The URL can be used to link to this page

Home My WebLink About2644 ELDEN AVE - Building Permits r srt AVEMUE, 2614 alEMEMINZIA - 2644 ELDEN UNIT A-1 1 ` - • m®tea 3106 - 8-3-56 ris w/att gar $8,694. - B1400 OJNDO $73,420. - 44611 - 1-4-65 P=.bg. NC ii.S. ) // /JS . PC 172-84L UNIT Al :48926 - 10-6-66 Pi:og. NC (water r,-;els-or' P14255 MISC use _ s/i/S- � 814001 UNIT Al - - BaPp--13�8- Deno Res. w/ 1,000. -Ca+e�IL ia'a`6a att. garage - 4s`�0 / MISCO . - 37/470 UNIT Al ®®® m it -4.400,7 „” TEMP Pra - M15591 t MISC ) 713ilE a � p _ea /,s/es B1400 � 14127 SEWER LATERAL $3,500. - _ M155826 FRPLC- 244 . -;//f/0- 814001 Chit Al - • E14539 MISCMI.59y3 MISC- z4i565 - - • a —sal= 3A5ig C 814001 UNTT Al ; - B17342 TRASH ENCT, $300. /�30/ds/ PC 172-34S j ,1 U I il II I II i • I, I I - - - 'l- _. ---.J CITY OF COSTA MESA ;y:41114:tv BUILDING DIVISION ta'� , 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa,ca.us f� FOR INSPECTIONS CALL: (714)754-5626 PERMIT NUMBER: P08-00201 PERMIT TYPE PLUM STATUS: ISSUED APN: TPN00581 DATE ISSUED: 09/17/2008 ISSUED BY: YH JOB ADDRESS: 2644 ELDEN AV CM Suite/Unit: Vicinity: rvP D n SCOPE OF WORK: CHANGE OUT WATER HEATER/SAME SIZE-SAME LOCATION. DATE /c2 -&-Oil—/1/0 OWNER: ELDEN COVES HOA Address: 2644 ELDEN AV UNIT B001 PHONE: City/State/Zip: COSTA MESA,CA APPLICANT: NOCK,TIM - Address: PHONE: 714 532-4857 City/State/zZip: CONTRACTOR: ORANGE INSTALLERS License No. 511971 •. Address: 905 E CHALYNN AV PHONE: 714-532-4857 City/State: ORANGE,CA ZipCode: 92865 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 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. sGPE/ INSPEcnON TYPE iNTMALS cQUr INSPECPON FPI INpMLS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place _ 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy WORKERS'COMPENSATION DECLARATION: Owner ID verified by drive,_..,sense. 0 Yes 0 No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: ❑ 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. - ❑ 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 0 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 rio building structure,scaffdding,falsework,or demolition Cartier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Gry (This seggn need not be completed dine permit is valued of are hundred dollars(El 00)w less) 2 Aft':2Sec.341;Title B,California Administrative Code). Policy Number: ./^� i ,1/41 1 0 As owner-builder, I will not employ anyone to do work which would �f�J 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 becomeysubjt z. such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if rl;shpui become subject tot - worker- •mpensation provisions of Section 3700 0�7 Applicant's Signature Date the Labor Cod:, I sh.II forth •mply with these pro ' ions. c _i_ _ /5 ' • a °Division of Industrial Safety Permit Number: -4 r l ` . qpp TnP 1[�a� Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: ":ILURE TO 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? 0 Yes ❑ No (5100,000), 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 ATTORNEYS 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 Professio s 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 ❑ No �'11 ((G Lic.# J ;1 7. ` 1 Class# C l"1 ,„ (Section 25533 of the California Health and Safety Code, with some • V��1 /\ c `�',tr , b-ii exceptions, requires registration with the Costa Mesa Fire Department by ` I each business which at any one time has on hand a quantity of acutely Cdruactor'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). ❑ 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 6 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 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 ❑No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California 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? 0 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(5500).): 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? 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 city ordinances regarding Hazardous Materials and Emissions. - ❑ 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 Signature Date property who builds or improves thereon,and who contracts fa 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 , upy or allow occupancy of any building authorized by this p7 it ntil fin- spection. , Signatu'• • 7.) Date B� 3057<e(3/07) Signature Date ,� P. / •7` An.or A 'or t r Applicant ) iDate ' CITY OF COSTA MESA F BUILDING DIVISION F` 7,,.��,,yy��iii 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa. us - FOR INSPECTIONS CALL: (714)754-5626 p 644 PERMIT NUMBER P08-00056 PERMIT TYPE PLUM STATUS: ISSUED APN: 93794043 DATE ISSUED: 0212012008 ISSUED BY: RMD JOB ADDRESS: 2644 A001 ELDEN AV CM Suite/Unit: A001 Vicinity: SCOPE OF WORK: CHANGE OUT(E)WATER HEATER TO A HIGH EFFICIENCY"ENERGY STAR"WATER HEATER FOR UNIT A001. OWNER: EMPEY,PATRICK AND DENISE Address: 2644 ELDEN AVE A001 PHONE: 949-645.8580 City/State/Zip: COSTA MESA,CA APPLICANT: LINGFORD,SEAN Address: 30300 PUERTO VALLARTA : PHONE: 800-727-0977 City/State/zZip: MENIFEE,CA CONTRACTOR: ALL STAR WATER HEATERS INC—� License No. 812894 Address: 30300 PUERTO VALLERTA �3 , PHONE: 800-727-0977 11 I-- City/State: MENIFEE,CA ZipCode: 92584 / / , CELL: ARCHITECT: License No. C ,PHONE: ENGINEER: License No. �� L g ArONE: PLUMBING PERMIT FEE SUMMARY PLAN CHECK FEE: $0.00 PERMIT FEE: $35.80 TOTAL FEES: $35.80 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODEC INSPECTION TYPE, OATS IN$ c00F IS INSPECTION TYPE DATE INTMAL4 1816 Fixed System Final Fire Prevention 206 Final Mechanical y( p 1266 Pool Spa Final 208 Final Plumbing 'r-8 of t- N 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 WORKERS'COMPENSATION DECLARATIONS Owner ID verified by drivx .Cb..._. 0 Yes 0 No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: ❑ 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. ❑ 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 0 I hereby certify that no excavation five(5)or more feet in depth into which a number are: dr'4-/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 Carrier: -� ° or dismantling thereof,will be more than thirty-six(36)feel high.(Chap.3.2,Grp (This section need be completed a me perms is valued at one hundred dollars(SI 00)or less.) 2,Art 2,Sec.341,The B,California Administrative Code). Policy Number: n-01 WC ❑ As owner-builder, I will not employ anyone to do work which would O 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 worke compensation provisions of Section 3700 of - - - Applicant's Signature Date the Labor Code,1 5:7 fes• A comply with these provisions ` v )1 Cf Division of Industrial Safety Permit Number: A P.; r 'rat re Date / HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SS URE 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? 0 Yes 0 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 license is in full force and effec 7 a registration form for acutely hazardous materials? 0 Yes 0 No Lic.# "j�S/C` Class# 6-7 6 (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by /.�j�l each business which at any one time has on hand a quantity of acutely r7J.l� r!s"natur. 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 CONSTRU TION 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 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 Dale 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? ❑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? ❑Yes 0 No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Government Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be fumished 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? 0 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 California 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 (II 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 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 ❑ 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 : occupy or allow occupancy of any building authorized by this permit until f'. inspection. Signature of L_r Owyegs) pate Signature Dale / of 14 ! 305]-a6(3e]) A,'�or/4' 'oozed APW,cant /// Date I r • • CITY OF COSTA MESA 4BUILDING DIVISION F• _4401_11111k%) DEVELOPMENT SERVICES DEPARTMENT PE IT NUMBER PERMIT a. � rla� B06-01834 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.c1543ILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 2644 ELDEN AV Status: ISSUED Suite: A001 Applied: 10/30/2006 Vicinity: DINING ROOM AREA Issued: 11/01/2006 Primary Occ: R-3 Dwellings/Gong Res<10 Type of Construction: V-N Parcel Number: 93794043 Zoning: Applicant: EMPEY, PATRICK AND DENISE - Address: 2644 ELDEN AVE A001 Phone: 949-922-8509 ISSUED BY: X.741./d COSTA MESA,CA Zip: 92626 Owner: EMPEY, PATRICK AND DENISE Address 2644 ELDEN AVE A001 Phone: COSTA MESA,CA Zip: 92626 Contractor: OWNER-BUILDER Address: Phone: Zip: License: 000000 Arch : Eng: Address: Address: \ Phone: Phone: Zip: License: License: \\ SCOPE OF PERMIT REMOVE SLIDING PATIO DOOR AND INSTALL FRENCH DOORS(LIKE-FOR-LIKE)IN THE DINING ROOM OF AN EXISTING CONDO. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $2,400.00 Permit: $83.25 Claim Valuation: $0.00 SMIP Res: $0.50 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $83.75 PLANNING & ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0.0 • Rear 0-0 Left 0.0 . Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 c' 'ally, 'rk ie NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related 1 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)754-5826 2448-46(WOO) . r I i r DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit Is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carrier and policy number are: Carrion Policy Number: (This section need n completed If the permit is valued at one hundred dollars($100)or less.) 15a I certify that int 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 la - of Cal' ia,and agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Cade,I shall forthwith comply with these "al App�FAILURE TO– b �� Date: II II bit, THOUWARNAN: D FAILURE E( SECURE INADDERS'CTM EN fi N PENS IS NUNLAWFUL S A SHALL SUBOR I AN EcTL�E7 TO HECRIMINAL PENALTIES AND CIVIL ADEN IUPO tN ONE HUNDRED THOUSAND OOLLARE(5100,000),IN ADDITION TO THE OF COMPENSATION,DAMAGES AS PROVIDED FOR IN RECTION OF3706THE 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.Lie.a Class# Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is Issued.(Sec.3097,Civil Code). 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,altar,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,es 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 awn employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is -,cold "hin 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.). )b',0-1,as caner 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 ursuan to the Contractors License Laws.). ❑ I am nxe un or s6 Business and Professions Code for this reason: Signa . / CDate:s it l l l blO Owner ID verified by drivers ken :. - es 0 No Dr(vl_si_c_ranee No. L Expires;\� .Z.-� Ch Verification of Ownership by(type of d• • ant,i.e.-property tax bill or deed): � DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth Into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2.Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ AS owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 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). ._. _ _.._...._ _ ._._..._..__.___.................._...._.__._..____... s?__. Yes 2 Does or will the applicant or present or future building occupant need to filo a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health end 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). ....._—_r.__ _._._.._____ _________ —__.________ 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 Celifomia Health end 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? 0 Yes C]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 ❑No (If yes',the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Cede). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (if'yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I cenify that under penalty of perjury the Information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Sig tura: Date: CERTFI TE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penally of perjury that I have read this application and state that the Information given is correct.I a'ree to ply wit��t�ail state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-desc p Ipfirhpection purposes.I agree not to occupy or allow occupancy of any building authorized by this permij tin.'final inspection. i OI. a1Owner(s) I� IL.D�J And/Or Authorized Applicant Date CODE I LNSPECTION TYPE PATE gf AU BODE( INSPECTION TYPE PATE g/R11AL6 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site �y 204 Final Demolition 250 Final Building/Occupancy 14-C 05� F r i$ CITY OF COSTA MESA 44@ BUILDING DIVISION :J,,,, s. D$ DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER 4: .PERMIT 'Pia P06-00894 " +oma+� (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.PLUMBING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 2644 ELDEN AV Status: ISSUED Suite No A001 Applied: 11/01/2006 Issued: 11/01/2006 Vicinity: UNIT Al Parcel Nunmber: 93794043 -+ ..:'3i+':+: Applicant: EMPEY, DENISE .....41144!..+:Y: /�r *« Address: 2644 ELDEN AVE .«,,,. +;:;++*,:,$y .,« / / A001 Phone: 949-922-8509 ..:' ' !o.+44+44*.'4 o++, COSTA MESA,CA Zip: 92626 . ;.. *`+++'to°d4-.4.,"`+4+y'*+'.'.+`9:«;' .4a+++.*1-4.+4 lots +4S($ t tt Owner: EMPEY, PATRICK AND DENISE y '°+y I+ St,a+ Vis:'«*3 ,n Address 2644 ELDEN AVE - 't«,```' ";°. • >$4.a.'« A001 Phone: ,crfr'att.«,a: 4++4.45 :4+{r.�+6*i COSTA MESA,CA Zip: 92626 : +*'6,..^,`y* �.., ff: '+�'*`' Contractor +44.40$4011147,0 , OWNER-BUILDER 4zSt. =* «+*« ° Address: ,.. +' '3*w'44 +4. Phone: MS : 444.,+t..++,'. Zip: `++`t:t:;Atte* Licensee; '*«I'' ' « ° +44-74.+9 aP . '11:44.bra• . Selig OF;P..ERMIT' - CHANGE-OUT OF A WATER HEATER TO A`TANKL!•ESS;WATER ATER IN AN"ELDEN COVE CONDO COMPLEX." :«.i ^*+> • { 1 WATER HEATER $st*++S+t+'>";`ti.A.« '• 9°9 . +4.'4-WV -++«*:o*:v«+. NO OTHER WORK AUTHOR! <3s ` .,,HIS PE" $:4- +.y. > $i.: .......+4.....01++.++.r AkY AMT QTY '+°8.4 ;a;;, '+t'a r - AMT QTY AMT Q ISSUE FEE $23.50 Laundry+,�TutW1Nasher°+ $0.00 0 Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscapeslrrig bd $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P,,?ar`aP ? $0.00 0 Trap Primer $0.00 0 Bathtub $0.00 0 *+:. ' Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System $0.00 •: °t«;: P%c zPiiping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 . Connect(Ice,Soda,etc) $0.00 0+Si.* Receptors • $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 gv 4:;:sSeptic Tank $0.00 0 Wash Basin $0.00 0 Dishwasher $0.00 +; a_ti4ttfeb.+4 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain,Floor $0.00 4.•*.*• *«alga;5-ewer Connect $0.00 0 Waste and Vent System $0.00 0 ' Drain,Rainwater $0.00 4 t4* ': .-r -Ovate Line '$0.00 0 Water Closet(Toilet) $0.00 0 Drain,Roof $0.00. . 0 = t.- $0.00 '0 Water Heater/vent , $12.30 1 Drinking Fountain $0!00 Sink, .t $0.00 ' .0 • ` Water Piping(Inst or Rep.) $0.00 0 Expansion Tank X00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve s 5;, 0 Sink,Floor $0.00 0 Water Service $0.00 0 •, Gas(1-4 outlets) • t, , 0 Sink,kitchen $0.00 0 Water Softener $0.00 0 Gas(Over 4 outlets) . $0.I s**++a$•, Sink,service/mop $0.00 0 OTHER $0.00 Gas Repipe a• +`* Spa(private) $0.00 0 VIOLATION $0.00 Gas Service 1.3.° IP..;t,S+ ::'*.++,« Spa(public) - $0.00 0 , PLAN CHECK $0.00 Interceptors(Grease Oil) .4$),i!•''=*1011:.3+•: REINSPECTION $0.0o 0 Interceptors(Sand;M $a gs.,� O'iat.d. , • +`+:4$$+.,+y++:**4-+... TOTAL CALCULATED FEES: $35.80 COMMENTS/SPECIAL CONDITIONS s f l',:ay�,r 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 • • �` 6 WORKERS'COMPENSATION DECLARATION: . I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued. My workers'compensation Insurance carrier and policy number are: Cartier: Policy Number: (This section need n \be completed If the permit is valued et one hundred dollars($100)or less.) 5:A I certify that In t erform nce 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 law I Cal mla agree that if I should become subject to the workerscompensation provisions of Sectio 3700 of the Labor Code,I shall forthwith comply with thesep r 'si .n I) I 1 II Ap -lt�nt_SIgna tl Q Date' l6b WARNING:FAILURE TO SECURE WORKERS' N COVERAGE 15 UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE(Mow),IN ADDITION TO THE 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.Lia# Class# Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lenders Name: 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 fore 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 himse 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 in 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.). 1A,1,as• er of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.704.4,Business end Professions \- Code: ' e 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) rsuant license• uant • he Contractors License Laws.). ❑ I�, • de -e'. Business and Professions Code for this reason: Signature:, • .y kf ur Date: III t )Ole 1 Owner ID verified by drivers license. 0 s 0 No DMars'ticense'No: ( Expires:1'1 .-lo('0 S Verification of Ownership by(type of documen,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: . ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made In connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(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 ❑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 lime during a reported year a quantity of 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). 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 end 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 greeter then 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 It an RMPP Is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a pllcation apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes 0 No (Section 65850.2 of the California Government Code requires that the requested Information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 if a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes 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: CERTIFICA OF IMPLIANCE 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 agr:: to co(•ly w' all state laws and city ordinances relating to building construction,end authorize representatives of the City of Costa Mesa to enter upon the above-describe• • CH 20. fo pe• ••purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final i sp ction. Alin ,1 'k 1 - ` 110 • ly:ign:ture• 1'els"ner(s);,^ LDate_..Y And/Or Authorized Applicant • Date COOE I INSPECTION TYPE PAIS UffiAL3 CODE( INSPECTION TYPE gAIE l 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing ' 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention • 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204' Final Demolition 250 Final Building/Occupancy • - " - , 0411 CITY OF COSTA MESA e � BUILDING DIVISION tit t• ,ri. ..........j. .., .,.,i,. ./ DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER PERMIT + o yo E06-01245 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 2644 ELDEN AV Status: ISSUED Suite No A001 Applied: 11/01/2006 Vicinity: UNIT Al Issued: 11/01/2006 Parcel Nunmber: 93794043 +;+ /Applicant: EMPEY, DENISE #':1+*+.t++.:>+e. Address: 2644 ELDEN AVE e.k A001 Phone: 949-922-8509 '*`'*'**c+ / 4`*A tom$«:+ +.^++*p+,.r.,+*#4+,g*+�01 . COSTA MESA,CA Zip 92626 J,:>,".".;X• 02:11-rw ,;;*n r,>*�,;t,. Owner: EMPEY, PATRICK AND DENISE rF.*+ ',.*. <444±14:4*.,,* r,3r, *OW Address 2644 ELDEN AVE hF �. N>;`+`aa,-0°o`,+*+ {' A001 Phone: '4414044144+4...,y'. fl:+,1*` `r+*+ .;fit+74.4-44- �.+- :. COSTA MESA,CA Zip: 92626 a«'++:a tta . ' Contractor: OWNER-BUILDER " 44 _ Address: ,,n„„*+'c:.;+*:*+`+^. ^»,.. . Phone: 'It. ++.«11 1+.tt4+o Zip: ':i +':; . +8`+$*r`,a Y' License 000 « .,;„a SCdVIEroF P -` . +q#..t. CHANGE-OUT OF A WATER HEATER T'• $--6-+# - r•• .4;441:1"...3;t"4 * ER IN AN"ELDEN COVE CONDO COMPLEX." +,+�+'***•,'*S _ . 1 RES APPL a` ++v;'*++ ::+* teit.. NO OTHER WORK AUTHORIZED WL THIS PERM6' '" FEE*SUMMARY moo+ • • % Quanti :+;o c;., - Quantity ISSUE FEE $23.50 '"'e :ftt+ T plDist System/Lighting $0.00 • 0 Tempservice test $0.00 :r;i;+tA:4-++ BusGia /100 ft $0.00 0 Res.a/c package $0.00 `rt a+. v'*'1+'' ;'5r>o, nding Section - $0.00 0 New Res(1-2 units) $0.00 •;..R11g ^ t +%?q$`. 'Sc Electrical Equipment $0.00 0 New Res(3+units) $0.00 :;++, 0``"+11�`r*;+21+*++ .` ransformers up to 1 kva/kw $0.00 0 Pool/Spa $0.00 1};±':-4-A -+$$S%,+ up to 10 kva/kw $0.00 0 Lighting Fixls $0.00 ` 0 +`1vo.;c*,"++;+,+ up to 50 kva/kw $0.00 0 Recept Outlets $0.00'v'�++`+� +-44... ..4 p *>"'+�'' {v0. .+.. up to 100 kva/kw $0.00 0 ' Switches $0:00.+a+r1r ,o.�.C.;O c+,: over 100 kva/kw $0.00 0 Non Res Appl $0(00,6'•*,. "0+4e..,. - Low Voltage Equipment $0.00 0 s. Res Appl -.75 ' 1 . ( +n&+f,1 * Low Volt Wiring System/Ckt $0.00 0 . Service to 200a �5p*o- 0 +.' 'B _ Misc.Conduit - $0.00 ' 0 Service to 1000a $Q.'4. 0 Misc.Conductor ' - $0.00 0 .r1.:02,-...a Service over 1000a $0.r . Circus(gen or ride) $0.00 . 0 Motors to lhp $QO0 +*+t:$?# Circus(mech ride or lights) . $0.00 0 Motors to 10hp 0:00, '"� r•*::;1,;;",_ Christmas Tree Stand $0.00 0 u:+.+4' ( Motors to SOhp gap:b.. r s Fireworks Stand $0.00. 0 Motors to 100hp $0.00:",60; 0 Other.Electrical Fee $0.00 Motors over 100hp $QAO:: ;0„1 +0 Communication drops.. $0700-*+;°,,''+,. O) Investigation Fee $0.00 Sub panel to 200a t=e'F.*+ $6:00 °'i'"•A: Plan Check Fee $0.00 Pole Light Pkg .•» ;d. '-++y$0�'00 ,. 0 Reinspection Fee $0.00 Sign Circuits c:40.04:$0`00 S.�o., 0 Temp Pwr Pole $0:00;'x`>r,,"• 0 TOTAL CALCULATED FEES $28.25 Intermed Pole $0.00^'";so-° 0 P1•10,--4.4"�& .�-rt^,i. 7 . 42 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain Inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46 WOO) DECLARATIONS . .. WORKERS'COMPENSATION DECLARATION: • I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued. ❑ I have and will maintain workers'compensation Insurance,as required by 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(S f00)or less.) �2,I certify that in t e 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 I ws of California,end agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with the provisi (�3^ Applicant.Signature: Date: U t I Di WAP ING:FAZE TO SECURE WORKERS' ENA COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER'?CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3700 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 end effect.Lic.a Class 11 Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). 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 1lie 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 toe 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.). 4 as o er of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code: a contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license p, suant,the Contractors License Laws.). ❑ I am exertp nd.t c M1 F� ' Business and Professions Code for this reason: MP- Sigrtelure;-X11�f • T eT�- CDaIe,1 E 1 ( l L7 W c� Own ler D verified by drivers license. Yes 0 No Driver s Ucerise, Expire3: a / Verification of Ownership by(type of docu ent,i.e.-property tax bill or deed): C.------ DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 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 Califomia Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a 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 ❑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 Califomia Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this application a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes 0 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 (II yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit athe South Coast s Quality cri ed Management District or other et pollution control district3 agency is re es for the work which is the subject of this application,have all of the disclosures prescribed by CaliforniaCalifoHealth and Safety Code Section 42303 been made? ❑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 arding Hazardous Materials and Emissions. SI Nature: Date: CE- FIGATE 0 COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application end state that the information given is corre :,re. • co y th all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-d= e. ,r„ rt r inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit gntil final inspection. 4110 Si alar- 'Legal Owner(s) ll alJteKJ_ . • And/Or Authorized Applicant Date ;ODE$ INSPECTION TYPE DEE INTIALE VOCE INSPFCTION TYPE GALE IIS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Well 212 Final Fire Prevention • 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Bullding/Occupancy a w • GcT .&F COSTA MESA As..„. . BUILDING DIVISION > • DEVELOPMENT SERVICES DEPARTMENT PE IT NUMBER o PERMIT / 05-01443 itcw•warrsoe (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.B.I.MLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 2644 ELDEN AV Status: ISSUED Suite: A Applied: 08/29/2005 Vicinity: BLDG A,UNITS 1,2 AND 3 Issued: 08/30/2005 Primary Occ: R Type of Construction: V-N Parcel Number: TPN00581 Zoning: Applicant: CAVASSA, FIORELLA Address: 3419 VIA LIDO SUITE 459 Phone: 949-283-5880 ISSUED BY: NEWPORT BEACH,CA Zip: 92663 Owner: ELDEN COVES HOA Address 2644 ELDEN AV UNIT B001 Phone: COSTA MESA,CA Zip: 92627 Contractor: SURDYKS DECORATING • Address: 3419 VIA LIDO SUITE 459 Phone: 949-283-5880 • NEWPORT BEACH,CA Zip: 92663 License: 854996 Arch : - Eng: Address: Address: Phone: Phone: Zip: License: • License: SCOPE OF PERMIT REMOVE AND REPLACE ROTTED RAILS ON 2ND STORY BALCONIES FOR BUILDING A,UNITS 1 -3,TO MEET 1997 U.B.C.REQUIREMENTS. FEE SUMMARY Plan Check: $0.00 • Calc Valuation: $5,000.00 Permit: $111.25 Claim Valuation: $5,000.00 SMIP Res: $0.50 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 . Total: $111.75 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 • • ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 •Required: 0 Proposed: 0 • • 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 2446413(&p0) • , 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. H, -.1 h ye and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which Nis mlit is ias,led. rg[I Mq workers' 1pf compuationInsurance carrier and poli�number are: t- Wm?C 1IONNcRup—} +(: ''Poyjumber: 1 6 14 3CI 611 V (This section need not be completed ll the permit is valued at one hundred dollars($100)or less.) ❑ I certify that In the performance of the work for which this permit Is Issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Califon ,and agree that If I Id become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisi ,r ��C6��7 .PSignaiure:�' PCi (A • rvr 'D Date:, r' O h'-' 30 MPAN(F FAJ RE'TO SE$ E WORKERS'COMPENSA ON COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPL ER MINAL PENALTIES AND CML FlNES UP TO ONE HUNDRED THOUSAND OOLLARE(Si ),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.l.am_Iicensed u e provisions of Chapter. (commencing with Ion 7000)of Divislo of-the•Bueiness_and Professions Code,and my license is In full "tor a end eflect...Lic.t l ��Igi / 7 Class N -- C 3-z)j tCartracior's Signature ./,ham�'i Date; 40 X-30-0‹ 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 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. ❑Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,Le.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth Into which a person is required to descend,will be made In connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 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 hes on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the 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 a permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes jJ 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 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 prescnbed by California Health and Safety Code Section 42303 been made? 0 es 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 purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. - v Date _toSi ntatisre OI pl Owner(s) P O -3Ja 9' C AnmOrAiforiiedAPpldaet.- v ...z • CODE I INSPECTION TYPE PATE INTmALE CODE( INSPECTION TYPE PATE 10TIAL6 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 204 Final Demolition 250 Final Building/Occupancy y� ✓ . __ . - _ _.-- -__v ` Applicant to fill in all spaces except those within heavy border lines and sign all app late declarations. Z%p CITY-Of COSTA MESA I PER NO. TRACT NO. LOT NO. BLDG. NO. ,vtI NI \�tCQJ'a1STFrlJCTJON PERMIT /5100 ry//f/ -(� 1 Ile- ( 3681 7/39/9y l:-IL', do Pkject Address _ y i eICIC vl /,/-ye / p TYPE"OFCONSTRUCTION ICJ NEW ADD U ALTERATION -I REPAIR ' ,NO` Applicant's Mailing Ad�dfrress : /� AIPr-'f°t" ay Dr .5—/O ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# �� - ' -/fl Zone �`� 1}• Owner's Name ''ff+YC,y Fret IA)I.Cy Phone740'8Yn0 DESCRIPTION OF WORK Ll / A ��ppp��uttl �pf S Main Building: Acce55ory,Building: Z AddressI/S.Z Se Pt ba...,, !s'J Cr'i�4 Me 44.: TYPE OF PERMIT -*GRADING 3 FOUNDATION 1C� STRUCTURAL E Front 2,O f N Arch/Eng. "-- -( License No. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B �a._y 1 Rear .0 N Address STZ Gruff De F+6rcj a_ 5o4,0 0.•wit. 91'-72 ❑ OTHER j • A Contractor's Name '-±+- --- *� Phone -,f Y-�t PROJECT DESCRIPTION SQ. FT. ' • 00 • _ •r UPANCY Cr gib K Right 3J' G Address(mailing) 101 -sa•a+/ohm '- +.+r �f• �'Li'ib'Zs••' CONST RUCTIN TYPE a. •LON $ c„• -a1.0 $ Left EA i - E R City License No. U V ZONE Al_ - GRADING CU.YDS. coY'JACRES a 116 2_ Ping. Ref.# DA- 07 , Park.Fees $ O LICENSED CONTRACTOR DECLARATION Remarks: /_ - /300 sir/is Co„dos 3 3 Le CC/oom Parking Req./Provided 9 �J 5 1 U I hereby affirm that I am licensed under provisions of Charter 9 (commencing Y k with section 7000) of Division 3 of the Business and Professions Code,and ah baJJ r'P `'7 /1J'/ . / i+,i- ,iJ r 7 / _Oi/L Use of Building: r•�J C¢ E R my license Is In I fo ce and effect. 1 La"5 O l ! 67' Planning Van M License Class - -:T' 1 PLUMBING �-.../0 ),OVp..4 FEES g [ Cut FOR SPECIAL REQUJR�m>;tvls E Date Signature -�� •• Bar Sink Showers N .el-=i.`.JORKE RS'COMPENSATION DEC • RATION T affirm- ' bthat I havetifitconsent to self-insure or a certificate - r_erey a certificate ofBackflow Preventer Service Sink Workers' Compensation Insurance, or a certified co y thereof (Section - • S f(� Lab. c. . 7�s / �y • Backflow Irrigation Sewer Cap _ ELECTRICAL -� FEES 1 Policy No. �` �/ 7-'tT� Company Certified copy is hereby furnished. : Bathtubs Sewer Connection- - ''. • Automatic Washer Transformer ❑ 15:50 KW • B Certified copy filed with the city Build ion- Imo/ - 0 50+KW Date'x 7-7� 7 Applicant x ,L{ Clarifiers Solar Collectors Construction Pole Sub. _ - EXEhMtPTION FROM WORKERS'C PE 5 N ECLA RATION Dishwasher Solar'Pi In ,/� Q (This section need not be completed If th er is or one hundred 00)or p 9 • _ Cooking Unit Meter Oup to 100 amps ' less). DrinkingFountains F� - els I certify thatm In the performance ii, the work for as to this permit a issued, Solar Tank • I Dishwasher Meter Dover 100 amps o ' employ anyiperson of any manner so as to become subject to the Workers' Compensation Laws California. Floor Drains Swimming Pool w/Spa Dryers NGaS ❑Electric Sub Panel / Date Signature NOTICE:Compensation er makingnr visof declaration,you shouldCode,becomesubject to the Floor Sinks Urinal Fan Motors❑0-1 HP ❑1%-8 " comply Com such 1pprovisions she Labtf you muet forthwith comply with such provisions or this permit shall be deemed revoked. Gas Service 'OutletsWater Closet ' f� CONSTRUCTION LENDING AGENCY - - F.A.U. Ina Solar ❑9-15 HP❑16-15+ n.,.�/� I hereby affirm that there is a construction lending agency for the performance Interceptors Water Heater Fixtures Microwave W of the work for which this permit is Issued (Section 3097 Civ. C.) / • Lender's Name 4 Kitchen Sink ' Water Service l Device Boxes Pole Light Lender's Address OWNER BUILDER DECLARATION Lavatories • -i Outlets s� Range I I hereby affirm that I am exempt from the Contractor's License Law for the . _ .. ^� following reason (Section 7031.5 Business and Professional Code: Any city or P-Trap • Switches county which requires a permit to construct,alter,improve,demolish or repair Sign any structure, prior to Its issuance, also requires the applicant for such permit Roof DrainsGarbage Disposal Standing Sections to file a signed statement that he/she is licensed pursuant to the provisions of rhe Contractor's License Law(Chapter 9(commencing with Section 7000)of Generator ❑0.5 KW ❑5-15 KW vision 3 of the Business and Professions Code) or that he/she is exempt Trash Compactor irefrom 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 Reinspection Fee 3 A enalty of not more than five hundred dollars($500). Pa $25 Issue Fee $ C I, 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 REQUIRE N S License Law does not apply to an owner of a property who builds or Improves Boiler Hood or Type I 0 ,- i I I 1 j� poy, andwho does such work ove elms ael f or through his or her own Zoning Approved By _ VVI v Date thereon,employees, oetl that such work improvements are not intendedroughs rofferedfor Canopy Type II 0 sale. If, however, the building or improvement Is sold within oneyear of com- Duct-Under Ground p Building Approved By pterion, the owner will have the burden Of proving he/she did not build or im- Date Frove for the purpose of sale). Duct-Structural Refrigeration System Application Issued By Date 7-9,99 I,as owner of the property,am exclusively contracting with licensee con- ❑0.100,000 BTU ❑100,000 BTU ractors td construct the project (Section 7044,Business and Professions Code: Duct-Ventilating 3$-$ftSUMMR V• 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 0 Multiple 0 System Repair/Alteration an BUI LDING PERMIT $ y SMIP $ '?-'/� Pectoris) license pursuant to the Contractor's License Law). c't I' PLAN CHECK $ 127,67 PERMIT 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# - • PLUMBING $ ISSUANCE $ Data Owner f -' A AidYr • Heating System&Ducting PLAN CHECK 25% $ ENERGY P.C. $ I hereby c`rtify'that I have read t' s ••pf1ratlon and state that - , above 00-100,000 BTU 0100,000 BTU— - GRADING $ BTU— Information is correct. I agree to c• J'h all city and county • •Inances ELECTRICAL $ and state laws relating to building cons r.ction,and hereby aut ice repre- sentatives of this. ty to enter upon the above-mentioned property for PLAN CHECK 50% $ MICROFILM $ Inspection Signature A/t/l��r/ds / // ` 3 2/'ey MECHANICAL $ TOTAL FEE $ 4/09' Reinspection Fee $25 Issue Fee $ 3 PLAN CHECK 25% $ Drivers' Llce se # - - ..__ _ __ , . . CMF 0865-46 rev.12/83 white-Building;canary-Applicant;Pink-Accounting;Goldenrod -Assessor A• r rf ,- . ` ; '�-{CONSTRUCTION AND PLANNING P001 PA h1 ,$iPPRQVACS Permit# Date Inspector APPROVALS Permit# - Date . Inspector • 1. Temporary Electrical Service or Pole • 52. Pool & Equipment Location r r , 2: Soil Pipe-Undrgrnd. 53. Steel Reinforcement • - • - 3: Electrical Conduit Utility-Undrgrnd. 54. Forms 4.1 Electrical Conduit-Undrgrnd. - 55: Electrical Bonding _ 5.'Steel Reinforcement 4 UL56. Rough Plumbing & Pressure Test - • 6. Electrical UFER Grnd. •, '- ge_- 57. APPROVAL TO COVER-GUNITE 7. Footings tat{ �(/ 58: Electrical Conduit-Undrgrnd. : , • 8. Foundation , - 8 14'fr(1 V.4"- 59. Gas Pipe, 0 Undrgrnd., Test _ 9. Water Pipe-Undrgrnd. , 8114/Iti 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final • 12. Sewer Cap 63. Heater& Vent-Final • •13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final - - •• 15. Rough Electrical-Conduit - 66. Solar System-Final • - - 164 Rough Electi-ic Wiring 67. Fencing & Access Approval 171 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 ❑Oil 23, Gas Pipe-Rough & Test - 72. Underground Flush 24. Roof Framing // 73. Undergrnd.Storage Tank O Gas ❑Oil (a 25. Roof Sheathing (mars /9/V/kY (/Ci 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat . ` ` 75. Dry Chemical 27. Frame and Flashing t /� $y vv 76. Dry Standpipe 28. Lathing & Siding !i IA, 77. FIXED SYSTEM FINAL \ 29._Insulation • j/ dit( VC_.--- 78. FIRE PREY. FINAL \30. Drywall Nailing // q jQ V44j HEALTH DEPT. REQUIREMENT • X31. Plaster Brown Coats 727M- F 79. FINAL INSPECTION i r r 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED ,, ,,��J 33. Final Electric Notes: 16/�Y'' L Q{C � (aa-ift 34. Final Heating & Air Conditioning � �/ a" u (2 Kr i . 35. Final Gas Pipe-Test 6!J _/,�_�� 36. Hood-or Canopy. O/I"'��` • 37. Final Factory Fireplace _. - 1 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 Attenuation 46. Handicap Regulations - 47. FINAL STRUCTURE & BUILDING 9/dif" �v 48. Special Requirements Completedt'/�[�...�r- clic • 49. Electric Release to Edison "'-_J 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY ?Ve.//1-7, 1 NO. //08 • Date d/2p/C City of Costa Mesa Development ServicesDepartment Building SafetyyDivision CERTIFICATE OF OCCUPANCY No. U11.G S P.O.Box 1200 Costa Mesa,California The Building located at 2644 FTdIRU AV1 Ni1R i1NTT *A-1 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group P-1 _ Occupancy. , Use of Building (n,rrwrr,n -rmrr Legal Description 41q-271-1n (See reverse side for Metes and Bounds) Building Permit No 8-140111 Electrical Permit No.F-1-4540 Plumbing Permit No.P-14257 Mechanical Permit No. Ml KSQl Ml:R7A Ml t•.OQR Number of apartments - and/or guest rooms ISSUED TO: Building Official ' 4- • /<' JEFFREY Y FRAWfEY by /l ' 0, 1152 SALINAS AVE. , COSTA AESA, CA. 4 2/9 /A Date " CV 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 I' r c Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. 5086 7/30/04 3i:.';- - CITY OF COSTA MESA CONSTRUCTION P PERMIT P/171 ,5-7 O'/ ` TRACT NO. LOT NO. UNITp10/ Project Address '64li JC t-pg/t/ TYPE O O J U ADD U ALTERATION U�REPAIR a�39I /'/1F-.4i{!/ �� OF CONSTRUCTION PZI NEW Applicant's Maili Addr ss �l Owner's Name �I�' E • Phont��d— 324 El CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# I Zone n DESCRIPTION OF WORK/USE OF BLDG. Address /� Mini 2 �2r Sv-/� S Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMIT U GRADING air FOUNDATION ❑ STRUCTURAL E Front O y Address 0 TENANT 0 ELECTRICAL l7u PLUMBING 0 MECHANICAL B Rear N Contractor's Name'�7 C '/ ❑ OTHER / M«L RA16. C/Methonet aS C Right N • Address(mailing)?03 / MEIQ11/DE/Q L/. AlA'• • PROJECT DESCRIPTION SQ. FT. OCCUPANCY K Left G A 7 q CONSTRUCTION TYPE VALUATION$ $ City License No. 0(��000 ZONE GRADING CU.YDS. ACRES R LICENSED CONTRACTOR DECLARATION a�sPing. Ref.# Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: K/(/DO / Planning Notes: M with section 7000) of Division 3 of the Business and Professions Code,and 4� T r.S my license Is in full forc/alone of ect. /�-f T W License Mei I 1'' t Licen a Asstd /34Q s. • Date 7/ A Pl7/ Signature 7720.),1/4 /�/..�� PLUMBING FEES WORKERS' OM ENSATION DECLARAON Bar Sink Showers ELECTRICAL FEES LJ I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' Compensation Insurance, or a certifie co y thereof (Section Backflow Preventer Service Sink 3800, Lab. C. /' Q �s�-r..,I� Automatic Washer Transformer 0 15-50 KW Pnolicy No. ) 4q 3 Company sJ "gni • Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+KW 41 Certified copy is hereby furnished. �j CertiLD c�p Wailed with the city Itling Division.' /f 4 2 Bathtubs Sewer Connection Y O Q Cooking Unit ' - Meter ❑up to 100 amps Date Applicant 1t 8• Ce11 EXEMPTION FRO WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps (This section need not be completed if the permit is for one hundred(s100)or less). / Dishwasher Solar Piping a oC Dryers OGas ❑Electric Sub Panel I certify that in the performance of the work for Which this permit is issued,1 shall not employ any person In any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors 00-1 HP 011/2-8 Workers' Compensation Laws of California. 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 with such provisions or this permit shall be deemed revoked. - Microwave CONSTRUCTION LENDING AGENCY i Gas Service Outlets C 3 2) Device Boxes Water Closet i hereby affirm that there is a construction lending agency for the performance ,]C/ Pole Light of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors / Water Heater s ?oo Outlets Range Lender's Name _ Lender's Address / Kitchen Sink Water Service a 00 Switches Sign OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the s-Lavatories /O 00 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 any structure, prior to its Issuance, also requires the applicant for such permit Generator 005 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 - 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). U I, 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 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 prove the owner se of have lh0 burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Date 0o I, for the purpose theoe). tr I, as to construct or ct eproperty,rojectSe tion cu mess ing with Ilsstl ode- Duci-Structural Refrigeration System Application Issued By Dat Thee Ors the project (Section 7044, tos Business and Professionsfproperty Code: The Contractor'smprosLicenseherlaw does noteraapply to an owner ie is thta who Duct-Ventilating 04100,000 BTU 0100,000 BTU SUMMARY OF FEES • builds or Improves thereon,and who contracts for such projects with a con- SUMMARY 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 CHECK $ PERMIT ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# PLUMBING $ q/'SD ISSUANCE $ Date OwnerHeating System& Ducting PLAN CHECK 25% $ 7 /.1 ENERGY P.C. $ I hereby certify that I have read this application and state that the above ❑0100,000 BTU 0100,00087 ELECTRICAL $ GRADING $ information Is correct. I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize repre- sentatives of this city to enter upon the above-mentioned propert for / inspection purpos (/ Signature ------/ Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ CMF 0865-46,rev.4/84 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor I// • POOL&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. d Lg 53. Steel Reinforcement 3: 'Flectfical Conduit Utility-Undrgrnd 54. Forms • 4:•.Electrical Conduit-Undrgrnd. -1' 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test UFER Gind. 57. APPROVAL TO COVER-GUNITE • 7..;Footings • 58. Electrical Conduit-Undrgrnd. 'r 8.Fouridaflon %, 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. '3l,ti cso 60. Backwash Lines, P-Trap, O Undrgrnd. 10:ttliiucttirel Floor.System 61. APPROVAL TO DECK 11 Property Sewer Line & House Connection ' • • 62. Backwash & Receptor-Final 12. Sewer Cap y • 63. Heater & Vent-Final 13. Roof Drains •I 64. Plumbing System - Final ! • 14. Rough plumbing; (6/(7( t( t.&.7 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 7f. 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: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test ,//err ..4471" 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 3(u/j'S' tIe-a0 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 • • ' L/ �• � 3 Applicant to fill in all spaces except ithose within heavy border lines and sign all appropriate declarations. CITY OFA dr COSTA � CEON$ UCTION PERMIT P�?MITINO. TRACT NO. �I O. uNj No% ' 9703 10/09/64 ®e017 IL Project Address nen (►', _/7—C]L/'I7�� T/7/_ �' I P d TYPE OF CONSTRUCTION L'I'IVEW LI ADD ALTERATION REPAIR �. OApwner's Nat's Mallin• /AAds ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.5W I Zone Owner's Name/ 41 if ,� Pho /h�• DESCRIPTION OF WORK/USE OF BLDG. Address ` '0 f; ��1�'!T V S Main Building: Accessory Building: I Arch/Eng. License No. TYPE OF PERMIT LI GRADING U FOUNDATION U STRUCTURAL T Front 0 V Address �r1)� �,/ww��77. _ /l ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING D1U gCHANICAL BB Rear N ,,/P Contractor's Nam -/.7�s� ! =%C—Y/�,r hJ''�eu�.�,--/,{'� �;'t•, ❑ 'OTHER C Right N ` t , Address(mailing) ''D .O Al , 4A— PROJECT DESCRIPTION SQ. FT. OCCUPANCY K Left - I" gf7[j f CONSTRUCTION TYPE VALUATION $ $ R City License No. �IS�!- ZONE • GRADING CU.YDS. ACRES , • LICENSED CONTRACTOR DECLAR TION - Ping. Ref.# Par king.Req./Provided - E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: ' (� !'l O I Planning Notes: M with section 7000) of Division 3 of th• Business and Professions Code, .nd l my license is'n ul • ce and,effect. T •License vs,. 'moi r Llcens,-Noah I - - , Date r ta Signature . •4 — �- - PLUMBING - FEES WORKER-'C• 'P'NSATION DEC ' RATION Bar Sink Showers I hereby affirm tha I have a certificate of consent to 'elf-insure or a certificate ELECTRICAL FEES , of Workers' CompensationppInsurance, or a certi i•• copy thereof (Section ' ' 3800, Lab. $sIA U1�00((J� , - Backflow Preventer _ ... -Service Sink d/// V� 0/(JAutomatic Washer Transformer 0 15-50 KW Policy No. Company 1 •II I/ • Backflow Irrigation • I Sewer Cap1 • 0 50+ KW Construction Pole Sub. 8 Certifie c py is hereby furnished. Cer ' s filed with the city B:,•ing •' isiop. A Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps • Date Applicant J _ 4_e0 a / r EXEMP IO- WORKERS'COMPENSATIO DECLARATION Clarifiers • Solar Collectors Dishwasher 1�M¢L¢r Dover 100 amps • (This section need not be completed if the permit is for one hundred ($100)or Ill 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 011/2-8 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 ' . Gas Service utets Water Closet Device Boxes ' I hereby affirm that there is a cods ruction lending agency for the performance Pole Light of the work for which thiy(byt is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Lender's Name /! Y grits. 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 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 any structure, prior to its issuance,also requires the applicant for such permit Generator 00.5 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 Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil enalty of not more than five hundred dollars($500). I, 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 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 pietion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground Building Approved By • Date glove for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Dat tractors to construct the project (Section 7044,Business and Professions Code: The Contractor'smproLicense Law does noteraapply to an owner je is thta 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 thatExhaust 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 $ PE ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBO# PLUMBING $ RMITISSUANCE $ • Date Owner Heati stem& Ducting 4 PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify th I I have read this application and state that the above r I 100,000 BTU 0100,000BT r $ GRADING $ information is torr ct. I agree to comply w II city and county ordinances W ELECTRICAL and state laws a ting tot building constr ctlo and hereby authorize repre- sentatives epo- PLAN CHECK 50% $ � oQ MICROFILM $ s¢ptdll V¢a of t i city nt o,,enter�uppn 0 b ve-4lentioned prop rty tor inspection pure i;�y„w� /tet /o p /f MECHANICAL $ TOTAL FEE $ Signature ASS* V / Date Off`/ Drivers''License or 55 ��(/�� Applicant;Pink-Accounting;Goldenrod-Assessor CONSTRUCTION AND PLANNING POOL& SPA • APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector -1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. - • - 53.-Steel Reinforcement .3. •Electrical Conduit Utility-Undrgrnd: 54. Forms 4. Electrical Conduit-,Undrgrnd. 55. Electrical Bonding • 5. Steel Reinforcement 56.-Rough Plumbing & Pressure Test 6. .Electrical UF ER Grnd. - 57. 'APPROVAL TO COVER-GUNITE 7. Footings !' ; 58. Electrical Conduit-Undrgrnd. 8. Foundation - - 59. Gas Pipe, 0 Undrgrnd.,Test - - 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, ❑ 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 7 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-TBar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning iq 4y 7PC FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace / �7/! [' 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 Si. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED - 33. Final Electric Notes: 34. Final Heating & Air Conditioning 3Asidas G60 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 1.‘"' 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed i • 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY • No. Date • • Job #3012 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. D454 10/17/84 CITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT O. / TRACT NO. LOT NO. UNITA9.1 Bebe IR •• Project Address 2644 Elden in 1/J LJ Mailing Address P.O. Box 695 Walnut 91789 TYPE OF CONSTRUCTION LI NEW 1U ADD Li ALTERATION IJ REPAIR Owner's Name Coastview Development Phone 720-1383 ElCONVERSION ElDEMOLISH CIOTHER - _ A.P.# I Zone DESCRIPTION OF WORK/USE OF BLDG. Address 160 Newport Ctr Dr. ,Ste.108 Newport Beach S Main Building: Accessory Building: •Arch/Eng. • License No. TYPE OF PERMIT EDGRADING U FOUNDATION LI STRUCTURAL E Front O Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N AJR Construction 594-5911 ❑ OTHER A Contractor's Namp Phone C Right N 03 Address(mailing) P.O. Box 695 Walnut 91789 PROJECT DESCRIPTION 59. FT. OCCUPANCY K Left • G 010196 CON ST RUCTION TYPE VALUATIONS s R City License No. ZONE GRADING CU.YDS. ACRES 1Ping, Ref.# Parking Req./Provided E `- LICENSED CONTRACTOR DECLARATION Q I hereby affirm that 1 am licensed under provisions of Charter 9(commencing Remarks: n's 1 l I/yr) Planning Notes: M with section 7000) of Division 3 of the :usiness and Professions Code, and 0l -f co my license is in full force and effect T P License Cl s 1t al 0 Li;-n 3 228 S. Date I - -' Signature .�•` �� PLUMBING FEES WORKERS'COMPENSATION OECLA• •TION Bar Sink Showers I hereby affirm that I have a certificate • •nsent to self-Insure or a certificate ELECTRICAL FEES of Workers' Compensation Insurance, • a certified copy thereof (Section Backflow Preventer Service Sink 3800, Lab. C.) Automatic Washer Transformer 0 15-50 KW Policy No. W0005151 Company ; Irrigation - Sewer Cap Construction Pole Sub. 0 50+ KW aver Insurance Backflow 9 Certified copy is hereby furnished. Certifiedc i fled with the city j, st••. Bathtubs Sewer Connection -tI e-04 = Cooking Unit• Meter Dula to 100 amps Date V I G t5 Applicant - � V ' EXEMPTION FROM WORKERS'COMPEN• ION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps (This section need not be completed if the p•- 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'h-8 Workers' Compensation Laws of California. Date Signature Floor Drains Swimming Pool w/Spa F.A.U.- Int.Solar 09-15 HP 01615+ 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. Fixt Ur¢s 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.) Lender's Name Interceptors Water Heater 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 • 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 any structure, prior to its issuance, also requires the applicant for such permit Generator 00.5 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 taw(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 - natty 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 offeretl - - for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Reinspection Fee $15 Issue Fee $ 3 ern Law does not apply to anr owner f a proowho builds s or improves thereon,mpland, who does such work ovemneshimself/herself or intended his or her own - • DEVELOPMENT SERVICES REQUIREMENTS: employees,hprovided that such or improvement are not within offered for Boiler Hood or. Type I 0 sate. If, however,wnthe dof pro i sold within one year of corn- Canopy Type H ❑ 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 U I,rove for the r of the property,of oe). e t rs owner tr the roject tcontracting with of licensedionode- Duct-Structural Refrigeration System Application Issued BY Dat hetqrs construct the project (Section 7044,Businessto and Professions t Cotle: The sContractor'smproLicense Law does'wnot apply to an owner je propertyitwho Duct-Ventilating ❑0.100,000 BTU 0100,000 BTU SUMMARY OF FEES builds or improves thereon,and'whoCon contracts for such projects with a con- tractors license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple❑ 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. ICBO# 2301 1 Metal Fireplace 4 00 PLUMBING $ PERMIT ISSUANCE $ Date Owner Heating System& Ducting ENERGY-P.C. $ PLAN CHECK 25% $ I hereby certify that haverread thismapplication all ytl state that the above ❑0.100,000 BTU 0100,000B GRADING $ information ist tartest, ag rep to comply with all city and county the above ELECTRICAL $ and state laws relating to • I •i • onstruction,and hereby authorize repro- PLAN CHECK 50% $ MICROFILM $ Inspection fives of this city Don t • above-mentioned property for Inspepurpo$es.� 10-12-84 MECHANICAL $ 7.00 8'00 Signature ( J\ �� Pink-Accounting;Goldenrod -Assessor CONSTRUCTION AND PLANNING POOL& SPA APPROVALS Permit# Date Inspector APPROVALS Permit# _ Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd, 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation - 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 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 1 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace MCA Ca 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 & 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 7.`"111111 - • Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. 's CITY OF COSTA MESA - PERM T NO. TRACT NO. LOT NO, BLDG.NO. - - - - CONSTRUCTION PERMITa? ? • %5 998 2 • 1303. 10/31 /E4 • I3e0 ' IL ' Project Address , tggp ELDEN ST. COSTA MESA TYPE OF CONSTRUCTION 6NEW U ADD U ALTERATION REPAIR , - - - -O Applicant's Mailing Address 1 60 NFWPORT CENTER DR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# - I Zone Owner's Name COART VTFW DFVFT OPMFNT Phone 770-1183 DESCRIPTION OF WORK S Main Building: , Accessory Building: Z Address - TYPE OF PERMIT U GRADING ❑ FOUNDATION LI STRUCTURAL E Front N Arch/Eng. License No. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING EN MECHANICALA, Rear - r N ' Address • El !OTHER C Right N Contractor's Nameii SIERRA ENVIRONMENTAL Phone 957-5991_ PROJECT DESCRIPTION SQ. FT. - OCCUPANCY R 2121 SOUTH GRAND AVE. S/�, /��705 CON STRUCTION TYPE VALUATION $ S LeftE '1_ CityrLsslnsei ling) ZONE GRADING CU.YDS. ACRES Q "J City License No. I C20 405194 ffff�� Ping. Ref.# • Park.Fees $ U • I LICENSED CONTRACTOR DECLARATION • - Remarks: ES, / goo/ - Parking Req./Provided - 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 I Use of Building: I , E my license is In full force and effect. -405194 • I License Class C20q �/SIe�nservQ,TV ' PLUMBING FEES Planning Notes: M Date 10-30-84ATIO ure7i `/ `. , E WORKERS'COMPENSATION DECLARATIO • Bar Sink • Showers N 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'S certified copy thereof (Section - - - - - . 3800, Lab. C.) R24232 Backflow Irrigation Sewer Cap ELECTRICAL FEES Policy No. Com ny -..! • CONSTRUCTION AND PLANNING . • POuL& SPA • APPROVALS Permit - Date Inspector _ APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole . 52.- Pool & Equipment Location 2.. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. • 54. Forms 4. Electrical Conduit-Undrgrnd. . 55. Electrical Bonding .5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. • 57. APPROVAL TO COVER-GUNITE 7. Footings - 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe,,0 Undrgrnd.,Test • 9. Water Pipe-Undrgrnd. - 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK - 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12., Sewer Cap - 63. Heater& Vent-Final 13. Roof Drains 64. Plumbing System- Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit - 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval - 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING • 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating afidiis, 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: 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 • . 1 No. Date • Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. PERMIT NO. TRACT NO. LOT NO. UNIT NO. Ion OF eosrA M^ESA r T gAir PER 1 C �� 572; 6/OG/C!4 r•::e4'` ,. • Project Address Vim& er b �/Yf — 4I/ LU Applicant's Mailing Addr ss t 1 `77 Wh//%�/1 ! d}/.4� TYPE OF CONSTRUCTION IVEW ADD U ALTERATION U REPAIR Owner's Name � a++� ❑ CONVERSION 0 DEMOLISH 0 OTHER A,P-916 Zone �/ /� h ne DESCRIPTION OF WORK/USE OF BLDG. Address/&N#AJ y2 �1� 1. S Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMIT U GRADING U FOUNDATION U STRUCTURAL E Front Z Address A Rear Contractor's Name ELECTRICAL 0 PLUMBING 0 MECHANICAL N J4 ck • / PhoneCab loco 0 OTHER ,�1C Right N Address(mailing) /777 t..) CoS .1ak$� PROJECT DESCRIPTION SQ. FT. OCCUPANCY K G 17 CON STRUCTION TYPE VALUATIONS $ Left City License No. ZONE GRADING CU.YDS. ACRESR CS.) LICENSED CONTRACTOR DECLARATION - - Ping. Ref.# - Parking Req./Provided E \}1 I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: a— /4j / Planning Notes: M 1 with section 7000) of Division 3 of the Business and Professions Code,and my license is In full force)n_d a(}ect. 6......... T O Ucen Class Signatur /ur Lice No.err% s S' 1 . Date SigPLUMBING FEES . WORKERS'COMPENSATION DECLARATION Bar Sink Showers I hereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL FEES of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink 3800, Lab. C.LL ••''``? utomatic Washer / Transformer 0 15.50 KW Q7 Policy No. Cl 7C.t v1 rl�n W C 'j �t- AlenT7ompany 1, 1 Backflow Irrigation Sewer Cap0 50+ KW Construction Pole Sub. ertified copy is hereby furnished. ert}'�Ipd py is filed with the city BuilpinDiyl£W,n,,,.L.,, Bathtubs Sewer Connection Cooking Unit ' `_ Meter pup to 100 amps / ,! Date ` IO�Qi Applicant r.K\ • N % 1e--, DU EXEMPT io FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher / Meter Lover 100 amps / DO (This section need not be completed if the permit is for one hundred ($100)or less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric / Sub Panel / (p 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 S Workers' Compensation Laws of California. _ ❑ ❑ 3 (� Motors 0.1 HP 1X-8 Date Signature Floor Drains Swimming Pool w/Spa F.A.U. / Inc.Solar ❑9-15 HP ❑16-15+ , 00 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 'L CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet ��- Device Boxes Pole Li I hereby affirm that there is a construction lending agency for the performance - Light 80 /Z of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets 3 Range Lender's Name 17 (e 30 Lender's Address Kitchen Sink Water Service Switches •� Sign O OWNER BUILDER DECLARATION — ('I- O 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 Garbage Disposal , Standing Sections I C . 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 00.5 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 Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil enalty of not more than five hundred dollars($500). 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 — for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL 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 I DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such Improvements are not intended or offered for Boiler Hood or Type I 0 sale. lf, 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 trove for the purpose of sale). _ Building Approved By Date U I,as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued Bye Data J b tractorsto construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU 0100,000 BTU SUMMARY OF FEES builds or improves thereon,and who contracts for such projects with a con- tractor(sl license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple ❑ System Repair/Alteration proof of their Worker's Compensation insurance should be provided to me. BUILDING PERMIT $ - SMIP $ - PLAN CHECK $ PERMIT 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBO# PLUMBING $ ISSUANCE $ _ PLAN CHECK 25% $ ENERGY P.C. $ Date _ - Owner Heating System& Ducting I hereby certi that I have read this application and state that the above 0o-100,000 BTU ❑i00,000BT 4t I'Marina - cor ELECTRICAL- agree to comply with all city and county ordinances _ $ 4(4,400 GRADING $ !� and st. e laws relating • buil construction, and hereby authorize repre- PLAN CHECK 50% $ 7 .AY1V MICROFILM $ sentati - of this c o e upon the above-mentioned roper for inspect .• - -• MECHANICAL $ TOTAL FEE $ Cia 40 Signa ure Drivers' License or SS$ Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ ' 4 CMF 0865-46,rev.4/84 White-Building:Canary-Applicant;Pink-Accounting;Goldenrod -Assessor . . CONSTRUCTION AND PLANNING POt,� & SPA -1: APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector rt. 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. ElectricalUFER.Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8.,Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property.Sewer Line`& House Connection 62. Backwash Si 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 44y ev 67. Fencing & Access Approval 17. Rough Wiring Sign 7 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 iStructural) & 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 Lt 80. FOOD CERTIFICATE ISSUED 33. Final ElectricU G l � Notes: 34. Final Heating& Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation - 44. .Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed .. 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co \ 51. CERTIFICATE OF OCCUPANCY No. Date • Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA '(J:OI�$T.RnUCTI N 'ERMIT PERMIT NO. TRACT O. LOT NO. •UNIT NO. 4'97 7/19/04 r0'It) Project Address �` Cw , S' I t4 I Z1 1 i`lq7 +F+ B /A s ��• -,'sew TYPE OF CONSTRUCTION agiNEW ❑ ADD LI ALTERATION Li REPAIR Applicant's Mallin Address R-lL■ 'a A / ❑ CONVERSION 0 DEMOLISH 0 O/Tan _ A.P.# i Zone Owner's Name ��iw�s/�rsr IIEbt� EEp • Phone 0 SCRIPTON FWOORKK/USEE OFF�B,LIDGGbS,rC--1. ... � Address /60 /s.�fsv��'T �� ""^-" sm. los � -w C•_ � S Main Building: AttessoryBuiltling: i Arch/Eng. License No. TVP OF PERMIT Lf GRADING 0 FOUNDATION STRUCTURAL E Front 0, Address ••��.... e.s��,/ p ❑ TENANT ❑ ELEC ICAL Ti PL BING ❑ MECHANICAL B Rear IN! Contractor's Nam- -• �W 1 - Pho•e a e-4282- ❑ OTHER 4 �1-�J - .c IWV(l/.t C Right IN Oka. �_ I `_ ��. j •>•_•. •ROJECT DESCRIPTION St T. (� OCCUPANCY_, - K . ,G Address(mailing) `-�LeCON ST RUCTION TYPE VALUATIONS � SQO'� s Left City License No. 02.4.5€4, ZONE GRADING CU.YDS. ACRES II IIE LICENSED CONTRACTOR DECLARATION 1 Ping. Ref.# Parking Req./Provided � I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks:Le r I A �/O/-. ? /" 7R4 nC •Y�q(' t re-- Planning Notes: IM ' with section 7000) of Division 3 of the Business and Professions Code,and (//7 �1\ my license is In II for e and el ct �1 t LL �—y—/ j T SID License C1 ss - C -- , Licen it: o._- C /j'/a K 31 ej LCr4 ,, 2)O't / G ` �jk- S. I Date 7 17_Is' Signature �. - i ,' • v (J `v/ PLUMBING I FEES • WORKE S'COMPE SATION DECLARATION Bar Sink Showers hereby affirm that I have a certificate of consent to self-Insure or a certificate ELECTRICAL 'FEES If Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. � Automatic Washer Transformer 0 15.50 KW , ; I •C 1 Backflow Preventer Service Sink v Policy No.64./4-•:-. z492•444 3 Company Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+ KW Certified copy Is hereby furnished. (' Certified o is sled with the city B Division. I [t Bathtubs Sewer Connection Cooking Unit Meter ❑up TO 10Qamps Date -71'1-�+I-II/-y'Q�`- Applicant EXEMPTIONF RO WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher nil Meter Cover 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 00-1 HP 01%-13 Workers' Compensation Laws of California. Date Signature • Floor Drains Swimming Pool w/Spa F.A.U. •NOTICE: If,after making this declaration,you should become subject to the Inc.Solar ❑9.15 HP 016-15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures 'Microwave F comply with such provisions or this permit shall be deemed revoked. - CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device BoxesPole 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 - Outlets Range Lender's Name Lender's Andress 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 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 Generator 00.5 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 Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil enalty of not more than five hundred dollars($500). I, as owner of the property or my employees with wages as their solo Reinspection Foe 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 DEVELOPMENT SERVICES REQUIREMENTS: thereon, and who does such work himself/herself or through his or her own Hood or Ty • pe provided that such Improvements are not intended or offered for Boiler 1 0 Zoning Approved By nate 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 r01�u tj nate g 8'� rove for the purpose of sale). rl I,as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By flair 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 BTUSUMMARY OF FEES builds or Improves thereon, and who contracts for such projects with a con- tractors) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple❑ 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.Bit. ICBG# PLUMBING $ 44• SO ISSUANCE $ Date Owner Heating System& Ducting• PLAN CHECK 25% $ Z 8 q C. $ I hereby certify that I have road this application and state that the above ❑0.100,000 BTU 0100,000 BTL 'GRADING $ information is correct. I agree to •mpy with all city and county ordinances ELECTRICAL $ i and state laws elating to builds g ••nst uctlon,and hereby auth Ize repre- sentatives of th city to ente u•on he above-mentioned pr per yyryyy for Inspection purpose—' 7 /p a/, MECHANICAL $ Signature Pink-Accounting;Goldenrod-Assessor CONSTRUCTION AND PLANNING ,� POOL & SPA APPROVALS Permit Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3.: Electrical Conduit Utility-Undrgrnd. 54. Forms • 4. Electrical Conduit-Undrgrnd. v 55. Electrical Bonding 5. Steel Reinforcement ,r 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd: 57. APPROVAL TO COVER-GUNITE 7.,Footings •^ 58. Electrical Conduit-Undrgrnd.• 8. Foundation ,y. 59. Gas Pipe, D Undrgrnd., Test 9. Watei Pipe-Undrgrnd. .t 60. Backwash Lines, P-Trap, D Undrgrnd. t i • 10. Structural Floor System ,. 61. APPROVAL TO DECK • 11. Property Sewer Line;& House Connection 9/(jr.( Giro 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. 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 41in C,� 22.•Ducts, Ventilating 71. Product Piping DGas DOil 23. Gas Pipe-Rough& Test - 72. Underground Flush Witt (,Em 24. Roof Framing 73. Undergrnd.Storage Tank D 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. DrywallNailing HEALTH DEPT. REQUIREMENT 31'. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: .7,/,/ 7 f 7767- 34. Final Heating & Air Conditioning 7/u/)y S'Tanopaet INSP. no NYi/2Oa 1,.reA 35. Final Gas Pipe-Test )-Z(. -$c1 ;/,)5,4q44 SAI t/4nq Zeal elm, G�I 36. Hood or Canopy rhrsd wtoy to 5-025. 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 ,Costa Mesa Building Department APPLICATION FOR PERMIT P. O. Box 3!7 31.39 BUILDING 1 i COSTA MESA, CALIFORNIA FOR OFFICE USE ONLY FOR APPLICANT TO FILL IN Receipt No. Permit No. Building2 /� I 5/ O Address lo4� ` LAE Costa Mesa, California Received by Date?R1-SZ ec/'d. / Date Issued` / Nearest .--7,=-70 6 v%J"1 'l'S (O S� 7 V K Cross St. 'S- te - Building Address OwnerO s tItAiut F Costa Mesa, California Mail Address -C44 F Lp P(LS Nearest Tel. Cross St. City C0%1-A Nett A. No. Zone No.of Type Group//t Architect or Lic. AO I Plans I �L'J� Engineer ----- No. — Approved by Date Address \ [I.', � ' /I t YON ,ntractor 3 t 1 , f'1 f N/1 c— No.Lic;ct q 3 , , I R Address 'T.e12 ( f/..Irl. Ld NG b, r Legpt Lot I �� CI PLANNING DEPT. Description I No. 4o Block I Traet37 (Attach Metes and Bounds) / �j O —X ( No.of Bldt7 gs / tj� 10. Gate S�'�-� Size of Lot G G �b�I Now on Lot PL4N, tiE Use of No.of i No.of ^_ 0 Existing Bldg. V FS . I Families I Rooms - tt I1 Setback Line from / 4- Rear Yard 2T ' t -- `l I 11.\ i .1 R Z Center of Street S-B Side Yard S' t 1.04,/i5`'x _ D DESCRIPTION OF WORK 1 i l - -- r New IKI Alteration I I Addition I .\I 9. d l9.1l1 Repair I I Moving I I Demolish I Building. , No.of _ _ -7.c Y;T:Qla Size 5I la x 40 Rooms Stories I rt� �tf.. Utia r1 ' •"' xterWall I Ch+ UO Cat, J Roof `�� APPROVALS .ove rinln g $j U p F o Covering Use of New y-� Foundation Location Inspector Date Building L-c-�CiL�% Forms,Materials, / + % Under-Pinning Frame: Fire Stops, Bracing,Bolts I hereby acknowledge that I have read this Application and state that the above is correct and agree to comply Lath.Int. with all City Ordinances and State Laws regulating building const 'on. Lath. Ext. Signature of Permittee 1''"-/ c Plaster, Int. Authorized Ag , '`I Plaster,Ext. Valuation '/ Permit Fee $ 0701 — Masonry Reinforced $ t/ / I yy, Plan Check$ / / — Bond Beam D / Total Fee $ 33 — FINAL FORM 209 '0.55 D.P.&5. • a h ry ao V 'Ag-ad-i'31,51---33 vo a • • c F.k st - ...' 1 • ;'• •',; - 1 Street • PLOT PLAN Show location and distances from property line and between buildings. r Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PERMIT O/� �y TRA T NO. LOT NO. BLDG.NO. CONSTRUCTION PERMIT Y '''i 3S22 a�� ala 6850 10/15/81 24800 TLi Project Address G / cGd „ . . _.. / /(J TYPE OF CONSTRUCTION Owner Z-41-.e,2,.., /got( Phone c,(/6 Jif 9 0 NEW 0 ADD 0 ALTERATION ' Address /goes � eet1G L� A.2e • 0 REPAIR 0 CONVERSION DEMOLISH r ZONING REGULATIONS Arch/Eng. License No. ❑OTHER A.P.# [ I Address DESC RIPTI OI(1'/��F WORK � /�v Iff�� 224 — /0 /,�,+r�'..,� •'�-5 L krr yy4A-EACF ZONE 812, PLNG. REF.$ Contractor Floc=�tr�e G ��//�Ehdne�JL Ca TYPE OF PERMIT / BUILDING/ R yNU NE Address O Z(� `/ SETBACK C/L ST. �7 seri /i sr. j- 1 • ❑GRADING 0 FOUNDATION 0 STRUCTURAL SIDE YARD ,. . r}lti/ LICENSED CONTRACTOR DECLARATION 0 TENANT 0 ELECTRICAL ❑PLUMBING ['MECHANICALI E YARD IN�,I/1"}Y I hereby affirm that I am licensed under provisions of Charter 9(com• RIGHT mencing with section 7000) of Division 3 of the Business and 0 OTHER REAR YARD(TO P Professions Code, and my license Is in full force and effect. PROJECT DESCRIPTION License Class/� LSC se No�+�7 cre7 PKG.SPACE RE PROVIDED Date / —/-C-747/ Signature (n SQ. FT. STREET WIDTH PARK FEE 5 WORKERS'COMPENSATION DECLARATION . OCCUPANCY CONSTRUCTION TYPE I hereby affirm that I have a certificate of consent to self-Insure or a VALUATION / 0-6"6• ZONE ZONING APPROVED BY I�LV' U sn DATE 1 certificate of Workers' Compensation Insurance, or a certified copy / `V F.� l K thereof(Sect oq 9�OQ3 La; ^d✓� SPECIAL CONDITIONS: �Ilcy No. 3 ��Company ! i"r"•M eS GRADING CU.YDS. ACRES ryQ t Certified copy Is hereby furnished. REMARKS: ��C��y/`� �,VM Certified copy is flied with the city Building Division. Y -AEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed If the permit Is for one hundred p/s'"' Z o' ($100) or less). MM • Certify that In the performance of the work for which_this permit Is _ Issued, I shall not employ any parson In an nner so as,to become PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK subject to the Workers'Compe tion ws llfornia. G 6ARAUt Dat /C� Slgnatur SO FT. BATHTUBS SHOWERS SO FT. SO FT NOTICE: If after making this claration, you should become subject TOILETS URINALS GENERATOR 0-1 KW_1-10 KW to the Workers' Compensation provisions of the Labor Code,you mustTRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS - APPLIANCE 10-50 KW_SO+KW " revoked. . CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS MOTORS 0-1 HP 1-10 HP - I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS (INC.SOLAR) 10-50 HP 50+HP formance of the work for which this permit is Issued (Section 3097 Civ. C.). FLOOR SINKS _ FLOOR DRAINS .FIXTURES OUTLETS SWITCHES Lender's Name Lender's Address _ _ DRINKING FOUNTAINS GAS TUBE SIGNS OWNER BUILDER DECLARATIONPOLE LIGHTS I hereby affirm that I am exempt from the Contractor's License Law for INTERCEPTORS CLARIFIERS the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP LUNSI FMK- (UN . Any city or county which requires a permit to construct, alter, 9 POLES METERED SUB Improve, demolish or repair any structure, prior to its Issuance,also re- WATER SERVICE ALTERATION PANELS MAIN SUB quires the applicant for such permit to file a signed statement that he Is licensed pursuant to the provisions of the Contractor's License Law f2 SERVICE AMP (Chapter 9 (commencing with Section 7000) of Division 3 of the GAS SERVICE OUTLETS business and Professions Cotle) or that he Is exempt therefrom antl the WATER HEATERS - BTU OUTPUT basis for the alleged exemption. Any violation of Section 7031.5 by -vy applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS - A not more than five hundred dollars ($500). 1, as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS -ole compensation, will do the work,and the structure is not intended or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE Contractor's License Law does not apply to an owner of a property / APPLICATION APPROVED BY • DATE who builds or improves thereon, and who does such work himself or ISSUE FEE through his own employees, provided that such Improvements are not Intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK ' SUMMARY` OF FEESis ofsold p proving tn onehe did year of (build port improve for the ror thelll have the purrpose of sale). HEATING SYSTEM 0-100,000 BTU BUILDINGERMIT $ �' S0 SMTP $urden .....<6 ❑ I, as owner of the property, am exclusively contracting with AND DUCTING licensed contractors to construct the project (Section 7044, Business 100,000 +BTU PLAN CHECK $ PERMIT and Professions Code: The Contractor's License Law does not apply to CD --•-• ISSUANCE E an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING 5 tracts from such projects with a contractor(s) licesned pursuant to SYSTEMGRADING E ' the Contractor's License Law). 100,000+BTU PLAN CHECK E ❑ I am exempt under Section B.& P.C.for this BTU ELECTRICAL 5 5 reason PLAN CHECK $ MICROFILM E Date Owner SYSTEM REPAIR,ALTERATION TOTAL FEE E I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL.E LESS AD- Information is corre I a ee to com y with all city and county PLAN CHECK $ VANCE PC $_ ordinances and stat aws r sling o r tion,and hereby authorize Lrepresentatives 0 is y t on the above mentioned property Acre. Signature �� -I Date/OW -o / FINAL FEE $ Drivers'Li ense - ISSUE FEE CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor CONSTRUCTIONIAND PLANNING POOL& SPA \ APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Soil Pipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn - 45. Forms 4. Electrical Conduit-Undrgrn . .I • , 46. Electrical Bonding 5. Steel Reinforce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undrgrn 8. Foundation 50. Gas Pipe, ❑Undrgrn,Test 9. Water Pipe-Undrgrn 51. Backwash Lines, P-Trap. ❑Undrorn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. 'Backwash & Receptor-Final 12. Street Sewer Connection 54. Heater& Vent-Final 13. Rough Plumbing 55, Plumbing System - Final 14. Rough Electric-Conduit -- .56. Electrical-Final 15. Rough Electric-Wiring - •- - 57. Solar System-Final 16. - Rough Heating & Air Conditioning ' " 58. Fencing &Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating • 19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL 20. Roof Framing 21. Roof Sheathing 22. Frame and Flashing NOTES: 23. Insulation 24. Lathing &Siding 25. Drywall Nailing 26. Plaster Brown Coat ' 27. Electrical Power Meter-Final 28. Final Electric I • 29. Final Heating & Air Conditioning 30. Final Gas Pipe-Test 31. Final Plumbing 32. Water Service-Final 33. Gas Service-Final 34. Solar Domestic-Final _ 35' Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY• t-No- Date - - I \ Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. -- . - or ' '' ' -' crrY OF COSTA MESA _ AN -RgC2.171 PEW i PERMIT NO. TRACT NO. LOT NO. UNIT NO. 5721 B/D6/ 4 PI l I E 11-1-5-39 0 ft' Tr Project Address t940 yr au u.,e APPIICant's Mailing Addriss /7)7 isiAste-K., CO4 till In eal_CA.... TYPE OF CONSTRUCTION yckNIEW LI ADD LI ALTERATION li REPAIR ID CONVERSION ID DEMSH 0 OTHER A.P.# I Zone Owner's Name Co 1- cAl PhAio e7An r.... .._. . DESCRIPTION OF WORK/USE OF BLDG. Addres/b0 Atasift0 z obi 11/414,4e0 -silo— S Main Building: Accessory Building: Arch/Eng. ' License No. TYPE OF PERMIT LI GRADING 0 FOUNDATION 0 STRUCTURAL E ZT Front 0 Address 0 TENANT .IK ELECTRICAL 0 PLUMBING 0 MECHANICAL B Rear . . N -3- Contractor's N •J• A.", Phone4467000 . D -OTHER - A C Right I N PROJECT DESCRIPTION So. FT. OCCUPANCY . I:SD Address(ma i I i ng)I fi/ 1/44.) & yyl et ‘,..... VALUATION$ K G I City License No. 17-1410 • CONSTRUCTION TYPE s Left ZONE . GRADING CU.YDS ACRES . - ' R 0 LICENSED-CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E ---- I hereby affirm that I am licensed under prOvisions of Charter 9 (conim .encing Remarks: . Q I with section 7000) of Division 3 of the Business and Professions Code,and . IVe tt to-e- cSon?oie.--e d it- Planning Notes: , NI .......... my license is in fuitr?8nd effe Lica Class ic e hicLiteri iti , °-.0 RA-Ott& C-c oter., I.75 . Dat _ _ Signatur PLUMBING FEES . ' . WORKE 5'COMPENSATION DEC RATION Bar Sink I Showers I hereby affirm that I have a certificate of consent to self-Insure or a certificate ELECTRICAL FEES P If WorkersCompensation Insurance,.or a certified copy thereof (Section 3800, Lab. C.) Backflow Preventer .- Service Sink . Automatic Washer Transformer 0 15-50 KW - . Polisy No. ' Company Backflow Irrigation Sewer Cep Construction Pole Sub. 0 50+KW ACertified copy Is hereby furnished. Certified copy is filed with the city Building Division. Bathtubs ' Sewer Connection . Cooking Unit ' Meter Oup to 100 amps I SpO Date Applicant — — . EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Clover 100 amps (This section need not be completed if the permit is for one hundred($100)or less). Dishwasher Solar Piping Dryers 0Ges 0Electric Sub Panel I . I certify that In the performance of the work for which this permit Is issued, I — 5 OC) . 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 0 0-1 HP Di t6-8 Data 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. „ i —.-L—.__I Microwave SO 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 26 , of the work for which this permit is issued (Section 3097 Civ. C.) • Interceptors Water Heater Lender's Name 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 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 Generator 00-5 KW 05-15 KW Trash Compactor ii 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 - genaity 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 I BIB 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 employees, provided that such Improvements are not intended or offered for Boiler Hood or Type I 0 DEVELOPMENT SERVICES REQUIREMENTS: sale. If, however, the building or Improvement is Sold within one year of cam- Canopy Type II 0 Zoning Approved By Date 'Action, the owner will have the burden of proving he/she did not build or im. Duct-Under Ground glove for the purpose of sale). -- Building Approved By Date U I. as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By--...._. .r) Date_a_fe_ tractors to construct the project (Section 7044,Business and Professions Code: Tho 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) Iftense 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. 0 lam exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICB0+ PLAN CHECK S PERMIT PLUMBING $ ISSUANCE $ Date Owner Healing System&Ducting PLAN CHECK 25% $ ENERGY P.C. $ I berets i i y • have read this application and state that the above DO-100,000 BTU 0100,000 BT Inform on IS Correct. •ree to comply with all city and county ordinances ELECTRICAL $ 114-(a0 GRADING $ anq st.te laws relating • bui g construction,and hereby authorize repro- sentati s of this ci to er upon the above-mentioned property for PLAN CHECK 50% $ 5--- 0 MICROFILM $ Insbe Po • -,•. MECHANICAL $ 20.40 Signe ure S71- DateS___4ke TOTAL FEE $ Reinspection Fee 115 Issue Fee $ 3 PLAN CHECK 25% $ Drivers' License or$S# Applicant:Pink-Accounting;Goldenrod-Assessor CONSTRUCTION AND PLANNING POOL a SPA '� - Date Inspector Date Inspector APPROVALS, Permit# APPROVALS Permit # ,'• 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3.,Electrical'Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding - - S:;Steel Reinforcement 56. Rough Plumbing & Pressure Test • 6. Electrical UFER Grnd. 57. 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 Ble! 4061 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 , /1� f� 'n n 80. FOOD CERTIFICATE ISSUED 33. Final Electric / / �l.__- Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation - . •. 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No Date Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA CONSTRUCTION PERMIT — PERp4I i NO.�� TRACT'NO. LOT NO. UNIT NO. Project Address /:G'17', / Ide .—1 �L A- l(JJ' 1 f,1 Applicant's Mailing Ad r l�l_Aha.Q c -i l'tr .Dr- "JOa TYPE OF CONSTRUCTION t'V NEW LI ADD U ALTERATION U REPAIR // ❑ CONVERSION ❑ DEMOLISH ❑ OTHER # � one Owner's Name/.Tr Yr..I, f� 720y'c.LllL/ -/ Phone 3� A.P. 3 DESCRIPTION OF WORK/USE OF s LDG. - Address //j2 C �' , ^f-e• $4 A- v! •CA • f p A 1• _ r- S Main Building: ye c'r{`�s Y,Bui1 Trig: II f1 _ 2 Arch/Eng. - License No. TYPE OF PERMIT GRADING FOUNDATION .TRUCTURAL T Front • 'I V ,j 0 Address • ❑ TENANT 0 ELECTRICAL 0 PLUMBING 0 MECHANICAL B Rear r N Contractor's Name O ^Phone-. 0 OTHER II �Jr�CN 29X985 a !+ • 1 �'//�) PROJECT DESCRIPTION SO. FT. - OCCUPANCY C Right / i� N Address(mailing) — "" C' CONSTRUCTION TYPE VALUATION$ �n • s Left —' 0:— f ••nnr- City License No. ZONE GRADING CU.YDS. ACRES - eq R LICENSED CONTRACTOR DECLARATION /s _ Ping. Ref.# -/ Parking Req./Provided - E 1 hereby affirm that I am licensed under provisions ggqqqqf Charter 9(commencing Remarks: Pc 1 7 2_g� Planning Notes:. M with section 7000) of Division3 of the Busin a 11?Q1e55ions Code, and 1 my license is in full forceaand ofd effect. I-11\IIVVIIVVII�,�1 T License Class L e - $. Date Signature PLUMBING FEES • WORKERS'COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL FEES I hereby affirm that I have a certificate of consent to self-Insure or a Certificate of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink 3800, Lab. C.) Automatic.Washer ' Transformer ❑ 15-50 KW _ :obey 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 Opp 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 shallnot employ any person In any ma• er o as to beco e subje to the Drinking Fountains Solar Tank Fan Motors 00-1 HP ❑1%-8 Workers' Compensation Laws of Califor I . „Date Signature �- 'NOTICE: If,after making this declaratl• Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar ❑9.15 HP 016-15+ Workers' Compensation provisions of ;�o./ • d b-come subject o the for Code, you must rthwith Floor Sinks Urinal Fixtures Microwave comply with such provisions or this •e mit shall be deeme• revoked. - - CONSTRUCTION LENDING AGENCY - ^Gas Service Outlets Water Closet Device Boxes -Pole Light I hereby affirm that there is a construction lending agency for the performance g 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 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 county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays Generator ❑0-5 KW 175-15 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 i5 exempt therefrom and the basis for the alleged exemption. Any violation of Section . 7031.5 by any applicant for a permit subjects the applicant to a civil ' penalty of not more than five hundred dollars($500). - - 0 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 i 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 ❑ Zoning Approved By 'ea Date elation, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By C`- ft's•° Date I-24-S� prove for the purpose of sale). //�� d [��j qp I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System • Application Issued By 414/6 Data I-29�OS 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 00100,000 BTU 0100,000 BTU SUMMARY OF FEES C builds or improves thereon,and who contracts for such projects with a con- • S6 tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple 0 System Repair/Alteration BUILDING PERMIT, $ ' I'1• %J10 SMIP $ ' proof of their Worker's Compensation insurance should be provided to me. - • PLAN CHECK $ �f �!L PERMIT 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBO# Fire Dampers PLUMBING $ ISSUANCE $ ' Date z_�_q�rtl'n Owner 9• _.• r i -a _. Heating System& Ducting Registers ENERGY P.C. $ �— PLAN CHECK 25% $ I hereby certify that I have read th ..••• ation and state that e above 00-100,000 BTU 0100,000 BTL GRADING $ information is correct. I agree to Co p y th all city and county ordinances • ELECTRICAL $ and state laws relating to building construction, and hereby authorize repre- sentatives of t• s- sly to enter upon the above-mentioned property for inspection pur••s • MECHANICAL $ TOTAL FEE $ 2.�F.4 2- Signature Signature f � -'Applicant; Pink -Accounting;Goldenrod - Assessor - - - ' CONSTRUCTION AND PLANNING POOL . 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 �/3t//"L(/ 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. f . 57. APPROVAL TO COVER-GUNITE 7. Footings f// fr," 1(' 58. Electrical Conduit-Undrgrnd. 8. Foundation . ! 59. Gas Pipe, O Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, ❑ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 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 O Gas 0 Oil . 23. Gas Pipe-Rough& Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED/ 33. Final Electric Notes: 1_2-j0,/is< L, Ory G £4 C 34. Final Heating & Air Conditioning (0 ` /7`d 7 35. Final Gas Pipe-Test i 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 ®Ilinffinninnn EnniEnannIn - 2644 ELDEN UNIT A-2 - a n _ 814002 _ 'CONDO $73,420. _ 51/ 7/gs PC 172-84L UNIT A2 _P1425 MISC 3 ///85 B14002 UNIT A2 - ®1454 MISC /5795/ UNIT A2 _ M15592 E1Isc 3//585 1314002 UNIT A2 _ M15827 FEPLC 35/6 s B14002 Unit A2 ® ua :t yrra ; ✓:mss„ ® M15999 3/4--/5 5 . 314002 UNIT A2 1 . 1 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations- CITY OF COSTA MESA PERMI NO. TRACT NO. LOT NO. BLDG. NO. • CONSTRUCTION PERMIT 4 /410 0.2 lL}1-�7, I 21 3662 7/09/04 469.11 li Project Address �tv y7 J •�y -L 'TYPE OF CONSTRUCTION IN NEW LJ ADD LJ ALTERATION LJ REPAIR Applicant's Mailing Address /6O Aire ioCi-r"-r" *Jt Pr ❑ CONVERSION ❑ DEMOLISH 0 OTHER A.P.# ,- _ 2,2-1I /O I Zone 3,+� DESCRIPTION OF WORK C-0••-40 �� Owner's Name Jr rQ-1-' L f �`- Phoney S Main Building: Accessory Building: Z Address /1 sZ -- //'r-a'S A - 122514 Me j4 1�-h t� tO� E 0 yy TYPE OF PERMIT El GRADING_.4 FOUNDATISON la] STRUCTURAL T Front �-- -) ' pJ I - Arch/Eng. \/�C lcn,ci License No. ❑ TENANT 'N ELECTRICAL / PLUMBING 161 MECHANICAL B I W' . / �j ^' �a Rear Q�A �/ N M Address • 7.2 e_o_— -, a_ 4-,-04-i 3.•$C —le ❑ OTHER }—� - C Right 3 1 G I Contractor's Name Lr,"{- Do Phone Ci g PROJECT DESCRIPTION SQ. FT _ 7° .13 y�p-��}y)p�ANCV /s: .,. Tr Si E rr • ,Z � CONSTRUCTION TYPE �-o� 0 VALU✓<aTION$ 10,01_,CV S Left Address(mailing) ,-L. Qt n f J ZONE K.- 7— GRADING CU.YDS. ACRES 'YID Z .38 Q r City License No. ,/ Ping. Ref.# ��-��-0� Park.Fees $ ' zZG� U • LICENSED CONTRACTOR DECLARA ON Remarks:f i!O/�O� 4i<#" fG I Parking Req./Provided 2 rJ 2 1 I hereby affirm that I am licensed under provisions of Charter 9 (commencing �� R with section 7000) of Division 3 of the Business and Professions Code, and Use of Building: rte.); Loa_. ,E my license is in full rce ntl effect. License Class License No,/S /•� , PLUMBING FEES Planning Notes: BOLOOR SPECIAL REQUIREMENTS M E Date Signature ''ORKERS'COMPENSATION DECLARATION Bar Sink Showers 'T T affirm that I have a e of consent to self-Insure or a certificate Backflow Preventer Service Sink . - S Workers' Compensation insurance, or a certified copy thereof (Section x800, Lab. C.) - Backflow Irrigation Sewer Cap ELECTRICAL - FEES Policy No. 67...c2/5.-4.4/ Company - ' eCertified copy is hereby furnishd. - Bathtubs Sewer.Connection . Automatic Washer Transformer 0 15-50 KW Certifleg.coos,is filed with the city �B4'f' Diws / Clarifiers - ❑ 50+KW Date 7-�-�y Applicant y� , Solar Collectors Construction Pole Sub. . EXEMPTION FROM WORKERS'CO P ION DECLARATIO Dishwasher Solar Piping . I - CookingUnit Meter ❑u to 100 amps (This section need not be completed t e'p mit Is for one hundred 100) or ' P P fess). Fountains • I certify that in the performance of the work for which this perm isIssued, I Drinking Solar Tank Dishwasher Meter Dover 100 amps shall not employ any person In any manner so as to become subject to the - Workers' Compensation Laws of California. Floor Drains Swimming Pool w/Spa Dryers ❑Gas ❑Electric Sub Panel Date Date Signature NOTICE: If°after making this declaration, you should become subject to the Floor Sinks Urinal Fan Motors 001 HP 011/4-8 Workers'. Compensation provisions of the Labor Code, you must forthwith • • comply with such provisions or this 'permit shall be deemed revoked. Gas Service Qutlets Water Closet 'A,U. Inc.Solar 06-15 HP 016-15+ 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 Js issued (Section 3097 Civ- C-) e Lender's Name - - Kitchen Sink Water ServiceDevice Boxes Pole Light Lender's Address OWNER BUILDER DECLARATION Lavatories Outlets Range s • I hereby affirm that I am exempt from the Contractor's License Law for the - - following reason (Section 7031.5 Business and Professlonal'Cotle: Any city or P-TrapSwitches 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 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 - Generator ❑45 KW ❑5-15 KW Trash Compactor `Ivislon 3 of the Business and Professions Code) or that he/she Is exempt - P erefrom and the basis for the alleged exemption. Any violation of Section 031.5 by any applicant for a permit subjects the applicant to a civil Reinspection Fee I $25 - Issue Fee $ 3 enalty of not more than five hundred dollars($500). I, as owner of the property or my 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 REQUIREMEN : I I License Law does not apply to an owner of a property who builds or improves Boiler Hood or Type I ❑ • -] Ry thereon, and who does such work himself/herself or through his or her own Zoning Approved By (o • Date ` 18/ employees, provided that such Improvements are not Intended or offered for Canopy Type II ❑ 7^�^g� If, Duct-Under Ground sale- te however,wthe will havn t the burdendopro isohewithin one yeard rem- ♦ Building Approved By Date pletio for the owner se have of proving he/she did not build or Im- ' �r ve the purpose of sale). Duct-Structural Refrigeration System Application Issued By ` .iL> nate 7-9—�/ I, as owner of the property, am exclusively contracting with licensed con- ❑0100,000 BTU ❑100,000 BTU 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 - • - - op ,r', /4 builds or improves thereon,and who contracts for such projects with a con- Exhaust System ❑ Multiple 0 System Repair/Alteration BUILDING PERMIT $ .365 SMIP $ tractor(s) license pursuant to the Contractor's License Law). .a<�0- PLAN CHECK '$ j+Z9'C 7 PERMIT ❑ I am exempt under Section B. & P.C.for this reason Firepl/Fact.Blt.ICBO# ✓ PLUMBING '$ ISSUANCE $ � Date 7- _ Owner '� ..:.. /�' Heating System&Ducting ENERGY P.C. $ PLAN CHECK 25% $ 1 hereby certify that I have read I' .p.'cation and state th. ne above - 00-100,000 BTU 0100,0008 - GRADING $ - information is correct. I agree to y Ith all city and coun•f ordinances • ELECTRICAL $ and-state laws relating to building construction,and hereby a horize repre- PLAN CHECK 50% $ MICROFILM $ sentatives of thi cit to ester up•n the .bove-mentioned property for Inspection pure• r/ • MECHANICAL ' $ Signature I' . - SL Data _ TOTAL FEE $ �' 11/ Drivers' !Jeans,. /' _ - Reinspection Fee $25 Issue Fee $ 3 PLAN CHECK 25% $ . CMF 0865-46 Goldenrod -Assessor • • CONSTRUCTION AND PLANNING POOL PA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1'. Temporary Electrical Service or Pole 52. Pool & Equipment Location - - ' • 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement _ 3.' Electrical Conduit Utility-Undrgrnd. • 54. Forms . - 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding - . 5. Steel Reinforcement .t I W._ 56. Rough Plumbing & Pressure Test _ • 6. Electrical UFER Grnd. 7V Qi 57. APPROVAL TO COVER-GUNITE' - . 7. Footings G' - Ur ✓� 58. Electrical Conduit-Undrgrnd. ,. . , ' 8. Foundation •, 14,410 Vv 59. Gas Pipe, 0 Undrgrnd.,Test L 9. Water Pipe-Undrgrnd. 1 60. Backwash Lines, P-Trap, 0 Undrgrnd. ; • 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 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. Sola? System-Final - - --- - 1ough Electric Wiring 67. Fencing & Access Approval 6tR - 17t'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. REQUIREMENTr _ - 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 OGas 0.Oil 25. Roof Sheathing /7,/�Jn w 74. Overhead Hydro r i - i 26. T-Bar Ceiling (Structural) & Monocoat ( /( 75. Dry Chemical - , 27. Frame and Flashing Wei VC-- 76. Dry Standpipe , 28. Lathing & Siding it Zip( {/E� 77. FIXED SYSTEM FINAL 29. Insulation I�/ /Sf/�� 78. FIRE PREV. FINAL - I 30. Drywall Nailing / 'u ` HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat WA-A- /i.f 79. FINAL INSPECTION • 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED • 33. Final Electric Notes: ("It' 144:411.1 34. Final Heating & Air Conditioning ' - 35. Final Gas Pipe-Test • •: . 36. Hood or Canopy - { . - : I 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 71Ar I(� . ' • 48. Special Requirements Completed �` i/&s-' elf �1 49. Electric Release to Edison T�/ OU ' 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY �� • No. 409 Date 4± 9Z t~ '�YJ!/ 1 City of Costa Mesa n Development Services Department CERTIFICATE OF OCCUPANCY No.OC 413.(r S Building Safety Division P.O.Box 1200 Costa Mesa,California The Building located at 7F44 Ff,rlat A%1P 1rrR LtUTm Q '-2 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group u_i Occupancy. Use of Building rvtitrvvrra rmi Legal Description_ 439-221—]0 (See reverse side for Metes and Bounds) duilding Permit No R-1 Ann') Electrical Permit No.r_iA t1 Plumbing Permit No.a1 A151 Mechanical Permit No.f-t1 Scg1;Mi t:R77M]cQQQ Number of apartments and/or guest rooms, ISSUED TO: Building Official D. le JI- FREY FRAWLEY %/ by ,f 1152 SALINAS AVE. . Cf1Sri�1 .]ESA. CA. Date /� 7�f //`j/ 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. , CITY QF COSTA MESA CONSTRUCTION PERMIT I PERMIT NO�f' 8' TRACT NO. LOT NO. UNIT NO. 5067 7/30/94 38067.: ?: Project Address - ` L -G'- Applicant'sM311in• 'ddr -� LA/, ,'.� TYPE OF CONSTRUCTION RI NEW IJ ADD LiALTERATION REPAIR Ira, �s� lie'An ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# Zone Owner's Name !i. phone �j DESCRIPTION OF WORK/USE OF BLDG. Address SO a .. CIL �-�.: t # DR' SV—/o • S Main Building: Accessory Building: • Arch/Eng, License No. TYPE OF PERMIT El GRADING IX LI FOUNDATION LI STRUCTURAL E Front- O Address ❑ TENANT ❑ ELECTRICAL YLY PLUMBING 1::I MECHANICAL A Rear • N Contractor's Name AFC 7 - F 4,.. _Phone •. Z.r ❑OTHER C Right N Address(mailing) - - ✓ -cL ) _'A % - PROJECT DESCRIPTION SQ. FT. OCCUPANCY K Left G a611g CONSTRUCTION TYPE VALUATION$ 5 City License No. p[ ZONE GRADI NG CU.YIDS ACRES - R LICENSED CONTRACTOR DECLARATION �t �s , Ping. Ref.# Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: /4/0// L Planning Notes: M with section 7000) of Division 3 Of the Business and Professions Code,and T my license is in full fort andel effect. • ` License C ss t '3G License/1/.467340 S. 00 Date Z (/�//— Signature — T/1 PLUMBING FEES _ W WORK RSCOMPENSATION DECLARATICASIT Bar Sink Showers I hereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL FEES of Workers' Compensation Insurance, or a certifie co y thereof (Section Backflow Preventer Service Sink 3800, Lab. C.) 2 }� Automatic Washer Transformer 0 15-50 KW Q Policy No. Q4g f company S �1.,1 Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+ KW Certified copy is hereby furnished. � .7 — Certiti copy' led with the city g Division�. ////�� Z Bathtubs Sewer Connection Aja ` Cooking Unit - Meter Dup to 100 amps Date 'LION \ � KERS'dnt {TION DECLARATION 94444 .{�A.i EXEMPTION FROM WORKERS'COMPENSATION DEClarifiers 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 c2__opDryers OGas ❑Electric Sub Panel I certify that in the performance Of the work for which this permit is issued, I. snarl not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank • Fan Motors❑0-1 HP 0115-8 Workers' Compensation Laws of California- 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 with such provisions or this permit shall be deemed revoked. Microwave CONSTRUCTION LENDING AGENCY / Gas Service Outlets S sJ 3 Water Closet ��-77� Device Boxes I hereby affirm that there is a construction lending agency for the performance C. Pole Light of the work for which this Permit is Issued (Section 3097 Civ. C.) Interceptors Water Heater , Lender's Name P ext-�/J Outlets Range Lender's Address _ / Kitchen Sink Water Service c9- c c Switches Sign OWNER BUILDER DECLARATION . Disposal osal Standing Sections g I hereby affirm that I am exempt from the Contractor's License Law for the S Lavatories /O CS GarbageDis 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 any Structure, prior to its issuance, also requires the applicant for such permit Generator ❑D-5 KW❑5.15 KW Trash Compactor to file a signed statement that he/;he 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 analty 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 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 Boiler , 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 ByDate rove for the purpose of sale). 7/3 7^� 0 I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By _ Date ` 3i1 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 thatBUILDING PERMIT $ SMIP $ proof of their Worker's Compensation Insurance should be provided to me. Exhaust System 0 Multiple 0 System Repair/Alteration PLAN CHECK $ PERMIT 0 I am exempt under Section B.& P. for this reason Firepl/Fact.Blt. ICBG# PLUMBING $ 3l S-Z, ISSUANCE $ ' Date Owner Heating System& Ducting PLAN CHECK 25% $ 7/3 ENERGY P.C. $ I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000 BTL 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 city to ente pen the above-mentioned pr pert for Inspection purpos• ''l MECHANICAL $ TOTAL FEE $ 36. 3 Signature !i✓ Date / Drivers' License or Pink-Accounting;Goldenrod -Assessor • • CONSTRUCTION AND PLANNING POOL & SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. A3,y• [,Q,d 53. Steel Reinforcement 3:-Electrical Conduit Utility-Undrgrnd. 1 54. Forms 4f.Electrical Conduit-Undrgrnd. 55. Electrical Bonding • 5. Steel-Refinforcerrient- • 56. Rough Plumbing & Pressure Test 6. Electrical OF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7.:Footings 58. Electrical Conduit-Undrgrnd. •� ' 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 8(3/01 ILO 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 f12. Sdwer'Cap , • , . :' 63. Heater & Vent-Final • 13. Rdof Drains •• I - 64. Plumbing System - Final • 14. RoughPlumbing i 0//741Y LiD 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 18r 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 I Notes: 34. Final Heating& Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 3/11/16- 1.t' 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backf low 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 • ,nL �i Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 9704 10�09�U4 8.0i. 1 CITY OF COSTA MESA /"CO ,(T�RyUCTION PERMIT PERMIT NO. TR.9UT NO. t'BTIQO" U"it3T NO. ' i Project Address L1!/ t - LIG/n1�f�� 1YMIMI 55012- �JC/]S//� '/{�'//J� Applicant's Mailin• Addrei -O• feat of y nA TYPE OF CONSTRUCTION t NEw U ADD LJ`ALTERATION ❑ REPAIR � �� CI CONVERSION CI DEMOLISH ❑ OTHER A.P.# ' . I Zone Owner's Name /'-t I 'hon �y•f/�. DESCRIPTION OF WORK/USE OF BLDG. Address ! /Q'/ [r% -Met• - S Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMIT U GRADING CI FOUNDATION ❑STRUCTURAL T Front O L / Address i ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING CHANICAL B Rear N �+,�� //]� !� / /. �'1 / iD ❑ -OTHER A I Contractor's Nam• -.�-.zi'�. i .!� one C Right N / G PROJECT DESCRIPTION SO. FT. OCCUPANCv sp Address(mailing) '�'''1 �,j ' y /� , (�7D•� CON STRUCTION TYPE VALUATIONS S Left G City License No. („/`J� ZONE GRADING CU.YDS. ACRES 7 • PROJECCONTRACTOR DECLARATION / Ping. Ref.# Parking Req./Provided / E I hereby affirm that ram licensed under provisions of Charter 9 (commencing Remarks: (1 ) I �D ) 2.- Planning Notes: - / M - t with section 7000) of Division 3 of the Byslness and Professions Code,and �L� my license is in f f and effect. I// T �J 5 ' M 5' Y /License _ Date Signature _. • Pr PLUMBING I FEES S WORKERS'COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to tel -insure or a certificate Bar Sink Showers ELECTRICAL FEES of Workers' Compensation Insurance, or a certified, opy thereof -ction Backflow Preventer Service Sink r 3800, Lab. Cllr„n/Ocs�sry Automatic Washer - Transformer ❑ 1550 K • • Policy No. IYI-N- L jS�[1\ Company r.' /�� 5 • Backflow Irrigation Sewer Cap - 0 50+K ' 9 . Construction Pole Sub. 9 Certified op is hereby th the ed. • / Certi ' pe f'ed with the city Buil-'; -n, 1 • Bathtubs Sewer Connection Cooking Unit Meter Duo to 100 amps Date •`� Applicant r I i • C/ EXEM'TI• RO WORKERS'COMPENSATION 0 CLARAT •N 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 00-1 HP ❑1'h 8 Workers' Compensation Laws of California. - Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 0915 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. Microwave CONSTRUCTION LENDING AGENCY - Gs Service Outlets Water Closet Device Boxes Pole Light I hereby affirm that there is Construction lending agency for the performance - g of the work for which/'this ermlt 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 Disposal Garbage following reason (Section 7031.5 Business and Professional Code: Any city or 9Standing 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 Generator 00-5 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 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 I $15 Issue Fee S 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 prpvlhg he/she did not build or im- Duct-Under Ground Building Approved ByDate rove for the purpose of sale). �L,. �-�'�� I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Dat 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 00.100000 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 ❑ Multiple❑ System Repair/Alteration BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation Insurance should be provided to me. PLAN CHECK $ PERMIT 0 lam exempt under Section B.& P.C.for this reason Firepl/Fact.BIt. ICBG# PLUMBING $ ISSUANCE $ Date Owner Heating System& Ducting PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above QD-100;600 BTU 0100,000 BTI ELECTRICAL $ GRADING $ Information is come ogbin di comply const wit all city ande y countyh ordinances • state laws hrei t' g to building constru o ,and hereby authorize r pre- PLAN CHECK 50% $ MICROFILM $ in• spection of chi icy to enter upo a v -mentioned prop.rt for Inspection purpos D a Signature �//,U4Dv • �'r� Date IL MECHANICAL $ :699 TOTAL FEE $ • Drivers' License 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.:Ele[rical.ConduitUtility-Undrgrnd. . - 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding .5. Steel-Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7:-Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation - 59. Gas Pipe, O Undrgrnd.,Test 9. Water Pipe-Undrgrnd. . 60. Backwash Lines,P-Trap, 0 Undrgrnd. - 10. Structural Floor System - - 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection , 62. Backwash & Receptor-Final • 12. Sewer Cap • 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final . 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning ^,�/ky FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace `�" n ! 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: 34. Final Heating& Air Conditioning q/,s/8fCO L 35. Final Gas Pipe-Test -z� 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 ar • Job #301 2 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. • — PERMIT NO. TRACT NO. LOT NO. UNI NO. 0455 10/17/84 8.00 TL • CITY OF COSTA MESA CONSTRUCTION PERMIT2•, Project Address 2644 Elden •Applicant's Mailing Address P.O. Box 695 Walnut 91789 TYPE OF CONSTRUCTION U NEW U ADD U ALTERATION REPAIR 1o Owner's Name Coastline Development Phone 720-1383 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.91,6 Zone Address 160 Newport Ctr Dr. , Ste 108 Newport Bch DESCRIPTION OF WORK/USE OF BLDG. S Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMIT U GRADING U FOUNDATION U STRUCTURAL T Front 0 ' n 1 Address ❑ TENANT ❑ ELECTRICAL 0 PLUMBING ❑ MECHANICAL BB Rear N eAJR Construction 594-5911 ❑ OTHER Contractor's Nam Phone PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right G Address(mailing)P.O. BOX 695 Walnut 91789 Left X10196 CONSTRUCTION TYPE_ _ - - VALUATIONS S R City License No. _ ZONE GRADING CU.YDS. ACRES Ping. Ref.# Parking Req./Provided E i LICENSED CONTRACTOR DECLARATION ({ O I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: j5'40l/-�/Z Planning Notes: M with section 7000) of Division 3 of t i• Busess and Professions Code,and 1 T my license is in full force and effect. License last' I —2�.� ; e Np.e _306228 S. Date 1U—I ZI Signature ` I �^�" PLUMBING FEES WORKERS'COMPENSATION DELLA' •TIO Bar Sink Showers I hereby affirm that I have a certificate of cons' t to self-insure or a certificate ELECTRICAL FEES of Workers' Compensation Insurance, or a ertified copy thereof (Section Backflow Preventer Service Sink Automatic Washer Transformer 0 15-50 KW 3800, Lab. C.) W0005151 aver Insurance Policy No. o Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+ KW Certified copy is hereby furnished - Cery4 11XJ 11¢tl aap Sfiled with the cit = illkg \_.. — Bathtubs I Sewer Connection Cooking Unit Meter ❑up to 100 amps Date I 1`CApplicant f� EXEMPTION FROM WORKERS'COMPENSA' ION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps (This section need not be completed If the •er t t Is for one hundred($100) or less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel I certify that in the performance of th• wo' 1r w is tis per . is issued, I shall not employ any person in any a 6 o O e s a to the Drinking Fountains Solar Tank Fan - Motors 00-1 HP 01%-B Workers' Compensation Laws of Califo i.. 1 ` Date Signature IFloor Drains Swimming Pool w/Spa F.A.U. NOTICE:If,after making this declaration, y•u - ould become subject to the Inc.Solar 09-15 HP 016-15+ • Workers' Compensation provisions of the bo Code, you must forthwith Floor Sinks Urinal comply with such provisions or this per 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 performance - 9 OI the work for which this permit is issued (Section 3097 Civ. C.) Interceptors . Water Heater Outlets Range Name an 9e Lender's Address Kitchen Sink Water Service Switches Sign OWNER GUILDER I]ECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories 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 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 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 enaity 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 I $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL l 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 ❑ 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 rove for the purpose of sale). I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Dat tractors to construct the project (Section 7044,Business and Professions Code( The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU 0100,000 BTU SUMMARY OF FEES builds or improves thereon,and who contracts for such projects with a con- - tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple❑ 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# 2301 1 Metal Fireplace 4 00 PLUMBING $ ISSUANCE $ Date Owner Heating System&Ducting PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify t . I have read this application and state that the above 00.100,000 BTU ❑100,000BTL— information is torr ct. a• e- to comply with all city and county ordinances and state laws rela ing o •u di • construction,and hereby authorize repre- sentatives of this ci .• e ter p the a ve-mentioned property for inspection purpose ( 10-12-84 MECHANICAL $ 7.00 TOTAL FEE 18.00 SiDgners' \ar - CMF 0865-46,rev.4/84 ` / White-Building;Canary-APPlicanp Pink-Accounting;Goldenrod -Assessor CONSTRUCTION AND PLANNING POOL& SPA APPROVALS Permit# Date Inspector APPROVALS. Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, ❑ 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 1Structurat) & 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 Wafer GEp 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. 1304 10/31/84 I3.0'1 TL. . CITY OF.COSTA MESA CONSTRUCTION PERMIT PERMIT NO. 9 9 TRACT NO. LOT NO. UNIT NO Project Address I Applicant's MailAddress TYPE OF CONSTRUCTION KNEW U U ADD ALTERATION REPAIR /in'g�4t4 .17 //I P� ,9e'�• Phone ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.#6 I Zone . Owner's Name( DESCRIPTION OF WORK/USE OF BLDG. • Address - S Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMIT U GRADING ❑ FOUNDATION• U STRUCTURAL E Front — ZO Address n '/ ` Inn ❑ TENANT El,ELECTRICAL ❑ PLUMBING ILY MECHANICAL B Rear N Contractor's Names/L��.<—y—[ ter--4 S7.5Phone In (7 ❑ 'OTHER • A • I G/`JYtn PROJECT DESCRIPTION SQ. FT. - OCCUPANCY C Right - 'N I'n Address(mailing) I S• �� A � CONSTRUCTION TYPE VALUATION$ S Left - G • _. _. _ R City License No. ZONE GRADING CO.YDS. ACRES Ping. Ref.# Parking Req./Provided E LICENSED CONTRACTOR DECLARATION - Q tv I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: B .7 4 7O.�. Planning Notes: M p with section 7000) of Division 3 of the Business and Professions Code,and and _ / - '\ my license is in full f c pd effect. �// T License Class_ �v Ll erase 0 / S N Date Signature /�i_a__, L PLUMBING • FEES r WORKERS'COMPENSATION DECL RATI Bar Sink Showers ELECTRICAL FEES hereby affirm that I have a certificate of consent to self-Insure or a certificate ,f Workers' Co ensatlon Insurance, or a certified copy thereof (Sectio Backflow Preventer ... Service Sink - ' 3800, Lab. C. ely,y ) yAutomatic Washer Transformer ❑ 15-50 KW' , Policy No. ) �"'/ Company 47//1-141) Backflow Irrigation Sewer Ca - 0 50+KW ' P Construction Pole Sub • . Certif led copy is hereby furnished. • r' — X\'‘ Certijjletl 55pppy is file( ith the city Build OlVisi Bathtubs • Sewer Connection ' Cooking Unit . Meter ❑up to 100 amps / Date LG•6j/ 6 f Applicant - EXEMPTIONFROMWORKERS'COMPE ATION ECLARATION Clarifiers So12r 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 Workers' Compensation Laws of California. Fan • Motors❑0-1 HP ❑1'/a-R 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 01615+ Workers' Compensation provisions of the labor Code, you must forthwith Floor Sinks • r • 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 Lender's Name r !' Outlets Range • Lender's Address - - Kitchin Sink - Water Service SwitchesSign OWNER BUILDER DECLARATION - ' _ I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal following reason (Section 7031.5 Businessand Professional Code: Any city or - - - 9Standing 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 00-5 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 . Division 3 of the Business and Professions Code) or.that he/she is exempt - therefrom and the basis for thealleged 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). . 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 for sale (Section 7044, Business and Professional Code: The Contractor's - MECHANICAL 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 ZoningApproved sale. If, however, the building or Improvement is sold within one year of com- ._ Canopy Type II ❑ pP By Date pletion, the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground Building Approved By Date _ prove for the purpose of sale). , •- // -i 0 I. as owner of the property,am exclusively contracting with licensed can- Duct-Structural Refrigeration System Application Issued By `� Date /0 `//^ir/�/ 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 BTUSUMMARY 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 BUI LDING PERMIT $ SMIP $ proof of their Worker's Compensation insurance should be provided to me. ' PLAN CHECK $ PERMIT ❑ I am exempt under Section B. & P.C.for this reason Firepl/Fact.BIL ICBG# Fire Dampers ' - ISSUANCE $ I Date ' Owner Heating System& Ducting . Registers PLUMBING ' $ PLAN CHECK 25% $ ENERGY P.C. $ 1 • 1 hereby certify th I have read toms yp with all and state that the above ❑6100,000 BTU 0100.000BT - - - $ Information iscon re t. I bur toIgem•stru th a,l city and county ies I ELECTRICAL .$ GRADING• and state laws h a mgt buil, g co sou Bon,and herebyion authorize yrepre-fr , - , MICROFILM $ ' sentatives of th s city e• ..,. e above-mentlonod property for 1 - • PLAN CHECK 50% $ , n Inspection perp LI' /f7U 1% '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. ElectricalUFER'Grnd. 57. APPROVAL TO COVER-GUNITE ' • 7. Footings I 58. Electrical Conduit-Undrgrnd. 8. Foundation i 59. Gas Pipe, Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, O Undrgrnd. • • 10. Structural Floor System - 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection ' 62. Backwash & Receptor-Final 12. Sewer Cap 63: Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit - 66. Solar System-Final 16."Rough Electric Wiring 67. Fencing & Access Approval • 17. Rough Wiring Sign - 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling, 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating .IN/ C40 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank ❑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 ' —__ --_ —. 1 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. \ CITY OFyCOSTA MESA O zR ION P RMIT• PERMIT NO. TRACT NO. LOT NO. UNIT NO. 5723 8/06/04 50e4n TI a4ytr�''/�U �l% 2 e I �S4 I - Pt-eject Address _ Applicant's Mailin Address TYPE OF CONSTRUCTION NEW U U ADD ALTERATION U REPAIR j� 10 erg,,,, 0 CONVERSION 0 DEMOLISH 0 OTHER Owner's Name —gh.41 ✓ DNA Phone 7lN OT+D A.P.AP `N+ Zone DESCRIPTION OF WORK/USE OF BLDG. Address S Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMIT0 GRADING U FOUNDATION U STRUCTURAL E Front • ZO Address El ]TENANT 'ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B C / Rear - N ��/� �,�,, ❑ -OTHER Contractor's Nam _ `/ honePT - C Right N �.Address(mailing)-�7 7?L{J_f/a� a C/L 1��•.... PROJECT DESCRIPTION SQ. FT. OCCUPANCYK �� CONSTRUCTION TYPE VALUATION$ s Left G City License No. ZONE GRADING CU.YDS. ACRESR LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E I I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: 3/. ) 400 7-- Planning Notes: , M o with section 7000) of Division 3 q).in uslness and Professions Code, and my license is in full fo e and eff [r T Licens Class teens ;21/9813 S. = Date f'1Yt. b Signatu PLUMBING I FEES I WORKER'COMPENSATION DECLARATION Bar Sink Showers 'hereby affirm that I have a certificate of Consent to self-insure or a certificate ELECTRICAL FEES , ! Workers' Compensation Insurance, or a certified Copy thereof (Section 88ckfIOW Preventer Service Sink .800, Lab. COutomatic Washer - I Transformer 0 15-50 KW / DO Policy No. �Cv� �bSz� Company-o� I ' " 1 Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+ KW entified copy is hereby turn fished. •_ Certifie copy Is filed with the city Bui in Division. Bathtubs Sewer Connection - Cooking Unit Meter ❑up to 100 amps DO Date Applicant r.- F 1-ea IG • - I S EXEMPTIII3N FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher • Meter Clover 100 amps 'l (This section need not be completed if the permit is for one hundred ($100)or / less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric i Sub Panel I / I certify that in the performance of the work for which this permit is Issued, I (1 CO shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan3 Workers' Compensation Laws of California. Motors❑0-1 HP ❑1 X-8 '3 Date Signature Floor Drains Swimming Pool w/Spa F.A.U. NOTICE:If,after making this declaration,you should become subject to the - ' Inc.Solar 09-15 HP 016-15+ ) DO Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks ' • Urinal comply with such provisions or this permit shall be deemed revoked. Fix[umS / Microwave Z90 CONSTRUCTION LENDING AGENCY - Gas Service Outlets Water Closet Device Boxes �[�- Pole Light (Z$ I hereby affirm that therewhiis a construction agency for the performance - 9 of the work for which this permit is Issued (Section 3097 Civ. C.) Interceptors Water Heater Lender's Name Outlets 30 Range Lender's Address _ Kitchen Sink Water Service • - Switches q 4 0OWNER BUILDER DECLARATION fN^ Sign O 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 _� Garbage Disposal / Standing Sections I03 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 00-5 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 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 penalty 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 $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 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 novo for the purpose of sale). - ,� p {-� U I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By 91 "L� Date tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating _ 00-100,000 BTU ❑100,000 BTU SUMMARY OF FEES builds or improves thereon,and who contracts for such protects with a con- - - tractor(s) license pursuant to the Contractor's License Law). I am aware thatBUILDING PERMIT $ SMIP $ proof of their Worker's Compensation insurance should be provided to me. Exhaust System 0 Multiple 0 System Repair/Alteration ID PLAN CHECK $ PERMIT I am exempt under Section 8. & P.C.for this reason Firepl/Fact.Blt. ICBG# PLUMBING $ ISSUANCE $ Date Owner Heating System& Ducting ENERGY P.C. S ❑0100,000 BTU ❑100,000BTL PLAN CHECK 25% $ / I hereby cern I haverread this application and State thaty the above ELECTRICAL $ Cr0•(.0 1 GRADING $ dstatinformatics. correc . I agree to comply with all dy and county ordinances sen state aws relatingci . buil. g construction, and- herebyion authorize retire- • - MICROFILM S sentative of this ci • a-, r upon the above-mentioned property for PLAN CHECK 50% § -r✓)� inspects• p •o // r TOTAL FEE $ �PR•�'� Signature 1� Accounting;Goldenrod -Assessor I� -CONSTRUCTION AND PLANNING POOL _.SPA �> r Date Inspector Date Inspector APPROVALS Permit# APPROVALS Permit# '1771;;;;;;;;- Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3.'Electrical Conduit Utility-Undrgr'nd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6.• Electrical UFEIa Grnd. • 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8.-•Foundation - 59. Gas Pipe, 0 Undrgrnd.,Test - 9. Water Pipe-Undrgrnd. f 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 /a 4 67. Fencing & Access Approval 17. Rough Wiring Sign �s� A ' 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 ❑Gas ❑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 / l�s� fit" 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 . _ - .,t .. 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 k a -.. . ." _ - 2644 ELDEN UNIT A-3 - a - 814003 CONDO $73,420. . 4/7/75-- PC 172-34L UNIT A3 E P14257 MISC 34i4S- 814003 UNIT A3 E14542 z.-.,MISC - 77/51rs UNIT A3 - _ M.5593 MISC - 3/is/,1S B14003 UNIT A3 1 ▪ M15$�28 METAL FWLC - 3//3/Br B14003 Unit A3 M16000 RISC 31{/35-- B14003 UNIT A3 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PERMIT O. TRACT NO. LOT NO. BLDG.NO. 3683 7/09/84 481• i . CONSTRUCTION PERMIT 52003 I i4( LJADD J ALTERATION Li A3 Project Address 2i 1'W Fldi. A'V L TYPE OF CONSTRUCTION NEWREPAIR Applicant's Mailing Address , /60 001-1.4-rib C_-�r 1!�♦r 1-103 ❑ CONVERSION 0 DEMOLISH 0 OTHER - A.P.# 4361 - 2 LI — /0 I Zone g,2� DESCRIPTION OF WORK 4VpQ""" (-0,cd�S 7 Owner's Name re. f' v'U `-' /` Ph/cane 74-(042r4 S Main Building:�yAccessory Building: Z Address /�5Z Ss i`r-4-`} r C1-1:•L- _' "'4 TYPE OF PERMIT U GRADING �s STRUCTURAL T Front Cit N \VnJ ! La FOUNDATION Arch/En 0�C�VL Ceti" I4 -.—' License No. �p7(t i t {-,I N 9 1 1 LL l' 0TENANT KN ELECTRICAL PLUMBING MECHANICAL B Rear i Ci tJ 00 Address 92 C"-o-La sau De- FS-L dtc -4"de•xv •, ❑ OTHER P_J F' Contractor's Nam a�`zies.-� 'hon• e.'s.W ..y PROJECT DESCRIPTION SQ. FT. PANCY / A..7 K Right SII G Address(mailing) `-• ' 4 `O CONSTR CTION TYPE �D--t ':"AY[1 b•7""•$ $ Left 81 R �/ E r ZONE 2- GRADING CU.YDS. ACRES -,e6,z-- Ping. Ref.# r�2 ( Pafk.Fees $ �1 /� Q O City License No. ^f On I 1�-✓s! •�CJ U LICENSED CONTRACTOR DEC ARATION Remarks: �G' / y2, 5"¢,. ' 7#101-og' ad Parking Req./Provided .d/2.5 1 I hereby affirm that I am licensed under provisions of Charter 9(commencing .c' s,`nleR with section 7000) of Division 3 of the Business and Professions Code, and Use Of Building: r !rC Ak.l Is_C.� E my license Is in fu rc and effect. � License Class License No.937 G'17/ PLUMBING I FEES Planning Notes: HOLD FOR SPECIAL REQUIREMENTS M E Date Signature _ "7RKER5'COMPENSATION DECLARATION Bar Sink Showers ,--Nr :reby affirm that I have a certificate of consent to self-Insure or a certificate Backflow Preventer Service Sink - - S Workers' Compensation Insurance, or a certi •d copy thereof (Section -Policy No. Lab. 0.��/�_ • - / Cp_ I„ Backflow Irrigation - -Sewer Cap - ELECTRICAL FEES Policy No. Company ��•A�-� • 8 Certified copy is hereby furnished. . ' ': Bathtubs Sewer Connection ' ' Automatic Washer Transformer ❑ 15-50 KW - Certified copy Is filed with the city B" In. •-vision. Z Date .. J'', Applicant V.--.L-- - J: Clarifiers Solar Collectors Construction Pole Sub. ❑ 50+ KW EXEMPTION FROM WORKERS'CO - • AT••N D LARATIONDishwasher Solar Piping . Cooking Unit Meter ❑up to 100 amps (This section need not be completed if e per is for one hundred - 00)or less). Drinking - Fountains - I certify that in the performance of the work for which this permit is issued, I 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,1after making this declaration,you should become subject to the Floor Sinks Urinal Fan Motors 061 HP-❑1%-8 '/,, 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 09-15 HP 016-15+ • CONSTRUCTION LENDING AGENCY - 1 hereby affirm that there is a construction lending agency for the performance Interceptors Water Heater Fixtures Microwave I 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 Lavatories OWNER BUILDER DECLARATION - •• Outlets Range I hereby affirm that I am exempt from the Contractor's License Law for the P-Trap 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 • + Garbage Disposal Standing Sections to file a signed statement that he/she Is licensed pursuant to the provisions of t tti a Contractor's License Law(Chapter 9(commencing with Section he/she is 7000)of the ^' Generator ❑0-5 KW❑5.15 KW Trash Compactor arefrom and the basisieandss ll for the allegediCode)ons exa piiothat or .Any violationaof Section • , "031.5 by any applicant for a permit subjects the applicant to a civil Reinspection Fee I $25 Issue Fee $ 3 ' atnaity of not more than five hundred dollars($500). U I, as owner of the property or my 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 REQUIREME TS: License Law does not apply to an owner of a property who builds or improves Boiler Hood or Type I ❑ I /�, p,C`� thereon, and who'does such work himself/herself or through his or her own - Zoning Approved By - I�iJ Date ��LJ employees, provided that such improvements are not Intended or offered for Canopy Type II ❑ saley Duct-Under Ground .7-7-171— elation, — -8'¢ elati If, the own, the hav building dImprovement i sold within one year of Im- - Building Approved Date platten, owner will have the burden of proving he/she did not build or Im- �r Pryve for the purpose of sale). Duct-Structural Refrigeration System Application Issued By ` Date 9 IN I, as owner of the property, am exclusively contracting with licensed con- ❑O-100,000 BTU ❑100,000 BTU tractorsto 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 roc' j¢ builds or Improves thereon, and who contracts for such projects with a con- Exhaust System ❑ Multiple❑ System Repair/Alteration //�� //BUILDING PERMIT $ S53' SMIP $ S- tractor(s) license pursuant to the Contractor's License Law). _ . 4tq/(.PLAN CHECK $ 1.29,- LT PERMIT ❑ I am exempt under Section B. & P.C.for this reason Firepl/Fact.Blt. ICBG# PLUMBING $ ISSUANCE $ Date ` Owner' �-a, = Heating System&Ducting _ PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I haverreadtot p " i' all and state thatdInan/above • ❑6100,000 BTU 0100,000 BT I GRADING $ information Is correct. I agree to co p all city and county, tlinancez ELECTRICAL 5 and state laws relating to building construction,and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ sentatives of t s cit to enter upon the .bove-mentioned property for q Inspection purpses.'r: 1- 19,• MECHANICAL $ TOTAL FEE $ Q-$ /- Si Signature I ��. / Date Drivers' Goldenrod-Assessor J 1 CONSTRUCTION AND PLANNING .POOL ,PA - - Date Inspector - • Date Inspector APPROVALS Permit# APPROVALS Permit - 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 3 v 56. Rough Plumbing& Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE ' 1. 7. Footings 14.. 58. Electrical Conduit-Undrgrnd. _ 8. Foundation lly Jrlul �j 59. Gas Pipe, 0 Undrgrnd.,Test- . 9. Water Pipe-Undrgrnd. _ 60. Backwash Lines;P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK . 11. Property Sewer Line& House Connection 62. Backwash & Receptor-Final - : , 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System -Final • - . 14. Rough Plumbing - 65. Electrical-Final - ':` ' ' 15. Rough Electrical-Conduit 66. Solar System-Final - ' - - - " - - -- 16. Rough Electric Wiring 67.. Fencing & Access Approval - 1- -1- ,1,1- ' i - -- - - ' ---- - 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# i ' 21. Ducts, in Structure 70. Underground Hydra 22. Ducts,Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test /// 72. Underground Flush i "r 24. Roof Framing /0 Viet �� 73. Undergrnd.StorageTank 0Gas. OOil 25. Roof Sheathing lll` 74. Overhead Hydro .- 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical ' 27. Frame and Flashing !/ inL/C.- 76.. Dry Standpipe ; . _ ' 28. Lathing & Siding JI tRl-+ (/-7 77. FIXED SYSTEM FINAL i 29. Insulation /r/tc� (C�/ 78. FIRE PREV. FINAL 30. Drywall Nailing41/1114-/ ` HEALTH DEPT. REQUIREMENT . 31. Plaster Brown Coat yi ` . i 79. FINAL INSPECTION :32. Electrical Power Meter-Final /ff 80. FOOD CERTIFICATE ,CEERTIFICATE ISSUED , ' - �C 33. Final Electric Notes: "�;fry:locE /is • 34. Final Heating & Air Conditioning - - 35. Final Gas Pipe-Test - - _ 36. Hood or Canopy - - c 37. Final Factory Fireplace � - r , - 38. Final Plumbing - u 39. Water Service-Final • 40. Gas Service-Final •- - ` ' 41. Solar Domestic-Final - . • - . - _ , - - ' 42. Backflow Preventer _ , - 43. Backflow IrrigationI 44. Landscape Irrigation System 45. Sound Attenuation ' 46. Handicap Regulations • - + , - 47. FINAL STRUCTURE & BUILDING %' //d,� VU ! , _ 48. Special Requirements Completed (L'y/�S ,,49. Electric Release to Edison �! , + - '7` 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY '''///�� II'�/-7� - 41-179/11.--No, l��n Date41-179/11.-- ,y i�� / 4 City of Costa Mesa Development Services Department CERTIFICATE OF OCCUPANCY No.001110 Building Safety Division P.0.Box 1200 • �-. Costa Mesa,California The Building located at 2644 EUWN AVFIJU'F. UNIT f<'A--3 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto fora Group It-]. Occupancy. Use of Building COIIIUM Legal Description 439-221-10 (See reverse side for Metes and Bounds) Building Permit No 13-14003 Electrical Permit No E-14542 Plumbing Permit No. P-14259 Mechanical Permit NoN1`S141,nt1;w)g mi gn fl Number of apartments and/or guest rooms ISSUED TO: Building Official�_ /�-��,/� �tL' HF E FIIl?Y FRAWIk Y by -Zre 7�l;: 1152 SALINAS AVE. . (Y).STA MESA. Cly_` Date 144/61 /ss- 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. CITY OP COSTA MESA,,CONSTRUCTION PERMIT — PERMIT NO i TRACT NO. LOT NO. UNLT N 508 : 7/3 �gp, i: Project Address .2c cY ECDE/4 2- 8 `.Y/ /�- Applicant's Mailing Addre _. ✓ -.1.. P: !• TYPE OF CONSTRUCTION (NEW ❑ ADD LI ALTERATION U REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER F. Owner's Name (�//�A,, �Q' �[( Y Phone7�0e/383 A.P.# I Zone R� aYL•W F 12Tt D1�LVE 5O /D�' DESCRIPTION OF WORK/USE OF BLDG. Address S Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION T O U STRUCTURAL Front Address ��/'yy�� Maa�� '/� amt. /�� w' El TENANT CI ELECTRICAL 'PLUM GING ❑ MECHANICAL B Rear N Contractor's Name rrl�lq/yl ( tfrie, amt Phone? 5-1/Z ❑'OTHER Address(mailing) -�a Lf/• /F/-8• r PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Left G �- !9 CONSTRUCTIONTYPE VALUATION$ E R City License No. I `7 ZONE GRADING CU.YDS. ACRES1 M LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: /�00 3 Planning Notes: M with section 7000) of Division 3 of the Business and Professions Code,and T my license is in full force d - f- t. AL Ucens' C .ss _ Lice e o.l�73`71 S. Date r PE Signature L.7....... - - — PLUMBING I FEES .4WORKERS' • • NSATION DECLARATI I / I hereby affirm that I have a certificate of consent to self-insure or a certificate - Bar Sink Showers ELECTRICAL FEES of Workers' Compensation Insurance, or a certifie c y thereof (Section Back Preventer Service Sink 3800, Lab. C.) ��//�� r'-- - Automatic Washer Transformer 0 75.50 KW Policy No. C'j'r3 Company Pim D. Backflow Irrigation Sewer Cap Construction Pole Sub. - d 50+KW liCertified copy is hereby furnished. Cer Iii d cgpy,�Is�filed with the city mss' In Division. /p 2 Bathtubs Sewer Connection 3/pc Cooking Unit Meter Dub to 100 amps Date lb t `Yy Applicant d�ILle(��`++ EXEMPTION OtAlill 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). 1 Dishwasher Solar Piping a Oat 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 ❑1 h-8 Date Signature Floor Drains Swimming Pool w/Spa F.A.U. NOTICE:If,after making this declaration, you should become subject to the - - InC.Soler 09-15 HP ❑16.15+ 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 /� Sc — hereby affirm that there is a construction lending agency for the performance / y Q r/ '�ci Device Boxes Pole Light of the work for Which this permit is issued (Section 3097 Civ. C.) - Lender's Name Interceptors Water Heater 02 Od Outlets Range Lender's Address Kitchen Sink Water Service 0 00 Switches OWNER BUILDER DECLARATION Sign I hereby affirm that I am exempt from the Contractor's License Law for the S Lavatories J0 DO 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 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 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 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 rove for the purpose of sale). /} n I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By l '. Date / 0 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- tractors) license pursuant to the Contractor's License Law). I am aware that BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation insurance should be provided to me. Exhaust System ❑ Multiple❑ System Repair/Alteration PLAN CHECK $ PERMIT ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# PLUMBING $ .3/--SO ISSUANCE $ Date Owner Heating System& Ducting PLAN CHECK 25% $ 74 43 ENERGY P.C. $ I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,0006 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 city to enrp r upon the above-mentioned pro arty for Inspection pun K�/ 3p Signature �" Date .7 F - - MECHANICAL $ TOTAL FEE $ O'6� Drivers' License or S5 +, Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ :allue at♦1 OI CMF 0865-46,rev-4/84 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor CONSTRUCTION AND PLANNING POOL& SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector t: Temporary Electrical Service or Pole • 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. gr (�ti LW 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. ElectricalGr OF ER rid- 57. APPROVAL TO COVER-GUNITE 7. Footings- _ 58. Electrical Conduit-Undrgrnd. - ' • ` Sr:Ftiundaik n " '• ' 59. Gas Pipe, O Undrgrnd.,Test 1,1 9. WaierPipe-Undrgrnd. �/d/8 Ldp 60. Backwash Lines,P-Trap, O Undrgrnd. 10. Structural Floor Syitem ' 61. APPROVAL TO DECK 11...property Sewer Line & House Connection ' ' f: 62. Backwash & Receptor-Final 12. Sewer Cap ,j ; 63. Heater & Vent-Final 13, Roof Drains 64. Plumbing System - Final u 14. Rough Plumbing.; /4117/9..y LLr7 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 O Gas ❑Oil 23. Gas Pipe-Rough&Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas ❑Oil 25. Roof Sheathing 74. Overhead Hydra 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 ,g/ 4..' i/r'!" 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 3////er C40 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 • h742-- Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY Of COSTA MESA, O TIRUCTION PERMIT T PERMIT NO. �� TRACT NO. UNITO. 9705 10/09/84 BaOG IL .Project Address /IL 1�1 5-Lcg , .s Applicant's Maili•g Address , p . ',X / •-� / �• •/. TYPE OF CONSTRUCTION S"nnEW U ADO ALTERATION LI REPAIR 1 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# Zone Owner's Name 1112.1 ' V 0• _ Phon O DESCRIPTION OF WORK/USE OF BLDG. Address YN1.Leit 1Pir_ t I S Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING 0 FOUNDATION LJ RDCTURAL T Front O ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING �I•�j ECHANICAL B Rear N /� Addresses �� %e . ❑ ,OTHER A I W Contractor's Nam• Mil it. IU./.'�� al6nirn ho•e 1/1r� C Right N / -ZLl PROJECT DESCRIPTION SQ. FT. OCCUPANCYK G I Address(mailing) -'' L .112 IP r CONSTRUCTION TYPE VALUATION$ s Left R City License No. DI ZONE GRADING CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION Ping. flet.# Parking Req./Provided E I hereby offirm that I am licensed under provisions of Charter 9 (commencing Remarks: �-+ I L433 2 Planning Notes: M JY with section 7000) of Division 3 of he Business and Professions Code,and (3 T my license is In f 11 and effect. I , / Da en l Licen e .4 dIl L/ S. Date Signature 1a.r .. Cr •%��]/ PLUMBING I FEES WORKERS' COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL FEES I hereby affirm that I have a certificate of consent to -If-Insure or a certificate of Workers' Compensation Insurance, or a certif .• copy the f (Section 3800. Lab - - Backflow Preventer Service Sink Automatic Washer Transformer 0 15-50 KW . Policy No r� P '/ .e ! Company . i Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+KW 8 Certifed copy is hereby furnishetl. CR opy is filed with the cityBuil. •i I. I /l Bathtubs i Sewer Connection Cooking Unit Meter !Duo to 100 amps Date rp"HV r�.,L,/� Applicant - ' L a.... �� li ...471 EXEMPT FROM WORKERS'COMPENSATION O r LARATIO Clarifiers ��• Solar Collectors n Dishwasher Meter Dover 100 amps (Thissection eed•hot 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 00-1 HP 01%-B Workers' Compensation Laws of California. _ N—__. Date Signature Floor Drains '' Swimming Pool w/Spa F.A.U. NOTICE:If,after making this declaration,you should become subject to the Inc.Solar ❑9.15 HP ❑16.15+ 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. 4 Microwave CONSTRUCTION LE rrr'''{{{DING AGENCY ' Gas Service Outlets Water Closet Device Boxes I hereby affirm that the rlf Is a construction lending agency for the performance Pole Light of the work for Atlas permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Lander'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 Garbage Disposal following reason (Section 7031.5 Business and Professional Code: Any city or 9 sP 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 Generator ❑Q-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 — Lienalty 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 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 ❑ DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for BoilerZoningApproved sale. If, however, the building Or improvement is sold within one year of com- Canopy Type II ❑ pV 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 LJrove 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 Duct-Ventilating 00-100,000 BTU 0100,000 BTU SUM RY OF FEES builds or improves thereon,and who contracts for such projects with a con- tractors) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK S PERMIT 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBO* PLUMBING $ ISSUANCE $ Date Owner ^Heats ystem& Ducting I— PLAN CHECK 25% $ ENERGY P.C. $ 1 hereby certify that I have read this application and state that the above0.100,000 BTU 0100,000 BTL ELECTRICAL $ GRADING $ Information is orrect. I agree to comply with all city and county ordinances 111 and state law- relating to building c• ruction, antl hereby authorize repre- sentatives o this city to enter/us• the -bove-mentioned property for PLAN CHECK 50% inspection p (•• l ,I MECHANICAL $ a , TOTAL FEE $ Il• CO Signature ALA .; ri Date +� Drivers' License or SS* / , Pink-Accounting;Goldenrod -Assessor CONSTRUCTION AND PLANNING POOL & SPA •• APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1..Temporary Electrical Service or Pole - - - 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. _ 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. • 54. .Forms • 4. Electrical Conduit-Undrgrnd. - 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. - - 57. APPROVAL TO 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. 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 Sigh 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning /0%//y 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 s- 33. Final Electric Notes: 34. Final Heating& Air Conditioning a'a'/Ps c 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. Backf low 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 • Job #3012 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 045610/17/84 – PERMIT NO. TRACT NO. LOT NO. UNIT NO. B•�� T1,CITY Of COSTA MESA CONSTRUCTION PERMIT ' X2e It .yl Project Address 2644 Elden (L-� • TYPE OF CONSTRUCTION U NEW U ADD LI ALTERATION REPAIR Applicant's Mailing Address P.O, Box 695 Walnut 91789 Coastline Developmenm 720-1383 ID CONVERSION El DEMOLISH ❑ OTHER A•P•# Zone Owner's Name one DESCRIPTION OF WORK/USE OF BLDG. Address 160 Newport Center Dr #108 Newport Beach S Main Building: Accessory Building: Z Arch/Eng. License No. TYPE OF PERMIT U GRADING ❑ FOUNDATION ❑ STRUCTURAL T Front p 1 _ Address ❑ TENANT El ELECTRICAL El PLUMBING ❑ MECHANICAL B Rear - N y/ , AJR Construction 594-5911 ❑ OTHER Contractor's Namp gime C Right N P.O. Box 695 Walnut 91 /by PROJECT DESCRIPTION SQ. FT. OCCUPANCY K G Address(mailing) 01 01 96 - CONSTRUCTION TYPE VALUATION$ § Left R ----• CiLicense No. ZONE GRADING CU.YDS. ACRES _ - - Ping. Ref.# Parking Req./Provided E LICENSED CONTRACTOR DECLARATION a { I hereby affirm that I am license: uncle'provisions of Charter 9 (commencing Remarks: h I�C0-5 Planning Notes: M with section 7000) of Division c of t , r siness and Professions Code, and �- 7 T my license is in full force and off et. ucenseasl _. !M. +i< �5 06228 S. Date U Signature A PLUMBING I FEES WORKERS'COMPENSATION DEC • ` •TION Bar Sink Showers I hereby affirm that I have a certificate o consent to self-insure or a certificateELECTRICAL FEES of Workers' Compensation Insurance -r a certified-copy thereof (Section Backflow Preventer Service Sink 3800, Lab. C.) Automatic Washer Transformer 0 15.50 KW W0005151 Ar.ver Insurance • 0 So+Kw Policy No. Ompa Y / I n 6ackf low Irrigation Sewer Cap Construction Pole Sub. 8 Certified copy is hereby furnished % CAA Certifiedpy i n with the cit B •In, ' • ' 0[�A01.. Bathtubs Sewer Connection Cooking Unit Meter Duo to 100 amps f6ate -1�—u` EXE ApplicantRSC ♦��aaaa EXEMPTION FROM WORKERS'COMpEN ION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps (This section need not be completed if the pe is for one hundred ($100) or less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel I shall no thatm in the performancepersoninof the work for which this permit is issued,toI shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors 00-1 HP ❑1:4-8 Workers' Compensation Laws of California. Date Signature Floor Drains Swimming Pool w/Spa F.A,U. Inc.solar❑9-15 HP 016-15+ NOTICE:if,after making this declaration,you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures comply with such provisions or this permit shall be deemed revoked. Microwave CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes Pole Light I hereby affirm that there is a construction tending agency for the performance 9 of the work for which this permit Is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Range Lender's Name Lender's Address Kitchen Sink Water Service. Switches OWNER BUILDER DECLARATION Sign I hereby of firm that I am exempt from the ContraCtor's License Law for the Lavatories Garbage Disposal Standing Sections following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct,alter,improve,demolish or repair P–Trap Generator ❑0-$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 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 I $15 Issue Fee S 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 ByDate rove for the purpose of sale). �^_^,,�f� O I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By O—> Dat tractors to construct the project (Section 7044,Business and Professions Code: ?PAL) The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 0o-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 thatExhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ §MIP $ proof of their Worker's Compensation Insurance Should be provided to me. PLAN CHECK $ PERMIT ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.BIt. ICBG# 2301 1 Metal Fireplace 4. 00 PLUMBING $ ISSUANCE $ Date Owner Heating System& Ducting PLAN CHECK 25% $ ENERGY P.C. $ I hereby certi that have read this application and state that the above 00-100,000 BTU 0100.000 BT ELECTRICAL $ GRADING $ information I cor •ct. I .•ree to comply with all city and county ordinances and state law rela 9 t• uil•'ng construction, and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ sentatives of thi ••t t` ent-r upon the above-mentioned property for inspection put•oS.•. - MECHANICAL p Signature _ - Reinspection Fee '$15 Issue Fee $ 3 I PLAN CHECK 25% $ 1 n0 CMF 0865-46,rev.4/84 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor CONSTRUCTION AND PLANNING POOL& SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE • 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe,-D 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 ❑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 If 33. Final Electric Notes: 34. Final Heating& Air Conditioning 35. Final Gas Pipe-Test •. 36. Hood or Canopy gAs'337. Final Factory Fireplace 36A6-- 38. 8. 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 /Y{ /e) v Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. 1305 10/31 /84 I,3.0 . TL CITY OF COSTA �1SA CONSTRUCTION PERMIT PERMITR.MINO. TRACT NO. LOT NO. UNIT V Prgje2t Address �`�'�� [��/lt-�'V S r N�/ co '' �{ r I - - licant's Mails Addreu ' // TYPE OF CONSTRUCTION F-N AppEW U ADD H ALTERATION L.J REPAIR IOwner's Name Q'45 T i4 Cu) PC+U'Ishone ❑ CONVERSION ❑ DEMOLISH ❑ OTHER - A.P.#• Zone ll....77 DESCRIPTION OF WORK/USE OF BLDG. Address - S Main Building: Accessory Building: Arch/Eng. License NO. TYPE OF PERMIT El GRADING U FOUNDATION L I STRUCTURAL E Front 0 Address _ m I�, Ell TENANT ❑ ELECTRICAL ❑ PLUMBING� MECHANICAL A Rear N Contractor's Nam- aArA ghat /1Sy/•Phon• / ❑OTHER Address(mailing) 1-1-/ "A S ' Cr-4'4A- i4{.e_ / PROJECT DESCRIPTION SQ. FT. OCCUPANCY CK. Right N CONSTRUCTION TYPE VALUATION$ S Left G City License No. • - ZONE GRADING CU.YDS. ACRES R LICENSED CONTRACTOR DECLARATION 111��s Ping- Ref.# Parking Req./Provided E I hereby affirm that I am Ilcensed under provisions of Charter 9 (commencing Remarks: /l / U 1003 Planning Notes: M CI with section 7000) of Division 3 of the Business and Professions ode,and r ' / T my license is in full fo arbect. [JO /G // License Class G-Cl �_ tens NO./ 7 7 S Date ' Signature4�� `- PLUMBING FEES A WORKERS' COMPENSATION DECLARATI N 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. Co p. y Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+KW Certified copy is hereby .furnishedY ./ ' n • p p '� Cert/fieri{opy-s I d with the cit B i I, Bathtubs Sewer Connection CookingUnit Meter ❑u to 100 amps Date PT ION F �fl Applicant t�� • l,� ^I EXEM TION need M WORKERS'COM- NSAT ON DELL• ' fired Clarifiers Solar Collectors Dishwasher Meter Clover 100 amps _ y (This section need not be completed if Chi permit is for one unfired (5100)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 00-1 HP 01%-B 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 0g-15 HP 01615+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures Microwave comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes Pole Light. I hereby affirm that'there is a construction lending agency for the performance 9 . 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 Garbage Disposal i 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 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 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 . ' IIS 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 S 3 compensation, will do the work,and the structure is not intended or offered - - Fee $15 Issue Fee S 3 Reinspection for sale (Section 7044, Business and Professional Code: The Contractor's ' MECHANICAL FEES 0 • 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 1 0 sale- If, however, the building or improvement Is sold within one year of tom- Canopy Type II 0 - Zoning Approved By Date pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground -' • Building Approved By - Date prove for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with•licensed con- Duct-Structural Refrigeration System Application Issued By CW._- Date /0-&-/1 i 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 U �•r.__Duct-Ventilating _ ❑o-100,000 BTU 0100,000 BTU I, 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 CHECK $ PERMIT 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBO# Fire Dampers PLUMBING $ ISSUANCE $ Date Owner - ' Heating System& Ducting Registers - PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that t have read this application and state that the above DOA 00,000 BTU 0100,000 BTL-- ELECTRICAL GRADING $ Information Is to rect I agree to co .Iy with ail.city and county ordinances - $ - and state laws latin to buil•ing •nstruction, and hereby authorize repre- $ MICROFILM $ - sentatives of is cid, ,er :•n e above-mentioned pro arty for PLAN CHECK 50% - - inspettion pW•os- , / I--I� ,O I r/� f MECHANICAL $ /.0 0 TOTAL FEE $ 13,2,X r Signature L, Pink -Accounting;Goldenrod -Assessor • CONSTRUCTION AND PLANNING ' ' r 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 ?.,;Electrical Conduit•Utility-Undrgrnd. • 54. Forms s , ' 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding T. • 5. Steel Reinforcement , - 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings I _ 58. Electrical Conduit-Undrgrnd.• ' 8. Foundation , •_ 59. Gas Pipe, 0 Undrgrnd.,Test • 9. Water Pipe-Undrgrnd) 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System ' __ 61. APPROVAL TO DECK • 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final • • 12. Sewer Cap • I 63. Heater & Vent-Final 13. Roof Drains C 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 345fir Ca 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 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. Backf low Pret,enter 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 _ / d Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. PERMIT NO. TRACT NO. LOT NO. UNIT NO. - , CITY OF-COSTA MES, ONSI�UCTION PEW/11T 5724 8/06/94 63.4:. Ti r�(o,�t,/ ,�l[�f1 ,y" I a 14 S 4 Z , ' Projdct Address Qy�'� U'REPAIR TYPE OF CONSTRUCTION 6 NEW Li ADD Li ALTERATION •Applicant's Mailin�°•q-ddress ❑ CONVERSION ❑ DEM LISH ❑ OTHER A.P.# Zone' Owner's Name l .�lr$ L� �'t✓ Phone 760DESCRIPTION OF WORK/USE OF BLDG. Address S Main Building: Accessory Building: E Z Arch/Eng. License No. TYPE OF PERMIT U GRADING U FOUNDATION ❑ STRUCTURAL T Front O Address / �.�/ 0 TENANT r !ELECTRICAL ❑ PLUMBING ❑ MECHANICAL A Rear N "D- Contractor's Na Phop.V•L�f,�LQ.QO 0 OTHER C Right N (D Address(mailing)_L 7 77 ba� Lr r Get O ..�(G$�. PROJECT DESCRIPTION SQ. FT. OCCUPANCY G CONSTRUCTION TYPE VALUATION$ S Left rr�I City License No. ZONE GRADING CU.YDS. ACRES Ping. Ref.# 'Parking Req./Provided E ie.-) LICENSED CONTRACTOR DECLARATION - Q �. I hereby affirm that I am license• rovisions of Charter 9 (commencing Remarks: � 's 11\O� i Planning Notes: 1 with section 7000) of Divisf• siness and •rofesslons Code, and o M my licT ense is in full fo e a; / .a 3 - S. Lice Class �� ;ic ao. - PLUMBING FEES •a WORKE•S'COMP,EN$ATION DECLARATIO Bar Sink Showers 1 'I hereby affirm that I have a certificate of consent to salt-insure or a certificate ELECTRICAL FEES ' of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink 3800, Lab. Cs.L_ �Z,( `��S.t Jy__ •- Automatic Washer r Transformer 0 15-50 KW / 00 Policy No. 1.O.:i1J . Company L- 'AM yl Backflow Irrigation Sewer Cap - Construction Pole Sub. • 0 50+KW Certified copy is hereby furnished. - - Certifi c pytls filed with the city BuiUWY Division.�1— ' Bathtubs Sewer Connection - Cooking Unit Meter Cup to 100 amps GQ Date €5(O P`O`I- Applicant T-J- E1eCTI 1� — -- I I S EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors L Dishwasher I 1_.__ I Meter Cover 100 amps (This section need not be completed if the permit is for one hundred ($100) or 1 - less). Dishwasher Solar Piping Dryers ❑Gas QElectric I Sub Panel ' CO • I certify that In the performance of the work for which this permit Is issued, I — - shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan 3 Motors❑0.1 HP ❑i% B a cO Workers' Compensation Laws of California. ✓ _ Date - Signature Floor Drains Swimming Pool w/Spa F.A.U. Ina Solar 09-15 HP 016-15+ NOTICE: If,after making this declaration, you should become subject to the - ' f 30 Workers' Compensation provisions of the Labor Code, you must forthwith Floor •Sinks Urinal Fixtures comply with such provisions or this permit shall be deemed revoked. - / Microwave 2 .� CONSTRUCTION LENDING AGENCY Gas Service . Outlets Water Closet - ��( Device Boxes I hereby affirm that there is a construction lending agency for the performance YiT Pole Light I L Ze of the work for which this Permit is issued (Section 3097 Civ. C.) Interceptors -Water Heater Outlets 'y . Lender's Name pV Range (D CO Lender's Address Kitchen Sink _ Water Service Switches OWNER BUILDER DECLARATION �LO Sign co I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Disposal Garbage following reason (Section 7031.5 Business and Professional Code: Any city or 9I Standing Sections f Oe county which requires a permit to construct,alter,improve,demolish or repair P-Trap any structure, prior to its issuance, also requires the applicant for such permit - Generator ❑O-5 KW❑$-1$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 civii - , 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 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 dues 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 II ❑ Zoning Approved By Date plellon, the owner will have the burden of proving he/She did not build or im. Duct-Under Ground Ufor the purpose of sale). Building Approved By Date UI as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By CISDate _t 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-Ventilating00100,000 BTU 0100,000 BTU builds dr 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 System Repair/Alteration BUILDING PERMIT $ SMIP $ proof o// 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# PLUMBING $ ISSUANCE $ Date Owner Heating System& Ducting PLAN CHECK 25% $ ENERGY,P.C. $ I hereby • • I have read this application and state that the above 00100 ,000 BTU 0100,000 BT I ', inform on is correc I agree t• comply with all city and county ordinances ELECTRICAL $ `Tip-(007� GRADING $ and s -te laws relati : . bui-.ng construction, and hereby authorize repre- . PLAN CHECK 50% $ 21 �V MICROFILM $ senlat es of this to Via•er upon the above-mentioned property for I ' _ MECHANICAL $ VQ Signature — Date TOTAL FEE $ V• Q Drivers' License Or SS#• ' . Reinspoction Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ CMF 0865-46,rev.4/84 White-Building:Canary -Applicant;Pink-Accounting;Goldenrod-Assessor . 'CONSTRUCTION AND PLANNING POOL&SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector r1. Temporary Electrical Service or Pole" 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms • . 4.'Electrical Conduit-Undrgrnd. 55. Electrical Bonding • 5..,Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER" Grnd. 57. APPROVAL TO COVER-GUNITE 7. footings , 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test .• 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11.•Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains ', 64. Plumbing System - Final • 14. Rough Plumbing;. • 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring /d/pr, te% 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts,in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas ❑Oil 23. Gas Pipe-Rough &Test 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 PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 3//g/t6 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 - 2644 EDEN UNIT B-1 - lam • '. .. _ - .. � - 814004 CONDD $73,420. _ 7/f5 PC 172-84L UNIT 81 tfi1• 3/4,./sir 814004 UNIT B1 - ...E1454 MISC - S/5735 814004 UNIT 131 CO allIMIWINECI II1=Y - M15594 V/3 /S.5.- 814004 UNITas ===tasazza!za H1 ' _ - ML5822$/s K FRPI.0zsgailanithi - // M1600 MISC _ 3//(/g 3 814004 UNIT 131 • 1 ' 4 Wit CITY OF COSTA MESA - t BUILDING DIVISION F •.,, ,) DEVELOPMENT SERVICES DEPARTMENT PERM UMBER PERMIT 5-01444 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.B.UJLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 2644 ELDEN AV Status: ISSUED Suite: B Applied: 08/29/2005 Vicinity: BLDG B,UNITS 1,2 AND 3 Issued: 08/30/2005 Primary Occ: R Type of Construction: V-N Parcel Number: TPN00581 Zoning: Applicant: CAVASSA, FIORELLA Address: 3419 VIA LIDO SUITE 459 Phone: 949-283-5880 ISSUED BY: NEWPORT BEACH,CA Zip: 92663 Owner ELDEN COVES HOA Address 2644 ELDEN AV - UNIT B001 Phone: COSTA MESA,CA Zip: 92627 Contractor: SURDYKS DECORATING Address: 3419 VIA LIDO SUITE 459 Phone: 949-283-5880 NEWPORT BEACH,CA Zip: 92663 License: 854996 Arch : Eng: Address: Address: Phone: Phone: Zip: License: • _ License: SCOPE OF PERMIT REMOVE AND REPLACE ROTTED RAILS ON 2ND STORY BALCONIES FOR BUILDING B,UNITS 1 -3,TO MEET 1997 U.B.C.REQUIREMENTS. FEE SUMMARY Plan Check: $0.00 Calc Valuation: 55,000.00 Permit: $111.25 Claim Valuation: 35,000.00 SMIP Res: $0.50 SMIP Com: $0.00 Other $0.00 - . Inspection: $0.00 - Total: $111.75 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0.0 Left 0-0 s- Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 - Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§ 1, 12.21-92) EXPIRATION: This permit shall automatically expire and become void if work Is not commenced within 180 days,or 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 2446-46(BIRD) DECLARATIONS • WORKERS'COMPENSATION DECLARATION: } 'I - '--• I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued. I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued. My workers'compensation Insurance carrier and policy number are: / Carder: SATE COMP�TIou IP&L, N �'GJ JN D PdicyNumber. 6 U 3c(? (This section need not be completed if the permit is valued of one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit Is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Cali min,and agree the ' hould become sub ec to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these pr ns. /, Applicant Signature: ��hh" l//_)jS' i Data: CS3 o -o‘5- - WARNING:FAILURE TO S RE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($108003),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 u @�.Ptyq�``4�100�[[!!sel Chapter 9(commencing it action 7000)of Division 3 of the Business and Prolusions Code,and my license is in full force and effect.Llc.# )`i-1`'t b / ! Class# /j C 33 Contractors Signature: .I O'.i�&GO ( -�Up'SSALt Date: OS,-3t 0O. CONSTRUCTION LENDIN 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 fore permit subjects the applicant to a civil penalty of nol moro 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.11,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ' ❑ 1,as owner of the properly,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 end 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 feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 6,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above,unless such person has e permit to do such work from the division. Signature: Date: Division of industrial Safely Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I Will the applicant or present or future building occupant need to file end 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 tiled with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ._._ _...._ �.t.. _._ 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 aro required to register acutely hazardous materials with the Fire Department. 4 II en RMPP is presently required,has Section 25534 of the California Health end 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 kPaermit for such construction or modification from the South Coast Air(Duality Management District or from any other air pollution control district or agency? Yes L!No (Section 65850.2 of the California Government Cale requires that the requested information be furnished on applications for non-residential building permits). e Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes ❑No (If yes',the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescnbed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (II yes',attach certificate of compliance from thehe 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. iAc Signature Of LegeT�Jwne)( ,„ 0 nip .-QatO Qs And/Or Authorizz3d Applicant�� `v0 `jDate SORE r INSPECTION TYPE QATE MEM CODE! INSPECTIONTYPE PATE MALE 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site ) 204 Final Demolition 250 Final Building/Occupancy CITY OF COSTA MESA 41. ►� BUILDING DIVISION F:j'„ 1; DEVELOPMENT SERVICES DEPARTMENT PEpIT 05 0 NUMBER t �� - PERMIT 373J (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT • • Job Address: 2644 ELDEN AV Status: ISSUED Suite No B1 Applied: 05/13/2005 Issued: 05/18/2005 Vicinity: Parcel Nunmber: 93794040 - - - _ ISSUED BY: Applicant: SZABO, KEVIN-,d-'<c."-' - - Address: , v Phone: t- , " r - ' , / - - ' ZiP: Owner ' CASTAGNOLI,'STEPHANIE >\ Address 2644 ELDEN AVE UNIT B-1 i Phone: - COSTA MESA,CA Zip: 92627 Contractor: COAST ROOTER PLUMBING.HT.G &AIC . Address: 17390 MT CLIFFWOOD - Phone: (714)241-1414 ' -FOUNTAIN VALLEY Zip: 92708 License: 529127 SCOPE OF PERMIT , , - WATER HEATER CHANGE OUT(SAME LOCATION). FEE SUMMARY ' AMT OTY AMT' OTY AMT f OTY ISSUE FEE. ' $23.50 Laundry Tub/Washer $0.00 ' 0 Sump Pump '', - $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation _.$0.00 0 Swimming Pool' $0.00 - 0 Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer /-,- , - $0.00 ' 0 Bathtub ', . $0.00 0 Pressure Regulator.- . $0.00 0 Urinal /,•,'; ' - $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) - $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units . . $0.00- 0 Septic Tank $0.00 "0 Wash Basin $0.00 0 Dishwasher - $0.00 0- - • Sewer Cap for Demo - $0.00 - 0 'Wash Basin Set $0.00 0 Drain,Floor • $0.00 0 Sewer Connect - $0.00 0 Waste and Vent System $0.00 0 Drain,Rainwater 10.00 0 " . Sewer Private Line - '-$0.00 0 -.,Water Closet(Toilet) / . . $0.00 0 Drain, Roof - x$0.00 0 A�-5• 'Shower '' $0.00 '0 '-55: -Water'Heater/venter/i / $12.30 1 Drinking Fountain , $9.00,'. - 0. Sink, ar - - $0.00._ -0 - Water Piping(Inst or-Rep.) $0.00 0 Expansion Tank • <-$0.00 , 0/, ' Sink,commercial - -"10.00 ---0- .,Water.Re-pipe ,- - - $0.00 0 Gas Earthquake Valve . $0.00 o ' „ -Sink, Floor- - - $0.00- 0_, `;Water.Service ' $0.00 0 Gas(1-4 outlets) $0.00;-. 0 - Sink kitchen._ $0.00- '0 Watei Softener' $0.00 0 Gas(Over 4 outlets) $0.00 0- • Sink,service/mop $0.00 - 0. . OTHER $0.00 Gas Repipe $0.00 -0-. Spa(private) $0.00. 0 - VIOLATION $0.00 Gas Service $0.00 0 Spa(public) $0.00 0 . ' PLAN CHECK $0.00 Interceptors(Grease,Oil) $0.00 0 - - 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 2448-48(WOO) DECLARATIONS re\ - WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: i - w ❑ I have and will maintain a certificate of consent to sell-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit Is issued, L -31 have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carder and policy number ere: Cams.r - IJ\ 4 CO - Policy.Number: I-1 Co 8610-7-00q r hcompletedpermit Is valued at one hundred dollars($100)or less.) C --` dissection need not be it the ❑ I certify that in the performance'of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Califomla,end agree that If I sh uld become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. r�/ d-� �pplicam'Sigrteture: n "Date j S V WARMNG:FAILURE TO SECURE WORKERS' {SENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TOONE HUNDRED THOUSAND DOLLARE(siro,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3106 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES, LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business Professions Code,and my license is in full force and effect idcrfr 'S77'1(Z 1 Class'ff, Contractors Signature: ( - �!'� Date: S7$/OC� 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). Lendors 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 0(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 fora 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 ere 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.). O I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers 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: O I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder. I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be tiled with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes 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). ...._ __._.._pr.___......_._ _ 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 $ Does or will the applicant or present or future building occupant require for the work which Is the subject of this a plication apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes 0 No (Section 65850.2 of the Califomia Government Code requires that the requested information be furnished on applications for non-residential building permits). ._..r..this.__..r._ 6 Will any pan 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 Califomia Health and Safety Code). _.__...._._......__ ... _—_ ._ .. 7 If a permit from the South Coast Air Quality Management District or other air pollution— for control district or agency is required 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 property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Sig Lure 1 Legal Owner(s) cligD to rAuthortied Applicant blob te` _ - COPE A 1NSPECTIQNTYPE -, ' i MU '' RIDB8S, QODFA INSPECTIONTYPE PdTE 1616 Fixed System Final Fire Prevention , 206 Final Mechanical • 1266 Pool Spa Final 208 Final Plumbing /^'T/7 fr r 200 Final Re-Roof 210 Final Elodtrical - 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place - 220 Final Planning'Approval . - 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PERRi NO. TRACT NO. LOT NO. BLDG.NO. 3684 7/G9/04 41i.°0. !' _ • CONSTRUCTION PERMIT /4/6 0 V /LILL17 Project Address __.2...,r2Y/ (t'd1�••c 4__II`�� I� p TYPE OF CONSTRUCTION NEW Q ADD U ALTERATION U REPAIR Applicant's Mailing Add/-ryee�ss. /4i0 A)t ip�y.�it Gtr //r— '/Db U CONVERSION ❑ DEMOLISH ❑ OTHER q,p,# J-��_ �2/ - 1� Zone R. 2.. ,rt'^e r't r=r4-1-s .•-•,•,..J.. l �p DESCRIPTION OF WORK Owner's Name I / C.05 Phone��Odd r,'' rpt S Main Building: Accessory Building: Z. Address IX 5z-- �*Jt,'u+v�_�)) �p'C J� e`�`t TYPE OF PERMITI��pp ❑ GRADING 131 FOUNDATIIONN L'J STRUCTURAL T Front ��411 Cl b1 N Aroh/Eng, �PoK Crime/el l/n-s-% n License�( No. /'� ( ❑ TENANT y�ELECTRICAL ® PLUMBING ICJ MECHANICAL B / I 317- Ca.c" t't-c _W f relA 55a.,a WH.•4-e ❑ OTHER c- I A Rear n '/ !// N Address '"� I Contractor's Nam• —ai• �s-•'---ter' Phone PROJECT DESCRIPTION SD. FT. /300 #/'� Uo, uPANCY /t....E' C Right ? G ti • CONSTRUCTION TYPE �d 0 Alt $ _.I��.q�� S Left 3i l / R r.,! Address(mailing) 7- '-- - . - �„- /-`— r� E I (5 Q ZONE GRADING CU.YDS. ACRES_ -$1 Z Ping. Ref.# U� - � Park.Fees $ 1zig ^ Q CityLicense No. / 7 w LICENSED CONTRACTOR DEC ARATION- Remarks: l� I r-r ._c,¢ `O/ O7 Or� Parking Req./Provided /�_5 U I hereby affirm that I am licensed under provisions of Charter 9 (commencing /�G G� - q with section 7000) of Division 3 of the Business and Professions Code,and • Use of Building: re _,� E my license is in full force and effect. yv.,_______ t�-T�T/ PLUMBING FEES Planning Notes: r r r M License Class License No. - I 1 ! . - _ - - l . r 1. E Date Signature - -N WORKERS' COMPENSATION DECLARATION Bar Sink ShowersT ' hereby affirm that I have a certificate of consent to self-Insure or a certificateBackflow Preventer Service Sink S Workers' Compensation Insurance, or a certified�copy'-�' thereof^ (Section - - -Policy Lab. C.) / ,O - - [. Backflow Irrigation Sewer Cap . ' _ ELECTRICAL " - FEES No. �75Z`'s-Xy 'Company • - e Certified copy is hereby furnished; Bathtubs Sewer-Connection _ _ _ Automatic Washer Transformer ❑ 15,50 KW . Certified cop s filed with the cityB Id Divisi / 0 50+KW • Date f^9' Applicant {/) � Clarifiers Solar Collectors' Construction Pole Sub. . EXEMPTION FOM WORKERS'CO ION DECLARAT Dishwasher ' (This section need not be completed I th p Itis for one bund ($100)or Solar Piping Cooking Unit Meter ❑up to 100 amps less). DrinkingFountains I certify that in the performance of the work for which this permit is issued Solar Tank �_ Dishwasher Meter Dover 100 amps; shall not employ any person In any manner'so as to become subject to the Workers' Compensation Laws of California. Floor Drains , . Swimming Pool w/Spa Dryers ❑Gas DElectric Sub Panel. Date Signature - NOTICE:If,iafter making this declaration,you should become subject to the Floor Sinks Urinal Fan - Motors 00-1 HP 01%-8 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 09-15 HP 016-15+ 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 Issued (Section 3097 Clv. C.) . i Lender's Name Kitchen Sink Water Service Device Boxes Pole Light .-- Lender's Lender's Address Lavatories OWNER BUILDER DECLARATION 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 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 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 Generator ❑0-5 KW❑5-15 KW 'Division 3 of the Business and Professions Code) or that he/she is exempt , Trash Compactor 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 Reinspection Fee I $25 Issue Fee - $ 3 enalty of not more than five hundred dollars($500). • 0 I, as owner of the property or my 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 REQUIREMENTS: License Law does not apply to an owner Of a property who builds or improves Boiler Hood or Type I 0 ^K /��]�JyE��. thereon, and who does such work himself/herself or through his or her own Zoning Approved By O' 1--7�.• Date employees, provided that such Improvements are not Intended or offered for Canopy Type II 0 q sale. If, however, the building or improvement is sold within one year of corn- Duct Under Ground - Building Approved BY Date 7'^ / -t�'Q-" plellon, the owner will have the burden of proving he/she did not build or im- r ve for the purpose of sale). Duct-Structural Refrigeration System - Application Issued By �-.2 Date _2-'9"0 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 , The Contractor's License Law does not apply to an owner of property who • mo /¢ builds or improves thereon,and who contracts for such projects with a con- Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ ,J�' SMIP $ moi tractor(s) license pursuant to the Contractor's License Law). • �fl.PLAN CHECK $ I�`7 60 ' PERMIT 1 0 1 am exempt under Section / , B.& P.C.for this reason Firepl/Fact.BIt. ICBG# PLUMBING $ ISSUANCE $ Date 7-7-417 OwnerE i"X - ed! , ,„ Heating System& Ducting • PLAN CHECK 25% $ ENERGY P.C. $ • I hereby certify that I have read th li +eon and state that above - ❑0.100;000 BTU 0100,000 BT ELECTRICAL $ GRADING $ information is correct. I agree to co ply w all city and count dinances i • and state laws relating.to building onstructlon, and hereby au rise repro- . PLAN CHECK 50% $ MICROFILM $ sentatives of this lly to enter upon tM1' above-mentioned property for Inspection purpos f. MECHANICAL $ d Ig'? - x Accounting;Goldenrod-Assessor ,/ CONSTRUCTION AND PLANNING POOL. A -- 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 T/ Ve 56. Rough Plumbing& Pressure Test - r - 6. Electrical UF ER Grnd. I ' Va- 57. APPROVAL TO COVER-GUNITE 7. Footings ,7 ppp��' if la/ 58. Electrical Conduit-Undrgrnd. -.. •• 8. Foundation r6LAU Sj(� ve- 59. Gas Pipe, 0 Undrgrnd.,Test - •A _ - 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK - 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final - ' 12. Sewer Cap • - 63. Heater & Vent-Final - 13. Roof Drains 64. Plumbing System - Final - . 14. Rough Plumbing - • 65. Electrical-Final • - ' 15. Rough Electrical-Conduit 66. Solar System-Final - , - - .-- - - _ . - - 16._Rough Electric Wiring 67. Fencing & Access Approval _ - • -- 7, 17Y1Rough 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 i 22. Ducts, Ventilating 71. Product Piping ❑Oil ,) 23. Gas Pipe-Rough &Test 72. Underground Flush, 24. Roof Framing 73. Undergrnd.Storage Tank O Gas ❑Oil 25. Roof Sheathing `�1'q`% vv 74. Overhead Hydro ' 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing /r /� �e/ 76. Dry Standpipe • - i . ' • 28. Lathing& Siding 11/1 w( /v 77. FIXED SYSTEM FINAL , • 29. Insulation 1/ / a l 1�c- 78. FIRE PREV. FINAL ' ; 30. Drywall Nailing (/). q eic HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat i�/€5 eJ,F• 79. FINAL INSPECTION , 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED /J 33. Final Electric Notes: ox f / - O tL_.A.1_ _ - 34. Final Heating& Air Conditioning 35. Final Gas Pipe-Test , 36. Hood or Canopy - - I 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 • I 45. Sound Attenuation _ - 46. Handicap Regulations 47. FINAL STRUCTURE &,BUILDING el ) fr V� ' • 48. Special Requirements Completed 17r/S- te , - ' 49. Electric Release to Edison J - 50. Gas Release to Southern California Gas Co 5. - CER IFICATE OF OCCUPANCY - No. �// Date d f�9/R,1-- 41%7 - - City of Costa Mesa Development Services Department CERTIFICATE OF OCCUPANCY No. 0 J 1.S 11 Building Safety Division P.O.Box 1200 Costa Mesa,California The Building located at 7644 FT,1lFN AVFTQTF TINT'!' flfi-1 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group R-1 Occupancy. Use of Building (TWITT'1TNTTIM Legal Description 439-771-1f1 (See reverse side for Metes and Bounds) Building Permit No B-14004 Electrical Permit No.E-14543 Plumbing Permit No.P-14756 Mechanical Permit No. M15S44 M1 tiR2Q MIAMI Number of apartments and/or guest rooms ISSUED TO: Building Official 2. 4 . K. Jeffrey Frawley / by `v//LGPv 11.52 Salinas Ave. , Costa Mesa, Ca. Date /9 A.C. This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 le) 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. CITY OF COSTA MEJSgA ONSTRUCTION PERMITPERMIT NO TRACT NO. LOT NO. UNI NO. 50gI1 7/3p/gt: 39.R• 7' Project Address aLP�y E'-06./ —,u 'MI7, /� • ft tTYPE OF CONSTRUCTION ft NEW U ADD ❑ ALTERATION REPAIR Applicant's Mallinn�A��ddyrre - 0 t' / •11,,a ! . a. • I / �V V. PhoneZ2O I3t"5 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# - Zone Owner's Name A // �C DESCRIPTION OF WORK/USE OF BLDG. Address /Go A/EI•JP- ' Cav7 'Z Q,2. Su-!o8 S Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING SIU FOUNDATION ❑ STRUCTURAL T Front ZO Address ll ❑ TENANT ❑ ELECTRICAL X PLUMBING ❑ MECHANICAL BA Rear N Contractor's Nam¢n� N1l�. /knit. 1%hon/elh� 'S�/�s CI OTHER C Right N Address(mailing)20 8l Alt.nA�t LA/ ?.A. PROJECT DESCRIPTION SQ. FT. OCCUPANCY Left �•s CONSTRUCTION TYPE VALUATION 3 K G Th-- City License No. (n GZ49 ZONE GRADING CU.YDS. ACRES R Ping. Ref.# Parking Req./Provided E 43 LICENSED CONTRACTOR DECLARATION `/ Q I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: ,�/'/ T G 0 Planning Notes: M with section 7000) of Division 3 of the Business and Professions Code,and PLUMBING I FEES T I. my license is In full forcee2 eft•ct. /,� ca License C .55 Licens- No.g 0Mo S Date t i�`s� C%—Signature It, , WORKERS' OM'ENSATION DECLARAT ON 'hereby affirm that I have a certificate Of consent to self-insure or a certificate Bar Sink Showers ELECTRICAL FEES A Workers' Compensation Insurance, or a certifie co y thereof (Section 3800, Lab. C.) Qr C Backflow Preventer Service Sink Automatic Washer Transformer 0 15-50 KW' Policy No. 44 Q 3) Company ✓ D Backflow Irrigation Sewer Cap Construction Pole Sub. ❑ 50+KW flCertified c y is hereby furnished. Cer -fi co y f led with the city15148,1iling Division.FLA 8• • 2 Bathtubs Sewer Connection 0 Cooking Unit Meter ❑up to 100 amps Date Applicant Ns 1l. EXEMPT! N F OM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Cover 100 amps (This section need not be completed if the permit is for one hundred (S100)or �) less). / Dishwasher Solar Piping .2 Q Y 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 manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors❑O-1 HP ❑11/2-8 Workers' Compensation Laws of California. _ Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar❑g-15 HP 016-15+ NOTICE:If,after making this declaration,you should become subject to the Workers' Compensation provisions Of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures comply with such provisions or this permit shall be deemed revoked. Microwave CONSTRUCTION LENDING AGENCY / Gas Service Outlets' 3 Water Closet s 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 ..--46, Outlets Range Lender's Name Lender's Address , Kitchen Sink Water Service OWNER BUILDER DECLARATIOCJs.CO Switches Sign I hereby affirm that I am exempt from the Contractor's License Law for the S /0 T Lavatories •'G 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 Generator ❑O-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 n 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 '-z 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). U 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 ❑ sale. If, however, the building or improvement Is sold within one year of com- Canopy Type II ❑ 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 rove for the purpose of sale). U I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By (.1(/ Date 30 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 builds or Improves thereon,and who contracts for such projects with a con- SUMMARY OF FEES tractors) license pursuant to the Contractors License Law). I am aware that Exhaust System ❑ Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $ proof o their Worker's Compensation Insurance should be provided to me. PLAN CHECK $ _ PERMIT 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# PLUMBING $ .it•SO ISSUANCE $ Date Owner - Heating System& Ducting PLAN CHECK 25% $ 7.2.3 ENERGY P.C. $ 1 hereby certify that I have read this application and state that the above ❑G100,000 BTU ❑100,000 BTL 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 city to enter upon the above-mentioned pr pert for inspection purpose ,Tw Signature 1 9-... Pink-Accounting;Goldenrod -Assessor . CONSTRUCTION AND PLANNING POOL di SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole! 52. Pool & Equipment Location • 2. Sbil Pipe-Undrgrnd. �a�a(,( (,at 53. Steel Reinforcement 3.,,Electrlcal ConduifiUtility-Undrgrnd. ,,. 54. Forms 4:Elect,tcaj:Conduii-Undrgrnd. 55. Electrical Bonding 5:"Steel Reinforcement - :; 56. Rough Plumbing & Pressure Test 6' Elec;ricalUFER GrndT 57. APPROVAL TO COVER-GUNITE •� 7.-Footings: 58. Electrical Conduit-Undrgrnd. . 8. "Eci,undation '. , 59. Gas Pipe, 0 Undrgrnd.,Test • 9. Wafer.Pipe-Undrgrnd: OWN- („(t0 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10.,Str;uctural Floor System 61. APPROVAL TO DECK 11.:Property Sewer Lined House Connection r • 62. Backwash & Receptor-Final 12. Sewer Cap '- J,' 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final •` 14. Rough,Plumbing k fp X1701 L40 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:, 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test ��r 1/,J2° 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 3//{,jd',$- C.rL0 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 60. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date • (rite Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 9708 10�09�0/1 ee01 T� CITY OF COSTA MESA CO QTRUCTION PERMIT ( 5 561- PER IT NO. TRAT NO. 5 8 � UNIT NO. • • • Project Address � - F.I �`� At it r AI./. , /I TYPE OF CONSTRUCTION • -rJEW U ADD ALTERATION U REPAIR Applicant's Maillg Adepts �• ,I,�(1 ��v/"y�7 �'{�� 'p/ )�.J ❑ CONVERSION ❑ DEMOLISH 0 OTHER A.P.# I Zone Address NaIp•1�� 'V�P 1 lis�'^�� Sy P �" DESCRIPTION OF WORK/USE OF BLDG. S Main Building: Accessory Building: TYPE OF PERMIT 0 GRADING U FOUNDATION U UCTURAL E Front Z Arch/Eng. License No. T N Add /' 0 TENANT 0 ELECTRICAL 0 PLUMBING CHANICAL B Rear N A Contractor's Nam- Atratila,mi one ,�1ES•1(. ❑OTHER C Right ,� G / i/((�� • p 1:4:57 PROJECT DESCRIPTION SQ. FT. OCCUPANCY — City Licensess e(mailing) ' ��',,��s4�0�,1- � t "'' w Y�fes/ CONSTRUCTION TYPE VALUATIONS $ Left r City License No. JH/i ZONE GRADING CU.YDS. ACRES R LICENSED CONTRACTOR DECLARATION x,,�)) , I Ping. Ref.# Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: l I '4001/4[✓ Planning Notes: M j- with section 7000) of Division 3 of the Business and Professions C•de, and 111 ii' t my license's I ful . d effect. T Ucense S. Date I .lkSL Signature 11971 f Lice �;1 eft r PLUMBING FEES h WORKER C•M'ENSATION DEC ARATION Bar Sink Showers ELECTRICAL FEES hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' Compensation Insurance, or a certif'•• copy there f (Section Backflow Preventer Service Sink 3800, Lab. ��((t�,/y� �,//J - - , Automatic Washer Transformer 0 15-50 KW Policy No. ��s'r+ $51 Coy pony .•i�_. JO-, Backflow Irrigation Sewer Ca 0 50+ KW 1 P ' Construction Pole Sub. 8 Cer ' I d o y I hereby furnished. - Cer A.E i filed with the city 1 ding_•I Ay9� . !./• / Bathtubs • �� Sewer Connection Cooking Unit Meter ❑up to 100 amps Date '1 Applicant r tj1l��al•, C - EXEMPT! N RO WORKERS'COMPENSATION DEC •RATION Clarifiers Solar Collectors • Dishwasher Meter Dover 100 amps (This section need not be completed if the permit is for one hundred (8100)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 00.1 HP 011/2-8 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 SinksUrinal Fixtures Microwave comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LE{{{JJJ ppDING AGENCY - Gas Service Outlets. Water Closet I hereby affirm that the •n a cogztructlon lending agency for the performance Device Boxes/ Pole Light of the work for wh QVtISSNIJ/L//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 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 any structure, prior to its issuance, also requires the applicant for such permit Generator 00.5 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 Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil enalty of not more than five hundred dollars($500). I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Foe $ 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 aro 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 Motion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Date rove for the purpose of sale). I,as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Dat tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 0o-100,000 BTU 0100,000 BTU SUMMARY OF FEES builds or improves thereon,and who Contracts for such projects with acon- tractor(s) license pursuant to the Contractor's License Law). I am aware thatExhaust System ❑ Multiple ❑ System Repair/Alteration BUILDING PERMIT $ _ SMIP $ proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT 0 1 am exempt under Section B.& P.C.for this reason Firepl/Fact.BIt. ICBG# • PLUMBING $ ISSUANCE $ Date Owner' Heatin stem& Ducting A PLAN CHECK 25% $ ENERGY P.C. $ I hereby certif. that I have read this .••h4 cation and state that the above 100,000 BTU ❑100,000 BT ELECTRICAL $ GRADING $ information Is orrect. I agree to com•ly w th all city and county ordinances 1 and state la - relating to building c•n tr tion,.4nd hereby authorize repre- sentatives o this city to ent41 u•o e •ove-mentioned propgrty�(or� V. Inspection p p. 6. f / - � {z 1 ZF�..I MECHANICAL $ all TOTAL FEE $ COC Signature AL 41....,...... CMF 0865-46,rev.4/84 White-Building;Canary-Applicant;Pink-Accounting:Goldenrod-Assessor • CONSTRUCTION AND PLANNING POOL&SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector .1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. - - 53. Steel Reinforcement 3.,Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Uridrgrnd. 55. 'Electrical Bonding 5' Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. - 57. APPROVAL TO COVER-GUNITE 7:.Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation - 59. Gas Pipe, 0 Undrgrnd., Test • 9. Water'Pipe-Undrgrnd. ' _ 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer-Cap - 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final . 14. Rough Plumbing_ ' - 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning !t'/I 1DI.�r7/gv f'C FIRE DEPT. REQUIREMENT 20. Rough-Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating : 71. Product Piping 0 Gas ❑Oil 23. Gas Pipe-Rough &Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 1 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 3/,5/e5- (,re.49 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 Job #3012 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITU OF COSTA MESA CONSTRUCTION PERMIT `PE IT NO. TRACT NO. LOT NO. UNIT NO. Project Address 2644 Elden ( 5�2-9 ('Ijr_J 0457 10/17/64 8.00 11 • Applicant's Mailing Address P.O. Box 695 Walnut 917889 TYPE OF CONSTRUCTION U NEW ❑ ADD U ALTERATION LJ REPAIR Z Coastline Development 720-1303 ❑ CONVERSION ❑ DEMOLISH 0 OTHER A.P.# Zone Owner's Name Phone 160 Newport Center Dr.108 Newport Beach S Main Building: Accessory Building: DESCRIPTION OF WORK/USE OF BLDG. —1 Address Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING U FOUNDATIONE 0 U STRUCTURAL Front Address ❑ TENANT ❑ ELECTRICAL 0 PLUMBING 0 MECHANICAL B Rear N AJR Construction 594-5911 ❑ •OTHER A _ I Contractor's Name Phone C Right N /J P.O. Box 695 Walnut 91789 PROJECT DESCRIPTION SQ. FT. OCCUPANCY K G CO Address(mailing) Left 010196 CONST RUCTION TYPE VALUATIONS $ City License No. E ZONE GRADING CU.YDS. ACRES I LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E �- I hereby affirm that I am license•'b der pgbvisions of Charter 9(commencing Remarks: .14^r � Planning Notes: 1 M Iwith section 7000) of Division s of the Or ness and Professions Code, and lJ l] T r- my license is in full force and oft•ct. 1_21 I3 6228 ense lJaszj a L, S. Dat ',en tyle.{-.)bLj. — Oate �I UU a Signature _ J PLUMBING FEES .i , WORKERS'COMPENSATION DECLA- •TION .Bar Sink Showers ELECTRICAL FEES I hereby affirm that I have a certificate •f ••nsent to self-Insure or a certificate , of Workers' Compensation Insurance, •r a certified copy thereof (Section 3800, Lab. C.) W0005151 Beaver Insurance Backflow Preventer Service Sink Automatic Washer Transformer 0 15.50 KW - Policy No C. •an Backflow Irrigation Sewer Cap Construction:Pole Sub. ❑ 50+KW 8 Certified copy is hereby furnished. — r (� CertifrF®tgpardeljed with the city .:ui .1 ,• D' i 1•s. ,t� . \)_ Bathtubs Sewer Connection Cooking Unit- Meter ❑up to 100 amps Date Applicant 3 . �M�-'� EXEMPTION FROM WORKERS'COMPEN r ON DECLARATION Clarifiers Solar Collectors Dishwasher Meter Clover 100 amps (This section need not be completed if the pe mi:is for one hundred ($100)or less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel I certify that In the performance of the work •r 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-8 Workers' Compensation Laws of California. - 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 Sinks Urinal Fixtures Microwave comply with. such provisions or this permit shall be deemed revoked. - CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes Pole 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 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 Garbage Disposal •Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P—Trap 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 LIpenalty of not more than five hundred dollars($500). • I, 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 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 . 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 ono year of com- Canopy Type II ❑ Zoning Approved By Date pietlon, the owner will have the burden of proving he/she did not build or Ins- Duct-Under Ground Building Approved By Date rove for the purpose of sale). O I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Dlb 17 ate `b tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 0o-100,000 BTU Dioo,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 thatExhaust 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 ❑ I am exempt under Section B.8. P.C.for this reason Firepl/Fact.Blt. ICBO 42301 1 Metal Fireplace 4 00 PLUMBING $ ISSUANCE $ Date Owner Heating System&Ducting PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have r•ad this application and state that the above 00100,000 BTU 0100,000 BTL Information Is correct. I agree • comply with all city and county ordinances ELECTRICAL $ GRADING $ - and state laws relating w di • construction,and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ sentatives of this cit e to u•on the a¢eve-mentioned property for inspection purposes. ) ,e (l 10-1 2-84 MECHANICAL $ 7.00 TOTAL FEE $ 8.00 Signature - Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ 1 00 CMF 0865-46,rev.4/84 W ' e-Building;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor CONSTRUCTION AND PLANNING POOL& SPA APPROVALS Permit# _ Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54, Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, E Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, E 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 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 34 fir LAO 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. 1306 10/31 /04 13e0:: TL CITY OF COSTA MESAThp .,(C,� ST UCTIION,.PERM(IT PERMIT-NO:-- ; — TRACT NO. LOT NO. UNIT 1y0. : Project Address itif &'G-oc1 J r • ini�p0/ EaNEW `` (J(A[7 / Applicant's Mails Address TYPE OF CONSTRUCTION E,NEW 0 ADD u ALTERATION REPAIR T '-7 0 CONVERSION 0 DEMOLISH 0 OTHER Owner's Name 1g <T /-1/eW 1Z1".4Phone A.P.# I Zone DESCRIPTION OF WORK/USE OF BLDG. Address S Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMIT 0 GRADING 0 FOUNDATIOfJ:. ❑ STRUCTURAL T Front p Address s 7�1 ,�ss /r- ❑ TENANT ❑ ELECTRICAL 0 PLUMBING y.� ,^,,ECHANICAL B Rear N E/�/4fF (�� SY phone ❑ 'OTHER / A g I Contractor's lidi / G14� aft-- PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right G Address(mailing) S CON STRUCTION TYPE VALUATION$ S Left R City License No. ZONE GRADING CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION • f'•� I _ Ping. Ref.#' Parking Req./Provided •• E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: 6 I Un D L/ Planning Notes: M with section 7000) of Division 3 of the Business and Professions Code, and 17,00 my license Is in full f. dined. CY% • T License Class // LI ense No. S Dale Signature {({,a',� PLUMBING FEES 4� WORKERS'COMPENSATION DEC •TIO vv/ hereby affirm that I have a certificate of consent to self-Insure or a certificate Bar Sink Showers ELECTRICAL FEES I of Workers' Compensation Insurance, or a certified copy. thereof (Sect' n Backflow Preventer Service Sink is 3800, Lab- C.) Qn �, l/ j� Automatic Washer • Transformer 0 15-50 KW U Polity NO. f re I pt 3ACompany rg/ � Backf low Irrigation4.: Sewer Ca ❑ 50+KW ? iiP /Construction Pole Sub. Certified copy is he eby furnished. Cert'f d opy_i d with the city Build g D_l ay.i�i(.o�n. Bathtubs Sewer Connection Cooking Unit Meter pup to 100 amps \ Date / Applant ONp cL - • p EXEM TION FROM WORKERS'GOMPEl'$ATI ECL RA 0 Cleflf iers Solar Collectors Dishwasher Meter Dover 100 amps (This section need not be completed if the p:rmit is for one hundred ($100)or • less), DishwasherSolar Piping Dryers ❑Gas ❑Electric Sub Panel 1 I certify that in the performance of the work for which this permit is issued, I I i shairnot employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan - Motors 00.1 HP 01%-8 Workers' Compensation Laws of California. Date Signature Floor Drains Swimming Pool w/Spa F.A.U. i 'NOTICE: If,after making this declaration, you should become subject to the - Ina Solar ❑9-15 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 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 Outlets Range Lender's Address Kitchen Sink i 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 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 Trash Compactor any structure, prior to Its Issuance, also requires the applicant for such permit P to tile 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). ; 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 I 515 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 )❑ salI , however, the building or improvement is sold within one year of com- Canopy , Type II 0 . Zoning Approved By ' • Date i pletion, the owner will have the burden of proving he/she did not build or im- Ducts-'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 id.3/—S y tractors to construct the project (Section 7044,Business and Professions Code: o ' The Contractor's License Law does not apply to an Owner of property who •1, Duct-Ventilating 00-100,000 BTU 0100,000 BTU O SUMMARY OF FEES builds or Improves thereon,and who contracts for such projects with a con- ++ , tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple❑ System Repair/Alteration BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation,Insurance should be provided to me. PLAN CHECK $ PERMIT • ❑ 1 am exempt under Section B.& P.C.for this reason Firepl/Fact.alt.ICBG# Fire Dampers PLUMBING $ ISSUANCE $ Date Owner Heating System& Ducting Registers ' ENERGY P.C. $ PLAN CHECK 25% $ I hereby certify that I haverread this application all and state that the above - ❑Q100,000 BTU 0100,000 BTL - ELECTRICAL GRADING $ Information sola I oef tin ',agree to co ply with all city and county r ordinances — $ sen state laws re a t if totqp I ing n euction, and hereby authorize $ MICROFILM $ sentatives of s cit L/grlbl r the above-mentioned property t - PLAN CHECK 50% MECHANICAL $ TOTAL FEE $ ,/�" inspection Signature our s „3j _ �i Slqnature Date Reinspection Fee $15 Issue Fee Drivers' License or SS# -Accounting; Goldenrod - Assessor • 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-Undrgrnd. • 53. Steel Reinforcement 3. Electrical Conduit•Utility-Undrgrnd. - ' 54. Forms . 4.'%lectrical Conduit Undrgrnd. 55. Electrical Bonding S: Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 'f 7. Footings I ^ 58. Electrical Conduit-Undrgrnd, • 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test • 9. Water Pipe-Undrgrnd. - • 60. Backwash Lines, P-Trap, O Undrgrnd. • • 10. Structural Floor System • 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap • I 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 34sits'440 71. Product Piping ❑Gas ❑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 1 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System • 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING • 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. &ffiY OF COSTA M6Sq O T U TION PE M}T PERMIT NO. ''rr TRACT NO. LOT NO. UNIT NO. Project Address -`� � / • C 4'S `t-3 5725 9/06/E4 699/40 T1 • Applicant's Mailsny�A�d,,dr ss TYPE OF CONSTRUCTION F.NEW ❑ ADD ❑ ALTERATION ❑,REPAIR / • Owner's Name s oc-.-tv/s4J LJC✓ Phone-noWoo ❑ CONVERSION ❑ DEMOLISH ❑ OTHER - A.P.# Zone DESCRIPTION OF WORK/USE OF BLDG. Address ff S Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMIT LJ GRADING ❑ FOUNDATION ❑ STRUCTURAL T Front - G Address ❑ TENANT I ELECTRICAL ❑ PLUMBING 0 MECHANICAL BA Rear N ``�� Contractor's Nam- �-/� ❑OTHER P one / � • C Right - N 1 PROJECT DESCRIPTION SQ. FT. OCCUPANCY G Address(mailing) - w A. - �` CONSTRUCTION TYPE VALUATION$ S Left • City License No. R - ZONE GRADING Cu.YDS. ACRES Ping. Ref.# Parking Req./Provided - - E so LICENSED CONTRACTOR DECLARATION • � �/-�� Q I hereby affirm that I emlicensed under provisions of Charter 9 (commencing Remarks: 17 140D� Planning Notes: M with section 7000) of Division 3 of th usiness and Professions Code, and T O my license is in full fora and effe �/p S. License Class O ice No! YT 3 1 Oate - Signature PLUMBING . ' FEES .� WORKERS'COMPENSATION DECLARATION( Bar Sink Showers • ELECTRICAL FEES I hereby affirm that I have a certificate of consent to self-insuie or a certificate of Workers'. Compensation Insurance, or a-certified copy thereof (Section •Backflow Preventer Service Sink 3800, Lab. C) ��p /�,,,, - - Automatic Washer ' - -/ Transformer ❑-15.50 KW r' j t�yss """ OS Company �`�"��-r`tz 1 Backflow Irrigation Sewer Cap I Constructior• Pole Sub. • 0 50+KW Policy ab.. A/ 8 Certified copy is hereby furnished. CertI c filed with the�city B Itl g Division. Bathtubs Sewer Connection - Cooking Unit Meter ❑up to 100 amps / S Date f" Applicant I -�, ierr%Tv lG 63 EXEMPT((ION ROM WORKERS'COMPENSATION DECLARATION Clarifiers . Solar Collectors . Dishwasher I Meter Clover 100 amps �• / OO (This section need not be completed if the permit Is for one hundred ($100) or - `� l less). Dishwasher Solar Piping Dryers OGas ❑Electric 1 Sub Panel I (� I certify that in the performance of the work for which this permit is Issued, I shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan 3 Motors❑0-1 HP ❑1'h-8 3 OC Workers'. Compensation Laws of California. ' Date Signature Floor Drains i 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 /'•I' Microwave - • -Z comply with such provisions or this permit shall be deemed revoked. ' CONSTRUCTION LENDING AGENCY' Gas Service Outlets . Water Closet - ( ,L Device Boxes Pole Light I hereby affirm that there is a construction lending agency for the performance 2 C:- of the work for which this permit is Issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets 30 Range //__ 00 Lender's Name - - w Lender's Address - - Kitchen Sink - Water Service . . Switches c/ OWNER BUILDER DECLARATION �,Q Sign T 00 I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories - Garbage Disposal • ' Standing Sections following reason (Section 7031.5 Business and Professional Code: Any city or . - j county which requires a permit to construct,alter,improve,demolish or repair P-Trap - - ` Generator 00-5 KW ❑5-15 KW Trash Compactor any structure, prior to its issuance, alsorequires 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 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 _. S_does not apply to an owner of a property who builds or Improves _ - _ES 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 orimprovementis sold within one year of com- Canopy Type II ❑ Zoning Approved By Date elation, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Date LIrove for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Dat tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of,property who Duct-Ventilating 06100,000 BTU 0100,000 BTU SUMMARY OF FEES I 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 thatExhaust System ❑ Multiple ❑ System Repair/Alteration BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ .PERMIT i 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# PLUMBING $ ISSUANCE $ Date Owner - Heating System& Ducting PLAN CHECK 25% $ 'ENERGY P.C. $ I hereby certify that I have read this application and state that the above ❑0-100,000 BTU 0100,000 BT - informatio • agree to comply with all city and county ordinances ELECTRICAL $ 44P.G 0 GRADING $ and state aws relating . • ildin construction, and hereby authorize repre- - PLAN CHECK 50% $ Zi •9C MICROFILM $ sentatives of this city . ent upon-the above-mentioned raperty for Q ` ` Inspection •urease 6 et/ - - MECHANICAL $ TOTAL FEE $ ea'40 Slgnatu Date 07 • • Drivers' License or SS# / Pink-Accounting;Goldenrod -Assessor • • Y i . CONSTRUCTION AND PLANNING • POOL&SPA 44brr 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.i Electrical Conduit-Undrgrnd. 55. Electrical Bonding ✓ ' 5. Steel Reinforcement - 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE c.7. Footings : 58. Electrical Conduit-Undrgrnd. 8.;Foundation 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 Connection 62. Backwash & Receptor-Final 12. Sewer Capti 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 4%4 42 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-Final3��I6S C ,, 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 - 2644 ELDEN UNIT B-2 - r 814005 CONGO $73;420. +•- - 407495 PC 172-34L UNIT 52 - IS P14259MISC - • 3/ii/55� 514005 UNIT B2 +tiAUMEN1121=11022=It . 14544 . MISC - _' J/1.578S B14005 UNIT B2 a -- -- ' • •- M15595 MISC t 37/s/7f 214005 UNIT B2 , nt M15830 }- FRPLC 5i/ /5 214005 Unit 52 L.t 416002 / MISC 3// 3// s 514005 UNIT B2 R" • Cri rJ: 1 - Applicant to fill In all spaces except those within heavy border lines and-sign all appropriate declarations. I , CITY OF COSTA MESA- PERMIT TRACT NO. LOT NO. BLDG.NO. • CONSTRUCTION PERMIT • ? / J <. f�i i -7 / 6� 3695 7/CJ9/B4 4P9.E2 TI Project Address _-2.C.211-/—:--- -&`-&r �-/� L TYPE OF CONSTRUCTION `fsa NEW LI ADD U ALTERATION H REPAIR - Applicant's Mailing Address��.tres� • I/seo At..4f It r.�r _Dr ; //J q ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# I , 7-12,2J-In -!1 O I—IC) •I Zone Q 2. Owner's Name trema" Fr&u)l-,- yt/., DESCRIPTION OF WORK rc-tss�d9 '-i'�_l7 .Ld/ L/ T" / !hone 7�'O[�(J S Main Building: Accessory Building: / Z; Address ` CSS {� T Q�" N .-t 5-z_ 0.1-47A-,..) c TYPE OF PERMITq•� ❑ GRADING l� FOUNDATION W} STRUCTURAL E Front 1 Arch/Eng.'J5A' C•Yli� ls•s CteU�eLicense No, ❑ TENANT L1i ELECTRICAL ® PLUMBING uCi MECHANICAL B ad- ---j �, I q Rear ad N Address -3,7 &u-t a-w P . P--- n-14- mar,v. Cita'"lc ❑ OTHER K—I C Right • / G N Contractor's Name d a ,D-icy Phone 1 We PROJECT DESCRIPTION SQ- FT. ale • UPANCY ll^a.,£ K 5/ E Address(mailing) ��-°t •cat2 g0 ,n61-# CON STRIJ,GTTION TYPE Co ' •LUA ION$ _ $ Left `2, ZONE /` 2 GRADING CU.VDS. ACRES y67 Ping. Ref.# - 84- 7 Park.Fees $ /020q 38 Q City License No. q U LICENSED CONTRACTOR DECLARATION Remarks:roc I7_1--84. /�/�07 R •� Parking Req./Provided � V Z.5 I I hereby affirm that 1 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. OLD FOR ECTAL REQOIREMENTS E my license is in fullce and effect. � � �•,�� I M License Class / License No. 'Fly PLUMBING FEES Planning Notes: In Date Signature Bar Sink Showers norm d Q 1161E ,T '-'ORKERS'COMPENSATION DECLARATION T • • ereby affirm that I have a certificate of consent to self-Insure or a certificate Backflow Preventer Service Sink - • - • S Workers' Compensation Insurance, or a'certified copy thereof (Section _ - 3800, Lab. C.) C¢ _-)' Backflow Irrigation Sewer Cap _ ELECTRICAL - FEES Policy No. _�SZ�s •s Company' �"�-'jC✓ - _ ' ! Certified copy is hereby furnished. ' Bathtubs • Sewer Connection Automatic Washer Transformer D 15-50'KW 8 Certified cop i filed with the city Sul 1ln• 'alvislo• 0 50+KW Date '7 ' Applicant Clarifiers Solar-Collectors • ' Construction Pole Sub. . .. ` EXEMPTION FROM WORKERS'COM- 1 '•N DECLARATION ,i J. Dishwasher Solar Piping CookingUnit Meter ❑u to 100 amps(This section need not be completed.if e r t Is for one hundre+ 100) or o p ' less). DrinkingFountains ' I certify that In the performance ofthe.work for which this permit is issued I Solar Tank r - Dishwasher Meter Clover 100 amps shall not employ any person in any mannereso as to become subject to the - , • 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 ❑1'/x-8 Workers' Compensation provislons•of the Labor Code, you must forthwith l comply with such provisions or this permit shall be deemed revoked. Gas Service Outlets Water Closet 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 - • Fixtures 'Microwave - 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 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 - 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 a Signed statement that he/she Is licensed pursuant to the provisions of - •tbe Contractor's License Law(Chapter 9(commencing with Section 7000) of ' 1',,,vision 3 of the Business and Professions Code) or that he/she is exempt - - i' Generator 00-5 KW 05-15 KW Trash Compactor •, ; ij tirefrom`dntl the basis for the alleged exempt)on. Any violation of Section , , ' • `%Il'331,5 by any applicant for a permit subjects the applicant to a civil Reinspection Fee $ 3 - peenalty of not more than five hundred dollars($500). . pe .$25 • Issue Fee ' U I; as owner of the property or my 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 REQUIREMENTS: License Law does not apply to an owner of a property who builds or improves r Boiler Hood or Type I ❑ /may / ••-� /� thereon,,and who does such work himself/herself or through his or her own Zoning Approved By s 1!1V� Data I �`I Ig 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 _ - Building Approved By /—9—4 � pletlon, the owner will have the burden of proving he/she did not build or im- Date grove for the purpose of sale). - Duct-Structural Refrigeration System Application Issued By Date 7-9-7 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 SUMMARY OF FEES The Contractor's License Law does not apply to an owner of property who ao PI— builds ¢ builds or improves thereon,and who contracts for such projects with a con- Exhaust System ❑ Multiple 0 System Repair/Alteration BUILDING PERMIT $ 35-5' SMIP $ s-" r ctor(s) license pursuant to the Contractor's License Law). 40 , PLAN CHECK $ /•2Y. '° PERMIT A I am exempt under Section B.& P.C.for this reaion , , Firepl/Fact.Bit. ICBG# - / PLUMBING $ ISSUANCE $ Date 7••9 % Owner e t�/-,(��s �L - �Jf—,-.17 e _ PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have-read thi al Jl on antl state titbove 00-100,000 ■ s s i s s : _ GRADING '$ _ information is correct. I agree to co ly wi all city and counnces ' ELECTRICAL $ and state laws relating to building construe on, and hereby outepre- _ PLAN CHECK 50% $ MICROFILM $ sentatives of this city to enter upon the above-mentioned property for inspection purpo1 s. p� �-Z Signature , .._. Goldenrod-Assessor CONSTRUCTION AND PLANNING POOI 'PA • Date Inspector - ' Date ' Inspector APPROVALS Permit# APPROVALS Permit# 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 ✓� a- 56. Rough Plumbing & Pressure Test _ 6. Electrical UFER Grnd. Y Q, 57. APPROVAL TO COVER-GUNITE . • 7. Footings i✓� 58. Electrical Conduit-Undrgrnd. - . 8. Foundation •S(.�l d g JI ✓ .. 59. Gas Pipe, 0 Undrgrnd.,Test - , - . 9. Water Pipe-Undrgrnd. 60. Backwash Lines,:P-Trap, 0 Undrgrnd. , 10. Structural Floor System 61. APPROVAL TO DECK • _ 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final - - • 12. Sewer Cap 63. Heater & Vent-Final . 13. Roof Drains 64. Plumbing System - Final - - , . 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final- - -- - ---- -- -.- ._ . 16. Rough Electric Wiring • 67. Fencing&•Access Approval . - •.- . - - . - 17r"Rough Wiring Sign ' 68. APPROVED FOR PLASTERING - _ 18. Rough Electrical-T Bar Ceiling , 69. POOL/SPA SYSTEMS FINAL • 1 ' 19:4 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 1.9 7A VC-- • 74. Overhead Hydro ' 26. T-Bar Ceiling (Structural) & Monocoat lir( 75. Dry Chemical -27. Frame and Flashing iU" 76. Dry Standpipe i • • -28. Lathing& Siding t( /& 77. FIXED SYSTEM FINAL 29. Insulation 1i 1(itf V4"-- 78. FIRE PREV. FINAL • ' 30. Drywall Nailing lr�� (/1 / HEALTH DEPT. REQUIREMENT ': - 31. Plaster Brown Coat 1/ i A 79. FINAL INSPECTION , 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED • ' 33. Final Electric Notes: e t,// Y //, - �G_ 34. Final Heating & Air Conditioning - 35. Final Gas Pipe-Test Y .., _ 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 _ , •• - 1 43. Backf low Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations _ I - 47. FINAL STRUCTURE & BUILDING, ymite V G • 48. Special Requirements Completed /// `-•�714'-£, ' • ' 49. Electric Release to Edison ((( 50. Gas Release to Southern California Gas Co , . 51. CERTIFICATE OF OCCUPANCY �i��c',/�O No. Date $7- 1. �:�D�g / • City of Costa Mesa Development Services Department CERTIFICATE OF OCCUPANCYNo. 1)61.11Z Building Safety Division P.0.Box 1200 Costa Mesa,California The Building located at 2 44 FTIICTT At7P'NTIP rinrrr 4n—f has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group o--1 Occupancy. Use of Building (Y1VrY1MMTT17M Legal Description 434_971-10 (See reverse side for Metes and Bounds) Building Permit No B-1411(15 Electrical Permit No. F.-1d54d Plumbing Permit No. alnSr, Mechanical Permit No. Ml c:oc Ml RQ zn Ml1Znno Number of apartments and/or guest rooms rooms • ISSUED TO: Building Official ✓ �• c� rt JEFFREY FRAWLEY by ef3&Ieif 1152 SALINAS AVE. . (7DSTA MESA. ('A. Date 4059/9S- • � This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 lel U.B.C. CMF 1015-46 rev.1/83 White-Owner;Canary-Numerical File;Pink-Bldg. Permit File r -- Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. f1 PERMIT NO. TRACT NO. LOT NO. UN T5964 7/80/94 39. .'7 '1 CITY OF COSTA MESAEA� CONSTRUCTION PERMS .09 �5 - Project Address )G� E t ..i i> Pj 4/. �� rr 11 wall _ • Applicant's Maili//gqp.��A.��d��dr s d LA/. TYPE OF CONSTRUCTION NEW LJ ADD U ALTERATION U REPAIR tP421" DEV Phone 7.20-&23 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# Zone Owner's Name /�yyam� �•�, �,J�,, A • DESCRIPTION OF WORK/USE OF BLDG. Address �� •✓/e••- [s/'/JL�X. , i SO, lot rr I _ S Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING ppLIII FOUNDATION U STRUCTURAL E Front O Address /y /�`,r/�.- p ❑ TENANT ❑ ELECTRICAL yon.PLUMBING ❑ MECHANICAL B Rear N Contractor's Namr• / /'�/•$'d^•�`•^'^„�Phonel � CI OTHER A C Right N Address(mailing) 04032/ Mi Yom` CAA sN B. PROJECT DESCRIPTION SQ. FT. OCCUPANCY K G A`1, + CON ST RUCTION TYPE - VALUATION$ S Left City License No. f `� ZONE GRADI NG CU.YDS. ACRES R LICENSED CONTRACTOR DECLARATION - R Ping. Ref.# Parking Req./Provided E 7� I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: i!>/4OQS Planning Notes: M rx, with section 7000) of Division 3 of the Business and Professions Code, and 0+`�+ my license is in full force .= • f•ct. �/��0 T License C .ss - License No. -- S- t Date • ir Signature / - — PLUMBING FEES C WORKERS' 0 'ENSATION DECLARATION / Bar Sink Showers . FEES I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink 3800, Lab. C.)4423/, N� Automatic Washer Transformer 0 15-50 KW Policy No. 44 3 Company E A ,Backflow Irrigation Sewer Cap , Construction Pole Sub, 0 50+ KW ., 11 Certified co is hereby furnished. Cert fie9 co 1h�Is Jlied with the city ({�d''ng Division. Grier Bathtubs Sewer Connection II Cooking Unit Meter ❑up to 100 amps Date /01/ jis Applicant //SMI F2 rata. I (�7Y-r EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter ❑over 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 00-1 HP ❑1%-B Workers' Compensation Laws of California. Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar ❑9-15 HP ❑i6-15+ • 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 S' Water Closet a• a■ PoleLight ., I hereby affirm that there is a construction lending agency for the performance • Device Boxes of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors - Water Heater • . Outlets Ran e Lender's Name _ Lender's Address _ / Kitchen Sink Water Service •0. Switches - Sign n ■ • OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories �Q •a Garbage Disposal 'Standing following reason (Section 7031.5 Business and Professional Code: Any city or 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 Generator 00.5 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 Division 3 of the Business and Professions Code) or that he/she is exempt • :herefrorn 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 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 Hood or Type I 0 DEVELOPMENT SERVICES\REQUIREMENTS: employees, provided that such improvements are not intended or offered for Boiler sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 Zoning Approved By Date prove the owner have the burden of proving he/she did not build or im- Duct- Under Ground Building Approved By Date Ufor t ove the purposese of sale). tr I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Dat tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00.100,000 BTU 0100,000 BTU builds or improves thereon,and who contracts for such prefects with a con- SUMMARY OF FEES tractor(s) license pursuant'to the Contractor's License Law). I am aware thatExhaust 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 O I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBO# PLUMBING S /...5-6 ISSUANCE $ Date - owner Heating System& Ducting PLAN CHECK 25% $ . S ENERGY P.C. S 1 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- sentatives epro ■ PLAN CHECK 50% $ MICROFILM $ sentatives of this city to e , uion the above-mentioned pr pert for ✓ I Date inspection perp. .7 30 MECHANICAL $ \ egg', TOTAL FEE $ �' 4� Signature 1� Drivers' License or SS • '• -.. Pink-Accounting;Goldenrod-Assessor CONSTRUCTION AND PLANNING POG_ & SPA • APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1'. Temporafy Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. Wslei ciao 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.; Elect�idal UFER Grnd. - 57. APPROVAL TO COVER-GUNITE r • 7..footings: • 58. Electrical Conduit-Undrgrnd. 8!:Foundation 59. Gas Pipe, 0 Undrgrnd.,Test • • 9. Water Pipe-Undrgrnd. 9F4/alit LEO 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property.Sewer Line,& House Connection • • 62. Backwash & Receptor-Final 12. Sewer Cap63. Heater & Vent-Final 13. Roof.Drains ` � 64. Plumbing System - Final 14. Rough.Plumbing, : /0//7/g', CR!) 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 - .1;72:'.Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas El 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 ,t ' 80. FOOD CERTIFICATE ISSUED �/ ./642 -E 33. Final Electric l• , Notes: ,,Z J'- -? 4'•. <.S yi�f 4C'y 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test )?/;'. Ver he{ 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 3////j'S' LpD 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 nil -22 1 \ Applicant to fill`n all spacext those within heavy border lines and sign all appropriate declarations. CITY'OF COSTA MF„SA' 4ONST/[RUCTION PERMICT • PERMIT N, O. TRACT N0. ct--p�9�N0- UNIT - - Project Address %�Q'4111, I(-� �{Ot'Q� • r�_ S'r Ta 9707 10/09/84 ' 5.00 TI • 1� - / i iklYPE OF CONSTRUCTION W ADD TERATION REPAIR - Applicant'sMailingQ, dre5s1 g-.4e• _ - 'I }(1/ J ❑ CONVERSION ❑ DEMOLISH • ❑ OTHER _ A.P.# • Zone • Owner's Name?�t LN{�UXJJII .5� a '�Iyyt7 Phon 'f� - DESCRIPTION OF WORK/USE OF BLDG. ' Address WV PW I ti -Z� y' - �`� ♦ S Main Building: Accessory Building: * Arch/Eng. - License No. TYPEOF PERMIT ❑ GRADING Cl FOUNDATIOO�N��CI STRUCTURAL E Front - o Address • 1 - / y� ❑ TENANT ❑ ELECTRICAL El PLUMBING LTMECHANICAL .. B Rear • ' N slat lb. JAL 'M1D � 'IG.S IGU ❑OTHER _ II�L^J Contractor's Nam oe C Right N '/t�-ss / - PROJECT DESCRIPTION SQ. FT. OCCUPANCY Address(mailing) V/--''�"� /� ��p _v CONSTRUCTION TYPE •VALUATION$ S Left G City License No. E/ 5� ZONE GRADING CU.YDS. ACRES t R 1 LICENSED CONTRACTOR DECLARATION • /� _ Ping. Ref.# Parking Req./Provided / E �� I hereby affirm that I am licensed under • of Charter 9 (commencing Remarks: pcT ' L. co 5 Planning Notes: - _ /• Q i with section 7000) of Division 3 of th- lusiness and Professions Code, an• �4+..�� M my license is in f. I :r, - and effect. T • " License Cl. s �� ansa �� 'r�1 •/ /, S. Date ' I 1gi7 Signature • !OM/,_I �� , PLUMBING FEES A WORKERS' 0 PE SATION DECLARATION t) • I hereby affirm that I have a certificate of consent to set insure or a certificate Bar Sink Showers t ELECTRICAL FEES of Workers' Compensation Insurance, or a certifi opy thereof"(Section Backflow Preventer _ Service Sink - 3800, Lab- filo Op Gj�1 UI-rJ'IK�J -, . . . Automatic Washer _ Transformer 0 15-50 KW _ Policy No. �VrC.4V o-••7 Company - ' Backflow Irrigation Sewer Ca - •' I 0 50+ KW P Construction Pole Sub. Certifies co ry is ereby furnished. - CerCf' , •• s iled with the city 'l��I Bathtubs Sewer Connection ® Cooking Unit a ■ . is . • Date , ' a Applicant EXEMPTI•N -O WORKERS'COMPENSATION ECLARATION Clarifiers 1' ` Solar Collectors 1 I Dishwashermps • - ■• • 11 . (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 manner so as to become subject to the * Drinking Fountains Solar Tank Fan Motors❑0-1 HP ❑i'h-8 Workers' Compensation Laws of California. ' Date. Signature .. Floor Drains. t r Swimming Pool w/Spa F.A.U. NOTICE: If,after making this declaration,you should become subject to the . / Inc.Solar ❑9-15 HP ❑16-15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks . Urinal " 7 comply 'with such provisions or this permit shall be deemed revoked. " --- - . - - - - - - Fixtures _ Microwave_ . - CONSTRUCTION LENOI G AGENCYGas Service Outlets. • ' Water Closet s' Device Boxes Pole Light • I hereby affirm that there is 4o struction lending agency'for the performance of the work for which }.�V� P it is issued (Section 3097 Civ. CJ Interceptors - Water Heater • ' Outlets - Range Lender's Name Orr; - • • 9 Lender's Address - Kitchen SinkWater Service Switches. Sign • OWNER BUILDER DECLARATION • . - . I hereby affirm that I am-exempt from the Contractor's'License Law for the ' Lavatories ' - , 1 following reason (Section 70315 Business and Professional Code: Any city or Garbage Disposal Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P-Tra - Compactor Generator ❑0-5 KW❑5-15 KW Trash .any structure, prior to its issuance, also requires the applicant for such-permit p - 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 Roof Drains 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 ot-enalty of not more than five hundred dollars($500). ' LU I, as owner of the property or my employees with wages as their sole ' Reinspection-FeeI $15 Issue Fee $ 3 compensation, will do the work, and the structure is not intended or offered - - Reinspection Fee f $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 D sale. If, however, the building or improvement is sold within one year of corn- - 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 he pf ope). (01 U 0 t as owner of tthe project Se exclusively contracting ing witholicensedioncon- Duct-Structural Refrigeration System Application Issued By (J/a)V'/1/ Date fl tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑0-100,000 BTU ❑100,000 BTU 'SUMMARY OF FEES builds or improves thereon,and who contracts for such projects with a con- tractor(s) license pursuant-to the Contractor's License Law). I am aware thatExhaust System ❑ 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. (CBO# ERMITISSUANCE $ PLUMBING $ Date Owner I Hea ' ystem& Ducting ; 4 PLAN CHECK 25% $ ' ENERGY P.C. $ I hereby certif t at I have read this application and state that the above 11 0-100,000 BTU ❑100,00013TO— GRADING $ information is r ect. I agree to comply wit city and county ordinances ELECTRICAL . $ and state laws r I ting to building con truc on, d hereby authors a re pre- PLAN CHECK 50% $ MICROFILM $ sentatives of [h city to enter up• th b e- entioned ro rt rpm inspection purpo st,,, ,,,1 sa� to MECHANICAL $ I7� TOTAL FEE $ ��1J Signature a/f'tvvll.( V J / �? Drivers' License or SS Pink-Accounting Goldenrod-Assessor CONSTRUCTIOI'i'AND PLANNING POOL&SPA ' • APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location -r r 2. Soil Pipe-Undrgrnd. _ _ - 53. Steel Reinforcement _ - ,Electrical Conduit Utility-Undrgrnd. -. ^ __ 54. Forms - 4.-Electrical Conduit-Undrgrnd. . _ 55. Electrical Bonding • 5: Steel Reinforcement•. 561-Rough Plumbing& Pressure Test 6. Electrical UF ER end.: _ _ 57.-APPROVAL TO COVER-GUNITE : _ 7.. Footings' _1 r _ ., . 58. Electrical Conduit-Undrgrnd. 87 Foundation I- _ - 59. Gas Pipe, 0 Undrgrnd.,Test i • " 9. Water'Pipe-Undrgrnd. • 60. Backwash Lines, P-Trap, 0 Undrgrnd. , •10. Stfuctural Floor System r - • . 61. APPROVAL TO DECK • 11. Property Sewer Line& House Connection ' " 62. Backwash & Receptor-Final • 12. Sewer Cap --. ii _ - ' 63. Heater & Vent-Final 13. Roof Drains ' 64. Plumbing System - Final � , 14. .Rough plumbing„ -, ' 65. Electrical-Final 15. Rough Electrical-Conduit - 66. Solar System-Final - __ 16. Rough Electric Wiring . - - • 67. Fencing & Access Approval 1 . 17: Rough Wiring Sign 68. APPROVED FOR PLASTERING • ' 1,8. Rough Electrical-T Bar Ceiling - 69. POOL/SPA SYSTEMS FINAL. 19. Rough Heating & Air Conditioning ,./37/ry �/lpg FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace �T l��G APPROVALS Permit# 21. Ducts;in Structure 70. Underground Hydro i . 22. Ducts, Ventilating . 71. Product Piping 0 Gas 0 Oil . 23. Gas Pipe-Rough & Test 72. Underground Flush i 24. RoofFraming - 73. Undergrnd.StorageTank 0Gas 0Oil 25. Roof Sheathing 74. Overhead Hydro ' 26. T-Bar Ceiling (Structural)•& Monocoat 75. Dry Chemical . 27c Frame and Flashing 76. Dry Standpipe ' 2,8,. Lathing & Siding • I 77. FIXED SYSTEM FINAL 29. Insulation ' 78. FIRE PREV. FINAL 30. Drywall Nailing - HEALTH DEPT. REQUIREMENT (31. Plaster Brown Coat 79. FINAL INSPECTION i . 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED r. 33. Final Electric Notes: 34. Final Heating & Air Conditioning VelarGEO 35. Final Gas Pipe-Test • 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing • 39. Water Service-Final 40. Gas Service-Final i 41. Solar Domestic-Final 42. Backflow Preventer t-. - 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 Job #3012 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY-OF COSTA MESA CONSTRUCTION PERMIT PERMITO 3O TRACT NO. LOT NO. Uy�r Ng I 0458 10/17/84 8.00 tt. • Project Address 2644 Elden in IrV1'I r Y.�G— Applicant's Mailing Address P.O.Box 695 Walnut 91789 TYPE OF CONSTRUCTION ❑ NEW U ADD Li ALTERATION U REPAIR • CCM the DPYP1 OR1P.Ilt Phone 720-138"1 CI CONVERSION CI DEMOLISH ❑ OTHER A.P.# I Zone Owner's Name B DESCRIPTION OF WORK/USE OF BLDG. • Address 160 Newport Center Dr. #108 Newport Beach S Main Building: Accessory Building: E -• Z Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL T Front 0 Address ❑ TENANT ❑ ELECTRICAL CIPLUMBING ❑ MECHANICAL B Rear - N ' •AJR Construction 594-5911 ElOTHER . A I Contractor's Name Phone C Right N AddP.O. Box 695 Walnut 91789 PROJECT DESCRIPTION SQ. FT. OCCUPANCY K G License(mailing) CONSTRUCTION TYPE VALUATION $ - _ S Left03 R City No. 010196 Ping. Ref.# Parking Req./Provided E ZONE GRADING CU.VOS. ACRES LICENSED CONTRACTOR DECLARATION `_ �• I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: • i' 1 ' t I-^^S Planning Notes: NI I with section 7000) of Division 3 the Mist less and Professions Code, and ✓✓ —1 11♦ ' _ T t� my license is in full force and effe111MZL' �306�2�8' - S. �' License Class is nse o.�.` .�_, Date 10-12-I4 Signature -`a IF PLUMBING FEES a WORKERS'COMPENSATION DECLA-A ION Bar Sink Showers • ELECTRICAL • FEES ' I hereby affirm that I have a certificate •f c.nsent to self-insure or a certificate of Workers' Compensation Insurance, •h a certified copy thereof (SectionBackflow Preventer • Service Sink - • - 3800, Lab. C.) - --Automatic Washer Transformer 0 15-50 KW W0005151 Beaver Insurance 0 So+Kw Policy No. Co;pa y Backflow Irrigation Sewer Cap Constructioi•--Pole Sub. El Certified copy is hereby furnishe r - CertifiedcGGpy is,Esled with the'ci y : hi,: ivi ' r „� 1 Bathtubs ; Sewer Connection Cooking Unit Meter 0u to 100 amps • Date G �4 Applican S r& - EXEMPTION FROM WORKERS'COMP •TION.DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps. (This section need not be completed if the per it is for one hundred ($100)or less). • Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel I certify that in the performance of the wo 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%-8 Workers' Compensation Laws of California. - , Date Signature Floor Drains Swimming Pool w/Spa F,A,U. • Inc.Soler 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 - Microwave - comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY - Gas Service Outlets Water Closet Device Boxes 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 Name Range Lender's Address - Kitchen Sink Water Service Switches OWNER BUILDER DECLARATION. r Sign 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 GarbageDisposal '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 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 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). , '0 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 offeretlReinspection 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 D Zoning Approved By Date sale. If, however, the building or improvement is sold within one year of com- Canopy Type II ❑ pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Date move for the purpose of sale). I IJ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Dat L • tractorsto construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU ❑100,000 BTU SUMMARY OF FEES builds or improves thereon,and who contracts for such projects with a con- _ tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP ' $ proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG#2301 1 Metal Fireplace 4 OO PLUMBING $ ISSUANCE $ Date Owner Heating System& Ducting PLAN CHECK 25% $ ENERGY P.C. $ _ I hereby certify that I have read this application and state that the above ❑0-100,000 BTU 0100,000 BTL $ GRADING $ Information is correct. agree‘t]c. ply with all city and county ordinances ELECTRICAL and state laws relating to build D 9 r nstruction,and hereby authorize repre- • PLAN CHECK 50% $ MICROFILM $ sentatives of this cit to a-t: u..n he above-mentioned property for Inspection purposes. 0 -� iA \ . Date 10-12-84 - MECHANICAL $ 7.00 TOTAL FEE $ 8.00 Signature J� Drivers' License or SS# � Accounting;Goldenrod-Assessor CONSTRUCTION AND PLANNING POOL &SPA APPROVALS Permit# Date Inspector APPROVALS Permit Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location , 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd, 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation - 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final • 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil • 23. Gas Pipe-Rough& Test • 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 0il 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 Weer LEO 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. 1307 10/11 /94 13¢.7 . TL CITY OF COSTA MESSCONSTRUCTIONTRPERMIT t PE R,M I/i0' - TRACT NO. LOT NO. UNIT NO. Project Address 01-04 7((� T 1 �� C�V�-g� ��_�IIII''''TTTT ( j Applicant's Mail/s/ngg�/AAaddres`s TYPE OF CONSTRUCTION fr NEW U ADD U ALTERATION REPAIR Owner's Name CO 9 5/ s/Z•tc," D O.Phone ❑ CONVERSION ❑ DE LISH 0 OTHER A.P.rik Zone DESCRIPTION OF WORK/USE OF BLDG. Address • S Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMIT U GRADING U FOUNDATIOry U STRUCTURAL E Front p Address C �'•�� f p P1 efO 0 TENANT 0 ELECTRICAL C PLUMBINGGCYT MECHANICAL B Rear N Contractor's Namn S/C/CR7f &Va. SVC Phone -7 C�"/ 0 .OTHER C Right N Address(mailing pt/ 3 • 41...4NO .4‘,-a-- PROJECT DESCRIPTION SQ. FT. OCCUPANCY K - - - G CONSTRUCTION TYPE VALUATION S S Left City License No. - ZONE GRADING CU.YDS. ACRES R LICENSED CONTRACTOR DECLARATION 8 ' / Ping. Ref.# Parking Req./Provided E 1 hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: I - OD ` Planning Notes: T with section 7000) of Division 3 of the Business and Professions Code, and J J my license Is In full f - effect. &. / G License Class ICJ lcen3e No. ! S Date Signature /r PLUMBING FEES l.A L Q WORKERS'COMPENSATION DEC RATI N Bar I hereby affirm that I have a certificate of consent to self-Insure or a certificate ELECTRICAL FEES Sink. Showers 1 .of Workers' Compensation Insurance, or a certified copy thereof (Set •n Backflow Preventer - Service Sink -- �, 3800, Lab. C.) /� ` / • sr.. Automatic Washer Transformer 0 15-50 KW \'+ •Policy No. �(f y4';� Compan A L I/ Backflow Irrigation 0 50+KW 9 R Sewer Cap Construction Pole Sub. Certified copy is hereby furnished. car/❑fled••��o y i ed with the city : ild •• i i• Bathtubs Sewer Connection Cooking Unit Meter [hp to 100 amps \ ate/ Ct- p I - Applicant w EXE PTION FRO WORKERS'COM'ENS TION 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 00-1 HP ❑1%-B 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 Ina Solar ❑9-15 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 Pole Light I hereby affirm that.there Is a construction lending agency for the performance 9 •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 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 01 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 • Uenalty of not more than five hundred dollars(5500). - I, as owner of the property or my employees with wages as their solo Reinspection Fee $15 Issue Fee $ 3 _ 1 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 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 prove for the purpose 01 sale). I�pz, . 0 I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By �^`.-- Date 70-3/-a `7 tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Lr Duct-Ventilating • 0o-100,000 BTU 0100,000 BTU ,- ' SUMMARY OF FEES builds or Improves thereon,and who contracts for such projects with a con- tractor(sl license pursuariCto 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 ' • .0 I am exempt under Section B,& P.C.for this reason Firepl/Fact.Bit. ICBO# ' Fire Dampers $ PERMIT 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 0100,000BT - - GRADING $ Information Is'corr t. 1' ree to comply with all city and county ordinances , ELECTRICAL $ and state laws rela ing t bu lding co s uction,and hereby authorize repre- PLAN CHECK 50% $ ' MICROFILM § sentatives of this ity up bove-mentioned property Inspection purpoyO MECHANICAL /, A ? Qa Signature dI�1 Date $ TOTAL FEE § i Drivers' License r SS 9P , Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ , , 0/) • Pink -Accounting; Goldenrod - Assessor • CONSTRUCTION AND PLANNING -- POOL &SPA , 'APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit!Utility-Undrgrnd. 54. Forms • 4.'Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE ' 7. Footings ' 58. Electrical Conduit-Undrgrnd. 8. Foundation , I - 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. i • 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System l • 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 dai' GS° 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 & Sidi'ng • 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 Applicant to fill in all spaces except those within heavy border tines and sign all appropriate declarations. e- • CITY F COSTA�M/$�A//J(,O,Ni�/TpJ ,1T/LON Pi?MIT PERMIT NO. TRACT NO. LOT NO. UNIT NO. 5726 E/OE/Fitt �sBo�. T.I • Prd(ectt Address IJr/`17 'l.!l/bv S Z el Ort Applicant's Mailipg Addr s TYPE OF CONSTRUCTION LI NEW U ADD U ALTERATION U REPAIR 1 / �s �.t as./ mss/0 Vico 0 CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# Zone Owner's Name -(/'�•'� li/�/ Phone/M� QT DESCRIPTION OF WORK/USE OF BLDG. Address • S Main Building: Accessory Building: E Z Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING T O U FOUNDATION U STRUCTURAL Front Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N `I �// -L ❑ OTHER A I Contractor's Name `ae�rC L.�}- Phone 4 �G zAee C Right N Address(mailing) /777 (r_/7 __t�. Caft. c_ PROJECT DESCRIPTION SQ. FT. OCCUPANCY K G CONSTRUCTION TYPE VALUATION$ S Left R `-r City License No. ' ZONE GRADING CU.YDS. ACRES CP LICENSED CONTRACTOR DECLARATION p Ping. Ref.# Parking Req./Provided E 1 I hereby affirm that I am licensed under provisions Of Charter 9 (commencing Remarks: 1 J p.4 W S - Planning Notes: • M 0 with section 7000) of Division 3 9S�l1n!`9 siness and Professions Code, and Q my license is in full ford nod frT. T i.-__•• Lice= e/'e ice o.;e/tre,% PLUMBING FEES S Dat Signature F ......._ WORKERS' COMPENSATION DECLARATION Bar SinkShower3 ELECTRICAL FEES I hereby affirm that I have a certificate of consent to self-Insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer - Service Sink Automatic Washer f Transformer-❑ 15-50 KW / CO 3800, Lab. C.)Policy No. U.1CU301052-`1 Company • ' Backflow Irrigation Sewer Cap0 50+ KW Construction Pole Sub. • 8 Certified copy is hereby thehed. - • Certifierc ppyy+s filed with the citymBuildin Division. Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps / Soo Date Bb�DY KERS'ant -lC! Clarifiers Solar Collectors Dishwasher I Meter Dover 100 amps EXEMPTION FROM WORKERS'COMPENSATION DECLARATION P (Thissection need not'be completed if the permit Is for one hundred (5300) or less). Dishwasher Solar Piping Dryers OGas ❑Electric ' Sub Panel shallI ltno thatm in the performance of the work for aswhich othis permit is issued. I - ' employ anyiperson inf any manner so as to become subject to the Drinking Fountains Solar Tank Fan 3 Maters❑0-1 HP 01%-6 3 Workers' Compensation Laws of California. Date Signature Floor Drains Swimming Pool w/Spa F.A.U. / Inc.Solar 09.15 HP 016.15+ j CO 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. Microwave 2- CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet 11 I hereby of firm that there is a construction lending agency for the performance 7 Device BO%¢5 POIe Light 2.- $C of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets 3o Range I Lender's Name Lender's Address ^Kitchen Sink Water Service Switches SO Sign (k 00 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 Garbage Disposal / Standing Sections I oV 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 00.5 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 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 eenalty 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 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 ❑ 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 rove for the purpose of sale). ,A{.�,�\ I, as owner of the Property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By 4'V� Dateiai 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 oftheir Worker's Compensation insurance should be provided to me. PLAN CHECK PERMIT $ PE ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.BIt. ICBG# PLUMBING $ ER MIT ISSUANCE $ Date Owner Heating System& DuctingENERGY P.C. $ I hereby I have read this application and state that the above DO-100,000 BTU 0100,000 BTL PLAN CHECK 25% $ ELECTRICAL $ L{'rP-LQQ GRADING $ Inform '•n is correct, agree to empty with all city and county ordinances p and sta.- laws relating •uili,/g construction,and hereby authorize repre- PLAN CHECK 50% $ Cj0 MICROFILM $ sentativ-- of this cit . • e-5-r upon the bove-mentioned property for (� inspe to •ur;• - -Sr Date,tali MECHANICAL 6 Signature '� $ TOTAL FEE $ /PO Drivers' License or SS# / Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ _ CMF 0865-46,rev.4/84 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor - (I. CONSTRUCTION AND PLANNING POO. SPA APPROVALS Permit# - Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location • 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3.-.Electrical Conduit Utility-Undrgrnd. 54. Forms , 4..Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5.'Steel Reinforcement 56. Rough Plumbing & Pressure Test 6',-''Electrical UFER,Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings •- 58. Electrical Conduit-Undrgrnd. .8Foundation .4. • 59. Gas Pipe, O Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10, Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12.'Sewer Cap 63. Heater & Vent-Final 13. Roof Drains • 64. Plumbing System - Final 14. Rough Plumbing' 65. Electrical-Final 15. Rough Electrical-Conduit - 66. Solar System-Final 16. Rough Electric Wiring /4la 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 ❑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 /A 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 46. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date '2644 ELDEN UNIT B-3 - • ® • " It _ 314006 CONDO $73,420. _ PC 172-84L UNIT B3 -- -P14260 MISC 31/4//g5— B14006 814006 UNIT B3 • a . a E14545/ _ MISC 3/$ iS B14006 UNIT B3 M15596MISCcal - 3 S�f a7annSrn6 UNIT B3 Iin _ M1S831 FRPLC 34-'/EB14002 Unit B3 M16003 Mrd _ 3�/s�--4--"" 814006 UNIT B3 •• I a f s , --J Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY•OF COSTA MESA PERMIT O. TRACT NO. LOT NO. BLDG.NO. ' • CONSTRUCTION PERMIT -/9'i ii /-t7 3685 7/09/6: /+;,ae 1 Rroject Address ___.2.6-- #11-Y./f///.l e�t-'telC- L TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR Applicant's Mailing Address . ((O A14-4-‘100I /L (....iS10 p ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# 437 -9-9--/ 21 / - 10 l Zone kz • 11 L 1td+)1 /O�a0 DESCRIPTION OF WORK • / " .0/�-I \ Owner's Name - Phone 7 S Main Building: Accessory Building: Z M Address //5 2-- Jam. •f.-.w-'> /4'Y G C!s"sl a- At t 9 et Cpl rq• E O �2N --µ. TYPE OF PERMIT I.J GRAPING�/Pr FOUNDATION id STRUCTURAL T Front N Arch/Eng.Yr�(-A/�t /Jokelar'2Oe+ License No..c / ❑ TENANT 0ELECTRICAL 11J PLUMBING MECHANICAL B n /] r I Address 512- est--' '-'o `L4 EE.-J6 .- •., CIe•"`C+ttL ❑ OTHER • A Rear C..� N ( Contractor's Name' - �d C v r Thy Phone -_._a0 PROJECT DESCRIPTION SQ. FT. / Y 0 OCCUPANCY K Right 51 G } ' Address(mailing) 79 -- N" '� /- J s 't b CONSTRUCTION TYPE no C VALUATION$ S Left 3• I v RE City License No. 0/iC'3 ZONE k 2- GRADING CU.YDS. ACRES Z Ping. Ref.# )/ -al^D7 Park.Fees $ 1Z29 8 n LICENSED CONTRACTOR DECLARATION !J G-^ i v U Remarks: V' r/�,,,$L7-,L , //91.07��r if Parking Req./Provided /' S/z--0 I I hereby affirm that I am licensed under provisions of Charter 9 (commencingR with section 7000) of Division 3 of the Business and Professions Code, and Use of Building: re.�(/� 0 y10— E my license ism foil f ce nd effect. , PlanningNotes: I' SPECIAL REQUIREMENTS M License Class_ License No. ��7 >'� PLUMBING FEES Q E Date - Signature WORKERS'COMPENSATION DECLARATION Bar Sink Showers N T I hereby affirm that I have a certificate of consent to self-Insure or,a certificate Backflow Preventer Service SinkS of Workers' Compensation Insurance, or a certified copy thereof (Section - -- - 3800, Lab. C.)) n� /_v __I Backflow Irrigation Sewer Cap - ELECTRICAL • FEES Policy No. C 7/5.-41 • Company �'F'�-�I-�/ • Certified copy is hereby furnished. Bathtubs Sewer Connection - -- . Automatic Washer Transformer 0 15-50 KW B Certified copyjs Wed with the city!ermlsfor In (vision,�y/ - ❑ 50+ KW Date 7-�/-CrApplicant /i - Clarifiers Solar Collectors Construction Pole Sub. _ , EXEMPTION FROM WORKERS'COM TI TI DELLA RATIO Dishwasher Solar Piping - CookingUnit Meter ❑u to 100 amps (This section need not be completed if one hundred ($100) Or p p less). _- DrinkingFountains I certify thatm l they¢person In the work for aswhich othis permit is issued, I Solar Tank - . Dishwasher Meter Dover 100 amps '- ort ' employ anyiperson any mannerso as to become subject to the - - 2-2 workers' Compensation Laws of California.la. Floor Drains Swimming Pool w/Spa Dryers ❑Gas ❑Electric Sub Panel DateOSignature - - NoTICE: ,iter makingrov ions oflth,you Labor becomeusubject h it0 Floor Sinks • Urinal - Fan Motors❑0-1 HP❑1'h-6 comply • orplrs' ithsuchCompensationprsio r Of she rmitCode, eau muet frrtoth - _ - CONSwith such provisionsINGor this permit shall be deemed revoked. Gas Service Outlets Water Closet - F.A.U. Inc.Solar ❑9-15 HP 016-15+ CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the performance Interceptors Water Heater Fixtures Microwave / ' Of the work for which this permit is Issued (Section 3097 Civ. C.) , Lender's Name Kitchen Sink Water Service Device Boxes Pole Light t Lender's AddressLavatories OWNER BUILDER DECLARATION Outlets Range I hereby affirm that I am exempt from the Contractor's License Law for the p-Toe 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 Garbage Disposal 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 '(vision 3 of the Business and Professions Code) or that he/she is exempt Generator 00.5 KW 05-15 KW Trash Compactor erefrom and the basis for the alleged exemption. Any violation of Section 031.5 by any applicant for a permit subjects the applicant to a civil Reinspection Foo I $25 laud Fee S 3 penalty of not more than five hundred dollars($500). LJ I, as owner of the property or my 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 REOUIREMEN • License Law does not apply to an owner of a property who builds or Improves Boiler Hood or Type I 0 J/TT$��)(((L,,�C�.C�l� ,l //�� thereon, and who does such work himself/herself or through his or her own Zoning Approved By M/ T,..�( rV Date employees, provided that such Improvements are not Intended or offered for Canopy Type II ❑ 11T/ ^ sale. If, however, the building or Improvement Is sold within one year of com- Duct-Under Ground Building Approved By -9-g� pletion, the owner will have the burden of proving he/she did not build or im- Date f ve for the purpose of sale). Duct-Structural Refrigeration System Application Issued By -f�� Date 2 9'� fj�Qp I,as owner of the property,am exclusively contracting with licensed con- rectors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating ❑0.100,000 BTU 0100,000 BTU ,. SUMMARY OF FEES The Contractor's License Law does not apply to an owner of property who •' 00 - builds or Improves thereon,and who contracts for such projects with a con- • Exhaust System 0 Multiple❑' System Repair/Alteration [- /27,619#BUILDING PERMIT $ 5•51-,' SMIP $ s tractors) license pursuant to the Contractor's License Law). - PLAN CHECK /27,619# PERMIT 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# ISSUANCE $ • A ., Date -c+' Owner i-' '(. Heating System& Ducting _ PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have read th14 penton and stat that above 00-100,000 BTU 0100,000 BTL— ELECTRICAL $ GRADING $ information is correct. I agree to commp) th all city and count dlnances and state laws relating to building constr ction,and hereby aut orize repro- PLAN CHECK 50% $ MICROFILM $ sentatives of t s•city to enter, upon he above-mentioned property for Inspection pur•. e r / ,��u BU MECHANICAL $ 8� Pink-Accounting:Goldenrod -Assessor CONSTRUCTION AND PLANNING POOL ,PA _ • • - Date Inspector - Date Inspector APPROVALS Permit# APPROVALS Permit# - 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 4 VQ 56. Rough Plumbing & Pressure Test . 6. Electrical UFER Grnd. 1 tie.., 57.. APPROVAL TO COVER-GUNITE. 7. Footings • - ✓Pj 58. Electrical Conduit-Undrgrnd. - 8. Foundation 5LA& 8`i,{lt( ft-- 59. Gas Pipe, 0 Undrgrnd.,Test , - 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final • 12. Sewer Cap• 63. Heater & Vent-Final , 13. Roof Drains64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final - 15. Rough Electrical-Conduit - 66. Solar System-Final - ' . - 16. Rough Electric Wiring 67. Fencing & Access Approval - ' 1,7CRough 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 i 73. Undergrnd.Storage Tank 0 Gas.0 Oil 25. Roof Sheathing toll/ 2...t/ 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing Ai fly I(/ 76. Dry Standpipe 28. Lathing &Siding II/ Qppy t� 77. FIXED SYSTEM FINAL r_ OP*29. Insulation a//) (/C/ 78. FIRE PREV. FINAL 30. Drywall Nailing I)/1/t( �Ci HEALTH DEPT. REQUIREMENT 31: Plaster Brown Coat V.../ l r 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED • 33. Final Electric Notes: B2-- 7,....434. 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 1. - -. - 43. Backflow Irrigation 44. Landscape Irrigation System . 45. Sound Attenuation 46. Handicap Regulations - • 0</ •. 47. FINAL STRUCTURE & BUILDINGt' ��/48. Special Requirements Completed 7/8S• Cy, - 49. Electric Release to Edison / ' 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY ?--/e, ' .No. 17/.3 Date 1i-A0r- • City of Costa Mesa r Development Services Department CERTIFICATE OF OCCUPANCY No. 00111 3 Building Safety Division P.O.Box 1200 Costa Mesa,California The Building located at 2644 »F'N AVENUE UNIT 0B-3 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group 17-1 Occupancy. Use of Building CflN1lf?19TNT71M Legal Description 419-791-1n (See reverse side for Metes and Bounds) Building Permit No 14-1AnnC Electrical Permit No. W-1 AS/1A Plumbing Permit No. 1,147ff1 Mechanical Permit No.M1 c4QA Nfl SR I r.11Icnni Number of apartments and/or guest rooms ISSUED TO: Building Official ../ 4 C es e ,7RFF 2PY FRAWLEY ✓o /ft by (/f�dLJ 1152 SALINAS AVE. . COSTA MESA. C A. Date V ¢4Ql /sc This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises aid 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 Tines and sign all appropriate declarations. PERMIT NO. TRACT NO. LOT NO. UNIT N • CITY OF COSTA MESA CONSTRUCTION PERMIT ��a �� 5089 7/38/94 3f3.C".3 T. Project Address 47,/v est-DEN 3-8 �p TYPE OF CONSTRUCTION MPJ NEW Li ADD U ALTERATION REPAIR Applicant's Mailing ddress ❑ CONVERSION El DEMOLISH 0 OTHER A.P.# Zone ` Owner's Name `�tr hone-i3yp3 DESCRIPTION OF WORK/USE OF BLDG. Address /t6 ftakMyatt $U- /a p S Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMIT El GRADING U FOUNDATION U STRUCTURAL E Front 0 El TENANT El ELECTRICAL ® PLUMBING ❑ MECHANICAL B • N Address //,,5f'' �� El OTHER A Rear I Contractor's Namv�nn/__�'[.�4fN��6 �.•vtP�e: y� PROJECT DESCRIPTION SQ. FT. OCCUPANCY K Right N Address(mailing) �YnnO''a/ on CON ST RUCTION TYPE VALUATION$ s Left R City License No. O �� 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: • 0/5/49.01 0/5/42 s Planning Notes: M with section 7000) of Division 3 of the Business and Professions Code,and 1 my license is in full for ar]p Ceet. T j Date 7 Signaturetl1J1 K PLUMBING FEES --.) WORKERS' MP NSATION DECLARATI Bar Sink Showers ELECTRICAL FEES I hereby affirm that I have a certificate of consent to self-insure or a certificate — of Workers' Compensation Insurance, or a certified op thereof (Section Backflow Preventer Service Sink 3800, Lab. C.) Automatic Washer - Transformer 0 15-50 KW b Policy No. 4414•Q 3 Company S FunD Backflow Irrigation Sewer Cap Construction Pole Sub. • 0 50+KW gCertified copy Is hereby furnished. ^ n Certifs c s iled with the city Division L Bathtubs Sewer Connection 1400 Cooking Unit Meter ❑up to 100 amps Date in elle Applicant ��s��t(�[�1ppg�"�'�S- �e - EXEMPTION cc, WORKERS'COM EV NSATION 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 I certify that in the performance of the work for which this permit is issued, I - - p Dryers ❑Gas ❑Electric Sub Panel 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 01%-8 Date Signature Floor Drains Swimming Pool w/Spa FA.U. olar ❑9-15 HP 016-15+ NOTICE:If,after making this declaration,you should become subject to the Inc.. 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 1 Gas Service Outlets s 3 Water Closet 5 so• 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 tot% Outlets Range Lender's Name Lender's Address / Kitchen Sink Water Service a Oe Switches OWNER BUILDER DECLARATION Sign I hereby affirm that I am exempt from the Contractor's License Law for the S Lavatories /O o e 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 any structure, prior to its issuance, also requires the applicant for such permit Generator 00-5 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 • 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 , LJmalty of.not more than five hundred dollars($500). I, as owner of the property or my employees with wages as their solo Reinspection Fee I $15 Issue Fee I $ 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 pletlon, the owner will have the burden of proving he/she did not build or int- Duct-Under Ground Building Approved By Date prove for the purpose of sale). U I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Dat tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00.100,000 BTU 0100,000 BTU SUMMARY OF FEES builds or improves thereon,and who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Law). I am aware thatExhaust System ❑ Multiple ❑ System Repair/Alteration BUI LDING PERMIT $ SMIP $ i 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# PLUMBING $ c=5/• 6PERMIT ISSUANCE S Date Owner Heating System& Ducting PLAN CHECK 25% $ 7•/5 ENERGY P.C. $ I hereby certify that I- have read this application and state that the above -❑o-i 00,000 BTU 0 100,000 BTU— • GRADING $ / ELECTRICAL information is correct. I agree to comply with all city and county ordinances $ and state laws relating to building construction, and hereby authorize repre- sentatives of this city to • `r upon the above-mentioned pr erty for inspection pur•- signature % i_ Date — MECHANICAL $ TOTAL FEE $ 3,-63 Drivers' License or • — _ - Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ 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 PikUndrgrnd. � ' 1143C( 4C0 53. Steel Reinforcement ? • ..Electrical Conduit'Utility-Undrgrnd • - 54. Forms 4..'Electrical.Conduit-UndArnd. t • 55. Electrical Bonding 5: Steel Reinforcement t - 56. Rough Plumbing & Pressure Test ,. 6: Electrical UFER Grtid. • • 57. APPROVAL TO COVER-GUNITE 72 Footings 58. Electrical Conduit-Undrgrnd. • BCFoundation -; i 59. Gas Pipe, O Undrgrnd.,Test 9; WaterPipe-Undi- rnd; criaAtlyKip 60. Backwash Lines,P-Trap, O Undrgrnd. 10.•Sfructural Floor'System 61. APPROVAL TO DECK 11. Property, Sewer Line& House Connection -1 - 62. Backwash &'Receptor-Final 12. SefiverGap '� •- 63. Heater & Vent-Final • 13. Roof Drains - '%) - 64. Plumbing System - Final 14. Rough Plumbing (q/(l/gy (.4r% 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 g/47/ff 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing andiS 460 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 pr .. 11 O'740 3 Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. - PERMIT NO. �n TRA NO SrO. CITY OF COSTA gdgSA/ ONS ••UCTION PERMIT M SS-- 1 co rj 9706 10/Q9/84 /0.00 IL Project Address LL��22''--1I'' [0 fir, - �O — ✓ [�O w Applicant's Mailin• •ddress '0 - 0P,., TYPE OF CONSTRUCTION LLTFTTL FFEEW u ADD ALTERATION U REPAIR • ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# Zone ' Owner's Name _ 6.6 r a�l, P•pq�ne-__5 /JJ •�/ DESCRIPTION OF WORK/USE OF BLDG. I / Address /8, ,/ p� / ✓ �`6 S Main Building: Accessory Building: / Arch/Eng. - _icense No.ITYPE OF PERMIT U GRADING U FOUNDATION U STRUCTURAL T Front - / O Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING u-MLCsiANICAL RA Rear N • yC}/- ❑ -OTHER Contractor's Name v I•I I G�!!!//5� C Right __ - - N /� /4�yu`.lOJECT DESCRIPTION SQ. FT. OCCUPANCY K ,— - G Address(mailing) 7J K - CON ST RUCTION TYPE -VALUATIONS S Left Y City License No. Q/ S2& ZONE GRADING CU.YDS. ACRES R LICENSED CONTRACTOR DECLARATIO Ping. Ref.# Parking Req./Provided E I hereby affirm that I am licensed under p visions of Charter 9 (commencing Remarks: 1 (4/��,.s Planning Notes: M with section 7000) of Division 3 of the Business and Profe io• •.•e, ntl 1s-- ` �(� my license Is n f fJand effect. T Ucense C tel/ lice s¢ A / Albr _ S. Date 1 Signature / r/� PLUMBING FEES WORKERS'C MPE SATION DECLARATION Bar Sink Showers I 1 hereby affirm that I have a certificate of consent to -If-insure or ace ificate ELECTRICAL FEES of Workers' Compensation Insurance, or a certiie• copy there (Section Backflow Pf¢v¢Ot¢r Service Sink _ - ' 3800, Lab. �[I� A I there Automatic Washer . Transformer 0 15-50 KW Policy No. WA �� 6 m Company I Kt • Backflow Irrigation Sewer Cap0 50+ KW ` Construction Pale Sub. 8 Certified co•. Is hereby furnished. Cer y I I -d with the city l / Bathtubs / • Sewer Connection ' Cooking Unit Meter ❑up to 100 amps Date f/ E11 Applicant / �'/ EXEM' I•N•'ROM ORKERS'COMPENSATION D CLARATION Clarifiers Solar Collectors Dishwasher ,Meter Dover 100 amps (This sectio need no be completed if the permit is for ne hundred($100)or Dishwasher less). 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 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. ' NOTICE: If,after making this declaration, you should become subject to the Inc.Solar ❑9.15 HP 016-15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor SinksUrinal Fixtures comply with such provisions or this permit shall be deemed revoked. Microwave CONSTRUCTION LEN NG AGENCY . - • Gas Service Outlets . Water Closet Device Boxes PoleLight I hereby affirm that the e i a construction lending agency for the performance 9 of the work for w c D s er It is issued (Section 3097 Clv. 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 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 any structure, prior to Its Issuance, also requires the applicant for such permit 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 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 ------ penaltyenalty 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: employees, provided that such Improvements are not intended or offered for Boiler Hood or Type I ❑ sato- If, however, the building or improvement is sold within one year of com- Canopy Type II ❑ 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 rove for the purpose of sale). ��J� 3 I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By LLJDat tractors to construct the project (Section 7044,Business and Professions Code: V 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 thatExhaust System ❑ Multiple ❑ System Repair/Alteration BUILDING PERMIT $ SMIP § proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT IDI am exempt under Section B.8 P.C.for this reason Firepl/Fact.BIt. ICBG# PLUMBING $ ISSUANCE $ Date OwnerI Heat System& Ducting PLAN CHECK 25% $ ENERGY P.C. S I hereby certify • at I have read this application and state that the above 6100,000 BTU 0100,000 BTL. a r. ELECTRICAL $ GRADING $ Information is cor ect. I agree to compl all city and county ordinances and state laws r ating to buildingcon ruct •n,andb- hereby dproer y f - PLAN CHECK 50% $ MICROFILM S atate t • city enter, po he ab•aher bye a pro authorize r f inspection purp• Signature -II.l f MECHANICAL $ iTOTAL FEE $ �, •ate Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ f ��,� Drivers' License or SS# Pink-Accounting;Goldenrod-Assessor i) • I/. 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. SteelReinforcement 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, E Undrgrnd.,Test 9. Water Pipe-Undrgrnd. - 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10. Stiuctyral 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,.f 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 7Gb/rfd/.f�r" FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace •r�7� APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating • 71. Product Piping Gas EOil .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: 34. Final Heating & Air Conditioning 3/45- GgG 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 - r 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING t 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co • 51. CERTIFICATE OF OCCUPANCY No. Date • Job #301 2 Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. • PERMIT NO. TRACT NO. LOT NO. UN T N CITY Of COSTA MESA CONSTRUCTION PERMIT ill 15% 0459 10/( 7/84 8.00 TL Project Address 2644 Elden r.� Applicant's Mailing Address P.O. Box 695 Walnut 91789 TYPE OF CONSTRUCTION U NEW U ADD Li ALTERATION U REPAIR Owner's Name Coastline Development720-1383 CI CONVERSION ❑ DEMOLISH 111 OTHER A.P.# Zone Phone DESCRIPTION OF WORK/USE OF BLDG. Address 160 Newport Center Dr. #108 Newport Beach S Main Building: Accessory Building:E _ Z Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING U FOUNDATION ❑ STRUCTURAL T Front 0 Address - ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N Contractor's Name__ Construction Mule 594-5911 ❑ .OTHER A _ _ I PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right N Address(mailing) P.O.Box 695 Walnut 91' K G L 010196 CON ST RUCTION TYPE OCCUPANCY VALUATION g Left R City License No. ZONE GRADING CU.YDS. ACRES Ping. Ref.# Parking Req./Provided E CO LICENSED CONTRACTOR DECLARATION - Q , I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: /L. I (4 c( Planning Notes: M with section 7000) of Division 3 • the : si :55 and Professions Code, and �f T my license is in full force and effec a it - - - Ucense'Class Ilk s Inc }N0. 3 6228 PLUMBING FEES S 1 - Date 10—1 2:4 5i9nature j tl I\ k9�--.lJ�L/� WORKERS'COMPENSATION DEC LA RA ON Bar Sink Showers ELECTRICAL ' FEES I hereby affirm that I have a certificate of t sent to self-Insure or a certificate of Workers' Compensation Insurance, or certified copy thereof (Section Backflow Preventer Service Sink Automatic Washer Transformer ❑ 15-50 KLab. c 3800, J0005151 B-aver Insurance - KW z. Policy No. • •anyl • Backflow Irrigation Sewer Cap Construction Pole Sub. ❑ 50+ KW •Polis 9 Certified copy is hereby furnished T Corti( oily 84iled with the cit Bu(d 'Alto" �L) Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps Date C Applicant e. L, - �T/ ' EXEMPTION FROM WORKERS'COMPEN ION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps (Thissection need not be completed if the p• t Is for one hundred ($100) or less), Dishwasher Solar Piping Dryers ❑Gas DElectric Sub Panel I certify that in the performance of the work r 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''h-8 Workers' Compensation Laws of California. 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 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 Cly. C.) Interceptors Water Heater Outlets Langer'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 Disposal Garbage following reason (Section 7031.5 Business and Professional Code: Any city or 9Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P—Trap Generator ❑0-5 KW❑5-15 KW any structure, prior to its Issuance, also requires the applicant for such permit p Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains i 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)- (J I, 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 — 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 love 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 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 the Contractor's License Law). I am aware thatBUILDING PERMIT f Exhaust System 0 Multiple❑ System Repair/Alteration $ SMIP $ Proof o their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact,BIL ICBG# 2301 1 Metal Fireplace 4 DO PLUMBING $ ISSUANCE $ Date Owner Heating System& Ducting PLAN CHECK 25% $ ENERGY P.C. S I hereby cert that have read this application and state that the above Do-ioo,000 BTU 0100,000 BT ELECTRICAL $ GRADING $ Information is correct. 1 a'ree to comply with all city and county ordinances and state law rell in. tot•uilfing construction,and hereby authorize repre- sentatives of hi J • enter upon above-mentioned property for $ Inspection pur s' . . •� 1 \) 10-12-84 MECHANICAL $ 7.00 TOTAL FEE $ 8.00 Signature \� �•X� Date Drivers' License or SS Y APOlirant;Pink Accounting;Goldenrod -Assessor CONSTRUCTION AND PLANNING POOL & SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd.' 53. Steel Reinforcement • 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. • ' 55. Electrical Bonding 5. Steel Reinforcement - - 56. Rough Plumbing & Pressure Test 6. Electrical UF ER 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. 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 OOil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE 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 • 3/0/ 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 INo. Date Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. - CITY OF COSTA MES NSTR UCTION PERMIT $ PERMIT NO. TRACT NO. LOT NO. UNIT NO 1 308 10/31 /U4 1300 , TL V EG heti -ST 1,1 /6.oa3 , 3 Project Address 0011 Applicant's MallinJp��ddress/ TYPE OF CONSTRUCTION 161 NEW U ADD U ALTERATION ❑ REPAIR Owner's Name L d/IS 7~ U1c�} DG 'phone ❑ CONVERSION 0 DEM6LISH 0 OTHER A.P.i I Zone DESCRIPTION OF WORK/USE OF BLDG. Address S Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMIT 0 GRADING U FOUNDATION 0 STRUCTURAL E Front O Address a 5.4/41. '�� 0 TENANT 0 ELECTRICAL 0 PLUMBING g MECHANICAL f3 Rear N -Contractor's Name- e/4%l C U, S VS• Phone9J 7 n/ ❑ 'OTHER A C Right N / / OMn'O �,�� PROJECT DESCRIPTION SQ. FT. OCCUPANCY K g • Address(mailing) G CONSTRUCTION TYPE VALUATION$ S Left R n City License No. - ZONE GRADING CU.YDS. ACRES Ping. Ref. Parking Req./Provided E LICENSED CONTRACTOR DECLARATION /3 Q I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: /y0 �n Planning Notes: lyt with section 7000) of Division 3 of the Business and Professions Code, and (�J T I' my license is in fullygrcayty.�ffect. 9'O 'l G� s License Class C- LlJ License No. 7 rl J / Date Signature PLUMBING FEES WORKERS'COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL FEES hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' Copensation Insurance, or a certified copy thereof (Sectio " Backflow Preventer Service Sink - 3800, Lab. C.) A) J y)3 Automatic Washer Transformer ❑•15-50 KW Policy No. II/C(J' Company �2-u' Backflow Irrigation Sewer Cap /Construction Pole Sub. - 0 50+KW ❑ Certified copy is hereby furnished. 7 Cer "f a py fled with the city Buil. • Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps (Date /�-` 9. � Applicant G/� .LL_ - ' EXEMPTION FROM WORKERS'COMPE SATION DECL•RATION . Clarifiers Solar Collectors Dishwasher Meter Clover 100 amps (Thissection need not be completed If the permit is for one hundred($100) or - .mss). 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 . I Fan Motors❑0-1 HP ❑i sc-8 .Workers' Compensation Laws of California. . Date - Signature • Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP ❑18-15+ '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. 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 Range Lender's Name g 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 ❑0-s 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 Ofains • • 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). • $ 3 LJ I, as owner of the property or my employees with wages as their sole • Reinspection Fee $15 Issue Fee compensation, will do the work,and the structure Is not intended or offered - ..... - Reinspection Fee I $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL I FEES • - - - License Law dons not apply to an owner of a property who builds or improves _. . _ oy who does such work himself arelf or through his or her own Hood or TypeDEVELOPMENT SERVICES REQUIREMENTS: employees,f, o provided that suchorimprovementsimry are not intended or year c for Boiler I 0 ( sale, If, thwown, the will building dof pro i sold within one your of rim- Canopy Type II 0 Zoning Approved By Date proved, the owner sehave the burden of proving he/she did not build or Im- Duct-Under Ground - Building Approved By / Date J• ' • Move for the purpose of sale). • ///p/]]] � / ,.�/ _,( I, as owner of the property,am exclusively contracting with licensed con- . Duct-Structural Refrigeration System Application Issued By gAi Date •�/ V tractors to construct the project (Section 7044,Business and Professions Code: z� ' The Contractor's License Law does not apply to an owner of property who l Duct-Ventilating '❑0-100,000 BTU 0100,000 BTU g- -- SUMMARY OF FEES builds or improves'thereon, and who contracts for such projects with a con- 51 tractors) 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 $ PERMIT ❑ I am exempt under Section B:& P.C.for chi's reason Firepl/Fact.Blt. ICBG 4 ■ Fire Dampers PLUMBING $ ISSUANCE $ Date Owner Heating System& Ducting Registers _ PLAN CHECK 25% $ ENERGY P.C. $ I herebytcertlfy hat have read this application and state that the above- •i4___ii1 : - - GRADING $ information i c• recti I agree to com•I with all-city and county ordinances t ELECTRICAL $ and state law, • late • to .0 I. ng c• 'r on,and hereby authorize repre- i PLAN CHECK 50% $ - MICROFILM S • sentatives of , is •J. t• • -r above-mentioned property for i inspection pur•os . / Irrl 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-Undr§rn�d. - 54. Forms 4. Electrical Conduif;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, O Undrgrnd. 10. Structural Floor System ' 61. APPROVAL TO DECK • 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final • • 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 1& Rough Electric Wiring 67. Fencing & Access Approval 17 Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceilingi 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. pucts, Ventilating I 4/ CAP 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 iStructurall & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32: Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 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. 5727 6/06/C4 62e40 T! ' - on OF COSTA MESAS CO f $ZR}1�I�V P�ERMIL I• PEBVI �r�� TRACT NO. LOT NO. ' UNIT NO. Project Address Si.(pCf�f' �� C,/�( C� J pppt� • Applicant's Mailing Adds TYPE OF CONSTRUCTION 7-NEW ❑ ADD U ALTERATION U REPAIR ❑ CONVERSION ❑ DEM LISH 0 OTHER0 Owner's Name (0 �/ (/u1 Phone6O A.P.# Zone 4,8 DESCRIPTION OF WORK/USE OF BLDG. Address S Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMIT U GRADING U FOUNDATION E D U STRUCTURAL Front Address ❑ TENANT tiT ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N • ' ❑ -OTHER Contractor's Nam a a C Z Phon 4'/4 10 200C Right N Address(mailing)�? CO j 1••• [4/L Canial� PROJECT DESCRIPTION SQ. FT. - - OCCUPANCY KG Left CONSTRUCTION TYPE VALUATION $ R City License No. CO ZONE GRADING CU.YDS. ACRES Ping. Ref.4 Parking Req./Provided - E LICENSED CONTRACTOR DECLARATION -� I �, Q 1 I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: 'I/1LJ ILIo0C9 Planning Notes: M Q with section 7000) of Division 3 of the Business and Professions Code,and - T my license is in full force/nQpj{ect. n �� 1 Lice�f Class " C/ Bens lo. S. DatSignatur PLUMBING I FEES WORKE COMPENSATION DECLARATION • Bar Sink • Showers ELECTRICAL FEES ( I hereby affirm that I have a certificate of consent to self-insure or a certificate L of Workers' Compensation Insurance, or a certified copy thereof (Section - Backflow Preventer Service Sink ^� 3800, Lab. C.) g�,�, Automatic Washer / Transformer ❑ 15-50 KW Policy No. we --30q o�4 CompanyWeSi 7 r 1 Backflow Irri anon , - ❑ 50+ KW 9 Sewer Cap Construction Pole Sub. 8 Certified copy is hereby furnished. Cer led copy is filed with the city Buildinp Djxisio �] Bathtubs Sewer Connection Cooking Unit Meter )Pup to 100 amps S co Date nj t le Applicant C-\.1. sl .�+-isf \C - ' EXEMPTION FROM WORKERS'COMPENSATION DECLARATION l Clarifiers • Solar Collectors Dishwasher Meter [Dover 100 amps ) (This section need not be completed if the permit Is for one hundred ($100)or less). CC . Dishwasher Solar Piping Dryers ❑Gas ❑Electric/ Sub Panel / (p .,-(] 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 3e Motors Do-i HP OVA-8 3 Workers' Compensation Laws of California. - cis Date Signature Floor Drains Swimming Pool w/Spa F.A.U. I Inc.Solar 09-15 HP 016.15+ ( NOTICE:If,after making this declaration, you should become subject to the DO 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. �� 2..2,0 CONSTRUCTION LENDING AGENCY • Gas Service Outlets Water ClosetDevice Boxes I hereby affirm that there is a construction tending agency for the performance �l, Pole Light I'Z 'gQ of the work for which this permit is Issued (Section 3097 Civ. C.) Interceptors Water Heater Lender's Name p Outlets 30 Range (D CO Lender's Address Kitchen Sink - Water Service Switches ZO Sign 4 OO OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories . Garbo a Disposal following reason (Section 7031.5 Business and Professional Code: Any city or 9 P Standing Sections following county which requires a permit to construct,alter,Improve,demolish or repair P—Trap - 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 - 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 I $15 Issue Fee $ 3 compensation, will do the work, and the structure Is not intended or offered - Rainspection 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 for yP 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 rove for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Data 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 0o-100000 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 - BUILDING PERMIT $ SMIP $ proof of their Worker's V 0 Multiple 0 System Repair/Alteration Compensation insurance should be provitletl to me. PLAN CHECK $ PERMIT ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.BIt. ICBG 4 PLUMBING $ ISSUANCE $ Date Owner Heating System& Ducting PLAN CHECK 25% $ ENERGY P.C. $ I hereby-certif that'Ihave read this application and state that the above 00-100,000 BTU 0100,000 BT ELECTRICAL $ 4�• fon. GRADING $ Informa . . I agree to comply with all city and county ordinances e.0W and s e laws resat" • to b ding construction,and hereby authorize repre- PLAN CHECK 50% $ 21 . MICROFILM $ sentat yes of..[ : • t enter upon the above•mentioned roper for Ins• fI27" • SignatuN� Date MECHANICAL $ TOTAL FEE $ G8• Drivers' License or SS$ " / - Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ CMF 0865-46,rev.4/84 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor - I • 111. CONSTRUCTION AND PLANNING POOL &SPA f ,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.,Elecfrical Conduit-Undrgrnd. ' 55. Electrical Bonding 5.'-Steel Reinforcement 56. Rough Plumbing & Pressure Test 6: Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE r7.'.Footirigs • I 58. Electrical Conduit-Undrgrnd. 8: Foundation 59. Gas Pipe, O Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer.Cap 63. Heater & Vent-Final , - 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring M/�jy ref) 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 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 //S/�� ^� 80. FOOD CERTIFICATE ISSUED 33. Final Electric /1 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. CERTIFICATEOF-OCCUPANCY No. Date