HomeMy WebLinkAbout2656 ELDEN AVE - Building Permits ELDEN AVENUE, 26/56 thf1.1 F
20932 - 2-10-65 r-es fierce C) $7,360
20933 - 2-10-63 ea_dence D) 7,360
• '20934 - 2-10-65 residence d.; 7,360
20935 - 2-10-6'3 residence F) 7,360
70550 - :11-23-76H PLbg. NC (gas sys)
P 7426 Gas lire #E •
69(63 -
- P8391WATER SERVICE
8/2'SI'7 (BLDG. A & B) •
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9 _ CITY OF COSTA MESA
4 BUILDING DIVISION
Fri- -a) DEVELOPMENT SERVICES DEPARTMENT P RMIT NUMBER'
TAgliqk
PERMIT 4E03-00177
se
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
ELECTRICAL PERMIT
Job Address: 2656 ELDEN AV Status: ISSUED
Suite No Applied: 03/13/2003
Vicinity: UNIT C-2ND METER HOUSE METER USE ONLY Issued: 03/14/2003
Parcel Nunmber: 43922113
_01,-
Applicant: SAHIN, ISMET ISSUED BY:
Address: 19 OAKTREE LN
Phone: 949-212-2633
IRVINE,CA Zip: 92612-2232
Owner: SAHIN, ISMET
Address 19 OAKTREE LN - -
Phone:
IRVINE,CA Zip: 92612-2232 "
``
Contractor: OWNER BUILDER
Address: ' •
Phone: . . - ,
• Zip:
License: 000000 -
SCOPE OF PERMIT ,
INSTALL 100 AMP HOUSE METER ONLY FOR APARTMENT COMPLEX.HOUSE METER WILL BE LOCATED
ON UNIT C.PER APPLICANT, EDISON HAS AUTHORIZED THE INSTALLATION OF A HOUSE METER ON
THIS UNIT WITHOUT A SEPARATE ADDRESS DISTINCTION. ,
•
•
. -- _- • FEE SUMMARY '
Quantity - Quantity
ISSUE FEE $23.50 Temp Dist System/Lighting $0.00 0
Temp service test $0.00 Busway/100 ft . $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 A
• •
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 $0.00 0 • up to 50 kva/kw $0.00 0
Recept Outlets " $0.00 i .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 . $30.50 '1 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 1hp $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
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord.No.92-28,§1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
2446-46(8/00)
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.
❑ I have and will maintain workers'compensation Insurance,as required by section 3700 of the Labor Coda,for the performance of the work for which this pervlit is Issued.
My workers'compensation Insurance carrier and policy number ere:
Carrier: Policy Number:
(This section need not be Completed I/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: Date:
WARNING:FNLURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED
THOUSAND DOLLARS(Sl W,000).IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3106 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.R Class a
Contractor's Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,CMI Cade).
Lender's Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or County which requires a permit to construct,alter,Improve,demolish,or repair any structure,prior to Its issuance,also requires the applicant for such permit
to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of OMslon 3 of the
Business and Professions Cade)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(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(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.).
KI,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 dors License Laws.).
• exe ••t under/ Businoss and Professions Code for this reason: �'7
//.,.%/:�'i sr _ _ Date: 3j /4 Q1
enlied�dri+icense. �� e—NoifillOP r 4�
Verification of Ownership by(type of documen,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(38)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:
I 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? 0 Yes 0 No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Flre 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? 0 Yes 0 No
(Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Flre 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 ❑Uo
(Section 25534 of the California Health end Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Flre
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 appermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes 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? 0-Yes 0 No
(If'yes",the facility must meet the requirement of Sections 25534 end 42303 of the California Health and Safety Code).
7 If TPermit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No
8 (If yes-,attach certificate of compliance from the appropriate air pollution control officer). _
CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHOR •• 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 al state laws : a city or•Inances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described properly for section•urpy.s.ir:.e not to occupy or allow occupancy of any building authorized by this permit until final In pection.
/�u:�e. wt• ,. 3 ► i �0 3
Signal' :Of tall, er(s)
And/Or Authorized Applicant Date
CODE I INSPECTWN TYPE PATE MAI ;ODE( 18SPECTIONTYPE PATAh IIS
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
,� t CITY OF COSTA MESA
:,. tI% BUILDING DIVISION . • •
DEVELOPMENT SERVICES DEPARTMENT 74. / E9$_00472
;# PERMIT -V/ PERMIT NUMBER
riejt
(714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626
ELECTRICAL PERMIT
Job Address: 2656 ELDEN AV Status: ISSUED
Suite No Applied: 05/18/1998
Vicinity: Issued: 05/18/1998
Parcel Nunmber: 43922113
Applicant: SARIN, ISMET.
Address:
Phone:
Zip - -
i
Owner: SAHIN, ISMET. " -
Address 2656 ELDAN AVE#A . � / - ; , ,
�
Phon_e:,,_.. - i7,-
COSTA MESA,CA / . = Zip: 92627 - t -,.::-..;:s---c. ' y - 'j :��,\
. - . -.
Contractor: , - �
Address: N.,'
Phone: -
i - '
• Zip: i.. .
•::License:' .` • - •- - I '
- - - SCOPE OF PERMIT -
CHANGE ELECTRICAL SERVICE
.
N ,
FEE SUMMARY
- Quantity • ' , Quantity
ISSUE FEE $22.00 - Temp.Dist System I Lighting $0.00 0
Temp service test $0.00 Busway/100 ft -' $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 $0.00 0 -- 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 ' $27.25 1 - Misc.Conduit $0.00. ' - 0
•
Service to 1000a $0.00 0 - J " , Misc.Conductor $0.00 0 ,
Service over 1000a $0.00 0 ,Circus(gen or ride) $0.00 0 .
Motors to 1hp $0.00 ;, 0 - ` Circus(mech ride or lights) 10.00 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- $49.25
Intermed Pole $0.00 0 -
COMMENTS/SPECIAL CONDITIONS
•
•
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
DECLARATIONS
WORKERS'COMPENSATION DECLARATION: -
I hereby affirm under penalty of perjury one of the following declarations: •
❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
work for which this permit Is issued.
❑ I have and will maintain workers'compensation insurance,as required by 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 if the permit Is valued at one hundred dollars($100)or lass.)
❑ 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 provlslons 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 UNIAWFUL MID SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED
THOUSAND DOUARE(s100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37C6 OF THE LABOR CODE.INTEREST,MID 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 end Professions Code,and my license is in full
force and effect.Lic.a Class a
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
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 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 Contr. Laws.).
I am exempt un.a sec. / Business and Professions Code for this reason:
7•1/ 4111I
ature: yLZ - � Date: ice/c7
Owner ID verified by dnver. en 0 es ❑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,end 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? 0 Yes 0 No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic 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? 0 Yes 0 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 California Health and Safety Code been fully complied with? 0 Yes 0 No
5 Does or wit 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 Alr Quality Management District or from any other air pollution control district or agency? 0 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? 0 Yes 0 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 Alr Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No
8 (If yes-,attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF 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-descdb.. pro.: . coon purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
n;. a Of :.al Owner(s) / ate �
•�` And/•r Authorizetl Ic -- �- Date Cie
Cat INSPECTION TYPF DATE =ALS COL/ INDEECmgi TYPE DAM Id11IlA S
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing 1 "
200 Final Re-Roof 210 Final Electrical -r/V IW ayG
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
•
2446-46
Applicant to fill In all s acei exce t those within heavy border lines and sign all a \
D D 9 Dproprlata declarations. - .-, 11030 B/1 7/133 50.1•• TI
CITY OF COSTA MESA pER IT "TRACT NO; LOT NO. • BLDG.NO. -
•�y�, CONStTRUCTION PERMIT - - , ,•••/•-' 3 9 1 - //////�77��� - - •
' 1 - �.
^b ' Applicant's Mailing Address.] c2 T.`��K -T D aL/•L ' - TYPE OF CONSTRUCTION U NEW Li ADD U ALTERATION EPAIR i -
Project Address "'S' a Cas ,' •�•p ' ❑ CONVERSION 0 DEMOLISH ❑BTHER _ ' -
CtIi7? 7b9� DESCRIPTION OF WORK 'Xe' e0 _ ,
, Owner's Name ' ��I'G✓/ r �Qa�J 7 Phone -' 5e-Rtty 06 : I _ , - - ZONING REGULATIONS •
-
{v Address 34t73 `-+ `�fr�to-e,4 /4' 'TYPE OF PERMIT LJIG RADING U FOUNDATION U STRUCTURAL A.P.-Yr‘ I - ZONE -
•
a Arch/Eng. •- - - Litense.No.' ,, ❑ TENANT ELECTRICAL PLUMBING ❑ MECHANICAL PLNG• . REF.•IN. - BUILDING' -
Address. .. ❑ OTHER - - ' - cs=TAACv rvr sr
•
,TO BUILDING - ---._y i
A _ �/,' ' PROPERTY LINE REAR YARD (TO P/L)
' Contrecior's Name •V'�'+�<le An1I M hone .o7i� PRajECT DESCRIPTION SD.FT. - OCCUPANCY �•
03 Z 1} .#h /�c CON STRUCTION TYPE VALUATION$ •'LEFT SIDE YARD ! RIGHT SIDE YARD - -
LicensAddresslmailingll / O 6O ZONE - • , ! - - GRADING Cy.YDS. rACRFS _ FKG.SPACE'REO. PROVIDED
License No: '_ ! - -
LICENSED CONTRACTOR DECLARATION Remarks: I • STREET WIDTH r ' _ PARK FEE$ - ' - ,.
I;hereby,affirm that I am licensed'under provisions of Charley 9 (commencing •;
- - . -- - - -_- ''CONSTRUCTION AND PLAN-ING -- _ - - POC SPA _ - - - - _
> : APPRO •
VALS . Permit�h Date Inspector APPROVALS. Permit • Date Inspector
;1. Temporary Electrical Service or Pole 52: Pool & Equipment Location
42. 'Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. ,Electrical Conduit.Utility-Undrgrnd. ' It . 54. Forms .
4. Electrical Conduit-Undrgrnd. - • . ' ' . 55. Electrical Bonding -
.5. Steel Reinforcement l'' r ' 56. Rough`Plumbing:& Pressure Test
•6. Electrical UFER'Grnd, , , 57. APPROVAL TO COVER-GUNITE
7. Footings .,4 - . '• 58. Electrical Conduit-Undrarnd:,
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 & HouseCorinection 62. Backwash & Receptor-Final
12. Sewer Cap .' I 7./ - • 63. Heater & Vint-Final -
-
•
13. Roof.Drains ' t- 64. Plumbing System -Final
14. Rough Plumbing'- • 65. Electrical-Final . •
•
15. Rough Electrical-Conduit, - •66. SolarSystem-Final - - ._
16..Rough Electric Witting - 67. Fencing& Access Approval
17. Rough Wiring Sign: • ' ' 68. APPROVED FOR PLASTERING '
18. Rough Electrical=T Bar Ceiling 1 ' 69. POOL/SPA SYSTEMS FINAL . -
19. Rough Heating&Air-Conditioning r FIRE DEPT. REQUIREMENT
20..,Rough:Factory Fireplace APPROVALS Permit#
' 21. Ducts,in'Structure I 70. Underground Hydro
' 22.-Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
I 23. Gas Pipe-Rough&Test ' 72: Underground Flush
24. Roof Framing. ' i '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 t Notes:
31. Plaster Brown Coat
32. Electrical Power Meter-Final I •
33. Final Electric
34. Final Heating& Air Conditioning .
35. Final Gas Pipe-Test r
•
36. Hood or Canopy
37. Final Factory Fireplace - 1 ' , - -- - '
38. Final Plumbing j// . p' '
39. Water Service-Final '
40. Gas Service-Final '
41. Solar Domestic-Final .
42. Backflow Preventer - , '
43. Backflow Irrigation
44. Landscape Irrigation System I
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. CERTIFICATEOF OCCUPANCY , _- ,
No Date
FEL RECEIVED
Y 20932 NOV 11963
. COSTA MESA BUILDING-SAFETY DEPARTMENT • FINANCE DEPT
P.O.BOX Si] . COSTA MESA.CALIFORNIA .
\ CITY OF COSTA MESA
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDINGEIU
7 / /�// I For Office Use Only
ADDRESS!G �OI ���J Mein �I(
RECEIPT NO. PERMIT NO.
COSTA MESA. CALIFORNIA (�//.�I` 3 I
J Recel B DA ee v ' O T Nor*
62
OWNER (//thee s 1 lor
30/71.
�O// Hey
e Zn BUILDUG
MAIL ///�( ADDRESS
ADDRESS r
/ �/�,✓FIRE
CITYv6 5t6 �B6sr NEC �W Jti ZONE TYP- GROUP /
APPROVED a ACPARCHITECT TEL. BY DATE L%
OR ENGINEER NO. _ / /
ZO. ING itt , e
AD. .SS tinOr ,/�
CONTRACTOR 1.1 an. es , T7 O , I' PPLANS (r-_BBUILDING/� n/ 22-12..
ADDRESS Leo /7 1 0/Yr c. e I-c . DEBCRI'NYN/y,E }� ,%D {"(.�i r1V� /!p
CITY Ce�Sry f� [�/{ esk. /'7(/' A.P.Na. /! — v 86— /1
JL-°L .01r NO.* L�a s4 NOTE: NO SAVE OVERHANG SHALL BE LESS THAN
STATE TEL. NO' HIDE V ROVE P.L
LIC.NO.
OP L LOT L7/CX_?O I NOW ON LOTS ALLOWED (U.B.C.REQUIREMENT)
OF
YARDS APPROVED YARDS APPROVED
USE OF ? // `.� %/��� _ MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG. _ h` (�
�? (FROM C/LS/TRE. r� „yy/ \ 1
SETBACK LINE ��++�� / FRONT UFT. /I/-�-�� J
CENTER OP STREET C/ 1 I{EAR YARD.7S
SIDE YARD I LEFT ....4r.-1 I RIGHT .P� / R.SIDE /SP--;
/�
T. djin 1 FT.
DESCRIPTION OF WORK L.SIDE •-`J F--r. FT.
NE' - ALTERATION ADDITION REAR -17--C.)FT. ,w! 'I FT.
DISTANCE BET. - -C/1'-'ACCESS.OL
REPAIR MOVING DEMOLISH MAIN BLDGS. ^30 I ACCESS.SLOGS. •
BUILDING�J '7�/ .. -7 NO.OP VAR.SC DATE
SIZE .C_7 �J.f�' ROOMS STORIES / _ C.U.P. APPROVED
EXTERIOR WALL ROOF APPgp�E ��/l/ /
COVERING I COVERING BY W-�- (y "'/ i...�DATE /7 - -1P t
USE OF BUILDING AND WORK TO BE PERFORMED
HOLD FOR SPEC AL RE
OUIRFMENTS
S//i is ,fess 4.07,r• 1,1",,f- eif-F 54 "-
. 2ce 6 N
Sq.PT. n
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE Y
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. G
PLY WITH ALL CITY DINANCES AND TAT REGULATING J1 N
SIGNATURE OFBUILDING u •N VALUE ON PERMIT FEE S '` 9( `^^moi
PERMITTEP t S /� / PLAN CHECK $ 3, a_a
/ f0 ' D
/ C�
AUTHORIZED ENT E
\ TOTAL FEE 5
• C
FEE RECEIVED
20933 NOV 11963
LOSTA' MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT.
P.O.BOX 917 COSTA MEGA,CALIFORNIA
CITY OF COSTA MESA
For Applicant to Fill In Completely APPLICATION FOR PERMIT.
TYPE OR PRINT • BUILDING
'�// �� Iln aAFor Office Use Only
D REI6S -/L1 Q{� I�de,/ [�
RECEIPT NO.
PERIIT NO.
COSTA MESA, CALIFORNIA an&R3
-/_/ ,RpEc IV�A.�sJ/ 7 RyaV� DATE ISSUED /n
OWNER t)Q mmeCi 2% v�l 'V I /1- /�J o
BUILDING
AD RESS LSO/( goy&a �A . ADDRESS
Y IRE
A/// TEL / ZONE TYPE GROUP
CITY Cr)S AL. /Y! e$ NO/ ��J
ARCHITECT TEL APPROVEDR7 DATE//I.s(rA
2
/
OR rmGINEER NO.
• ZONING
AD�..:69 ZON� NO.Or ILO;
SE OF NEW _<;rr
^/ ////// NS BUILDING
CONTRACTOR `i L?, r/j Q,j 1- er I/ ,f ` /
DESCRIPTION IIf L //// �/( 1 la la-2(v
ADDRESSSS,..?6,/,' My U` L� at' a
CITY ( L 7 S �••[r 0 e t,- A.P.NO. J / - o /] —� I
STATE j,PI 3�3 ✓wrier
facc✓ 90?TO SIDE @ REAR P.L OVERHANGE: NO EAVE SHALL BE LESS THAN
LIC.NO. K-U .y •J / EAVES
SIZE OT ( li� /•At Sar I No. F LDOS. ALLOWED (U.B.C.REQUIREMENT)
OF
USE OF YARDS APPROVED YARDS APPROVED
EXISTING BLDG. a, Alkaa r / ��, MAIN BUILDING ACCESSORY BUILDING
'J (FROM C/L STREET) IL
SETBACK LINE STRE FROM L'1, j REAR YARD�[�/ FRONT 7, /�a l�^ �•
CENTER OF STREET c
f / R.SIDE 5 FT. PT.
I /''
SIDE YARD LEFT (.J 'I RIGHT P
DESCRIPTION OF WORK . L.SIDE .5-FT, FT.
NE _'ALTERATION ADDITION REAR20 FT./moi[^. FT.
-/ DISTANCE BET.n U BET.MAIN @
REPAIR MOVING DEMOLISH MAIN SLOGS. / a �� ACCESS.BLDGS.
BUILDING NO.OF `/^ / VAR.# DATE
SIZE 47 4,x2 ROOMS V STORIES / C.U.P.# APPROVED
EXTERIOR WA ROOF AP- •V
COVERING COVERING i ,/ BY . I as �/DATE - -6 ,F
USE OF BUILDING AND
WORK TO/BE PERFORMS. HOLD
FOR S•ECTAL5.-/-.o....2-0--1_
REQUIRrM :T*
1.
Sinfie nes/ (i Plll..P t/A/i- ' may/ `'/ �, U � cr�1 1 N
/ 3 V SO.FT. L//'///j B
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE Y
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. G
PLY WITH ALL CiT RDINANCES AND STATE REGULATING F.•d
BUILDING CONST ON. 1/ VALUATION --////7T ._� •
d
PERMIT FEE $ ��/ j
SIGNATURE 0 �o/J/J ^ ///yyy IW j $y. D
PERMITTE r[%� ,.>/1....,
✓ $ • 3 D� PLAN CHECK S / �I E
AUTHORIZ GENT •
/ 6 2
TOTAL FEE $ 5/01
• 20934 FEE RECEIVED
NOV 1 1913
COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT.
P.O.BOX 317 COSTA MESA.CALIFORNIA
CITY OF COSTA MESA
For Applicant to PHI In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
For Office Use Only
ADDRESS -•,Zh 46 E/den ie
RECEIPT NO. p(Jyg14
COSTA MESA. CALIFORNIA � "LLJJ1l�l1�L��lJdJ�"J�
REC ve0 ecy�6 DATE/ISSUED_
OWNER J am e 1/er /� /RIC-1'3
MAIL / BUIL�G
ADDRESS
SO& Are. LA - 9//�j/ADDRESS -
FIRE
CITY( OS/Q 441es- NO.TEL. /a^�`a ZONE TYPE GROUP .•�
APPROVED d / -3L
ARCHITECT TEL BY DATE
OR ENGINEER NQ. I
NTNG .y(p
ZONE NO.OR .� I use or NEW ','�Q �/
�/, Puns VJ�11 BUILDING
Jon?om eS -L%a
3c / 1oyc e
LEGAL /
ADDRESS// fa
Lam,. DEBDRIPl1• / G} pd .( C 3
CITY C.O S/ G //�( QfK • A.P.NO. I I. ( .—c (7 —I
STATE 'J O 7 J p/ NQ. L T Mciiir 90NO?TO SIDE&REAR P.L OVERHANGE: NO HAVE SHALL BE LESS THAN
LIC.NO.iC / J/FIa�J(J /� n J. !7 JCI
6(p /\ 3o I NOW ON LOT •j EAVES
SIZE NO.OF BLOTS. ' ALLOWED (U.B.C.REQUIREMENT)
OF LOT
YARDS APPROVED YARDS APPROVED
USE OFMAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG. sal.ffOU.T e S 'I Gc,P•b 'i
(FROM C/�L STREET/
SETBACK LINE FROM re" I -' / FRONT 0FT. PT.
CENTER OF STREET �L/� REAR YARD at.r
r 1 �♦
I RIGHT A., R.SIDE / 0Fi. II FT.
SIDE YARD LEFT J.--
DESCRIPTION OF WORK L.SIDE 5.--FT. FT.
NE" �(/ ALTERATION ADDITION REAR - FT.
DISTANCE BET. 0-0•1-'/ A BET.MAIN a
REPAIR MOVING DEMOLISH MAIN SLOGS. ACCESS.SLOGS.
VBUILDING 2 3!�y4.RO
3OMS S STORIES , CAU.P. APPROVED
SIZE
EXTERIOR WALL. J ROOF / APPWE
COVERING Wood COVERING L..O��Q BY W• ty I •ATE // --I — L
USE OF BUILDING AND WORK TO BE PERFORME HOLD FOR.Vet REQUIREMENTS
Si . /e �e sidenc e On t (% _ 7
/a 6 SQ.FT. N
B
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE 5
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O
PLY WITH ALL CITY ORDINANCES AND STATE a REGULATING SA,— ii
—
BUILDING CONST IDN. VALUATION PERMIT FEE 5029, •--. rt
SIGNATURE ',L
PERMITTEE��7Y-�//� OU D
s 936 A PLAN CHECK $/3 150 2
AUTHORI ZC GENTSc) d
442
TOTAL FEE 5 •_,
20935 . FEE . RECEIVED
Nov 11968
`FOSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT.
P.O.BOX 917 COSTA MESA.CALIFORNIA
CITY OF COSTA MESA
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
e �J/ / K�i, For Office Use Only
ADDRESSuILDING �(,b�CD /de�/
RECEIPT NO.
COSTA MESA, CALIFORNIA
r
OWNER VapGS -f--/er R1:3317.1
7/ /07 D DATE ISSUED
11-1C-63
///JJJ BUI NG
MAIL 3a'i ADDRESS '
ADDRESS (J /CJ{/(//,,G .L�rQo•mayFIRE
CITY /��/ /[v/P+ So NOLO{j fr, . -ZONE TYPE GROUP
Q S 2
ARCHITECT TEL. BP/PROVED �1/f- DATE /��j�r�3
OR ENGINEER NO. (✓
ZONING
AD. -53 ZON NO.OF USE OF NEW
,—r.• /
---
PLANS 2I BUILDING
CONTRACTOR Oa rn .G$ J ler /� I, n
/` AA/nn/ OEsCRIFDOK /\/G/1_ 41- j TR, 137/1
ADDRESS/307/ /!Q(/G P �h , r (%
CITY ` 4 S/ (ice // MesR A.P.NO. I / ! 7e - //
STATE � ,�� p / NO-A�jer_` NOTE: O a REAR p.L. SHALL BE LESS THAN
LIC.NO. G J Z O 30'TO SIDE a REAR P.L
EAVES
OFLOT (4',Y3ar I NOW ON IDT ALLOWED _ IU.B.C.REQUIREMENT/
YARDS APPROVED YARDS APPROVED
USE OFMAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG. cx ND fire ACV (FROM C/L STREET)
CENTER OFJO
SETBACK ISTREETNE M 3// °�� REAR YARD� FRONT 0'0 PT. ($!//� FT.
SIDE YARD I_ LEFT I.? ' I RIGHT H./ R.SIDE SFT. � FT.
DESCRIPTION OF WORK L.SIDE /0 rr. /S-4' FT.
NEV ALTERATION ADDITION — REAR ,O 5FT. Fr.
DISTANCE BET. BET.MAIN&
REPAIR MOVING • DgMOLIBH MAIN SLUGS. /���i ACCESS.BLOCS.
� VAR,# DATE
BUIE (1 .2 LDING 2 3 '3S .Jr"- STORIES
SIZL ROOMG.U.P. APPROVED
EXTERIOR WA I ROOF APPRO ED
COVERING COVERING BY DATE //- -
USE OF BUILDING AND WORK TO BE PERFORME
p .T rry FOR CPF.r..T
4L RtQUT FTI—..—e
•
S;4fr/2. Res/ dent e C�„', •
/''/rw�// N
W 6G.FT. G
r.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND GREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O
PLY WITH ALL CITY ORDINANCES AND STATE EGULATING
BUILDING CONSTR N. VALUATION �•//� —, w
SIGNATURE OF t1�\Tp/1 - PERMIT PEE $ /�
PERMITTEE +�/h. SII/I/ w CN . S
AUTHORIZED NT
$ 736 D/ -
TOTAL FEE $ D/
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
BLD -NO' II SD 4/Gtilt3 TL
CITY OF COSTA MESA ' - '� IT-NO. 'TRACT NO LOT NO. ,tI ,t q , Doo
CONSTRUCTION PERMIT- •
7�
Applicant's Mallin dress - 1��3�, " '-_,,,,:374',.yy' t - TYPE OF CONSTRUCTION-_ `U,NE1y7�'}U ADD,. L-ALFTnE RATION PAI :+_, j - i r_ , j I
t'S& rcvr 7 y/..0 i ❑ CONVERSION ❑ DEMOLISH Y� OTHER `E- �� �s� G; ` ` a; ' i 7.t . I
ProjectAddress; Y0 �^� ,e ._ .. ' - -
' Owner s Na e -7 /�V / �'x�^� "Phone���� //G DESC RIPTION'OF WORK 1 k^fJEc,`��'^��,_ • 'ZONING REGULATIONS • '
Address "' EjCO^/ •S ' I.' F'' TYPE OF PERMIT •❑ GRADING .. 1U FOUNDATION• U STRUCTURAL I _ A.P:# - "' - ONE {
Arch/EngC- - - ' License NO. 0 TENANT 0 ELECTRICAL' AJ PLUMBING. 0 MECHANICAL- ' 4 PLNG.REF.#, • I + =BUILDING - _ -
Address ' ,'OTHER + - - - - I ,TO BUILDING' ' - I - - - -
i d t '- (� { - - - - PROPERTY LINE • I I ;REAR YARD (TO P./1-):1
Contractors Name/9/ 4311 "'41%7 /71ttr.A Phone^ S'3767I ' PROJECT DESCRIPTION $ FT - - ' OCCUPANCY ,
�7 ;LEFT SIDE YARD RIGHT SIDE YARD. ;
�00.�.2fs 9�' 1p Sr'3 CONSTRUCTION TYPE - VALUATION$ Ir - ,
Licen• Address i�6�G k I I I PKG.SP.ACE'REO. •
+ PROVIDED • -' l
i Oo2ly , ! 1 I ' ZONT ' ' GRADING CU,YDS: .ACRES _ ,
License No, • __ - - + - + ..
' LICENSED CONTRACTOR DECLARATION I i • Remarks; ' • - ' • I 1 'STREET WIDTH ! - PARK FEE$
rcThI: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 1 r- I SPECIAL CONDITIONS: I - 1
/ my license is in f I Pore and effect, t
_ - Si . 3.io�2/ i PLUMBING I I Id
; r I j
-�V Licen • Cass' '� -`"�,Licen e
Date • j� Signature Bar Sink Sewer Cap ' ELECTRICAL
FORK:RS COMPENSATION-D LARATION , I ' '
\ .500, Lab. '• . { Backflow trrvat oe^'--_ ^- - -�wer�nnection' - �--- -i AutomaticWasher I *Meter Clover 1 W amps,-, _ 4
reby.afflrm that I have a cert i-.te of.consen Lto self-Insure or.a,certificate ., - _
•
}Workers• Compensation Insu -nte,;or a certified.copy thereof (Section
i?: I r� // ./-1 / g (lectors Construction Pole Sub Panel' I I
PoII_c_y No. -''7 -' ib Y j Company'.e,l✓10/iE .iT6�, i _. I
Cooking Unit .- Sub Pole . I I
Certified•cppras hereby furnish ii -, �-J Bat•htubs Solar Piping 1 I S ' _
Certiile p ISS filed with the . v: ng D sl Dishwasher ' 'Motors OQ 1 HP '01'48 ' i
ti 's- '' ' Clarifiers ; Solar Tank ' - - +
Date ����//p//'�yyyyi Appll _ ___ _ __ __ _ _ _
EXEMP N.FROM WORKERS' PENSATIFN DECLARATION I - 1 , Dryers-OGaS,❑EIeCtric + :I ria Solar_09;15 HP 016-15+ - 1 j•
(This section need not be complete• f the permit s for,one hundred($300) or Dishwasher 1 , Swimming Pool w/Spa + - -..
less):, r' o .' I I t I I I Drinkin FountainsFan 1 I ' i" I ,Microwave I
I certify that in the performance of the work for which this permit is issued, I 9 j 1 Urinal . • I I ; I I . I I I
• shall,not employ any person In any manner so'as to become subject.to the - } I i F.A.U. ( ;Pole Light I I l j
Date s•(CompensatloniLaws of California.. + i ! ; Floor Drains I I ! Water Closet l !.' i
Date ' his-deure ! , tures , I ' . . n 'e _ ' 1 ,
-NOTICE:It-after-making this -you shouldrbecome subject to the- - . Floor Sinks s L.---.. - -Water-Heater--- -- - ---- --I - . - ,- - Fixtures_ !Re.g �_ . ____ - ,t._. . _
Workers';Compensation provIslonsof the Labor Code„you,must forthwith, . - I I • '
comply 'with)such Provisions'-or thls� ermtt I shall be 'deemed revoked.' _ �' I Device Boxes Sin i
p P Dj 1 'n. Gas Service. - Water.,Seryice _ ,� 'q, g ,
CONSTRUCTION!LENDING AGENCY • j - - - - - I '
I hereby affirm that there is"'construction lending agency for the performance Interceptors' - + _ , , • I r . I N Outlets 'Standing Sections j I j
of the :work for, which this' permit-•is issued (Section .3087. Civ: C.) - - ' _ • ( , 1 !
r { 1 a', I + I j ! rr i - i I Switches I. Trash Convector t ,
Landers Name• j - Kltchen;Sink f + I : ' ! 1 + I
Lender a Atleress i I - . i - 4. ' rt,
i ' I Lavatories n'. i i t' O ( I Garbage Disposal 1 I i 1 ' I '
OWNER/BUILDER DECLARATION' l ' ` : „ to,I r: + '3 j .-,l i ' 1 .' + • ,- I I
• I hereby:affirm that I am'exempt from the Contractors License Law for the - I '� _ - s, i Generator,00-5 KW ❑5-15 KW i
following reason.(SectIon:7031.5 Business and Professional;Code: Any city or - - i e-Trap, <' r„ - _ - , .
'county which:requires a permitto construct;alter improve;demollsh:orrepair ' _ . - , ' Transformer 015-50 KW ' , I .
any structure,prior to Itslissuance,-also requires the-applicant for such permit Roof Drains - - - - _ , - .
to file a signed statement that he/she is licensed pursuant to the provisions of _ - - ❑5U+KW r ' - '
, the Contractor's•IJcense Law;(Chapter 9(commencing-with Section-7000)of - !- 'C j : I - i I Reinspection Fee I T $15' •
vision 3`of the Business'and/Professions Code) or,that'he/she!is'exempt 1 Shower; - - ReinspectioniFee . $15 -'
g x"')from-and the basis for the alleged exemption -Any,violation'of Section �- - •_ Meter O'up to 100;amps 'Issue Fea j ! $ 3
'tr 1:5 by_any applicant for permit-subjects the applicant to a-civil ' S I + - i $ 3 re- - -.— ,
laity of not more than five hundred dollars($500) r; ._ Service Sink; ! Issue Fee_, ' Zoning Approved By ' I i 'Date ' '
I,as owner off the'property orrmy employees with wages;as their sole ' , • I I I I i •
• compensation will do the work,and theistructure,Is not intended or offered I I .,, j • 1 1 ,� MECHANICAL' , Application Approved By sate I i
- for sale i(SeciIon 7044, Business and!Professional-Coded The'Contractor's ;
/ +/
License Law does not apply to an owner of a property-who builds or improves j ' j Boiler ; - I 'i1 , 1 : I Refrigeration System + 1 ; gpplicati• Istuad ' - sate 0I j
' thereon,iand who:does such'work himself/herself or through his or her own - I I
' employees, provided that such improvements are.not Intended or offered for 1 00-,,100,000 BTU ❑100,000 BTU( - 1
Duct-Under;Giound ' i I
, sate. I/, however,the building or improvement Is sold within one y build
com- ' I + : SUMMARY OF FEES , +
Dletion,the owner!wlll have the burden of proving he/she did not build or im- 1 ; - 1 I I
grove for the purpose ofl sale): f ( ; I i Duct-Structural l System Repair/Alteration : ;BUILDING PERMIT $ , 1 I SMTP I $ j - I
L I I,as owner of the property,am exclusively contracting'with'licensed con- ' 4 j I i i • I I I
_tractors to construct.the'project-(Section 7044,Business,and Professions,Code:. • _ ', Duct-,Ventilating„I -' _ _e _ _.- -„ j___ __ -_ I- _ - !PLAN CHECK( $ , PERMIT
I The Contractor's License Law does not apply to an owner of property who , j I j ISSUANCE 1 $ + J
' builds or improves thereon,and who contracts for such projects with a con- , Exhaust System 0 Multiple 0. I I • ; I PLUMBING j 1 $ �'�' _ i
trac_tor(s) license pursuant to the Contractor's License Law). - I ( GRADING i $ i
1 i , ; • , I ,PLAN CHECK' $
0 lam exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# l , , , I , ,
ELECTRICAL I $ I , $ j
: Date ' I Owner i • { I •Heating•System&Ducting j I I $ i
_ _ (PLAN CHECK' $ I . 1 MICROFILM f
1-hereby-certify that-IYhave-read this•appith all city
stateuthat the above 00-100,000 BTU.0100;000 BTL --.- ---•-•--- ,- --+ - I 1 ' •
Information is correct. I agree to comply with all city antl county repre-
ordinances I 1 MECHANICAL , TOTAL FEE• $
antlstate laws relating,to building construction,'and hereby authorize rHood or ' 5 I i i $ 1 '• ' I '
sentativas f I 'city t to app ter upgn the ova-mentioned pro rt for ( Canopy: Type I ❑� Reinspection Feel ' $15 PLAN CHECK ! $ LESS ' j 1
• Inspection !7,14:Si. I j - = 1 - + I ADVANCED PC 1 $ {
py: TYpe I I 0, 1 s i 1
Drivers'
_ Date 1 I _ ( ' , { i j I - j '
-Builtling:Canary-Applicant:Pink-Accounting;Goltlenrotl-Assessor
C °CONSTRUCTION:AND_�PLA MNG',/" o I 92..` ; ip ` ' 'c POOL ^rA ;7A - - -
APPROVALS , Permit# f'7YVr : _ Date 1 Inspector), :{APPROVALS _-Permrt# - - Date Inspector
• Temporary Electrical Service orE.Pole , - a_'. , : .(52 Pool &,Equipment Location ,.; ,. 2 ,
r �t 1So11 Pipe-Ulndrgrnd' �, `:_rp ' - f :53: Steel Reinforcement - =- - ,
-3! Electrical Conduit Utility-Undrgrnd: i- ;-- ' - _ a'-7 i ;-F54, Forms i-c, : ••
4: Electrical Conduit-Undrgrnd'. - - ° C - 555, ElectricalBondin - "' `
5 Steel iReinforcemerit i � I-; _ ', `F -e !r- : - ; ,56-- Ft-Pugh-151U'mbing& Pressure Test 1 ' • ^'' '
6. IElectricel OF ER"Grnd - 'i ra - c ---! 57: APPROVAUTOCOVER-GU_NITE
I V }
7. Footings , I I I i : n Mm i Ir, = i m ` ' , 58, Electrical Conduit=Undrarad -
8, Foundation •! j ' 1 - .... .. i i .-.7, , L ! ;59 Gas Pipe, O Undrgrnd Test i,' I'
9. :Nater:Pipe- ` ' I `- s` ,60- Backwash Lines,P-Trap, O Undrgrnd V e I
10. Structural Floor System : o ), r2.1` " !.61. APPROVAL-T'0 DECK
11. Property Sewer Line&House Connection r -t: ° X62. 'Backwash & ReceptorFinal - - -
12- Sewer.Cap 1 , -. . - - - y
I ! ' I ,__ ' r. • ; 63. Heater &•Vent-Final , _
13. Roof,Drains - _1 -� - - -1;# In • - I .- .64- Plumbing:System -,Final ' - - -
c 14. ,Rough Plumbing; ' ! - - - -65. Electrical-Final=s - r.- - i . '
0
'- 15.',Rough-ElectricaRConduirT r 7- , - - 7 iT-r 166. SolarSystem-Final 7 ---: -.. - - _ _ _ ,. _ -
.16- IRough Electric Wiring, , 1 F 1 ; ' -'L- - -67 Fencing& Access Approval -- - ----- - % --
d 17. 'Rough Wiring Sign,r ,' -i 1 ., 1 v I x 1 - I - • • I - ' ,
_ I ,' c 1 ! ;c, .68.E APPROVED FOR PLASTERING • -
•_ - 18- Rough_Electrical-T.Bac Ceiling 11 ; i I- i I 1• ;69. POOL/SPA SYSTEMS'FINAL- • ' 1..-r-,
r, 19: Rough Heating&;Air.Conditioning 1 I ' l v I I • ; 1 ';FIRE DEPT REQUIREMENT t'
I ' r'
l
20:.Rough,Factory Fireplace;1 !' ' I APPROVALS . Permit# I - 1
121.•Ducts,in Structure' I �; IlI I l ; ' I 70, Underground Hydro , .
' '4;22.!Ducts, Ventilating C i H II ;I } i I ,71) Product Piping OGas boil i f'-i
z `'.23. Gas-Pipe-Rough & fest r- I 72. Underground Flush _ '
24., 00f Framing ; , I',i Ii,- 1. , I : . .'1 ;- 17
I : 3., Uodergrn
Rd, Storage Tank EJ Gas;D Oil I '
c _25_.:Roof Sheathing I I J { I IIS'II I ;r, j a' j.,. : I I i j 74., Overhead Hydro I ;o I
E. ,26-IT-Bar Ceiling (Structural),& Monocoat I : ' ' ' ` 1 ,'; ;75. Dry Chemical : • ' ; '
-27. Frame and Flashing} i 1, ! 1 ; ., , � . I I I .76.: Dry Standpipe ' 4 I `
,i 28. "Lathing &-Sidings it ? : i I '1 ll i I - ' ' 1 177: FIXED SYSTEM=FINAL • . : ' i
. 1 29._,Insulation '-- s I n � 1 11 I! 11 I i I ' it 178; FIRE PREY. FINAL .1 i • '
r: io .i -
-30. Drywall, Nailinn. I g - y ' : • 1 Notes:
I 1 1 1
- '31.:Plaster`Brown Coat; , 1 " '. ' , 1 1 1 ' I 1 ' • .
o '`32.€ElectricaI!Power Meter,-Final ' II I I I l 1 , . f- - ,; t ,.i
33. Final Electric_ II __ f • ' -! _ . I.
1vI 1
34. Final Heating & Air Conditioning 1 i I , I -
35. Final Gas,Pipe Test i- I . 11.I • o ' 'j -r17 fr , " - - -
36- Hood or:Canopy- I° : I '1 � . .. l f ,. 1r IriZ .- It I I, I
- _, -
37, Final Factory Fireplaces; ; _. ! P.: , = l , I I I I _. _
38. Final Plumbing i 1 , I i "" 1- 1 1 1 ,- , II 1 '
39. Water iService:F nal ! I I I I i ' i 1 i i ! I I
40. Gas Seu`rvice-Final I 1 I I 6�'.�3. ��t
41. Solar Domestic'Fina1 I I 1 I ' I I - ' • i i
•
42. Backflow Frreventer I I I ,T'- _,,• - I_-, --i---1_ :--_ _- - _
tui I, ; 1 1 , ': .v w - 'a Ic t. ';,4, r'i - I .
43. Backflow Irrigation 7:0 1 i I c I I n I `! = 19 I
J i. L.M I r' l .. 1 • -
44- Landscape Iirigstion System; I Er!I '1 i° ` i : s ; ' : I I '
.` 1
45, Sound -A 'ttenuation ' 4 1 1 ! ' -,i i ,I - i i - _
4-.• ..a Q II R 4 I 1 ' . . 1 . i - - - - .-
46- Handicap Regulations 1 1 ( ;
I '' ' i '.r 1 I' I 1 i a.1 1
t ,
47. FINAL STRUCTURE & BUILDING I: '11' 1
a- 1 - 1 ! 1 I l i I 11_ [r
n
t' I I I I I i I:. I F I 1:;
48. Special Requireinents Completed . , , l I '_ 1 i I i . , 1 r. .-
49. Electric Releaselto)Edison' 1f I : ! 1 1 1 i ' I _� I_ ! J_1-_ I_+ -' _
G i I I I 1 -' ' ' I 1--1.-, -.-1 1 I 1', I I IJ
IIi. I I I I III I 50- Gas Release to Southern California Gs Cu ' 1 1 1 1 II i '51. CERT,IFICATETOF, OCCUPANCY I,_ f.J-;._I ._, 1-). �L _ __ _I`! . !
IrNo I Date i- ! ii , - Iv ! JI ? -
;,.: ._ .__... .-.- ,- :-.ter-`- -- •- ---- - - -- -�--` ,.
ILey'
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
— PERM O ^ • TRACT NO. LOT NO. UNIT NO: -�
CITY OF-COSTA MESA/ CONSTRUCTION PERMIT r.y I26E 7/IC/E7 C• r
Project Address /9&Sb e)it ' 5' I� / /S� LI
l
Applicant's Mailing/•ddress 11 / I- TYPE OF CONSTRUCTION LI NEW u ADD LI ALTERATION SLI REPAIR
Owner's Name G� I I Phon nil/ , El CONVERSION El DEMOLISH El OTHER q,p.# • Zone
�n 'rap- DESCRIPTION OF WORK/USE OF BLDG. _ _- _ ----
Address L, S Main Building: Accessory Building: ,
Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING fin' FOUNDATION ❑ STRUCTURAL E Front 0
•Address . _ ❑ TENANT [I] ELECTRICAL /IJ PLUMBING ❑ MECHANICAL B Rear • N
Contractor's Nam- A! .,a . li/ /ie Phonek1599OO5 ❑ OTHER A I
o ' y1 �L' PROJECT DESCRIPTION SQ. FT. OCCUPANCY• C Right N
Address(mailing) a N `/ ( ,7 /YY . - K G
�D / CONSTRUCTION TYPE VALUATIONS S Left
' City License No. ZONE GRADING CU.YDS. ACRE$ R
LICENSED CONTRACTOR DECLARATION Ping. Ref.# •
Parking Req./Provided E
I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: Planning Notes: Q M
with section 7000) of Division 3 of the Business and Professions Code, and CD JUL 2 1987 T
Ir`Y\'71�Vp my license is In ful o e .nd effect. s RFCEIVG
Licen- i I s N•/ A_ Ta S
Date/'/. i• 'rte Signature .—- //����L� PLUMBING FEES
WORKERS' COMPENSATION DECLARATION Bar Sink •
Showers
'hereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL • FEES
{ Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer - Service Sink •
,� )0, Lab. �C,Lq 03 9 Automatic Washer Transformer ❑ 15.50 KW
•
Policy No. "o Company Backflow Irrigation Sewer CapConstruction Pole Sub. 0 50+KW
841 tified copy is hereby furnished.
ifs5eS�q pxys ed with the city vi ) Bathtubs - Sewer Connection . • ' - Cooking Unit Meter Duo to 100 amps
EXE TION II Applicant p(This
( kvvvvvTTTTTTP FROM WORKERS' i NSATION DECLARATION Clarifiers - • • Solar Collectors - Dishwasher Meter Dover 100 amps -
(Thi,section need not be completed if the permit If for one hundred($100)or -
less). Dishwasher Solar Piping Dryers ❑Gas DElectric Sub Panel
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 Drinking Fountains . Solar Tank Fan • Motors 00-1 HP 011/2-R
Workers' Compensation Laws of California. • .. •' - . — -
Date Signature Floor Drains Swimming Pool w/Spa' F.A.U.
NOTICE:If,after making this declaration, you should become subject to the - - Inc.Solar ❑9-15 HP 016-15+'
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks - Urinal Fixtures Microwave
comply with such provisions or this permit shall be deemed revoked. - •
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes Pole
I hereby affirm that there is a construction lending agency for the performance Light
of the work for which this permit is issued (Section 3097..Civ. C.) Interceptors - ) , Water Heater — Outlets
Lender's Name - _ - w Range
.Lender[s Address Kitchen Sink .,. Water Service •
Switches - - , - Sign - -
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash . Garbage Disposal
following,reason (Section 7031.5 Business and Professional Code: Any city or - • 9 P , •
Standing Sections
' county which requires a permit to construct,alter,improve,demolish or repair P-Trap 4 4 LaundryTrays Y Generator ❑0-5 KW ❑5.15 KW Trash Compactor
to
era signed
prior tom Its hat he/, also requiresicesthe tcapplicant for such permit P
to file a statement that he/she 9licensed pursuant to the provisions of Roof Drains ' -
the Contractor's License Law(Chapter (commencing with Section 7000) of 1 .
• 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 •,
'1.5 by any applicant for a permit subjects the applicant to a civil .,
laity of not more than five hundred dollars($500). $ 3
Li I, as owner of the property or my employees tires withwages as their sole Reinspection Fee $15 Issue Fee
•
compensation, will do the work,and the structure Is not intended or offered Reinspection Fee . I $15 Issue Fee $ 3
' for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES
License Law does not apply to an owner of a property who builds or improves '
thereon, and who does such work himself/herself or through his or her own - DEVELOPMENT SERVICES REQUIREMENTS: '
employees, provided that such improvements are not Intended or offered for Boiler Hood or Type I 0
sale. If, however, the building or Improvement is sold within one year of tom- Canopy Type II 0 Zoning Approved By Date
pletion, the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground Building Approved By Date
prove for the purpose of sale). p•/�
❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System -. Application Issued By Date 1O�b /
tractors to construct the project (Section 7044,Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating DO-100,000 -100,000 BTU 0100,000 BTU SUMMARY OF FEES
builds or Improves thereon, and who contracts for such projects with a con •
-
tractors)'Ilcense pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple❑ System Repair/Alteration BUILDING PERMIT $ SMIP $
proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT -
❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# Fire a- PLUMBING 5 S. DO SS UA NCE $-
Date Owner Heating System& Ducting PLAN CHECK 25% $ ENERGY P.C. $
I hereby certify that I have read this application and state that the above ❑0100,000 BTU 0100,0006TL ELECTRICAL $ GRADING $
information Is correct. I agree to comply with all city•and county ordinances
and state laws relating to building construction,and hereby authorize repre-
sentatives of •is city to enter up-n the above-mentionedproperty for •
•
inspection p eA/ I MECHANICAL $ I�Q
Signature I/ /,� /. �/ dr_ Data /"(ll//t %/ 7 TOTAL FEE $
Drivers' License or 55# _'_ainIrinaI•
0865-46,rev.10/84 White - Building; Canary -A••licant; Pink -Accounting;Goldenrod - Assessor
CONSTRUCTION AND PLANNING POOL& SPA
APPROVALS Permit# Date • Inspector APPROVALS Permit Date Inspector
1. Temporary Electrical-Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement jo
yti
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
.
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement - 56. Rough Plumbing & Pressurs:Test
•
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-?,UNITE
7. Footings 58. Electrical Conduit-Undrgrid&
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Tbs.;
9. Water Pipe-Undrgrnd. . - 60. Backwash.Lines, P-Trap, alndrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
•
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign - 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit# _
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough& Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical •
27. Frame and Flashing - 76. Dry Standpipe '
28. Lathing& Siding 77. FIXED SYSTEM FINAL
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 Ode LOP . .
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 _