HomeMy WebLinkAbout2572 ELDEN AVE - Building Permits Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
PERMIT NO. TRACT NO. LOT UNIT NO. Zone
CITY OF COSTA MESA CONSTRUCTION PERMIT y )7 A.P.�W LOCI— 1/�1 /� !r o R
Project Address Q67�] ELD-N AVE J I r�� r
$1'-H DEL /(� Q TYPE OF CONSTRUCTION LJ NEW ADD U ALTERATION U REPAIR $ Main Building: Accessory Building:
Applicant's Mailing"TAN
r� p
E Z
VANC L./(�J TO AlPhone 424"5 C U CONVERSION ❑ DEMOLISH ❑ OTHER • B Front N
Owner's NameDAAIP_T�N OF OR KLU$`E OF BLDG. —rn I A Rear
Address 1 S N F+ DF[. M A-C2 !o c_�- O,(}W—� `12 �ns>�xJt
Arch/Eng. License No. TYPE OF PERMIT LJ GRADING FOUNDATION U STRUCTURAL C Right N
Address B ID TENANT 0 ELECTRICAL 0 PLUMBING ❑ MECHANICAL S L R
Contractor's Name (0 J Phone ❑ OTHER I Ping. Ref.ap Parking Req./Provided E
Address(mailing) PROJECT DESCRIPTION SQ. FT. OCCUPANCY +� Cr-
City
r
g CON ST RUCTION TYPE VALUATION ( (APlanning Notes: 5� /.. .Parking
6j filo, k is" 11 fic/4ra M
License No. ZONE GRADING CU.YDS. ACRES S.
LICENSED CONTRACTOR DECLARATION
I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks:
with section 7000) of Division 3 of the Business and Professions Code,and ELECTRICAL FEES
my license is in full force and effect. —
License Class License No.
Date _ Signature PLUMBING FEES Automatic Washer Transformer 0 15-50 KW
WORKERS'COMPENSATION DECLARATIONConstruction Pole Sub. 0 50+ KW
I hereby affirm that i have a certificate of Consent to self-insure or a certificate Bar Sink Showers
' Workers' Compensation Insurance, or a certified copy thereof (SectionCooking Unit Meter Duo to 100 amps
0, Lab. C.) Backflow Preventer Service Sink
..Icy No. Company Backflow Irrigation Sewer Cap Dishwasher Meter Dover 100 amps T_
Certified copy is hereby furnished. Dryers ❑Gas DElectric Sub Panel '
_ Certified copy is filed with the city Building Division. Bathtubs Sewer Connection .
Date Applicant - Fan Motors 00-1 HP 01%-8
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors
(This section need not be completed if the permit is for one hundred ($100) or Dishwasher Solar Piping F.A.U. • Inc.Solar 09-15 HP 016-15*
less).
' I certify that in the performance of the work for which this permit is Issued, I Fixtures Microwave
shall not employ any person In any manner so as to become subject to the Drinking Fountains Solar Tank
Workers' O¢tgp s3ti n ws of Cali/Orn' .F Device Boxes
Date l�f 4i9 Si nature f/1'LLOYI Pole Light
7 y g Floor Drains Swimming Pool w/Spa 9
NOTICE:If,alter making this deciaralio , you shoultl become subject to the Outlets Range
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Switches Sign
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, CJInterceptors Water Heater Garbage Disposal Standing Sections
Lender's Name Generator 00.5 KW 05-15 KW Trash Compactor
Lender's Address Kitchen Sink • Water Service
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash
following reason (Section 7031.5 Business and Professional Code: Any city or
county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays
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 Reinspection Fee $15 Issue Fee $ 3
"ea'gfrom and the basis for the alleged exemption. Any violation of Section
11.5 by any applicant for a permit subjects the applicant to a civil
salty of not more than five hundred dollars($500). DEVELOPMENT SERVICES REQUIREMENTS: p
• .....II, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee„ $ 3 Zoning Approved By (`Q- Date "— 2 6!J
compensation, will do the work, and the structure is not intended or offered -
fal sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved By Date
License Law does not apply to an owner of a property who builds or Improves pp
thereon, and who does such work himself/herself or through his or her own Boiler Hood or Type I 0 Application Issued By Datn fh�-sl,� R�
employees, provided that such improvements are not intended or offered for
sale. If, however, the building or improvement Is sold within one year of com- Canopy Type II 0 SUMMARY OF FEES
:motion the owner will have the burden of proving he/she did not build or im- Duct- Under Ground ,7 q /-550
prov r the purpose of sale). BUILDING PERMIT $ SMIP $ V
as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK $ PERMIT
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 PLUMBING $ ISSUANCE $
builds or improves thereon.and who contracts for such oroiects with a con- —
tractor(sl license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 ' System Repair/Alteration PLAN CHECK 25% $ ENERGY P.C. $
proof o// their Worker's Compensation Insurance should be provided to me. ELECTRICAL $ GRADING $
0 I am exempt unger Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG* Fire Dampers MICROFILM $
PLAN CHECK 50% $
Date Owner .. ia__f Heating System& Ducting Registers MECHANICAL $ TOTAL FEE $ 3)
I hereb car Ify that I have rea.this application and state that the above 00-100,000 BTU 0100,000 BTL PLAN CHECK 25% $
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 our ses 1Signature Date
p 3 O
Drivers' Licenors6x 55
-Applicant: Pink -Accounting; Goldenrod - Assessor
CONSTRUCTION AND PLANNING POOL `A
APPROVALS Permit# Date Inspector APPROVALS Permit #0? 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. �1'� 57. APPROVAL TO COVE R-GUNITE
7. Footings SF��� 9 7 58. Electrical Conduit-Undrgrnd.
8. Foundation 'V 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
' 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit#
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24..Roof Framing 73. Undergrnd.Storage Tank O Gas ❑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 //fil A-bC4-
48. Special Requirements Completed /% ' L -iv
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 - PERMIT NO, TRACT NO. LOT�57A NO. UNIT NO. A P # Zone
- tLf0� ' 394.
Project Address /C.1 - 1-
S Main Building: Accessory Building:
Applicant's Mailing Address /oe� /'7e act HR2 TYPE OF CONSTRUCTION Lkl NEW L I ADD U ALTERATION U REPAIR E Front Z
S H e —/A/7' U Phoneetr-91's'C ❑ CONVERSION ❑ DEMOLISH ❑ OTHER - 6 N
Owner's Name r DESCRIPTION OF WORK/USE OF BLD . Rear
Address JR/—tf Pitt I-p- L ' / _ A I
I C Right N
Arch/Eng. License No. TYPE OF PERMIT III GRADING ❑ FOUNDATION • STRUCTURAL K G
Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL s Left R
Contractor's Name
a/f? Phone ❑ OTHER I Ping. Ref.# Parking Req./Provided E
PROJECT DESCRIPTION Sgtp. oCCUPArvCYR` Planning Notes: M
Address(mailing) STRUCTION TYPE VALUATION 5 / O__ 's__
T
City License No. ZONE GRADING CU.YDS. ACRES S.
LICENSED CONTRACTOR DECLARATION pp //
I hereby affirm that I am licensed undenprovisions of Charter 9 (commencing Remarks: kE ' $ 3 a /
with section 7000) of Division 3 of the Business and Professions Code, and —w
my license Is in full force and effect. ELECTRICAL FEES
License Class License No.
Date Signature PLUMBING FEES Automatic'Washer Transformer 0 15.50 KW
WORKERS'COMPENSATION DECLARATION Construction Pole Sub. 0 50+KW
I hereby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink $hOW¢r3
' workers' Compensation Insurance, or a certified copy thereof (SectionBackflow Preventer Service Sink Cooking Unit Meter [pup to 100 amps
300, Lab. C.)
Policy No. Company Backflow Irrigation Sewer Cap Dishwasher Meter [Dover 100 amps ,
8 Certified copy is hereby furnished. Dryers ❑Gas ❑Electric Sub Panel
Certified copy Is filed with the city Building Division. Bathtubs Sewer Connection
Date Applicant Fan Motors Do-: HP ❑1X-8
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors —
essis section need not be completed if the permit is for one hundred ($100)orlDishwasher Solar Piping F.A.U. inc.Solar 09.15 HP 016-15+
I certify that in the performance of the work for which this permit is issued, I Fixtures
shall not employ any person in any mann r so as to become subject to te Drinking Fountains Solar Tank Microwave
Workers' GGorry�en a on Laws of Californl
Date '7 /� �Pi* Signature _ (�� Device Boxes Pole Light
/ Floor Drains Swimming Pool w/Spa 9
NOTICE:If after making this declaration, you should become subject to the Outlets Range
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal
Comply with such provisions or this permit Shall be deemed revoked.
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Switches Sign
I hereby affirm that there is a construction lending agency for the performance Garbage Disposal
of the work (Or which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater 9Standing Sections
Lender's Name
Lender's Address Kitchen Sink Water Service Generator 00-5 KW 05-15 KW Trash Compactor
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash
following reason (Section 7031.5 Business and Professional Code: Any city or .
county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays
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 Reinspection Fee $15 Issue Fee $ 3
'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
malty of not more than five hundred dollars($500). DEVELOPMENT SERVICES REQUIREMENTS:
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 Zoning Approved By Date
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved By
Date
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 Application Issued By __ _ Oat;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 SUMMARY OF EE
pietion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground
prove for the purpose of sale). •
BUILDING PERMIT $ Z.5---00 SMIP $ p .3--0
••❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System _ PLAN CHECK $ �� �� PERMIT
tractors to construct the project (Section 7044,Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑0-100,000 BTU 0100,000 BTU PLUMBING $ ISSUANCE $
builds or improves thereon. and who contracts for such oroiects with a con-
tractor(s) license pursuant to sne Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration I PLAN CHECK 25% $ ENERGY P.C. $
proof of their Worker's Compensation insurance should be provided to me. ELECTRICAL $ GRADING $
❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBO# Fire Dampers MICROFILM $
PLAN CHECK 50% $
Date 1eir1Er. Owner a ' Ira _ Heating System& Ducting Registers _ MECHANICAL $ TOTAL FEE $
I hereb certify that I have read this application and state that the above ❑0-100,000 BTU 100,000 BTU PLAN CHECK 25%
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 t en r upy� the above-mentioned pr arty for
I ig nation purpos N -sr_
, .2 9
Drivers'r e License or 5S# ate Reinspection Fee $15 Issue Fee $ 3 01 209335:13-05038505 I CT -.1.,,,`_
0865.46,rev. 5/B8 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor DATE: 07/2Q/u7 TInE: 0*%2,}
CONSTRUCTION AND PLANNING POO6 _dPE1 !
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
Surf?rf? (-41 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test r
9. Water Pipe-Undrgrnd. + 60. Backwash Lines, P-Trap, 0 Undrgrnd. 1
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection I 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16./Rough Electric Wiring 67. Fencing & Access Approval
17) Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT
.t .
20._Rough Factory Fireplace APPROVALS Permit#
21. Ducts, in-Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping ❑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 J 76. Dry Standpipe
28. Lathing& Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREY. FINAL
3D. Drywall Nailing 't HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes: c' -5 4 F D�
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 1'
41. Solar Domestic-Final
42. Backflow Preventer •
43. Backflow Irrigation
,
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING 1frill 'DW
48. Special Requirements Completed
49. Electric Release to Edison ; '
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date �' 7
E` 3L'3'2) Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA CONSTRUCTION PERMIT 1 PERMIT NO. E 3c g3 TRACT NO. LOT NO. UNIT A P # Zone •
Project Address ISit 2 0E4) QV 5" 0T
TYPE OF CONSTRUCTION LIYNEW Li ADD LIALTERATION U REPAIR S Main Building: Accessory Building:
Applicant's Mailing Address ,tet Front Z
( t exe i/bf0/lvaewT Gig Crqr 0CONVERSION ID El OTHER T N
Owner's Nameg �/� Phone DESCRIPTION OF WORK/USE OF BLDG. - I A
Rear I
Address 19/-1,t 1 &z frri�le_
Arch/Eng. License No. TYPE OF PERMIT GRADING C7 FOUNDATION ❑ STRUCTURALSTRUCTRAL K Right NG
[11 TENANT ELECTRICAL III PLUMBING LI MECHANICAL i $ . Left - R
Address ❑ OTHER .
Ref.# Parking Req./Provided E
Contractor's Name I ' r, Phone RL- /-eszt Q
PROJECT DESCRIPTION SQ. FT. 3Z-76 OCCUPANCY PlanningNotes: • M
Address lmailing) / !` 5� f�'�Of^I LCi'V•'+E7 P�• �D`�'�'��1
/ l Sb CONSTRUCTION TYPE VALUATION$ T
City License No. ZONE ' GRADING CU.YDS. ACRES S.
LICENSED CONTRACTOR DECLARATION
Az I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: l
1 e with section 7000)=f Division 3 of the Business and Professions Code, and
IIELECTRICAL FEES
my license is in full force and effect. a.
License Class Li•:•se o. / PLUMBING FEES
v • Automatic Washer Transformer 0 15-50 KW
Date Signatures : re ,� _ -r
WORKERS'COMPENSATION O-CLA-ATIONBar Sink Showers Construction Pole Sub. 0 50+KW
•
' ereby affirm that I have a certi icate of consent to self-insure or a certificate , •
Workers' Compensation Insurance, or a certifi copy thereof (Section Cooking Unit Meter 0 u to 100 amps •
_a00, Lab. C.) Backflow Preventer Service Sink
�j y '7 /^� ,/� Dishwasher Meter Dover 100 amps
Policy No. (dg 3 76 y Company �^I/ - Backflow Irrigation Sewer Cap - _
BCertified copy is hereby furnished. Dryers ❑Gas ❑Electric Sub Panel '
Ce�t�{ted c py 9#with the city Bu'- irye D �. Bathtubs Sewer •Connection
Date TIONFROM Applicant FC•✓ •
- Fan Motors 00-1 HP ❑1'/:-8
EXEMPTION FROM WORKERS'C PENSATION DELL RATION Clarifiers Solar Collectors —
(This section need not be completed if the permit is for one hundred ($100) or Dishwasher Solar Piping F.A.U. • "' Inc.Solar ❑9-15HP.❑16-15+ .
less). •
I certify that in the performance of the work for which this permit is issued,I ' ' Fixtures Microwave
shall not employ any person in any manner so as to become subject to te Drinking Fountains Solar Tank
Workers' Compensation Laws of California. Device Boxes PoleLight Date - Signature 9
Floor Drains Swimming Pool w/Spa
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 Outlets • Range -
comply with such provisions or this permit Shall be deemed revoked.
CONSTRUCTION LENDING AGENCY Gas Service Outlets ' Water Closet Switches Sign
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.) • Garbage Disposal Standing Sections
Lender's Name Interceptors Water Heater .
Lender's Address - Kitchen Sink • Water Service Generator 00-5 KW❑5-15 KW Trash Compactor
OWNER BUILDER DECLARATION (s � lam�^ -
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash / coli . • //41.
following reason (Section 7031.5 Business and Professional Code: Any city or — r��y
county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays ,42.7-!
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 • C. of
ivision 3 of the Business and Professions Code) or that he/she is exempt Reinspection Fee $15 Issue Fee $B
. 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
penalty of not more than five hundred dollars($500). - DEVELOPMENT SERVICES REQUIREMENTS:
LJ I; as owner of the property or my employees with wages as their sole Reinspection Fee I ' $15 Issue Fee $ 3 • Zoning Approved By Date •
,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 Building Approved By - / Date q/��x�
License.Law does not apply to an owner of a property who builds or improves l✓` `7 V
thereon; and who does such work himself/herself or through his or her own Boiler Hood or Type I ❑ - ' Application Issued By Data
employees, provided that such improvements are not Intended or offered for
sale. If, however, the building or-improvement is sold within one year of com- Canopy Type II O. • SUMMARY OF FEES
pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground
prove for the purpose of sale). BUI LDING PERMIT $ SMIP $.
❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System • PLAN CHECK � $ - PERMIT
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 PLUMBING $ ISSUANCE $
builds or improves thereon.arm who contracts for such oroiects with a con- ENERGY P.C. $
tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple ❑ �I System Repair/Alteration I• PLAN CHECK 25% $
proof of their Worker's Compensation insurance should be provided to me. ELECTRICAL $ � t GRADING $
al am exempt under Section B. & P.C.for this reason Firepl/Fact.Bit. ICBG* Fire Dampers er
PLAN CHECK 50% $ - - ') .MICROFILM $ p
Date Owner - Heating System& Ducting Registers MECHANICAL $ TOTAL FEE • $ SSS'33
I hereby.certify that I-have read this-application and state that the above ' 00-100,000 BTU ❑100,000 BTL - ' -- PLAN CHECK 25% $
Information is correct. I agree to-comply with all city and county ordinances
and state laws relating-to building construction, and hereby authorize repre- - . • -
sentatives of th city to enter titan the above-mentioned property for •
inspection pur es •
Signature ./
- DATE: 09/12/88 TIME: 16:14
0865-46,rev. 5/88 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor
, .,
CONSTRUCTION AND PLANNING PO i 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'. . • t., 54. Forms
'4:Electrical Conduit-Uidrgrnd. 55. Electrical Bonding i
5.` Steel Reknforcement ' ! 56. Rough Plumbing & Pressure Test I (
6. EleciriclUFER\Grnd.I 57. APPROVAL TO COVER-GUNITE
i
7' Footings 58. Electrical Conduit-Undrgrnd. I
i i r 8'.'Foundation , . 59. Gas Pipe, 0 Undrgrnd., Test
V'. 9�Water Pipe-Undrgrnd. �� , 60. Backwash Lines, P-Trap, 0 Undrgrnd. i
I
Structural Floor System 61. APPROVAL TO DECK
PloT
4
rkr
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewef Cap ' I • 63. Heater & Vent-Final
• 13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing I ' 65. Electrical-Final •
15. Rough Electrical-Conduit 66. Solar System-Final
16: Rough Electric Wiring 9 9-ea y / 7. 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#
I.r l
-421. Ducts, in`Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23w-Gas Pipe-Rough & Test 72. Underground Flush I
•
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing ; ,i 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 9. FINAL INSPECTION
32. Electrical Power Meter-Final 9190C/ :; FOOD CERTIFICATE ISSUED
33. Final Electric *A./4- f,.a otes:
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 I -
43. Backflow.Irrigation - -
44. Landscape Irrigation System -
45. Sound Attenuation
46. Handicap Regulations -
47. FINAL STRUCTURE & BUILDING - I
48. Soecial 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.
PERMIT NO. TRACT NO. LOT NO. UNIT NO.
CITY OF COSTA MESA CONSTRUCTION PERMITCOI -( A.P.# Zone
Project Address 251a EtAG/�•� �V UV - L ` 1 t
• TYPE OF CONSTRUCTION 1+�1� NEW ❑ ADD H ALTERATION L I REPAIR S Main Building: Accessory Building:
E Z
Owner's
Mailing Address ` ` ❑ CONVERSION ❑ DEMOLISH ❑ OTHER T Front - O
Owner's NameGL QE-UELl1'M�Kl�phone � 7`��n�J DESCRIPTION OF WORK/USE OF BLDG. A Rear • N
Address /I/-i El- M1ghz 7J (JF .
•
Arch/Eng. License No. TYPE OF PERMIT GRADING H FOUNDATION ❑ STRUCTURAL K Right N
Address p� ��< ❑ TENANT ELECTRICAL H PLUMBING
❑ MECHANICAL S • Left R.
Contractor's Nam- / .! I ' ' iii • ler one o ./th 'S El OTHER ping. Ref. # Parking Req./Provided ' E
g . /'�^�� r•. PROJECT DESCRIPTION SQ. FT. OCCUPANCY M
Addres5lmailin 1 U � 0. cd rt, p� c----"*“.-.
Planning Notes:
C-1-4-. CONSTRUCTION TYPE VALUATION$ . 5W
/�J(/U,]�]-.(yy(ryrypp T
City License No. `� /" 03 ZONE GRADING CU.YDS. ACRES S.
LICENSED CONTRACTOR DECLARATION •
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Jh �' 2 )_ 5.:__I A Asti c s(l7 9244-i-4-,with section 7000) of Division 3 of the Business and Professions Code, and
my license is in full force and effect. ,/ ( ' ELECTRICAL FEES
Licens- ass C.(.4 ��
ense No. /'Y'�aJ Automatic Washer Transformer ❑ 15-50 KW
-' IJ
Date Signature -.r PLUMBING FEES
WORK RS' COMPENSATION DECLA•ATIONConstruction Pole Scab. • ❑ 50+ KW
I hereby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink Showers
of Workers' Compensation Insurance, or a certi i _..co thereof (Section Cooking Unit Meter ❑up to 100 amps
00. Lab. c.)) Backflow Preventer Service Sink •
licy No. 4/04.7IiI/ Company e4-0/4w.9.-sf/ri`o-u-.•��� Backflow Irrigation Sewer Cap Dishwasher Meter Dover 100 amps
�.] certified copy is hereby furnished. Dryers ❑Gas DElectric Sub Panel
.1TCerti(+y�p�py is d with the ci ui inq �iy/ffsiop. Bathtubs Sewer Connection
Date QON fR Applicant [ V ->u� Fan �i Motors MO-1 HP ❑112-8 G Cd
EXEMPTION SROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors _
(This section need not be completed if the permit is for one hundred ($100)or F.A.U. • Inc.Solar E19-15 HP ❑i6-15+
less) Dishwasher Solar Piping
I certify that in the performance of the work for which this permit is Issued, Fixtures Microwave
0 shall not employ any person in any manner so as to become subject to te Drinking Fountains Solar Tank
Workers' Compensation Laws of California. •
Date Signature Floor Drains Swimming Pool Vv/Spa Device Boxes Pole Light
NOTICE: If,after making this declaration, you should become subject to the •
i Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Outlets Range
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY _ Water Closet Switches Sign
Gas Service Outlets 9
7 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 ' Garbage Disposal Standing Sections
ILender's Name
Lender's Address Kitchen Sink Water Service Generator 00-5 KW ❑5-15 KW Trash Compactor
itOWNER BUILDER DECLARATION '
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash , . Ift ev(i
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
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 • Reinspection Fee
therefrom and the basis for the alleged exemption. Any violation of Section _ P ! $15 Issue Fee $ �/
131.5 by any applicant for a permit subjects the applicant to a civil
tatty of not more than five hundred dollars ($500). I DEVELOPMENT SERVICES REQUIREMENTS:
J I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ 3 Zoning Approved By Date
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' Building Approved By Date
License Law does not apply to an owner of a property who builds or improves _ Q
thereon, and who does such work himself/herself or through his or her own - Application Issued By Date 8—fI�1 I'�7)C,
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 11 ElSUMMARY OF FEES
'Diction, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground
Grove for the purpose of sale). ', BUILDING PERMIT $ SMIP $
LI I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK $ PERMIT
tractors to construct the project (Section 7044,Business and Professions Code:
The Contractor's License taw does not apply to an owner of property who Duct- Ventilating ❑0-100,000 BTU I:1100,000 BTU _ PLUMBING $ ISSUANCE $
builds or improves thereon.and-who contracts for such oroiects with a con- __ —
tractor(s) license pursuant to me Contractor's License Law). I am aware that Exhaust System ❑ Multiple ❑ System Repair/Alteration • PLAN CHECK 25% $ ENERGY P.C. $
proof of their Worker's Compensation insurance should be provided to me, _ ELECTRICAL $ �I• 00 GRADING $
❑ lam exempt under Section B.& P. C.for this reason Firepl/Fact.Bit. ICBG dk Fire Dampers MICROFILM $
• PLAN CHECK 50% $
Date Owner Heating System& Ducting Registers MECHANICAL $ 2' r--
N
I hereby certify that I ha - rear,this application and state that the above 00-100,000 BTU 0100,000 BTL . TOTAL FEE $
information is corre t. I .e-ee omply with all city and county ordinances PLAN CHECK 25% $ •
and state laws rel. in• . b ' • ng const ucti•n, and hereby authorize repre-
sentatives . thi- ' to -• er u•`n t • above-mentioned property f -
inspection • -p -5. I '/
Signature / Date
Drivers' Lir se or 55# Reinspection Fee $15 Issue Fee $ 3 D! 00030525-ORfJ4Q52� -E"'Q �'
"ATE; QE/"_7/8y TIME4
0865-46,rev. 5/88 White - Building; Canary -Applicant; Pink - Accounting; Goldenrod - Assessor �'�`�r'
CONSTRUCTION AND PLANNING POOL 7 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 • -> 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. 'Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation • 59. Gas Pipe, O Undrgrnd.,Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11.•Property Sewer Line'& House Connection 62. Backwash & Receptor-Final
12. Sewer:Cap - 63. Heater & Vent-Final •••
13. Roof Drains - 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16, Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning 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 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 ^ FOOD CERTIFICATE ISSUED y/
33. Final Electric /l�Z tc�:C 'Vat (1/6. 47410 t( crt
34. Final Heating & Air Conditioning K
35. Final Gas Pipe-Test q--19-75 I/`F
36. Hood or Canopy C // [ //
Irl a/Peli amte
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 I
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
49. Electric Release to Edison
• 50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date D •
I1
P y j`.5'V.2—'-
PROJECT ADDRESS: 2572 ELDEN AV UNIT: CITY OF COSTA MESA - BUILDING PERMIT
OWNER'S NAME: L&L DEVELOPMENT - '
ADDRESS: SAME AS ABOVE PERMIT NO: P 044542 PLAN CHECK NO: • N GOVT: N SUPP : N
• CONSTRUCTION TYPE: PERMIT TYPE: PLU PURPOSE: NEW
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION , SQ FT: •
ADDRESS: 0 UNIT: - ,
•
• 00000 - CLAIM VALUE: CALC-VALUE: GROUP OCC: I'
PERMITTEE: ABBOTT LANDSCAPE ( 714 ) 969-3005 .
• ADDREss: : . 209 11TH STREET - COMMENTS:
' HUNTINGTON BEACH CA 92648 ********************ifin-yrititrt*+t+E*+t*******x-*etif*****dr+r******+¢¢tide -* -**ke*>EItdL**>EaE***eta(-*
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING R EQU IR EMENTS • -
7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. SETBACKS .
Cm LIE.:021879 - STATE UC.:0 035 CUSS: 7
Date: '/0//-778-1 Signatur4...r..., ....... - _. ------'- MAIN BUILDING -'--- ACCESSORY BUILDING ---
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of con 'Ito self-insure or a cenificateof Workers' FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Compensation Insurance,or a certified copy thereof(Section 3800 Lab.C). LEFT: FT IN RGHT: FT LN LEFT: FT IN RGHT: FT IN
POLICY NO.: EXP.DATE:
COMPANY: PARKING REQUIRED: PARKING PROVIDED: PARCEL: 43916119 ZONE:
n Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES>
> • _ .
.,. APDIIcant: *******************************************************************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (ms section need not be completed if the permit is for one hundred(5100)or less). D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
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 i
subject to the work¢ Compensation Laws of California. ZONING APPROVED BY DATE:
Date: 1��7(a' f Signature: BUILDING APPROVED BY •
DATE:
NOTICE:II,after mal0ng this declaration you should become subject to the Workers'Compe n provisions of the Labor
Code,you must forthwith comply with Such provisions or this permit shall be deemed revok . q
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: '.',DATE: /
which this permit is issued(Sagan 3097.CIv.C) 7F �****
LENDER: *******************************************************************************
ADDRESS: . LEGALIZATION: N ' F E E S U M M A R •Y STRUCTURAL SEGMENT:N
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT ' PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: My city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 2 , 00 -
repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed2 5% SMIP/NON-RES
pursuant to the provisions of the Contractors State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business •
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by PLAN
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(5500). ' ISSUE FEE 3 . 00
I, as owner of the property or my employees with wages as-IAelr sole compensation, will do the work, and the BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Cade: The Contractors'State License Law TOTALS-- --> 2 . 00 3 . 00 0 . 00 5 . 0 0 5 . 00 , 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through •
his or her own employees,provided that such improvements are not intended or offered for sale.If,however the building or --> -
improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS COLLECTED • 5 .00 OVER/SHORT:' 00 C
for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business • 5 . O O - •
❑ and Professions Cade: The Contractors'State License Law does not apply to an owner of properly who builds or improves thereon
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware *******************************************************************************
that proof of their Worker's Compensation insurance should be provided to me. IND I V I •D U A L F E E BREAKDOWN •
❑ I am exempt under Section: B.S P.C.
•
for thh reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: owner PLU 1 BACKFLOW IRRIGATION 2 . 00 2 . 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and , END OF FEES '
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a - .
permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from
these provisions. ,
I
Date: ' Applicant:
I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ,
ordinances and state laws relating to building construction and hereby.ut .:.•represent'ves of thi '. to enter upon the abovem,gned
property for inspection purposes._ / 7411 ,
Date: �d�J�3 a' Signature., •
Driver's License or So aI Security -
1841.48 WhIte—Buildin Green—Coda Enforcement;Canary-Applicant:Pink—Revenue:Goldenrod—Assessor . Q: E I:r1 ),-j, ] 7 f_ - -
9: --�;1`. 1„ in .I1_ �IQ:�:
4.
I POOL 'A
/ CONSTRUCTION AND PLANNING
APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical Service;or Pole . ,- 52. Pool & Equipment Location j
2. Soil Pipe-Undrgrnd..- 53. Steel Reinforcement '."
3.2-Electrical Conduit Utility-Undrgrnd. 54. Forms ^•
Y
4.Electrical Conduit-Undrgrnd.• :"- 55. Electrical Bonding
• -' 5. Steel Reinforcement' 56. Rough Plumbing & Pressure Test .
' 6. Electrical UFER Gfnd. ` 57. APPROVAL TO COVER-GUNITE
. 7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation ,..,:-.1''-: 7. `r- 59. Gas Pipe, 0 Undrgrnd., Test ',
9. Water Pipe-Undrgrnd. - ` '.y 60. Backwash Lines, P-Trap, 0 Undrgrnd. %7
10. Structural Floor System /7 61. APPROVAL TO DECK v-2
11. Property Sewer Line•& HoConnection ., 62. Backwash & Receptor-Final ;1
12. Sewer Cap 'f;-,• �' 63. Heater & Vent-Final •:i, '
13. Roof Drains . - r • 64. Plumbing System - Final 7
•.7
14. Rough Plumbing t' ' • 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 - - - - i• APPROVALS '-Permit #
21: Ducts, in,Structuiet- • r. , ,. ..70. Underground Hydro
22..,Ducts, Ventilating - - e ' ' I < • _71. Product:Piping O Gas O'Oi'
23. Gas'PipeRough & 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 v - _ . 75'Dry Chemical _
27.-Frame and Flashing -- - Standpipe
`. 76. Dry
- 28. Lathing & Siding -•' - .. 77._, FIXED SYSTEM FINAL -
"29. Insulation • - •- _ 76::FIRE PREY. FINAL ,
.-30. Drywall Nailing . - - - HEALTH DEPT. REQUIREMENT
-;31. Plaster Brown Coat -- - I .`,' : -79. FINAL INSPECTION
_ 32: Electrical Power Metei-Final ,: I I- 80.:FOOD CERTIFICATE ISSUED-,
_33.-Final Electric a Notes: -J -
•
34.; Final Heating& Aii,Coriditioning .. ,, : K . :. - s -
35. Final Gas Pipe-Test . ,• . - * - •- - -
36.-Hood or Canopy s I I '--i) -.- -
- 37. Final Factory Fireplace - ` -
•
138. Final Plumbing - n . _
"•39. Water Service-Final. .= V '
:40. Gas Service-Final - -
_ a
.:.41. Solar Domestic-Final -•
'42. Backflow Preventer. .. . - , -, , - _
43. Backflow Irrigation 2e/t 4 ,, 3_ -I -
44. Landscape Irrigation System . , � •- - _
45. Sound Attenuation • - " T: -' - - - -
46:'Handicap Regulations _ • r r. - `
.r 47.. FINAL STRUCTURE & BUILDING:: • - -
I .. _
48; FINAL PLANNING - _ -
1 49.- Electric Release to Edison % . n
i 50r Gas Release to Southern California Gas Co ' - - .
i 51. CERTIFICATE OF OCCUPANCY
' No. Date
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO.
X3344 2-9
Project Address APS.,I 01—O trAl
Oe H ADD H ALTERATION U REPAIR
Pa_ Ian TYPE OF CONSTRUCTION.IOIU NEW
Applicant's Mailing Address ��/ O4'Z /"L..-y El CONVERSION lit DEMOLISH ❑ OTHER A.P.# Zone
Owner's Name .-�rf «U?b4/ PhoneGYr-•?Yit DESCRIPTION OF WORK/USE OF BLDG.
Address /&/ "d/ 0C C Al 17/7_ S Main Building: Accessory Building:
Arch/Eng. License No. TYPE OF PERMIT CI GRADING ❑ FOUNDATION CI STRUCTURAL E Front o
Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL BA Rear N
,,ill ❑ OTHER I
Contractor's Name .t/ S! $, Phone C Right N
Address(mailing) v I PROJECT DESCRIPTION SQ. FT. OCCUPANCY
CONSTRUCTION TYPE VALUATION$ L �rV S Left G
City License No. ZONE GRADING CU.YIDS. ACRES R
LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E
Q
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: M
with section 7000) of Division 3 of the Business and Professions Code, and T
my license is in full force and effect.
License Class License No. $
Date -- Signature PLUMBING I FEES
WORKERS' COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL FEES
I hereby affirm that I have a certificate of consent to self-insure ora certificate -
' Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink
00, Lab. C.) Automatic Washer Transformer 0 15-50 KW
,-olicy No. Company Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+KW
8 Certified copy is hereby furnished, --
Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps
Date Applicant
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps
(This section need not be completed it the permit Is for one hundred ($100)or -
less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel •
I certify that in the performance of the work for which this permit Is Issued, I
snall not em toy any person in any manner o s to become subject to the Drinking Fountains Solar Tank Fan Motors 00-1 HP ❑1,A-8
Workers' C en Lo.s of California. ,/ '
Date 99 b$'' /Signature O(y `q / Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar ❑g-15 HP 016-15+ '
NOTICE: a er 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
I hereby affirm that there Is a construttion lending agency for the performance Device Boxes Pole Light
of the work for which this permit Is Issued (Section 3097 Clv. 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.l am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal Standing Sections
following reason (Section 7031.5 BusIness and Professional Code: Any city or —
county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays
any structure, prior to its issuance, also requires the applicant for such permit Generator ❑0-5 KW O&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
`31.5 by any applicant for a Permit subjects the applicant to a civil —
nalty of not more than five hundred dollars($500). $ 3
Ii I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee
compensation, will do the work,anti 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
pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Date
pro e purpose of sale).
I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By CrIN Data' — q
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 ❑100,000 BTU SU MARY OF FEES
exiles or improves thereon, and who contracts for such projects with a con- D
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
TJ lam exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers ISSUANCE $
PLUMBING $
Date a4Owner � 4 Heating System& Ducting Registers PLAN CHECK 25% S ENERGY P.C. $
I hereb c tify that I have read this application and state that the above 00-100,000 BTU 0100,000 BT ELECTRICAL $ GRADING S
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 rjty to en r up the above-mentioned Apr erty for r,,�
inspection purpose <
Signature
/ Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $
CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor 01 000038&s-00003389 TOT 25.50
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, 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 ❑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 C.
33. Final Electric Notes:
34. Final Heating & Air Conditioning •;t:
35. Final Gas Pipe-Test
36. Hood or Canopy
•
37. Final Factory Fireplace •
38.-Final Plumbing
•
-39. Water Service-Final '
40. Gas Service-Final ri '
•41. Solar Domestic-Final •
'
'42. Backflow Preventer -
C43. Backflow Irrigation i
44. Landscape Irrigation System _
t,45. Sound Attenuation
'46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING 7/.5/Se 4.
48: Special.Requirements Completed ••
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. l Date
Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations.
CITY.F COSTA MESA..,CONSTRUCTION PERMIT PERM T NO.540/ TRACT NO. LOT NO. UNIT NO.
j project Address • 23 7e EL(JEN /wt- i 3 r'
jpialicant's Mailing A`T1ress /S'/`H (7SL di-1.074 TYPE OF CONSTRUCTION Ll NEW LI ADD U ALTERATION LI REPAIR
Owner's Name -Z, hi, .4-./A„, 7-04_, Phone n-9YS{ LI CONVERSION El DEMOLISH El OTHER A.P.# I Zone
DESCRIPTION OF WORK/USE OF BLDG.
Address /8/--/l JBL 1.-MAS Main Building: Accessory Building:
Arch/Eng. License No. TYPE OF PERMIT U GRADING LI FOUNDATION LI STRUCTURAL E Front 0
Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL BRear N
El OTHER
OTHER I
Contractor's NamePhone C Right N
Address(mailing) f L PROJECT DESCRIPTION SQ. FT. OCCUPANCY K Left
G
CONSTRUCTION TYPE VALUATION$ S
City License No. R
ZONE GRADING CU.YDS. ACRES Ping. Ref.# Parking Req./Provided E
LICENSED CONTRACTOR DECLARATION Q
I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: Planning Notes: M
with section 7000) of Division 3 of the Business and Professions Code, and T
my license is in full force and effect. $
License Class License No.
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
Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink
100, Lab. C.) Automatic Washer Transformer 0 15-50 KW
Policy No. _ Company Backflow Irrigation Sewer Cap / Construction Pole Sub. CD50+KW SO
8 Certified copy is hereby furnished.
Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Cooking Unit ' Meter Dap to 100 amps Ig ,SD
Date Applicant 1
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps
(This section need not be completed if the permit is for one hundred ($100) or -
less). Dishwasher 'Solar Piping Dryers ❑Gas ❑Electric Sub Panel
I certify that in the performance of the work for which this permit is issued I
shall not employ any person in any mann r s t becre subject to the Drinking Fountains Solar Tank Fan Motors 00-1 HP 011A-8 -
Workers' . •e sa 'on. Laws of Californi -
Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP 016-15+
NOTICE: I ,afte making this declaration,you should become subject to the —
Workers' ompensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures • Microwave
comply with such provisions Or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes .
I hereby affirm that there is a construction lending agency for the performance POI¢ Light
of the work for which this permit is issued (Section 3097 Civ. C.)
Interceptors Water Heater Outlets Range
Lender's Name
Lender's Address Kitchen Sink - Water Service Switches Sign -
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal Standing Sections
following reason (Section 7031.5 Business and Professional Code: Any city or
county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays Generator 00.5 KW 05-15 KW
any structure, prior to its issuance, also requires the applicant for such permit Trash Compactor •
to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains
the Contractor's License Law(Chapter 9(commencing with Section 7000) of 2 sva POLES- .-CD
Division 3 of the Business and Professions Code) or that he/she is exempt
ierefrom and the basis for the alleged exemption. Any violation of Section
)31.5 by any applicant for a permit subjects the applicant to a civil
enalty of not more than five hundred dollars($500). $ 3
❑
I. as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee �/(
compensation, will do the work,and the structure is not intended or offered - Reinspection Fee I $15 Issue Fee +/ j5 $y
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 m -
thereon, and who does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS:
Hood or Type provided that such improvements are not intended or offered for Boiler I 0
sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 Zoning Approved By Date
pletlon, the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground
wave for the purpose of sale). Building Approved By Date
1 1,as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Datfl�
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 of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT
0 I am exempt under Section ��� B. & P.C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers PLUMBING $ ISSUANCE $
Date 'f 1 Owner i1` $
PLAN CHECK 25%Heating System& Ducting Registers ENERGY P.C. $
I hereb certify that I have read this application and state that the above ❑G-100,000 BTU 0100,000 BTL. ,^
information is correct. I agree to comply with all city and county ordinances ELECTRICAL $ W e , CO GRADING $
and state laws relating to building construction, and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $
sentatives of this city to enter up n the above-mentioned property for //� 7T�
inspection purposes.�J MECHANICAL $ TOTAL FEE $ w SV
DSirivers' frF� - -- jqD,.te ��'/�� Reinspection Fee ( $15 Issue Fee $ 3 PLAN CHECK 25% $
Mk
Drivers' License or SS
. ,_CME0865_46,rev_70/84 White - building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor 01 00010556-00010556 TOT 63.50
- - IVsTC♦ fl9/09/00 TTMC. AO.40
•
CONSTRUCTION ANb'PLANNING r • POOL&SPA
,
APPROVALS Permit# Date Inspector Date Inspector
i. APPROVALS-. Permit# _
11 Temporary ElectricahService or Pole S_id 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. a 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 'a; 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. - 57. APPROVAL TO COVER-GUNITE
7. Footings r 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 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: f'
34. Final Heating & Air Conditioning '7
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38: Final Plumbing
39. Water Service-Final •
-40. Gas Service-Final •
41. Solar Domestic-Final
i
42. Backflow Preventer
43. Backflow Irrigation r "
•44.=Landscape Irrigation System. •• r
45. Sound Attenuation
46.,Handicap Regulations . -\
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY _
No. Date rM (.1., `I