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HomeMy WebLinkAbout2603 ELDEN AVE - Building Permits tr. - * .'4 05111 MF CITY OF COSTA MESA - - Cre_w ,..m....i.,...n...:1 DEVELOPMENTBUILDINGSERVICESDIVDEPAISIONRTMENT P MIT NUMBER PERMIT 4. �� B00-01484 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa, .p5 DING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 2603 ELDEN AV CULL Status: ISSUED Suite: F Applied: 09121/2000 Vicinity: UNIT F Issued: 09/21/2000 Parcel Number: 93009747 Zoning: Applicant: SCHAEFER, RICK Address: 3160 INCLINADO ISSUED BY: Phone: (949)361-9233 SAN CLEMENTE,CA Zip: 92673 ' • Owner: DE ROOCK, DIRK TR Address 18231 SECOND ST _ F Phone: - ' , 'FOUNTAIN VALLEY,CA Zip: 92708 Contractor: SKYLIGHT SPECIALTIES Address: 3160 INCLINADO ' Phone:4 (949)361-9233 . SAN CLEMENTE,CA Zip: 92673 License: 395551 Arch : _ • Eng: Address: Address: . Phone: Phone: Zip: License: License: SCOPE OF PERMIT INSTALL NEW 22"x 37"SKYLIGHT(BRISTOLITE-ICBO#2469)IN STAIRWELL OF EXISTING CONDOMINIUM(UNIT F). _ FEE SUMMARY. Plan Check: $15.28 _ . . Calc Valuation: , . $soo.00 Permit: . $23.50 Claim Valuation: , $500.00 SMIP Res: $0.50 SMIP Corn: $0.00 Other: ' $0.00 Inspection: $0.00 Total: $39.28 � 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' 6-o ' PARKING Existing:' 0 Required: b Proposed: 0 ' NOTES: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(6/00) DkCL RATIONS r 1 fl , WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: O 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 L work for which this permit is issued. C - IIhhave 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. ' --7+1y workers'compensation Insurance carrier and policy number are: pc r Carder. 51;41-€ c�,,e/4 /Pogcy Number C630 //J ` -( his'sedtion no t be completed if the pe s 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 workers' compensation laws of C, m 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 p 11Applicant Signature: .' Da�te:--- ( —1 -/—00 WARNING`FAILURE TO • RE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EJ EY R TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOUARE(5100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm)theht'arn licensed under r Igns of Chapter 9(commencing with Section 7000)of Division 3.of the Business and Professions Code,and my license Is In full fo�ce.and,efleci..Uc_x-3 / Classx R • Contractor's Signature:_ l Date! ?---.7.12/---04, 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: 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 end 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).): O I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,end the structure Is not Intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or Improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth Into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,wit be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Tltie 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 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). ._._—_._ -______ __....._.a.__—_._ �.... ..._...._........_.._ _ . 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 01'500 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 11 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 apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? IJ Yes D 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 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 idah-6-017ii Air Duality 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. /L /o Sig Ot Legal ner(/,vs) Date 6 lC 9-Z/- e Apd/Or Authorized Applicant"------ (Dale` CODE}a INSPECTION TYPE DATE E MA POE/ IISPECTION TYPE QAIL IIB aft 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1268 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 G7 I 204 Final Demolition 250 Final Building/Occupancy (���l Ap`y S1 t- - r • City of Costa Mesa ` Development Services Department CERTIFICATE OF OCCUPANCY No. 001471 Building Safety Division -} P.O.Box 1200 i Costa Mesa,California ` The Building located at 2603 Elden Avenue #F `: has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto �2 for a Group R-3 Occupancy. J Use of Building Condominium F Legal Description 439-071-10-15 i; (See reverse side for Metes and Bounds) Li o1 tv Building Permit No x18478 Electrical Permit No. G18478 Plumbing Permit No. G18478 ', () Mechanical Permit No. 618478, M19770. P420177 Number of apartments11 and/or guest rooms ri ` / �J / , !ISSUED TO: Building Official , Mar-Elden Developrtent ��/ n M' �� �_� 18226 W. McDurnvtt by i c. Irvine, CA 92714 Date �!nc /9965 C y,/ _ ? This Certificate of Occupancy SHALL BE posted in,ajcorispicuous place on the premises and SHALL NOT BE removed except by the 27 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 CI z. ' 11 • '/- • • � t -.-,~ City of Costa Mesa 'yq8 Development Services Department CERTIFICATE OF OCCUPANCY No. O 014 C Building Safety Division P.0.Box 1200 Costa Mesa,California The Building located at 2603 Elden Avenue 4F has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto • for a Group 11-3 Occupancy. Use of Building Condominium Legal Description 439-071-10-15 (See reverse side for Metes and Bounds) Building Permit No CA.8478 Electrical Permit No. 618478 Plumbing Permit No. G18478 Mechanical Permit No. 67.8478, M]9770. M20177 Number of apartments and/or guest rooms ISSUED TO: Building Official AO nd , /\ r Al4.4/7. Mar-Elden Davelot nt ' 18226 W. McDtott by -- tm ' CJ Thi ,' nLrv� Irvine, CA 92714 ' • Date -13,0_-eG I / O ) 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 / Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. ',clTY 'COSTA MESA ` 1257 . 4/14/85 • p6: t, PERMIT NO. TRACT NO. LOT NO. BLDG.NO. _ �.,p Q: T. eCi 5aiCT�N PERMIT • - % 1 B / '.�c/y . P , • . - ' - : r/Projec Address •i til•'-//I♦:\INE - TYPE OF CONSTRUCTION 0 NEW U ADD U ALTERATION U REPAIR , Applicant's Mailing Address 18226 W. MCDurmott, Irvine ❑'CONVERSION ❑ DEMOLISHy, ❑ OTHER p� A.P. 3q-p 1-(/- 10-t /5- j zone n 2 ' , ' Owner's Name Mar-Elden Development Phone 474-0601 - DESCRIPTION OF WORK `` � co, b, S Main Building: Accessory Buildin : 0Z Address 18226 W MrDurmntt- Irvine 92714 �l E Chris R. Stephens C12963 • TYPE�-1 OF PERMIT U GRADING FOUNDATIONf�t' }n STRUCTV RAL T FrOnSN�Y� S N AVCh/Eog. License NO. - 0 TENANT `ELECTRICAL PLUMBING ICIMECHANICAL - B 151 ' - 'N 18226 W. McDermott; Irvine 92714 Rear Ail.dress ❑ OTHER A 1 1 1 Contractor's Name The Richard F. Crawforc' pe• 474-0551 PROJECT DESCRIPTION SQ. FITI.�1 ,_ OCCUPANCCY-- R K Right 2-S w+ i_, ` - •G Address(mailing) 18226 W. MCDurmott, Irvine 92714 -CON STRUCTION TYPE V' "••K VALUATION$ a +)? - _ $ Lef t �Qi , E CS eL16643 3QGLPQ" • ZONE GRADING CU.YDS. ACRES Ping, Ref. awn 11�z• .I-1 Pafk.Fees $ '7� /y� ���� ,IO City License No. ,�+V6YJ fa - `•u� -24/-y /J • I�{QLr ' %/ y0 1.a? O 00 LICENSED CONTRACTOR DECLARATION Remarks: Parkin R¢ /Provided j I'hereby,affirm that I am licensed under provisions of . ter • (commencing _ P•.C• "1",6' d •7/L g Q' 30 /3� R with section 7000) of Division 3 of the Business an. • of• ons Code, and - , Use of Building: rondo .E j my license is in full fo • and effect- - •y - - M ' License ss ' - ge LI 41j- . PLUMBING FEES Planning Notes: _ w . • I ,,... N ate •l� signature ►��/ Us!\s�' Bar Sink 1 Showers . 2 11iT r.�� STEM IORKERS' COMPENSATION DECLARA O1.ma_. - - T s I hereby affirm that I have a certificate of consent to self-insure or a certificate Backflow PreventerService Sink • - I • - S -of Workers' compensation Insurance, Or,-a-certified copy thereof (Section - - - - - - - ' 3800, Lab. CJ- b. �✓� - �� Backflow Irrigation r Sewer Cap -- - ' -- -_ - :•••.- I ELECTRICAL I FEES ' Polis No. - 4,- V Company_aJ - - ertified copy Is h eby furnished. I Bathtubs / Sewe?Connection �{'00 Automatic WasheF 1 .Transformer 0 1$.50 KW - Ce EXEMPTION PROM ed with the city�,L/4+�� _ -- Date `7 I-II Applicant / -'� Clarifiers Solar Collectors ..,, ' Construction Pole Sub ❑ 50+KW - EXEMPTION FROM WORKERS'COMPENSA CLARATION • Dishwasher Solar Piping -- (This section need not be completed it the permit Is for one hundred($1001 or 1 , P 9 - 7 Cooking Unit l - Meter ❑up to 100 amps - -, less). P. .. '` I cacti( [emplo the performancersoni of the work for which this permit is t to I • Drinking Fountains Solar Tank - / (+]•Over 100 amps 9 Y, / Dishwasher Meter shall not employ any person in any manner-so as to become subject to the —' , • �� ' Workers' Compensation Laws of California.' I Floor Drains. : Swimming Pool vv/Spa y , - / Dryers L7Gas, DElectric / -Sub Panel ' Date Signiture ' -- NOTICE: If,after making this declaration,you should become subject to the . Floor Sinks • Urinal- - r__-- - Fan 7 ' Workers' Compensation provisions of the Labor Code, you must forthwith - ' ' - ' - - / - - Motors❑0-1 HP ❑i X-8 • comply with such provisions or this permit shall be deemed revoked. / Gas Service 2...Outlets ' Water Closet 2_ aF.A.U. ' • Inc.Solar❑9-15 HP ❑1645+ - CONSTRUCTION LENDING'AGENCY r' / .. I • I hereby affirm that there is a construction lending agency for the performance Interceptors' , / Water Heater - , n, Fixtures CMicrowave of the work for which this permit is issued (Section.3097 Civ. C.) �� -2f 41-• Lender's Name. . ' / Kitchen Sink - / _Water Service - • - '1400 Device Boxes 'Pole Light ' Lender's Address ' - Lavatories ' M 3� OWNER BUILDER DECLARATION ,3• - _ - 3 ' 1,2 00 V Outlets / Range ,7 (0t< ' I hereby affirm that 1 am exempt from the Contractor's-License Law for the —' V l following reason (Section 7031.5 Business and Professional-Code: Any city or - P-Trap • ' . - , . 74 Switches , Sign , - -•t o� county which requires a permit to construct,alter,improve,demolish or,repalr . :y structure, prior to its Issuance, also requires the applicant for such permit Roof Drains "c'-dile a,signed statement that he/she is licensedpursuant to the - n Garbage Disposal Standing Sections I oe / provisions O( •s Contractor's License Law(Chapter 9(commencing with Section 7000)of - - • ptvision 3 of the Business and Professions Code) or that he/she is exempt - - - i .Generator ❑65 KW ❑5-15 KW Trash Compactor I .therefrom and the basis for the alleged exemption. Any violation of Section - —1 7031,5 by any applicant for a permit subjects the applicant to a civil Reins ction Fee LJenalty of not more than five hundred dollars($500). P,e $25 • Issue Fee $'3 ; I„as owner of the property or my employees with wages as their sole MECHANICAL Reinspection Fee , $25 Issue Fee /.5 3 compensation, will do the work,and the structure is not intended or offered ' ., FEES / for sale.(Section 7044, Business and Professional Code: The Contractor's - - ------- - - - -- - - — -- - - - ---- - PUBLIC SERVICES REOUIREME S:. , / License Law does not apply to an owner of a property who builds or improves Boiler • Hood or Type I 0 es thereon, and who'does such work himself/herself or through his or her own - - ZoningApproved ByW +•'%• �'(S - employees, provided that such improvements are not intended or offered for Canopy Type II ❑ ,/ PP ' Date ' sale. If, however, the buildingor improvement Is sold within one year.of com- Duct- Under Ground ' P y Application Approved By , Date prove f, the owner will have the burden of proving he/she did not build or im• =7 1i/It�/-r groove for the purpose of sale). Duct-Structural Refrigeration System Application Issued By W Dat: Mr IJ I, as owner of the property, am exclusively contracting with licensed con- tractors to construct the Levi (Section 7044,Business and Professions Code: Duct-Ventilating ' 00-100,000 BTU ❑100,000 BTU S M v OF FEES -the Contractor's Licensea Law does not apply to an owner of property who a - $ Fo 15 • builds or improves thereon, and who contracts for such projects with a con- Exhaust System 0 Multiple 0 System Repair/Alteration ..- BUILDING PERMIT $ SMTP J tractor(,) Ipursuant to the Contractor's License Law). - - PLAN CHECK $ 2•�P PERMIT (7 I am exempt -under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# _ PLUMBING $ 2_5-00 ISSUANCE $ Date Owner .. i i H9sing System& Ducting IOU ' ' PLAN CHECK $ S•Sc) ENERGY P.C. $ I hereby certify th. I have read ,s.1�/appl'-ati n and state that the above / (80.100,000 BTU 0100,000BT1U- - ENERGY GRADING $ information is lorry. .gra 0 y h I'city and-county ordinances ��, ELECTRICAL - $ 3�'1•Je' and state laws re r. n •• .and hereby authorize repre- I PLAN CHECK • $ jb-Zs MICROFILM $ sentatives of th• • -♦•• hove-mentioned property f r i'✓ .i ---Inspection Purp. // �(, MECHANICAL $ S Z� $) Signatures=� Pink-Accounting;Goldenrod -Assessor - - - - iir CONSTRUCTION AND PLANNING - & SPA • �P PROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector .Temporary Electrical Service or Pole - i 52. Pool & Equipment Location ���2. Soil Pipe-Undrgrnd. 3,0, ,y!� , 53. Steel Reinforcement �. Electrical Conduit Utility-Undrgrnd. 1 :.- 54. Forms y4. Electrical Conduit-Undrgrnd. 5,7ie' 00 55. Electrical Bonding ' S. Steel Reinforcement 5//s5 ' gj yl 56. Rough Plumbing& Pressure Test / .;, 57. APPROVAL TO COVE R-GUNITE 6. Electrical UF ER Grnd. :' ' / nA,,,, 7. Footings �,o J - ' 3.1I lgt 6 v'j 58. Electrical Conduit-Undrgrnd. 8. Foundation Sli7/CY4n� . 'I. ,¢{jigs ' Erg/ 59. Gas Pipe, 0 Undrgrnd.,Test ' 9. Water Pipe-Undrgrnd. •; . . i,/ d' - 60. Backwash Lines, P-Trap, 0 Undrgrnd. • 10. Structural Floor System-' . i . ! 61. APPROVAL TO DECK r• 11. Property Sewer Line & House ConnectionShH0Y cgo 62. Backwash& Receptor-Final 12. Sewer Cap ,r 63. Heater & Vent-Final 13.. Root Drains J . , . 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring cdic frc �(` 67. Fencing & Access Approval 17- Rough Wiring Sign / 68. APPROVED FOR PLASTERING 18. Rough Electrical-T.Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19, Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil `?3. Gas Pipe=Rough& Test 72. Underground Flush 24. Roof Framing • 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 7//2/95--/3 71 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat / t� 75. Dry Chemical 27. Frame and Flashing 71}S'&5- S�A 76. Dry Standpipe 28. Lathing & Siding =�Shr �-//ic//6/r '�,�_( 77. FIXED SYSTEM FINAL 29. Insulation S2Or Ate/ 78. FIRE PREV. FINAL r wCi' 30. Drywall Nailing Q/y/$S- el/t'l HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat ' 79. FINAL INSPECTION 32. Electrical Power Meter-Final ,('I•,� /� 80. FOOD CERTIFICATE ISSUED I ��JJ,, 33. Final Electric I l`'� Notes: ��e//c/o�/g. 47 O77c yam( 34. Final Heating & Air Conditioning 2�5- LED • _ „ - /t r _ •y ,� ///_PS.�/��_ 35. Final Gas Pipe-Test `g//227$f 14,0 '�„',�-2/' 36. Hood or Canopy �Y 37. Final Factory Fireplace , 38. Final Plumbing • Or 39. Water Service-Final I - -- 8/ s' Cto 40. Gas Service-Final 41. Solar Domestic-Final ' , 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45j Sound Attenuation • 46. Handica?Regulations ti 47. FINAL STRUCTURE & BUILDING �r/7g/ 48. Special Requirements Completed J/F85-- A/9(✓ 49. Electric Release to Edison • 50. Gas Release to Southern California Gas Co _ 51. CERTIFICATE OF OCCUPANCY / p(_�// I No, - 1i7I Date �4 -p-c !90�! /,C jv. r • AP Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. .; CITY OF COSTA MESA CO`N,6TRUCTION PEROT PpRRMIT NO. TRACT NO. LOT NO. UNI Project Address 2CO {zt e..r/ .,/,w_/ �G '•/ /q 7? b U U 1 6. 160 7/08/65 21 ,12 7L Applicant's Maili�n�glAddress �`/ /Yft'�./(�/r�S,I (-{� TYPE OF CONSTRUCTION NEW ADD LJ ALTERATION U REPAIR Owner's Name /44.1., t�•/)� Plitt Phonlfo`10� �V ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A•P-4 I Zone Address ZVcr FY SCAiaet Plitt ArP�• DESCRIPTION OF WORK/USE OF BLOC. S Main Building: Accessory Building: E - Z Arch/Eng. tt_&' License No. TYPE OF PERMIT U GRADING U FOUNDATION U STRUCTURAL T Front O Address � ❑ TENANT T ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL Rear . N Contractor's Name Vitt t i b /-14,4 yPhone cop eLC' T✓ ❑ OTHER B • C Right N • Address(mailing) 12/1 L.S ,sem t. 4A'S tidy mon PROJECT DESCRIPTION SQ. FT. OCCUPANCY CONSTRUCTION TYPE VALUATIONS g ,Left G City License No: 4,e 3d - ZONE - GRADING CU.YDS. ACRESR LICENSED CONTRACTOR DECLARATION Ping. Ref.4 Parking Req./Provided E Q I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: - - M with section 7000) of Division 3 of the Business and Professions Code, and - my license is in full force and effect T • license lass rens• N^ y S 'Date 7 Signature_(,� PLUMBING I FEES - WOR ERS' COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL FEES I hereby affirm that I have a certificate O1 consent to self-insure or a certificate - - of Workers' Compensation Insurance, or a certified copy thereof (Section • Backflow Preventer -. Service Sink - - - 3800, Lab. C.) - Automatic Washer Transformer 0 15.50 KW - Policy No. Company Backf low Irrigation - Sewer Ca l 0 50+KW P - Construction Pole Sub. • Certified copy is hereby furnished. Certified copy is filed withththethe city Building Division- Bathtubs - Sewer Connection - Cooking Unit Meter ❑up to 100 amps • Date Applicant • - EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors • Dishwasher Meter Dover 100 amps , (This section need not be completed if the permit is for one hundred ($100)or less). - Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel ) I certify that In the performance of the work for which this permit is issued, I - - shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors❑01 HP❑1'h-B •Workers' syyn Laws of Califor - - Date 9 ] Signature �s^•"� Floor Drains Swimming Pool w/Spa F.A.U.'NOTIC :If, f making this declaration, you should become subject to the _ Inc.Solar 09-1$HP 016-15+ , Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks _ - Urinal comply with such provisions or this permit shall be deemed revoked. Fixtures Microwave CONSTRUCTION LENDING AGENCY Gas Service .Outlets Water Closet • Device Boxes Light I hereby affirm that there is a construction lending agency for the performancePole 9 of the work for which this permit is Issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Range • - Lender's Name - Lender's Address Kitchen Sink Water Service Switches OWNER BUILDER DECLARATION Sign I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash I Garbage Disposal following reason (Section 7031.5 Business and Professional Code: Any city or P ;Standing Sections ' county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays Generator ❑0-5 KW ❑5-15 KW ' my structure, prior to its Issuance, also requires the applicant for such permit Trash Convector 'o file a signed statement that he/she is licensed pursuant to the provisions of • Roof Drains • the Contractor's License Law (Chapter 9 (commencing with Section 7000)of Division 3 of the Business and Professions Code) or that he/she is exempt - therefrom and the 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 solo - Reinspection Fee I $15 Issue Fee $ 3 compensation, will do the work,and the structure Is not Intended or offered - ---- - - - Reinspection Fee $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's , MECHANICAL FEES License Law does not apply to an owner of a property who builds or Improves thereon, and who does such work-himself/herself or through his or her own DEVELOPMENTSERVICES 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 com- 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 Apprqved ey Date - prove for the purpose of sale). ❑ I,as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Z Duct-Ventilating 9, 00-100,000 BTU ❑100,000 BTU SUMMARY OF FEES builds or Improves thereon,and who contracts for such projects with a con- - ' tractors license pursuano the Contractor's License Law), I am aware that Exhaust System BUILDING PERMIT $ SMIP $ • proof of t t their Worker's Compensation Insurance should be provided to me. ❑ Multiple ❑ System Repair/Alteration PLAN CHECK $ - PERMIT • ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG 4 Fire Dampers PLUMBING $ ISSUANCE $ Date Owner Heating System& Ducting Registers 6 PLAN CHECK .25% $ ENERGY P.C. $ , .i hereby certify that I have read this application and state that the above0-100,000 BTU ❑100,000BTL— __l GRADING $ information is correct. I agree to comply with all city and county ordinances / �_ , Oa ELECTRICAL $ and state laws relating to building construction,and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ sentatives of this city to enter upon the above-mentioned property for inspection our poies. Signature G(J Yom! + Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ 3/ r • a - CMF 0865-46,rev.10/84 White - Building; Canary.- Applicant; Pink -Accounting;Goldenrod -Assessor - • CONSTRUCTION AND PLANNING . .OL&SPA •APPROVALS Permit# Date Inspector APPROVALS Permit Date Inspector 1. Temporary Electrical Service or Pale 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. , 53. Steel Reinforcement 3.'Electrical C6nduit Uiility-UndrgrQil. 54. Forms 4:Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5, Steel ieinforcement' . ' 56. Rough Plumbing & Pressure Test 6.!ElQctrical UFER Grrid. 57. APPROVAL TO COVER-GUNITE 7: Footings • •i 58. Electrical Conduit-Undrgrnd. 8�'Folirldatjon 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 I 1).4 Property Sewer Line & House Cgnnection ; 62. Backwash & Receptor-Final vl . 12. Sevie .Cap 63. Heater& Vent-Final 13. Rodf;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# 21.1 Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating /([p/gc Lk-9 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 PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 131. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating& Air Conditioning 'i fldds J 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 111111111111r ..., Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. - 8002. -8/02/85 • - --E4OD ,TL" CITY bF COSTA MESA CONSTRUCTION PERMIT • PERMIT NO. r. TRACT NO. LOT NO. , UNIT O. " - �.•Project Address Z!� lel/`„7`� /�r� r 7 1 1 ! / �22% • 1 _ i ' - - -Applicant's Mailing.Address 2li,1 / riC./1s 41.- a / TYPE OF CONSTRUCTION &NEW DD U ALTERATION -U REPAIR I�r Altitase .ELDER/ d Phone .reed ❑ CONVERSION ❑ DEMOLISH OTHER A.p # .413 9*`�Q7We-Al .�f Zone 12 y . Owner's Name / ' DESCRIPTION OF WORK/USE OF BLDG. - _ ' JT 'Address 2VI) ‘/eff#l'aitg.4 PAIL 6� / /i. A"? • . -. 1� - S Main Building: • - - Accessory Building: . ' Arch/Eng. E & £ License No. C it4GZ TYPE OF PERMIT. `❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL , T Front - O Address - ❑ TENANT- 0-ELECTRICAL ❑ PLUMBING ❑ MECHANICAL BRear T , - ' N Contractor's Name/¢ n�' cJ- L!T([�L�y/one.ryl�Of0� El ,OTHER A _ - . I' C Right G ,,Ass ��-��_ ��� I PROJECT DESCRIPTION' SQ. FT. OCCUPANCY - Address(mailing) - K - CONSTRUCTIONTVPE VALUATION$ .$ Left City, License No.• ZONE ' - - • GRADING'CU.YDS- ACRES r - •R O LICENSED CONTRACTOR DECLARATION ' - J^ _ Ping. Ref.# Parking Req./Provided 41 E ;I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: • r 7 g/' - •aV L 7 • Planning Notes: l M with section 7000) of Division 3 of'the Business and Professions Code,and 111��� u� 'my license is in full for d effect. _• /'; I Q •I"f Q i _ I :' T '�. License Class� cense No.� l C 1`l / C, 1 • '$ate �- Signature PLUMBING : FEES - - ORKERS'COMPENSATION DECLARATION - ' nereby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink Showers i i ELECTRICAL FEES of Workers' Compensation Insurance, or a certified copy thereof (Section'. Backflow Preventer - - Service Sink - . - - - 3800, Lab. C.) Automatic Washer I Transformer '❑ 15-50 KW Policy No. 41.45 Company � � /41I�0 Backflow Irrigation • Sewer'Ca - - ,❑ 50+KW ' P Construction'Pole Sub, i Certified copy is hereby furnished. , Certjiittl gop i led with the city Bui " on. Bathtubs ,, Sewer Connection Cooking Unii__ ,r Meter Dup to 100 amps i. Da e !S / Q Applicant • , EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers . i^ Solar Collectors Dishwasher • a' Meter Dover 100 amps (This section need not becompletedif the permit is for one hundred ($100)or ' --•- - - - - . less). Dishwasher Solar Piping Dryers ❑Gas .❑Electric Sub Panel I certify that in the performance of the work for which this permit is issued I - • ' shall not employ any person in any manner so as to become subject to the Drinking Fountains - Solar Tank Fan - Motors❑0.1'HP ❑1'/x-g Workers' Compensation Laws of California. - - ' Date Signature Floor Drains . f ' , Swimming Pool w/Spa F.A.U. - inc.Solar ❑9-15 HP 016-15+ 'NOTICE:If,after making this declaration, you should become Subject to the - - Workers'-Compensation provisions of the Labor Code, you must forthwith Floor Sinks -- - - - - - Urinal. - - - - --- - - comply with such provisions or this permit shall be deemed revoked. Fixtures Microwave CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet• - • - Device Boxes Pole Light I hereby affirm that there is a construction lending'agency for the perform'anc¢ - g • of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors -" Water Heater - Outlets Lender's Name -. Range 1 Lender's Address I - 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 following reason (Section 7031.5 Business and Professional-Code: Any city or .I Garbage Disposal ;Standing Sections county which requires a permit to construct,alter,improve,demolish or repair - P-Trap ' any structure, prior to its issuance, also requires the applicant for such permit _ Laundry Trays Generator ❑0.5 KW 05-15KW Trash Compactor' _ • file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains - + a 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 - . therefrom and'the basis for the alleged exemption..Any violation of Section - ' 7031.5 by any applicant for a permit subjects the applicant to a civil - enalty of not more than five hundred dollars($500). . ' - U I, as owner of the property or my employees with wages as their sole • Reinspection'Fee I $15 ' - ' Issue Fee ' • $ 3 compensation, will do the work;and the structure is not intended or offered - Reinspection Fee $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's ' • , -- - MECHANICAL FEES License Law does not apply to an'owner of a property who builds or improves - • thereon, and who does such work himself/herself or through his or her own .. DEVELOPMENT SERVICES REQUIREMENTS: i ' employees, provided that such improvements are not intended or offered for -Hood or Type I 0 , - , - • - , sale. If, however, the building or improvement is sold within one year of com- _ • Canopy Type I I 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). ( t: I, as owner of the property, am exclusively contracting with licensed con-' Duct-Structural , Refrigeration System Application Issued By 1.1.4v1 j • nate c 8 2- _ tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does,not apply to an owner of property.who Duct-Ventilating - - , - - 00-100,000 BTU' ❑100,000 BTU SUMMARY OF FEES builds'or improves thereon, and who contracts for such projects with a con- '' - - - - • tractor(s) license pursuant to the Contractor's License Law). I am aware that - ' BUILDING PERMIT $ • SMIP $, proof off their worker's Compensation insurance should beExhaust System 0 Multiple❑ System Repair/Alteration provided to me. 1 • PLAN CHECK $ • - PERMIT' ❑ I am exempt under Section B.A P.C.for this reason •• / Firepl/Fact.Blt. ICBG#I I4( Fire Dampers PLUMBING $ • ISSUANCE ' $' Date Owner Heating System&Ducting, Registers • PLAN CHECK ' 25% $• ENERGY P.C. $ I hereby-certify that -I-have read this application and state that the.above 00-100,000 BTU 0100,000 BTU - • -. 1 GRADING $ information•is correct. I agree to comply with all city and county ordinances i ELECTRICAL' $ - 1 and state laws relating to building construction,and hereby authorize rept¢-• PLAN CHECK 50% $ MICROFILM $S. ' sentatives of this to ter upon the above-mentioned property for � I • N.� inspection purposes. _ .p / y, ' MECHANICAL : 5 -�� TOTAL FEE I $ e.00 Signature ; dl , Drivers' License or 55* Date Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK ' 25% $1 1 •�� ' CMF 0865-46,rev.10/84 white - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor I `CONSTRUCTION AND PLANNING • P &SPA / - Date' Inspector Date - Inspector APPROVALS Permit# APPROVALS Permit# •' 1. Temporary Electrical Service or Pole '' P . Y 52. Pool & Equipment Location 2. Soil Pipe;Undrgrnd. ';, 53. Steel Reinforcement 3. Electjical Conduit Utility-Undrgrnd. • - 54. Forms 4:c.Eled6ca,l Conduik-Undrgrnd. IF 55. Electrical Bonding •,)' ti 5':Steel BemfgrcemN '1- 2nt. r• 56. Rough Plumbing & Pressure Test ,1•. , 6.•;EjpctiCal GF ER Gr,nd fr 57. APPROVAL TO COVE R-GUNITE -4,, 7.,,Footings )' ,`,:i 58. Electrical Conduit-Undrgrnd. ,: 8. oyndation' "It /f-IF 59. Gas Pipe, 0 Undrgrnd.,Test i !s . 9. W er'Pi a-Undr md. • ai P 9 :� P � 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10 ;,Str,uctural FloorSystem i61. APPROVAL TO DECK 'vim 11!Prgperty Sewer Line & House Connection }: 62. Backwash & Receptor-Final 12. Sewer Cap7 ' , �" Ty 63. Heater & Vent-Final V 13. RootbrainS - "` 64. Plumbing System - Final 14. Rougtc Plumbing!'=, -"j - 65. Electrical-Final • 15. Rough Electrical-Conduit66. Solar System-Final 16. Rough Electric Wiring 67. Fencing &Access Approval • 17..Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-TBar Ceiling 69. POOL/SPA SYSTEMS FINAL 19.: Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT . 20..Rough Factory Fireplace F-4/3'-in- APPROVALS Permit# _ 21:Ducts,in Structure r iir 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 0 Gas 0 0il 25: FSoof 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 34. 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 Jelildr cD 38.,Final•plumbing temss /Milt 3 39. Water Service-Final '�"_�/� 40. Gas Service-Final , • 41. Solarpomestic-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 OPPOCCUPANCY No 11 - - Date . - ' CITY OF COSTA'MESA zn BUILDING DIVISION 4 > '1 DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER %I IPERMIT P05-00366 t. P05-00366 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 2603 ELDEN AV Status: ISSUED Suite No Applied: 05/12/2005 Issued: 05/18/2005 Vicinity: Parcel Nunmber: 93009749 .-.---4`. , -/-12!„-:'. . :�r,-,,.` ISSUED BY: Applicant: SZABO, KEVIN/ir %-,G _ , ' f Address: :'.;L.'% c A \1 : -; I '\ v ,�� , 1 \Phone: I- 1 Ji: / ;' '1--1 ,.7., . \ /J, jig /'A _ :� „ZIP = _ / ( 'ii A-N��� � - \-..?\ 7, i' ,�/ am \ t - ---:12,:k, �\� i, i -� ' !/' �� !� • ' /Owner:' 7, RMSTRONG';NORMAN � N• Address 2603-D ELDEN'AVE ` ‘�/ / *- N / H • ,,' Phone: -K COSTA MESA,CA Zip: 92627 p \At, I ,_ r /11� Contractor COAST ROOTER PLUMBING HTG &AIC OAS �% V•c'-\ • - ,.Address / 17390 MT CLIFFWOOD ` ° ° - - - - �� I _ , `,0 V A ' - t / 'i\ v ,� Phone: (714)241-1414 '� I�l �. ( FOUNTAIN VALLEY.,-. Zip: 92708 -� ''',,�, , , r�'- _ / License 529127 A ' K' 1 t- _ ✓/ I, �� .'. l' 1. ,�. l / 1 , l , SCOPE OF PERMIT /i - ' ' ' :\ - - I ' WATER HEATER CHANGE OUT(SAME LOCATION). �\ '1J _-__ _'FEE�SUMMARY' / ' ` '-J �� AMT OTY' - __ . AMT ,�•OTY ,/'/11 i AMT '!JOTY ISSUE FEE- " \ ,,v'523.50 2 Laundry Tub/Washer .$0.00, 0 .Sump Pump (,)// ;'---$0:001., .0 Backflow irrigation c 50.00 0 Landscape Irrigation ;$0.00 :-,0 Swimming Pool'', ' .� $0.00 ' , 0 Backflow PreQente', '\ $0.00 0 P-Trap -$0.00--0- Trap Primer (/j, rj ^:$0.00;'' 0 Bathtub' \\, - , '$0.00 0 Pressure Regulator.'„ >-... $0.00 0 Urinal `�// , H_ /50.00% 0 Clarifier System "$0.00 0 Process Piping-7(6e1(10 It)'-- .$0.00 0 Vacuum Brkr Bkflow(1-4) $0.00' 0 Connect(Ice,Soda,etc) $0.00'. 0 ' Receptois ` - $0.00, .-0 Vacuum;Brkr Bkflow(5+Y ' $W00 0 r. Dental Units. \ $0.002'` 0 Septic Tank ,° c- $0 00 -7.0.:_,,2, Wash Basin �! $0.00 0 Dishwasher �,, - $0.00 Ho d-+- ,c,Sewer;Cap for Demo-,o., $0 00:, J-0- - -,'Wash�Basin Sett-,; �,$0.00 0 Drain,Floor $0.00 \0'�, - Sewer Connect 3 ) ;$0 00 0 Waste and Vent System' , 50.00 0 'i Drain,Rainwater ,,\ <J$0:00 , 0� :jSewer Pnvate Line $0.90, 0 y WateCloset(Toilet))/ , $0.00 0 Drain,Roof $0.00// 0 ��Shower • ' $000 ' 0 cam-'r'Water..Heater/vent,,' 512.30 1 Drinking Fountain � $10M0yr di\'Sink bar " $0,00-j-,91-2.1i:-----;2- Water Piping-Oat/0r Rep.) $0.00 0 Expansion Tank ,;:$0.00 c%� ,Sink.comme7�ial `� c-'-r $0 00 - .0= (-2 c Water Re pipe'V 7 $0.00 0 Gas Earthquake Valve \-8000 ��"`-- 0 Smk Floor ------±:±50.00-: 0_ \Water Service $0.00 0 Gas(1-4 Outlets) $0.00 0��,, Sink,kitchen_ _ $0.00-3 0 H��\ \ Wafer,Softerier $0.00 0 Gas(Over 4 outlets) $0.00`?:,0� '/ \ Sink,service/mop--l'- ,-f$0.00`-- 0 \�� OTHER -" $0.00 Gas Repipe $0.00 *0-12-2,1--_,-,_ Spa(private) , ' . -' $0.00 c_0 - ;VIOLATION $0.00 Gas Service $0.00 O� p_Spa(public) r L. A\•„--' '$0.00' -0__-; „:-'7,79:-PLAN CHECK $0.00 Interceptors(Grease,Oil) $0.00 0 -C i'Jr-';..---- REINSPECTION $0.00 0 Interceptors(Sand Auto) $0.00 0 - - `_ __ TOTAL CALCULATED FEES: $35.80 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 2448-46(WOO) DECLARATIONS re eD 41 0 WORKERS'COMPENSATION DECLARATION: • I hereby affirm under penalty of perjury one of the following declaratidnsi . n"' ❑ I have and will maintaina 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'n � I compensation Insurance carrier and policy number are: /[�i' Carrier: An /x 7InC0 . Policy Number: 7 / 1bO 6 •so-TOOL, (This section need not be completed i/the permit is valued et one hundred dollars(5100)or less.) ❑ I certify that inthe 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 agr e that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisio Applicant Signature: .0,— Date: T/1 WO S WARNING:FAILURE TO SECURE WORKERS' PENSATION 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.if S?-j (2-i1//14. // Class a G— L Contractors Signature: P ti--- Date: C"/LK/O 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: 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 ts 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 We hundred dollars(5500).): Cl I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement Is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec." - Business and Professions Code for this reason: Signature: n' Date: Owner ID verified by driver's license. 0 Yes 0 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(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: 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 Califomia 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 Y 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 Califomia 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 274 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application 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 Califomia 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 Califomia Health and Safety Code). 7 Iia permit from the South Coast Air Quality Management District or other err pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by Califomia 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-described properly for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Sig . ur' et Legal Owner(s) to S//�/o C Or Authorized Applicant Date CODE I' INSPECTION Me ' ' '' I . QDIE - II{BDEL9 ' COM I INSPECTION TYPE t - - ' Pell. BMW 1616 Fixed System Final Fire Prevention •• • • ' 208 .. Final Mechanical p 1266 Pool Spa Final 208 Final Plumbing 3-t._0 1pI BN 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 4`p • M69 CITY OF COSTA MESA . BUILDING DIVISION > • �., ,' DEVELOPMENT SERVICES DEPARTMENT P IT NUMBER PERMIT E02-01025 'e,.„ 0 44. (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 2603 ELDEN AV Status: ISSUED Suite NoApplied: 11/13/2002 Vicinity: Issued: 11/13/2002 Parcel Nunmber: 93009749 �� . . Applicant: SANCHEZ, EDWARD ISSUED BY: Address: 1170 E FRUIT ST Phone: 714.245.4300 SANTA ANA,CA , Zip: 91720 : • Owner ARMSTRONG, NORMAN ' Address 2603-DELDENAVE - - H - - . ' Phone: - . - _ - COSTA MESA,CA Zip: 92627 • Contractor LAMBCO ENGINEERING INC Address: 1170 E FRUIT ST • - 4 Phone:T 714.245.43.00 ,SANTA ANA,;CA- ', Zip: 91720 License: 605267 - • SCOPE OF PERMIT r ELECTRICAL TO-INCLUDE: LIGHTING DISTRIBUTION SYSTEM AND STANDING SECTION LOCATED ON ' . CORNER OF DEL MAR AVE AND ELDEN AVE FOR METER.PEDESTAL. ' FEESUMMARY •Quantity -', Quantity ISSUE FEE ., $23.50 1, - " - - Temp Dist System/Lighting- '. $12.30 1 Temp service test . $0.00 - - - - ,•--- _Busway/100 ft- - $0.00 0 Res.a/c package $0.00 ' Standing Section $16.25 1 New Res(1-2units) $0.00 0 Misc Electrical Equipment $0.00 0 , ' New Res(3+units) ., $0.00 , / 0 Transformer4.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 Appy .. " -$0:00 ', 0 : 'F. ' Ldw Voltage Equipment $0.00 0 Res Appl '$0.00_ ?.-‘ 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 1 hp -' $0.06,. . • 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 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No. 92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 • 2446-46(WOO) DECLARATIONS r-) • • 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 wit 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: Policy Number: (This section need not be completed if the permit is valued at one hundred dollars(5100)or less.) aaF.vi'certify that in the performance of the work for whi 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 t at if should b me subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. pplicant �t=& / Aignature:''5.P-002e-weir L 4Dati I� 134 Ti WARNING:FAILURE TO SECURE WORKERS'COMPENMAT N COVE WFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE T OF COMPCN ATION 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 undo provisions of Cha ter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full forcaand.e t-t-AS.267 I Ca assiff - iT /41c. Contractors Signature: ycl/i'ate*/ !� _3 Date:. /T7/.3//O f 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: 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 end 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 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.). " ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made In connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Op 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 Witt 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? ❑Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application aggermlt 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? 0 Yes 0 No (If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health end Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district Or agency Is required for the work which Is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No e (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 end 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. �Sipnatu�Of ew Le9a ner(s) // D /3// 2-- .L3_ri �A a ruAuttoriz=•i;•pllcaril fee CODE 0 INSPECTION TYPE PATE EMU cODEt INSPECTION TYPE pAle BMW 1616 Fixed System Final Fire Prevention _ 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing ,'1�� �T rw�- 200 Final Re-Roof 210 Final Electrical ( aZ. 4 1. 201 Final Block/Retaining Wall _ 212 Final Fire Prevention P 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 .G ' ft . BUILDING DIVISION :5L �l 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us tl, IIP,411 . FOR INSPECTIONS CALL: (714)754-5626 � "° ' * PERMIT NUMBER! M07-00578 PERMIT TYPE MECH STATUS: ISSUED APN: 93009746 DATE ISSUED: 12/19/2007 ISSUED BY: RMD JOB ADDRESS: 2603 E ELDEN AV CM Suite/Unit:: . E Vicinity: ATTIC - - - _ , SO. FT: 0 ,.. -. SCOPE OF WORK: CHANGE OUT FA-C100 K BTU LOCATED IN ATTIC FOR UNIT"E". - • OWNER: MOURAY,VALENTINA TR . ' ,-Address: 2603 ELDEN AVE#E. Unit: PHONE: - - .•.• City/State/Zip: COSTA MESA,CA APPLICANT: LEMOND,.RICHARD - - Address: 25920 IRIS AVE Unit: - PHONE: 951-486-0337 - • • ••'" -City/State/zZip: -.MORENO VALLEY,CA CONTRACTOR: TELFORDJONES INC' License No. 856936 Address: 25920 IRIS AVEUnit: STE 13 A400 PHONE: 951-486-0337 City/State: MORENO VALLEY,CA ZipCode: '92551 CELL: . 3 MECHANICAL PERMIT FEE SUMMARY MECH ITEM FEE: ' $38.30 PLAN CHECK FEE: $0.00 . . :. INVESTIGATION FEE: $0.00 • - • REINSPECTION FEE: - "$0.00' . TOTAL FEES: $38.30 • 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. CODE S. INSPECTION TYPE DATE INI111ALS CODES INSPECTION TYPE DATE INTIflALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical I—10O-08 LJ IY 1266 Pool Spa Final . 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Anal Block/Retaining Wall 212 Final Are Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver's licL . ❑Yes ❑No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: . 0 I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. L.yrmI nave and will maintain workers'compensation insurance, as required by • section 3700 of the Labor Code,for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation(we(5)or more feet in depth into which a number are: 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 Lamer:T:74^c717/7 /Tl or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (This section need not be completed it the permit is valued Cat�one hundred dollars($100)orless.) 2,Art 2Sec.341,Title 8,California AdministrativeCode). g PolicyNumber: 677 ad47/72%/ �- ❑ As owner-builder, I will not employ anyone to do work which would ❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued,I shall not employ any •er ••-• in any manner so as to become subject such person has a permit to do such work from the division. to the I. ' compens. ars of California, and agree that if I should .- ' beco• e subject • the • compensation provisions of Section 3700 of Applicant's Signature Date the abor Cod-. •• with comply with these provisions. rI 1/47VP" Division of Industrial Safety Permit Number: lirApplicant's Signature Date-- HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes ❑ No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. 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 LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my lice• II force and effect. ta registration form for acutely hazardous materials? ❑Yes ❑ No o2/0l0 ' Li'.#�/.� %-i►./ �C'lass (Section 25533 of the California Health and Safety Code, with some -JO. �� 2 exceptions, requires registration with the Costa Mesa Fire Department by 1 each business which at any one time has on hand a quantity of acutely •!tors Signal - 'Date 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 CON •- CTION LENDING AGENCY: temperature and pressure). ■ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? ❑Yes CINo (Section 25534 of the California Health and Safety Code provides that the Lender's Address: 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. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes ❑No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction ' Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No 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 (Section 65850.2 of the California Government Code requires that the requested License Law(Chapter 9(commencing with Section 7000)of Division 3 of the information be furnished on applications for non-residential building permits). Business and Professions Code) or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes ❑No applicant for a permit subjects the applicant to a civil penalty of not more than (If'yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec. 7044, Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes ❑ No thereon,and who does such work himself or herself or through his or her own 8 (If"yes",attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and 1:1I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044, Business and Professions Code:The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: 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. Sign of le Os) 72/ patg/�� Signature Date Y� 3057-06(3I07) r —And/or Authorized Applicant Date PROJECT ADDRESS: 2603 ELDEN AV UNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO: EM 063371 OWNER'S NAME: ROBERT B AODREss:CHRISTIANSEN KIM PERMIT NO: EM 063371 PLAN CHECK NO: N GOVT: N SUPP: N 2603 ELDEN Ae COSTA MESA, CA 92627 CONSTRUCTION TYPE: V-N PERMIT TYPE: ELE MEC PURPOSE: OTH \� ARCMIENGINEEfl: REG.NO.: JOB DESCRIPTION : INSTALL NEW A/C UNIT SQFT: ADDRESS: UNIT: PERMITTEE: CLAIM VALUE: CALL-VALUE: GROUP OCC: R-3 / ADDRESS:S & S HEATING 6 AIR COND ( 714 ) 837-2000 27324 CAMINOR CAPISTRANO 157 COMMENTS- NO OTHER WORK AUTHORIZED BY THIS PERMIT LAGUNA NIGUEL CA 92677 ########4*****#*************#*******#********************#***#******#********** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions al Chapter 9(commencing with Section ZONING R E Q U I R E M E N T S 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. • CITY LIC.:027758 STATELIC.:393818 CLASS: _20 SETBACKS Date:l� 3 Signature:— j MAIN BUILDING ACCESSORY BUILDING f WORKERS'COMPENSATION DECLARATION: (hereby affirm ttllffaallhave arend'cppc3333T( of__consent__toselbinsureoracertificate ofWorkers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance.or a certified copy Ihereol(Section 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.:CA WC1012733903 EXP.DATE: 01 /01 /94 r.OMPANY:TRANSCON PARKING REQ• PROV: PARCEL: 13917109 ZNE: REF NO: Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES> rDate: V —i-4 i Applicant: �� *#*#*##*##*****r_,4p ' ********##**##**#**#* st**********#***##**********#**>E*#***###*# EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). DEVELOPMENT S E R Vr I C E S REQUIREMENTS 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 j subject to the Workers'Compensation Laws 01 California. ZONING APPROVED BY •L" / DATE [late: Signature: Cr r NOTICE:It.after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY • DATE: Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. '/% CONSTRUCTION LENDING AGENCY: Slim that there is a •• ion lending agency for the performance of the work for APPLICATION ISSUED BY• �/q which this permit is issued 3097.Civ.C). , r DATE: €31cti. ll ***#*****#***********iP**************ay# ****** ********************************* LENDER' *#**#*#*****##***##****##******#***#*%*#***#*#*************************#ie****** ADD ELECT WORK INCIDENTAL TO LEGALIZATION:N F E E f - CVM M A R Y STRUCTURAL SEGMENT: N . I MECH PERMIT -';',. el OWNER BUR: : DECLARATION; I hereby affirm that l am exempt from l • I .ctors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC .MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Busine . e • • • 'mal Code: An - • •.' • .. is requires a permit to construct,alter,improve,demolish,or PERMIT 11 '00 y 9,00 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 c• t1)% 25* SM I P/NON-RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by p LAN any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars($500). ISSUE FEE3.5, 0 0•%' 15 . 00 ❑ I. as owner of the property or my employees with wages as their sole compensation. will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLANTCH'ECK TOTAL PAID DUE structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 20 . 00 3000 •�' . 9; 00 50. 00 50. 00 . 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through ( i his or her own employees.provided that such improvements are not intended or offered for sale. II,however the building or \ • C..",improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> \ COLLECTED: 50. 00 OVER/SHORT• ,00 4 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK I,as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044.Business 2 6 . 0 0 7 2 4 . 00 ❑ 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'Slate License Law).I am aware that proof of their Worker's Compensation insurance should be provided to me. *"***#***#**##**#***###***#****#****'****IIF�E***********#****'**#*'#'*'*'#******#*****#* o I am exempt under Section: B.8 P.C. IND I V I D U Alii 'F * E BR EAKDOWN for fres reason: TYPE QTY DESCRIPTIO N �. UNIT COST TOTAL COST Date: Owner: -ii, led I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and ELE 1 M Z SC CONDUIT NOTI S T ED- REQ PERMIT 11 . 0 0 11 . 0 0 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a MEC 1 REFRIGERATION SYSTEM ! . <="100 K BTU/H 9 . 00 9 , 00 permit for construction or modification from the Air Oualily Management District.Residential construction applications are exempt from END: OFA,FEES these provisions. e Date: Applicant: a• 4 I h .1 r hereb• y certify that have read this application and state that the above information is correct. agree to comply with all city and county •k. ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned F' ` property for inspection purposes. rr ^, J/ `L/V'h"4'.�.�.`} �. 1,it Date: (F'� 91 Signature: -7i 01 00144293-00144294 TOT Driver's License or Social Security Pink—Revenue:Goldenrod—Assessor I' CONSTRUCTION AND PLANNING POC SPA APPROVALS Permit# . . Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole . 52. Pool & Equipment Location I • 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. E.ecr'icat UF ER Grnd. 57. APPROVAL TO COVE R-GUNITE `/ Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation - 59. Gas Pipe, G Undrgrrd.,Test 9. Water Pipe-Undrgrnd. , 160. Backwash Lines, P-Trap, Undrgrnd. • f � 10. Structural Floor System - 61. APPROVAL TO DECK 1'. Property Si.v.ar Line & House Connection 62. Backwash & Receptor-Final • - 12. Sewer Cap i 63. Heater& Vent-Final If 13. Roof Drains I 64. Plumbing System . Final 14. Rough Plumbing • 65. Electrical-Final 15 Rough Electrical-Conduit 66. Solar System-Final I-- 10. Rough Electric Wiring 67. Fencing & Access Approval r - 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 2C Ro,.;h Facto•y Fi,eplace APPROVALS Permit 'e 21. Ducts, in Structure • 70. Underground Hydro 22. Ducks, Ventilating 71. Product Piping I7 G,,s C Oil 23. Gas Pipe-Rough & Test 72. Urde•groun-I Fii,,h 24. loot Framing 73. Undergrnd,Storar. Tank CGas COiI 25. Root Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & hlonocoat 1 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding l 77. FIXED SYSTEM LINAC 29. Insulation 78. FIRE PREY. FINAL . Drywall Nailing HEALTH DEPT. REQUIREMENT I 31, Paster Brown Coat II 79. FINAL. INSPECTION I 1 IL32 Electr.cv Poster Meter Final I 80. FOOD CERTIFICATE ISSUED I 33. Fina' Electric Nate :a-&7'� o ____ 3 No ►t� FromE L 34. Final Heating & Air Conditioning I !3 /e-$c E Mane_( ' -6 35. Final Gas Pipe-Test i -ill=h7=1'5 723 .dw_ 4 -L'�to Lal 35. Hood Cr Canopy I 37. F;ral Factory Fireplace 38. Final Plumbing I I 1 39. Water Service-Final I ___I 40. Gas Service-Final 1-41. Solar Domestic-Final I I 42. Backflow Preventer i i 43. Backf low Irrigation 1 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48 FINAL PLANNING 49. Electric Release to Edison I 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 appropriate declarations. CITY GF COSTA ESA CONSTRUCT( PERMIT PERMIT NO. TRACT NO. " I, LOT NO. • UNIT NO. - o3 �adcn � 2asq y /x.44 / Project Address / , Lek-DID '' ` U - - •Applicant's Maili A dre 5 J • TYPE OF CONSTRUCTION NEW L ekDD ALTERATION REPAIR r • �� y5— ❑ CONVERSION ❑ DEMOLISH ❑ OTHER Owner's Name'rp"T/ j/ ) vho e b�^����76 A.P.#�f - 07/ - 33 Zone �/ j/�`+R'C� DESCRIPTION OF WORK/USE OF BLDG. Address O - S Main Building: Accessory Building: V Arch/Eng. License No. TYPE OF PERMIT U GRADING L� FOUNDATION STRUCTURAL T Front 25n1 i0 Pena C61126 ? Address 0 TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear —I l ) 11 n� �v-f' .0a lr�'a' Contractor's Name O/� Phone CI OTHER f{� J`P^ PROJECT DESCRIPTION SO..FT. /OR OCCUPAN Y I.• 3 C Right �"�' N Address(mailing) V ..Gq LUATION 5 pO.O J K Left - G CONSTRUCTION-TYPE $ City License No. ZONE GRADING CU.YDS. ACRES 7'� R LICENSED CONTRACTOR DECLARATION Ping. Ref.# rlf- 8-]-��. Parking Req./Provided.—^^•' E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: 12 i—(� a 7 9` `/ ?Irma coy E'i'f� • 0 Planning Notes: y q -►'j/l1 tAnte xf M with section 7000) of Division 3 of the Business and Professions Code, and r'"""""' my license is in full force and effect. T License Class License No. S Date Signature PLUMBING FEES WORKERS'COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL FEES I hereby affirm that I have a certificate of consent to self-insure or a certificate I of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink ',ROO, Lab. C.) Automatic Washer Transformer 0 15-50 KW c No. Company Backflow Irrigation Sewer Cap • 0 50+KW Y 9 Construction Pole Sub. Certified copy is herebythre U Certified copy is Med w with the cite<Ity Building Division. Bathtubs Sewer Connection Cooking Unit Meter Dup to 100 amps Date Applicant EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps (This section need not be completed if the permit is for one hundred ($100) or less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel I certify that in the performance of the worr hich this permit is issued, I shall no -employ any person in any m -r15r J g,5p ubject to the. Drinking Fountains Solar Tank - Fan Motors 00-1 HP 01'A-B Worke mp.Isatiorp Ts of Calif II�d/`T (DI _ Date 7/•` •7 7 /Signaturp� Floor Drains Swimming Pool w/Spa' F.A.U. Inc.S 9-15 HP 016-15+ NOTICE: If,after makin this declaration, you should become subject to Workers' Compensation provisions of the Labor Code, you must forth Floor Sinks 'Urina� Fixtures comply with such provisions or this permit shall be deemed revoked. Icrowave CONSTRUCTION LENDING AGENCY Gas Service Outlets er Closet • Device Boxes I hereby affirm that there is a construction lending agency for the performance Pole Light of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater • Lender's Name p Outlets Range Lender's Address Kitchen Sink Water Service Switches Sign OWNER BUILDER DECLARATION I hereby affirm that.I am exempt from the Contractor's License Law for the Lavatories Auto-Wash following reason (Section 7031.5 Business and Professional Code: Any city or Garbage Disp Standing Sections r p county which requires a permit to construct,alter,improve,demolish or repair P—Trap structure, prior to Its issuance, also requires the applicant for such permit Laundry Trays Generator DO-5 KW,❑5-15 KW Trash Compactor to file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains the Contractor's License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code) or that he/she is exempt --- . therefrom and the 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 Reinspection Fee $15 Issue Fee $ 3 •11pensation, will do the work, and the structure is not intended or offered - Reinspection Fee $15 Issue Fee $ 3 .o'r sale (Section 7044, Business and Professional Code: The Contractor's • MECHANICAL FEES - - License Law does not apply to an owner of a property wno builds or improves - DEVELOPMENT SERVICES REQUIREMENTS'/�, thereon, and who does such work ovem pts himself/herself or through his or her own Boiler Hood or Type I 0 /71-151t-- / /els —] /A�/R� employees,If,yhprovidedthe that such improvements are not intendedwihinor offered c for Zoning Approved By w•51� Date (//♦ 7 V sale. however,wnw building improvement opot i sold within one year of or im- prove Canopy Type II ❑ prove for thetowner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Date prove the r of he property,f oe), q --4.43 1 ❑ t rs owner of thet roject tcontracting with of licensedionode- Duct-Structural Refrigeration System Application Issued By Data KK tractors construct the project (Sections 7044, to an of property Code: . The Contractor's License Law does not ato owner je pr withta who Duct-Ventilating 00-100,000 BTU 0100,000 BTU SUMMARY OF FEES builds or Improvesicense thereon,toand who contractsfor such prOw), I as with eta- BUILDING PERMIT $ iG'to SMIP tractor se pursuantrk 'sothe Contractor'sninsurance ccense should be I provided aware that Exhaust System ❑ Multiple 0 System Repair/Alteration $ proof of their Worker's Compensation insurance shoultl be P.C.for this toea me. PLAN CHECK $ 10.40 PERMIT 0 1 am exempt under Section B.& .for this reas6n Firepl/Fact.Bit. ICBG# Fire Dampers a/ / PLUMBING $ ISSUANCE $ Dat — ZS Owner JirrC!S'.'f-.�-.-..._..� Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that hive read this application and state that the ab,-e 00-1 00,000 BTU 0100, BTI/--- • ELECTRICAL $ GRADING $ Information is correct. I agree to comply with all city and County ordina• es - and state laws relatin• to building c•nstructlon, and hereby authorize repro- PLAN CHECK 50% $ MICROFILM $ sentatives of thi to en n the above-mentioned property for inspection purp•?. 2.(0./.0 �� .� MECHANICAL $ TOTAL FEE $ F Signature -Accounting; Goldenrod - Assessor CONSTRUCTION AND PLANNING POOL &SPA APPROVALS Permit# Date Inspector APPROVALS Permit# - Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location • 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE • 7. Footings frA74, � / 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. Fending & Access Approval • 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL • 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# _ 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush • 24. Roof Framing 73. Undergrnd.Storage Tank 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 iAQk7 4-f-1 48. Special Requirements Completed !!lldddd .• 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. C1.TYUF COSTA MESA CONSTRUCTION PERMIT I PERMIT NO. • - -TRACT NO. LOT NO. UN T NO. - ., .��// 1514,47 I I Zz� - . : bl�.J I i ee 4/16185 9 $3 IL Project Address�trs03 ELN �Y� p'1 0 ._ . Applicant's - Applicant's Mailingin�g/Address /g22& akfirc zo10T1 ..rev; TYPE OF CONSTRUCTION X NEW ADD U ALTERATION REPAIR Owner's Name "gide- C-_LO V aVEG, Phone4 'O&/O, CI CONVERSION ❑ DEMOLISH ii OTHER �� A.P,# G� -071 — 1.0, 1,‘ it 13 ,l4-ISI Zone' 1j' /�IZ(/ W• /11C'O!/lLmUrT '°.O .r•Cy. mita. DESCRIPTION OF WORK/USE OF BLDG. L'-� 1' 9 -i g Address 77�� `1 S Main Building: AccessoryBuilding: Arch/Eng. C N.' &'Ztwt CtNI E ( . • Z Q �z License No.Clanz.3 TYPE OF PERMIT Li GRADING ❑ FOUNDATION STRUCTURAL T Front Vei 0 - Address /e42 C0' J.,4 '4 i,4rc7T r0 rr Chong . n?, ❑ TENANT ❑ ELECTRICAL CI PLUMBING� ❑ MECHANICAL B Rear *aI _ N Contractor's Nam¢ '/ 0�C *t'' l"O `-phone t71-c5J, CI-OTHER YMl y"L� is O -I-I A ._ -. I ',4:21 c'}� PROJECT DESCRIPTION SQ. FT. OCCUPAN Y C Right • lo 1 GL. jL� N Address(mailingl/82� �. A/crV (./CV, C'wx, dC K- rl _ `-i G `• 1,'.31/ r/ CONSTRUCTION TYPE VALUATION§ " rr1 �O S Left D R City License No. �( ZONE GRADING CU.YDS. ACRES 1--� LICENSED CONTRACTOR DECLARATION ,,,///•••��� - Ping. Ref.# V�-8L1-- 47 Parking Req./Provided E I hereby affirm that I am licensed underprovisions of Cha r 9 (commencing Remarks: (.5 / cog-6c, (3/ s- \ Plannin Notes: 1 �'1/ 0 with section 7000) of Division 3 of the Business and • •ssions Code, and ' '/ Lr F J g ° " 'a G� \��'`L M . my license is in full force and effect. r License Class - i G�3 `� }}l(�}.4 _ S Date • - . - Signature • '1d.1�>/A \\ PLUMBING FEES WORKERS'COMPENSATION DECLAR'TIO Bar Sink ELECTRICAL FEES I hereby affirm that I have a certificate of consent to self-insure or a certificate • ' Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer - - - - -- - Automatic Washer 'Transformer 0 15:50 KW 800, Lab. CJ/ .. - - Policy No. /02r4J company S naw.0 Backflow Irrigation • 0 50+KW '-, 9 Construction Pole Sub. .�Certified copy is hereby furnished. Dat ee ifiep c$$py-is filed with the city B I I on. Bathtubs Meter Dub t0 100 amps //'d.S Applicant t EXEMPTION FROM WORKERS'COMPEN CLA0. • Clarifiers Dishwasher•• Meter Dover 100 amps ' (This section need not be completed if the perm s f r one hundred($100)or ,• • . less). - Dishwasher Solar Piping • Dryers 0Gas 0Electric Sub Panel I certify that in the performance of the work for which this permit Is issued I - shall not employ any person in any manner so as to become subject to the Drinking Fountains , Solar Tank ' Workers' Compensation Laws of California. - Motors❑01 HP ❑1'f;-8 . Date Signature - Floor Drains • Swimming Pool w/SpaIna Solar ❑9.15 HP 016-15+ 'NOTICE:If,after making this declaration;you should become subject to the - - Workers' Compensation' provisions of the Labor Code, you must forthwith Floor Sinks Urinal. • comply ,with, such provisions or this permit shall be deemed revoked. - _ Microwave - i CONSTRUCTION LENDING AGENCY- - Gas Service Outlets 'Water Closet k,..m.,r,n I hereby affirm that there is a-construction lending agency for theperformance - ' POIe Light _ of the work for which this permit is issued (Section 3097 Civ. CJInterceptors Water HeaterLender's Name - RangeLender's Address - Kitchen Sink • Water Service Sign OWNER BUILDER DECLARATION -• • -I hereby affirm that am exempt from the Contractor's License Law for the Lavatories Auto-Wash ;Standing Sections •folloing 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 ' any structure, prior to its issuance, also requires the applicant for such permit Generator ❑0.5 KW❑5-15 KW Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains the Contractor's License Law(Chapter 9 (commencing with Section 7000) of , Division 3 of the Business and Professions Code) or that he/She is exempt - ' 'erefrom and the basis for the alleged exemption. Any violation of Section ' 's I - i -31.5• by any applicant for a permit subjects the applicant to a civil - tnalty of not more than five hundred dollars($500). ' • 0 I. as owner of the'property or my employees with wages as their sole Reinspection Fee i $15 $.3 - - '- compensation, will do the work, and the structure is not intended or offered ' Reinspection Fee I $15 Issue•Fee ' $ 3 for sale'(Section 7044, Business and Professional Code: The Contractor's • MECHANICALFEES 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'� REt]�UI E ENTSS /rte ��_QQQ��� employees, provided that such Improvements are not intended or offered for Boiler Hood or Type I 0 ZoningApproved By -y ` `'/1 '^'�S sale- If, however, the building Or improvement is sold within one year of com- -- - - Canopy Type II 0 : pP /� '^ Date r pletlon, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground .1.---.-___. prove for the purpose of sale). Building Approved By "c-� Date_— ❑ I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System f , Application Issued By Date L- ( 5-8 tractors to construct the project (Section 7044,Business and Professions Code: • The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU 0100,000 BTU - • SUMMARY OF FEES • C builds or improves thereon,,and who contracts for such projects with a con- V p tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT , $ o-5) SMIP $ • proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ t3Ztb3 PERMIT ❑ I am exempt under Section B.& Pi.C.for this reason Firepl/Fact.BIt. ICBO# Fire Dampers -.i. i ' - • PLUMBING 1 , $ __ ISSUANCE $ Date Owner Heating System& Ducting • Registers ) • PLAN CHECK 25% $ ENERGY P.C. I ' I hereby certify that I-have read this ation state that the above 00100,000 BTU 0100,000 BTL - -- ELECTRICAL GRADING ' $ Information is correc - tree to omp th all --d county ordinances $ • and state laws relatingto/ d,'• co ction, d i eby authorize re re- ' ' p PLAN CHECK 50% $ MICROFILM $ sentatives of this c •' 'r u... he a•.ve- • ntioned pfoperty for • inspection purpose �, �� / 2 ' Signature �'= Date N•// '�j I MECHANICAL $ TOTAL FEE ,$ �DJ•� J Drivers' License or -Accounting; Goldenrod -Assessor -- � � • POO SPA .. . ; CONSTRUCTION AND PLANNING ' APPROVALS - Permit# Date Inspector APPROVALS Permit# Date Inspector i r 1. Temporary Electrical Service or Pore 52. Pool & Equipment Location .`2. -Soil Pipe-Undrgrnd. '�. in 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 ,�' i 7. Footings -Rf ^ �3o/i� 58. Electrical Conduit-Undrgrnd. 8: Foundation -' i, ( ,• . 59. Gas Pipe, 0 Undrgrnd.,Test • •�, ' 9. Water Pipe-Undrgrnd.,'; 41-- - - 60. Backwash Lines, P-Trap, 0 Undrgrnd. . 10. Structural Floor System r 61. APPROVAL TO DECK • • .1- 11. Property Sewer Line & House Connection . 62. Backwash & Receptor-Final 12. Sewer Cap • I j 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing65. 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 Electribal-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 ❑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 Tq� • 33. Final Electric Notes: 9A.At x,(/OT ,,,Ao, , . 7_ J1�; ; 34. Final Heating & Air Conditioning /3 /��'5,- O, � �f _ _ `y""�f//-�- 35. Final Gas Pipe-Test / /v f�/�!� 36. Hood or Canopy 37. Final Factory Fireplace - 38. Final Plumbing 39. Water Service-Final • 40. Gas Service-Final 41. Solar Domestic-Final ' 42. Backf low,Preventer 43. Backflow Irrigation 44. .Landscape.lrrigation System - 45. Sound Attenuation ' 46. Handicap Regulations • , 47. FINAL STRUCTURE & BUI LDING /v/// 48. Special Requirements Completed � - Th r 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF'OCCUPANCY . - i 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. - - CONSTRUCTION PERMIT _ (3 /00Jvac he /�� IR:0 HI �^ R1/ /" . 3Ete♦ a ' - 7/� C/ t C ' EW U ALTERATION. LI REPAIR • Project Address , TYPE OF CONSTRUCTION-_ ,�1V U ADD - ,i Applicant's Mailing Address •••SEArjair Ili❑ CONVERSION OEMOOLISH ❑ OTHER A • .P.#.39-0 / / 7� -/3 , /5 Zone �2 ��/e � Phone " - DESCRIPTION OF WORK ; '�,F c'� / r- OF- •S�c�� .1 • Owner's Name (� f�.nJ ,���- a. s/ 'fl// ccvv n ) - - S Main Building: Accessory Building: ' , Z Address P6 F_e'n 163 aa4t FSO i4 IS C. n C -d•1��/I - 0 • TYPE OF PERMIT Li GRACING '`EOUNDAnoN LI STRUCTURAL T From a97 r/b�� N Arch/En . C«2 CS S 7EenS4-5 License No.ri2 6 LI 1 v �- - I Arch/Eng � �' El LECTRICAL PLUMBING ECHANICAL B Rear ;�+�' /5� - N • •Address ❑ BOTHER • - C Right _4.5/ ' ' - G Contractor's Noma /At S SIE-er-fryr-r 'nc-- : PROJECT DESCRIPTION SQ: FT ' ' OCCUPA C't K _ Address(mailing) ' CON ST RUCTION TYPE VALUATION$ // 75JG $ •Left Q - R A2cle.S 3 I ZONE - GRADI NG CU.VDS. ACRES Ping. Ref.#7F 85�• ZP33-83Fees $. /2,-0]�.3'8 Q ' City License No. C/ /vs 7 �� qI U LICENSED CONTRACTOR DECLARATION I Remarks: /�YA^� /•o� A� 3-aa'3s Parking Req./Provided�,J I • • I I hereby affirm that I am licensed under provisions of Charter 9 (commencing ,a. 0, R - with section 7000) of Division 3 of the Business and Professions Code,and ' • Use of Building: /'2'5/de •0J plan chc IC - E my license Is in full for • nd-effect. G , License tar License • - . Z • PLUMBING • I FEES Planning Notes: _ - • E Date'• IC9 : Signature .!..u. • r 1�i- • MID. FOR SPECIAL REQUIREMENTS 'WORKER 'CO PENSATION DECLARATION. ' Bar Sink ' Showers T Iereby affirm that I have a certificate of consent to se f-insure or a certificate Backflow Preventec - _.. _ Service Sink , •, - . - . . _. - • S • r Workers' Compensation Insurance, or a certified,copy thereof (Section 3800, Lib. C.) • Backflow Irrigation Sewer Cap • ELECTRICAL - FEES Policy No. 6Jse,Su 23 C anycSi t- 9---u'� • ---- Certifie copy is hereby furnished. T . Bathtubs Sewer Connection) / Automatic Washer • Transformer 15-50 KW J._ Cer ' ' o y s it tl with the city B IDI g Division. \/M `' I ❑ 50+KW •• Date Applican " Clarifiers Solar Collectors Construction Pole Sub. EXEMPTIO FR M WORKERS'COMPENSATION DETION Dishwasher , Solar , ing V / Cooking Unit ' Meter ❑up to 100 amps (This section need not be completed if the permit is for onene```"`hhhhhh unfired ($100)or `V/ \ / / — less). DrinkingFountains S I o thatm in performance of the work for as tthis permit is to I • ,=� ,u� i • / Dishwasher • Meter Dover 100 amps shall not employ any person In any manner 50 as to become subject to the G Workers'Compensation Laws of California. • Floor Drains Nil-r 1 001 w/Spa ) Dryers as DElectric / ,Sub Panel ' Date Signature s-f _ NOTICE:If,atter making this declaration,you should become subject to the Floor Sinks • -_ 1'.r - . _ Fan - •Motors 00-1 HP ❑1.X-8 / ' Workers' Compensation provisions of'the Labor Code, you must forthwith 7 comply with- such provisions or this permit shall be'deemed revoked.. Gas Service Outlets • ® Vater Closet - . • / F.A.U. ' ' Inc.Solar.09-15 HP 1016-15+ / -- CONSTRUCTION LENDING AGENCY-. - - - I hereby affirm that there is a construction lending agency for the performance • Interceptors - .. - Water Heater ' 7 Fixtures , • Microwave / i/775 of the 'work for which this permit is issued ,(Section 3097 Civ. C.) _ . Lender's Name - Kitchen Sink '• , - - Water Service Device Boxes ' • - Pole Light Lender's Address ' - OWNER BUILDER DECLARATION - ' ' Lavatories - - !-7r Outlets Range 5" I hereby affirm that I am exempt from the CdntractorYLicense Law for the P-Trap following reason(Section 7031.5 Business and Professional Code: Any city or P _ -. • /0 Switches Sign 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 - - - I Garbage Disposal StandingSections 1 ) 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 - - • r - Generator ❑0-5 KW❑5.15 KW Trash Compactor .isidn'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 _.Reins Reinspection - - - - $ 3 Re/laity of not more than five hundred dollars($500). , - pe I - $25 Issue Fee U I, as owner of the property or my employees with wages as their soleReinspection Fee $25 Issue Fee $ 3 • compensation, will do the work, and the structure is not intended or offered • MECHANICAL ' I FEES • for sale,(Section 7044, Business and Professional Code: The Contractor's - PUBLIC SERVICES REOUIR ME TS: •• License Law does not apply to an owner of a property who builds or Improves Boiler I Hood or ;Type 1 ❑ I / / thereon, and who does such work himself/herself or through his or her own - ,. Zoning Approved By "`-'^' nate i� /de( (Q employees, provided that such'Improvements are not intended or offered for Canopy . Type If 0 . sale. If, however, the building or Improvement is sold within one year of com- Duct-Under Ground - ;Application Approved By Date pletlon,the owner will have the burden of proving he/she did not build or im- - - , _ rove for the purpose of sale). Duct-Structural Refrigeration System I i f Application Issued By . ��7 Date/.lG/-9"3 • C I, as owner of the property, am exclusively contracting with licensed con- mss" f tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating ' ❑0-'100,000 BTU ❑100,000 BTU ,t 'SUMMARY O7ps FEES The Contractor's'License Law does not apply to an owner of property who BUILDING PERMIT /��r/ r builds or improves thereon,and who contracts for such projects with a con- , - Exhaust System 0 Multiple 0 System Repair/Alteration . i. $ SMIP ' $ 23 tractor(s) license pursuant to.the Contractor's License Law). - •' PLAN CHECK • $ PERMIT 0 I am exempt under Section B.& P.C.for this reason � Firepl/Fact.Blt. ICBG# is PLUMBING $ ISSUANCE $ • Date - Owner ) Heating System& Ducting PLAN CHECK ' $ ENERGY P.C. - $ ; I : I hereby .certify that I have read. this.application.and state that the above r ❑0.100,000 BTU 0100,00087E - - ELECTRICAL $ • GRADING $ information is cor -et. I agree to comply with all city and county ordinances : I and state laws rel. ing to building construction;and•hereby author ze repro- - 1 - PLAN CHECK $ I MICROFILM $ sentatives of, this sty to enter. upon the abov- mentioned pro•erty for p• inspection purposes i ' I Signat ' • MECHANICAL $ TOTAL FEE $ >: 8442' Driverure '. - Accounting:Golden-rod-Assessor - - - - " - - - - - CONSTRUCTION AND PLANNING _ _ - , _ POO WA APPROVALS Permit# 131-1047 70 Date inspector. ,APPROVALS Permit Date Inspector 1. •Temporary Electrical Service or Pole • _ 52. Pool & Equipment Location • 2. Soil Pipe-Undrgrnd_ - 53. Steel Reinforcement 3/Electrical-Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. . . 55. Electrical Bonding 5. Steel Reinforcement . _ '- - 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. -' 57. APPROVAL TO COVE R-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.StructuraiFloor System - . 61. APPROVAL TO DECK 11. Property Sewer Lirie & 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-Firial 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 is, 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough&•Test .'7,2. Underground Flush 24. Roof Framing , 7l. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing • 74. Overhead Hydro M 26. T-Bar Ceiling (Structural) &Monocoat • f 75. Dry Chemical 27...Frame and Flashing - 's>7'• 76. Dry Standpipe 28: Lathing & Siding • 'iJ 77'. FIXED SYSTEM FINAL 29. Insulation 7 .i 78. FIRE PREV. FINAL 30. Drywall Nailing . HEALTH DEPT. REQUIREMENT _31. Plaster Brown Coat 79. FINAL INSPECTION . 32. Electrical Power Meter-Final 1 ' • 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: �A " „ D � "- - 34. Final Heating & Air Conditioning . - _' r ; /' r :. - G----57r--------7) / Pee 35. Final Gas Pipe-Test / 36. Hood or Canopy / 37. Final Factory'Fireplace /- • / 38. Final Plumbing• / 39. Water Servide-Final j 40. Gas Service-Final 41. Solar Domestic-Final / 42. Backflow Preventer / r i 43. Backflow Irrigation 44. .Landscape Irrigation Syyy/m ' . . 45. Sound Attenuatiop/ , . • 46. Handicap Re Cations . 47. FINAL UCTURE & 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 declaration,. CITY OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. BLDG.NO. - - • CONSTRUCTION PERMIT • I• '� - /0 Olo� /c�0/ / A l • Project Address GLpO 3 B id en - TYPE OF CONSTRUCTION NEW • ADD 'U ALTERATION -' REPAIR ' / ,„, ,_, •. - .n"° -,-, -7. Applicant's Mails g 'ddr'S5, `• ❑ CONVERSION ❑ DEMOLISH '.❑ OTHER. - • LJ 41'39.- D l -/3/ i7 i5 Zone R .- •!l�.�el• • A.P.# 7 Owner's Name f���s� �s. DESCRIPTION OF WORK ' Li : i 17►IYJ�i�� 'Phone t•' ''50V �7O S Main Building: Accessory Building: Z Address �'- IG/= [0 I� T 1�'C71 Ci blC� • N _ pp TYPE OF PERMIT GRADING - 0 FOUNDATION STRUCTURAL Front Arch/Eng. ' , .i "'ic5,se NO.c 12°“1� ' - , ❑ TENANT ❑ ELECTRICAL S.PLUMBING ❑ MECHANICAL • B Rear ;/9/ � N V},\ Address 'CO. LC/ '^ — � ,�• ❑ OTHER A "V Contractor's ream' ' Phoneic4 PROJECT DESCRIPTION SQ. FT-' ' OCCUPANCY(p�77 C Right bort, 33 7 C GR Address(mailing/ ' CON ST RUCTION-TYPE VALUATION$R',, 0. 3 S Left al Mrd Q+�✓ E �7. ZONE - • GRADING CU. ACRES - Pin Ref.# k.Fees $' O City License No. 02-7 a5-1 _ _ gz...-,3 -99 P-83-> lzig-9.38. : U ' LICENSED CONTRACTOR DECLARATION Remarks: ar/ [[ q ParkingRe /Provided I hereby affirm that) am licensed under provisions of'charter 9 (commencing - • f 1 o 3'$ �� '^�' Req./Provided J-��.II ,, I' ^��wn t� R With.section 7000) of Division 3 of the Business and Profe sions Code, and • Use of Building: EC�d 0,LM L✓ � ^^!/„r SII um, • E my licenseis in full ce and'effect. • • Ucen 1 ''� • License 7i I PLUMBING FEES Planning Notes: i M • Date le IsVitj Signature_ .�- HOLD FOR SPECIAL REQUIREMENTS - E • WORKER 'CO PENSATION DECLARATION ' Bar Sink Showers N • i T tereby affirm that I have_a certificate of consent to self-insure or a certificate _ -. Backflow Preventer . ._,. _- - Service Sink '' - - - - _ . - - . • I - . • - _ S i workeis'- Compensation Insurance,-or a certified,copy thereof (Section - 3800, Lab. ) _B 8-4/ , - n Backflow Irrigation Sewer Cap • : ELECTRICAL • FEES Policy No- 1 Co anyS - -a-e-l�� , - ` , Certified copy is hereby furnished. Bathtubs • Sewer Connection ��[(Cer`If'yd c Y s fit with the city Buil i Division: • tomatic Washer • Transformer 0 15-50 KW t is `G/ 1Pe t'J Applicant ' Clarifiers Solar Collectors / I - tPole Sub. ❑ 50+KW 1 EXEM PTI N•ee M WORKERS'COMPEN ATION DELL RAT ON ”' Dishwasher • Solar Piping ! / 'Meter ❑up to 100�ps . (This section need not be completed if the permit is for one hundred ($100)or ' / , less). • I : '• Drinkin Fountains -y •• - . r 100 amps- i I certify that in the performance of the work for which this permit is Issued ! 9 Solar ' • Meter Dov shall not employ any person in any manner so as to become subject to.the - p R Workers' Compensation Laws of California. ' Floor Drains e11,/�• W/Spa e i Sub P 2 / Date Signature - �/ _ NOTICE:It,'after making this declaration,you should become subject to the Floor Sinks _ ' -, >t rl 1 I _ / F.an. ..- .-_ otors 00-1 HP 01%-S . Workers' Compensation provisions of the Labor Code, you must forthwith pf���6{�p comply !with such provisions••or',this 'permit'shall be deemed, revoked. • Gas Service -Outlets - C- r Closet ` - 'y F.A. I. I2 CONSTRUCTION LENDING AGENCY- - 1 0.Solar ❑9-15 HP 016-15+ I hereby affirm that there is a construction lending agency for the performance • , Intercepters' Water Heater • .- • • • Fixtures Micro Ve of the work -for which this permit- is issued„(Section 3097. Clv. C.) , . ' Lender's Name ' - ' ' Kitchen Sink ' - -Water Service Device Boxes / Pole Light , Lender's Address : ! Lavatories OWNER BUILDER DECLARATION - ' - '' utlet5 I. ' Range • I hereby affirm that I am exempt from the Contractor's License Law for.the • —P-Tra - / - following reason (Section-7031:5 Business and Professional Code: Any city or ' ^ ,P' n - �0 Switches • Sign p • county which requires a permit to construct,alter,Improve,demolish or-repair , - s any structure, prior to its issuance, also requires the applicant for such permit Roof Drains v Garbage D. pose! • ' Standing Sections , I \/ ---- to to file a signed statement that he/she is licensed pursuant to the provisions of ' ' ' . - / ro(fie Contractor's License Law(Chapter 9(commencing with,Section 7000)of - : , , • I - Gener or ❑0-5 KW• ❑5-15 KW • •Trash Compactor r ,vision 3 of the Business and Professions Code) or that he/she-is exempt . . - _. ., - ! ..-3refrom and the basis for the alleged exemption. Any violation of Section ` . __ - - �� - �. - - ' J31.5 by'any applicant for a permit' subjects the applicant to a, civil Reinspection-Fee $ 3 - , , enalty of not more than five hundred dollars($500).• - pe I $25 Issue Fee s 1, as'owner of the property ormy employees with wages as their sole MECHANICAL •• Reinspection,Fee , $25 Issue Fee $ 3 compensation, will do the work, and the structure is not intended or offered - ^ ----FEES - - for sale (Section 7044, Business and Professional Code:, The Contractor's --- _ -- - - -- - (PUBLIC SERVICES REOUIREME TS: License Law does not apply to an!owner of a property,who builds or improves Boiler. Hood or' Type I ❑ \ r thereon, and who does such work himself/herself or through his or her own • CanopyType Ili , 11,- 1 Zoning Approved By DhC. ane Date /�'/6/(' 2. employees, provided that such-improvements are not intended or offered for yP r sale. If, however,the building or Improvement is'sold within one year of com- Duct- er Ground - •a i Application Approved By \ Date• pletion, the owner will have the burden of proving he/she did not build or im- � �/G rove for the purpose of sale). Duct-Structur Refrigeratio ystem :'t I'gpA)-plication Issued By ' flf, flats�' / Oo I,as owner of the property,am exclusively contracting with licensed con - ❑0.1 00 BTU ❑100,000 BTU tractors to construct the project(Section 7044,Business and Professions code: Duct-Ventilating • ^f SUMMA Y OF FEES -• Z The Contractor's License Law does not apply to an owner of property-who ...-•-...-•-! BUILDING PERMIT $ 7 .�� SMIP • • $ r . •-7J S• ( builds or improves thereon,and who contracts for such projects with a con- Exhaust System 0 Multiple ,-.System Repair/Alteration H. i tractor(s) license pursuant to the Contractor's License Law). ,s 7 PLAN CHECK $ PERMIT • ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.BIL ICBG# to '9/ Of'? I PLUMBING $ ! ,ISSUANCE ' $ • + Date Owner I Heating System&Ducting \ E NE RGY,P.C. $ hereby. - PLAN CHECK $ , I certify-that I have.read_this application and state that the above-. ❑0-100,000 BTU-0100,000BTL GRADING i $ Information is cor ect. I agree to comply with all city and county ordinances / ' - ELECTRICAL $ and-state laws rel ting•to building construction, and hereby authors a repre- / ✓ .! I PLAN CHECK $ i MICROFILM $ sentatives of this ity to enter upon t ove- entioned prop{frty/for (r(jLON • • � Applicant;Pink-Accounting;Goldenrod-Assessor - - - - - -' - -- - -- '-- - CONSTRUCTION AND PL NINGPOO WA APPROVALS - Permit# /o "p Date Inspector APPROVALS Permit# • Date Inspector • 1. Temporary Electrical Service or Pole • 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd: - - 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd: 54. Forms • 4. Electrical,Cond-uit-Undrgrnd.- . 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test . 6. Electrical UFER Grnd. , 57. APPROVAL TO COVER-GUNITE 7. Footings • 58. Electrical Conduit-Undrgrnd. . 8. Foundation 59. Gas Pipe, Undrgrnd.,Test • • 9. Water Pipe-Undrgrnd. # 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer-Line & House Connection 62. Backwash & Receptor-Final I ' 12. Sewer Cap - - - ' 63. Heater & Vent-Final 13. Roof Drains _ 64. Plumbing System - Final , 14. Rough Plumbing ,. 65. Electrical-Final 15. 'Rough Electrical-Conduit - 66E Solar System-Final 16. Rough Electric Wiring - - 67. Fencing & Access Approval . 17. Rough Wiring Sign - 68. APPROVED FOR PLASTERING i • 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 472,.•Underground Flush .� • 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil . 25. Roof Sheathing ',74 . Overhead Hydro t • 26. T-Bar Ceiling (Structural)'at Monocoat - ; .75. Dry Chemical , ' 27.. Frame and Flashing ' 76. Dry Staridpipe `' 28. Lathing & Sidingi•' 77. FIXED SYSTEM FINAL `1. 29. Insulation , • - 78. FIRE PREV. FINAL 30. Drywall.Nailing , HEALTH DEPT. REQUIREMENT 31. Plaster Iii-own Coat . • 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED • 33. Final Electric Notes: (a- - - n o 34. Final Heating& Air Conditioning ✓ ,� • . • _• (�' �Y�_ 7C 07 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 - • - • , , • 44. .Landscape Irrigation System - • 45. Sound Attenuatioh 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 - -' • PEWIT NO. T,A�O/,q. 1 LOT NO. BLDG.NO. _ :Hi6 Ir/I"/"�' Si 'Io/y T CONSTRUCTION PERMIT. /=/OQ,7 L� ,(tel �Y' •. / •� • • • ' Applicant's Mailing Address ' -PO BOX 203 Balboa Island TYPE OFCONSTRUCTION .0 NEW U ADD ALTERATION-4 REPAIR' - - Project Address 2603 Elden Avenue - ❑ CONVERSION :0 DEMOLISH ❑ OTHER + - - - . . . _ - Owners'Name Mar-Elden Development "Phone 474-0601 DESCRIPTION OF WORK • : _ - ,. ' /' I ZONING REGUy�L�A�nTsIONS Address.• PO ROX 704 Ralhna Island 97667 TYPE OF PERMIT_ 'U GRADING U FOUNDATION U STRUCTURAL t 'Z ' A.P.•.gt 14,31j-071-- 131 i'-, IS 'ZONE FQ Arch/Eng.ChrIS R. Stephens License No. C12963 , 0 TENANT ❑'ELECTRICAL ❑ PLUMBING 0 MECHANICAL 9r 'p�n UILDING ; 1 - PLNG.RE F.51E(rp'.w -! I -L.T'-U�� Tanrfr rrr 5T.. . Addr•ess PO' Box 203 Balboa Island 92662' ❑,OTHER , TO BUILDING i1 "'Olt' �'1�•1 y, �`'�^ Contractor's Name ChriS 'R.' Stephens 1nC'Phone' 474-0601 t PROJECT DESCRIPTION SO.FT. OCCUPANC/y ' ," PROPERTY LINE ��Q ' REAR VARD`(TO P/U IX� GI Uwts.�l Address(mailing) -PO Box 203' Balboa Island 92662 CONSTRUCTION TVPF VALUATION$ RV/ g•3 •( LEFT SIDE YARD a;34- / RIGHT SIDE YARD ccU 1`J I ZONE • ' GRADING CU.YDS. - •ACRFS - .PKG.SPACE REQ. PROVIDED h License No. I 029Q53" -• /22:204.4.. , - r�-rJ' �/'.S ''q Q. LICENSED CONTRACTOR DECLARATION y ' 1 Remarks: 4 �ff " P /e �;`! -y.=„S[� i-� _ STREET WIDTH I(��Q / 'PgRK FEES Nhereby affirm that I am licensed under provisions of�Cherter 9(commencing I LLL...!!!/// i `+r • 1 _. 1 > ' with,section 7000) of Division 3 of a Business and Professions code,and : I ) / j . I . 'SPECIAL CONDITIONS: �, j ' myllcensee issIn full+fgforce andeffect. i - - - . - • Cicensle fr.721 /d3 License - - 1 , PLUMBING , : i , - i _ 1 • iu-T(ml>;nR sPFCIAti REQUIREMENTS 1 Date 1 Signature • 1 , i Bar Sink ' I I Sewer CaP- I I : ELECTRICAL i • ' ORKERS'COMPENSATION DECLARATION I - - -- E,gereby affirm that I have a certificate of consent to self4nsure of a certificate • '_ Backflow Prevedter-.' - �' . .-Sewer.Connection;_ �' - _ Automatic Washer I - , i 'Meter ❑over 100 amps• - _ c -Workers' Compensation'Insurance, or"a"certified,copY'thereof (Section . - - a800, Lab. C.) r j " t ! - ' - 1 Construction Pole t :Sub PanelI 6ZSOR4-F13 • I Comp ny State Cnmp 'Fund • Backflow Irrigation I Solar Collectors : I Poll[- No, , : Cooking Unit • Sub Pole 1 - Certifled:copy is hereby furnished. , I i t Bathtubs , Solar Piping I I I 11 •. Cerq{1�yoyy It (led with the city Builtl (• Division I s - A ) ( (Motors ❑0.1 HP ❑1yiA• 1 + • Date l'/ { `t0/� ' Applicant - --�.. - - - Clarifiers ' i I • Solar Tank _ I �I Dishwasher J I , EXEMPTION PR M WORKERS'COMPENSATION DEC •RATION"- )or - - Dryers ,OGas•'OElectric•• --- Inc.Solar-09-15'HP ❑16=15+' ' (This section geed hot be completed if the permit Is for,one hundred ($100)or • Dishwasher Swimming Pool-w/Spa . ' less)' 1 r - - - s Fang ' I •Microwave 1 1 certify that In the performance of the work for which this permit Is Issued I ' 1 Drinking Fountains , Urinal il ' ' 1 ' shall not employ any person In any manner so las to become subject,to the i - ' . F.A.U. I { PalelLight I Workers' Compensation'Laws of California,, j 1 Floor Drains: • I 1 Water Closet; -� • Date I Signature , +y� { (' l Fixtures I I ) NOTICE:if Lifter making this ions declaration, should become subject to the , - Floor Sinks ,� „i _ Water Heater, ,.� ' 1 P___ _f__ _ (Range I Workers' Compensation, provisions of the.Labor, Code, you must forthwith - ) I ' comply with such provisions:or:this. permit i shall be :deemed revoked:: Gas Service ( .Outlets' •`1 WaterServic I -- ! - !, Device Boxes I .Sign i • , ' CONSTRUCTION;LENDING'AGENCY:. " -• - _ p}� '� - I , I hereby affirm that there Is this trbctlon lendinge agency for the.Performance Interceptors .s r r- ; `+^� 1s✓ pj ! Outlets 1 I I .Standing Se[tions of the work for; which 1 this_ permit-is 'Issued•,(Section.,3097, Civ. CJ ; ` - • (Will"! - - Lentler's; Name - I - ,. i Kachen,Sink` ? -' + _ . , 1 Switches r Trash Compactor I , Lender's Address j ' ' . - , I . . • - _ `` ' Lender's, Lavatories. - . .' ! i Garbage Disposal I r , OWNER BUILDER DECLARATION - - , • r 1 z ` I hereby• 'afflrm that I am exempt'from tnetContractor'i:License Law for the : r �, , _ . - - Generator 00-5 KW 05-15 KW ' i I - I • ' following reason (Section,-7031.5 Business and Professional Code: Any city or P-Trap: v_ : _ c _ , I.county which:requires a permitto construct;alter improve,demolish or repair 1 t - - - - Transformer ' any structure, prior to its Issuance,also requires the applicant for such permit. • ' Roof-Drains, ! v - - ? '- • 15-50 KW I • I i , f to file a signed statement that he/she Is licensed pursuant to the-provisions of: L. - '" ' • ❑5U+KW I f 'Rain coon Fee • the Contractor's License Law•(Chapter 9(commencing with-Section 7000)of i - ' • .- . t - ' t 11 - see , $15 ` 'ision,3-of the Business and Professions Code) or that•he/she is'exempt : i Showers _ • r _ , _ . + • ReinspectiunjFee $.15 . - efrom and the,basis for the alleged exemption. Any violation:of'Section � - - , - Meter ❑up to 100 amps j , .Issue Fee' '$ 3 .1:5 by any applicant for;a•permit-subjects -the applicant to' a•civil 'v i - < •,$.3 • -_ - - - - ' natty of not more than five hundred dollars($500): , t . . ♦ Service Sink • Issue Fee ��Be r f I Zoning Approved BY .Date ..co iris of;the property ormy employees with ince wages:as their sole - MECHANICAL f - - - + compensation will:do the work, -and -structure is not intended or offered . - _ , 1 , f AppliWtion Approved By 'Data 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 Boiler, , - - Refrigeration System + • /I^1 thereon„and who does such work himself/herself or through his or her own ' i ' Application Issued By "'Vi �/ •Date ���L/gam ' employees, provided that such improvements arernot Intended or offered for DO-100,000 BTU ❑100,000 BTU sale. If, however, the building or Improvement Is sold within one year of corn- ; i Duet.Under Ground ' , , • 1 SUMMARY OF FEES platten, the owner,w111 have the burden of proving he/she did not build or Im- - - - ' rove fort he purpose of'sale)'. I I - ! .' • . Duct-Structural r 1 System Repair/Alteration BUILDING PERMIT $'I L7 2F ' SMIP , $ `_'73 U I, as owner of the property,am exclusively cantracting:with licensed con- I . . .. 4 I I ' tractors to construct the'project(Section 7044,Business and Professions Code: Duct-Ventilating . • •s 1 9-•' 'PLAN CHECK. $ • PERMIT The Contractor's-License Law-does-not apply to an owner of-property who ' . - . ., 1 ISSUANCE ; ; $ ' • builds or Improves thereon;and who contracts for such projects with a con- I i Exhaust System 0 Multiple O - .J , PLUMBING S. - - 1 ' tractor(s) license pursuant to the Contractor's License Law)., f - - PLAN CHECK • $ GRADING j $ '' • 0'i am exempt under Section ' I' B.& P.C.for this reason : ! Firepl/Fact.BIL ICBG 4I+ I. I ' I , ' $ f, ' Date' • Owner ` Heating System& Ducting 1 �, • ' ;ELECTRICAL: $ 1 ' i. I hereat certify t -t.1•have'read this application and-state that the above- .'. :- 00:100,000;BTU-0100,000 BIU_ _ _ __ PLAN CHECK $ MICROFILM • $ ' Information is corrtit. 1-agree to comply with all city and county.ordinances , - r T , ' I ' TOTAL,-FEE' ' $ • • 1 ' and:state laws :aleft•g to building construction,and hereby auth•rice repre- p 1 - t :MECHANICAL' ; $ sentatives of'this;el y to enter upon the' e- entionetl pr•pert for Hood or- Type I ❑' , D Canopy: , Reinspection Fee $15 ,PLAN CHECK' I $ ADVANCED-PC $ ( I Inspection purposes. -• ) p py: Type II 0- 1 , 519nature - • Goldenrod--Assessor . - - ” ' - `-' - - --" . - '- �` CONSTRUCTION AND PL - NING ,k ��' , -.�..�` pOOP SPA r - tr. _ -_ APPROVALS- !Permit# r '��- , lobate,, Inspector_ ''APPROVALS. Permit#' -Date Inspector' r r1:ITempoiary Electrical Ser'vice;or Pole I . ' ^ :r_; - I - ,52. Pool & Equipment Location" .2, Soil Pipe-Undrgrnd'. « s I- I I y•. ` 1 r•. • :, , - ,53.-Steel Reinforcement _ `- e. : ' - . :3.tElectrical Conduit Utility Undrgrnd. m Y , co ,; 1 : ;54. Forms., _ 1 ' _'- - ., i t4..Electrical Conduit-Undrgrnd.-..4.42 1 ` E. ' __ Q - i .c.. E `55. +Electrical Bonding - •_ . • , '5.I;Steel Reinforcement ! , _o 5 °. :.56.._Rough Plumbing-8i Pressure Test. ' _ - " 6.;1- Electrical UF ER Grndi i a 2 ` _ nt .. ` 57-.'APPROVAL TO COVER-GUNITE - 7.IFootings ' ' 1 j ; `- . �.. = .. ` -' 58. Electrical Conduit-Undrgrnd.- , 8.I Foundation ' I , 6 < r 4 i r r - 59. Gas Pipe;D Undrgrnd;,Test .. 9. Water Pipe Undrgrnd. Ir, - _ - 60 BackwashLines,P-Trap,0 Undrgrnd. • - - 10.;Structural Floor1System ; ; c $, r , ; • --1 i_ 7 .61.,APPROVALJO DECK , " 11. Property Sewer Line. House Connection ; 62.rBackwash'&'Receptor-Final J. . _ 12.15ewer Cap' ! ) j lc i. ; ,. '- •• c t'63. Heater &,Vent-Final_ . . 13.;Roof Drains : ' .' i I 1_f 1 .; R 1 s= 164. Plumbing System -Final _ . _ : - _ - - K 14.;Rough Plumbing ' ' I -2 ' -I . - '-65. Electrical-Final ‘` - . " 15`'Rou h-Electrical=Conduit'- - " T-T --C - "" - -` - 9 i-' `j ; .166. Solar System-Final i -"r - - - - -'l 116.'R;ougtt Electric Wiring 1 I'D 1'', I . j c;ETI-.9 • im T i 67. Fencing,&Access Approval : ; _, � - .•-� a- I:: Wiring,Sign) ° ' -; :' 1 ` i 1i . It. . f_ ` i ,68, APPROVED•FOR PLASTERING '- - - - 18.'Rr.ough El'e rival-T.'Bar Ceiling' i! i y ;- i • _ ' "..• , 69. POOL/SPA'SYSTEMS FINAL - : ; - 1 F 19I,Rough Heating& Air-conditioning j 1 : .I : ' I i I ' FIRE DEPT;REQUIREMENT 20: Rough Factory Fireplace 1 ; ',' l I - , 1 ,APPROVALS Permit# ' ' 21. Ducts,in Structure• '! ' j 1 i� 1 � I 1 ' ! 170. Underground Hydro - - ' I 22?Ducts,'Ventilating,. • , j : (i !, I I ! j . ' I 171• Product Piping 0 Gas 0 Oil i :23;Gas Pipe-Rough &Testo i I .1'11-.1 i ! I _ 72. Underground Flush ; ' r•24, .Roof Framing : j ; 3 ! i *, -:". 11A-1I;_ 1,; i m' •� w 1 . I -•I-. i 73. Undergrnd.Storage:Tank-D Gas E_Oil ; t 25:)Roof Sheathing ' I i 1' 9r I, I ? 'r ;4 f r ; ` ' •1 ' '74. Overhead Hydro ' 1 1 --,26.187ar Ceiling (Structural)I1& Mon'in at I : j , 1 1 . I i 175. Dry Chemical 1 : - r 1 F27. Frame:and'Flashing 1i I ' i' I1I 1 i . ' 1 i ;76.'D�yStandpipe: ` - ' _ , , • ei 28.I Lathing&Siding 4 ; I ,1 '1 I I. 1 I. 1:•? , 77 �r1IXEDISYSTEM FINAL., ' 29° Insulation a I er " ; 4 I I, I ; I I • ,78. FIRE PREV. FINAL . I :. t - 30 ,Drywall Nailing '� I : 1. 1' _1 I i 1 .t: i Notes:0,14,1n:4241 ' --aD( 1 r. T'31^Plaster Brown Coat; ; 1 ! Il II I I 7 I ,r.I i . 1 _ ,32..E1ecVicalPoweaMetei-Final ' II ,1 11 ' '-�`�1 i 1 � ' i I { I , r 11 , _33 n Final Electric I'_ .;'_-1_,,._ i._. ...1. - _ 34. Final!Heating&.Air-conditioning :! l - ;G • 35. Finalas Pipe-Test'. 14: '; ft : _ '� 1 - Il- i- I I - - . 36. Hood''or.'Cano ? 'i 1' ' r , PY�t n,1r •:-- � a"+1 Il I ^ 11I ` %'il I ! 1 - - • _ ' 37. Final iFactory'Fireplace� _o ! i,: ; ' l = I : _- _ - •. 38. Final Plumbing' I I.. f of _ 9 I ` p I II 1 I i 1 - - 39. Water'Se'rvice-Final I '' 7..11 1 ' I 11 1 . I 40. Gas Service-Final ' I `-:i , ' l• I ' ' i i ' • 1 l 1 1 I 1 ;._1 I 1 i I I I , , 41. Solar Do : mesticlFinI I 1 ' i , i al I I I I ill i- - - -- I- -F - - • 42. Backflow Preventei,-i " r` - ' - ••- l - 1 • 43. Backflow Irrigation <I " I I I :- ','_I' ^ ; (=. I 'I : ' 44. Landscape Irrigation.Sy emI i i' 1 } - -. • 45. SoundfAttenuation Ia . ; _ , 1_ 1_ 46. Handicap Regula ;.ns S - 1 1. _ 1 , 47.-FINAL STRUT UREI& BUILDING I5 ! I a. :> : j I i . 48. Special Re. 'repents Co i pleted ii4 1 j I I : " ! 1 ; 49. Elect iic••'eleasetolEdisori 11 . . ;_L4_1_ J__i_.i. _; _. _.--. ' , P . 50. Gas '-lease to Southern California Gas Co i I ! r I 1 I I . i ' : 51. C.-TIFIICATE OF OCCUPANCY l '- L f.4 L „�-;". r_ ._' ' . 1 • ' No .i I I I Date ' 1 u I I l ' I I ' • Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. • CITY OF"COSTA MESA` a PERMIT NO. TRACT NO. LOT NO. t. BLDG.NO- ' __ 1 CONSTRUCTION PERMIT. • • ' ' . ' '6':' /dyet:.].7- •z��QJoi'-/ _ I - 6/ • • , • 5�3 I / 3 heY Applicant's Mailing A'ddre'ss PO Box 203=Balboa Island. Cf TYPE OF CONSTRUCTION bd.NEW LJ ADD .U ALTERATION- U REPAIR. _ . • • _ i Project Address 2603 Elden Avenue ' ' • . - • ❑ CONVERSION ❑ DEMOLISH ❑ OTHER- • - • ,y Owner's Name 'Mar-Elden DeVelopthent -phone474706Ol DESCRIPTION OF WORK One residential unit nf: seven arms[_ , • , P.O. Box .203 Balboa cl stand 92662 p *' . 20NING REGULATIONS Address , 7ypE`O F PERMIT - U'GRADING yp FOUNDATION, yrs STRUCTURAL ' _ A.P.•gW Q Q 7/ —1,3 I�' /BONE 2 Kt• A� Arch/E Chris R. 'Stephens LicenseNq, e12963 - �+�- - - Arch/Eng. ❑ TENANT ®,ELECTRICALS 0 PLUMBING El MECHANICAL IND i • LIDO 'Box 203 Balboa Island 92662 I ❑,OTHER - P,LNG.REF. W'�j'(� 7 '9� � S � - Address ,. .. n Asx rn. T TO BUILDING - ' REAR YARD(TO P/L) [ /. I� ,/ ( j. ! PROPERTY LINE .0,n//Nip T / i bid Contractor's Name Chris R ".Charihrans- I nfphone LL78-O6D1 .PROJECT DESCRIPTION SQ.FT. OCCUPANCY R /- CI' - G • I ,LEFT SIDE YARD ; RIGHT tp �.J CONSTRUCTION TYPF vN '1 ' ' VALUATION SIN �,3y` f /f Address(mailing) 'P-0 t Raw- 704 Ralklna! [stand 42663 _ - / - 029054 ZONE GRADING CU.YDS: • ACRES • - PKG.SPACE REQ. a 5 • • PROVIDED a• 5 : L • License No: - - , LICENSED CONTRACTOR DECLARATION ` Remarks: /'- / �. • STREET WIDTH /� 'i ;PARK FEE'$ / a- a, 1-herebyaffirrn that i•arm licensed under provisions of Charter 9(commencing I•�"`'� """""� `��Q /�'*"t' !��"' `�'�-� „_ With'section 7000) of Division 3 o the Business and Professions Code,and I I 1 j , < • , .. 1 .. 'SPECIAL CONDITIONS: . i t I. -` 1 • mydicense Is In full force and effect. ( I I i , - - •- - 1.4.6_ _',IFQB SPECIAL REOUIREMER"TS .- License Class ` cents. • _ _ _ t -� -- PLUMBING ' 1 t Il➢ " Dated RS'/23 Signature 3 I Bar Sink Sewer Cap .401 ELECTRICAL ' • - ORKERS'COMPENSATION DECLARATION 1 1 - - vI� A reby affirm that I have a certificate of consent to 5.0.f-insure:or a certificate ' Automatic Washer • 'Meter Dover 100 amps • 1 . _ - . _-Backflow.Prevente.__$___•t _ Sewer-Connection j,__ -. _ - _ - - _ __,_ _ _- Workers' Compensation Insurance,;or a certified.copy thereof (Section - - - t00, LSD. C, 1 { ' : - - ; • �g Construction Pole 1 Sub Panel i ' • 1 f ; Backflow Irrigation i Solar Collectors 1 Policy No. 6 25084-83 Com n State. COfRn. Fund ! _ - - - - G` Cooking Unit Sub Pole !l.�.I Certilleocopy b hereby furnished. 1 I '; Bathtubs 1 • Solar Piping r `v ! 7 �'� L ' 1 . . 1 p0 Ce /JgppyI fil with the clty_Bull n Division•. /It - v`. 1 Dishwasher 1 + -Motors �0-1 HP �1ya$ I : Date A 1 Nyo((-' - APpntant_' — 1, �+�1`I Clarifiers I { Solar Tank `, I I 1 ! EXEMPTIO IFR ORKERS'COMPENSATION DECLARATION" -". _ , '='` Dryers•'®Ges!'OElectric " 'IInCSolar D9=15 HP D16-15+_ (Thissection need not be completed if the permit Is forone hundred ($100)or 1 Dishwasher I I SWlmmi. PO. • : less • 1 1 1 ( ' -- _- ' 1 Fan ' - - - f ). i ! i ' .Microwave , I certify that in the performance of the work for which mss permit Is'Issued' I I Drinking Fountains Urinal ( ' • shall'not employ any person In any manner so las to become subject,to the f I t • - F.A.U. I .Pole ( ' Workers'CompansatlOnj Laws of California.l j I { , Floor Drains i k Water Closet. , i , iI I ' ' Date • - Signature , ] Fixtures l 'Ran i NOTICE:If,after making this eeelarf the-you should,becomeahbjeatto the_-1.. .�: Floor Sinks 2 - ...1_-_-_ 2__. __ _.fyat_er-Heater_._I_ �.. _ • -1__ _ 9e I ' Workers', Compensation provisions of Labor Code,-you must forthwith 1 ` Device Boxes comply Iwlth, such provisions:or mislIpermit Vitali. be'deemed' r_evoked.; , ,- ' Gas Service I GOutlets 'Water Service , ' _ i r Sign; , . 1 • , • CONSTRUCTION LENDING`AGENCY.' I - ' 'J _ ' L. • - '= " ' ' - • I hereby affirm that there Is a'construction lending agency for the yv erformance' I ' Interceptors , 0- t - ,� ' _ t • , • ' 125 Outlets 1 I Standing Sections I 1 of the 'work fon.which^this- permit„is issued"(Section•,3097- Civ. CJ: 1 -. •• - - 1 , , 1 Lender's', Narita•- ' - ' d• ' Iv' ' I KitcheniSink, r "1 I - - 'I0 Switches ' Trash Compactor ! I I 1 • Lentlar's Address •- I ,- ' ' ,- I ' i , 1 . - ; , I ' , OWNER.BUILDER DECLARATION- i :, I i -1 - -- 1 ; ' Lavatories , : I - I I ; r 1 / 1 Garbage Disposal 1 , 1 I I hereby'affirm-that I am'exemptl from the'Contractor's[License Law for the ' , - , , , , Generator❑D-5 KW 05-15 KW , I i ! ' following reason-(Section-7031.5 Business and-Professional.Code: Any city or I P-Trapi ' q ' i ! I I i ' 1 ; ' county which',requires a permit to construct;alter Improve,demolish:or repair { - .. - ; ' - , Transformer 015.50 KW I , j ? !Any structure, prior to Its issuance,also requires the'applicant•for such permit Roof Drains• 1- . 1 ' I ' '1, , I - ,to file a signed statement that he/she is licensed pursuant to the provisions of - ' ; - the Contractor's Ucense Law'(Chapter 9(commencingtwltnSection 7000)of ' ' ( t I 1 , i DSU+KW I 1 1 'Reinspection Fee • $15 r-lsion•3,.of. the,Business and.Professions Code)tor that'he/shetis'exempt Showers T j . j -t I -r Reinspeetion1Fee ! ,:}• $15 ' _ 1 4+f,"',.efrom,and the.basis for the alleged exemption. Any violation'of Section Meter D;up to 100,amps J j ; ? 'issue Fee' t r .$ 3' s • '� `1l5 by 'any applicant for a'permit subjects the(applicant to a..civil `` Service Sink{ J ' `•'. 1 ' Issue Fee I $ / natty of dot more than five hundred dollars($500). i fro ( I I i - , I• ,~ ' j' , 3 JZoning Approved By .Dnc,JI v6' I 'Date I op(.(t/t_'S:j I •I,-"as{owner of•the'property or'my employees with•wages:as their sole l ' ! I compensation wield() the work,and the'.structure is not intended or offered ' MECHANICAL ! 1 I ' j va 1 - _ I /' 1 Application Approved By Date ' I , for sale'(Section 7044', Businessland-Professional perty de:!Ther Contractor's • , Ucense Law does not apply to an owner of a propertylwho builds or improves 1 Boiler, �'I 1 j Refrigeration System I' ' I � i ; thereon,And who.d eat such improvements himself/herself or through his or her own - t ' I Application Issued By v / Date �y��G/� employees, provided that such Improvements sol t intended or offered for ; --• , I 00.700,000 BTU ❑100,000 BTU, - 1 sale. If, however,the building or improvement is sold within one,yeatdf corn- • tr Du1ct'UnderiGround , i r 7 ' I I SUMMARY OF FEES ' • 1 gr,oven,the owner,will have the burden of proving he/she did not build or Im- , , f,l r,., { ! ! l • rove fpr the purpose oisale)'. 1 , ;� 'I , • Duct-Structural I ( ) System Repair/Alteration ,I / �, ;BUILDING PERMIT $ •-):/7.:(.1u, ! SMTP I . $ • S 23 U I, as owner of the property,am exclusively contracting with licensed con- I . I • I 1 I ' tractors to construct the project (Section 7044,Business and Professions Code: . • Duct-Ventilating I ; I i 1 'f PLAN CHECK' I $ PERMIT The'Contractor's License Law- oes notapply-to-an owner of property-who--r ' I ! ISSUANCE $ ' : I builds or Improves thereon,and who contracts for such projects with a con- I I Exhaust System 0 Multiple 0! 7 - ✓ ' 'PLUMBING $ ' . I ,tractor(s) license pursuant to the Contractor's License Law): , ' I I 1 GRADING , $ - 1 D'I am exempt under Section B.& P C.for this reason j 1' Firepl/Fact.Blt. ICBG* I I .PLAN CHECK. $ • - . •ELECTRICAL ! $ `I Data • - I owner I - i Heating System Ducting& ) I MICROFILM I $ 1 I hereby certify that.tihave teed-this:application and-state_that_ttie above 1 '• 13b100,000'BIU.0100o00 HD:: __ w __ I ;PLAN CHECK $ - , Information is to\ act. I agree to comply with all city,and county ordinances ' i . �. -, - ' 1 i ( 1 TOTAL FEE, - $ ! • antl state laws rel ing:to building constructlon,And hereby author ze repro- ! Ho-od or Type I ❑ 1 , MECHANICAL $ • sentatives of phis By;to enter, .•n th. ova antionetl pro-arty or ( i j Reinspection Fee: $15 ;PLAN CHECK' I $ LESS ' 1 '` ' ' Inspection purposes- q , 1 Canopy; Type II D. I - - • 1 ' • Signature TAccounting:Goidenrod'-Assessor -` ''- ^•.--^- _._ • • - 52 CONSTRUCTION AND PLANNING ,. -• - ; L - Y c y.-,;.•° - -: - - G F - �.OD�, . .'Date Inspector,. -- ' - • '• • _ - Date : -Inspector, . 3APPROVALS; Permit# - _• . . _i, ,•, r r - ;'APPROVALS,- Permit#, - • ; ; , ar. Tempo?ary Electrical Serviceior Pole " t e'.,' I L 3 ! 52' Pool•&Equipment Location 1. X2.1 SoilPipe-Undrgrndi m ; if:-..2_ 1 p cc ••• . '53. Steel.Reinforcement I f3.)ElectricalConduit UtilityUndrgrnd. s_; T= j ° "S41.Forms;- - :1 ` - . _ - - • Irjr c t4.1Electricel Conduit-Undrgrnd._si : i . 5 ^ ;` :� °55.TElectrical Binding,:-„ _ - - i as ;5.'Steel Reinforcement ' n :, c o- ; I _,, ` •` 0-:_ ' 56..RougNPlumbing'& PressureTest - '6.! Electrical UFER,Grnd. F- ' ' e 3 r 3 57'. APPROVAL TO COVER-GUNITE 71Footings i • , I3 ?C �'I :rF E I i. I` 5e.l•Electrical'Conduit-Undrornd:. • - ' 8.IFoundation I I ' ' ' 8 � 1:1 r ' _ 'r 159.`Gas Pipe,O:UndFgmd test'„ • • 9-'Water Pipe;Undrgrnd- d ` i - ' `- c« .60- •Backwash'Lines,P-Trap, O Undrgrnd: _ 10-j Structural Floor System ;, o u c _ i .i t= ' !' -61.;APPROVAL TO DECK _ _ - - c' 11. Property Sewer Line & House Connection x r ° n • ' : r_62-'Baekwasfi.&'.Receptor-Final= x . • 12. .Sewer Cap; i " ° ,,, jri "63. Heater & Vent'-Final - - - - 13.IRoof Drains , : : ' ! i -P64._Plumbing System - Final - 'I e 14.'Rough Plumbing . ' •- I ' .- '- `• i` -65. Electrical-Finan - i - 15:;Rough'Electrical:Conduit-f r !---F-7-7- -r;'-,-" 1' I' 166 Solar System-Final, : - -16.1 Rou h ElectricWirin 1 E ;,;-a-3;4±, _ - i ,-r' - - - l• 9- _ 9 II _- (� I T ;67 Fencing&Access APProval , _ _ ,( _17. Rough Wining Sign' a ' FII I '-r c 1 I_. I = :Iz 1 " ! ,681 APPROVED FOR PLASTERING E i ! _ - - • _ - 18.;Rougt Electrical-T4Bar Ceiling ' I;f I J . i .- I , '69. _POOL/SPA'SYSTEMS FINAL. _ " 1 - - 191 Rough Heating& Air„Conditioning ' I ` 1 ( ! ' i ' ! ' ; !FIREIDEPT: REQUIREMENT ; - - 20.1 Rough Factory Fireplace I I Ij 1 I i I i - 'APPROVALS Permit# ;I '' I - 21_ Ducts,injStr •Kcture; '� 1 I '1- L I i i I .I 1 70 Underground Hydro - I I r;22..Ducts,'Ventilating..•• ! T I I r i 1 I I I j71, ProductPiping;OGas ❑Oil • j i j •.23/dal•Pipe.Rough &Tet I 1;I• 1_ - - -- T ' -. .M121; Underground Flush 'r - - _ .I • .j _ i -.24: Roof Framing ' , i ' I i l:5,1•.r r n i r : I , Iy 73. Under rnd.Stora e,Tank O Gas O Oil i 25: Roof Sheathing i . ` I .I,,ra, = 1, i ' _ I _i, - i -'.I `• '74. Overhead Hydro , • 126. T-Bar Ceiling`(Structural)i& Monocoai l I i •.i` ` I '' : �75l Dry Chemical ' - - . -27.'Frame'and:Flashin ; ' v ' ' ! I 9 . ! li !. . , _ .•'. ,:,i r 76, Dry Standpipe' • - 1 ' �28- Lathing&%Siding ^ o i I II i I ' i ,4- ;:T j I i 77. FIXED'SYSTEM FINAL. Y .294. Insulation_ -: , ,` '' ' I ' I� ! I ;;fir"! / I 1 I ! 78. FIRE PRE IV. FINAL F,; -30.,,Drywall Nailing j i y i ! II i; 1 I 1 1i'•, I r i i Notes: . - )i ' 31.,Plaster Brown Coat• ! , I ! I�. 11 I ,..,, '•,I- I -i--1- I ' I -' -�7i1( If , I ' --f - • 32.Il Electrical Power Meter-Final i II :L_•'1 ✓ 1 I Il ft ! ' ! l i i ' ' : r• -t Electric ! I I i 4'•jI 4<" i 1 I I i I ! •.1T) 1 .. _ ,I 1_ I _ 34. Final;He'atirig:&.Air Conditioning °- I 1 , ! ' . , - ` • 35. FinalPGas Pipe=Test! I114. * I ^_! P., 1 ; 1`3 I ' I': 'r I " I' - - 36. Hood;orilCanopy' '- !! 1 ' ;I d I 12 1 ` .4 : I ' ; ! 37. Final'Factory Eireplace`- i i ' c; Il V o ' ' ! - ,'/ I I I - _ 1 , 38. Final;Plumbingl I ii I aI . '. A i ! I 39. Water"Sere :rvice-Final I I •.' i 7 1 ` I - _ . e 40. Gas Service:Final. ' I I l II i '/I ! ; I I i i _ , 41. Solar lDomestic-Final I ' 1 i i ' • ' - , 1 i I i el 1 I I I ' I I - - 42. Backflow Preventer e l I m i • - 43. Backflow Irrigation' IP .� ' • `t2! ' ! n' ' 'I .- . •,, i 2i 44. Landscape Irrigationieyt -,,,,q- w aeml , 2I_ I-19 1 ..., • ` 1 _ ,j ' I -r _ 45. Soun ...• . tnu �n• 1: i . 1. 'I r ' I I_ i '' 1 i l r_ _ _ c _ 46- Handicap ,dlei ations' 1 r Ii. :� 1 i i 47:FINAL-STRUCTURE& BUILDING 1 I I ; I I , ; 48. Special Requirements Completed ;i ~ ' �' i ' /4/ElectriclRelease to!Edison I ' h • _.1.- 1 _ t-- ' _ - 4 . ' 50. Gas Release,to Southern California Gas fn : I 1 ! , i i ' • 51. CER,IFICATE-OF OCCUPANCY II ,_ - ' -.'(., r . _ _j _; ..,__,- i-- No 1, I Date 1 1 t { I • ; • Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA 4 I i ' ' I a PERMIT NO. ' TRACT NO. ' LOT NO. • BLDG.NO. • ....11i7.7= I c/I rY r, 3,-,14.0 7 1 CONSTRUCTION PERMIT. " 'r I • /� =/D 0=73 //0�0/[(T/,' /• •I Applicant's Mailing Address PO BOX 203- Balboa I slalld 92661 TYPEOFCONSTRUCTION 1 lel NEW U ADD IJ ALTERATION PAIR:. - • Project Address 'gill 'Elden °Avenue I ` ' ' . 1 • •- • 1 ❑,CONVERSION -0 DEMOLISH ❑ OTHER •_ - •• Owner s Name I Y-F'Iden Development- Phone' 4740601 'DESCRIPTION OF WDRJK • - - i - _ ` Rrix' 703 Ralhna Island._ -GA. 92662 f One 'Residential Unit o�flSeven..UrntrttY'roject 'zoNING.REGULATION$ Address) PQ ' " TYPE• OF PERMIwT I •Uc. ;GRADING lg.FOUNDATIQN E STRUCTURAL • i • A.P`106 �34J-0 1/-/3 'I �5•ZONE � •, 1 ' I ' Arch/Eng r.ht'is R Stephens' License Np.I C 12963 ❑ TENANT pt ELECTRICAL 0,PLUMBING MECHANICAL ' , ' - 1 PLNG.REF,qp UILDING .c " .., / - - W'L1J l-/.' P-U� Taerr rfl 5T ' Address PO:Rnx ?WI•Ralhrla Island! CA 92662 i d ❑OTHER .• .TO BUILDING no, ) ; ��1•ic-R.- StP hensiG-R.- StP hens I Inc- PhoneR740607 iPROJECTDESCRIPTION SQ T. - ) OCCUPANCY 1� PROPERTYLINE(7(� I •REARYARD•(TOP/L) 99 I CJ !JQ Contractor's Na 1 1F�• G •)_ - J Address•l(mailing/00; Rnx 7Q3 Ralhna (Gland; CA 9�6f 71 ♦ ; CONSTRUCTION TYPE li A71 I �VALUATIONS-5- 8--✓ :LEFT SIDE YARD RIGHT SIDE YARD (�( , �'1 _ I - ! ' �_ , ZONE I GRADING CU. • 'ACRES • PKG.SPACE REO. , i PROVIDED - • ' License No. ___ -ID 29os3 , - �/.5_• ' , a--;5_= r _ . LICENSED CONTRACTOR DECLARATION , , Remarks:////1 • r ' :S/ , I • STREET WIDTH 1QW/ • i • 'PARK FEES / (-hereb• y affirm that I.am licensed under provisions of Charter 9(commencing ��.IM � l° �; - ���7�,5 ` I `�a7��C• - . With'section 7000) of Division 3 of the Business and Professions Code,and I I ! I , I SPECIAL CONDITIONS: I ! ' mr Iicenseis In fun tote and'effect. • ' 1{092 SO I - - , - I ' •I ' Ocense Class' tS- I _ I j. : , PLUMBING ' •• I I 1 Horn FOZ`SPECIAL REOU EMC TG , Dale' 1 COMPE/29 NSATION $:gnat DE RA--24/11946.•l ' , Bar Sink + � 1 Sewer Cap 1 I • ELECTRICAL I • WORKERS'COMPENSATION DE RATIO - ' - -- ' ereby affirm that I have a certificate of consent to salt-insure or a certificate ' 1 I ' 1 Automatic Washer 'Meter Dover 100 amps' Workers' Compensation-Insurance, or a certified!copy thereof (Section • BackflOw�Preventer •-.�- .- -SB Wer COnnectiOn. - . _ .. _ _• a_.. _ -. --_ L - .,a00, Lab. I ' - -- - I Construction Pole ,Sub Panel , I t , . Backflow Irrigation 1 Solar Collectors I 25084=83. State Com Fund I Policy No. Co pony P' I . •- - / Cooking Unit I - Sub Pole ' ' • I�—sII CertHiatl •opy I hereby furnished. ' I Bathtubs ( I Solar Piping I - 1 ! i Da Cert a y ed with the eh B ding, • I ' _- _ .__ I • j Dishwasher • I (Motors X0.1 HP 01%- • ' } Date AppllWnt + Clarifiers 1 Solar Tank I / 1�. 'EXEMPT ON,F OM WORKERS'COMPENSATION ECLARATION `-` rOishwOsher I f , ' Swimming Pool w/Spa • •� %j! Dryers )<+vas ❑Electric- 'rr' 1 -' ';Inc.Solei109-15 HP-016-15 (This sec Ion need not De completed If the permit Is or.one hundred MOO)or ! '-� less): I 1 i i t ! I - Fan 1. .•�. 1 I i .Microwave � I I certify.that In the performance of the work for which this permit a issued I • Drinking Fountains i Urinal ! ! .^ - shall not employ any person in any manner so as to become subject.to the . I . . ' y •. F.A:U. , j I IPole,Li ht f 1 Workers',Compensation'Laws of California.: t 1 Elliot Drains' , 1 1 , Water Closet ' \\er. I - 1 I g ' Date I Signature ' �- Workers', 1.If,,after making this declaration,you should become subject to the ; 1 Floor.Sinks ,ti, -. 1 _Water Heaters •1,ei �'' Fixtures ' - - Range A WorkerCompensation• provisions of the Labor Code, you must forthwith • - - • - .. ( - -- - . comply ,with;such provisions:1ra r this"permit shall be Ideemed revoked . Gas Serviee11 ;Outlets jWater Ser . Device Boxes . Sign ' , I CONSTRUCTION ILENDING•AGENCY . , ' I 1 I - - - - 5 • I hereby affirm that there is a:construction lending agency.for the performance I i Interceptors: a. f f • I '! r V, I •,•1 .• 25 Outlets I f Standing Sections I I I 1 of the work for, which•this, permit Is issued (Section 3097 Civ. C.): I • - • 1-404. • ` - , , . Landers Name • 1 I, , I • ! I . : ', I Kitchen:Sink.. ; ; 1 .: I I , , / Switches • ( I + /� Trash Compactor I , ' Lender T Address • • r • • • W - , ; ( - ,. / Gerba a Di oral i ' • I • OWNERIBUILOER DECLARATION( I t 'I .: I f, ' r P I_avatories� n{ 1 r. I t c. .e , r, , - 9 sp 1 I I I I I hereby affirm that I emi exempt from the Contractors License Law for the' - • , ., I „ - -- _ Generator 00;5 KW 05-15 KW , - I ' 1 ' following reason.(Section-7031.5-Business and Professional Code: Any city or P Trap• 1 iv . ' • ._ I i I' I , county which'requires a permit to construct,alter improve;demolish'or.repair • - , „ _ 1 - I Transformer 015-50 KW t ' I to filestructure, a statemerior to nt thas t / is lic,also ensed pursres the uant to the,provisiant for such ons of I. ! ROOfr Drains i. I , ._ I 11' ! , , I _ ' 1 I 1' signedhe/she Ir .. I I, �5U+KWI F ' ' IReini ction Fee ,.the siont'31-of the • , , ,t' the Professions ext Code) A that)he/she ftSecmpl Showers - _ I Reinspection Fee I $15 sfrom,and the for alleged exemption' appli int Oft Section - - ' , - • Meter Oup to 100,empi : , ' Tissue Fee, ( $ 3 I' q__ S.'-1:5 by-:any applicant for.aehun permit- the applicant to.a.civil ' - 1 - , ' /' p_nalty of not more than five'hundred dollars(S500): , ;. , peruke Sink 'y . y , Issue Fee? I $ 3 I • i ! Ll ,. c i I t I i Zoning APPraved BY Date (peasaown,' of th work; Or the-structure,emuuewith intendedntenor offered sole 1 - 1 `for sale (Section will 70 the work;andProfessional essiI' not •The Contractor's F• ; u ) - - _ MECHANICAL' I - - ' 1 I , : for sale (Section 7044; Busine55rantl Professlonal'Cotle:'TDB I� � • -- - -- -- -- - � Application Approved By I/n1 (nate ,,, > LI<anse Law does not apply tom/owner o/a property who builds or Improves 1 I goiter t 1 Refrigeration System I 1 ,:1' Application Issued By 7v/,�� ' Date /� /e`2 ' 1'thereon, and who does:suuc work himself/herself or through his or her own : 1 employees, provided that such improvements at intended or offered for 1 00-100,000 BTU ❑100000BTLI 4 +sale. I/ however, the buildinge or Improvement Is sold within onot build corn- Duct=Under,Gr'ou nd I i �, ' !. I '" SUMMARY OF FEES gr,oven, the Ow l have the burden of proving he/she did not build or Im- - / I I I Ii ,. 1 I. , '; I' shrove for the purpose oftopert I ! I tr• t ! 1 , Duct-Structural i I I. System Repair/Alteration i at,+ '^' ! BUILDING PERMIT $I 3,9/IC/V 1 f SMTP 1. • - $ I s 7-3 r 0 I,as owner of the property, Se exclusively contracting,wlthlllcensed con- I ' - - ' •• , ! tractors to construct the project (Section 7044,Business and.Professions Code: , Duct-Ventilating -. I , , 1 :, i r+� PLAN CHECK( I $I I ! • PERMIT •- i-The-Contractor's License•Law•does who Yapply-to arrowner projects etc withta• con- - - - -.- -- - - .. ; , - - • ' I I I i + ISSUANCE I ' $ � ' ' builds or Improves thereon, and who contracts for such projects a con- I Exhaust.System 0 Multiple 01 ,, ,. I' / - 7 'PLUMBING $ I I 'tractor(s)'lkense pursuant to the Contractors License Law): I I - � I I t I ' I I GRADING I I, $ I f , I ,-, ••• :PLAN CHECK!. $.. I I $ , 1 0'l am exempt under Section I , B-& P:e.for this reason ' /1 Firepl/Fact.Bit. ICBG I : j , ! I I 1 ; ! ,Date:. 1. I owner : I ' ' Heating System&Ducting '' i 1 (ELECTRICAL', I $I L ' I i• '' I. ' + " ' MICROFILMS $ • - ' .I.hereby certify_that khave read this application and_slacount t.the.anove / s0-100;000 BTU.0100,000BTL . �- -- I •PLAN CHECK' 1 $; 1 41- I ' Information is correct. I agree to comply with all city'and county ordinances I. I •' • 1 ,"1'" e 1 • I I TOTA LIFE E' I $ L 1 aentatl es laws r ting to bull ng.consyructlabove- hereby authorize repro- E - 'MECHANICAL $ '• - , sentatives of Iq�4,:�kytto ep(g6�rr up-n, the above-mentioned pro-arty.for HOOd or Typal ❑. 1' ' 1 I 1 1 ; tyl0 1 I • Reinspection Fee's $15 'PLAN CHECK $ LESS I Inspection pu a 1 1 ; ' /; Canopy' Type II ❑I r I i t ADVANCED PC $ i I:Signature Re • gisters ( - I Issue Fee , , , : 3 1 1 I , ' FINAL FEE ' ' $ :� CMF 0865-46 rev:12/82r'-White-Buildin9:•CanarY•AFPli ant;Pink-Accuuntine Goldenrod-Assessor--- - ' - �•'-`- `--•- - - - - - --- - - -- -- -" ' --- -- - --- - "' "'-" - h CONSTRUCTION AND PLANNING - ' t'l V - ' - - ?__ SOI 'PA c - j•;-- _ , _1 _ -_ APPROVAGSr, Pelmlt# (3t'0073' cDate? +I dspector` '> _` Date Inspeetor� , +APPROVALS, Permit 71 F7. Temporary Electrical Service'or Pole , ''i :' c •. "'ci 252'.Pool &'E ui merit Location _ -E - ' t2.1SoilP'pe-Undrgrnd' _ ;:,.."-1.-1, ! . 1-,11:::,-7' • i - ' ^ ` _53':".Steel m einforceent -_ .. - '3,!Electricpl Conduit Utility'Undrgrnd, I 1-_ j I`:r ` :g.:::.,..: ,;54:7-Forms' _ , , :., _ - ! • I ' ;' t4.jElectrical Conduit-Undrgrnd t ' ' - i'.., ` ,:_ ,.r '55! -Electrical.Bonding - , ' '° 1 :{ $..Steel Reinforcemj ent , r,;9; 1 . a 11,t.g. r ' '56 ;?13 -& Pressure Test _ ' • 6-;Electrical UFER Grnd{ I s -" ' 5 r `: ' E57' 'APPROVLATO:COVER-GUNITE - ' c ' ! t, : I, ' ' 7 Footings , I ; , 1 ' , '- f i ' ,5E1.`Electrical . - .. ' Conduit-Undromd. - ! 8.!Foundation -1 . ' I ••.; =' _ c _ , _ I - X59- Gas Pipe, 0 Undrgrnd„Test ' - j 9.1Water Pipe Undrgrnd- , , p • . , ; r - , 60• _Backwash-Lines,P-Trap,0 Undrgrnd:- i - 10.iStructural Floor System - y ,1 : .;61 APPROVAL TO DECK ' 11,,Property Sewer Line & House'Connection . ' , t? - _62,.Backwash & Receptor-Final: • ' 1 ,I 12.ISewerCap' I ,• { p. ! ` , ". c r . - - _ " _ -. 63. ;Heater &Vent`-Final ) 13. Roof Drains ! I I I +" � 1 ° Y • 1 ` � -, `64-.Plumbing System - Final: ` - 1 Q • 14.,Rough Plumbing I 1 a ! ! r ' ` ' 1=65. Electrical-Final - - ' . . • =15:.Rough-Electrical:Conduit; -__'-- - i66:Solar • - - ` . -' --1 I 11 „ T�-}- ( I System-Final, t_ 16.+'Rough Elec'tricWiiing N l t IN-1-', i1 n -Io T . -i67: Fencing&Access.ADProval • .1 ` -- \'- • -' -s ;. `-17-•RoughIWir g'Sign"' ` in ' i' I '1 'in, I•-, I.-;' I ° 1 c •' I; 8 '6 . APPROVED-FOR PLASTERING I '• ° _- 18, Rou'91rEleEIrical=ThBar Ceiling li Ir In I i I {" 'T ' ' O I - ' : I• -: „- I ' '69� POOL/SPAISYSTEMSFINAL 1 I ;- . 19. Rough'Heating& AirpCon 1itioning II, I I 1 I I f 1 ! ;FIRE DEPT:REQUIREMENT . ' . - I _ • u 20.E Rough.Fa'ctoFy Fireplace ' I II II ,. I ! 'API ROYALS Permit�k ' ` ! • { g - . ,. 1el. . II II I I I a • 21.'•D'ucts,in'Structure ., 1 jl I{ I 1 ' ' 170 Underground Hydro a It 11 ! I I J I I 1 I I I 1 r 1:'22.CDucts„Veniilating�T+-" q i I iI Ii I I I ( ;711 Product piping OOil - t. S_23.!I1Gas:Pipe-Rough&Testr, 1 .I I',Ii I t . I I 7,--I 172i Underground Flush' , , 1 r -' 24. Roof Framing' ' I 1 W 1 1112JI•; , • 1r. 1 ;'r, , l I ;:-..I73; Undergrnd.StorageTank:0Gas.0Oil ' 1 25.,;Roof Sheathing I I > i I Fr iI L ' • j- I ` c i- J ' - 174, Overhead Hydro 1 " . , -26.-.T-Bar Ceilingr9Structuralh,& Monocoat II =I I I 31 - 1751 Dry Chemical , - - . 1 I . , - ; ,27. Frameand,Flashing ' '' I I II i I ' � ^' I � •,, , I I. 1.76;:B y Standpipe, - ' I, ' -„ __ 28.1 Lathing&Siding , 'c i 1 it ' I ( 1 1-' 1 " I 1' :its; FIXED SYSTEM FINAL . = I { 29.uInsulation' - i ' '• r* i ' ( ' 1-,?78. FIRE PREY. FINAL . • • Z 230.jDrywall Nailing ' `.. .. 9 I 1 11 li I I ; I ! )J ! Notes: / i ._ // 1 1 '31.; Plaster Brown Coat 1 IIII I '- e i I` ' ''32.9Electrical Power Meter-Final I 11 II 11 : I . ,7 I I I I i , , I 1 • 33.,1Fina1 Electric I !�_ J. .I �_ :_ 34. Final Heating&•Air conditioning • I • • },.; -I , , , I • 35. Final GasPipe-Testi- '�' I " -•I p I - ,t� ILltj ' ITi-. 1 - ' -: I•- 'r`1- . , - _ • . NIR 1f� 1 1 r 36. Hood or�Canopc' it i r, .. o I. ti - I.,• 1 I I ' ; , . I V 1 _ 37, Final Factory'F,i:eplace•. r. : y1 `i'! I> I� t I : I ! I 1 I i r , :+ 38. Final Plumbing I ! I 1 cl Y • I o ( i I ' 1 1 I I l ! -' 39. Water'Si-vide-Final I I 1 'I ' I I .,, 1 .1 I 1 I i 1 - 1' - 1'.I 40, Gas Service-Final I 1 41. Solar Doinestic1Final II ! _3`�F_ '_ _ I + � _i_ _I - ._ , - c!--• _ , _ 42. Backflow Frt ter _ I I I it I_ i-I- r _ _,y__ __l._ - _}_ .- 43. Backflow irrigation It. i1 -1 I _! { 44, Landscape Irrigation ysterfl � ., I _: 1-; I_- l el , :" • i ' 45. Sound,.Attenuatwn�I. , a I - I - , . 1 , I ._ • , _ - _ 46- Handicap Regulation i r !• i r 1' : 1 !- 1 1-111 i , F i ` c .3 47. FINAL STRUCTI E'& BUILDINGII Ili .? 1 I is 1, ',I ' ' , i 48. Special.Requir ants Completed ' I1 I I`V I 1 I - 6 1 , 1 1 1 1 , , 49. Electric,Rel' e'tolEdison• i 1 l N _ Ir._ ..__l. .L4_. ._ i�_�_ . ,_ L. r _._ _ r 1 . .., 50, Gas Rale e�to Southern California Gas Co I I i ! I i j ' I ' 1 1 1 51. CERT' ICATE OF OCCUPANCY I ;.___i___-1..4. •_! '_ I _ I No - ! I i Date : j; I- ,-i-' ' -{-�-t- '-1 -1 - 1 - r 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. . 0679- 1 2/'i "/;C '-"324'e 73- T' CONSTRUCTION/�PEERMIT / , - - ,( =/Q67/ • /adl4 - i ' I . /� J Project Address 4.00 A5 24'0 1 ...-- 046 ✓s"'Y'QTYPE OF CONSTRUCTION ,Z'b1EW U ADD H ALTERATION LJ REPAIR p' - • -• - ❑ CONVERSION ❑ DEMO ISH '❑ OTHE / y� / — 071- l�3 !y, �5 R.�. Applicant's Mailing Mrs' e.F_k �•+-LI pL A.P.# 2one . - - J DESCRIPTIO OF'WORK Le //K, CA-1-l7 Owners Nameme / ••/ � Val` Phhoonne� i ' z OtJ L�,Le� (! - - S Main Building: - Accessory Building: ' / 2 Address 1'" '0 Q q '`U I ryr/l,'t��'1WL s=✓�� 11,.S TYPE OF PERMIT ' ❑ GRADING FOUNDATION ❑ STRUCTURAL n E Front %Acirr I GI bid - - O Arch/Eng. \ ' - -. t -• •a Llcehse 1`1�0s. ,r,•�� 7t1`r'7 ❑ TENANT 54,ELECTRICAL _PLUMBING ❑ MECHANICAL • B' Rear 14)..0-1/1 / '3L/ . ,..i N Address 1, •S.//11 _ / PF-r•,e5Q- 1S• ❑ OTHER _ . . - • _ • .- r�L�� A Right -/Q-V AZT Contractor's amp 4\ct� '1L- - ipt- - o e� 7 PROJECT DESCRIPTION SD.,FrT, OCCUPANCY. p-p C - G / �S - - i� i.• • 1 •CON ST RUCTION TYPE YN VALUATION$/1 .) U Ja $ Left ��.4 " IUr q0 _ R CityrLicen e ling) r E C° ZONE GRADING CU.VDS. ACRES Ping. Ref.# F¢¢5 $ Q City'Licanse No. �Z ,.ash_ - A _ z�-X33-Rg �p-(93-cam'. laa9.38 _ LICENSED CONTRACTOR DECLARATION p // - - U �fr Remarks: le��c Cea�� //_ _ -f// ,�/ ��/63.3 Parking Req,/Provided ci - _ ) I hereby affirm that I am licensed u •er provisions of Charter 9 (commencing IVF+' //'/K-civ YrP� '../..� ^ ' `,/^ R with section 7000) of Division 3 of he Business and Profe signs code, and / Use of Building: ri 0• 6/dent, n.! ronelijS - , E my,license is in full force and effect. i' 00 PlanningNotes: , M Licens yC s Licens �- - r PLUMBING FEES ,' • • - E Date_ }F�Signature RATION ' •'� Bar Sink Showers NEW FOR SPEC I4t RFeD ,y�1t�'�'� N WORKERS COMPENSATION DECLARATION; ,_ hereby affirm that I have a certificate of consent to self-Inure or a certificate ' ' - , / ' ' • F Workers'- Compensation Insurance; or a certified 'copy-thereof (Settlors °- Backflow Preventer- _ .Service Sink_ .. _ _ - S 3800, Lab. C11.) r-.:,/,1_L Backflow irrigation Sewer Cap - �� ELECTRICAL , FEES I Policy No. 4f-.SG S41''$3 Com fly c-CSO I Certified copy is hereby furnished. Bathtubs Sewer Connection • / Automatic Washer Transformer 0 15'-50 KW Cer Lep cQgY i)]f'letl with the city Bull n Divisio / 0 50+KW Dae C-�\b /$Z••a Applicant Clarifiers • Solar Collectors ,f{rr Construction Pole Suh. • 'EXEMPTIO FROM WORKERS'COMPENSATION DE LARATION Dishwasher Solar Piping r (This section need not be completed if the permit Is for.o e hundred ($100) or l I / Cooking Unit t ,Meter pup to 100 amps less). DrinkingFountairis • I - I certifyLhat in the performance of the work for which this permit is issued, I _ Solar Tank 4 / Dishwasher . Meter paver 100 amps - shalt not employ any person in any manner so as to become subject to te , - Workersa Compensation Laws of California. - Floor Drains Swimming /d / Dryers ❑Gas' ❑Electric Sub Panel ' Date - Signature ' - . V NOTICE: If,'after making this declaration,you should become subject to the Floor Sinks_ _ _ - , Urinal: p ' __ F.an' - Motors❑o-i HP ❑1X-S , Workers' Compensation provisions of the Labor Code, you must forthwith to • _ - ' _ -' comply with such provisions or this permit shall be "deemed revoked. Gas Serc'ice Outlets 16re�a1-CJ�E - • 1 ❑ ' CONSTRUCTION LENDING AGENCY - - • - - • Y► v`v / F.A.U. • Inc.Solar 9-15 HP ❑16-15+ r I hereby affirm that there is a construction lending agency for the performance Interceptors 7 _ - Watt atei , T 7 Fixtures ' Microwave of the work for which this permit is issued. (Section 3097. Civ, C.) tl - - - Lender's Name' _ - Kitchen Sink r Water Service . ' - - . - ' , Device Boxes ' • ,Pole Light Lender's Address - . ' ' ' ' ' OWNER BUILDER DECLARATION - ;' - Lavatories ' - • • , •c , - '1 eu''i�OUtlets Range - I hereby affirm that I am exempt from the Contractor's License Law for the p-Tra ' ' ' - following reason (Section,7031.5 Business and Professional Code: Any city or p - _ - ' - . /11 Switches Sign 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 - ' •• Garbage Disposal Standing"Sections I ,to file a signed statement that he/she Is licensed pursuant to the provisions of '' ' ' 7 - ' - •he Contractor's License Law(Chapter 9 (commencing with Section 7000)of - ' - • -r • Generator ❑0-5 KW ❑5-15 KW • Trash Com actor 'vision 3.0( the'Business and Professions Code) or that he/she is exempt • _ . I ' , P •refrom and the basis for the alleged exemption. Any violation of Section . • - - -• - J31.5 by any applicant for a permit'subjects the -applicant to a civil - - s - -s -. • _ _ enalty of not more than five hundred dollars($500)._ - _ I _Reinspection Fee I.. -$25 _, s_ - Issue Fee=--- :- $.3 T - - - I, as owner of they property or my employees with wages as their sole MECHANICAL Reinspection Fee $25 'Issue Fee. I $ 3 compensation, will do the work,and the structure is not intended or offered - . FEES - - for sale (Section 7044, Business and Professional Code: The Contractor's PUBLIC SERVICES REQUIREMENT • License Law does not apply to an-owner of a property who builds or improves Boiler - Hood Or• Type I ' 0 K �gj, //_ [�q thereon, and who does such work himself/herself or through his or her own 'Zoning Approved By +Qr 1c/ �N Date !�//t-I//LTV employees, provided that such improvements are not intended or offered for ( Canopy Type II 0 - sale. If, however, the building or improvement is sold within one year of tom- Duct:Under Ground • , Application Approved By _. - Date motion,the owner will have the burden of proving he/she did not build or im- - - - • rove for the purpose of sale). Duct-Structural m Refrigeration System , Application Issued•By Date i, as owner of the property, am exclusively contracting with licensed con- ❑0 100,000 BTU ❑100,000 BTU ; tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating ,.y ; SUMMpGpV QF FEES a�- '7 The Contractor's License Law does not apply to an owner of property who . - BUILDING PERMIT3�leDa V r�J builds or improves thereon,iand who contracts for such projects with a con- /Exhaust System 0 Multiple 0 System Repair/Alteration I y: $ SMIP $ tractor(s) license pursuant to,the Contractorts License Law). - PLAN CHECK $ PERMIT 0 earn exempt under Section - B.& P.C.for this reason / Firepl/Fact.Bit. ICBG 4 ' , 8 ger./5 f '� ISSUANCE $ PLUMBING $ Date Owner } • Heating System&Ducting •Z ENERGY P.C. $ 'PLAN CHECK • $ I hereby certfy-that i_have.read.this application and state that the above ❑0-100,000.BTU.❑100,DOOBTL_.. GRADING $ - information is correct. I agree to comply with all city and county ordinances / - -- -• ELECTRICAL I $ and-state laws relating to building constructlo and hereby author'ze repro- , PLAN CHECK $ MICROFILM $ ' sentatives of t is city to-enter pon -pove-Mentioned rorerty for inspection purpir s. / MECHANICAL Signature _ Accounting;Goldenrod ;Assessor - - - -- - - - - - - • - • - - • • CONSTRUCTION AND PLANNING POO 3PA APPROVALS. Permit /�7� Date Inspector - APPROVALS Permit Date Inspector. 1. Temporary Electrical Service or Pole. _ 52. Pool & Equipment Location • 2., Soil Pipe-Undrgrnd. • 53. Steel Reinforcement • 3.7Electrical Conduit Utility-Undrgrnd. , . 54. Forms 4. ElectricalConduit-Undrgrnd.- . . 55: Electrical Bonding , 5. Steel Reinforcement • ". , - • 56. Rough Plumbing & Pressure Test . . '6. Electrical UFER'Grnd. i •• ' - 57. APPROVAL TO COVER-GUNITE • • i 7.•Footings . - t, ' - . i _ 58. Electrical Conduit-Undrgrnd. - • 8. Foundation 4 I 59. Gas Pipe, O Undrgrnd.,Test 9. Water Pipe;Undrgrnd. _. 60. Backwash Lines, P-Trap,0 Undrgrnd. , 10. Structural Floor-System • . . - 'i 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 r 65. Electrical-Final • . • • 15:,RoughElectrical-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 Heai,ItAg & Air Conditioning FIRE DEPT. REQUIREMENT 20: Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure. 70. Underground Hydro 22. Duces; Ventilating.1.••, 71. Product Piping OGas OOil 4 23. GasPPipe-Rough&Test i ' 72. Underground Flush J_ , i 24. Roof'Framing '73. Undergrnd.Storage Tank 0 Gas 0 Oil ' 25: RooYSheathing - . - 74. Overhead Hydro 26. T-Bae Ceiling (Structural) & Monocdat ' 75`." Dry Chemical _ . 27. Frame and Flashing - -76. Dry Standpipe 28. Lathing & Siding - - 77. FIXED SYSTEM FINAL 29. Insulation • ' ; Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. • CITY OFCOSTA MESA EMIT NO. _TRACT NO. LOT NO. BLDG. O. ' ' • CONSTRUCTION PERMIT, �CS — /�O 1�S� jo�01 / j`t • Applicant's Melling AddressP(1 Rnx '203 Ralhna !Aland 97662 TYPE OF CONSTRUCTION kJ NEW ADD' U ALTERATION U REPAIR - - 1 "E ',' I ' / • Project Address 2601 Elden Avpnup 0 CONVERSION ❑ DEMOLISH 0 OTHER - r' Owner's Name Mar-Elden DeVelnpmen Phone 4711- DESCRIPTION OF WORK t 0601 -IONlNGREGULATIONS One residential unit of a seven unit{{ rprojest Address PO Rent 703 Ralhna' 1 c1anC1 97662 TYPE OF PERMIT. , U GRADING U FOUNDATION LW STRUCTURALS -• A.P.W��-O....,, -134 ISZONE - ' Arch/Eng.rhrig R Stephens License No, C 12963 • • ❑,TENANT ® ELECTRICAL 0 PLUMBING © MECHANICAL PLNG.REF.•y'• y� p �1 DING - . Address PO Rnx 703 Ralhna Island 97662 . : .❑.'OTHER ' - - - - . ' . I TO BUILDING /?/fir r ( bile PROJECT DESCRIPTION• SQ. FT. OCCUPANCY R PROPERTY LINE O(s l �, REAR YARD(TOr P./L)T acy CI bid Contractor's Nemerhri s R ' Stilf-thihns Inr Phone 474-D6Q1r /� , CONSTRUCTION VN VALUATIONS .75?/' (LEFT SIDE YARD 1� 3 RIGHTSIDE YARD, •�:.-._y - Address(mailing) Pi) 'Rmt 703 RAlhna Island 97667 +4 s•lJ-a ZONE ' - - GRADING CU.YDS: ACRES EKG.SPACE REQ. PROVIDED n License No. ' 0700VA- - /�- , / �•� IX - �p - LICENSED-CONTRACTOR DECLARATION I Remarks:e I chef_ G 3'�Jel cis . STREET WIDTH ; /-./„1 . - PARK FEE'S (sal,3L7t ' . 1 hereby affirm that 1 am licensed under provisions of Charter 9(commencing , tRG /-.{jLJ' . with section 7000) of. Division 3 of he Business and Professions Code,and ( . • SPECIAL CONDITIONS: ' my.11cense.6 In full.Lorce and effect. - , iJgerise clpaa [3 titan ` . PLUMBING - - ~ BUD FOR.SPECIAL REQUIREI<LN Lb ' Date •11'/29753 Signature i f • . -- _ �. WORKERS COMPENSATION DECLARATION , I , i • Bar Sink I ' _ . Sewer Cep' , I _ + ! ELECTRICAL : • preby'affirm that I have a certificate of consent to self- sure or a certificate 1 j Automatic Washer 'Meter ❑over)00 amps' I Workers' Compensation' Insurance,,lir-a'certified copy thereof (Section Bac •kflow P.reventer_.� — -Sewer ConnaCtion_.. ! __. - -,. _- _ ._1 _.- _ - _ - , 00, Lib. C-L : - ' • i - ' Construction Pole Sub Panel. , r , 'b25O HR-o3 Com •n State Com Fund Backflow Irrigation Solar Collectors i 1 - Policy No. Y R• _ S - • f Cooking Unit 1 Sub Pole ` { yn.I Certified-copy is hereby furnished, . ' I - I Bathtubs j Solar Piping , f . 1 ' , • ) Kl'Cert fie COD If tiled with the city Build a lvl Sion. C , - r 1 Date'Certified ' Applicant - - 4. u • _• I Clarifiers I i Solar Tank V 1 Dishivdsher • _ Motors ❑0-1 HP 01ys8 :' (ThisEsection Deed Dot be compRleteO'COMPENSATION permit IOsffor one hundrolON d 3100)or ( • Dishwasher I i ; Swimming Pool w/Spa , ' `+ - 1 Dryers 8)Gas?•❑Electric ?I nc.Solar 09-15 HP ❑16-15�- '•"j lass). r , 1 �O 71 Fan r ; Microwave _I . I certify that In the performance of the work for which this permit Is issued,I Drinking Fountains - Urinal • ' shall,not employ any person In any manner so as to become subject.to te - - •- F.A.U. Pole'Li ht Workers'.Compensation,Laws of California., ,1 • 1 I • Floor Drains 1 , - Water Closet•_ `Q.�'' 1 } Ig I • ' Date Signature ' 17 Fixtures NOTICE:If,after making this declaration,youshould became subject to the ' I Floor Sinks — - _Water Heater'. - �•, -. + _ . - � Range I Workers' Compensation provisions of the Lait Code, you must forthwith ``� Device Boxes ( , comply 'with. such provisions or.this permit shall be deemed revoked. ' des Service Outlets; Wates Service V: �i: . I Sign t I • - ' CONSTRUCTION LENDING AGENCY ' ' ' I I `' ' ' - 25 Outlets ' I her6Dy affirm that there is altons permit lending agency for the performance • ; Interceptors , �j 1 - , I , Standing Sections , ' I of the ,work for, which, this permit .is issued (Section •3097 Cly, C.) • - - , ' Lender's Name I - - Kitchen,Sink ':' ; _ + ' 10 Switches , Trash Convector • j Lender's Address i • I. r r • - - - 1 , • OWNER BUILDER DECLARATION •' - , Lavatories- ' r . , , _ ( 1 Garbage Disposal ,• , • I hereby affirm that 1 am exempt from the Contractor's Lionise Law for the - - - I Generator ❑0.5 KW ❑5-15 KW following reason (Section 7031.5 Business and•Professional Code: Any city orP�Trep - - t ; - ; I I I '.county which'requires a Dermit,to construct,alter improve,demolish or repair , . , , r , . . r Transformer ❑15-50 KW ' .any structure; prior to its Issuance,-also requires the'applicant for such permit. c , Roof Drains I ; , , • - , ! ' f : ( I ' •• to file a signed statement that he/she is licensed pursuant to the provisions of , ' I ' Me Contractor's License Law•(Chapter 9(commencing with Section,7000)of ' ' i ' - I ❑5U+Kcal , I 'Reinspection Fee ' ' $15 y§'', 'dsIon,3 of the(Business.and Professions Code).or thal'he/she-Is'exempt 1 I Showers - I - • Reinspection.Fee I•, $15 efrom and that basis /or the alleged exemption. Any,violation-of Section 1 Meter ❑up to 100,ampi I :Issue Fee' $ 3 $I 1.5 by any applicant for a,permit.subjects' the.applicant to a civil I I I , 4_ - .1� _ �ganelty of not more than five hundred dollars($500). 1 •- , • t I i ; Service Sink I I " Issue Fee $ 3 Zoning Approved By ' n -t.1( 1_ Data ./a/)fo� `� ' LLLLLLJJJJJJ I, as owner of the•property 'or my employees with wages as their sole ' ' MECHANICAL 1 - . I I I I ' • compensation' will do the work, and the structure,is not Intended or offered I ; •- I . i I Application Approved BY ' Date ' ; 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 ; I Refrigeration System ;r-- ! � /*3 thereon„and who does such work himself/herself or through his or her own , Bollef ',' I Application • Issued By ' A_ ••I Detain • employees, provided that such Improvements are'nol Intended or offered for ❑0.100,000 BTU ❑100,000 BTU, ' ' sale, II, however, the buildingor Improvement Is sold within one' ear of com- 1 Duet-under.G round I , I ' P y I _.• I j i SUMMARY OF FEES • elation,the owner.se have the burden of proving he/she did not build or Int- , I rove for the purpose of,sale): , t ' , Duct-Structural System Repair/Atteietiori �R.....0o "5::. SS� `. 'BUILDING PERMIT $ < r ' SHIP 1 $ •' I i � I, is owner it the propertyjest'am exclusively cusiness in d rof licensediocon- : • . ' I I tractors actors License the Law (Section Business o and-of property who ' - , Duct-Ventilating r t '(r' PLAN CHECK $ PERMIT - ' Tne-Contractor's there Law does not apply to an owner-rje property who” - - , builds or Improves thefeon,and who contracts for such projects with a con- 1 • Exhaust System ❑ Multiple 0 ; I • 'PLUMBING I S. ' ? ISSUANCE $ 1 • tractor(srlicense pursuant to the Contractor's License Law): GRADING j $ ' 0 I•am exempt under Section B.&P.C-for this reason 1 - ,PLAN CHECK $ 1 , Firepl/Fact.Blt. IC805W • 1 I 1 $ I f I f ' - • - ;ELECTRICAL. • $' - • Date • Owner.' 1 , Heating;System& Ducting I - , i 1 , I i : MICROFILM I $ ' I hereby' certify_that.P have,read this application and.state-that the above, ' 1 030-100,000 BTU-❑100,000bi,L _ • jPLAN CHECK( ' $ , 'information is correct. I agree t• comply with all city and county ordinances s , 1 , . I I TOTAL FEE ' antlalate laws relating to build q construction,and hereby authorize repro- , (MECHANICAL - $ - , , ' $ ' I sentatives of,this:city 1 to ent-,4upon the a•• ' one• property for 1 Hood or Typal ❑i i 1 ! - - i Reinspection Fee $15 'PLAN •CHECK- $ I LESS 1' Canopy TY, II ❑ I I 1 : ADVANCEOPC : $ • i Inspection Dur;y - �/ a g t _ FINAL FEE $ ( ` • CMF'0865-46'rev.12/82 Wliite--Building:Canary-Applicant; "n CONSTRUCTION AND PLANNING t. TEL, ` ' , 1, -•.POO' WA . _ Date. - Inspector ° /�7S , Date. -. Inspector-'- APPROVALS Permit# , �i APPROVALS,,, ^Peirmit# _ = i , - - . _ - _ 1.I Temporary Electrical Serviceior Pole z t "• f � - - 52: Pool &-Equipment Location : - •„ C2.1 Soil Pipe-Undrgrnd; _ -;t ! 13.1.-- kr, :i : _53J Steel Reinforcement &_ - • " 1 ' 13.1Electrical Conduit Util�itv•Undrgmd. • �- ; "_,., : ,, �: :i '54.';Forms ` • " - . - - a CA.lElectrical Conduit-Undrgrnd. :is "� 1 ' :d :c•= r. :55:tElectrical Bonding - - F.5. Steel Reinforcement , 2 , Z_ _ ' ? „ ? 56.,Rough Plumbing& Pressure Test-. ' -6.1 Electrical LIFER Grnd. ' ' •r; Z :` -St.-APPROVAL TO'COVER-GUNIT..E - -•• • 7.1 Footings , , I ' !`;, - 1 - -; 58. Electrical Conduit_Undrgrnd - - 8.l Foundation I ' I, s°L' - - ' 59. Gas Pipe, 0 Undrgrnd.,Test • 9.'Water Pipe-Undrgrnd. ' _ r _ 60. Backwash Lines,P•Trap, 0 Undrgrnd. 10.'Structyral Floor1System ' '-= _ _ ' , . :61.'APPROVAL TO•DECK - 11. Property Sewer Line & House'Connection ' 62. Backwash & Receptor-Final .. 12.'Sewer Cap ' I • ' - 63. .Heater& Vent-Final 13.•s Roof Drains • i • . : ; - - - -., - :64. :Plumbing,System• Final _ ' 14. Rough Plumbing i - :65. Electrical-Final - i .15.33ough Electrical.Conduit-r-r-T-'-„- "'-c- -7-1--- '66. Solar System-Finals - I - .. ... 16.`Rough Ele'ctricWiring . I I ',' Ii-,v}n J-i_• _ - . :^ .� _. _, _ . . •^• _ ? !1 , 1 ': , , - _ 67. Fencing & Access.Approval - ` 17 Rough_Wiring;Sign= s ,i I ' I II :I - ! - ` ' • ' - , 68, APPROVED FOR PLASTERING ' '18.:Rough Electrical-T Bar Ceiling d In. I i I' 69. POOL/SPA'SYSTEMS FINAL' - n { 19: Rough Heating& Air,Conditioning 'I � i ! _ i FIRE DEPT. REQUIREMENT _ - 201 Rough Factory Fireplace ' ' I' I ' I . I APPROVALS Permit# - - s. 21 'Ducts;in Structure' "^, ' I 1 ' ' , I J • • I ,70. Underground Hydro -• . 22! Ducts, Ventilating_ ! I ,71 Product Piping 0 Gas 0 Oil • 23.' Gas Pipe-Rough&Test, I ; , 1 ' r ' 1 i 72. Underground Flush • ' 24'Roof Framing I ' ryg , i a . ,“. '73 E Undergrnd.Storage Tank O Gas O Oil • ? 25.:Roof Sheathing ' , 1 I - I - - - '74. Overhead Hydro li ,26 T-Bar CeilingiStructural)i& Monocoat ; r 1 : - " ' i'it - 75. Dry Chemical ' 27. Frame;and'Flashing I 'I! ,I ; : 1 _ , 76. Dry Standpipe „ _ I. 28. Lathing &Siding `; p 1 i ' 1, I l I 1 v .77iseFIXEDSYSTEM FINAL • • 29, Insulation] r " n. ; II !, i 1 I •�.•• '78. FIRE PREV. FINAL ,n ° ,30..Drywall Nailing . ' I .' I� !i I 1 I f"'; I Notes:• � e ,� � 31: Plaster,Brown Coat I : i { i :,CZ, _t t 1 32. Electrical Power Meter-Final ! �; • ; 'i • J, .'-' I_ _ 34. Final;Heating.Bi.AirTConditioniung : ,. ! - : - - - , , 7 35. Final Gas Pipe:e;Test I � - - _ " _ • 36. HoodI'•or,CandPy -i , ! - I rI LI ' _ 1 i .. -- 37. Final Factory Fireplace, ,: . 2 !1 , /, - ' , ' ,' - - c 1 38. Final 'Plumbing' i 1 ! +1 9J •. " f i ! ° 39. Waters4Service-Flina,l I 1 IV I I ; I - •r - - ., 40. Gas Service:Final ' 1 1 z- it I - I ' I 1 , /i`' t4 •• 41. Solar Domestic-Final I I - 4 i' ! 1 ' ;__ 1, I -'-h -� - �- - - - -r - -11 ' - f I (- �,ai I ' ' , , 42. Backflow Preventer, _� _ 43. Backflow Irrigation 1 , •`• ,kilii . •' I i^ i ° , c 'I _ i s I . ! - 44. Landscape lrrig ttonSYstem1 ,. �',-: • . !^ I :II ., , , I . - - 45. Sound rAtteendatwn ;- I , ' g : I i • • ! • 46. Hand!cs jfSegulati&si ^ ! l 1 ° 1 ; 47. FIN&__/STRUCTURE'& BU;LDING I` I ' ' ! . , 48. Special Requirements Completed i , • - 49/Electric Release to Edison I It F . ' 4-- -r_ I . , 50. Gas ReleaseIto Southern CaliforniaGasba . ! i i , I' ' 51. CERTIFICATE OF OCCUPANCY n r _J,,,.. _'_ - . .. . No It 11 I I I 'Date I I i! I ' I I • Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESAPEIT NO. TRACT NO. LOT NO. BLDG.NO. e - CONSTRUCTION PERMIT , 3g�D Ialc+-1Z • r1 ZZ1 — 1T&3h CCI . 1189 4/16/86 34037 TL Project Address _2801 F1 den Ave TYPE OF CONSTRUCTION L I NEW ADD U ALTERATION L.J REPAIR • Applicant'sMailingAddress 18226 W. McDurmott, Irvine ❑ CONVERSION ❑ DEMOLISH U.OTHER - A.P.# 4_-5 -o-- -10-3- ES- [Zone In., Owner's Name Mar-Elden Development Phone 474-0601 DESCRIPTION OF WORK Clnn o Prof S Main Building: Accessory Building: Z Address 18226 W. McDurmott, Irvine 97714E D TYPE OF PERMIT' ❑ GRADING ❑ FOUNDATION U STRUCTURAL T Front LS ' C(,. $(✓�4 N Arch/Eng. Chris R Stephens License No.Cl 2964 ElTENANT ❑ ELECTRICAL IDPLUMBING El MECHANICAL 8I Address 18276 W Mrfurmntt Irvine 47714 ❑OTHER -rich rend 03 rC A Rear �l CL • {"Nv14: {c-t -- N Contractor's NampThP R (-hard F Crawfordprfpea 474-n551 PROJECT DESCRIPTION Sq. FT. OCCUPANCY C Right �(� G y���.s K --5w R L9 Address lmailing118226 W. McDurmott, Irvine 92714 CON ST RUCTION TYPE VALUATION$ leen $ Left J2t CL • I3c_t 4I E /�.--, 6 ZONE GRADING CU.YDS. ACRES ' } , `� W City License No. 6345 ZS/¢G Ping.Ref.# Ytr _ e4 _ 47 Park.Fees $ U 1 LICENSED CONTRACTOR DECLARATION Remarks:T2is�N g Parking Req./Provided 1 t hereby affirm that I am licensed under provisions of Charter 9(commencing R I with section 7000) of Division 3 of the Business and Professions Code,and Use of Building: - E myL license Is In full force and effect. ® 7 `� _ . , r Ucense Class Ice N �����3 PLUMBING Planning Notes: i .W:4: 14....e/-G E Date ti.//-Pr Signature - Bar Sink Showers N WORKERS' COMPENSATION DEC 10 - _ T I hereby affirm that I have a certificate of consent to self-Insure or a certificate _ •Backflow Preventer Service Sink • S of Workers' Compensation insurance,,or a.certified copy thereof (Section - 3800, Lab. CJi i/ Backflow Irrigation Sewer Cap ELECTRICAL • FEES • Policy No. GZ1 U5t Company Snigni F+rr' 0 75-50 KW (-tined copy 6 rebs furnished. , Bathtubs Sewer Connection Automatic Washer Transformer Cerppigqed cog* filed watt the city n ion Date '7 V/ r Applicant Clarifiers Solar Collectors Construction Sub. ❑ 50+KW EXEMPTION FROM WORKERSNCOMPMM ECLARATION Dishwasher Solar Pi -- (This section need not be completed if the permit is for one hundred($100)or Piping Cooking Unit Metes❑up t0 100 amps less). r trr I certify that in the performance of theaork for which this permit Is issued,I Drinking Fountains Solar Tank . Dishwasher ;Meter Clover 100 amps shall not employ any person In any manner so as to become subject to the - Workers' Compensation Laws of;Californla_.r Floor Drains Swimming Pool w/Spa Dryers ❑Gas ❑Electric Sub Panel • Date Signature - - NOTIcE:.If;after making this declaration,you should become subject to the Floor Sinks Urinal Fan- Motors❑0.1 HP ❑18-8 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 Closet F.A.U. Inc.Solar 09-15 HP ❑16-15+ ' CONSTRUCTION LENDING AGENCY • I hereby affirm that there is a construction lending agency for the performance Interceptors .Water.Heater _ Fixtures l Microwave of the work 'for which this- permit Is issued (Section 3097 Civ. C.) - _ Lender's Name - Kitchen Sink Water Service .'' Device Boxes Pole Lender's Address Light OWNER BUILDER DECLARATION Lavatories Outlets Range I hereby affirm that I am exempt from the Contractor's Ucense Law for the - ' following reason (Section 7031-.5 Business and Professional Code: Any city or P-Trap v) $witches Sign county which requires a permit to construct,alter,Improve,demolish or repair - 9 • any structure, prior to Its Issuance, also requires the applicant for such permit Roof-Drains Garbage Disposal to filea signed Statement that he/she is licensedpursuant to the '+ 9 P Standing Sections g / provisions of • the Contractor's License Law(Chapter 9(commencing with Section 7000) of • •` . Generator ❑0.5 KW❑5.15 KW Division 3 of the Business and Professions Code) or that he/she is exempt ' ! Trash OpmpaplOf therefrom arid 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). Reinspection Fee 525 Issue Fee $ 3^ - A LJ I, as'owner of the property'or my employees with wages as their solo - 'f. .Reinspection Fee i $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 REOUIREME�ITS: License Law does not apply to an owner of a property who builds or improves Boiler ' Hood or Type I 0 '- ,-��`` /1/` ' /- �s thereon, and who;does such work himself/herself or through his or her own - i J Zoning Approved By Pte.-- I pY 1 Date -����� employees, provided that such Improvements are not intended or offered for Canopy Type II 0 sale. if, however, the building or Improvement is sold within one year of com- Duct-Under Ground ,; Application Approved By -15 C?� Date - �J-O pletloh, the owner will have the burden of proving he/she did not build or im- grrove for the purpose of sale). Duct-Structural Refrigeration System y Application Issued By pat • U I. es owner of the property,am exclusively contracting with licensed con- ❑0-100,000 BTU ❑100,000 BTU .r I. tractors to construct the project(Section 7044,Business and Professions Code: Duct-Ventilating '. 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 0 System Repair/Alteration '� BUILDING PERMIT $ 2-0• SMIP $ SD tractor(s)license pursuant to the Contractor's Ucense Law). - PLAN CHECK $ l ' a PERMIT ❑ 1 am exempt under Section B.&P.C.for this reason Firepl/Fact.Bit. ICBG# - .j PLUMBING $ ISSUANCE $ Date owner ' Heating System&Ducting PLAN CHECK $ ENERGY P.C. $ I hereby certify tha . e rid ,i .ppli to./.nd state that the.above _ 00.100,000 BTU 0100,000BTL- -_ - ly GRADING $ information is correct. '.;..P• •• y w al sty and county ordinances / �)ELECTRICAL , $ and state laws at y y•';a -•nstr do •nd hereby authorize repr - MICROFILM $ sentetives of I .It'rz.+!%••�5-! - , ,- .•o • menilo❑e[l proper[ r ,j PLAN CHECK , $ inspection pu po !• 4A/ /7��/� MECHANICAL $ 34.. 3 Signature _ 4 Js' Pink-Accounting;Goldenrod-Assessor - - _ - - 1 CONSTRUCTION AND PLANNING POOL iY SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole"; 52. Pool & Equipment Location 2.,Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. ' ' 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding • 5. Steel Reinforcement 9015"' �f".{i 56. Rough Plumbing & Pressure Test • 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings IT? 2 4„ i2 58. Electrical Conduit-Undrgrnd. . 8. Foundation i 59. Gas Pipe, 0 Undrgrnd.,Test , / . • 9. Water Pipe-Undrgrnd. , 60. Backwash.Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System .t � 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 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: l /6r .s co 34. Final Heating & Air Conditioning a ` j„lasv-e 35. Final Gas Pipe-Test V ! oZT y7-711 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 /o/51(ar 87,2.7 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' • PE IT NO. TRACT NO. LOT NO. BLDG.NO. • CONSTRUCTION PERMIT PERMIT O 74 • _ All- _ / ,. 1 Teo �• • J $!)OX' Zd I '':/ , 'i,. Applicant's Mailing •ddress 2 L�-5<z�'• TYPE OF CONSTRUCTION NEW U ADD U ALTERATION U REPAIR - ProactAddress• • ' I • r1 ) E .per ' li ►2 y ' ❑ CONVERSION ❑ DEMOLISH ❑ OTHE- - Owner's.Name Le� �^ 'honeZs�{-4Sog DESCRIPTION OF WORK 'FJJulift• .i 0' -� j.L(Y U • rye Q.07-) �� 1^\ \ .. Apj / , car I 'T t ZONING REGULATIONS Address J ,C' t" C'W /+ n -.TYPE OF PERMIT ■ RADING I• FOUNDATION III STRUCTURAL A.P.qp/ -67/ -I 3/ II--'j 1 SioNE - Arth/Eng. Q r• , 'l/y� �ys��tlen�se NO.Y' I`'-��75�,.--s - ❑ TENANT ❑ ELECTRICAL ❑ PLUM BIND• ❑ MECHANICAL rn PLNG• .REF. • -83-gq -( DING / Address• - P"• VT+ D -J ".v�-s4 t' � v -❑ 'OTHER 3 -TO BUILDING / �,,a nr✓rtr gr - /1 /� ^x'• PROPERTY LINE O -I' GI hY ! REAR YARD(TO P/L) Lf/--F 1 Contractor's Nemr` Q 1 y {� et"2',^ hone ( 5f'4 7(/PROJECT DESCRIPTION SQ.FT. OCCUPANCY ,1� n, n O V.+Y'ry -CONSTRUCTION TVPF VALUATION$ TOO. .LEFT SIDE YARD ;94! al b RIGHT SIDE YARD la /!n // , Address(mailing) C 6 Y-4..../1447 • .-_Q,/tO� „�0 - ZONJ3 - - _ GRADING CU.VDS. ACRFS PKG.SPACE REQ. ; PROVIDED License No. ` I - - - - _ LICENSED CONTRACTOR DECLARATION Remarks: , • STREET WIDTH PARK FEE:$ ' • ' I hereby'affirin that-I am licensed•under provisions of Charter 9(commencing - r _ , - wItli•section 7000) of Division 3rof the Business and Professions Code,and - SPECIAL CONDITIONS: 1 _ my license is n full force and effect. ' - , License C s License M 12�a ; PLUMBING �L7B• .FOR SPECIAL REQ[J[REMEN:TS Date /JS' Signature • r 1 ' 7RKEiiS'CSATION DECLA ATION ' I Bar Sink Sewer Cap _ ; / ELECTRICAL • areby affirm that 1 have a certificate of consent.to d,co i e or a f cate - •gackflow'Preventar - _ . _ ..SewerCgnnection - --- -- ----r Automatic Washer,/ .'_ - '. . 'Meter,dov_ef 100 amps:_ ___, - _ _ • - _, Workers' Compensation Insurance, or a certifled,copy thereof (Section Construction Pole i ' 3800, Lab. C.) ' , ; 1 ' Sub Panel. , /ar S�O kla 1 Backflow Irrigation Solar Collectors • PoIICY No. n '�Go any "' [ _ ! _ ; Ii Bathtubs Solar Piping • Cooking Unit Sub Pole I • ,Certified copy Is hereby furnished. 4 r f P n9 ; ; 1 Certified copy is filed with the city Bull I D Ito I 1 Dishwasher Motors ❑0-1 HP ❑1X$ , Date • ` • AGPlicant . Clarifiers t Solar Tank iff ✓ _ - I EXEMPTION:FROM WORKERS'COMPENSATION DECLA ATION~ i - Dry• ers-OGsS, OElectric - ` '064.1-1V016-15+ _.. - [ • lessis section need not be completed If the permit IS for.one hundred ($100)or I Dishwasher ' , , Swimming Pool w/Spa , y 1 ; I nc.Solar'09-15 HP 016-15+ 1 1 certify'that n the •erformance oft•:at dor which s .•.rmit I Iss .d I - 1 Drinking Fountains • ' Urinal , Fan: :Microwave ) shalltnot a ay• person In any ,a"'••.—' .� - to the • ' Floor Sinks • - F A U - - Workers�C�y�f ._, '-.• sof Cal yr.e�� /'"` , Water Closet �� - Pole Light , Date f iaa Signature : " �d !-NOTIC If,ofI making this declaration,you should b e su• he Floor Drams Water Heater .�� Fixtur s , y ! •t. 'Range - - e Workers:Corn•ensatlon' provisions,of the Labor Code, you.must,forthwith ' 7 - comply with, such provisions'or this permit shall, be deemed revoked: ' 'Water Service ` } Device Box¢s ; Sin, 1 1 Gas Service 'Outlets !!S� 9 CONSTRUCTION'LENDING AGENCY • ' ; • ` . - ' _• 4 _ _. . r - _ Outlets �. ' I hereby affirm that there Is,a construction lending agency for the performance; I Interceptors 1 Standing Sections I , ; of the work, for which;this permit -Is issued (Section :3097 Civ. C.); �, ' • _ ' . .. ' - • Lender's• Name• ' - ' ' - ' Kitchen Sink .�F ^ - ' Switches Trash Compactor , Lender's' Address ` I - v - Lavatories - Garbage Disposal 1 , OWNER BUILDER DECLARATION ' r - ' • . �'f - ' I hereby1affirm that I am exempt from the•Contractor's License Lacy for the ' - Generator,00-5 KW 05-15 KW r i following reason:(Sectlon[7031.5 Business and Professional Code: Any city or • , F-Trap! - . - ' •- . • ; • county which'requires a permit to'construct,alter improve;demolish-or repair ; - . Transformer 1 , any structure;prior to Its issuance, also requires the applicant for such permit ' . ' Roof'Drains, , , 15-50 KW • , 1 to file a signed statement.that he/she is licensed pursuant to the provisions of - : 050+KW' 'Rein coon Fee 1 •.f$e Contractor's license Law.(Chapter 9(commencing with!Section 7000)of ?Pe $15 /(Sion 3'of the Business and Professions Code)-or-that he/she is•exempt Showers . Reinspection Fee -1-' $15 y`+arefrom'and the,basis for the alleged exemption. Any violation of Section . , - Meter Pup to 100'amps Issue Fee: ( $ 3 7031.5 by any applicant for a`permit subjects the applicant to' a.civil 'r, • ' - I , _ ,z� anally of not more than five hundred dollars($500): r Service Sink Issue Fee - $ 3 Zoning A roved B (-1 I�1 i Co-/Q J r _ 1 g PP Y �� •Date U i, as'owner of the'property or my employees with wages as their sole _ - " - - - for sale Sec will do the work, and•e structure Is not intended or offered , -' - . , _, MECHANICAL • Appjication Approved By ' - Date for sale:(Sec/Ion 7044; Business'antl.Professional per Cotle:.The Contractor's 1 -- -- - - - — - ----- - - T - y/�) ,rte License Law does not apply loan'owner of a property who builds or improves ' Boller T ' ' Refrigeration System Application Issued /1//�'"' i /f-� / � thereon,•and who does such.work himself/herself or through his or her own ' BT PP By Date i employees, ever,provided that such improvements is sol t intended or offered for 1 00-100,000 BTU 0100 000 BT.0 • sale, If, however, the building or improvement Is sold within one'year of cam- , Duct:Under:Ground l' r 1 SUMMARY OF FEES elation, the owner will have the burden of proving he/she did not build or im- ' I i ( , ! sp�siove/or the purpose of sale): , -• 1 : Duct-Structural System Repair/Alteration 1'. •-•".. (BUILDING PERMIT $, /a Co! SMTP , $ • 'i6 U I,as owner of the property,am exclusively contracting rwith'licensed con- , Duct; . , _ I - , • .i'�-�O tractors to construct the-project(Section 7044,Business and Professions Code:_ • y - Ventilating _ - - • a _ 'l -PLAN CHECK $' . PERMIT f • IThe Contractor's License Law does not apply to an owner of property who I • 3 , ; t - ISSUANCE ! ' $ . 7 I builds or Improves.thereon,and who contracts for such projects with a con- t Exhaust'System 0 Multiple 0; I • j-jt. PLUMBING $' ,tractor(s) license pursuant to the Contractor's License Law).. - • ' - - I I • 0 I am exempt under Section B.&P.C.for this reason ; ' Firepl/Fact,Blt. ICBG# i JP LAN CHECK: •$i ` , GRADING $ , ELECTRICAL? $ I 1 $ '• 1 • Data owner' ' ' • • ' Heatin Bm& Ducting f PLAN CHECK - • ' MICROFILM 1 $ I I I I:hereby certify that (.have read this appiicat ion-antl stale ore above 00-100,000 BTU•0100,000 BTU-- - "' -"4•" -. 'I ! $, I 1 • information is correct. I agree to comply with all city and county ordinances - !MECHANICAL. $ TOTAL,FEE' $ ; 1 • and state laws r- -ti • to build! g •nstructlon, and hereby author) rep e- . i Hood Or Type I 01 I i - t 1 ' • ' sentatives of It z y fn en - ,fon a .bove-mentioned prop�gerty or _ Reinspection Fee $15 'p LAN CHECK' LESS , inspection our.os- , ! 1 �9 2 • i Canopy Type II ❑' $ • ADVANCED PC 1 $ ' ' Signature Pink-Accounting;Goldenrod-Assessor ' el GCONSTRUCTION AND_PL NNING _. , - ;F - ... ._POG SPA _ - - ,. -- � CbT,( -`Date Inspector • Date Inspector • `APP,ROVAL'S n, P.ermiY# - - - APPROVALS.; Permit:# 'T .1 Temporary,Electrical Service or'sPole•' %i. q ' „ 'c` - ;52: Pool &:Equipment Location - :-IT- - ,' 5i ISoil'Pipe-Undrgrnd. __ ; 1 1 ; _ 53' Steel Reinforcement - ' .- �! Electrical Conduit Utility Undrgrndi ' ur • i ,'.- �•, • 54. Forms.; -- - - • a 4. Electrical-Conduit-Undrgrnd' • yccd 7, I .r 55- Electrical Bonding - f.• 'G SteeLReinforcement • ' � . •_ - t y^ ,_ ` -' - • 56. Rough Plumbing & Pressure Test - � • 6. 'El?ectrical UFER Grid: E - I • In-: •- L' 57: APPROVATO COVER-GUNITE - ^ 7. Footings r. �:ip , ¢'. " - r, .58. Electrical Conduit-Undrornd. 8. Foundation 'I ', . ' ' '.- ' ' ') ''?' `- o- , $9. Gas:Pipe, D:Uodrgrnd:-,Test• ':1 ' 'a 1 ' 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P,-TrapTr , 0 Undrgrnd. ' 10. Structural Floor:System I �', >•,• 1 ^ : ,61. APPROVALToIDECK - 11. 'Propert"y Sewer Line & House Connection' c • 1 62. Backwash&_Receptor-Final _.' - 7 ' 12. Sewei- Cap • ' ' , - • 1- 63.- Heater &Vent-Final 13. IRooflDrains u ' I 1 _ • •54. Plumbing.System -Final -- - c 14.;Rough Plumbing I- - . - 65. Electrical-Final - " I - '1 "215: -‘,Rough - -- " ' -T r--I -:- 'I - -- '66. Soler,Sys'tem-Final - • - - - L I; s- 1 - 06.jRough Elecmric1Wir,ing- r j ',t71- 1--.17.11--, -• "r' 67..-Fencing &Access'APproval -' • - - - ':I-" ' : 7. RougI Wiring'Sign:1 ' ' ' a '.' d• I - 68. APPROVED FORPLASTERING ' I . ( ?I - . is h8-.°Roughf Electrical-T Bar Ceiling I' i :, P. 1 ' 1 ' ' 69OO L/SPA SYSTEMS -.FINAL ' ' ' I' 1 19, Rougli Heating&Air Conditioning ' I , „ I - ' ' FIRE DEPT.,REQUIREMENT - • " 20.-Rough:Factory Fireplace ' II I, 1 I , ' APPROVALS! Permit# CS r 21.'Ducts • ,---in Structure I I 70. Underground Hydro " ;22. Ducts Ventilating o I i 1., {, , i j 1 714 Product Piping ❑Gas ❑Oil j s 1 'i.23, Gas:Pipe-Rough&Test 21. ' ;j I , I 72 Underground Flush I -24.;Roof Framing , 1 l' ;,Il �,, ;m , ' - 73. Undergrnd.Storage Tank C Gas_D Oil •' 25. oof Sheathing ,; , ,151 ' '„ ' `- 1 - _ '74. 'ROverhead Hydro • _ -26. .T Bar Ceiling'(Structurall,& Monocoat' ; I I ., i I75" Dry Chemical - , I j - t '_.27.• ;Frarne'and'Fleshingt 3 I j I I ' I 76)Dry Standpipe 28. • '�athing &• Siding! p Ii II ) 1 I I ' 1 I ,+77.. RIXED SYSTEM FINAL - I • 29 Ilnsulation -� _ a I t II �, ! i • '`• 178 FIRE PREV. FINAL n .• • a A30 Drywall Nailing I , ! I 1. , I ; I "Notes: .i' � I _ - _ . _ . I. 31 'Plaster,Brown Coat ' ,I 1 I i ' j�+ , I n I i , ' 1 I I • 32. Electrical Power Meter-Final 1 1 l 1 � }I' - , 33.''Final Electric ' 1.._ I I 1 1 '1/-'-.i_ - _ I'. 34. Final Heating&IAir Conditioning ' , • I I ',frit m 1,: , 1 - L 35. Final Gas Pipe-Testi ,„ 1 _l - I', : • - - - - - _ - 36. Hood or,CanoPY:;I ,I - _ - - _ .. - _ 37, Final Factory Fireplace '?I I c ; , _ - 1 -, 38. Final Pluinbing ; 1 I t i i I 1 - I 1 39. WaterSe1vice-Finale - i _ . 40. Gas Service-Final : I i (I I , • ' - 41" Solar Domestic-Final ' I '_i 1 _ 1 - I_ _ , , _ -- - _ _ - • 42. Backflow Preventer - I - -11 _{ i ' - : I I It , _ ; I , 43. Backflow Irrigation - I . ^1: _ 44, Landscape Irrigatio' System I - . ° o - 45. Sound;iAttenua ' n I ¢ ' • • , 46" Handicap Re lations'•' i r 1. - I I. I , I _ I '' ' I 1 -- ~, r " 47. FINALS UCTURE& SUI LDING 1 . I I '•' ' - ' 48. Specie. Requirements:Completed I I I i ' , •-'_: I • , . - .. 49. Electric Releaseto Edison) I ii ,,. i 1- I J. _-____ _ _• - ••-_t_ ,- --- .- - '' ;. 50.:Lias Release to Southern California Gas 61. ' 1 I I , ' , • t , , 51. CERTIFICATE-OF OCCUPANCY It i ____l , _ _I _ :_ _ -_ No ' ' I I 'I I i ' t ' ' . ' Date Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. r - PE T NO. TRACT NO. LOT NO. • —`�CITv OF COSTA MESA CONSTRUCTION PERMIT �t 4 uNiT NO. 3236 10%30/65 _'5p, U IL Project Addr€ss 221103 Etg)Erl Adi d�� �`z�Iz9 l .� TYPE OF CONSTRUCTION NEW U ADD LI ALTERATION R •Applicant Mailing Address ..�C�7,1 ;ME A�V�• ]� -/ CI CONVERSION ❑ DEMOLSH ❑ OTHER - • - Owner's Name 112.412 -CLC1 t✓ a tc Done C4.r-o9oli A.P.# I Zone DESCRIPTION OF WORK/USE OF BLDG. Address z41-r" FSe!/E.t_ 3 -7 COS rAr MESA 92-en zL � yf � S Main Building: Accessory Building: - Arch/Eng. C/'r't,S •Scar-''ei✓f License No. C]2943 TYPE OF PERMIT Ja GRADING 1J FOUNDATION LISTRUCTURAL T Front 0 Address - ❑ TENANT ELECTRICAL ❑ PLUMBING El MECHANICAL A Rear - • N • Contractor's Name-R/C7-f7t C4 r /'A,l w'% 9 Phone.S ,_22Orfs ❑ OTHER C Right N Address(mailing) --WC' ,CsCNf t / s6 - &! Ca:79.fle 'A PROJECT DESCRIPTION -SO. FT. OCCUPANCY K• G 3V6' '5 I CON ST RUCTION TYPE VALUATION$ - $ Left City License No/ T V ZONE GRADING CU.YDS., ACRES R LICENSED CONTRACTOR DECLARATION Ping. Ref. # Parking Req./Provided E I hereby affirm that I am licensed under provisions o Charter 9 (commencing Remarks: e(�y..siy07-. ',�^,,.�'9//l/-��' PI nning Notes: - M with section 7000) of Division 3 essd Pr fessions Code, and �5��/�{J my license is in full force an ffect. /n_}� �� �� �� T 111.License se Class nse Lf/96` ! h�t1NsL �� -G. /LJ(/yly/1_(./jL S • ' Date A) -So-A' Signature i PLUMBING FE WORKERS'COMPENSATION DECLARATION + I hereby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink Showers ELECTRICAL J FEES of workers' Compensation Insurance, or a certified copy thereof (Section _. • 3800, Lab. C.) Backflow Preventer • Service Sink 'Automatic Washer Transformer 0 15-50 KW 1 P licy No. 4-.Z,Ct SZ Company .57/77- Ft.-'e) • Backflow Irrigation Sewer Ca ❑ 50+KW Cap Construction Pole Sub.. Certified copy is hereby furnished. - -- Cooking - • Certifjagdypy'dyed with the city Builyi ion. _Bathtubs • Sewer Connection Cooking Unit / Meter,�up to 100 amps 00 Date 7 Y4 Applicant EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors s Dishwasher Meter Dover 100 amps (This section need not be completed if the permit Is for one hundred($100) or - - - less). Dishwasher Solar Piping , Dryers OGas ❑Electric / Sub Panel I certify that in the performance of the work for which this permit is issued I -- shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Workers' Compensation Laws of,California. _ Motors 170-1 HP 01%-8 Date Signature Floor Drains Swimming Pool w/Spa F.A,U. Inc.Solar ❑9-15 HP 016-15+ 'NOTICE: If,after making this declaration, you should become subject to the — - Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinki Urinal Fixtures Microwave - - comply with such provisions or this permit shall be deemed revoked. - CONSTRUCTION LENDING AGENCYGas Service Outlets Water Closet Device Boxes `l' 1 hereby affirm that there is a construction lending agency for the performance Pole Light of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors • Water Heater . Outlets Range Lender's Name - ' 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 following reason (Section 7031.5 Business and Professional Code: Any city or Auto-Wash Garbage Disposal ;Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P-Trap - Laundry Trays - Generator 00-5 KW 05.15 KW Trash Compactor any structure, prior to Its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains - 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 _ — p natty of not more than five hundred dollars($500). • Li I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 compensation, will do the work,and the structure is not Intended or offered Reinspection Fee $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 Boiler Hood or Type I ❑ DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such Improvements are not intended or offered forZoning Approved By nate sale. If, however, the building or improvement is sold within one year of com- Canopy Type II ID 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). ( /1l1 ❑ I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By l� Date 110 tractors to construct the project (Section 7044,Business and Professions Code: - ' The Contractor's License Law does not apply tO an owner of property who Duct-Ventilating ❑0-100,000 BTU 0100,000 BTU SUMMARY OF FEES builds or improves thereon,and who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Law). 1 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 ❑ 1 am exempt under Section B.S. P.C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers PLUMBING $ ISSUANCE $ DateIHeatin S stem& Ductin Registers PLAN CHECK 25% Owner - - 9 V 9 $ ENERGY P.C. $' I hereby certify that I have ad this application and state that the above 00-100,000 BTU CD 100,000 BTL— ELECTRICAL $ �8_Ba GRADING $ information,is correct. I agr o co ply with all city and county ordinances - C^1 and state laws relating to • ding •ns uctlon,and hereby authorize repre- PLAN CHECK 50% $ '1 ^ MICROFILM $ sentatives of nter ,pod,/ the above-mentioned property for inspection our /vir nD 3a -e / _ MECHANICAL $ . TOTAL FEE $ 05� Signature 'Date d Drivers' License or SS ' - Applicant; Pink -Accounting; Goldenrod -Assessor 4. CONSTRUCTION AND PLANNING POOL& SPA APPF?OVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. T mporary Electrical Service or Pole .• 52. Pool & Equipment Location 2." Soil Pipe-Undrgrnd. • 53. Steel Reinforcement .. 3. Electrical Conduit'Utility-Undrgrnd' 54. Forms 4.2Electrical Conduii-Undrgrnd. • ' 55. Electrical Bonding .7, 5. Steel Reinforcementy ;, ✓f 56. Rough Plumbing & Pressure Test - ',; _6`: Electrical UFER-Grrid. 57. APPROVAL TO COVER-GUNITE / 7:`Footings •' "/': 58. Electrical Conduit-Undrgrnd. . - • 8. Foundation . 59. Gas Pipe, 0 Undrgrnd.,Test , 9.-Water,Pi'pe-Undrgrnd•. , • n` !'' 60. Backwash Lines, P-Trap, 0 Undrgrnd. ' r, d 10. Structural Floor System , 61. APPROVAL TO DECK 11. Property.Sewer Line & House Connection 62. Backwash & Receptor-Final ' 12. SeweriCap:, / 63. Heater & Vent-Final 13. Roof Drains . ' 64. Plumbing System - Final 14. Rough Plumbing . 65. Electrical-Final ,F 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 ' 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20..Rough Factory Fireplace 1' APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro S 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 D Oil . - 25. Roof Sheathing 74. Overhead Hydro 26.'T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical - 27. Frame and Flashing76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL 29.. Insulation - - 78. FIRE PREV. FINAL ' -30.;Drywall Nailing _ HEALTH DEPT. REQUIREMENT 31t,IiPlaster Brown Coat - 79. FINAL INSPECTION . . 32'.•�Electrical Power Meter-FinalJ'31I / 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 r ' 45. Sound Attenuation 46. Handicap Regulations 1. . 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 lines and sign all appropriate declarations. CITY OF COSTA MESA • - PERMIT NO. a TRACT NO. LOT NO. BLDG.NO. • - - - CONSTRUCTION PERMIT S'/�,— •, .y6/( • o 64z -' - g /r/e k b yf. Project Address - / e.-I• TYPE OF CONSTRUCT,IM NEW -U ADD LJ ALTERATION ❑ REPAIR - Applicant's Mailing Address 2i r N /� s Go ❑ CONVERSION LJ DEMO SH '❑ OTHE• p - - - A.P.# D I'f IZone r, , r,•r - -_ � LL� DESC•IPTION eF WORK `e"-c' `a cr I t Owner's Name Moi•- C ff A 0 W �y d"phone - l •,t,� S 'Main Building: Accessory Building:- • Z Address, 9-003 1C 0 J VA.. /l�T7`e, E O / / TVP OF PERMIT ❑ GRADING ' FOUNDATION' ❑ STRUCTURAL • T Front N Arch/Eng. C 6 ,44 ( heti License No. ❑ TENANT ❑ ELECTRICAL L4t'PLUMBING ❑ MECHANICAL • B Rear 1 b l/ A " N Address �Q Z� �• ���'iwl� ft 9.1 � � ❑ OTHER � � � � -' � - , 1P•e .fro t G,v-i /2/..4i' Phone 2jt PROJECT DESCRIPTION SQ. FT. , OCCUPANS,Y C Right I r G J` Contractor's Name 4 ' _ Address(mailing/ 'Z) /a A/.... n'•/ ® r C/�i CON ST RUCTION TYPE �t VALUATIONS- �!/� $ Left E 6 p4 �/ 97�— y" ZONE GRADING CU.YDS. ACRES D Ping. Ref.# • Park:Fees $ 0 r1_ City License No. • _ f ` U `V LICENSED CONTRACTOR DECLARATION Remarks: Parking Req./Provided . 1 I hereby affirm that I am licensed under provisions of Charter 9 (commencing Use of Buildin R l with section 7000) of Division 3 of the Business and Professions Code,and g' i \ E my license is in full;force ji effect. Op license Clas; d r0ippnse No. PLUMBING s FEES Planning Notes: \� N CI Date // �� k> Signature L E 1 WORKERS'C MPENSATION DECLARATION Bar Sink • Showers 1 hereby affirm that I have a certificate of consent to self-insure or a certificate . Backflow Preventer • Service Sink S 1 .If Workers' Compensation Insurance, or a certified copy thereof-(Section - , 3800, Lab. C.) �n1,r[�� / < Backflow Irrigation i Sewer Cap I ELECTRICAL I FEES `\ Policy o. Company t c$! 1'C ,c.,_ .- rtifietl copy is hereby furnished. Bathtubs t K Sewer Connection Automatic Washer Transformer 0 15-50 KW Certified copy Is filed with the city Building Division. - , ❑ 50+KW Date Applicant Clarifiers Solar •Collectors Construction Pole Sub. EXEMPTION FROM WORKERS'COMPENSATIONDECLARATION - r Dishwasher - Solar Piping' - Cooking Unit - Meter-Dup to 100amps• - (This section need not be completed if the permit Is for one hundred ($100) or - less): - Drinkin Fountains I certify that in the performance of the work for which this permit Is issued, I 9 Solar Tank Dishwasher Meter (Dover 100 amps • -shall'not employ any person in any manner so'as to become subject to te Workers' Compensation Laws of California. Floor Drains • Swimming Pool w/Spa- Dryers ❑Gas ❑Electric Sub Panel ' Date Signature • NOTICE:If,after making this declaration, you should become subject to the Floor Sinks Urinal Fan Motors❑0.1 HP 01'A-8 ' Workers' Compensation provisions of.the Labor Code, you-must forthwith- . - - - - - comply 'with, such provisions,or this permit shall be deemed revoked. , 7 Gas Service 4L Outlets' .Water Closet . O-! F.A.U. • Inc.Solar 09-15 HP 016-15+ ' CONSTRUCTION LENDING ,AGENCY - _ I hereby affirm that there is a construction lending agency for the performance Interceptors Water Heater- i - • - Fixtures 'Microwave i of the work for which- this permit is issued (Section 3097 Civ. C.) _ - - - Lender's Name - Kitchen Sink • 1 7 Water Service - -- - /4 — Device Boxes Pole Light • Lender's Address Lavatories OWNER BUIL-DER DECLARATION , - -, - _ Outlets Range I hereby affirm that I am'exempt from the Contractor's License Law for the I p_Tre i following reason (Section 7031.5 Business and Professional Code: Any city or p• u - .. Switches • Sign , 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,' ' - Garbage Disposal Standing Sections • to file assigned statement that he/she is licensed pursuant to'the provisions of - _ - - - the Contractor's License Law(Chapter 9(commencing with Section 7000)of ' - - Generator ❑05 KW ❑5-15 KW Trash Compactor 4 1 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 _ 7031.5 by any applicant for. a permit subjects the applicant to a civil Reins ct io'n Fee $ 3 oeenalty of not more than five hundred dollars($500). ' Pe $25• Issue Fee LJ I, as owner of the property or my employees with wages as their sole Reinspection Fee $Z5 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 Hood or Type I 0 ' thereon, and who does such work himself/herself or through his or her own Zoning Approved By Date employees, provided that such Improvements are not Intended or offered for • Canopy Type II. 0 - sale. If, however, the building or improvement Is sold within one year of corn- Duct-Under Ground ' Application Approved By Date pletion,the owner will have the burden of proving he/she did not build or lm- I , /��/y� prove for the purpose of sale). , - Duct-Structural - - Refrigeration System - Application Issued'By �'/ �� /3i Date R LI I, as owner of the property, am exclusively contracting with licensed con- ❑0.100,000 BTU ❑100,000 BTU tractors to construct the project (Section 7044,Business and Professions Code: ' • Duct-Ventilating SUMMARY OF FEES r .The Contractor's License Law does not apply to an owner of property who- - _ - .. - - -- BUILDING PERMIT $ /7.SO SMIP $ .-V 0 builds or improves thereon,and who contracts for such projects with a con- Exhaust System ❑ Multiple ❑ System Repair/Alteration ' tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK • $ /7 r 3 7 PERMIT O I am exempt under Section B.& P.C.for this reason ' ' Firepl/Fact.Bit. ICBO# ISSUANCE $ • • I - PLUMBING $ %4 . Date owner I - Heating System& Ducting ' i PLAN CHECK $ ENERGY P.C.• t $ I hereby certify that I have read this application a , state that the above I 00-100,000 BTU ❑100,000BTL GRADING $ -information Is • ect. I agre- to comply with all c land county ordinances- • - - - •- - ' - - ---- - - - - - - _ ELECTRICAL $ and state law• tela Ing t•1• !ding constr ,I• • hereby authorize repre- PLAN CHECK - $ 1 MICROFILM $ • sentatives o this city n upon -mentioned prop ty or inspection • •os•. jev p • ' t z ` ��y �� //� MECHANICAL -$ TOTAL FEE , $ - •' Signature .4 , ,\ Accounting:Goldenrod-Assessor .• _... • L - i-• _ - 7,0 CONSTRUCTION AND PLAN IINpNGG� • POI._ di SPA • APPROVALS ' Permit#S (/�� Date Inspector APPROVALS Permit Date Inspector 1. Temporary Electrical Service or Pole. '- 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53.:Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. - 54. Forms 4. Electrical•Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement '56. Rough Plumbing & Pressure Test ' 6. 'Electrical 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 '740 i MC 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 O Gas ID 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: ///2,24-9 ��` /� �.rrn O./l nn /liwsu army- . 34. Final Heating & Air Conditioning n a v r z-5/1roo .(:.v, #9ef20 0,,i 35. Final Gas Pipe-Test r«:$4 36. Hood or Canopy 37. Final Factory Fireplace • 38. Final Plumbing • 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation ' 44. Landscape Irrigation System ' 45. Sound Attenuation • 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison • - 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY • No. . Date Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. i CITY OF COSTA MESA • '' PERMIT NO. 'j TRACT NO. LOT NO., ' BLDG.NO. • CONSTRUCTION PERMIT _ �'S— Applicant's Meiling Address P O- i Y � ,tom� ' • TYPE OF CONSTRUC O U NEW U ADD U ALTERATION U REPAIR - 4742 E/29/B3 , 155.5U TL Project Address 'W1 nn0'�'-2601 Lel-CEtA"Wt.: I4 Ve1414_ ❑ CONVERSION DEMOLISH t❑�/ OTHJR ( - Owner's Name M-tt,L• e1nCN •�eNita"JPhone 154• ' DESCRIPTION OF WORK p e �I�n vl, „TN v.,tel ti 1 I � - lb la � 4 Oto LD 1 • ZONING REGULATIONS o. i ;t. .-20_7, P-IA �JJ1 gddressf : / X •IAC �3''e'+^ 1 y' • TYPE OF PERMIT I GRADING FOUNDATION' U STRUCTURAL A.P.# ZONE I • Arch/En . • - F S�^a'i erase No. 3 ' ' Ili (Q ❑ TENANT ❑ ELECTRICAL 'PLUMBING ❑ MECHANICAL BUILDING . , r 9 PLNG.REF.* Address - �•�• l JgqbX �-�7 P�`'��.,sV`+ • AS�,t' - - • ' OTHER - 'nMQ 1 k-i I n N TO BUILDING, AFT gnrx rti AT G L Iej P• 471 FI F� J P one Tc 4•aF PROJECT DESCRIPTION SQ.F7. OCCUPANCY • �G PROPERTY LINE REAR YARD (TO P/U Cdntiector's Name d - - • qq ,T,`` c CONSTRUCTION VALUATION$- � �(YD �' LEFT SIDE YARD ' RIGHT SIDE YARD ' Address(mailing) F ,u 17 �hh°� 1S - - ./ . - ! eV I l ZONA GRADING CU.YDS. RFc • PKG.SPACE,REQ. PROVIDED t... License No. . • __ eV / - LICENSEDCONTRACTOR DECLARATION - Remarks: • • - - STREET WIDTH 1',+,PARK FEE$ I I,Pereby'attirm that I am licensed under provisions of Charter 9(commencing - - • .-1 . with section 7000) of Division 3 01 the = sines!and Professions Code,and • SPECIAL CONDITIONS: • - • my,license Is In full ice and-effect, , - - 1 License Cl.ss �. . " Lit ��� =� i PLUMBING , • - l • ; t • . , Date- Signature —. 'A 11• - , q� i , Bar Sink L Sewer Cap I .ate -- ELECTRICAL , 's1eRK RS'COMPENSATION DE •RATIO - I ' I - - „• ,.t, sre•y affirm that I have a Certificate of consent to sel ensure or a,certectioe Backflow Preventer - Sewer Connection! -- Automatic Washer.. ,r - Meter.❑over 100 imps-. ' _ _ Compensation Insurance,'or a Certified'copy thereof (Section • !.:.:-.,:,'"Workers' Construction Pole }- Sub Panel ! • y$oo, LSD. C.) I Badkflow Irrigation Solar Collectors . Policy No. • - Company - '- • , 1 eCertified copy is hereby furnished. I : j ' 1 ! Bathtubs I Solar Piping Cooking Uni[ I Sub Pole , Certified copy Is flied with the city.Building Oivislon. ; i • I - - i • Dishwasher Motors 00-1 HP 01X-8 i I. • ,_Dale l Applicant I _ , Clarifiers_ _ _ ' Solar Tank _ E%EMPTION,FROM WORKERS'COMPENSATION DECLARATION - - Dryers ❑Gas ❑Electric ,I nc.Solar•09-15 HP ❑16-15+ I ' I Dishwasher I r : Swimming Pool w/Spa , 1 (This section need not be completed If the permit Is for one aurae atl($100) or - F Microwave l t I I certify.thal in the performance of th rk for which this permit is issued I ! I Drinking o0 ntaihs , - Urinal j Fan' ' ) shall not employ a •sora In an r so as 0 • come uo7ect to the I •, - • • - F.A.U. Pole Light j • ' l workers',, n I4naws of Ca - ,/ �) r + • Floor Drains; ' Water Closet I_ - : Date, ignatur, L.-�� - , _ Fixtures Range. NOTICE: f,oafte making thvisjon oration,you should •atoms subject to the - Floor Sinks : }- Water Heater. , - complys', Compensation, provisions of the Labor you must forthwith {��\ ��� , Device Boxes , comply with,such prvisions'or !this permit shall be tdeemed, revoked.• t „ . Gas Service ' `.Outlets , .Water$e 1 t)(/S. Sign. I - , •• CONSTRUCTION'LENDING AGENCY' ( ` + ` y,\jJ'e 1`j� - - / - - ' I hereby affirm that there Is a construction lding agency for the performance, • ' Interceptors ' • Y _ Outlets ! Standing Sections I of the work for which.this•permit 'is 'Issued (Section 3097 Civ. C) 4s' - Switches% •'r'•T t ' Lender's; Name - Kitchen,Smk :� r - • r C la _ , ( Trash Compactor Lender's. Ad dress - .01' IOWNER,BUILDERDECLARATION I Lavatories , j� - �•Gerba6 DispOsdl I , . P . I ,affirm that I am exempt from the Contraessio'License Law for the- , •r - - Generator 00-5 KW 05-15 KW , ; following reason 15ection4031,5 Business and Professional Code: Any city or • P-Trap • • - - ) - - - county which requires a permittoconstruct,alter Improve;demolish or repair . . - / Transformer.X15-50 KW , • to structure,'prior to itsrat that also requires the applicant-for such permit ! Roof Drains - to file a signed statement that he/she is licensed pursuant-toithe,provislons of ' • - '•`'❑5U+KW , soft Contractor's License Law(Chapter 9(commencing with Section 7000) of -- , _ , ? I _Reinspection Fee M. 'yieion .3 of.the Business-and-Professions Code) or that he/she Is'exempt Showers . : Reinspection Fee $15 ' s/ i ',,refrom and sis for the alleged exemption.-Any violation of Section - _ :, Meter ❑uo to 100 amps r ! Issue Fee + '$ 3 •• "1.5 by any applicant fora,permit"s ($5 s -the applicant to, a'civil • • ♦ _ _ t penalty of notmore than tive'n undretl dollars($500). I 4 Service Sink Issue Fee $ 3 Zoning gPp�pyad By - •Date I t - LJ I,`as owner of the property or my employees with '.wages.as their tote MECHANICAL compensation will.do the work,and•the structure As not intended or offered - ! ,. • • t . . ' . :4 liotion'Approved By '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 ' Boiler• • Refrigeration System ' • 'thereon, and who does such work himself/herself or through his or her own 1 ' ' -r Applination Issued BY ti#y..• / Date c'/ ��3 • >employees,provided that such improvements are'not intended or offered for 100-100,000 BTU ❑100,000 BTU " • -- - • s - - /1 If, Duct'Under Ground _ ,'� I SUMMARY OF FEES •sale. however,r will haw the or improvement is g he/she ithin onot of tom- - 'd ' • i •pletion,the owner have burden of proving he/she did not build or Im- - _ - + +=e i 1 ( rove for the purpose oflsale)• i I , Duct-Structural System Repair/Alteration . •, BUILDING PERMIT $• 1Q SMTP - f $ j r SCA 'D 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 . ' ,. _ ; '- - -- . ' •' PLAN CHECK $I • ' PERMIT ' :The Contractor's License Law does not apply to an owner of'property who 1 S-�00 - , ISSUANCE ` ' 5 ' t builds or Improves:thereon,and who contracts for such projects with a con- I Exhaust System 0 Multiple 0 ' ) r PLUMBING $ I i i ' i.tractor(s)-license pursuant to the Contractor's License Law).. ! - • + , f ` GRADING ' $ ! - 1 0 I am exempt under Section B:& P:c.for this reason : • Firepl/Fact.Bit. ICBG# s s - PLAN CHECK $' i ) HeatingS stem&DuctingI '=ELECTRICAL• $! Date • ' Owner • ' Y t i ' MICROFILM• $ '1 hereby.certify that I1•have'read this-application and state-that the above .' ❑0.100,000 BTU 0100,000 BTU - p� PLAN CHECK' , $: ' information is corre . I,.gree to comply with all city'acounty ordinances t • ' - • MECHANICAL $, • - TOTAL FEE' ' $ ' and state laws rel • bulltlin• c•.truth• ,and herebyauthor) are r '- - ♦ p Hood of Type I ❑ •' • i 4 I - • 'sentatives of ,thl- G r .to gore%.•..,-the Bove-mentioned o tYP 7 I Reinspection Fee - $15- PLAN CHECK ' $: LESS Inspection purpos.• r/' ,� �� 3; Canopy Type 11 ❑' 'Signature / Accounting;Goldenrod-Assessor / `/0 01 2 ?CONSTRUCTION AND PL• N N tA. 3i ' ' '' _ "'..POOI PA- "--- --- : 'd APPROVALS Permit - . .(-`Date , ; Inspector '- _ 'Date ' Inspector { ,.• - ! -APPROVALS' . `Permit# ' 1(1p Tempoi-ry{Electrical Service or.Pole ; 1:2:I_ x n ., o '(id. ' ,:'.' '52-i ,Pool &,Equipment Location_ F. ; r' - - : _ . ,'e 2t ;Soil'Pipe-Undrgrnd._ • , �. <<, • . I .' ; Applicant to fill In all spaces except those within heavy border tines and sign all appropriate declarations. - CITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO.- - Project Address o26.o3 Ett)En/ AdF.vu' E Ia�70 -2/29L� - ` 19.. + i '' 1187 4/16/65 9000 IL tApplicanes Mailing Address �BZ2G W /�°13.i,G re_SEr6 • TYPE OF CONSTRUCTION u� NEW Cil ADD U ALTERATION U REPAIR , /NJ icz.fi teAl �L 6Lo)OM ./yy_CS37 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.#6 Zone Owner's Name (� one. DESCRIPTION OF WORK/USE OF BLDG- t _ Address 1922.6 tJ. ma 1iz.f4.mgerr s...,;-ac a/J".ted,,..4. ell) rdo 5 S Main Building: - - Accessory Building:. Z Arch/Eng. CL�15—ST L L�License No.(�jes..7.zp._ TYPE OF PERMIT._, �U GRADING FOUNDATION U STRUCTURAL T Front- -• 0 ' Address • q�,, l/ ❑ TENANT ✓ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear - N •Contractor's Name_le40.64 �� e°,41 vhon r e r.� ❑ OTHER A - s /.�C �6E / PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right ' - G Address(moiling)�B�t�IILLa/✓ =i IST . � �.. CONST RUCTION TYPE • VALUATION$ • S Left City'License No. „36, 67TZONE • - GRADING CU.YDS. ' ACRES - E LICENSED CONTRACTOR DECLARATION ' Ping. Ref.# Parking Req./Provided' , I hereby affirm that I am licensed under provisions of Charter 9 (commencing ` I' _ O ( 9 Remarks: ..C. .7,44 -cue , - Planning Notes: , _ • M ' with section 7000) of Division 3 of the Business a Professions Code, and93 - T my license is in full force and effect. • �� License Class_ - I se No _ -• $ I Date_y_/(s�� Signaiure ---c"i PLUMBING I FEES , - • WORKERS'COMPENSATION DECLARATION ' Bar Sink Showers • ELECTRICAL FEES I hereby affirm that I have a certificate of consent to self-insure or a certificate i of Workers' Compensation Insurance,.or a certified copy thereof (Section Backflow Pr¢v¢nter- - + --• Service SinkIli - "' -- 3800;'kers'' / - Automats ionPol Washer Transformer 0 15-50 KW' ,- Poli; No. •(DZ,rG-fw Company d.f ' •___05._.— Backf low Irrigation Sewer Cap • Construction Pole Sub. �Sa,,Q • ❑ 50+ KW .Q - ertifietl copy is hereby furnished.Certi)I d p�C,is ed with the city n I Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps i Date—Y'/_XC Applicant p EXEMPTION FROM WORKERS'COMPENSAT•N CLARATIONl) , ,Clarifiers ' Solar Collectors „ Dishwasher .•Meter Dover 100 amps -, (Thissection need not be completed if the permit is for one hundred($100)or Dishwasher less). Solar Piping I Dryers ❑Gas' ❑Electric .Sub Panel, , I certify that In the performance of the work for which this permit is issued, I - • shall.not-employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors❑0.1 HP ❑1%-8 r Workers' Compensation Laws of California. _ • Date Signature Floor Drains • Swimming Pool w/Spa II F.A.U. ❑9-15 HP 016-15+ 'NOTICE: II,after making this declaration,you should become subject to the . Inc.Solar Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks , Urinal •- - - Fixtures - -- comply with, such provisions or this permit shall be deemed revoked. Microwave- CONSTRUCTION LENDING AGENCY - ' Gas Service 'Outlets Mater Closet Device Boxes Pole Light 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.) Interceptors Water•Heater Lender's Name • p - Outlets • Range Lender's Address • - Kitchen Sink Water Service Switches Sign OWNER BUILDER DECLARATION - _ - - I hereby affirm that I em exempt from the Contractor's License Law for the Lavatories . Auto Wash Garbage 1 following reason (Section 7031.5 Business and Professional Code: Any city or .. - Disposal ;Standing Sections • county which requires a permit to construct,alter,improve,demolish or repair , P-Trap. LaundryTrays - ' any structure, prior to its Issuance,also requires the applicant for such permit y Generator ❑0.5 KW ❑5-15 KW Trash Compactor .to file a si§ned statement that he/she is licensed pursuant to the provisions of . Roof'DrainS ' the Contractor's License Law(Chapter 9(commencing with Section 7000)of - - Division'3 of the Business and Professions Code)'or that he/she Is exempt - - •, therefrom and the basis for the alleged exemption. Any violation of Section , - - 7031.5 by any applicant for a permit subjects the applicant to a civil - - • - r. -• - ' 7enalty of not more than five hundred dollars($500). . •I . 0 I, as owner of the properly or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 • ,compensation, will do the work,and the structure is not intended or offered 1 (Reinspection Fee $15 Issue Fee • $ 3 for sale (Section 7044, Business and. Professional Code: The Contractor's MECHANICAL FEES I License Law does not apply toan owner of a property who builds or improves _ _. _ -_ , thereon;and, who does such work himself/herselfror intended his or ere own DEVELOPMENT SERVICES REOUIREMENTS:I employees, provided that such improvements are not Intended or offered for Boiler Hood or Type I 0 sale. If, however, the have building or improvement is sold within one year of cos- • Canopy • Type II ❑ Zoning Approved By • Date oration, the owner will havthe burden of proving he/she did not build or Duct-Under GroundBuilding Approved By Dattr_ Grove for the purpose of sale). • (��l I ,I� LJ I,as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By �{.� Date tractors l6 construct the project (Section 7044,Business and Professions Code: U ` The Contractor's License Law does not apply to an owner of property who ' Duct-Ventilating 00-100,000 BTU 01 00,000 BTU SUMMARY OF FEES • • builds or improves thereon,and who contracts for such projects with a con- - -' - - - tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair• /Alteration .. BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation insurance should be provided to me. ' • PLAN CHE • CK $ PERMIT 0 lam exempt under Section B.& P.C.for this reason MilFirepl/Fact,Blt. ICBG'# IIIFireDampers PLUMBINGN CHE $ 'ISSUANCE $ Date - owner • Heating.System&Ducting - Registers - PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that L have rea• this application and state that-the above 00-100,000 BTU 0100,000 BT - - ELECTRICAL $ Q•�b GRADING S information is correct. i agree t• omply w all city and county ordinances - I ; ' and state laws relating to bui • g constr; tion,and hereby authorize repre- PLAN CHECK 50% $ _ MICROFILM $ 7-� -• sentatives of - cit to r upo /h• .hove-mentioned property for Q^ . inspection pu "dr . MECHANICAL $ I ` ) Signature S- i_ / Date 9'et TOTAL FEE $ Drivers' License or • , - - - Pink -Accounting; Goldenrod - Assessor • CONSTRUCTION AND PLANNING POOL (APPROVALS Permit Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole f r do 52. Pool & Equipment Location • 2. Soil Pips-Undrgrnd. 53. Steel Reinforcement • Electrical Conduit Utility-Undrgrnd. • + 54. Forms 4.;Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5:;:Steell Reinforcement 56. Rough Plumbing & Pressure Test �• 6'Electrical'UFERGrnd. 4! 57. APPROVAL TO COVE R-GUNITE 7. Footings `• _ 58. Electrical Conduit-Undrgrnd. 1'•� 8:•Foundation • 59. Gas Pipe, 0 Undrgrnd.,Test 9;Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Stiuutural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection - 62. Backwash & Receptor-Final • 12. Sew Ca P'. e e 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 t 72. Underground Flush 24: Roof Framing 73. Undergrnd.Storage Tank CI 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 i 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar 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. 0452 12/09/P3 -CITat OF COSTA-MESA ' - - — - .- T -- - ' PERMIT NO. TRACT NO. LOT NO. + - , BLDG.NO. • , - - - Ee nl T CONSTRUCTION PERMIT ? 3 -3 �/ , . - Project Address D /�y�� 4../, - TYPE OFCONSTRUCTION" S-NEW U ADD U ALTERATION U REPAIR l , 1 Applicant's Mailing Address�r�� �a 1-��X 1,n eb t ��f ❑'CONVERSION ❑ DEMOLISH ❑�OyT�HERR-p., sy ,.., ' A.P.# • I Zone - _ ' Owner's Name 'QQ'ei-D-- tO 1>,� /17 / ' DESCRIPTION OF WORK � "`Q "1' —"'- TU"'� \ 'hl1 tryw Phone I - • S Main Building: - - 'Accessory-Building: Z Address �& aS• 2p %-" ,44, !�i'.iP Z - 'Z TYPE OF PERMIT i UiGRADI NG ❑-FOUNDATIOry E 0 - • U STRUCTURAL T Rear + , , - _ - • N 60 Arch/Eng.f '4'��'S 'M gyp /License No. G/Z.1�3 - ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear AddressO, $f7- '7-�-J ��SI.-9(40"� ` '�s/+1v0 ❑ 'OTHER C Right - - N \ C/4PL'5 , STE-014V) a-, Phone 9)�6'D/ • PROJECT DESCRIPTION SQ. FT. OCCUPANCY 9 ' T - •- - G Contractor's Name • K R CONSTRUCTION TYPE - VALUATION$ S Left 1 . A ldress(mailing) �PS reel. Its5 I - E City;License No. C �ao� ZONE GRADINGCU.YDS. ACRES 'Ping. Ref.# ' Park:Fees $. U LICENSED CONTRACTOR DECLARATION • Remarks: - Parking Req./Provided ' I - - I- 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: _ E my license is Int force and effect. ' - ' - - License Class - r.}�Licen. -sy No. �Z-S ' - PLUMBING a FEES .Planning Notes: M Date 17--/-10 Signature L__�- (•tK(,a`•j,•l\ s . , _ E ' Bar Sink I Shower's I N WORKERS' COMPENSATION DECLARATION T I hereby affirm that I have a certificate of consent to self-insure or a certificate I - I , - - - -of Workers,.Compensation Insurance,1 or'a' certifiedb copy thereof (Section - - Backflow Preventer _ Service Sink.- _ . __ _- • + S 3800, Lab. ,) oe �3 _y _ -F s� Backflow hrigatioh i Sewer Cap f , ELECTRICAL r FEES • Polity No. S vt^ CompanyScri18..,v CV ' •, Certified copy is hereby furnished. I , Bathtubs Sewer Connections , .Automatic Washer .Transformer 0 15-50 KW , Certified copy Is filed with the city Building Division. • I Date v' Applicant Clarifiers ( Solar Collectors , J -Construction Pole Sub. TFr i 0 SO 100-amps S — EXEMPTION FROM WORKERS''COMPENSATIONDECLARATION• - -- -- Dishweiher - • - . '- Solar Piping - ' - . - -Cooking Unit '/ - •Meter ❑up to 100-amps - - ' - - - - (Thissection need not be completed if the permit is for one hundred ($100)or less): • - I - - DrinkingFountains ' ' I certify that in the performance of the work for which this permit is Issued, I _ Solar Tank _ Dishwasher i Meter ❑over 100 amps' shall:not employ any person in any manner so'as to become subject to the , - - - • workers' Compensation Laws of California. I. Floor Drains ' Swimming Pool w/Spa, i Dryers ❑Gas ❑Electric Sub Panel Date Signature - - - - , NOTICE:If,after making this declaration,you should become subject to the Floor Sinks - Urinal ' Fan' • J - Motors❑0.1 HP 0.11/2-$- Workers''Compensation provisions of the Labor Code, you must forthwith - - ' - - ' ' - ' - - - - - comply with' such provisions,or this permit-shall be deemed revoked. Gas Service 'Outlets • Water Closet _ ': F.A.U. - Inc Solar,U9-15 HP'❑16-15+ ' CONSTRUCTION'LENDING -AGENCY' . - ' ' -- ' I hereby affirm that there is a construction lending agency for the performance ' Interceptors • • ( • Water Heater -- • Fixtures Microwave ' of the work for which- this permit,Is I issued (Section-3097. Civ. C.} _ - - - - • Lender's Name. - - -' Kitchen Sink t • _ Water Service . - - • - Device Boxes ' l' 'Pole Light - Lender's Address - - lavatories.- _ I - • I OWNER BUILDERDECLARATION - - . _ Outlets Range • • I hereby affirm that I am exempt from the Cdntractor•s-License Law for the' - p-Trap, ' • following reason (Section 7031.5 Business and.Professional Code: Any city or • p, . - - ' - - _ Switches , Sign + 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. - - r- Garbage Disposal i Standing Sections • ' 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 i - ' ( , - • - • Division 3 of the Business and Professions Code),or, that he/she is exempt I r 1 - Generator ❑0.5 KW ❑5.15 KW Trash Compactor , therefrom and the basis for the alleged exemption:Any"violation"of Section + - - ^— - 7031:5 by any applicant for a permit subjects theapplicant-to 'a civil ' . • _ • ;'enalty of not more than five hundred dollars($500). - , , •Reinspection Fee•. •$25 Issue Fee $ .3 - U l,:as owner of the property or my'employees with wages as their sole Reinspection Fee $25 'Issue Fee' • $ 3 compensation, will do the work,and the structure is not intended or offered - MECHANICAL - I 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 _ Hood or Type I 0 oy, :who such work himself/herself nts areltot through his or her own - _ Zoning Approved By • Date te.employees, provided that such improv Improvements are ointendedhioor offered for Canopy Type II 0 _ _ • sale. if, however, the building or improvement Is sold within one year of Im- Duct-Under Ground Application Approved By • Date pletion,the owner will have the burden of Proving he/She did not build or On- rove foi the purpose of sale). , Duct-Structural Refrigeration System - Application Issued By Zr �� / Date�� �/p U I, as owner of the property,am exclusively contracting with licensed con- ❑0.100,000 BTU ❑100,000 BTU tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating I . SUMMARY OF FEES The Contractor's License Law does'not apply to an owner of property who - - ._. 1 builds or Improves thereon,'and who contracts for such projects with a con- , Exhaust System 0 Multiple 0 System Repair/Alteration - BUILDING PERMIT $ SMIP $ tractor(s) license pursuant to the Contractor's License Law), - PLAN CHECK $ I •PERMIT • ' alam exempt wider Section - B.&P.C.for this reason ' Firepl /Fact.Bit. ICBG# PLUMBING 1 $ I 'ISSUANCE , $ Date ' - Owner; - I Heating System& Ducting ' - PLAN CHECK $ ENERGY P.C. $ I hereby certify that I have road this application and state that the above 00.100,000 BTU 0100,000 BT ELECTRICAL r __ GRADING $ information Is correct. I agree to comply with all city and county ordinances- ' ' ` "- - • $ and-state laws relating to buildin• construction, and hereby authorize repre- PLAN CHECK $ MICROFILM $ •sentatives of is city' to'e t upon the above-mentioned property -for • _ + , • inspection ••r•'se Signature • z _ Reinspection Fee - I $25 Issue Fee $ 3 PLAN CHECK CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod 'Assessor - - - - • - . . CONSTRUCTION AND PLANNIN Z POOL &SPA let APPROVALS .Permit# e--91_, / Date Inspector APPROVALS Permit# Date Inspector - 1. Temporary.Electrical Service or Pole 1 /i3 i e-C 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 System61. APPROVAL TO DECK 11. Property Sewer.Line & House Connection -• 62. Backwash & Receptor-Final • t 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 - 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 y(7' BUILDING DIVISION • Fµ �� 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 �� 0� PERMIT NUMBER. P08-00029 PERMIT TYPE PLUM STATUS: ISSUED APN: 93009742 DATE ISSUED: 01/2312008 • ISSUED BY: BJK JOB ADDRESS: 2603 A ELDEN AV CM Suite/Unit: A Vicinity: UNIT A GARAGE SCOPE OF WORK: CHANGE-OUT OF A WATER HEATER IN AN EXISTING TOWNHOME UNIT A. NO OTHER WORK AUTHORIZED WITH THIS PERMIT. OWNER: STARR,CATHRYN - Address: 2603 ELDEN AVE UNIT A PHONE: City/State/Zip: COSTA MESA,CA APPLICANT: JERRY RIVERA(TECH 209) - Address: 1036 W TAFT : PHONE: 800-997-2743 • City/State/zZip: ORANGE,CA '100 ,�._9 CONTRACTOR: RAPID PLUMBING License No. 521992 Address: 1036 W TAFT - PHONE: 800-997-2743 City/State: ORANGE,CA ZipCode: 92863 CELL: ARCHITECT: License No. _ PHONE: ENGINEER: License No. • PHONE: • PLUMBING PERMIT FEE SUMMARY PLAN CHECK FEE: $0.00 PERMIT FEE: $35.80 TOTAL FEES: $35.80 ^r)^9 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§ 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. CODE/ INSPECTION TYPE OST INTm1L$ CODE1 INSPECTION PIPE DATE INTMALO 1616 Fixed System Final Fire Prevention 206 Final Mechanical �j 1266 Pool Spa Final 208 Final Plumbing "2,:j Z-D1 6)1--- 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 4 - 204 Final Demolition 250 Final Building/Occupancy WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver's lice.._.. 0 Yes 0 No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: O I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document.i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. gl 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy ❑ I hereby certify that no excavation five(5)or more feet in depth into which a number are: 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 Carrier: C 4.NC F u co or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2.Grp a (This sem nee ed not be completed el the pent g valued at one hundred dollars(SI 00)or less.) 2 Arlt Sec.341,Title S,California Administrative Code). Policy Number I g -I l (0 52 - 07 ❑ As owner-builder, I will not employ anyone to do work which would ❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued.I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of Applicant's signature Date the •b: Cn• I rthwith comply with these provisions. jilF - . t 23—Ot Division of Industrial Safety Permit Number: Applicant's Signature Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: rING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and I UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes 0 No ($100,010), IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. INTEREST.AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. 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 LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons,or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. a registration form for acutely hazardous materials? 0 Yes 0 No Lil SZACytClass# r' - yo cetio 25533 the California Health and SafetysaCode, arth somet b ....v)S\G, exceptions, requires registration with the Costa Mesa Fire Department by I- Zj-04 each business which at any one time has on hand a quantity of acutely contractor's Signature Date 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 CONSTRUCTION LENDING AGENCY: temperature and pressure). O I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 0 Yes 0 No (Section 25534 of the Califomia Health and Safety Code provides that the Lender's Address: 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. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the Califomia Government Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits). 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 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If'yes",the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation. WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec. 7044,Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by Califomia License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No thereon,and who does such work himself or herself or through his or her own 8. (If"yes",attach certificate of compliance from the appropriate air pollution employees. provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE:•I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and ❑ I. as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. • LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of Signature Date properly who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of Business and Professions Code for this reason: 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. 1 (] ag -u(•c egal Owner(s) Date 305)x6(107) Signature Date 2 _ _ .� f—L3— �Andlor Authorized Apperant Date • • M6 • CITY OF COSTA MESA ' • 4gat BUILDING DIVISION f•S.�I DEVELOPMENT SERVICES DEPARTMENT P MIT NUMBER / PERMIT B07-00109 • • 111111'�4ncrWM1��• DUILDINO PERMIT (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.ua 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 2603 ELDEN AV Status: ISSUED Suite: A-B Applied: 01/31/2007 Vicinity: Issued: 01/31/2007 Primary Occ: R Type of Construction: V-N Parcel Number: TPN007002 Zoning: Applicant: ANNIE PATTISON Address: 101 THE MASTERS CIRCLE41 40 _ __Phone: 714-444-1111 ISSUED BY: 4 COSTA MESA,CA __ =Zip: , 92627 - Owner MAR ELDEN-SQUARE Hk OA Address 2603 ELDEN AV '-:-"' _ Phone: COSTA MESA CAA } t. - Zip:- 92627 -- Contractor: ALL.COAST ROOFING AND:COATINGS _ Address://101 THE MASTERS CIRCLE ). �•.r % ,(:- Phone: 714-444-1111 COSTA MESA;CAS /Zip: 92627/7/2'1-7 License: 598440 A,'.[V • /Arch : . ` 4/,'.27 Eng: .•� Address: • - Address: - - Phone: • Phone: " Zip: , -%S' - - License: , - - ' ` License: - - SCOPE OF PERMIT REROOF OVER EXISTING LAYER.INSTALL 30 YEAR GAF TIMBERLINE SHINGLES,4:12 PITCH AND 2300 SQUARES FOR CONDOS. ' v . ; % �.i A.V > A, FEE SUMMARY Plan Check: $0.00 ; ,:-1 ' ` Calc Valuation: 52,300.00 Permit ' ` $83.25 `:'- ' `�-/ '/ � / -' , �•� ,,, '• • Claim Valuation: S2,300.00 • 'SMIP Res: ' $0.50 SMIP Com: $0.00- ` .- -. Other. $0.00 - - Inspectlon $0.00 _ y" b " ‘ Total `. $83.75 . _ �' ' PLANNING & ZONING .' SETBACKS , MAIN STRUCTURE Front Q 07 0 Rear 0 0- „ Left 0:0 , Right 0-0 ACCESSORY '- Front,131'0 1 ''"'''"'Rear =0-0 "", ,Left .0-0 '-r Right' 0-0 ,. PARKING:, v Existing i) 0 <Required:/ 0_A _ Proposed: 0 7 / / •C). vim' / ' N — N - c - �� ''/ / \ r / - .. / •_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 244846(&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 Code,for the performance of the work for which this permit Is Issued. 7 ` ^ My workers''c pensation I rance carrier and policy number are: ��� f� Cartier._ J,C4 e 1.4.-1 Policy Number:_ (This section need of be ple d it the permit Is valued et one hundred dollars($100)or less.) ❑ I certify that in the performanc: 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 Califo. :,and agree the I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provlsio ( (Applicant Signature: - - /.... - / C. rDat ea= :NA/figJ ` • WARNING FAILURE TO-5-ECURE ORNERS'C MPEN.ATION COVERAGE IS UNLAWFUL AND SHALL suaIECT AN EMPLOYER TO CRIMIES AND CIVIL FINES UP TO ONE HUNDRED THnJSAND DOLLARE($100,000).IN ADDITION TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706 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 te Busine'.'�5iand Prrooffeessssiioonnsd..'Code,and my license Is in lull -force and rseffect SIg.L.t.-p -1?_1yy 4 Lacy t r I Cors Signature: " f� l ------ CONSTRUCTION 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: 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 Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec, Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feel 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? 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 Califomia Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required.has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apEermit 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 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 ❑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 $ouch 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 prescnbed by California Health and Safety Code Section 42303 been made? 0 Yes 0 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•urposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. //,,///1ilt t Signal • Le.. Owner(s4 y 7-r / /pate i And/_•r Autho z:•Applicant / Dat CODE f INSPECTION TYPE ziTE INTRIALS Cypg_i INSPECTION TYPE PSIS IBM& 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final ��(� 208 Final Plumbing 200 Final Re-Root l�1/ 210 Final Electrical 201 Final BIocWRetaining 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 CERTIFICATE OF OCCUPANCY No. 'sllku.Lat:hD Building Safety Division P.O.Box 1200 Costa Mesa,California The Building located at 2603 Elden Unit A has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto fora Group R-3 Occupancy. Use of Building Condominium Legal Description 439-071-10 15 (See reverse side for Metes and Bounds) Building Permit No G18473 Electrical Permit No. G18473 Plumbing Permit Nof:l P471 Mechanical Permit No. G1 A473. M197l c Number of apartments and/or guest rooms 11120172 /J /eti / ISSUED TO: Building Official .�I Mar-Elden 17°velorsttertt _ _---� � 295 Fischer Suite 131 by yr Costa Masa. CA 92626 Date 1 0 0 8b 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 ) Applicant to fill In all spaces except those within heavy border lines and sign all approorlate declarations. ' .:69TY ; COSTA MESA ' . _ ERMIT NO. TRACT NC. LOT NO. BLDG.NO. 26•� rat '"' '-' ; cc�1�FF ..J • : 90t.. r• UCTION PERMIT • G t Cb(4 13 i. a9y R. Applicant's Itlailing Address18226 W. IcUUYTOOtL ' TYPE OF CONSTRUCTION U NEW U ADD LI ALTERATION U REPAIR Project Address 2603 Elden Ave. #A • 0 CONVERSION ❑ DEMOLISH 0 OTHER t ' . • Owner's-Name Mar-Elden Development -Phone 474-0601 DESCRIPTION OF WORK i1\ta I) C-040 . • //J� - ZONING REGULATIONS 18226 W. MrDurm(itt. Irvine 92714 • TYPE OF PERMIT U GRADING U FOUNDATION U STRUCTURAL - A. 1W�3/`07I""/O- JSZONE ,AZ ;Z _ . . Arch/Er/g• Chris- R. Stephens• License No.'C12963 0 TENANT 0 ELECTRICAL 0 PLUMBING. 0 MECHANICAL - Nn -BUILDING - , Address 18226 W MrDurmntt, Irvine 92714 , - ❑OTHER -- •- - PLNG.REF.Gz-I'_ -Y -L7 �/• CCTRarle r,i CT _ TO BUILDING - I• , REAR YARD(TO P/L) - 1. Contractor's Name ThP Richard. F -frawfor&hC4 474-0551 PROJECT DESCRIPTION SO,FTI4� 4'4 7 OCCUPA¢N�CY L�3 PROPERTY LINE 20 N.1�4 Addresslmailing)1A226.W Mrfli,rmntt Irvi lie CONSTRUCTION TYPE - ' VALUATION s •4 (bee ; LEFT SIDE YARD ; 10./ • RIGHTSIDE-YARD '51" CL � License No. 41 8641 .1464A ' ZONE - - ' ' GRADING CU.YDS. ACRES PKC.SPACE REO: SC,' 'Q PROVIDED 7�Q , . LICENSED CONTRACTOR DECLARATION Remarks: -'Pt /' 7�J /^ y L• STREET WIDTH • • . PARK FEES TS :36/.0g>`er Fnereby affirm that I am licensed antler provisions of Cha - 9(commencing - 4. Lv _ - �_ • / (1 with section •7000) Of Division 3 0} the Business tl ;silo Code,and I • • I I SPECIAL CONDITIONS: Qp„v „e,z rnvrt�11 ncninnitWNTS • -�” "-Y my licenseis in full force and effect. / r s I • 1 (lt/YY s vP u.••--- — 00 Ucens�e,ylass-�f a p . n o, ; PLUMBING ' 1 Date H-//-a"� Signature ' '4 __ _-air , ` I 'RKERS'COMPENSATION DECLARATI. ! Bar$Ink Sewer Cap - ELECTRIC- - . AL,r' - �, veby affirm that I have a certificate of consent to se -insure or a certificate - Automatic Washer , / 7Meter IO over 100 amps en . Workers' Compensation•Insurance,.or a certified copy thereof(Section- "' BeckflOwprevantec--_i=- _ - �. Sewer-Connection -• - -L -_ _ SO ' 3800, Lab. C.) �; • ,Backflow Irrigation Solar;Collectors - . Construction Pole; l' r / 'Sub Panel. 5b<% Policy No. - •������ Company • - • f7.�.�/Q , - - _- • .... Cookin Unit Sub Pole - [],feftified copy is hereby furnished., r , • 2, Bathtubs %' Solar Piping 9 i' kJ Certit��00d� copy Il fun with the city -u Dirk. i•, - - - - I $pier •Tank - l % Dishwasher Motors ❑0-1 HP ❑1/-8 ` j Qp Date `/ •//- Applicant ..,-_-.41•44 . - Clerjtiers 1 _ �/ • EXEMPTION FROM WORKERS'COMP N • -sr t D LARATION . . Dishwasher ' • . • Swimming Pool w/$pa ' :z._ ___,.. Dryers-Ribes ❑Electric t 'Inc:Solaf'❑9-15 HP ❑16 15+- 1 0G. (This section need not be completed If the permit Is for.one hundred($100)or • less): - -- - — Fan; ;Microwave ti + I certify that in the performance of the work forwhich this permit Is Issued I Drinking Fountains Urinal / / Z O shall.not employ any person In any manner so as to become subject to the --- - - - / F.A.U. I I ' ' ;Pole':Light - - workers' Compensationi Laws of California,• ( j • • Floor Drains. ,3 Water Closet, 'I OC 'a DateOhis.detIgnatcia - - — //- Fixtures t / Range ' _ -- • 3 Zn' Workers' , termaoUJs.tlonof th should become must totheFloor Sinks'J.. .. _ _Water,Heater .. .. Z comply suCompensationch provisions she mitLabor- Code, you emet fre ok d . Device Boxes • - ' comply with-TON provisionsNDINGor this permit ,shall be ,deemed revoked. '/ Gas Service' 7, Outlets! Water Service _ - Z + Sign , F CONSTRUCTION LENDING AGENCY - 1 - • _ -• I hereby-affirm that there Is',construction it lendinge agency for the performance, interceptors; • �• . ! 1 So Outlets . i ; ' -Standing Sections . • (n CO+ of the work for. which' this permit Is !Issued (Section'13097 CIV. C,) • - - - r - Lender•sl Name ' - - - ' _/, Kitchen!Sinki 'a' 1 ._i :) : i : u_ l ?z �. /Q Switches I • Trash Compactor •! 30 OWNERLender's Address UILDE ; - ` • Lavatories i ) { i -f' ( / Garbage Disposal j ; I i t OWNER•BUILDER DECLARATION- ! 1 ' . " ' - , 3 , tr: - ` � 1 I hereby-of firm that I am-exempt from the I Contractor 15 License Law for the ! ,, l _ ' I /Y Generator ❑0;5 KW 05-15 KW • . I ' , following reason'(Section 7031.5 Business and Professional Code: Any city or - ; P—Trap' . t _ , r, ' - ' I ` 1 I i I • county which requires a permit to construct',alter improve)demolish or repair ' i - I - • 1 TmnSformer ❑15.50 KW ' ' { • any structure; prior to Its,lssuance,•also requires the applicant for such permit i Roof,Drains( i• - , ,. . 1 i ' . • to file a signed statement that he/she Is licensed pursuant to the'provislons of , - - - ' Oso+KW' I - • • s.;rontractor'5 Ucense Law,(Chapter 9(commencing with,Section 7000)of -• ' ' ' 1 _ i ; ' I •.Reinspection Fee i $15 on,3'of the;Business anm Professions Code)'or that he/she B exempt Showers .. • :-i Remspection'Fee • $15 rem and the basis for the alleged exemption, Any-violation-o/'Section ' • 1 •' + , Meter Opp to 100 amps j I Issue Fee i I $ 3 7t31:5 by•any applicant for a'permit-subjects:the applicant to a-civil • • i ! , eoalty of not more than five hundred dollars($500). : • . Service Sink 1 . ; `- 1 I Issue Fee - $ 3 j �, N/) • - (-_.1s;-f/i`7� i • e Zoning Approved By �7 'Data .•� I, as,owner of he'property or my amployees'with wages.as their sole ' - - i li , . compensation will do the work,and th Profs cture is not Intended or offered _ - rI 1 1 . ' MECHANICAL + I • Application Approved By I 1 i 'flare for sale.(Sec/Ion 7044; Business'and Professional Code:'The'Contractor's ' - ----- - - •_ - - - - - ~- I Ucense Law does not apply to an owner of a property'wno builds or Improves ' BOilef r •: ' ' I Refrigeration System , I • , i ' .i S • thereon:and who does such work himself/herself or through his or her own I 1 ' Application Issued By 'nate emploees, provided that such improvements issolt Intended or offered for ' _ 1:3 07100,000 BTU ❑100,000RTU ; - . sale. If, however, the building or Improvement sold within one yearlof com- Duet-Under,Ground 1 : _ SUMMARY OF FEES prove , the owner will have the burden of proving he/she did not build or im- • ' t 6 rove for the purpose of sale). • , , 1 I Duct-Structural i , } I System Repair/Alteration , -<•, I BUILDING PERMIT $ 385.OC) ! SMTP i , $ • 5.0E3 E3 I 1, as owner of the property,am exclusively contracting-with licensed con- - -.- - V tractors to construct the project(Section 7044,Busineis and Professions Code: . � 1 Duct-Ventilating . - _- , , -_ ' - - t;PLAN CHECK: 1 $ Co • 0 PERMIT The Contractor's-License-Law does not apply-to-an owner of property who 7 -- - ' • builds or Improves thereon,and who contracts for such projects with a con- Exhaust System ❑ 'Multiple❑' i 9 +PLUMBING l $ ��• ens ISSUANCE 1 I $ _ tractor(s)license pursuant to the Contractor's Ucense Law): •, - (PLAN CHECK 1 $ j er. a' • GRADING $ i ' ❑'lam exempt under section i ; B.& P.C.for this reason , Firepl/Fact.bit.ICBG 91s , ' :ELECTRICAL. $ 3Y•r. $ Date I 1 Ow - 'I - ' He ting System&Ducting ' 1 , 4 '•PLAN CHECK $ Is.-7S ' MICROFILM $ i .I nereby:cesp f t• t I ave ..d thli ppl /tion:and'state that the'above'; i' �U1DD,000 BTU ❑100,0008T1��_-I- ' Information 1s • agr . com• y i all city and county ordinances 'i -- ' i TOTAL'FEE' $ ' and state to f d, ng .nstr • len,and hereby authorize repro- - } MECHANICAL $ 7, sentatives • •" t~, � a above-mentioned property for Hood or Type I ❑' I ' Inspection par.. rte+• , /� L / Canopy Type II ❑ Reinspection Fee; i $15 'PLAN CHECK. : $ ' / i� LESS . 7y�'�� ' • rJ Pi+OUri CY i ADVANCED PC 1 $= Signature �� Date 1 . • - - Drivers' LIcen r SS yf Applicant;Pink-•Accounting;Goldenrod-Assessor "`--' - -'--- - - - - ----' '- ' 1' • rCONSTRUCTION AND PLANNING 1 - --r _ -7 • . =e POO" ' SPA - _ ;y. r .- :Date - Inspector . Date- .Inspector JJAPPbVAIS, Permit _ _ _APPROVALS Permit# r" l��l�."Temporary Electrical Ser3iceior-Pole lc. "` - "r '- 52. :pool &•Equipment Location _ 2.'Soil Pipe-Undrgrnd: - ! : ' #73701.12f/ 7153. Steel Reinforcement - - i. t '3.'Electrical Conduit Utility Undrgrnd - ; - _ -_ 54, Forms' - . - . . 4. Electrical Conduit-Undr rn8. • - f o- , .. ,51:i Electrical Bonding - 5.,Steel Reinforcement , - - 4. ; /At '-� - 56. Rough Plumbing& Pressure Test - :6. Electrical UFER,Grnd. ; k ,., : j , - . - Tl. p- 57. APPROVAL TOCOVE R-GUNITE : - - • 7. Footings 3/,IE s RS '58. Electrical Co_nduit-Undrornd. 8. Foundation �f'>�tj ' • . '_&iew -59. Gas Pipe, 0Undrgrnd.,Test- - - ' . - 9.'Water Pipe_Undrgrnd. ,L,i : , r - - . -60. Backwash Lines,-P-Trap;'❑ Undrgrnd.- - . . _ - ..•10.,Structural Floor System' .•It' 1 , , I 61. APPROVAL TO DECK , 11.'Property Sewer Line & House Connection 61241/45- S$_C y 62. Backwash &•Receptor-Final •12.1Sewer Cap - j ' I ���+((( ' 63. Heater & Vent-Final . 13.!Roof Drains 't. : - -64. Plumbing System • Final - - • , 14. Rough Plurnbing• 4tAW�ipf" 65. Electrical-Final . - , ,15.',Rough-Electrical•Conduit--• 1 - ' ---. -r, --4- - T "--,- .661Solar System-Final: ' '- -- ` - ,16. Rough Electric Wiring k T. 7 1` C'�` , . 67. Fencing & Access Approval _ • , 4 - , = '-:17. Rough Wiring Sign? s ..74 i , 6 '.I _ : ! t i . - 68. APPROVED FOR PLASTERING - - , ` '16.:,Rou h Electrical TBar Ceiilin l ! _ 9 9 - i_ . 69: POOL/SPA SYSTEMS FINAL - 19. RoughHeating& Air Conditioning 'i Wiebr (49 • ,FIRE DEPT.'REQUIREMENT __ 20.'�Rough Factory Fireplace I;' I 1 , I . APPROVALS Permit# - - , - 21. Ducts;in Structure j i I i ' � 70. Underground Hydro ' . 22, Ducts,IVertilating, l , 'i, , ; I ' , '71. Product'Piping 40 0Oi1 , '23.'Gas Pipe-Rough & Test ! 1 'l r j 72! Underground Flush i 24,.Roof Framing •_1 I ` 1 1 ;1;;I/I,, I r ; i : ;i n, n.I 1 73. Undergrnd.'Stolrage Tank:0 Gas 0 Oil ' 25.• Roof Sheathing , i � ? ,' i,c. f 17/f 27,it5 -wif ?74. Overhead Hydro , ' 26. T-Bar Ceiling (Structural)i& Monocoat ; I I I -. I ,751 Dry Chemical ' - . • ' 27. Frame and'Flashmg I 7/,„„23/5,5,..1 fig '76. Dry Standpipe 28. Lathing& Siding • , i I , • j1fr8ffxr Yl "'" t 77. FIXED SYSTEM FINAL.' • 29. Insulation t ` ', ff.; i Er/62/5- 74" !78. FIRE PREV. FINAL ' 30,'Drywall Nailing l : Notes '31.•.Plaster'Brown Coat li I ` ' ---' i • 1 ' i I ' I 32. Electrical Power Meter-Final • tl i •!( , •' _ (0'31' et r • 33.`Final Electric i- .1 ` • • c . -I . 34, Final'Heatirig&,Air Conditioning : 1 'Riz i& 4,0 - - 35. Final Gas Pipe-Test '- c I n. _ /6/Z2j'e$ ceO - • • 36. Hood or Canopy'' r, ? I - 1 ? , I - . - 37. Final Factory Fireplace ' -.i 2! !! - `1= ' • $ ` _ 38. Final Plumbing, I o: !i - .ke ir '( ! - 1, 39. Water9Service-Final • I ij 15/13665t CED ' . 40. Gas Service-Final ' ' ;) , 1 ' ' I ? • - • 41. Solar DbmesticIFirial ! I , _ - _ i- - 42. Backflow Preventer - _ ' i • •• 43. Backflow Irrigation ' .- 44. Landscape'Irrigation_System: 1 `, - - I , 45. Sound:Attenuation: 1:.-; . 1 ; ' , I - - 46. Handicap Regulations! , • H I - , _ , , 47. FINAL STRUCTURE'& BUILDING' lj7/� , 48. Special Requirements Completed d pru lu j'na" K-�' i 1 49. Electric Release to,Edisori i ' _ ...H. ...._ , _ -. _1_ . . __ f 50. Gas Release to Southern California Gas Co s ( ; ' ' i t i r; i - 51. CERTIFICATE OF OCCUPANCY l: _ +. -, I _ - . No ! /SOD Date ' Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 7997 0/02/05 CITY OF'COSTA MESA CONSTRUCTION PERMIT PERMIT NO. _ TRACT NO: LOT NO. UNIT NO. UoO`) j I, Project Address 2443 e .,/ r " 1 � 1.7 � (,q2 Z9/ 1 Applicant's Mailiinyg�.Address 2.� frt.(ei96,i 3 - TYPE OF CONSTRUCTION pl NEW U ADD LI ALTERATION LJ REPAIR Owner's Name MAW-e-e.D4.✓ _01.6-el Phon•S -094y ❑ CONVERSION ❑ DEMOLISH ❑ OTHER - A.P.# y35 _ o 7/ -A0 - ' - I Zone/t Z G-S -/ Com, �� DESCRIPTION OF WORK/USE OF BLDG. Address n rT S Main Building: • Accessory Building: Arch/Eng.- 011C S S 0 ef License No. C /2943 TYPE OF PERMIT LI GRADING U FOUNDATION U STRUCTURAL • E Front O Address IE TENANT 17:7 ELECTRICAL 111 PLUMBING Ill MECHANICAL B Rear - N [1:1 -OTHER . • A I. • Contractor's Name'a eAti t.lr ra a�it/J/S1Pone - - - C Right - N Address(mailing) •" - _ PROJECT DESCRIPTION SQ. FT. OCCUPANCY K - - G � �7� '•' CON ST RUCTION_TYPE VALUATIONS S Left .City License NO: (IU ZONE - GRADING CU.YDS. ACRES - R LICENSED CONTRACTOR DECLARATION / G _ _ - Ping. Ref.# Parking Req./Provided • - E ,1.hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: A' 4 -7(// 6 T< Planning Notes: 1 I ' - M IN ,with section 7000) of Division 3 of the Business • Profe ions Code,and JV TTT ,Vn- my license is in full force an• ffect. �/ eL, /� I(-y, 1 1. i t • T 9C1,r t -Licen • ,lass I— se N• 7�Q �3 lel IYJ�( .l - S 'Date - - 4. Signature A4 / • PLUMBING FEES -L., WORKERS'COMPENSATION DECLAR•T • •Bar Sink ' Showers ' J •ereby affirm that I have a certificate of consent to self-Insure or a certificate. i ELECTRICAL FEES Workers' Compensation Insurance, or a certified copy thereof (Section .-1800, Lab. C.)d S �4 Backflow Preventer '- Service Sink A2 ` Automatic Washer - Transformer' 0 15.50 KW - Policy No. Company 9 f*I//f Backflow Irrigation Sewer Ca0 50+ KW `--� P r Construction Pole Sub.' ertified copy is hereby furnished. - Cejeiafied co filed with the city Ilion. - Bathtubs -, Sewer Connection Cooking Unit Meter Duct to 100 amps D ted7- /'4/ Applicant ' EXEMPTION FROM WORKERS'COMPS SATION DECLARATION Clarifiers Solar Collectors ' Dishwasher Meter Clover 100 amps Dishwasher (This section need not be completed if the permit Is for one hundred ($100) or, less). - Solar Piping Dryers OGas ❑Electric Sub Panel I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Drinking Fountains.' Solar Tank Fan • Motors❑0-1 HP ❑1%-8 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 09-15 HP 016.15+ Workers' Compensation provisions of the Labor Code, you must forthwith - Floor Sinks - Urinal Fixtures - - - - comply with such provisions or this permit shall be deemed revoked. Microwave CONSTRUCTION LENDING AGENCY • GaSService Outlets Water Closet Device Boxes I hereby affirm that there is a construction lending agency for the performance Pole Light of the work for which this permit Is Issued (Section 3097 Civ. C.) I - nterceptorsWater Heater Outlets Range ' Lender's Name 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 • - GarbageDisposal osal following reason (Section 7031.5 Business and Professional Code: Any city or ;Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P-Trap • LaUndr .Tra s any structure, prior to its Issuance, also requires the applicant for such permit . • I y y Generator 065 KW 05.15 KW Trash Compactor• to file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains • the Contractor's License Law(Chapter 9(commencing with Section 7000)of •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). - penalty as owner of the property'or my employees with wages as'their sole Reinspection Fee I $15 Issue Fee • $ 3 compensation, will do the work,and the structure is not Intended or offered _ - Reinspection Fee I $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's • • MECHANICAL FEES License Law does not apply to an owner of a property who builds or Improves - thereon, and who does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for, Boiler Hood or Type I ❑ sale. If, however, the building or improvement Is sold within one year of com- Canopy Type II 0 Zoning Approved By Date pletlon, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Date prove for the purpose of sale). _ - �^ . ^ • ❑ I, as owner of the'property,am exclusively contracting with licensed con- Duct-Structural . Refrigeration System Application Issued By• ✓�` Date Z-' tractors to construct the project(Section 7044,Business and Professions Code: ' The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00.100,000 BTU 0100,000 BTU SUMMARY OF FEES builds or Improves thereon,and who contracts for such projects with a COO- ' ' tractor(s) license pursuant to the Contractor's License Lav). I am aware that BUILDING PERMIT $ SMIP $ proof oftheir Worker's Compensation Insurance should be provided to me. Exhaust System ❑ Multiple ❑ System Repair/Alteration //� PLAN CHECK $ • PERMIT, ❑ I am exempt under Section B.6 P.C.for this reason / Firepl/Fact.Bit. !CBO# ((q' Fire Dampers Y "XPLUMBING $ ISSUANCE $ • • Date - owner Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $ -I hereby certify that I have read-this application and state that the above ❑6100,000 BTU 0100,000 BTL GRADING $ information.is correct. I agree to comply with all city and county ordinances I - ELECTRICAL $ and state laws relating to building construction,and hereby authorize repro- - _ t MICROFILM $ sentatives of t . ny enter upon the above-mentioned property for . • PLAN CHECK 50% $ C7 �d�57;y�jJy MECHANICAL' $ -7 ••bn TOTAL FEE $ �.Oa inspection purp/`P`� r- _G/ I t lire Date a G J Reinspection Fee ' $15 , Issue Fee ,$ 3 PLAN CHECK ' 25% $ I -(Y) ' 1 Drivers' License or SS$ - CMF 0865-46,rev.10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor , 1CONSTRUCTION AND PLANNING SPA APPROVALS Permit# Date Inspector APPROVALS kvrmit# Date Inspector „1. Temporary Electrical Service or Pole '. 52. Pool & Equipment Location • 2. Soil Pipe'-Updrgrnd. .3 r*' 53. Steel Reinforcement 3.,Electcal•Conduit � Utility-Undrgrnd. �' 54. Forms �.. 4rElectrlca1Cdnduit-Undrgrnd. -�, 55. Electrical Bonding .6ti 5. Steel ReinfQrcemenj; 56. Rough Plumbing & Pressure Test „ 6.fEle"ctiicel UxFER`$'irnd. 57. APPROVAL TO COVER-GUNITE 7::;0ootingsJ I �) 58. Electrical Conduit-Undrgrnd. 8. ,Fobntgation. 4 Alt 59. Gas Pipe, 0 Undrgrnd.,Test 9. WateffPipe-Undrgrnd. .!/ i! " / 60. Backwash Lines, P-Trap, 0 Undrgrnd.• .` 10. St?uctural Floor'System ' „( ;1 61. APPROVAL TO DECK 11. Prqperty Sewer ale & House Conniption 62. Backwash & Receptor-Final 12. Sewer`Carp 63. Heater & Vent-Final 13. Roo1•Drins � % 64. Plumbing System - Final 14. RoughPlumbing ' 65. Electrical-Final 15. Roudh 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 yl tear Lao APPROVALS Permit# • 21. Ducts, in Structure i? til 70. Underground Hydro 22. Ducts;Ventilating 71. Product Piping 0 Gas 0 Oil • 23:) Gas Pipe-Rough & Test i • 72. Underground Flush 24: Roof `, 73. Undergrnd.Storage Tank 0Gas 0 Oil 25. Roof Sheathing ;1 - 74. Overhead Hydro 26. T-Bar Ceiling (Structural) 9. Jlonocoat 75. Dry Chemical 27. Frame and Flashing76. 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. FinaLkactory Fireplace l0lzq/a'!X60 • 38. Final Plumbing 39. Water;Service-Final 40. GasrService-Final 41. Solar:Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation r 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 MEA . CON$ R CTION PERMIT PERM T NO. J TRACT NO. LOT- NO. UNI Nd.. .4•210".% a.t�t,�y �� A / ?2 � • • 6172 7/08/85 21475 TL Project Address �I '' _' LJ - Applicant's Mailing Address (Z, /ysy[�/�ri�4�5 �Wpy r.� TYPE OF CONSTRUCTION U NEW U ADD U ALTERATION REPAIR • ee Owner's Name - A44* L '� C✓ PhonArliaC ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P..h6 Zone /�..Y` A- - DESCRIPTION OF WORK/USE OF BLDG. — Address 2yr c4*,g. "9s e,.t rr S Main Building: Accessory Building: c • E Z Arch/Eng. J� License No. - TYPE OF PERMIT U GRADING ❑ FOUNDATION U STRUCTURAL T Front •- - - O Address I ,A�.�w� ❑ TENANT ❑ ELECTRICAL 0 PLUMBING ❑ MECHANICAL B Rear N Contractor's Name' /CC/11.062) /t Phone $Q 0 OTHER A 1 Address(mailing) /2/7 Cats Atka" wy "•� PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right - G O CONSTRUCTION TYPE VALUATION$ S Left City License No. _ 6 y� ZONE GRADING CU.YDS. ACRES PIng. Ref.# Parking Req./Provided E LICENSED CONTRACTOR DECLARATION r I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: Q 1 with section 7000) of Division 3 of the Business and Professions Code,and my license is in ful force and effect. roT License Class — 1 Inse No pJJ S • Date Signature PLUMBING FEES ' • WORK RS COMPENSATION DECLARATION Bar Sink Showers • ' hereby affirm that I have a certificate of consent to self-Insure or a certificate ELECTRICAL FEES f Workers' Compensation Insurance, or a certified copy thereof.(Section Backflow Preventer - - Service Sink - - 3800, Lab. c.) Automatic Washer Transformer ❑ 15.50 KW • Policy No. Company Backflow Irrigation Sewer Ca - ' 0 50+ KW ' B Certified copyp Construction Pole Sub. is hereby furnished. Certified copy Is filed with the city Building Division. Bathtubs • Sewer Connection iJr. Cooking Unit Meter ❑up to 100 amps Date Applicant EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers . Solar Collectors Dishwasher Meter Dover 100 amps (This section need not be completed if the permit Is for one hundred ($100)or less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel ' I certify that in the performance of the work for which this permit is issued, I - - ' • ' shall not employ any person in any ma ner so as to become subject to the Drinking Fountains Solar Tank Fan: Motors❑0.1 HP ❑1'h 8 Worke�/Cy�9bp95a['pn Laws of Calif rn , / __ Date ��/ 3sSignature +.-✓ Floor Drains Swimming Pool w/Spa F.A;U. 'NOTIC I ,after making this declare on,you should become subject to the ' •Inc.Solar 09-15 HP 016.15+ Workers' Compensation -provisions of the Labor Code, you must forthwith - Floor Sinks • Urinal Fixtures comply with such provisions or this permit shall be deemed revoked. Microwave CONSTRUCTION LENDING AGENCY -Gas Service Outlets - Water Closet Device Boxes I hereby affirm that there is a construction lending agency for the performance Pole Light • of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater - • Outlets Lender's Name Range Lender's Address ` Kitchen Sink Water Service OWNER BUILDER DECLARATION Switches Sign 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 - Laundry Trays Generator ❑0.5 KW ❑5-15 KW any structure, prior to its Issuance, also requires the applicant for such permit Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains - 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 . ;erefrom and the basis for the alleged exemption. Any violation of Section 831.5 by any applicant for a permit subjects the applicant to a civil • penalty of not more than five hundred dollars($500). 0 I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 • compensation, will do the work,and the structure is not intended or offered - Reinspection Fee I $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES License Law does not apply to an owner of a property who builds or improves _ _ _ __ - - thereon; and who does such work himself/herself or through his or her own - - - - - - DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for Boiler • Hood or Type I 0 sale. If, however, the building or Improvement is sold within one year of com- 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 l prove for the purpose of sale). / 9/5.5- tractors ) p ❑ I,as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date / 9 8� 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 'Z Duct-Ventilating r 00-100,000 BTU 0100,000 BTU d SUMMARY OF FEES builds or improves thereon, and who contracts for such projects with a con- tractors) license pursuan(to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ • PERMIT 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers PLUMBING i $ ISSUANCE $ Date owner �Herating System& Ducting 7 Registers 7' e7 PLAN CHECK 25% $ ENERGY P.C. $ Thereby certify that I have read this application and state that the above j p10.100,000 BTU 0100,000 BT �y�. GRADING $ information is correct. I agree to comply with all city and county ordinances + Q.E" ELECTRICAL $ • and state laws relating to building construction,and hereby authorize repre- T PLAN CHECK 50% $ MICROFILM $ 'sentatives of this city to enter upon the above-mentioned property for nspectio- p •oses. fre MECHANICAL $ TOTAL FEE $ gl.2� rivers' • se!� Date�/� //11--1s � 1 165-46,rev.10/84 White - Building; Canary - Applicant; Pink•-Accounting; Goldenrod - Assessor ' 'CONSTRUCTION AND PLANNING POC - SPA , i' APPROVALS Permit Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole-, ' 52. Pool & Equipment Location 2. Soil PipeiUndrgrnd. - 53. Steel Reinforcement • 3.;Electrical Conduit Utility-Undrgrnd. 4 54. Forms 4.:Electrical Coinduit-Undrgrnd. 55. Electrical Bonding 5'''Steel.Reinforcemenf' ; - 56. Rough Plumbing & Pressure Test 6. Eleetricaf OFER.Orntl. 57. APPROVAL TO COVER-GUNITE 7..Footings' -. 58. Electrical Conduit-Undrgrnd. -8: Foundation '; 59. Gas Pipe, 0 Undrgrnd.,Testft •9. Watei'fife-Undrgrnd_ I rt 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.'Sebver,Cap - 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final • 14.•.Rodgh 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 yi-- ,rt 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 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 It/U45" 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. FINAIL STRUCTURE & BUILDING 48. Special Requirements Completed 49.-Electric Release to Edison - • - 50. Gas Release to Southern California Gas 03 51.', CERTIFICATE OF OCCUPANCY - - No. Date • r • �_ a • • • City of Costa Mesa Development Services Department CERTIFICATE OF OCCUPANCY No. 001465 Building Safety Division t P.0.Box 1200 ) Costa Mesa.California } The Building located at 2603 Elden Avenue #B `i, has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto - •C `_! for a Group R-3 Occupancy. fUse of Building COAC�OIID. IItID1 ;;. Legal Description 439-071-10-15 Ai (See reverse side for Metes and Bounds) trl • Building Permit No G18474 Electrical Permit No. G18474 Plumbing Permit No. x18474 it Mechanical Permit No. 018474, M19766, M20173 Number of apartments ands/or guest rooms ISSUED TO: Building Official 12, K ' ? Mar-Elden Development C ;, 18226 W. ttDurnntt by / ' U/��/G�T Irvine, CA 92714 Date 3 Ag-c. MlPS 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. A CMF 1015-46 rev.1/a3 White-Owner;Canary-Numerical File;Pink-Bldg.Permit File R 'ff City of Costa Mesa Development Services Department CERTIFICATE OF OCCUPANCY No. Vitt .E0(3�5 Building Safety Division P.0.Box 1200 Costa Mesa,California The Building located at 2603 Elden Avenue OB has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group E-3 Occupancy. Use of Building COndoitiini.tzn Legal Description 439-071-10-15 �. (See reverse side for Metes and Bounds) • Building Permit No 018474 Electrical Permit No. 018474 Plumbing Permit No. r1R474 Mechanical Permit No. 018474. M19766, h120173 Number of apartments and/or guest rooms ISSUED TO: Building Official 15, ki ' Mar-Elden Development 18226 W. McDirnvtt by / • e Irvine, CA 92714 Date 3 /l e_ 19 O p S • 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 �/ Applicant to fill in all spaces1 • • `- 5 except those within heavy border lines and sign all appropriate declarations. CI' C TA MESA; PERMIT(N�O. —1 TRACT NO. LOT NO. BLDG.NO. ^c b3 II/1 il:j ' ' T ip?" T� �O Ti7•CfCT10N PRMIT i t'. G Pro 1 J�� 9yTh, Pp g 18996TYPE OF CONSTRUCTION NEW U ADD U ALTERATION • I A licant'a Mallin Address p - I.qq III f U REPAIR - - ProjectAddress 2603 (Elden A , 8 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER - - - • ! - Owner'sName Mar-Elden navel npptgpj; Phone 47,1 0601 DESCRIPTION OFWORK- ��� ��^ 1!yq!'� - ZO7dN�ING REGULATIONS Address' 18226 W. -SterihBOtt, Irvine C1296392714 TYPE OF PERMIT ❑ GRADING FOUNDATIONjCUSTRUCTURAL' A.P.9bci5g -a7)-/ -?; ZONE Ian Arch/Eng.� Chri's R. Stephens ' License No- ❑ TENANT• ELECTRICAL 'PLUMBING,MECHANICAL ' !LNG. REF-0 eye"- t17 • BUILDING SFreerr r•rr cr yy Address 18226 W. McDurmott,• Irvine 92714 ❑gTHER ' - • /� q TO BUILDING d.�• EAR YARD ie igPL)C -, I� 1 GLS Contractor's NameThP Rlrhd P[I F- Erawfprr�lf ba, 474-0561 PROJECT DESCRIPTION, SQ. FT. �e 41-70ccuPAN V !`�-•� PROPERTY LINE' 11-H CONSTRUCTION TVPF ' • VALUATION$ .LEFT SIDE YARD 1 -• RIGHT SIDE YARD 1 .61__5_,„, , - - Address(maifing) 18226 W. MCDurmott, it ins 94/, �� ' •� 1 +3ed/ ( f ZONE GRADING CU.YDS- • ACRFS ' • 1 PKG.SPACE:REG. 3671 PROVIDED 30 / :�'y2 ' License No. • '. - i 13 f 3‘/--,0;? .r d LICENSED CONTRACTOR DECLARATION , Remarks: FC' 7e0.--- gGiL STREET WIDTH 'PARK FEES 7 _Q • I:herebction that I am licensed under provisions of ter 9(commencing , 1 • with section 7000) of Division 3 of the Business an• les ons Code,and 1 _ SPECIAL CONDITIONS: ----- •b.*W�. my license Is In full/o e and effect. - I • ` - ,ap :• +: License Cl.ss .�' �_ U N. i _ , PLUMBING - ; 1 lIuEJ FOR SPECIAL REQUIREC1EdT.� - Data ' '�� Signature L �'� /�• - • ' Bar Sink: Sewer Car ! - ELECTRICAL, WORKERS'COMPENSATION DE - R' 1• Automatic Washer i • Meter ©Over 100 amps i �. 1 'Workers that I have a InsuranceCompensation ,;or a Certified copy thereof (Seaton - _ - _ , -^ "sb0, Lab- C.)% r , • �- _ , - -- .• Construction Pole. ' „I '7 Sub Panel �,I 'C �/ Backflow Irrigation , , Solarr/Collectors -- - Pollc�y/No. `rESd s40- Company -S7n.,� �9 :'/ 1 1 Cooking Unit - ' '•1 , Sub Pole - �°rtifled copy is!7 rebyfurnished. ' �• . I+ 1 L. Bathtubs •i" 1 , 1 Solar Piping f - < - , ; k(ND - , - ' ' , i ` i y�e rtdd copy re!with the city Bui Isi J•. l , - /'„ Dishwasher ' j.I 11 ( t Motors 0o-1 HP ❑1X$ I'..:� I ate y'/I-0. , • Applicant � !_ /' +' ' Clarifiers i Solar Tank _ i _ �. EXEMPf ION,FROM'WORKERS COMPENSATIO'� ' ARATION-- ` � Dishwasher Swimming Pool W/$pe ! .: :.n�Drye•rs-�GasT❑Electric -• '-.- line SolarlOS,15 HP ❑16-15+ •i �1'.l�C� , I (This section need-not be completed If the permit is for one hundred ($100)or l; I i ' - 2_00 , , less): ' .. .. , I - • /- Fan i i '/ (Microwave I t • L�'�b, I certify;that In the performance of the work for which this permit is Issued I.-• : Drinking Fountains I Urinal : ? ; -' ' - shall-not employ.any person In any manner so as to become subject to the•. - -- ; • --' '•'CQNSTRUCTION A gri.,PLANNING is a s,-.._;,-; :•:-..; : ' ' r- - z.'POOL PA • - ' - - -, _1 %' " - € T, s - -;Date , Inspector; h Date- Inspector =APPROVALS�; Permit i , y> , APPROVALS:, Permit# ":i. ;Temporary Electripl Service,or Pole; _r ? - -52: Pool &'Equipment Location : _ Wit;- - _ _ -•i 2..1Soil Pipe-Undrgrndr o', 1 :,tl� /'/ / , . ,53 Steel Reinforcement -1: rt 1 - .'' _ 13. Electrical Conduit Utility-Untlrgrnd. ' �,_ r c; - _54: F,orms� , - - ;-," �. .'Electrical Conduit-Undrgrkd - ti ' ' i- 7 rte/ „rice. '55. Electrical Bonding;: _ r o l Ft:: � 1 ,.. ; . r :5.!Seel'Reinforcement ' I .! ° ,; 56. Rough`Plumbing:&Pressure Test ' . . ' ! • , i 1 S�iIES .8 - • I6.;Electrical_UFER1Grnd; j t ,. i,` : �'I , _ 57: APPROVAL TO COVER-GUNITE - • - t, ' 7.'Footings ko- --0-r-,e sG 9-.1• ! i ' �' ` _58. Electrical Conduit-Undrernd. - . -t sY 4 �r lss �h'1 8.'�Foundation ..1 j,( ; 72 •.)'1 r>14E 10s- ' -59. Gas Pipe.; Undrgrnd.,Test 9.'Water Pipe,Undrgrntl. 1 `/,:t , . ; - t2.." ,j,r,- ,. _ ,60• ;Backwash Lines;P-i-rap, 0 Undrgrnd:r. ` .. 10. Structural Floor System" r:;. 61.•APPROVAL TO DECK - ° '� 11_1Property Sewer Line&Houstdonnection,b& !4c j,gO • - _62. Backwash &Receptor-Final ' 12.:Sewer Cap 1 ' I I I "4 ;,' 1, -i in; 7 63. Heater&'Vent-Final. - 13."Roof Drains . : ' . t , _ f :64. .Plumbing System.•Final- i - , 14. Rough Plumbing 1 I ' e6 : '7/id/9f first '65. Electrical-Final -• - • • . - 15.rRo-ugFi"Ele`fic-rival-Conduit _-'"' ' --r -•- -"-" " 66: SolarSystem-Final" - -- - - • - - ` 16.iiRoughiElectric Wiring ; i Z: 1 1t 1i-2,-;t. : qj 2 - 67: Fencing&Abcess Approval 'c -7,---.---'- - ' 17.,iRough Wiring Sign.. v I C I 'I T i .• l ; L • .• , �68: APPROVED,FOR PLASTERING - - - 18' Rough Electrical-T'Bar Ceiling 1 ' _ ;- r ; = i i ? j • 69. IPOOLUSPA SYSTEMS FINAL - 19. Rough Heating & AircConditionin9 j '7/IWo?- i j I :FIRE DEPT. REQUIREMENT . - - ' ` 20 ;Rough Factory Fireplace - 1 a ; I j APPROVALS I Permit* - , 21 1Ducts*in,Structure; ; ' 11 t I 1 { 70: Underground Hydro 22. Ducts Vertilating y � I i71. Product ;Piping0 Gas OOil 23.0Gas Pipe FRough &Tests '' I . l,-_I__ '1 _' ' - -- j , - ,72: Underground Flush- -. - - - - - - - - :: r.24.'•Roof Framing. • ; r' I i' 1 - 'la,: i y,9 - -- •73. Undergrnd.Storage Tank 0 Gas D Oil , m?'I : zio •. 25: Roof Sheathing I ' J ! I :It;' ;/1_I/gam y 74i. Overhead Hydro L . - -.261 T,Bar Ceiling"IStructurallqoncoat & Mot , j R . :it' - ' _ , : ,75. Dry Chemical �. , . 27. F.ramelarid'Flashing 2 I' ,• ' zF r l S , ' 76. Dry Standpipe' , • h l u 1. 743/sr f3?�/ I .. 28:' Lathing &,Siding j' �' I 177. FIXED SYST• EM FINAL. • • 29:1 Insulation` f , c ' .' I 1 1, 78. FIRE PREY. FINAL 1 ' 30l.Drywall Nailing >• ' 1 fl ii,: ,1 I Notes: 31'1,Plaster Brown Coat ; ' 1 It ' ' 1 I j -. - - '--i -, ' • 32. Electrical Power Meter-Final I �; • I 1 1 331 Final Electric ' ' ' II I ?r L .. �I 1 34. Final'Heating& Air Conditioning i. i bf azJ<> 6C9 - i. - 35. Final"Ga's Pipe:reit'" '. ' ^ ' 9.2i i - `jq'-�j` G0,0 • - " j_ - 36. Hoodyor CaI [•,i1 .. 'r.I 1 "1 n '- , _ I- i • I - ' - '' " l` I- _ - - p, 37. FinaltFactory Fireplace I o x I i,, 1_- 7 -' •�Q ' . i ' ri, - - _ 38. FinalhPlutnbing I j' 1 i I e, j 7+pfr Sr •- 39. Water= Srgice-Final i- 1 ''j 0' L d!.J - t.04 ; . - r. , r I l l 40. Gas Ser , vice;Final I ! V. ii i i : i I I _ . i . 41. Solar;Doniestic-Final l I .6: " I I , - • 42. Backflo Preventer1 1 I ± r--, -- _,` ; j_. _ -- - -_ . ,- _ J._ , - ,r • - , fL, 43. Backflow irrigation'i ! ', 1 j?�'_• g i ' , i• , , - . - _ , 44. Landscape Irrigation System 1 i = I , . 1 r 45. Sound:iA • • T c ttenitationi�;,� I ( I li I ' I " I I i I i - I I I - • - 46. Handicap Regulations .1 t- I I .•, I '_ 47.•FINAL STRUCTURE &BUILDING F l i/ It 'e-vii , i ' • . • 48. Special RequirementslCompleted C j L j-8J ,k4� • I ' , - r . 49. ElectricljRelease to Edison It L-4.--!-I i ' • ' . s50. Gas Release toSouthern California Gas'Cv I . , I • ' 51. CERTIFIC.,1 �O OCCUPA g .. ' _ I. '. 'No n I� 'Date �1i0 !L 6 Fe. Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. . • CITY OF COSTA MESA�1 // CONSLTR CTION PERMIT�1/ I D )71,1MIT NO. 7 /y TRACT NO. LOT NO. UN�/(�S���ID. 61 76 7/08/85 21975 It Project Address pt:IGC?37 eebtof/ efv� -PS " " — / I ? F-, 1 '. T- .x,397: 7s. Applicant's Mailing Address 2/7' su..�^ TYPE OF CONSTRUCTION U NEW U ADD U ALTERATION LJ REPAIR Owner's Name �/ /�r$IV GL(/C (I Phone�Vitt-Ser DI CONVERSION DI DEMOLISH DI OTHER q,p•# • • I ZOn¢ Z`!S ,CeseA CZ A'VE. 4,.M// r DESCRIPTION OF WORK/USE OF BLDG. E Address S Main Building: Accessory Building: t 4 IW License No. T O Arch/Eng. 5 / t TYPE OF PERMIT 0 GRADING U FOUNDATION ❑ STRUCTURAL Front Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N Contractor's Name 6siz-2371 DI OTHER A I (����(,� M" [.� Phone C Right - N Address(mailing) /Z''7 . Last$ ArttJII/415 Cji/"1-7 PROJECT DESCRIPTION SQ. FT. OCCUPANCY K Left G • CONSTRUCTION TYPE VALUATION$ $ City License No. _ Ip�3 Q ZONE GRADING CU.YDS. ACRES E LICENSED CONTRACTOR DECLARATION Png. Ref.# Parking Req./Provided Q I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: Planning Notes: M with section 7000) of Division 3 of the Business and Professions Code,and my license is In fu force and effect. - ' - - T • License ass + 'r nse No.Z aY cis S Date Signature PLUMBING I FEES WORKERS COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL FEES I hereby affirm that I have a certificate of consent to self-Insure or a certificate f Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink 1800, Lab. C.) - Automatic Washer Transformer 0 15-50'KW Policy No. Company Backflow Irrigation . - Sewer Cap. -: Construction Pole Sub. - 0 50+KW • 8 Certified copy is hereby furnished. Certified copy Is filed with the city Building Division. Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps Date Applicant - EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers • Solar Collectors Dishwasher , Meter Cover 100amps (This section need not be completed if the permit is 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, I shall not employ any person in any manger so as to become subject to the Drinking Fountains I Solar Tank Fan Motors❑0.1 HP Di h-8 Workeyo etion Laws of Calif Orf i•�1 ) _ Date Y/•{7 Signature L.V rn J 1.�� Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar ❑9-15 HP 016-15+ • 'NOTI I ter making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith - Floor Sinks Urinal - Fixtures ' Microwave comply with such provisions or this permit shall be deemed revoked. • CONSTRUCTION LENDING AGENCY ,— - . • Gas Service _Outlets Water Closet Device Boxes I hereby affirm that there is a construction lending agency for the performance - Pole Light of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Name Rang¢ • 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 following reason (Section 7031.5 Business and Professional Code: Any city or Garbage Disposal !Standing Sections • county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays Generator 00.5 KW 05-15 KW Trash Compactor any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of ."Drains - - , the Contractor's License Law (Chapter 9 (commencing with Section 7000)of Division 3 of the Business and Professions Code) or that he/she is exempt `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, as owner of the property or my'employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 " compensation, will do the work,and the structure Is not intended or offered - Reinspection Fee $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own Boiler Hood or Type I 0 DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not Intended or offered for Zoning Approved By Date sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Data orove for the purpose of sale). /� �{ ^� I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural • Refrigeration System Application Issued By (yam{Y/ /Date tractors to construct the project (Section 7044,Business and Professions Code: 3�' The Contractor's License taw does not apply to an owner of property who Z Duct-Ventilating ❑0.100,000 BTU ❑100,000 BTULSUMMARY OF FEES builds or improves thereon,and who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple❑ I System Repair/Alteration BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation insurance should be provided to me. • ED & • PERMIT ' PLAN CHECK $ PI am exempt udder Section B. P.P.C.C.for this reason Firepl/Fact.lilt. ICBO# Fire Da pe s �J PLUMBING $ ERMI ISSUANCE $ Date Owner Heating System& DuctingRegisters PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have read-this application-and state that the above = I K0.100,000 BTU 0100,000 BTL - - - $ GRADING $ information is correct. I agree to comply with all city and county ordinances • ELECTRICAL and,state laws relating to building construction,and hereby authorize repre- sentatives PLAN CHECK 50% $ MICROFILM $ sentatives of this city to enter upon the above-mentioned property for ' inspection pur es. tg} Signature — Reinspection Fee $15 Issue Fee • $ 3 PLAN CHECK 25% $ e 7 • a _ CMF 0865-46,rev. 10/84 White - Building; Canary "Applicant; Pink -Accounting: Goldenrod - Assessor 1 CONSTRUCTION-AND PLANNING POOL SPA Date Inspector Date Inspector APPROVALS Permit# APPROVALS Permit# 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe=Uridrgrnd. 'T, 53. Steel Reinforcement • ' • 3: Electrical Conduit-Utility-Undrgrnd. 54. Forms 4, Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5,%ateelReinfiiicement; J 56. Rough Plumbing & Pressure Test 6.,Electrical UFER-Grad, 57. APPROVAL TO COVER-GUNITE ' 7,7Footings •' 58. Electrical Conduit-Undrgrnd. 1' 8 ;Fouridation • 59.. Gas Pipe, 0 Undrgrnd.,Test �. 9:WaterYPipe-Undrg'rnds 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10,:,$truciural Floor System • 61. APPROVAL TO DECK 11, iPrgperty Sewer Line & House Connection i 62. Backwash & Receptor-Final 12.jSe4yerCap 63. Heater & Vent-Final • • • 13.11toof,Dr'ains 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 /48/6 Cin 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush p 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 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 (fifie eap 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 431 Backflow Irrigation 44.1 ,Landscape Irrigation System 45.E Sound Attenuation A 461 Handicap Regulations 47.1 FINAL STRUCTURE & BUILDING 481 Special Requirements Completed 491 Electric Release to Edison 501 Gas Release to Southern California Gas Co 511-CERTIFICATE OF OCCUPANCY No. . I Date r I Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. - 7998 8/O2/85 Geon TL • din,•OF COSTA MESA CONSTRUCTION` ' PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO. 1 • Project Address ZGO3 J f1G L�f`C0)/ �‘ 3 per''/,/ • • - I 1 Applicant's Mailing Address 2 ys tic-ib00.0 C TYPE F CONSTRUCTION CTION VNEW�LJ ADD U ALTERATION REPAIR Z ,3ke� Phon O ❑ CONVERSION ❑ DEMOLISH ❑,OTHER A.P.916 V 49 -4'7/-/v -Sr I Zone .2 Owner's Na�smlIott . DESCRIPTION OF WORK/USE OF BLDG. .• �7 >7 • Address .24 r Ciersa rC AI": Ti C M- . . S Main Building: Accessory Building: , Arch/Eng. CO #.: -STS License No. 12� TYPE OF PERMIT LIGRADING ❑ FOUNDATION ❑ STRUCTURAL T Front - 0 'Address /� L� ❑ TENANT>❑ ELECTRICAL 0 PLUMBING ❑ MECHANICAL B Rear - N /� d /S-O toK ❑ 'OTHER A - - I Contractor's Name."7/ tea ` hone. PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right N . Address(mailing) T7I, f CONSTRUCTION TYPE VALUATION$ $ Left G City License No. >7tg ZONE - • GRADING CU.YDS. ACRES R LICENSED CONTRACTOR DECLARATION -' ^ Ping. •Ret. Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: �� 7�G .&'`G Planning Notes: - a (�('� with section 7000)of Division 3 of the Business and Professions Code, and T - 1 , M W my license is in full torceygtl effect. I/ tG�� 67 I/1r I S 1 License class /��� L icense No. (f O PLUMBING FEES 1 Date_�L/_tJ_ Signature • 1 • WORKERS'COMPENSATIONDECLARATION Bar Sink Showers 1 • ELECTRICAL FEES I hereby affirm that I have a certificate of consent to Self-Insure or a certificate • 1 Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer - Service-Sink - - - --- - - - - 00, Lab. c.) /�'',,/) - Automatic Washer Transformer-0 15-50 KW .•olley No. Yj�J Company - � F ritizo Backflow Irrigation . I Sewer Cap•• Constructiori•Pole Sub. . 0 50+ KW Atecopy is hereby furnished. - Certi{jed copy 0.is al ed with the city suis n. Bathtubs Sewer Connection Cooking'Unit 1 • Meter ❑up to 100 amps D OG I f -al Applicant • EXEMPTION FROM WORKERS'COMPEN ATION DECLARATION Clarifiers j Solar Collectors Dishwashers. Meter Dover 100 amps (This section need not be completed if.the permit is for one hundred ($100) or - - - less). ' Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Drinking Fountains' Solar Tank Fan Workers' Compensation Laws of California. - Motors 00-1 HP 011/2-8 • Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP 016-15+ 'NOTICE: If,after making this declaration,you should become,subject to the Workers' Compensation provisions of the Labor Code, you must forthwith. Floor Sinks - Urinal - Fixtures comply - . - comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY -Gas Service Outlets • Water Closet Device Boxes • ' I hereby affirm that there is a construction lending agency for the performance Pole Light of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water HeaterOutlets r Lender's Name - Range Lender's Address Kitchen Sink •- Water Service Switches OWNER BUILDER DECLARATION Sign I hereby affirm that I am exempt from the Contractor's License Law for the _ Lavatories ' Auto-Wash • Garbage Disposal ;Standing Sections • following reason (Section 7031.5 Business and Professional Code: Any city or s county which requires a permit to construct,alter,Improve,demolish or repair P-Trap Laundry Trays Generator 00-5 KW❑5-15 KW Trash Compactor any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains • 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 . 131.5 by any 'applicant for a permit subjects the applicant to a civil - - . salty of not more than five hundred dollars($500). O I, as owner of the property or my employees with-wages as their sole - Reinspection Fee I $15 Issue Fee ' $ 3 compensation, will do the work,and the structure Is not intended or offered Reinspection Fee $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES License Law does not apply to an owner of a-property who builds or improves - thereon, and who does such work himself/herself or through his or her own Hood TypeDEVELOPMENT SERVICES REQUIREMENTS: Boiler or employees, provided that such Improvements are not Intended or offered for I 0 I sale. If, however, the building or Improvement is sold within one year of com- Canopy Type II ❑ Zoning Approved By Date Mellon,the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground Building Approved By Date prove for the purpose of sale). • - ' ❑ I, az owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By arDat tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00.100,000 BTU 0100,000 BTU • SUMMARY OF FEES . builds or Improves thereon, and who contracts for Such projects with a con- - ' • tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration 4 BUILDING PERMIT' $• SMIP i $ proof of their Worker's Compensation insurance should be provided to me. 1 PLAN CHECK $ PERMIT f O I am exempt under Section B.& P.C.for this reason / Firepi/Fact.Bit. ICBG llL�I Fire Dampers d,_ PLUMBING $, ISSUANCE $ Date • I • Owner I Heating System& Ducting- \ Registers . ENERGY P.C. $ ' - PLAN CHECK 25% $ -I hereby certify that I have read this application and state that the above ❑0-100,000 BTU-0100,000 BT ' GRADING • Information is correct. I agree to comply with all city and county ordinances ELECTRICAL $ $ and state laws relating to building construction, and hereby authorize repre- PLAN CHECK , 50% $ MICROFILM $ sentatives of this ci en r upon the above-mentioned property for • Inspection purposes. G �O'/ • - MECHANICAL $- TOO TOTAL FEE $ �• �1 Signature -Accounting; Goldenrod - Assessor + CONSTRUCTION AND PLANNING f POOL PA ' APPROVALS Permit# Date' Inspector APPROVALS Permit# • Date Inspector " 1. Temporary Electrical Service or Pole '�' 52. Pool & Equipment Location 2. Soil Pip-Undrgrnd. �: 53. Steel Reinforcement 3. Elect i,Cal Cinduit'Utilit Undr rnd. f ,:.0; Y- 9 'l /` 54. Forms L. 4.'Electi2Cal Conduif-Uadrernd. (it • ;• 55. Electrical Bonding 4( 1 ' • 5.-Steel Reinforcement,2a -1) 56. Rough Plumbing& Pressure Test - ! ¢, - in 6., Electfio4l cfER Gei1tl+'t 57. APPROVAL TO COVER-GUNITE 7.i,Fbotings \.41, !..S 58. Electrical Conduit-Undrgrnd. 8,t fiounda tion }},. ) 59. Gas Pipe, 0 Undrgrnd.,Test o 9.'Water,t e-Undrgrnd. / ;ii ) 60. Backwash Lines,P-Trap, 0 Undrgrnd. , � j 1, 10.'Sjructurtl Floor System ) 61. APPROVAL TO DECK 11.' Property Syr Line & House Connection �• 62. Backwash & Receptor-Final ,si • 12. Sew@r:CapL/it% ,l; 63. Heater & Vent-Final r 13. Roof•Draine `:� . 64 . Plumbing System - Final 14. RoughPiddlingI 'V ' 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 (.2 deks CSO APPROVALS Permit# _ 21. Ducts, in Structure ' ' 70. Underground Hydro 22..Ducts, Ventilating 71. Product Piping OGas DOiI 23:'Gas Pipe-Rough& Test •i 72. Underground Flush 21.,Roof Framing 'a - 73. Undergrnd.Storage Tank ID Gas 0 Oil 25'. Roof Sheathing ri: - 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 1 • 33. Final Electric Notes: 34. Final Heating& Air Conditioning - 35. Final Gas Pipe-Test 36. Hoodor Canopy , , 37. Final•Factory Fireplace /0/247/3-3 �O 38. Final Plumbing - • 39. Water Service-Final - • 40. Gas-Service-Final 41. Sola::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 ' 8 - CITY OF COSTA MESA 4L, 9 BUILDING DIVISION F• ', DEVELOPMENT SERVICES DEPARTMENT P MIT NUMBER opike qy PERMIT B07-00110 BUIbOINC PERMIT (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.dt.45 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 2603 ELDEN AV Status: ISSUED Suite: C-D Applied: 01131/2007 Vicinity: Issued: 01/31/2007 Primary Occ: R Type of Construction: V-N Parcel Number: TPN007002 Zoning: Applicant: ANNIE PATTISON / Address: 101 THE MASTERS CIRCLE Phone: 714-444-1111 c� COSTA MESA,CA - „ . ,Zip: . 92627 ISSUED BY: Owner: MAR ELDEN"SQUARE HOA Address 2603 ELDEN AV, - Phone: ; COSTA-MESA,CAS , _ Zip: " 92627 - - (, A •- ' . Contractor ALL COAST.ROOFING'AND COATINGS Address:/' 101 THE MASTERS CIRCLE" Phone: 714-444-1111 - COSTA MESA,CA' . - - Zip: 92627',V' o/ License: 598440 v /,: :V , Arch :,/ c //IV/ Eng: ; Address: Address: " Phone: ' , - Phone: License: - -_ `' � License: SCOPE OF PERMIT .- . RE-ROOF OVER EXISTING LAYER.INSTALL 30 YEAR GAF TIMBERLINE SHINGLES,4:12 PITCH AND 2300 SQUARES FOR CONDOS.BLDG C-D FEE SUMMARY Plan Check • $0.00 ,` / -.' ._ (-r / • - •,, sCalcValuation: 52,300.00 Permit:' $83.25 , ‘' •-'1 — -1 ' ✓ /i - • • • • : v.'Claim Valuation: 52,300.00 • SMIP Res:- $0.50 SMIP Corn: r $0.00 ' I' Other: $0.00 - Inspection; , $0.00 _ _, Total: ' $83.75 PLANNING & ZONING SETBACKS , MAIN STRUCTURE Front VAS Q 0 Rear )"0-0 Left : 0-0. Right 0;0, ACCESSORY - Front '0-0 -•':=-'Rear - 0-0 Left 0-0 Right 0-0 , �// PARKIN(ic Existing:,` 0v� Required 0 a - Proposed: 0 ' ' • /, - .. , i NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21.92) EXPIRATION: 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. r1.. 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 2448-48(8/00) iv DECLARATIONS s. WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ Ive 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 _ ark for which this permit is issued. _ ba —I have and WI 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 wo corn.pyens�`0p�nynsuranco carder and policy number are: Cartier: i�1-�- of L... Gdlcy.Number: 7-9157/37 'Mils sect not be cornAreted a the permit is valued et one hundred dollars(6100)or less.) 0- I certify that in the perform of the work fo wh this permit is issued.I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Ca'ornia.and agree ,t if should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provi is. '/ / -Applicant Signature: �•p 1 CDetd - - /pi /o7 FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE is UMAWFuL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PE RES AND CIVIL FINES uP TO ONE HUNDRED THOUSAND(OUARE(51 W,000).IN ADDIRON 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 Professions Code,and my license is in full -force and effect.Lie.a Class a C -Cohtrectors Signature: • r.---tate: ._ 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 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 then five hundred dollars(3500).): ❑ 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.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-properly tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feat 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? 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,ora volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ___.__.__ruu..__._..___.._.___.__...._ _ ___.. ____..._._... 2 Does or will tho applicant or present or future building occupant need t0 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 applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application appermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? l3 Yes LJ No (Section 65850.2 of the California Govemment 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 AT 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 alt state taws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property dot inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. SI rat ) A 4 ' Da r __. o ze AuthIcanl - (, '—oto hODE r INSPECTION TYPE DATE MEALS CODE( INSPECTIONTYPF RAN =AU 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Finalir 208 Final Plumbing 200 Final Re-Roof Z® 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 • City of Costa Mesa �sy Development Services Department CERTIFICATE OF OCCUPANCY No. 0C 166 Building Safety Division P.0.Box 1200 er Costa Mesa,California r� The Building located at 2603 Elden Avenue #C ' ,L has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto c. for a Group R-3 Occupancy. C S, Use of Building OOndamini1RR Legal Description 439-071-10-15 (See reverse side for Metes and Bounds) It Building Permit No G18475 Electrical Permit No. G18475 Plumbing Permit No. 018475 h, (' Mechanical Permit No. G18475, M19767, M20174 Number of apartments and/or guest rooms 1 ISSUED TO: Building Official d li X - Ce Mar-Elden Develtnnt 'om r 18226 W. McDuntt by / C {7/./ DYE ,,,,:t# Swine, CA 92714 pate a% /p .54 .1 This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the til Building Official of the City of Costa Mesa under Sec. 307 lel U.B.C. .4 CMF 1015-46 rev. 1/B3 White-Owner;Canary-Numerical File;Pink-Bldg.Permit File q .. City of Costa Mesa { Development Services Department CERTIFICATE OF OCCUPANCY No. ®5Ll ' '�.9 Building Safety Division P.O.Box 1200 Costa Mesa,California The Building located at 2603 Eldest Avenue AC has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group R-3 Occupancy. Use of Building Condominium Legal Description 439-071-10-15 (See reverse side for Metes and Bounds) Building Permit No 618475 Electrical Permit No. G18475 Plumbing Permit No. G18475 Mechanical Permit No. G18475, M19767, M20174 Number of apartments and/or guest rooms ISSUED TO: Building Official Il/ /4' • (1.44-1.../41f Mar-Elden Daveloprltentc- 18226 N. McDuallott by �� L G�IAA�//el Irvine, CA 92714 Date 7 L.2r / 7 (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 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. C�O_F C`3STA MESA PERMIT NO• . i TRACT go. LOT NO. BLDG.NO. I I X54 R/16/H5 D Ss XL IL ' • Ii'eIICTION,PERMIT. ; ' •i C7 I a��S 1a2q,-/ [' I : Applicant's Mailing Address 1A99F I"j- M/'O11)T310tt '-Tryl ne TYPE OF CONSTRUCTION- ry ( NEW LI ADD' U•ALTERATION U-REPAIR - - • Project Address 26/;3 Elden Ave 3._. #C' _- ' r' 0 CONVERSION 0 DEMOLISH 0 OTHER i - l _ _ • _ _ _ • • I ' • M C1.V D 1 Pnt Phone ala-n�n1 .DESCRIPTION.OF WORK IVL-JJ C.C1mm'D ' t - - • - Owner's Name ,. , yy�,l - 'Z p' ) / :' ZONING REGULATIONS. • _ ' Address, r1•R22F W MCDHrmntt_' Irvine 92714 I , TYPE OF PERMIT,C; 'U.GRADING ( -.FOUNDATION STRUCTURAL : A.PZ./.11 / -O7( -'[O'�1/S .ZONE ;I-� sC . i • Arch/Eng 'Chris' R. Stephens, ' License No. 012963 ❑ TENANT pyELECTRICAL �PC,UM BING: IGTMECHANICAL - ' / - PLNG. EF:#0,,Q�By-47', BUILDING .address. -18226-W. McDurmott, '.Irv.i ne 9271.4 . ' •❑OTHER SPraa x `T p L /� TO BUILDING ' ( REAR YARD(TO P/L). Contractors NemBThe Ri •chard El Crawfordp49e' 474-0551' PROJECT DESCRIPTION, SO.FT./�7 17 /a, 3. PROPERTY LINE I� ' C��JL+ � NI OCCUPANCf )„ LEFT SIDE YARD I- f ' RIGHT SIDE YARD � !- Addresslmailing) 18226 W. McDurmatt,' Irvine 92714 -C O N STRUCTION TYPE' ' " . - .VALUATION 8' 1 f5i,t�: d '2..,(0i;;.e• .'�(/ i ZONE - ' GRADING CU.YDS. - ACRE'S - PKC.SPACE REO. PROVIDED '} ) License No. i ' �.,f�Y��i�_ - - a , ; r �Q ` LICENSED CONTRACTOR DECLARATION Remarks: .�, C•.. 74110 ,� PG1/(__ i - STREET WIDTH ', 1 ,PARK FEE$ at; '•?/u/ OS I hereby affirm that.! am licensed under provisions of:Charter 9(commencing I ' • L.G/ • ,(�[,. I with section 7000) of Division 3 of the.Business and Professions Code,and I l' I . •( r i. , 'SPECIAL CONDITIONS: I""'�•----- 1 f t C 'i i tier/W-1 • my license is in full force and effect ; _;• _ / G (� I I' PLUMBING • • - 1 I I j flow frUIt SPECIAL REQUIRc?AENTS I ' License Clap �- Date off'/QSignature r ELECTRICAL, WORKERS'COMPENSATION DECLARATION I I Bar-Sink , Se Wer Cap • • hereby affirm that I have a certificate of consenttoself-Insure or a certificate • _ I Backflow Prevent/it.-. ' . I._- /- ' Sever Connection: _ Automatic Washer -, 'Meter DUver 100 amps, _i cry Wo}kers"-Compensation'Insumnce;.Or-a-certified'•dbey thereof'(Sectlon- - - - — -' - `� 400, Lab. C.�i,// ( • . 1 ' R. ,.'�'"�^�� •r 1 1 Backflow Irrigation ; ( • Solar Collectors�'• .,I • 1 --- Construction POIe� : r • / Sub Panel �:-I 4 4-7 CD Policy No. DJ[ej Compan �� �a„ , Cooking Un.t ',Sub Pole 't Iryl�,,..ertiflatl•copy Is h Yth the city B - �sIL; I 2.. Bathtubs I ) I SPIar Piping ; I• ,I ' t 4 I. - i . t rJ Cart!/l�aad�cop s ed with the city 8•i .411,-. 1 , , ) •F 1 , - /.' Dishwasher "' ; Motors ❑O-1 HP 0114-8 Data yi//_in APPilcant t ' Clarifiers ' Solar Tank I ti -'si '{ y - • ,-,�./ . ^ ,I OV EXEMPTION FROM'WORKERS'COMPENSA -•11 DEC RATION' -/" Dryers-IP' as"❑EIecVIc •' ;m c Solar•❑9-15 HP ❑18-15+ (This section naso not De completed I/the permit 15 or co: hundred($100)or i /, Dishwasher - Swimming Pool w/$pe ' `I Oa?) i. less). i - - Fan ' , l (Microwave ' ' - i I I certify that In the performance of the work 1or,whloh this per is Issued,1 ' Drinking Fountains 1. Urinal ' '.� 'Z Cd • shall not employ any person In any manner so as to become subject to te - q - - - - - / F.A.U. ' ' r ;Pole Light I + Workers',Compensation Laws of Californiaa I ' I Floor Drains, i 1 / WaterCloseti' '•-•. ' i. Date Signature - i / Fixtures . • ) - , NOTICE:Iftatter making this declaration,yOf.should become subject to the. ___ FIOof Sinks. - / __ _- _ : 7- _ 'Yater_Heater_ ___ .. __ to /! .-I .. - / Range _ I , _It - `JJ z-� , Workers';Compensation provisions of the Lapor Code, you must forthwith - cOmply ,With; such provisions!or zthls•.permlt -shall, be;deemed revoked:: 'u/ Gas Service 1 2 Outlets I ;_ , 6 (Water Service ! I ' i •�l I Z Device Boxes • , 1 I $ign- • , ) t , I CONSTRUCTION,LENDING oAGENCY r .« - i 1 hereby affirm that there Is a construction lending agency for the performance, ' Interceptors I _ • -I. •-•1 , ' t , , ` _ 30 Outlets I ' i Standing Sections ; (o,� , of the ;work dor which:this, permit*is Issued-(Section 3097 Civ: C.) _ i - , _ ,-,/, _ Z /g TrashCompactor • , t - 34i0 Lender's Name- -• - ` - I' 1 KitctieniSinki '• r r S i -•' t I - i I Switches ' I . i Lender's. Adoress' ` _ I " : ' , i 1 , { - q Lavatories I I e i t t I/ Garbage Disposal I - I t I I OWNE0.BUILDER DECLARATION ( ' i v, V / - { in t '' t /p 1 on t ' I 'affirm that I am'exempt from thanContractor s'License Law for the • U I - y Generator,❑0-5 KW 05-15 KW , ' I ; following• easonquiresion.7,031.5 Business and Profesproal:Cod : Any city or I _ , P Trap- •c t." .. - - 1 ' t I. I county which-requires a permanto construct,alter,improve;demrllsh'or repair - .. -- , Transformer 015-50 KW 1 t I I • ; "any structure;prior to Its issuance„also requires purse plicanbfor such ionsperrilltof - Roof Drains, - I i - - ' I t 1 to file a signed statement-that he/she Is IlcensOd pursuant to ctionovis ons oh- 1 ' ' - I - 1 the Contrzctor'teicensi Lawl(Chapt9(toi COde).ng.with'Section 7000)of _ - • - ' ' , v ' ❑$0 t KW' ( ' - :Reinspection Fee 1 $15' • ,_ Ition'3;,of the Business and Professions- ption.or that;ha he/she. Showers , ' Reinspection-Fee $15 • t etrom,and the'.basis for the alleged t subjects the viola lon'of;Section - _ - Meter Dud to 100 amps1. i I .Issue Fee' 1 .K'>r•1.5 oy.'any-applicant for/a.permit subjects,the:applicant to a.civil 1 ' . 1 ' ' r ' - - ! - ` _ tDk -{ *{'Tlalty of not more than fivehuntlretl dollars loyees($500)t , ' • Service Sink I ' .G f I ' I Issue Fee I $ 9 Zoning Approved By LI / G jell I Date 4- ' (S- 9,S , - ILI 1,'as owner of'the;property or.my employees'With inewages as their sole , I 1 compensation wiil'do the work;and the structure Is not Intended or offered 1 ' •; I - ..I I 1 MECHANICAL I ' I i ' e ' ' for sale (Section 7044, Business;ander of essloperty.who Contractor'sor I - Application Approved By !Date1 i I License Law does not apply solar owner of a property.who builds or improves , - Refrigeration System I • I i - Si p ' S ' thereoh„and who'd that ch"work himself/herself or through his or her own , Boiler, I .�'1 ; r ,I . r I v Application Issued By j - j assltl 'Date a 1 employees, ever, ed that such Improvements IS intended or offered for I - - 00-100,000 BTU 0100000 BTU' 1 - 1 If, Duct'-Under,Grbund ' sale. I however,the building or Improvement is sold within one. f COT- ! • I t I 1• ' ' SUMMARY OF FEES • I . pletlof the purpose o have the burden of proving he/she did not build or in-- - t I " . , Kaye for the purpose of,sale); ( I ' • , i I 1 I j Duet-Struetbrel i 1 I I System Repair/Alteration I. *': ` ;BUILDING PERMIT e 3'��'no • I SMTP ' ; ; $ I s f,g ' I, as owner of the property,am exclusively contraitinglwith:licensed con- ' tractors to construct the project (Section 7044,Business and Professions Code: : ,' Duct-Ventilating ! I I , , : ; Is „q I 'PLAN CHECK! 1 $ am in i PERMIT- I ! i I I r The Contractor's License.Law does-not appiy-to an'owner-of property who"r I bu1105 or. Improves thereon,and who contracts for such projects with acon- I Exhaust System 0 Multiple❑ 1 , i : i (f I ' !PLUMBING ' $' Z.9-Ct ISSUANCE , ; $ i ' tractor(s) license pursuant to the Contractor's License Law). I I _ - ' 1 , E , , -v I PLAN CHECK• $I (p•SO GRADING - j $ I i 0 I am exempt under Section ' t ' e.& P.C.for this reason Firepl/Fact.Olt.ICBG# ' , , 1 r Date " 1 I Owner' t ' ' I I i Heating'System& Ducting : i , , • ( ELECTRICAL $; 4•SO; ' I ( I $ ' ' ' I-herebycertif that Il have read t application and_state that ttie.above. P. _......T.-...-4-.' I i I.5.7]Si ; MICROFILM $ ! I , Y_ 0�100.000�BTU.0100.00O BTU . ...,.. . _- .i iPLAN CHECKi $ I Information IS co .c-' I agree to c• y w hall city and county authorizerepre- ordinances , i I - 4 •'CA ct ' ' TOTAL!FEE' . $ ' ' and.state laws to • r i tr ti• antl hereby rHood Ori - ;MECHANICAL $• , I • sentatives of• r ' Type I 0 I I - I `'•on he above-mentioned property f r t ( i Reinspection Fee 1,' ' $15 y 0O LES$ I 1 i 1 Inspection pu ��I/ { - ) I /3444 Canopy TYpe H ❑: �P LAIN CHECK! $! 1 " - l : Signatures` ♦ 'iL�L Dace ! ADVANCEOPC $ s Registers I • t ' Issue Fee , • $ 3 ' 1 I l ' f • Drivers' Licese 1 I 9 i I t , , FINAL FEE; I $ • 0,55..33 CMF 0865-46 rev:12/82' White-Building;Canary--Applicant;Pink--Accounting;Goldenroo-Assessor' - -" --' - ' ' . - • -- �'�.CONSTRUCTION AND PLANNING t j °I `' -- • POOL - �A -_ ,APPRO• VALS„ Permit#� '1 '^ r _ -Date I Inspectors '. APPROVALS. Permit Date Inspector r 1,ITem oras Electrical Serwce,-or Pole 1 j.'17: ° ' ? ' 'Ail P Y � r ,! .r , 52 Pool &_Egwpment•Location-: :;::•-, 'I'; :2.t Soil Pipe-Undrgrnd': W ^ . 4. z < 9,%{ ":74-707: •'53 -Steel Reinforcement ' - > - :32ElectricalConduit Utility!Undrgrnd, ;; '' ' It> - :54: Forms;, - _ I •4.'Electrical Conduit-Undrgrnd _ Er' Kiiii 'Eij ,ICC a 7 =55' ^Electrical Bonding_ - , •" i ';.5-.!Steel Reinforcement j',"; "I ; r S:::51/$s `irit i "56 Rough`Plumbing&Pressure Test • Cl 6.! Electrical LIFER'Grndl I 2 ; '-t ; L �- - 1- ' n57 .'APPROVAL TO COVER-GUNITE ' ' " e ' 7.i Footings SeJ /` E Q.' j . j;,;,./al :' I 58.:'Electrical Conduit-Undrornd3' � ' ! 1 ' ', ' S r 8.,Foundation '' ,� :-7 i.r 5 ass:gyyt �- '59."Gas Pipe, O.Undrgrnd.,Test' - ? _ 9.'Water Pipe,-Undrgrnd. I?` ;•- 3, ,' 7I t :60.'Backwash Lines,P•Trap, O Undrgrnd: • . ..- - 10.i Structural Floor 1System'; 'q J? ;. _ ,r, 37, i; ,61.;APPROVAL TO DECK ° - - -- 11.;Property Sewer Line &House'Corinectiori 4244 V. O- ' .62.•Backwash & Receptor-Final : _ - ' - ' 12. Sewer Cap ; ' � I 1 -n .✓1 . r =, �� 63. Heater &Vent`Final '- - 13.�Roof Drains I i I °,r-) / ° !'.' n =;-- ..64. Plumbing System.-Final ` 14.IRough Plumbing . 1 1 as ' • "'- i `65. -Electrical-Final • - - '15itlRough•Electrical=Conduit i , I. 1_,�T-- I ,-- 66. Solar System-Final •• -" - 7--T- - _'_... _ - I II l . 16. Roughs Electric Wiring i ; I iI '-r-r-"i/16 7 ,: reig1T t 67. Fencing& Acces`s;Approval . F - 17.eRoughWir,ing.Sign•? is, n , • 1I 1 ,- 1 , 1!r - s I i- $ �68• . APPROVED,FOR PLASTERING ' ' ..7; - 1 18.::RoughiEl'eciricaPTTBar Ceiling I', I ! I " 1 I •- ( ' ,' I69: POOL/SPA SYSTEMS FINAL, : ' - Lr 19.(iRough Heating & Airufonditionirig II I I Ways-- ( 0: 1 I FIRE DEPT; REQUIREMENT. i - 20. Rough Factory Fireplace !. 1 .1 ; I I i l I 1 'APPROVALS Permit# - - 21.'Ducts .in Structure. '" I I i, 1 I - . I ; : ; 1 I I I .7,0: Underground Hydro ° 22 J'Ducts,;Veritilatine- I r, I ' ' ;1 , I I I I I .71. Product piping'OGas ❑Oil • :23.4,Gas Pipe-Rough&Testi I I 14p.: 117 f 1-1 71. - 721 Underground Flush X24.:Roof Framing" I I " I I (1; li v I, i ' i eJ I:J ,r : I I 73; Undergrnd.Storage;Tank_O Gas ❑Oil • 25. Roof Sheathing : l ' ; I • ;:ii I7. I •7/.�%$' 1,-.Y4'7, /I 174; Overhead Hydro , 26.'YT-Bar CeilingiStructuralli1& Monocoat I 1 I ._ 1= '- I 175' Dry Chemical -27.1iFrame and'Flshiog S/O'�Or •, W,dg '4_%I .7fi Dry Standpipe, ' 28:1!lathing & Siding r ,, I I II II I hit'ilgr '. 241 177. FIXED SYSTEM FINAL-, li 29.'Insulation, = ` " �+ I 1 ' ' 178: FIRE PREV. FINAL • n I I 1. IVIIJAWWII ; i y' - g I rir {{i 'I i i ' . Notes: 1 ' z i30.�Di wall Nailin I I II I. 1 7��"7�SY �M//'v"/ 1 , � 'I T/ G� 9;/.12.5-' y1{(n�, 1. - I � ,� it 1 1 T 'x"--1-- -- - -, � f..- - - . 'tY�'� - � �"'�f -_ �`.W� ll 31: Blaster Brown Cpat1 1 1 I I r 1 I I I i 1 1 I . C I 32"E• e lectrical Power Mter-Final I II II 1 I 1 i : ' ON/ l jib' or . 33.pFinal Electric ' t }.._ 1 1I) ' _ - - i '7. _. . -. 34. Final Heating.&,AirChnditioning 'i .I • I, I - I 35. Final GasPi e'-Te`st `- I " HI '2 I = !`0,-0-61- • - - ' •' •• ` ` - - - - 36. Hoodior1'Cii:an6P/its .' 1 n i .. ^, it I .'' i S, I i'1 ' , , -." + - _ - : 37. Final Factor,y'-Fireplace, I i 1 u1 i ' ' ler - • ' i 'i, _ - - L 38. Final Pluriibingl I ' I if!! s', I ,. ,/t' Air., • I I I. I- _ 39. Water.Service'Final 1 . 1 l '-'1 i sf i I - :• t . . , 40. Gas Service-Final ' I ; ' 1 ' , Ii - I I i 1 I .Final I i - �- ' , 41. Solar Domestic; 1 F I 1 , I I - 9 - 42. Backflow Pr, , •,..i LL I I 'I • �1,'m, _ i _ zl. 1•i. L ! I ''"I fl) •I) ' i :I • s1 ' I .2 1• I ' 43. Backflow Irngation i . I i, : 13 :2 1 I - _ - F:1, a 44. Landscape lrrigatior System) I 1 SII . , P• -, , ti io, , • ' iv i I _ I • - a- 45. Sound,Attenuation . I 1 m ' Rr.. '1 -14I._ IL 1. I C - • v 46. Handicap RegulationsL . I iI i : I 1 I - I o • I - _ r - 47.-FINAL STRUCTURE & BUILDING I it I 4741 I ' i I 48. Special Requirements Completed 1 :�:/_;5S ° d... I ' 1 6 : o .., , .l it i 1 t i I I II 7 1 I ' I ,' 49. Electric Release tolEdison I 1 r' t r4-4- --L--j--- -- ! -±4- - 50. Gas Release'to Sotithem California Gas:o ! 1 1 I I I , , : , I , , 1 1 1 1 - I I I I , i • �l.r. 51. WO OCCUPANCY '1 I L. r-_ . No I: i, 1�`f Date 31) V7 V I' _.,. _... ..� __>..�i_a_�.__•&_L_ ___._ '__ ._rte_ __� _. ._.-- .- -. -- . 3 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. • CITY OF COSTA MESA CONC7 T UCTION PERMIT nPE� UNIT • — /��P 7 61 /7 7/08/E5 EI p 12 PERMIT NO. / TRACT NO. LOT NO. 'IL' Address ot�� GLDe.y ae G J/�/ I Applicant's Mailing Address .a// G ,Chiles q�,/ TYPE OF CONSTRUCTION NEW U ADD U ALTERATION' ElREPAIR - r❑ CONVERSION III DEMOLISH El OTHER A.P.# Zone Owner's Name Phoney JU"d?b `/ t, DESCRIPTION OF WORK/USE OF BLDG. — - V Address Z //SC% '` 041/40*it el S Main Building: Accessory Building: Arch/Eng, .SlT��%E�� License No. - TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL T Front f Z , O Address - -. El TENANT El ELECTRICAL El PLUMBING El MECHANICAL B Rear • N Contractor's Namet. iti �`) 'C�#tt4,one 45hZh� ❑ 'OTHER A • - I nn r-- PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right - N Address(mailing) �Z17 ,A-.4-2).„ A'3 ^77G�/f�/�s W y Cob? KG 6 V3 O CONSTRUCTION TYPE VALUATION$ S Left • R City License No. ZONE GRADING CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION _ Ping. Ref.# Parking Req./Provided E ' I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: i - Planning Notes: a with section 7000) of Division 3 of the Business and Professions Code, and -. NI T my license is in fu force and effect. O S Licens las ���- 7 License No ___ - Date�irjgs— Signature C -.�` - PLUMBING - FEES WORKERS'COMPENSATION DECLARATIONBar Sink Shower's hereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL FEES -- 4 Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink - - • - 3800, Lab. C.) • Automatic Washer Transformer ❑ 15-50 KW Policy No. . Company Backflow Irrigation • Sewer Ca 0 50+ KW P • Construction Pole Sub. 8 Certified copy is hereby furnished. ' , - Certified copy is filed with the city Building Division. • Bathtubs Sewer Connection _ • Cooking Unit Meter 0 u to 100 amps i Date Applicant - • ' • EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors_ Dishwasher Meter Dover 100 amps _ ' (This section need not be completed if the permit is for one hundred ($100) or ' - less). Dishwasher Solar Piping - Dryers ❑Gas ❑Electric Sub Panel I certify that in the performance of the work for which this permit is Issued, I - , shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank . •- Fan Motors❑0-1 ' ❑1%-g Date alb wisayon Laws of Calif rni • Date lf�d) Signatdre .-4--- -- / Floor Drains • Swimming Pool w/Spa F.A.U. NOTICE: If,after making this declaration,you should become subject to the Inc.IncSolar 09-15 HP 016-15+ 1 Workers' Compensation provisions of the Labor Code, you must forthwith - Floor Sinks Urinal Fixtures Microwave - - comply with such provisions or this permit'shall be deemed revoked. CONSTRUCTION LENDING-AGENCY' • Gas Service ' Outlets Water Closet • Device Boxes I hereby affirm that there is a construction lending agency for the performance Pole Light of the work for which this permit is•issued (Section 3097 Civ. C.) Interceptors Water Heater - Outlets Lender's Name' - Range • Lender's Address • Kitchen Sink - _ Water Service - Switches ' Sign OWNER BUILDER DECLARATION _ ' I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash - following reason (Section 7031.5 Business and Professional Code: Any city or Garbage Disposal Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P—Trap - Laundry Trays.. - Generator ❑0-5 KW ❑5-15 KW any structure, prior to Its issuance, also requires the applicant for such permit _ - _ — - • _ _ •Trash Compactor • to file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains - - - • he Contractor's License Law(Chapter 9(commencing with Section 7000) of __-_,-- -_ _ - pi vision 3 of the Business and Professions Code) or that he/she is exempt • • - - •x, nerefrom 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 . Reinspection Fee -! $15 Issue Fee $ 3 ,� , compensation, will do the work,and the structure Is•not intended or offered - Reinspection Fee $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's ' MECHANICAL 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 corn- Canopy Type 11 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 Love, sownorth° rpof the pf ope). �� /t/k� tractors s'o wont ct e project tcusiness ing with lissd ode- DUCt-$tructural Refrigeration$y5tem Application Issued By ( Date Tt constructctors the project (Sections 7044, to Business and Professionsfproperty Code: The Contractor's License Law does not apply to an owner je property who Z',Duct-Ventilating , ❑0-100 000 BTU ❑100,000 BTU builds or improves thereon, and who contracts for such projects with a con- �'' SUMMARY OF FEES tractor(s) license pursuant to the Contractor's License Law). i am aware that . Exhaust System 0 Multiple 0 L'I System Repair/Alteration BUILDING.PERMIT $ SMIP $ ' proof of their Worker's Compensation insurance should be provided to me. r PLAN CHECK $ PERMIT 0 1 am exempt under Section B.$ P.C.for this reason Firepl/Fact• .BIt. ICBG# Fire Dampers PLUMBING $ ISSUANCE $ ' Date • Owner. Heating System& Ducting ' 7 'Re9icters ' , St PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have read this application and state that the-above ( V0-100,000 BTU 0100,000 BT '• - • I Information is correct. I agree to comply with all city and county ordinances - /toe • ELECTRICAL • $ GRADING $ . and state laws relating to building construction, and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ sentatives of this-city, to enter, upon the above-mentioned property for Inspection ppu sec. • Signature( ( . Date e7/8/ter MECHANICAL $ TOTAL FEE $ 021/4>Drivers' License or S5$ Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ /0 • 1 CMF 0865-46,rev.10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor - CONSTRUCTION AND PLANNING POL 4 SPA APPROVALS Permit# Date Inspector APPROVALS . Permit# Date Inspector 1. Temporary Electric& Service or Pole. 52. Pool & Equipment Location 2. Soil Pipe-Uhdrgrnd. . � • ', 53. Steel Reinforcement 3:':Electr,ical 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, 0 Undrgrnd. ' 10: Structural Floor System61. APPROVAL TO DECK 11. Prop ;&erty Sewer LineHouse Connection 62. Backwash & Receptor-Final 12. SeweVCap .� 63. Heater & Vent-Final - 13. Ro61'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 0111/15- 14/1 71. Product Piping ❑Gas ❑Oil 23. Gas Pipe-Rough& Test 72. Underground Flush rk f} 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil , 25. Roof Sheathing 74. Overhead Hydro i 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 (/l�O r�5 O • 35. Final Gas Pipe-Test !!! _ 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. 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. ' .JCITY OF COSTA MESA CONSTRUCT/ION PERMIT PERMIT NO. / TRAZZNO. LOT NO, UN1ZNo. 7999 8/02/85 . EoOti TL Project Address �LA /��/sr/ G 1I]p�Illl,/IIIIOI Vi (//1 77 • Li -4- :Applicant's ,_Applicant's Mailing Address ' .27Y 6tie* .. a� TYPE OF CONSTRUCTION ''LJ NEW ADD U ALTERATION U,REPAIR . . '- ,s ' / �` ,/ ED CONVERSION El DEMOLISH ❑ OTHER • A,p•e(t _ Zone • Owner's Name lM/P9G �CJOrA/ PhonrV'.f J %�7� a 71 ��' „et Z_ • Z�j�� ` ��E D/ a Ml DESCRIPTION OF WORK/USE OF BLDG. ' Addiess J o - . -. S Main Building: Accessory Building: ,s Z Arch/Eng._f herter i✓-5 License No. e/ Z/PG� TYPE OF PERMIT U GRADING U FOUNDATION ❑ STRUCTURAL T Front •' O • .Address El TENANT ❑ ELECTRICAL-❑ PLUMBING El MECHANICAL • B Rear N Contractor's Nam. fi,em 7 �+ ✓ Sys=010 ❑ 'OTHER - _ _ A • - I G„/� '+i'�ones- , C Right - N I -�v PROJECT DESCRIPTION SQ. FT. • OCCUPANCY _ '- - - Address(mailing) ! �'E _ - G CONSTRUCTION TYPE - ' VALUATION$ S Left _ City License No. .3'46'9 ZONE GRADING'CU.YDS. ACRES - R -LICENSED CONTRACTOR DECLARATION /s I Ping. Ref. # Parking Req./Provided , E I hereby affirm that-I am licensed under provisions of charter 9 (commencing Remarks: / Cj 7 SlO �eVL_ , Planning Notes: • . , M with section 7000) of Division 3 of the Business and Professions Code, and - my license is in full force an ffect.,0 '! L t - ' (-1/75--- PLUMBING i _ • • , T License�CIa55 cense No.`+'�� �i..� �� I ���� • S Date_e_ .t Signature _ • PLUMBING FEES s WORKERS'COMPENSATION DECLARATION ` Iereby affirm that I have a certificate of consent to self-Insure or a certificate Bar Sink • Showers ELECTRICAL FEES. Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink - - - Automatic Washer Transformer 0 15-50 KW - J800, Lab. C.) // 't "ms Policy No. ,e2D/683 Y Company ,tv , i--ys Backflow Irrigation • Sewer Cap Construction•Pole Sub. 0 50+ KW R'Certified copy,is hereby furnished.d. Certified coal/tiled with the city ivis n- • Bathtubs ' Sewer Connection Cooking Unit Meter Duo to 100 amps Date lApplicant ' ' EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors , I I Dishwasher '. Meter Dover 100 amps (This section need not be completed if the permit Is for one hundred ($100) or - - - less). Dishwasher Solar Piping ❑ Dryers Gas DElectric Sub Panel • I certify that in the performance of the work for which this permit is issued, I ' snail not employ any person in.any manner so as to become subject to te Drinking Fountains Solar Tank Fan , Motors 00-1 HP ❑1'/a-8 Workers' Compensation Laws of California. Date Signature Floor Drains Swimming Pool w/Spa • F.A.U. Inc.Solar 1:19-15 HP 016-15+ 'NOTICE: If,after making this declaration,you should become subject to the — Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks. Urinal • -- , Fixtures - " 'Microwave comply with such provisions or this permit shall be deemed revoked.. _ - - ' • CONSTRUCTION 'LENDING AGENCY Gas Service . Outlets Water Closet • -- t Device Boxes Pole Light hereby affirm that there is a constructiob lending agency for the performance - - • —�— g. of the work for which this permit is issued (Section 3097 Civ. C.) Interce tors Water Heater - I- Lender's Name - p . Outlets Range Lender's Address ' • - Kitchen Sink' Water Service Switches Sign OWNER BUILDE R'DEC LARATION - I hereby affirm that I am exempt-from the Contractor's!License Law for the Lavatories - Auto-Wash . Garbage Disposal ;Standing Sections ' following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct,alter,improve,demolish or repair P—Trap ' Laundry Trays Generator 00-5 KW 05.15 KW Trash Compactor any structure, prior to its issuance, also requires the applicant for such permit . to file a signed statement that he/she is licensed pursuant to the provisions ofRoof .Drains - - -. 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 - - .. a , erefrom and the basis for the alleged exemption. Any violation of Section J31.5 by any applicant for a, permit subjects the applicant to a, civil . . - enalty of not more than five'hundred dollars($500). I e ' U 1, as owner of the property•or my employees with, wages as their sole Reinspection Fee 1 $15 Issue Fee $ 3 compensation, will do the work, and the structure is not intended or offered 1 s - for sale (Section 7044, Business and Professional Code: The Contractor's - -” MECHANICAL I FEES Reinspection Fee $15 Issue Fee $ 3 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 com- 'Canopy Type II 0 Zoning Approved ByI I • 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). • • 0 i,as owner of the property, am exclusively contracting with licensed con- Duct-Structural • Refrigeration System I . ' Application Issued By 'CfDate �(� tractors to construct the projectSection 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00100,000 BTU 0100,000 BTU SUMMARY OF FEES -builds or improves thereon, and who Contracts for such•projects with a con- ' tractor(s) license.pursuant'to te Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration ' BUILDING PERMIT $ SMIP $ proof of their orker's Compensation insurance should be provided to me. _ PLAN CHECK $. I PERMIT ' ❑-I am exempt under Section • B. & P.C.for this reason Firepl/Fact.Blt, ICBO# I Fire Dampers ('�� ISSUANCE $ I PLUMBING $5 Date Owner Heating System& Ducting- Registers . . PLAN CHECK 25% $' ENERGY P.C: $, I hereby certify that I have read this application and state that the-above- - • ❑0100,000 BTU 0100,000 BT - ELECTRICAL $ GRADING $' Information is correct. I agree to comply with all city and county ordinances • - ' and state laws relating to building construction, and hereby authorize repre- PLAN CHECK t 50% $ MICROFILM $: sentatives of this cit a upon the above-mentioned property f r q Inspection purposes. [� rr • MECHANICAL $' -7.00 TOTAL FEE ' $' O. n Signature Date JJ-/T� Drivers' License or SS 9f • Reinspection Fee $15 Issue Fee $ 3, PLAN CHECK ' 25% $ 1,CO CMF 0865.46,rev.10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor . .. . 1 CONSTRUCTION AND PLANNING PO( SPA . Date Inspector Date Inspector • APPROVALS Permit# APPROVALS Permit# -- 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location �, 1 2. Soil Pipe-Undrgrnd. s - �y • 53. Steel Reinforcement /3t 3.4Electtical•Conduit•Utility-Undrgrnd) 4 54. Forms - 4:i!Electtea.fConduit Updr rnd. 1 55. Electrical Bonding '1,.1 „ ) 5:-Steel R4prcen' ^ U56. Rough Plumbing & Pressure Test ,r t 6.Ef01ctricallfFER.Grnd.i) 57. APPROVAL TO COVE R-GUNITE • 7 Footings; I' -1 A ��58. Electrical Conduit-Undrgrnd. �.. S.f Foundatipn! 11' t' 59. Gas Pipe, 0 Undrgrnd.,Test ';. 1e 1:, 9.'Water„Pige-Undrgrnd. / . ; 60. Backwash Lines,P-Trap, 0 Undrgrnd. nl 10. Structural Floor System '_y 61. APPROVAL TO DECK f i 11. PrOpertyiSewer Line & House Cognection Ai 62. Backwash & Receptor-Final 12. Sewer'Cap/ ''.;, it 63. Heater & Vent-Final ' ' 13. RRof,brairif, r' y '! 64. Plumbing System - Final ;1 %r 14. Rdugtf Plumbing:• 65. Electrical-Final 15. Rougfi 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 <-2 APPROVALS Permit# _ 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23y 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 311 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. Fina4actory Fireplace - (o�L9/ds- tea 38. Final,Plumbing 39. Watei-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. Gass,Release to Southern California Gas Co , , 1 •51. CERTIFICATE OF OCCUPANCY ' ' - No - - Date I 4' - CITY OF COSTA MESA o . i. BUILDING DIVISION } ;1 „�i �r+iDEVELOPMENT SERVICES DEPARTMENT PE MIT NUMBER F 1 i i PERMIT 07-00093 . Jqt 0 DU (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.cci.ub -BHdG PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 2603 ELDEN AV Status: ISSUED Suite: E Applied: 01/26/2007 Vicinity: MAR ELDEN SQ CONDO UNITS E AND F Issued: 01/26/2007 Primary Occ: R-3 Dwellings/Cony Res<10 Type of Construction: V-N Parcel Number: 93009746 Zoning: Applicant: WILLIAMS, LARRY Address: 101 THE MASTERS CIRCLE a/ Phone: 714-444-1111 • COSTA MESA,CA –^ _.����.=:�Zip: ,926,27–.._ ISSUED BY: ��� '` Owner: MAR ELDEN'SQUARE-HOA - - ' Address 2603 ELDEN AVE! ' .// Vv L , Phone 2 ,; COQ SETA MESA,CA's . '. _ Zip: 92627-4654 l� .. �, Contractor(�ALLCOAST ROOFING'AND:COATINGS Address./101 THE MASTERS CIRCLE' 1�;. ,� . / / ,..�; �, N ' / \ \ Phone_ 714-444-1111 - / • '- `! \ / �S �_ fir. \ COSTA MESA,:CA .., A•' � ' /,I/Zip: 92627/��. V License: 598440 '\,AAAA / .\\ \ /Arcli :( - ( //�(�� - Eng: A� :V� .1 ,. Address: �-,,i ��fj Address: - – ` �', '/ n ,'�; ,/ - - Phone: 1 Zip: / 1/7- .i ., Licenser 1 C., _ ?�_. I License: ' _ it i r n ?r( SCOPE OF PERMIT '% _ , SREROOF CONDO UNITS E AND F. INSTALL"30-YEAR GAF TIMBERLINE COMP SHINGLES OVER ONE LAYER OF COMP.2400-SQ FT PITCH 4:12 A �V/ 2 ` A. FEE SUMMARY: ti Hari Check !. _-ir $0.00 , l[7 '/" 7 f, _ T' �,r , �k -y)Calc Valuation: $4,800.00 t'' , Permit ,$111.25 t_ _ Claim Valuation $4,800.00 i `SMIP Res: ' ' $0.50 C' --------"y- _ - - _ - _ - - - -_ SMIP Corry ' , $0.00 - - ,"` - Other:. $0.00 1 J _ �, �� 71 'i InspectOm'.',�l, , $0.00 - _ — i• _ /�4 Total \ $111.75 �\. _ _- PLANNING & ZONING SETBACKS-' I _, i;; MAIN STRUCTURE Fr't q0.0 ' Rear <•0-0 ,(v) Left 0 0 Right 0-,0 , ACCESSORY "Front '0-0' 4--',..-- .Rear 0 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. ,j4:: I have and will maintain vorkers'compo ion insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers' p nsato s e ca and policy number are: A__,- T .�z 'Gamer: /t.4 polity Number: I cSc LI 11 -(This section need of be completed if the perm) is valued at one hundred dollars($100)or less.) ❑ I certify that in the pe rmance of the wo . • which .is permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation taws of alitornia,an• :. , : lit If I eh.. Id become subject to the workers'compensation provisions of Secti n 3700 the Labor Code,I shall forthwith comply with these ro ions. - I Y T-7 NSignature:AI \ bate: (l WARNING:FAILURE E( SECURE WORK S' TOTHECOMPENSATION rm.', RAGE IS UNLAWFUL AND SHALL SUBJECT I N EMPLOYER TO CRIMINAL RAND CIVIL FINES rUPO N ONE HUNDRED THOUSAND DOLLARS 15100,0001,IN AD ON TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37060F THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: 1 hereby affirm that I am licensed and r4o ns of ommencing with Section 7000)of Division 3 of the Business pd Pr fessions Code,and my license is in full force and effect.Uc.a 1 5 Li Class 0 Contractor �s Signature: . 1. ' 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). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a 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.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ' ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding.falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2.Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I 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 presgnt 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 [J 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 wit the applicant cr 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 will the applicant or present or future building occupant require for the work which is the subject of this application aRermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency'? UP Yes LI 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 leafy to be constructed under this permit be within 1000 feet from the outer boundaries of aschool? ❑Ves 0 No (If yes-,the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ..........permit 7 a patrothan the South Coast s Quality cri edManagement DistrictHeor other airpollution ioncontrol district03 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 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 OMPUANCE AND • y • IZATION • ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree t. mply with • - , - - ••• city ordin.nces relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-descri':. party for i•sped...14, . es.I agree of to occupy or allow occupancy of any building authorized by this permit until final inspection. 1 P WSignat ;.'. ners) r 1 Die tfli' 1 •+n- / d/{x,,�� �� An Or Authorized Applicant '�D ate CODE' INSPECTION TYPE J PATE 1NIID9LS CODE' INSPECTIONTYPE ail )Nm1ALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof f'® 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 22D Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition • 250 Final Building/Occupancy _ CITY OF COSTA MESA t • �� ►9 BUILDING DIVISION >:f ..s DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER I. 1 j !s PERMIT Jektveftina"04. ✓M03-00638 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 MECHANICAL PERMIT Job Address: 2603 ELDEN AV Status: ISSUED Suite No D Applied: 12/05/2003 Issued: 12/05/2003 Vicinity: Parcel Number: 93009745 ISSUED BY: Applicant: STEVE SCHNIERER Address: Phone: 714-719-1689 Zip: Owner STOKES, SEAN C Address: 2603 ELDEN AVE D , - Phone: COSTA MESA,CA Zip: 92627-4654 Contractor: PREFERRED AIR CONDITIONING SERVICE CO. Address: 11 WRANGLER CT • Phone: (949)766-9500 ' TRABUCO CANYON,CA Zip: 92677 License:750418 SCOPE OF PERMIT REPLACE 70,000 BTU FURNACE FOR UNIT D FEE SUMMARY_ 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 $0.00 0 Evaporative Cooler $0.00 0 Inst/Rep.Recess Wall Htr $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 $0.00 0 - . 3 To 15 hp/500 k BTU $0.00 0 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 50 hp/1,750.k BTU $0.00 0/ Vent Fan/Single Duct - $0.00 0 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< 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 $0.00 0 Investigation Fee $0.00 Plan Check Fee $0.00 Reinspection Fee $0.00 TOTAL CALCULATED FEES $38.30 NOTICE: The work authors;ed 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 end 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 2446-48 WOO) DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: • ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. xI 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 w ers'compensation Insurance carder and policy number are: Carder. b) \€. RJ ` \r\8 Policy Number: (73 (This section need not be-completed if 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 alifomia,and-.re=that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these• sions Applicant Signature: �...MASS Date: I2 J sit)-5 WARMNG:FAILURE T• ECURE WO- RS'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 37C6 OF THE LABOR CODE,INTEREST.ANO ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed 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.Lie.a 7 I Class N C 20 Contractor's Signature: Date: /2/6k03 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 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 Ucense 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 end 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 wit 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 buids 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 0 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 feel 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? ❑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). __..._...— _ _ _.._........._...Y 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 Cale been fully compiled with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification from the South Coast Alr Quality Management District or from any other air pollution control district or agency? Yes LU No (Section 65850.2 of the California Govemment 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 0 No (If yes',the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ..._ llluti._._.._ nc_i__ _._.._._....—_f..thi__ 7 Ifa a permit fromv the South Coast s Quality Management District or other airpollution control district3 or aade?y 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:1 certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPUANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with 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. / gneWraOfyegal Owner(s) Date 2-1510, r uthorized Applicant Date CODE/ INSPECTION TYPE DEE RIIQIELS CODE! 1$5FEC1IONTYPE PATE 1616 Fixed System Final Fire Prevention – 206 Final Mechanical /�n -1 -c>11 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 ADDRESSDESULMC_ 2603 ELDEN AV chat: E CITY OF COSTA MESA - BUILDING PERMIT mouser NAMEIT H: VALENTINA MOURAY PERM NO: IB 083224 ADDS 2603 ELDEN AV #E C .M 92627 PERMIT NO: IB 083224 PLAN CHECK NO: N GOVT: N SUPP : Y 714 ) 646-9190 APct.MADDIG ADDRESS: — CONSTRUCTION TYPE: V-N PERMIT TYPE: OTH STR PURPOSE: OTH ARCHITECT OR MENER: UG NO.: JOB DESCRIPTION : SAFETY GARAGE DOOR INSPECTION SQ FT: MICK OR DC'S ADORESS: PIT: CLAIM VALUE: 44 . 00 CALC-VALUE: GROUP OCC: R-1 / CONTRACTORS NAME caAcTORSMUD COMMENTS : GARAGE INSPECTION AS REQUESTED BY CUSTOMER ADDRESS: LIG ND.: *31**3131x*x**333x****#3r3r3r3r*3rx*k*kkxx*****kxk*x3t3t3tkxx*xkk3tk*3t3r3t3tk*33t**31x31**3t 3t 3t***3t scar: ZONING REQUIREMENTS UCENSED CONTRACTORS DECLARATION:I hereby t under penalty of perjury that I am licensed under provisions d Chapter a SETBACKS (commenting wih Section 7000)at Di inion 3 d the Sueuan end Preece.Code,end my license is in hl taw and Wed. CrrYUC.NO.: M.CLASS: M.NO.: EXP: MAIN BUILDING ACCESSORY BUILDING FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Date: Contractor. LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN OWNER BUILDER DECLARATION:I hereby affirm under penely d Perjry that I am ex mpt Iron the Creams License Lew la the ) r-%wile reason(Seer 70313 Bursa and Professions Code:Any ply or county which requires•PannA la err.aka.nanwe. PARKING REQ- PROV: PARCEL ; 00000000 ZNE: REF NO- Mash.of repel any structureace m its bsrance.also requires the applicant for such permit to file a dyad steamers that he or she rj licensed pursuant to the provisions of the Contractors License Law(Chapter S(commencing with Section 7000)d Dation 3 d IM PLANNING N TES> .heaven and Profession Cods)or that he or de is exempt therefrom and the base for the alleged exemption.My violation of Section > 7031.5 by any applicant for apermsaatjem the applicant lo a civil penally of nor mamthan Me hundred do4rs(SSOOD 3r3r3rxxx3tk#xxerxkkkkxkilk3r*3tk3rx3rkkk3rirkkxxk>Ekxk3tkk3t#xxkkkkxkxxxx3rk3tk3rkxkxx1E"xk3rxx#x36x3r ❑ Lae owner dthe propenyo my employees with wages as Owe sole wmp.nsma..wildo the wok andEy erase is notkvanded D E V E L O P M E N '1' S E R V I C E S R E �' a offend for sale(Section7044,Business end Professions Code:The Contractors License Law does not pyton bvaar d properlypropy Q U I R E M E ,T S wtm builds or improves thereon.and eta does such work Mused or herself or through he Or her pith Mamyeel.aaeded that such 1 ham improvements ere no verde o offered fowls.IL however.the building o inprwement a sob within ore yeerdoaraleion.Re ZONING APPROVED BY DATE: (( owner-bolder will have the burden d awing he or she did nit bid or kn. . . the purpose d We). - - ❑ I.aownartl tit props y.am axdh stall mNrednp '.. .. IM protect('..ion 70M.&nt ad •• . • - thereonandwM BUILDING APPROVED BY : DATE: Profession*Code:The Contractors License new dons red .. n err •. .. who w) a contracts tor such pear w3N a awradOt)ficensed Pure t• girLew). \ Ed Iane:wnaunder Setion:B • ;, . B.6 P. . for : 411414 , APPLICATION ISSUED BY : 3Y DATE: : � U E Omen: a • *********************4****************** x 3txx k3Ek3E rx fxx3Ex3riFir3r3t3r.E * 1 Ili LEGALIZATION:N F E E S U M M A R Y STRUCTURAL S 'GMEIIT:Y �- .. candynal I am aware d and understand the requirements d Cc ... .Saw Cab .ions 25505.255.33,and a p .end that 1 or any Maa building onn0an.MI/vA not(circle one)need to comply with said were....- W the requirements i for /. a pens lamwtrWion o ncdlcetcn from the As—Wahegement District Residential oosInsc nappicat• -an evnpttmn Eau BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/AES GRADING wear. PERMIT 42 . 00 , Date: Applicata: — /, SMIP/NON-RES WORKER'S COMPENSATION DECLARATION:I hereby affirm wideraay d pe Pedal!one of the folwSig dede, • oatin: PLAN '. ❑ I have andu artful.,wmantel, artful.,d consent to self-insure nsurs errs'compensation.in provided for by Section 370001 the Labor ISSUE FEE Cods,fothpenamahwdmework fowl:chtheanmki issued. BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE o Ihew and oil wa nworkers'moration insurance.ea required by Section 370o dEn Lebo Code,for the perfammme of tit TOTALS----> 42 . 00 0 . 00 0 . 00 42 . 00 42 . 00. . 00 work for which this permit is bead.My workers'compensation insurance On,and KEPT number ore: Currier: REVENUE DIVISION TOTALS--> COLLECTED: 42 . 00 OVER/SHORT: "" • 00 Polley Number BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK ' ;Tits section wed no beamplsod t he Perms is tor ore kindred drlys(St00d o Mos.) 42 . 00 ❑ 1 candy that in the performance of the wank for which this peri is bored,I shall not employ any pass I.any maser n as to ber mauhjedto the raw(camperaatinIan dCafode.and aarnthddl ehwdbecomealpdtolhawake". 3r3r3r3r3r3r3r3r3r3r3r3r**intik***3r 3r 3r k3r#3r3rk3r3r3r3r3r3r x3r3r3r43r3r**it***x3r3rk3r xx-x3r3rxk3r3r3r3r3r3rkk,k3rx3r3rk3r3r3r3r 3t compensation provisions of Seaton 3700 01 the Labor Code.I that forthwith copy with throe risen INDIVIDUAL F E E BREAKDOWN - Date: Appltent: uWvar Failure aa@wfe'caa .don toaaIsunS M, WIpa MCfSfl ef mployer nalh.rages as mmesand TYPE QTY DESCRIPTIO N UNIT COST .In .. TOTAL COST • Secdon3iasalm.Lavaone rcoeAmtwc.d.od thousand dollars n$104000),In addition to the am.r'sfee INS 1 BUILDING RE—INSPECTION FEE 42 . 00 ` '" 42 . 00 ' CONSTRUCTION LENDING AGENCY:I hereby dim under penally of perjury that there is a construction hr&m agency for the END OF FEES r' performance 01 the week for with the perms is issued(Section 3047.Civ.C). LENDER'S NAME LENDER'S ADDRESS: , - I.. '. that l haw read thisapplication and dale that the above information is coned.I agree to comply with all ay end county ordinances ' and tate laws relating to building construction and hereby authorize representatives 01 this ay to enter upon the aboa.memcred property - fo \cars VAL ail NA aoN/ C6-179-199Z/ed:2 Vrl/842.n.J vnkia 1 t1�i#I:B1-JJJ/4/1 \�is� Date: b -q' i `r PERPi*T:19832i'4 Signature d. 7rTa'••• . . tree' • • • / (5151-46.WP) While-Buidtp A Sdey.Green-File:Canary-Appiram;Pink-Revenue Goldenrod-Assessor POC SPA CONSTRUCTION AND PLANNING APPROVALS Permit Date Inspector APPROVALS Permit Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, ❑ Undrgrnd. 10. Structural Floor System • 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap - 63. Heater& Vent-Final 13. Roof Drains + 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling - 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts,in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 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: 41 ,,exec Final Heating& Air Conditioning d'- ! L?✓ 4 _ - 60j`c-Q._t 4- 35. Final Gas Pipe-Test a 4- L 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 (�-(?-l)7c k 46. Handicap Regulations &eoc vat IC 015 to 47. FINAL STRUCTURE & BUILDINGje- 7. �>� �G 48. FINAL PLANNING 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 CERTIFICATE OF OCCUPANCY No. 001470 Building Safety Division 5 P.0.Box 1200 Costa Mesa,California 1 t The Building located at 2603 Eldon Avnttne 4E ( has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto r }, for a Group R-3 Occupancy. i dc , se of Building COnriniUM g t Legal Description 439-071-10-15 (See reverse side for Metes and Bounds) /. duilding Permit No G18477 Electrical Permit No. G18477 Plumbing Permit NoG18477 + brMechanical Permit No. G18477, M19769, M20176 _ Number of apartments Paan/d/or guest rooms IAt � ISSUED TO: Building Official C--)71.7S, �, 182261 Wen Develott e N LI 18226 W. McDurinott / by i 4/i ✓� Irvine, CA 92714 Date .77 Z. .a Mt This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the ;q Building Official of the City of Costa Mesa under Sec. 307 lel U.B.C. e CMF 1015-46 rev.1/83 White-Owner;Canary-Numerical File;Pink-Bldg.Permit File i City of Costa Mesa Development Services Department CERTIFICATE OF OCCUPANCY No. iJ C 2 ; I L Building Safety Division P.O.Box 1200 Costa Mesa,California The Building located at %0i Melon Aemmtra EF. has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto • for a Group R-3 Occupancy. Use of Building Condcminitzn Legal Description 439-071-10-15 (See reverse side for Metes and Bounds) Building Permit No G18477 Electrical Permit No. G18477 Plumbing Permit NoG18477 Mechanical Permit No. (118477. M19769, M20176 Number of apartments �aannd/or guestYrooms ISSUED TO: 6 Building Official cY,/y/ � �/k ( iL&_// - r73r-Elden Uwelo? nt /�/ ,moi 18226 W. NkOtninott { by / .// Irvine, CA 92714 Date a2r' /9f) 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 • t / . I. •• `, - ' Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. .ti /QF COSTAyME$A '� '41- - PERMIT NO. TRACT NO. ,.•+ LOT NO. BLDG.NO. . . --11.L., ' � PERMIT i , G 1 (6411 i3a.9 7 E I2' 6 ' A/16/9.6 •,5;:59115 TI Project Address 260.3 t I den Ave. , Itt : • TYPE OF CONSTRUCTION NEW ADD U ALTERATION W REPAIR J • Applicant's Mailing Address 18226 W -MrDurmott, Trvine_ 1 ❑ CONVERSION El DEMOLISH ❑ OTHE,R.,,,�,r� A.P. 39-07/- /dam /S• Zone AZ Owners Name. Mar-Elden Development Phone 474-0601 -DESCRIPTION OF WORK pa LC ) cal`�0 I -S Main Building: Accessory Building: • Z • Address 18226 W. McDurmott, Irvine 92714 - E ^ 1 - 0 1. TYPE OF PERMIT M GRADING �/ FOUNDATIO �A STRUCTURAL - T Front ill •'GLiSL' N Arch/Eng. Chris R. Stephens • License NO.0 12963 /t6 ❑ TENANT ELECTRICAL r PLUMBING MECHANICAL B I Address .18226 W. McDurmott, Irvine 92714 MV' ❑,OTHER A Rear Lr-r->�,- j • - .N Contractor's Namr 1 524' C Right' , The Richard•F. Crawfordh�9. 474-0551 PROJECT DESCRIPTION Sq.`F1Tr + +�OCCUPANQCY �� K it, I /� G 00 Addresslmailing) 18226 W. McDurmott, Irv3�e 92714 CON STRUCTI ON TYPE t1'AY VALUATION$JJ �� $ Left 131 ` 'E 43- 1e6S• ZONE - GRAD NG CU.YDS. ACRES Ping. Ref.443 Park.Fees $ O City License No. - �y - p / - 9 D,p-$y-47x/279 • /31 -Jr Opt/SO 1' LICENSED CONTRACTOR DECLARATION Remarks: - r . 'C . 7ti 6, -. 4 L , . Parking Req./Provided • / 3 O 1 • I hereby affirm that I am licensed under provisions of Chart 9(commencing _ - t,� R with lection 7000) of Division 3 of the'Business and Pr ions Code, and • Use of Building: Condo L - _.,, ;writ imcr�NTS E my license is in full force and effect. �Qr 9 PLUMBING I FEES BOLD FOR 5• . E License C is • - e >> PlanningNotes: s,.l.11ss. .W��. Date Signature Bar Sink / Showers ' • , 2.cC., 4 N WORKERS'COMPENSATION DECLAR TI -T li ereby'af firm that I have a certificate of consent to self-Insure or a certificate , Backflow Preventef Service Sink 1 S Workers' Compensation Insurance,,on'a certified copy thereof (Section - - - - - &B00, Lab. C.1It///--// - Backflow Irrigation Sewe�Cap •' �" ELECTRICAL - FEES Polis No. COQJ[pJ V Com Pant <<�' �. ' ' ertitietl copy is hereby furnished /. Bathtubs Sewer-Connection /: 'A-°Cs . Automatic Washer' -+ Transformer 0 15-50 KW' tifi cpgv isiiI4Cwlth the city Bu',xr�. isloa li - " v Date y/�0J Applicant �-� • _ Clarifiers I Solar.Coilectors'- • /�. ;`� Construction Pole Sub./ ❑ SO+KW - • EXEMPTION FROM WORKERS'COMPENS' ARC • RAT - -- . • (This section need not be completed If the permit Is for o • hundred ($100)or ) Dishwasher - Solar Piping -- .�i�Ci Cooking Unit I - - - Meter yup t0 100 amps less). - -, I ,_,/ -- - -�_ I cetify that in-the performance of the work for which this permit is issued I ' Drinking Fountains Solar Tank - - /' Dishwasher r.1 / Meter kIIOver 100 amps! S 7C shall not employ any person In.any manner So as to become subject to the - -- _ - &S Workers' Compensation Laws of California.• Floor Grains Swimming Pool w/Spa ',r' • / Dryers L7Gas ❑Electric I' Sub Panel 1 �O cc Date Signature - ' -- NOTICE:If,after making this declaration, you should become subject to the Floor Sinks Urinal •r / FanMotors Do-1 HP ❑1 4-R - -s 'Workers' Compensation provisions of the Labor Code, you must forthwith - - - -- - - comply 'with such provisions or•this -permit'shall be deemed revoked. Gas Service .Outlets 1 Water Closet• CONSTRUCTION,LENDING AGENCY - / , 2.-0.) / F.A.U. Inc.Solar ❑9-15 HP 016-15+ T CZ) I hereby affirm that there Is a construction lending agency for the performance Interceptors- 1 Water Heater • - -Z Iiia Fixtures , / -Microwave 3 4C of the work 'for which this permit, is issued. (Section'3097 Clv- C4' Lender's Name - - Kitchen Sink - Water Service Lender's Address - - - -� - ^7-�k4- CXO ' Device Boxes Pole Light , OWNER BUILDER DECLARATION kavotories . - - - ,.0 3 Outlets / Range -1i!/�- 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 P-Trap - _ • -2 Switches Sign ' It t county which requires a permit to construct,alter,Improve,demolish or repair • - 1 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 • — / 1 .00 the Contractor's License Law(Chapter 9(commencing with Section 7000)of •' ` • "v iision 3-of the Business and Professions Code)-or that he/she Is'exempt - Generator 00-5 KW 05-15 KW Trash Compactor refrom'and the basis for-the alleged exemption. Any violation of Section _ €'- X1'.5 by any -applicant for a permit subjects the applicant to a civil - .Reins Reinspection FeeS 3 - --` natty of not more than five hundred dollars($500). - pn ,I $25 Issue Fee Ll I, as owner of the property or-my employees with wages as their sole MECHANICAL - Reinspection Fee $25 Issue Foe $ 3 compensation, will do the work,and the structure Is not intended or offered ' - ' FEES - for sale (Section 7044, Business and Professional Code: The Contractor's - - P,GBLIC SERVICES REQUIREMENTS: License Law does not apply to an owner of a property who builds or improves Boiler . Hood or Type I 0 - - 1,5 ee thereon,;and-who does such work himself/herself or through his or her own - Zoning Approved By � �+ Date / Q employees, provided that such improvements are not Intended or offered for Canopy Type 11 0 /�fJ Duct-Under Groundrf sale. If, however, the will have building or improvement Is sold within one year of tom- Application Approved By nate pletion, the owner wl it havthe burden of proving he/she did not build or Im- Ll.-(I7 e_t grove for the purpose of sale). Duct-Structural Refrigeration System Application Issued By - Date U 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 00-100,000 BTU 0100,000 BTU - SUMMA V OF FEES , The Contractor's License Law does not apply to an owner of property who 590 qg builds or Improves thereon,and who contracts for such projects with a con- Exhaust System 0 Multiple 0 System Repair/Alteration �. BUILDING PERMIT $ 5 ma-A-1 SHIP $. 6.,G15 tractor(s) license pursuant to the Contractor's License Law). - • PLAN CHECK $ • PERMIT D am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# - • PLUMBING $ aS,O0 ISSUANCE $ Date - - Owner / • H ting System& Ducting I PLAN CHECK $ S•SO ENERGY P.C. $ I hereby certify that I ha e read�' app; .tion and state that the above / I0-100,000 BTU 0100,000 BTL- -Information GRADING $ information is tory t. I--'ce to I•ly ••h . city and county ordinances - - CQ ELECTRICAL $ and state law- joy ii• OnsJctiy, and hereby authorize repre- Z MICROFILM $ sentatives of t .$ 1i �y he`•ove-mentioneq. propert fo PLAN CHECK • $ inspection pun r �/ / /2 / A0fr I� S,gnature 4:1.4/.._ •. /1,4„.... ...c. Reinspection Fee $25 - Issue Fee $ 3 PLAN CHECK $ t•fl O . +„ CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor '- - �1 ONSTRUCTION AND PLANNING • POO. .PA • APPROVALS Permit Date Inspector APPROVALS Permit# Date Inspector rf; :'. i4. Temporary Electrical Service or Pole. !� 52. Pool & Equipment Location 2.,Soil Pipe-Undrgrnd. WA f/ �f'iC71-- 53. Steel Reinforcement ,f '"3,.•Electrical Conduit Utility•Undrgrnd. 54. Forms ' ;'• 4,Electrical Conduit-Undrgrnd. (1`716+ . ac 55. Electrical Bonding 4 1 1rfi, 5. Steel Reinforcement s///$s .8411156. Rough Plumbing & Pressure Test , •6. Electrical UFER Grnd. I- 57. APPROVAL TO COVER-GUNITE 1-,/ -t � � r�/-�� ��A 'r 7. Footings IS- Abu_ �"� 58. Electrical Conduit-Undrgrnd. - / ,I 8: Foundation /111157 en 1 • ,//kir B' j 59. Gas Pipe, 0 Undrgrnd.,Test i , 9. Water Pipe-Undrgrnd. : :�� '. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System. , . 61. APPROVAL TO DECK • 11. Property Sewer Line & House'Cdnnection 64(6--- s0 62. Backwash & Receptor-Final 12. Sewer Cap ' 1 ' ' 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 3/.�le� 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 1725. Roof Sheathing 7/1 A/$57P*' 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing rrd'-,/6/ g4 4.,- t"", 76. Dry Standpipe 28. Lathing& Siding -�f �1gj 77. FIXED SYSTEM FINAL 29. Insulation /�-�/�j 78. FIRE PREY. FINAL . 30. Drywall Nailing cj�///� NP- HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat OO !!//I/ 79. FINAL INSPECTION 32. Electrical Power Meter-FinalI , 80. FOOD CERTIFICATE ISSUED 33. Final Electric /, 'I) ' `� ,""1' Notes: i6/�J 50..f." L'seedgge dor AUC - 34. Final Heating & Air Conditioning (9 //5 comp -�,c2^L�� y�' � irAfr/jam - /- 35. Final Gas Pipe-Test A/2 Zit CCP 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing ' , i/P/tiCfr,jr 39. Water Service-Final 8/&( s- La) 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 ' • 44S4847. FINAL STRUCTURE & BUILDING /44/- 48. . Special Requirements Completed 11_i_a', /'VY 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co • ' 51. CERTIFICATE,p 0CC QPu � L /ic 1 No, 7 .. IA A'Pe Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. PERMIT NO TRACT NO. LOT NO. UNI -T CITY OF MESA CONSTRUCTIONLL�'` PERMIT d ' 6179 7/06/85 21075 TL' . Project Address ZG 03 kri) /0— / / 74.7 i - Applicant's Mailing Address I �� �� TYPE OF CONSTRUCTION U NEW U ADD LI ALTERATION LJ REPAIR Mme' .�G tN f'Il Phonon(7D{� ❑ CONVERSION III DEMOLISH El OTHER • A.P.# I Zone Owner's Name[ DESCRIPTION OF WORK/USE OF BLDG. Address. 24c GMSC E1. W—Li a-- S Main Building: Accessory Building: rZ Arch/Eng. s ip 4eA's License No. TYPE OF PERMIT U GRADING U FOUNDATION 0 STRUCTURAL T Front O Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear - N Contractor's Name .•1 /U./�/(�b "OAa��a � � L 7y ID OTHER A I W Ad 'arrii Phone C Right N Address(mailing) /L7 L et*-4445 Ce) a7. .�• PROJECT DESCRIPTION SQ. FT. OCCUPANCY K G / CONSTRUCTION TYPE VALUATION$ S Left City License No. 6ce 3 ZONE GRADING CU.YDS. - ACRESR LICENSED CONTRACTOR DECLARATION _ Ping. Ref.# Parking Req./Provided - E Q I hereby Ion affirm that I am licensedion under provisionsBusnss Charter 9i (commencing Remarks: Planning Notes: M with section 7000) of Division 3 of the Business and Professions Code,and my license is in ful fortes and effect. � • • T License ass �W License No. TrIS .��s� � � " i PLUMBING FEES • Date Signature 4 WOR BS'COMPENSATION DECLARATION Bar Sink ShowersELECTRICAL FEES hereby affirm that I have a certificate of consent to self-insure or a certificate Workers' Compensation Insurance, or a certified copy thereof (Section ' Backflow Preventer Service Sink . 4800, Lab. C.) • Automatic Washer Transformer ❑ 15-50 KW Policy No Company Backflow Irrigation Sewer Cip Construction Pole Sub. 0 50+ KW A 'Certified copy Is hereby furnished. • - Certified copy Is filed with the city Building Division. Bathtubs - Sewer Connection - Cooking Unit iMeter Duo to 100 amps Date Applicant • EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors • Dishwasher Meter Dover 100 amps (Thissection-need not be completed if the permit is for one hundred ($100)or less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel I certify that in the performance of the work for which this permit is issued,I shall not.employ any person in any manner so as to become subject to the Drinking Fountains - Solar Tank Fan Motors❑0-1 HP ❑1%-8 Worke��1rr������,,,,,,ppppppmggqqqqeeeeeepppppp������a I�Laws of Californiau _ i • Date F a Signature 7 a -ate&-s ' Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP 016-15+ 'NOTICE:If,after making this deciaratl oon,you should become subject to the - Workers' Compensation provisions of the Labor Code, you must forthwith Floor SinksUrinal - Fixtures comply with such provisions or this permit shall be deemed revoked. • Microwave CONSTRUCTION LENDING AGENCY' Gas Service Outlets Water Closet " Device Boxes I hereby affirm that there is a construction lending agency for the performance Pole Light of the work for which this permit is issued (Section 3097 Civ. CJ Interceptors Water Heater 'Outlets Range Lender's Name Lender's Address - Kitchen Sink - Water Service Switches Sign OWNER BUILDER DECLARATION • I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal 'Standing Sections following reason (Section 7031.5 Business and Professional Code: Any city or . , county which requires a permit to construct,alter,Improve,demolish or repair P—Trap Laundry Trays Generator 00-5 KW❑5-15 KW Trash Compactor any structure, prior to Its Issuance, also requires the applicant for such permit . to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains 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 J3I.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 Reinspection Fee I $15 Issue Fee $ 3 compensation, will do the work,and the structure Is not intended or offered - Reinspection Fee I $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL I FEES License Law does not apply to an owner of a property who builds or improves - - - --_ _ . thereon, and who does such work himself/herself or through his or her own Boiler Hood or Type I 0 DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such Improvements are not intended or offered foryp Zoning Approved By Date sale- If, however, the building or improvement is sold within one year of corn- - Canopy Type II 0 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). /� �,//f ❑ I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By ,ati/f l te7� 157 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 L Duct-Ventilating ' f 00-100,000 BTU 0100,000 BTU q +D3 SUMMARY OF FEES builds'or improves thereon,and who contracts for such projects with a con- - tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple 0 System Repair/Alteration BUILDING PERMIT $ - SMIP $ • proof of their Worker's Compensation insurance should be provided to me. i PLAN CHECK $ _ PERMIT 0'1 am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers PLUMBING $ ISSUANCE $ Date Owner Heating System& Ducting IT _Ragistecc ENERGY P.C. ' $ 1 - _ ��rs� f� PLAN CHECK 25% $ i.hereby certify that I have read this application and state that the above f jb-100,000 BTU 0100,000 BT / GRADING $ 1 ELECTRICAL $ information Is correct. I agree to comply with all city and county ordinances - +Cly and state laws relating to building construction, and hereby authorize repre- • PLAN CHECK 50% $ MICROFILM $ • sentatives of this city to enter upon the above-mentioned property for p �r G ' inspection our-pqs 1 Dato' _ — MECHANICAL $ /ICAO U TOTAL FEE $ I,T/rl'S 1 Signature _eta ��i Reinspection Fee $15 Issue Fee $ 3 • PLAN CHECK 25%' $ 3.7� Drivers' License or SS# . _ • CMF 0865-46,rev.10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor - -- j CONSTRUCTION AND PLANNING POL .SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector t^. 1. Temporary Electrical Service or Pole. - 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. • 53. Steel Reinforcement 3i Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding • 5. Stgel Reinforcement - 56. Rough Plumbing & Pressure Test 6.;Electrical UFER-Grnd. 57. APPROVAL TO COVER-GUNITE ` :� 7::Fd'otings 58. Electrical Conduit-Undrgrnd. B.-Foundation - _ 59. Gas Pipe, 0 Undrgrnd.,Test '1 CI 9. Water-Pipe-Undrgrnd. - •i 60. Backwash Lines, P-Trap, O Undrgrnd. • 101 Structural Floor Sysfem 61. APPROVAL TO DECK .! 11.1Pro perty 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 (la6c ) 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 PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT :31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED Ir 33. Final Electric Notes: ". 34. Final Heating & Air Conditioning li(a(iS 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 1 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. - 8001 5/02/85 _ tae 00 -TL CITY OF COSTA MESA CONSTRUCTION PERMIT NO. TRACT NO. LOT NO. UNIT - . Project Address ' 74:03 �G Yvl 7.o l-7G e Z 2 , • 1 _ - • Applicant's Mailing Address 2 .0 fes.}Lysrt a ? TYPE OF CONSTRUCTION ,LI NEW ADD U ALTERATION U REPAIR "' Ar ^��a ❑ CONVERSION ❑ DEMOLISHOTHER •: - A.P.# V.?, 0 7/ - / - . /y ,Zone Z� 'Owner's Name G EGV LS./ ? ._4' Phone... 9 _ DESCRIPTION OF WORK/USE OF BLDG. - Address 2 if scpsy.�.�_ a / G.'4�. - - S Main Building: Accessory Building: • �t Q /'L TYPE OF PERMIT U GRADING ❑ FOUNDATION • E 2 Arch/Eng. &ne �sy ,.�s License No. ,(y{ U STRUCTURAL T Front - - G Address - ❑ TENANT 0 ELECTRICAL ❑ PLUMBING 0 MECHANICAL B Rear N 'Contractor's Nameeee��«446,�joe •-5W-0,09. ❑OTHER C Right • - N Address(mailing) �,r:5. 11, PROJECT DESCRIPTION SQ. FT. - • OCCUPANCY - K • - G Left 4 '/ is - CONSTRUCTION TYPE VALUATION$ S - CityLicenseNO. �({f•�jf//_`f�fr ZONE GRADI NG CU.YDS. ' ACRESR LICENSED CONTRACTOR DECLARATION - - a-� Ping. Ref.# Parking R¢q./Provided E I hereby affirm that I am licensed under provisions of Charter 9 (commencing. Remarks: • - ' // d- . 7�` {{G Planning Notes: I ' M • with section 7000) of Division 3 of the Business and Professions Code,and • my license is in full force nand effect. /��'/� /):H �9 , T License Class f U 'cense No. Y TJ / S �. Date �%•F.S SignaturePL MBING FEES - - WORKERS'COMPENSATION DE LAq Bar Sink ShowersELECTRICAL• I FEES � <hereby hereby affirm that I have a certificate of Consent to self-insure or a certificate Workers' Compensation Insurance, or a certified copy thereof (Section Backflow'Preventef - -Service Sink - - - -• - - • -" Automatic Washer Transformer 0 15-50 KW-; J00, Lab. C.) 07.5-6-C1/ l'Yj►I( I�+-� ' " 0 50+ KW • Policy No. Company Backflow Irrigation, Sewer.Cap Construction Pole Sub. Certified copy is hereby furnished. ertified copy is pled with the city Buil���O� Bathtubs , ; Sewer Connection r Cooking Unit Meter ❑up to 100 amps I a Applicant � �/' EXEMPTION FROM WORKERS'COMPS SATNIDN DECLARATION Clarifiers r ' Solar Collectors Dishwasher Meter Dover 100 amps_ (This section need not be completed if.the permit Is for one hundred ($100)or ' less). Dishwasher Solar Piping ' Dryers OGas ❑Electric ' Sub Panel I'certify that in the performance of the work for which this permit is issued, I - shall not employ,any person in any manner so as to become subject to the Drinking Fountains " Solar Tank Fan Motors 00-1.HP 01•A-B Workers' Compensation Laws of.California. Date Signature Floor Drains I�-' Swimming Pool w/Spa F.A.U. Inc..Solar 9-15 HP 016-15+ 'NOTICE:if,after making this declaration,.yOu should become'subject to the . • Workers' Compensation provisions of.the Labor Code, you must forthwith Floor Sinks- - - Urinal • - Fixtures . - -- _ - comply with such provisions or this permit shall be deemed revoked. i Microwave- - CONSTRUCTION LENDING- AGENCY - Gas Service ', Outlets - Water Closet Device Boxes Pole Light I hereby affirm that there's a construction lending agency for the performance of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors • _ Water Heater, - _ ' Outlets Range ' Lender's Name ' 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-WashGarbage Disposal ;Standing Sections ' following reason (Section 7031.5 Business and Professional Code: Any-city or • county which requires a permit to construct,alter,improve,demolish or repair P—Trap Lau ndry.Trays Generator ❑0.5 KW ❑5-15 KW any'structure, prior to its issuance, also requires the applicant for such perm it • Trash Compactor -to file a signed statement that he/she is licensed pursuant to the provisions ofRoof .Drains' - ' • the Contractor's License Law (Chapter 9(commencing with Section 7000)of 'division 3 of the Business and Professions Code) or that he/she is exempt, - - - - erefrom and the basisfor 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). - - - b I, as owner Of the property or my'employees with wages as their sole ' Reinspection Fee, ' I $15 , . Issue Fee r- . $*3 compensation, will do the work,and the structure is not Intended or offered • - - Reinspection Fee I $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's , MECHANICAL FEES License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not Intended or offered for Boiler • Hood or Type I 0 sale. If, however, the building or Improvement is sold within one year of com- Canopy Type II ❑ 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). • LJ I, as owner of the property, am exclusively.contracting with licensed con- Duct-Structural Refrigeration System i Application Issued By Dat Z— tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply,to an owner of property who Duct-Ventilating - 00-100,000 BTU 0100,000 BTU SUMMARY OF FEES • builds-or improves thereon,and who contracts for such projects with a con- ' tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ - SMIP - ' proof o their Worker's Compensation insurance should be provided to me. PLAN CHECK __ • ❑ I am exempt under'Section B.& P.C.for this reason Fire I/Fact.Blt. ICBG# Fire Dam ere $ PERMIT 1 p l��I p «� PLUMBING $ - • ISSUANCE $ -- Date Owner Heating System& Ducting Registers PLAN CHECK , 25% $ ENERGY P.C. $ • -I hereby certify that'1 have read this application and state that the above - 00.100,000 BTU 0100,000 BTL -, - - -- . ( - GRADING $ ' information,is correct. I agree to comply with all city and county ordinances ELECTRICAL ' $ and state laws relating to building construction,and hereby authorize repre- sentatives of this cit a upon the above-mentioned roperty, for $ • Inspection purposes. 8 / MECHANICAL $ ���� Signature • Pink -Accounting;Goldenrod - Assessor CONSTRUCTION AND PLANNING _J POO" SPA APPROVALS Permit# Dater Inspector APPROVALS Permit Date Inspector 1. Temporary Electrical Service or Pole'' 52. Pool & Equipment Location 2. Soil Pipe;Undrgrnd. 1.'i -53. Steel Reinforcement 3yElectFical-Conduit Utility-Undrgrnd. 54. Forms J-; 4c.Ilect ica6 Conduit-Undfgrnd. „.,•i � 55. Electrical Bonding .1:e 5. SteellReGforcem'en(;l r 56. Rough Plumbing & Pressure Test yy .. 6.,E19ctrkcaidoER•'Grnd!f 57. APPROVAL TO COVER-GUNITE 7..:footings >? U'. 58. Electrical Conduit-Undrgrnd. 8/fFoundationl „., !(': i 1( 59. Gas Pipe, 0 Undrgrnd.,Test 9: Water•Pipe-Und rg'rnd. lip 60. Backwash Lines,P-Trap, O Undrgrnd. 10. Stjuctural Floor'System h' 1 61. APPROVAL TO DECK - 11. Property:Sewer Line & House Connection , 62. Backwash & Receptor-Final 12. Sewer.lp.7 / - 63. Heater & Vent-Final 13. Roof Drains I.. LI 64. Plumbing System - Final 14. Rough PlubingC 65. Electrical-Final A. m : r 15. Rough Electrical-Ponduit 66. Solar System-Final - . . 16. Rough Electric Wiring 67. Fencing &Access Approval 17.-Rough Wiring Sign 68. APPROVED FOR PLASTERING 18.jRough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS F I NAL le 19.'Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace Wfor ar APPROVALS Permit# • 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 41 71. Product Piping 0 Gas OOil 23.3 Gas Pipe-Rough & Test 72. Underground Flush 24e.Roof Framing73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 1 74. Overhead Hydro 26. T-Bar Ceiling (Structural) 8l'Monocoat 75. Dry Chemical 27. Frame and Flashing .7.11-L 76. Dry Standpipe 28. Lathing & Siding ,'w. 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. Fina,Factory Fireplace /0,4q,4- G,£o • 38. FinalifSlumbing 39. Water Service-Final 40. Gas'Service-Final it 41. Solar''Domestic-Final 42. Backflow Preventer 43. Bacl$flow Irrigation 44. ,Landscape Irrigation System , 45. Sounrd. Attenuation • 46. Handicap Regulations 47. FINAL STRUCTURE& 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 . : i • ' 1.1 City of Costa Mesa • Development Services Department CERTIFICATE OF OCCUPANCY No. 001469 Building Safety Division P.O.Boz 1200 ' Costa Mesa,California 7 q. The Building located at 2603 Elden Avenue #D , has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto s • for a Group R-3 Occupancy. { Use of Building Condominium C. . r Legal Description 439-071-10-15 I'a - (See reverse side for Metes and Bounds) r r Building Permit No G18476 Electrical Permit No. G18476 Plumbing Permit No. G18476 • i Mechanical Permit No. G18476, M19768, M20175 Number of apartments and/or gue�sstt•r0000ms '� ISSUED TO: Building Official r Mar-Elden Developfmttt e, �� �f... cz 18226 W.. MclAirnott by ,� Irvine, CA 92714 7 Date Qf This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the .:4 Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. 4 CMF 1015-46 rev.1/83 White-Owner;Canary-Numerical File;Pink-Bldg.Permit File 4 r 1 :7 . :1 _r- r City of Costa Mesa Development Services DepartmentCERTIFICATE OF OCCUPANCY No. s l;Ua id Building Safety Division P.O.Box 1200 Costa Mesa.California The Building located at 2603 Elden Avenue 4D has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group R-3 Occupancy. Use of Building COndartdniu m Legal Description 439-071-10-15 (See reverse side for Metes and Bounds) DBuilding Permit No G18476 Electrical Permit No. 018476 Plumbing Permit No. 018476 Mechanical Permit No. G18476, M19768, M20175 Number of apartments ands/or guest rooms ISSUED TO: Building Official /6), /4/, Mar-Elden Develaprlent 18226 W. McDuraott by Irvine, CA 92714 Date / /9 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.1/83 White-Owner;Canary-Numerical File;Pink-Bldg.Permit File 1 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. • i ChT'1,OF CQSTA MESA - PERMIT NO. J _ TRACT N�1 LOT NO. BLDG.NO. _ 255 ,!+/-I 6185 - E• Ee:,:.. IL • C IISTRUCTION PERMIT G I �� 1�o ` 1'���/ / •. ' .. : J .' POO SPA ONSTRUCTION AND PLANNING • Date Inspector Date- Inspector APPROVALS- Permit# APPROVALS Permit# a , 1il Temporary Electrical.Service or Pole - 7 - • 52. Pool & Equipment Location , 22.. Soil Pipe-Undrgrnd, ', • . .I in/ .0 53. Steel Reinforcement -, • '..3: Electrical Conduit Utility-Undrgrnd. 1'4, /. 54. Forms H 4: Electrical Conduit-Undrgrnd. . 55. Electrical Bonding - ,.4. 5. Steel Reinforcement S1j/SS /01-11 56. Rough Plumbing & Pressure-Test 6. Electrical UFERGrnd ; ,, �._ • -.57. APPROVAL TO COVER-GUNITE ' ; 7. -Footings 'pf>:S+r aca.!y:f SI,113k Igo . 58. •Electrical Conduit-Undrgrnd. 8. Foundation ` sin 1S.T oritr. �I/86'i • 59. Gas Pipe, O Uridrgrnd.,Test ., 9. Water Pipe-Undrgrnd. 1 • - t ,E _..�; 60. Backwash Lines, P-Trap, ❑ Undrgrnd, - - 10: Structural Floor System ,/i. ,-:;4.,", f- 61. APPROVAL TO DECK ' • 11, Property Sewer .Line & House Connection bAi!fk GIGO 62. Backwash & Receptor-Final 12. Sewer Cap • •c i' `r` ,. _ 63. Heater & Vent-Final . 13. Roof'Drains 'i:': '4I, 1 64. Plumbing System - Final . ' 14. Rough'Plumbing - 65. Electrical-Final 15: Rough Electrical-Conduit. • - • 66. Solar System-Final ' - 16. Rough Electric Wiring : . -7 kr, /J/j' 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 • --106- /e FIRE DEPT. REQUIREMENT 20: Rough Factory Fireplace APPROVALS Permit#. 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 Framing73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing • 742 fir 18//1 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat = 75. Dry Chemical • 27: Frame and.Flashingr-is sirs- IsAittS"" 76. Dry Standpipe i 28. :Lathing 8/Siding 7//( 4y- /fltj 77. FIXED SYSTEM FINAL 29. Insulation $h Or 78. FIRE PREV. FINAL 30. Drywall:Nailing '74-4837 •%yj47 HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat , �`• 79. FINAL INSPECTION - I. 32. Electrical Power Meter-Final f.'7 -n /t' 80. FOOD CERTIFICATE ISSUED 33. Final Electric ,r r( • (.�I Notes. .^Q/�.4.1frad 6 , e45.-2•-!t - 34. Final'Heating & Air•Conditioning : t�r,/ `„ 7 "P, - * - - 35. Fina(Gas Pipe-Test r• • 4/ZZ2 - cif?, 36. Hood or,Canopy - • - 37. Final.Factory Fireplace Osr/Ts'' - . 38. Final,Plumbing ff//y/yf - 39. Water Service-Final . 41.341? C,TO 40. Gas Service-Final ' r : - ._ • 41. Solar Domestic-Final ' . . ' 42. Backflow Preventer t7 . . . - - 43. Backflow Irrigation -- - 44. ,Landscape Irrigation System ' 45. Sound Attenuation r ' i . 46. Handicap Regulations . . ! ' 47. FINALSTRUCTURE& BUILDING• 1/jg/gam. - 48. Special Requirements Completed - ///_I_U_ .5-- /� . , , 49. Electric Release to Edison -. - , , 50. Gas Releaseto1SouthernCaliforniaGas Co '. " 51. CERTIFICATE// OFOCCUPANCY...,OCCUPANCi�) • qC' ., ' . : No, . �T ( Date Par- �G Q I 3 /C#7Ma' A nt-to.till in all spaces except those within heavy border lines and sign all appropriate declarations. - CITY OF COSTA MESA CON$TRUCTION PE IT WIT NO. /p �X^/ TRACT NO. LOT NO. UNI'7�/�jQ • - Project Address-aa3 tChi-H — /` 7� � T( / . Applicant's Mailing Address Z/ t4 �at>:�43 4J TYPE OF CONSTRUCTION LI NEW L ADD LI ALTERATION lJ REPAIR 6178 7/08/85 81 .75 TL Ole CI CONVERSION CI DEMOLISH CI OTHER A.P.# Zone Owner's Name / • Phon DESCRIPTION OF WORK/USE OF BLDG. Address 2€/V LS cote 4 'f!- S Main Building: Accessory Building: TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION - O Arch/Eng. ��ht .,rs License No. ❑ STRUCTURAL T Front AddressCICICICITENANT ELECTRICAL PLUMBING MECHANICAL B Rear N Contractor's Name 12(//(A0. //�e//f!(c�Phone b '�* ❑ OTHER • A I C Right N Address(mailing) / / 7 A's Ate-4i 4's to PROJECT DESCRIPTION SQ. FT. OCCUPANCY K . G City License N_o_ 64,30� • C O N ST RUCTION TYPE VALUATION$ S LeftR ZONE GRADING CU.YDS. ACRESE LICENSED CONTRACTOR DECLARATION _ Ping. Ref.# Parking Req./Provided Q • I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: M with section 7000) of Division 3 of the Business and Professions Code,and - T my license is In fu force and effect. Y License 1 ss 2'0 License No. Z 7 SSG a s t Date / Signature ,eeac • PLUMBING FEES 1 ' WORKERS' COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL • FEE$ I hereby affirm that I have a certificate of consent to self-insure or a Certificate of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink --- - 3800, Lab. C.) - Automatic Washer Transformer 0 15-50 KW Policy No. Company Backflow Irrigation • . - Sewer Cap Construction Pole Sub. 0 50+KW ' 8 Certified copy is hereby furnished. Certified copy Is filed with the city Building Division. BathtubsSewer Connection Cooking Unit Meter ❑up to 100 amps Date_ - Applicant - EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors . Dishwasher Meter Dover 100 amps • (This section need not be completed if the permit is for one hundred ($100) or - less). Dishwasher Solar Piping - Dryers ❑Gas- DElectric Sub Panel I certify that in the performance of the work for which this permit is issued, I - shall not employ any person in any man er so as to become subject to the Drinking Fountains ' Solar Tank Fan Motors❑0.1 HP ❑1�4-8 Workern7 ation Laws of Califo Date �/!C( $ r Signature i� - - Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP 016-15+ • NOTICE:l afte making this declaration,you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal . Fixtures -- .Microwave comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Gas Service Outlets - Water Closet - ' I hereby affirm that there is a construction lending agency for the performance - Device Boxes Pole Light of the work for which this permit is Issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Range Lender's Name - - Lender's Address Kitchen Sink Water Service Switches ' OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories • Auto-Wash Disposal ;Standing Sections Garbage following reason (Section 7031.5 Business and Professional Code: Any city or - county which requires a permit to construct,alter,Improve,demolish or repair P-Trap Laundry Trays Generator ❑0-5 KW❑5-15 KW .Trash Compactor any structure, prior to Its issuance, also requires the applicant for such permit ' to file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains 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 • penalty of not more than five hundred dollars($500). LJ I, as owner of the property or my employees with wages as their sole Reinspection Fee $15. Issue Fee $ 3 compensation, will do the work,and the structure Is not intended or offered —+ - Reinspection Fee $15 Issue Fee $ 3 for sale (section 7044, Business and Professional Code: The Contractor's ' MECHANICAL I 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 Hood or Type I ❑ - DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such Improvements are not intended or offered for Zoning Approved By • Date sale. If, however, the building or improvement is sold within one year of corn- - Canopy , Type 11 ❑ pletion, the owner will have the burden of proving he/she did not build or-lm. Duct-Under Ground Building Approved By Date rove for the-purpose of sale). • p O I,as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By / Date 7/�/p C 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 Z Duct-Ventilating . • fr ❑0.100,000 BTU ❑100,000 BTU L� „rp SUMMARY OF FEES ' builds or improves thereon,and who contracts for such projects with a con- - T tractor(s).11cense pursuant to the Contractor's License Law). I am aware that - Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $ proof of their Workers Compensation Insurance should be provided to me.; PLAN CHECK $ PERMIT 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.BIt. ICBG# Fire Dampers PLUMBING $ 'ISSUANCE $ • C • Date Owner Heating System&Ducting - ' / Registers 7 Ego PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above / X0.100,000 BTU 0100,000 BTL GRADING $ information is correct. I agree to comply with all city and county ordinances ELECTRICAL $ and state laws relating to building construction, and hereby authorize repre- irePLAN CHECK 50% $ MICROFILM $ �- sentatives of this city to enter. upon the above-mentioned property for •� C Inspection p r�Qsei•_ '/ /GS/ MECHANICAL ' S TOTAL FEE $ e? 7,25 Signature JAJ lit 1 Date p Drivers' License or SS# , Reinspection Fee I $15 i Issue Fee $ 3 PLAN CHECK 25%. $ - - - . CMF 0865-46,rev.10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor • CONSTRUCTION AND PLANNING POOL &SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2.,Soil Pipe.lindrgrnd. - 53. Steel Reinforcement 3. !Electiical Condu t.Utility-Undrgrhd. : 54. Forms • 4. Electrical ConduiUUndrgrnd. 55. Electrical Bonding 5. Steel Reinforcement : 56. Rough Plumbing& Pressure Test • 6. Electrical UFER.Gr"bd. ., 57. APPROVAL TO COVER-GUNITE - 7:.Footings 58. Electrical Conduit-Undrgrnd. • •� 8. Foundation 59. Gas Pipe, D Undrgrnd.,Test ' 9. Water,Ffpe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10: Structural Floor System • I 61. APPROVAL TO DECK h1: Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. SeW,ef,Cap 63. Heater& Vent-Final 13. Root 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# 21.1Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating Wan- 1 71. Product Piping DGas 0 Oil • 23. Gas Pipe-Rough & Test 72. Underground Flush , T 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 PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31JPlaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning f/1/3/315- cJ 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. 6000 9/02/69 6000 _TL" CITY OFCOSTA MESA. CONSTRUCTION PERMIT PERMIT NO. • . TRACT NO. LOT NO: • .UNIT I - - • - , . Proiect Address ' 260 /4`' _ [1/J/J ' - - - - - ,- TYPE OF CONSTRUCTION NEW LJ ADD U ALTERATION L EPAI R. Applicant's Mailing Address _ 2 fir //'�es_ w 's-,A/ L'_ ) '� phones-yr-07n / ❑ CONVERSION ❑ DEMOLISH .❑ OTHER A.P.# / , Zone 4..i__ ' Owner's Name 14040 �� sail) isyr-O7/1Y - y S Q 7� - • DESCRIPTION OF WORK/USE OF BLDG. ' Address , - ' ./ - - , . S Main Building: • • -Accessory Building: I r, • Arch/Eng. U,44 #J q/ r License No. G /.#GS TYPE OF PERMIT ❑ GRADING U FOUNDATION ❑ STRUCTURAL - E Front _ - •'- - - _ - " O •' Address - - - - ❑ TENANT-. ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL BA, Rear- ,- N Contractor's Name�L JG/ � C�JQ6✓/�/,C One �y�f`�p/� ❑ 'OTHER ,_ _ - - - , -{T o C Right N 'Address(mailing) PROJECT DESCRIPTION SQ. FT. OCCUPANCY K Left i G ���� CONSTRUCTION TYPE "VALUATION$ $ .•City License No.: 3 ZONE ' GRADING CU.YDS.. ACRES' . - - R c . LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking •Req./Provided - - -' E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: - ' P /� i// O�L t Planning Notes: • I M • with section 7000) of Division 3 of the Business and Professions Code,I'and -' ar JI n - ; • -my license is in ful a ct. �/I Y /' ( IN (.'-] /- • S V -License ss o. `[ 'o/ LJT ( w - . 1 'Date Signature • PLUMBING FEES ' • WORKERS' COMPENSATION DECLARATION • Bar Sink ' Showers' ' , ELECTRICAL I , , FEES f I hereby affirm that I have a certificate of consent to self-insure or a certificate - - - of Workers' Compensation Insurance, ora certified copy thereof_(Section • Backflow Pfeventer - - Service Sink - - "-' - - - 3800, Lab. c.) /}• Automatic Washer Transformer 0 15-50 KW Policy No. tea- S ' Company.5470417Z fC44JQ Backflow Irrigation T Sewer Cap D 50+ KW Construction Pole Sub. Certified copy is hereby furnished. - _ • Cert' ed cop isfy1ed with the city Bull n. ' Bathtubs Sewer Connection ' - Cooking Unit I Meter Cup to 100 amps .• Date / ears Applicant - . EXEMPTION FROM WORKERS'COMPENSATION DECLARATION - Clarifiers Solar Collectors' I - - ' Dishwash_er • • Meter Dover 100 a_mp5 (This section need not be completed if the permit is for one hundred($100) or:' - • less). . • Dishwasher • Solar Piping ' Dryers ❑Gas ❑Electric ' Sub Panel ' I certify that in the performance of the work for which this permit is issued, I• shall not employ any person in any manner so as to become'subject to the Drinking Fountains', , Solar Tank , Fan - Motors❑0-1• ,HP 01%1 8 Workers' Compensation Laws of California. - • - Date • Signature Floor Drains • Swimming Pool w/Spa F.A.U. Inc.Solar ❑9-15 HP ❑16-15+ NOTICE: If,after making this declaration,you should become subject to the - - - ' .Workers' Compensation provisions,of the Labor Code, you must forthwith- Floor Sinks. , - Urinal - - - Fixtures' ^I' - comply with such- provisions or this permit shall be deemed revoked.' Micfbwav¢ , ' CONSTRUCTION LENDING AGENCY • Gas Service Outlets _ Water Closet ' l - Device Boxes I hereby affirm that there is a construction lending agency for the performance - Pole Light of the work for which this permit is sued (Section 3097 Civ. C.) • , Interceptors - 'Water Heater . - Outlets Range ' Lender's Name - _ _ • Lenders Address' • ' ' - Kitchen Sink - _ Water Service_, _ - Switches Sign ' ' OWNER BUILDER DECLARATION - r - - ' I hereby affirm that I.amexempt from the Contractor's License Law for the Lavatories - Auto-Wash ' - 1 Garbage Disposal •' Standing Sections following-reason (Section 7031.5 Business and Professional Code: Any city or — - • • county which requires a permit to construct,alter,improve,demolish or repair P-Trap " - - LaundryTrays - • _.any-structure, prior to its issuance, also requires the applicant for such permit - y Generator 00.5 KW ❑5-15 KW' Trash Compactor' to file a signed statement that he/she is licensed pursuant to the provisions of • Roof Drains - - ' the Contractor's License Law (Chapter 9 (commencing with Section 7000)of I Division 3 of the Business and Professions_Cotle) or that he/she is.exem pt - - - therefrom and the basis'for-the alleged exemption. Any violation of Section , I . , , ' • 7031.5 by any applicant for 'a permit subjects the applicant to_a civil - - , ' - _ _ • ' I enalty of not more than five-hundred dollars($500). - LJ I, as oWner of the property or my employees with wages as their sole Reinspection Fee I ' $15 Issue Fee $ 3 • . compensation, will do the work, and the structure is not Intended or offered - • - ' Reinspection Fee $15 Issue Fee • $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's •_ MECHANICAL FEES License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her,own, - m 4 - DEVELOPMENT SERVICES REQUIREMENTS: , employees, provided that such improvements are not intended or offered for - Boiler - Hood or Type I IDI , sale. If, however, the building or Improvement is sold within one year of com-, • Canopy Type II 0 Zoning Approved,By nate: • pletion, the owner will have the burden of proving he/she did not build or im- Duct'Under Ground • Building Approved By • Date I prove for the purpose of sale). ICi° 0 I, as owner of the property,'am exclusively-contracting with licensed con-_ Duct-Structural ' • Refrigeration System Application Issued By Date �( tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who, Duct •-.Ventilating ❑O-100,000 BTU ❑100,000 BTU - SUMMARY OF FEES builds'orimproves thereon', and who contracts for such'projects with a-con= '-- "-' tractor(s) llcense'pursuaet to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration - BUILDING PERMIT $, SMIP . $ ' proof of their Worker's Compensation insurance should-be provided to me. �y PLAN CHECK ❑ am exempt under • _Section ;B. &'P.C.for this reason Firepl/Fact.Blt. ICBG#�I U Fire Dampers • ' . 1 1 , PLUMBING ' $ - , ISSUANCE • $PERMIT ' Date owner Heating System&Ducting Registers • PLAN CHECK 25% $ -- • - I ENERGY P.C. $ ' • I hereby certify'that'I have read-this application and-state that the above•- 00-100,000 BTU 0100,00013T - - . - - ELECTRICAL . GRADING • information-is correct: I agree to comply with all city and county ordinances $ - $ and state laws relating to building construction,and hereby authorize repre- PLAN CHECK 50% $ , • MICROFILM ' $, sentatives of this to enter upon the above-mentioned property foy c I , Inspection purpose • ��'_8./ - MECHANICAL. $ 7. 00 'TOTAL FEE $; G- O� Signat tire I _ ` � Pink -Accounting; Goldenrod - Assessor . . • ,- CONSTRUCTION AND PLANNINGPOOL.<SPA ' i APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or PoJ'e. `t'- 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. -•;i 53. Steel Reinforcement 3. Elect_ical Conduit Utility-Undrgrn71' , '' 54. Forms re.1 4.2 t ,': - ii i!' ' Electrical Condui;-1, l' 55. Electrical Bonding • . 5.,Steel peinfdreement -:r ayi ,. 56. Rough Plumbing & Pressure Test - -' i 6. ElpcicalOFER•trnd+t I 57. APPROVAL TO COVER-GUNITE 1 l i.':Footings t Ij? 58. Electrical Conduit-Undrgrnd. Pi 8l.;Fqurldat ion .\ •�% 59. Gas Pipe, 0 Undrgrnd., Test 9rWater'' a-Undr rnd. %} ���' 1:0' P 9. Y, ;� 60. Backwash Lines,P-Trap, Undrgrnd. ;4-i - 10/Str'pctural Floor System f` if• -1 61. APPROVAL TO DECK °yam -f <. 11:?Pra,'perty Sewer Line & House-Cognection 62. Backwash & Receptor-Final 12. Sewer„Cap-', 63. Heater & Vent-Final ' 13. Roof'Drainf 'r r` 64. Plumbing System - Final 14. Rough Plumbing .65. Electrical-Final 7' 15. Rough-"Electrical-:conduit _ 66. Solar System-Final .. . 1¢. 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 � ak/is. co APPROVALS Permit#-- - _ 21. Ducts,in Structure ` 70- Underground Hydro • -22: Ducts, Ventilating 71. Product Piping DGas ❑Oil - 23y 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) &'Moriocoat 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:.1 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. FinalFtactory Fireplace - /4/Sq/jr cr.° 38. Final,Plumbing 39. Water.Service-Final 40. Gas$ervice-Final 41. Solai Domestic-Final 42. Backflow Preventer 43. Backfllow Irrigation ' 44. .Landscape Irrigation System 45. Sound- Attenuation ' 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed' . 49. Electfic Release to Edison, - • 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY • No - Date