' ' • I FINAL FEE $ 0 % C, AND'PCANNIPW! '�5 ;1, 9: --,POOL*,& SPA 'ONSTRUCTION ; - - ��. 3�L_ 6A% _j T� !CAPPROVALS1? �erriiit q#___ ;Inspector r pe�;O_ C '-,APPROVALS it Date 'InspeI:tor, Torary pictricil S6rvice or Pole M j E�2- P0ol &_t di ne nt Location Z Soil Pipe-Uni Jrgrnd:t �.O� " 13' Steel Reinforcement 1 Electrical Conduit Uiilit'vmUndrgr'n d. 7 54�, Forms 4m Electrical Coi Conduit-Ukdrgrrid. -, f .: t Electrical Bol6di 119 t' Steel Relnforcemenf � I - ' : -, ' ; , L; -6. o u . -h ughliCribin'q'Ci Pressure Test :. ". 2. t 6: !Electrical OFER Grnd. j APP!36VAOCTO,COVER-GLINITE 7. Footings, •58: Electrical'Conduitj)6drornrl. 8. M Foundation 59m Gas Pipe; (f3.Undrdrnd;Test 9. WateiPipe-Undrgrnd. CO m Backwash. bnes,�'P-frap, 0 Undrgrnd. 2 10. Structural Floor SysiernL! APPROVA TOPECK 1.6.1. Ilm Property Sewer Uni &'House-Conmiction 62.BackwasK &-Receptor-Final'- -7- 12. Sewer Cap i V • 63. Heater &.Ve'nt-Firial 13. 136ol'brain; AC Plumbing-'Final .System 14m Rough Plumbing -b5. Electrical -'Final 15m Rough- Electri ca I:Co nd uit-- --I _PC S3Wr.SYite_m_m-Fma_I!_ .,...T I 16:'R'?ugh ElectricWir i ng. E I r 67.1 Fencing WAccess.Approval , 4'17., Rodgh Wiring Sign 68. APPROVED FOR PLASTERING 18:' Rough -.T ar. Ceiling' 1m: 69.1 PbOmL/SPASY§TEMS FINAL 4B 16. 'FGogh'Heating & bond[itioninii_- FIRE DEPT. REQUIREMENT APPROVALS POrnit*_1 20.. Rough_Factory Fireplace' • 2 Ducts,;m tructure-,, 1. S 7b. Under1ground H' Hydro i 22. Ducts, VeniiIIiiing71.1 1 Product ct Piping bG6s E']Oil -4 23m "Gas Pipe -Rough & Test < 72m Underground Flush! �24. Roof Framing" 7.3. Undergr rdl. Storage Tank, Ei 6as'-pbi I 1 25. Roof Sheathing r 74.' Nerfiead Hydro 26m I -Bar Ceiling (Structural),& Monoc0aP 75m] Dry qhemical•, 27m Frame and Flashing 76. Dry Stan�lpipe 28. Lathing & Siding I 'J 77.; FIXED SYSTEMIFIN'Al_ 29. Insulation . 78m� FARE 'PR'EV. FINAL 30. Drywall NAling Notes: 'ILI q: T'3 31. Plaster Brown Coat 21 r 32mm Electrical Power Meter -,Final 33m Fi at Electric I JI I L 34. Final Heating &Ai5Conditioning t "stm'.,'.- 35m Final Gas 'Pip'eTe r 36. Hood or CanDlpy 37. Final Factory 38. Final Plurbi'ng I 39. Water Service'mFinal. 40. Gas Servi cemFinal 41. Solar Domestic -Final 42. Backflow w Preventer 43. Backf lb�'Irr on' I gat 1 4 44. Landscape I rriqqtibn',System 45m Sound' AttenuAtion 46. Handicat!I:Regulations 47. FINAL STRUCTURE BUILDING 48m Special Requirements 6ompleted' i 49. Electric Release,to Edisonj 50. Gas Release to.Souihern California Gas Co 51. CERTIFICATE OF'OCCUPANCY NQ1 Date \ L C Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations •• CITY VF COS` A MESA ^ 1 _ CONSTRUCTION PERMIT 7 i PERMIT NO. _ 3s3 TRACT NO. LOT NO. I B - i =`J.,' , i •ALTERATION AppRcaut's Mailing Address _ ' , TYPE OF CONSTRUCTION NEW'% ADD 6h�8 • Project Address'44' 1 I [],CONVERSION ❑DEM OLISH�THE R. - _ I t1'/[f I ��'�•' ' ' F%esJv7 jl I Owner's hams hon - DESCRIPTION OF WORK i� �••r� •'!' ZONING REGULATIONS Addr@ss, 'TYPE OF. PERMIT p( ;GRADING FOUNDATION- STRUCTURAL ❑,TENANT ❑'PL'UMBINO ❑ A.P.-0 - - 'ZONE - Arch/Eng. License No.' _ )L_ LECTRICAL MECHANICAL PLNG. RE F. 'M- � BUILDING - Address�' 1 i I - POTHER - I' 1 i I '� TOBUILDING '- -, _ ' &mtracto Nam - - ` ` Phone ` PROJECT DESCRIPTION, SQ. FT.' - • • '• OCCUPANCY PROPERTY E :REAR YARD (TO P/L) - ' Add ('nailing) ��_2 j:e ,f%Q j�6' 'C ONSTRUCTIONTYPE VALUATION$LEFT SIDE YARD : - - RIGHT SIDE YARD /%/._ ZONE GRADING CU.VDS. AC RESt PKC. SPACE, REO. I PROVIDED r ' - LICENSED CONTRACTOR DECLARATION - ' Remarks: , '� `• .• ' = STREET WIDTH , (PARK FEE-$ - r _ 1 hereby'affirm that 1 am licensed under provisions of Charter,9 (commencing- - with section 7000) of Division 3 of the Business and Professions Code, and _ , I SPECIAL CONDITIONS: my license is In full fo and'I. Llcense C=ss '- I LI No. ! PLUMBING 1 + 1 i i I ) •) r _ Data Signature "ORKERS'COMPENSATI , - ' CLARATION • Bar Sink I Sewer Cap ELECTRICAL i areby'alfirm that I have Ificateof conunC.to Self-Insuje or a certificate ' - } Backflow Preventer- - - - -Sewer Connection: - ' ---, - '- - Automatic Washer. _ e - - - - Meter r 100 amps :, - 5 Workers' Compensation Insurance, or a certified copy thereof (Section 3600, Lab. C,) 7 i + Construction Pole' Sub Panel 1 Z , j Backflow Irrigation Solar Collectors f S� Policy No. ' Company ' BCertified copy ii hereby furnished. • ) ! , ! , - - ,- - , Bathtubs ( , Solar Piping , - Cooking Unit Sub POIB 1 ' Certlfled copy Is filed with the city Building Division. Date 2 Applicant Clarifiers Solar Tank 1 + I Dishwasher ' I r Motors 00-1 HP ❑ 1 X$ 1 E)(EMPTION• FROM WORKERS''COMPENSATION DECLARATION Dishwasher Swimming Pool w/Spa i g ^ Dryeri ❑Gas-' ❑Eledtiia '• ..`' in Solar Og-75 H_P (]16 (This section need not be completed If the permit Is for one hundred ($100) or :less)':- . i r t I 1 certify -that in the performance of the or }or which lhl 'mit Ii Issued I �. Drinki0g Fountains Urinal 1 f - } Fen: / :� ! Microwave 1 shall• not employ anyy person In any an r so as to be ne subject to the Workers' mpensatlon Laws o} Calif rni ' 1 Floor Drains j F ' A U + • Poie Light • { . ' 1 Hater Closet, I ' ; { Date' - 519nature N OTIC :Of. after m Ing this decl n, you zni Id become eubject -to the -� Floor Sinks----'-- -'—� ___ Y �yyater Heater --- -�--� -, -_ Fixtures r �.._ .1 ._ , _� _ ReOge __.y.. Y N Workers'( Compens provisl the labor Cotle, you, must. forthwith. . comply with, Such provisions this, permit shall be 'deemed: revoked:%' r - - T ' Gas Semite' •Outlets. - 'Water Service '` , ' Device Boxes ' 1 Sign, i ) CONSTRUCTION. LENDING AGENCY 1 .i I - I hereby affirm that there Is a,constructlon lending agency for,the,ppe8rformanca, - ' ' , Outlets s Stan{ling Sections s ? 1 Interceptors _ I - - f ti' 3 p r ; I of the work for which this; permit' Is dsaued .(Section' 3097: Civ. CJ: - , Lender's( Name. ) _ ' s - -_ 1 - - '- r - Kitchen,Smk _ -� - = ' 1 Switches . 1 Trash Compactor Lender's Address, •l I - I • : - ! - r W • s Lavatories is r r - 7 - i Gartiage Disposal 1 i i OWNER BUILDER DECLARATION- EC L'eRATION _ ,� { I I .t i - + - „ hereby, hereby, affirm that t am exempt from the'Contractor S:Llcense Law for the , following , _ I - P-Tfepl '. Generator ❑Q5 KW ❑5-15KW ( ' 1 I ' . reason_(Sectlon:7031:5 Business and Professional, Code: Any city or , county Whlahl roquires a perm)Lto construct; alter Improve; demolish or repair any structure; prior to Its.lssuanca,'alzo requires l6o applicant for such permit _ { , - �_ r Transformer El 15-50 KW - ' , ( _ _ - _ - _ { RoOf'Drains 1 Z. �.to file a ;signed statement that he/she Is licensed pursuant to the provisions of •he - •+ t - �_, ; " ' '� 05U+ KW 1 - t Reinspection Fee Contractor's License Law)(Chapter 9 (commencing with'-Seation•7000) of (vision 13 of the,Business Professions Code) that• he Ir > 1 Showers - Reinspection Fee $15 4 §j8 i and or she ;Is exempt erelromantl Inel basis for the alleged exemption: Any. vlola�lon:ofl5ectlon _ - -rApplicati6n up 10 100'emps t '$ 031.5 b aany applicant fora i permit -subjects the applicant to-a'civil enalty o/ riot more than five hundred dollars ($500): ' r I i _-_ I ` s ' 1 t:' Servide Sink - '- + = . , Issue Fee t y C $ 3I1' :Issue'Fee' - By 'Date I?. as,owner of the%property 'oi-my employees with wages as theli sole1{Compensation" will do the work, and,the structure is not intended oroffered - -. '._ MECHANICAL' ± i !Approved pprorod By ate fir saleLaw doe of ap ly to an antl:Prf a Cwho The, Contractor's law Ooes not aDP1Y to an owner of a ImprovesBoiler ' '' Refrigeration System CLJcensa 5thereon, pronal Droporty.who'builtls or who*does such, work himself/herself or (through his or her own . ! • 1 ;V, - • �- 1 ssued By Date land employ ass, provided that such Improvements are not intended or offered for { �, •1 ❑0,100,000BTU ❑100,000,8TUr sale. If, however, the building or Improvement is sold within one year,of Com. • Duct - Under'Ground . SUMMARY OF FEES ' Dlellon, the owner,w111 have the burden of proving he/she did not build or Im- Q�rr,ove./or the purpose otsale), . , LJ I, as owner of the property, alis exclusively contracting; wlth•licensed ton- f Duct -Structural $stem Re y. pair/Alteration -BUILDING PERMIT $ ' SMIP $, , . tractors to construd.the project ISection.7044, Business and.Professions Code: The Contractor's License Law does to _ Dutt_ Ventilating - y - - __ _ _ - _-j PLAN CHECK, $+ PERMIT, - not apply an owner of property who +- builds or Improves thereon, and wha contracts for such projects with a con- � Exhaust System ❑ Multiple I] � 'PLUMBING $ ISSUANCE , $ , tractor(s) license pursuant to the Contractor's License Law). ❑ 1 am exempt under - action B. 6 Pi C. for this Firepl/Fact. Ip LAN CHECK $ GRADING $ reason Bit. ICBG l :ELECTRICAL' $' $ , ' Date_' Owner I Heating;System & Ducting , 'PLAN r MICROFILM $ _ ^ f hereb certify Cha have aaatl this-appllcatiOm and statathaF [he -above y y Jagreo ` _I ❑6100,000 BTU 0700,000 I CHECK $' 1 ! -Information Is torr to complyy with all city and county ordinances and state laws r at inq'to bulldin truction, antl hereb authorizo repro- g : + MECHANICAL $ TOTAL FEE $ HOOd ❑I senlativos of Is. Cy to ante bn the above-mentioned roperly for p Ot Type I ! 1 Reinspection Feef $15 r ' a Inspection ou ose . ! ' Ceno T e II ❑• .PLAN CHECK. $; ADVANCED PC $ t ' S19nature . Drivers' V r 55 - I Registers i ' Issue Fees ._,:9 7.-"Z) CMF 0 6 rev 12/62 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor W �=CONSTRUCTION AND PLANNING -'•APPROVAES' Permit # S-JcS•3.T• Date _'"Inspector `>A PROVALS`- Permit 46 •Date Inspector. • 1. Temporary:Electrical Serbice or Pole :� _ '52: Pool & Equipment Location . _ 2 Soil Pipe-Undrgrnd.- r t_ - r� ; . _ 53: Steel'Reinforcement -, 3. Electrical Conduit Utilitv-Undrgrnd. :54' Forms ' 4. Electrical Conduit-Undrgrnd. - �^ - .55: Electrical Bonding - - _ 5. Sieel!Reinforcement - t _ ' ' x`• - :56. Rough Plumbing & Pressure Test _ 6: iElectiicyl LIFER Grad. ^. _ 57'. APPROVAL TO COVER-GUNITE - 7. Footings 58. Electrical Contluit•Undromd: -_ B. Foundation j - -59. -Gas Pipe,- Undrgrnd'., Test. 9. ,Water Pipe-Undrgrnd. - - - _ "60. Backwash Lines, P-Trap, ❑Undrgrnd.? - 10. Structural Floor System'- .61. APPROVALTODECK - - 11. Property Sewer Line &,House_Connection - -62. Backwash & Receptor-Final - 12. Sewer Cap - - 63. Heater &Vent-Final ` 13. 'Roof Drains I �' 64. Plumbing System - Final. - _ 14. Rough Plumbing '65. Electri cal=Final -15. Rough' ElectricafConduit 66. Solar,5ystem•Final ,16. )RoughtEleciric Wiring, , I 4-;6 r 67! Fencin &Access Approval 17. Rough Wiring-Sign;" • ! ' ' i j 6S: APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL 19. Rough Heating &,Air Conditioning _ I FIRE DEPT. REQUIREMENT APPROVALS, Permit # ' 20., Rough Factory Fireplace i 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating' - 41.i Product Piping O Gas 000 23. Gas Pipe-Rough & Test ,; 72.' Underground Flush 24. Roof Framing, J �3 : :. I - y 73. Undeigrnd. Storage Tank O Gas O Oil • ,� 25. Roof Sheathing - ,. - 74.' Overhead Hydro 26. T-Bar Ceiling (Structuraq, & 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 ' - Notes: '31.JPIaster Brown Coat ' A2. Power Meter-Final 33. Final Electric 34. Final Heating Sr Air Conditioning 35. Final Gas Pipe-test 36. Hood or Cariopy_ 37. Final Factory Fireplace • - - - - 38. Final Plumbing, 39. Water Service-Final' 40. Gas Seivice-Final 41. Solar D'oinestic--Final 42. Backflow Preventer 43. Backflow Irrigation - 44. Landscape Irrigetion'System- , 'n 45. Sound 'Attenuation 46. Handicap Regulations' , ! 47. FINAL STRUCTURE&BUILDING 'I, !r•; `, 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southein California Gas Co �OF, I I ! 51. CERTIFICATE OCCUPANCY- , No� i Date