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HomeMy WebLinkAbout2337 ELDEN AVE - Building Permits 1 21944 FEE. RECEIVED • OR 8 1984 COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT, P.O.BOX 917 COSTA MESA,CALIFORNIA CITY OF COSTA MESA For Applicant to Fill In Completely APPLICATION FOR' PERMIT TYPE OR PRINT BUILDING • • • 1 ✓✓✓ /7 • For Office`Use' Only - -- ( / BUILDING5 7 /'/J/ - /��� - I ADDRESS 7:. G 4:ie-f4/ �If- . �. RECEIPT NO. • 4IERMIT NO. COSTA MESA: CALIFORNIA""'•/ • - �• Ot/7 # / I�// / ��.�sr�� ` RREECyyJl�gpy/Y /O,IATER CEIV D. TE IB•UB '/ OWNER/Tl/J4t✓ ViY77 /L/� • J .!....:v. _1 IV-V/ iI OF `T �� T MAIL , / .�J L- ".. _ ADDRESS' 53l� J� �• i ADDRESS '°r 'l n. . //A�rppc : • ;-J .. ADDRESS // YYY»>•-C /,y/. 1 TEL'.: 9 �y FIRE • •�� ` CITY / `•Y( /PI' t<CL NO.O�J.2/.l7 ZONH I TYPB"• GROU-. .R - APPROVED /� ARCHITECT TEL -- BY //��. DATE (D //////QQQ,��, OR F"GINEER NO. - • ✓ jj� c NTNG QQQ4 Y ADL..-SS ZO� NO.or USE OP NEW h p � ��II PLANS 3/I BUILDING CONTRACTOR Ott I �7 DELESCRIPTION Lam-- a- 7 -ra) 3 o D ADDRESS l �q \ �t- A.P.NO. ' /1l Qi/r .1 I� CITY NOTE: NO EAVE OVERHANG SHALL BE LESS THAN STATE TEL. 30"TO SIDE It REAR P.L LIC.NO. NO. EAVES SIZE / / V r NOON LOGS. ./ ALLOWED (U.B.C.REQUIREMENT/ OF LOT 46 1 F an �l / NOW ON LOT 1 USE OF pp�� � `�l� ,�////�� �� ^� YARDS APPROVED YARDS APPROVED EXISTING BLDG. cekA.X- � .. W"t_4 MAIN BUILDING 1 ACCESSORY BUILDING (FROM C/L STREET)n . SETBACK LINE FROM 02 eke" / REAR YARD Act FRONT //OFT. /(!-E/i FT. CENTER OF STREET J y / SIDE YARD LEFT 07 I I RIGHT A° ••• R.SIDE /OFT. FT. V DESCRIPTION OF WORK L.SIDE `?7n. FT. NE`' ALTERATION ADDITION REAR /5 FT. FT. DISTANCE BET. BET.MAIN @ REPAIR MOVING X DEMOLISH MAIN BL//DGS.. ACCESS.SLOGS. BUILDING /. NO.OF VAR.#rl'-I/ DATE / SIZE � y 29 ROOMS :-, STORIES _C.U.P.# APPROVED `f'6 ICI EXTERIOR WA ROOF APPROVED /// COVERING A' C . I COVERING ///a''• M, BY •, I••ATI ' / ,i USE 99F�BUILDINGANq WORK TO BE ERFOR�MEnD Nene" VC'PI0c.(4� {Ce5 , mt.- , /�D✓� / h 0]ISPeK arLIAL�/. rREMENTS N SQ.FT. 1 ¢' 9�7/ R I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS OR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM• PURPOSE OF ESTABLISHING A PERMIT P E ONnLY._ PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION 4_ q BUILDING CONSTRUCTION. SIGNATURE OF �J PERMIT FEE 5/ m PERMITTEP 7lJ'rely�t E4/J/ , .".:707-'‘,P... JjJ/ $ tui -- PLAN CHECK $ ,P., 0 AUTHORIZED AG %T A �` ,di / TOTAL FEE ilt r. rtlet !; Fyt SPECIAL REQUIREMENTS:" (1) Dedication to the city of Costa Mesa of. all-land 50' from the center line of existing Elden Avenue. • _ ._ _ ..._ (2) Installation of residential sidewalks, with ,concrete driveway approaches, .by the applicant,. at his expense, as per .standard_ specifications of- the City of Costa Mesa. ' (3) - Completion within sixty days_ from date of *delivery., - (i-)' ; That applicant posts a $3000.00 bond with the City-of Costa Mesa. (5) That the existing shrubs in the front of this property be- cut down • tto meet the stpndard specifications ..of the City of Costa Mesa I , for fencing bra shrubs. .- �. ; .: _. . • t; . . ..... it' , '�•.. e . r Applicant to fill in all spaces except tho•erwithin heavy border lines and sign all appropriate declarations. CITY t A COSTA MESA CONSTRU TION PERMIT PEF�QIT N$o 200 f p D ,i. 7 UNIT NO. A P # l7c.39 _ 2 _ Zone / - I 7l 23 • Project Address - G N S Main Building: Accessory Building: Applicant's Mailing Address / ♦ 7 •F"r /e/ 620,26" van- TYPE OF CONSTRUCTION U NEW 0 ADD ALTERATION U REPAIR E Z ��tf/ �j,�V51/,� ❑ CONVERSION ❑ DEMOLISH III OTHER T Front' O Address Name E7 Phon r DE$CRIPJ�N O`J RK/USE OF G !�t ` b-aa fr I A Rear N Address C./ /� ❑ ✓ G ($ Arch/Eng. 1 License No. TYPE OF PERMIT GRADING FOUNDATION STRUCTURAL C Right N Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING 0 MECHANICAL S LeftR — G �•p� ( , / `/ v/- ❑ OTHER I Ping. Ref.# Parking Req./ProvidedJim..Contr actor's Name1�-f'd� �� �✓V Phone�T�-'��+ PROJECT DESCRIPTION SQ. FT. OCCUPANCYAddress Imailin I l77 ��I✓�ar�9C �• /�� 7� J_� Planning Notes:9 �JQ CON STRUCTION TYPEVALUATION$ I]City License NO. } �•3' �J ZONE G RADING•CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: COfcJCe 'Io7• 444s Cl,S4A.JGEt with section 7000) of Division 3 of the Business and Professions Code,and my license is in .t.rce and effect. eX 3 Ste 8-so O/3 Am° B- 4I/i ELECTRICAL FEES Licensees ass dense o� L !-' i is PLUMBING FEES Automatic Washer Transformer 0 15-50 KW Date Signet ur ���� 0 50+KW WORKERS' OMPENSATION D- re' . 10 Construction Pole Sub. hereby affirm that I have a cert Beate of consent to self-insure or a certificate Bar Sink Showers Workers' Compensation Insurance, or a cert ie co y thereof (Section Cooking Unit Meter ❑up to 100 amps y Backflow Preventer Service Sink Q Policy -00, Lab.No./fI 6 L.TS Compan- art-fBackflow Irrigation Sewer Cap ' Dishwasher Meter Dover 100 amps 7t(/ C-g V` Certified copy is hereby furnished. Dryers OGas ❑Electric Sub Panel "Catty' y is filed with th- ' • :rpm. psio . • Bathtubs Sewer Connection — Date co / A.• is ..i r. Fan Motors❑01 HP ❑i%-8 1 EXET‘.04- 1 ROM WORKERS'Cr- PE ' AT •N SECLARATION Clarifiers Solar Collectors (This section need not be completed if the permit is for one hundred ($100)or less). Dishwasher • Solar Piping F.A.U. Inc.Solar 09-15 HP ❑16-15+ I 1 certify that in the performance of the work for which this permit is Issued, IFixtures shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Microwave N. Workers' Compensation Laws of California. Date Signature Floor Drains Swimming Pool w/Spa Device Boxes Pole Light - NOTICE: If,after making this declaration,you should become subject to the ¢Outlets Ran Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal g 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 ich l r�mJ't �uetl faction 3097 Civ. C.) Garbage Disposal Standing Sections Lender's Name Up M..0.4/ f//fi Interceptors Water Heater Lender's Addreis Zr 'O U}��__ �y /y�/ / U Kitchen Sink Water Service _ Generator ❑O-5 KW CI 5-15 KW Trash Compactor • OWNER BUILDER ECCCA'x Ad.ION 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 -evision 3 of the Business and Professions Code) or that he/she is exempt • Reinspection Fee $15 Issue Fee $ 3 trefrom and the basis for the alleged exemption. Any violation of Section s 31.5 by any applicant for a permit subjects the applicant to a civil kenalty of not more than five hundred dollars($500). 3 DEVELOPMENT SERVICES REQUIREMENTS: LJReinspection Fee $ Zoning Approved By Date I, n owner of the the work,and my employeesctwith wages d or offeredf sole P $15 Issue Fee compensation,(Sectionec, will 0 work, the ProfessionaloIs not intended Contractor's for nse of ap ly to an and f aprCotle: uil mroves MECHANICAL FEES Building Approved By thereon,ereon Law does not apply to work owner himself/herself a property throughthbuilds s or Improves Date employees,andwho does such improvements or intended his or her own - Applifstion Issued By Det le. If, however, the that such or improvement are not wihior yeofar cred for Boiler Hood Canopy Type I 0 sale. If, hewbuilding thedof pro i g h She did one your of cpm- Type II 0 SU RY OF FEES plebe for the owner will have burden Of proving he/she not build or im- Duct-Under Ground rove the purpose of sale). RUI LDING PERMIT $ r � SMIP $ Oen) U I, as owner of the property, am exclusively contracting with llcensedton-- Duct-Structural Refrigeration System tractors to construct the project (Section 7044,Business and Professions Code: _ PLAN CHECK $ PERMIT The Contractor's License Law does not apply to an owner of property who Duct- Ventilating 00100,000 BTU 0100,000 BTU PLUMBING $ ISSUANCE $ builds or Improves thereon.and who contracts for such oroiects with a con- ENERGY P.C. $ tractor license pursuant to the contractor's License Law). I am aware that Exhaust System ❑ Multiple ❑ System Repair/Alteration I PLAN CHECK 25% $ proof off their Worker's Compensation insurance should be provided to me. ELECTRICAL $ GRADING $ IDI am exempt under Section - B.& P.C.for this reason Firepl/Fact.BIt. ICBG# Fire Dampers t PLAN CHECK 50% $ MICROFILM $ Date Owner Heating System& Ducting Registers MECHANICAL $ TOTAL FEE $ 8.57 /S I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000 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- sentativ t star non he pro erty for insp reo /r above-mentionedjP -7 01 00042912400429141 TOT i5,(� Signature ` Dat i 7 s Reinspection Fee $15 Issue Fee $ 3 DATE; 09/19/S9 TINE Drivers' L' ense or 55 16:12 0865-46,rev. 5/88 -Applicant; Pink - Accounting; Goldenrod - Assessor ' CONSTRUCTION AND PLANNING POC 3PA 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 .51 7ttt cl/ B0/e"'- 58. Electrical Conduit-Undrgrnd. 8. Foundation ��• 59. •Gas Pipe, O Undrgrnd.,Test ' , 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap,O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap - 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing ' 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16: Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough'Electrical-T Bar Ceiling • 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating& Air Conditioriing FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace . I APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro t 22: Ducts, Ventilating ;' 71. Product Piping LI Gas ❑Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing r • 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 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 GG(„/Y1 48. Special Requirements Completed ( UU 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date TRACT NO. LOT NO. UNIT N T ER Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. -- PM NO. O. ciTvaFCOSTAMESA CONSTRUCTION PERMIT 134 13 300 al _ A.P.# 3q.. - 2,3 zone IR 2_,; • Project Address - �-• •� l ' S Main Building: Accessory Building; Applicant's Mailin Address /77 t 1� /uen49tr I/� TYPE OF CONSTRUCTION ,cam+ NEW LI ADD ❑ ALTERATION U REPAIR E / - Z ��`` q ❑ CONVERSION 0 DE OLISH 0 OTHER ' T Front 0 Owner's Name ��Qf+✓ P onM`/-"g 71),- B i N ' DESCR IPTI• a yy'pRl�/USE,OF BLD . ��� G�j.L, I Rear 75 LAN A I I Address r s� - GRADING r FOUNDATION �� STRUCTURAL ' C Right + 2�� N Arch/Eng. _ License No. TYPE OF PERMIT Leftj, Address ,-, �/� /� / �1 0 TENANT 0 ELECTRICAL 0 PLUMBING 0 MECHANICAL $ 5' 'TV resp R Contractor's Name ( E fl ,4*2OL✓2 Phonet 9�-rl'� 0 OTHER 'Ping. Ref.# Parking Req./Provided E 7`� 1 ,p PROJECT DESCRIPTION SO. FT. OCCUPANCY i� 0 Address(mailing) ��7 .F I flar1 /2TIA6 DA�` /J Planning Notes: lO V. at M qq� 1q '1 /"'(� CONSTRUCTION TYPE VALUATION $ 37j aro � .I- .n City License No. O2 e'tO -72 ?�O'� ZONE GRADING CU.YDS. ACRES_ rOWs-t�� W7t�.C.� (IP t J T LICENSED CONTRACTOR DECLARATION n y S I hereby affirm that I am licensed under-provisions of Charter 9 (commencing Remarks: " 0 N,. _ ��I with section 7000) of Division 3 of the Business and Professions Code, and s-^�`s my license is in fug force and effect. /1 ELECTRICAL FEES License Ci Sc - — _ License No7 c - Date •�' - Signature _ �— PLUMBING I FEES Automatic Washer Transformer 0 15.50 KW e - - ❑ 50+ KW WO- RS CO " NSATION D CLARAT •N Construction Pole Sub. ' i hereby affirm that I have a certificate of consent to self-Insure or a certificate Bar Sink ShOwefs S/ Workers' Compensation Insurance, or a cert' sed copy thereof ( action Cooking Unit Meter Opp to 100 amps 3800, Lab.„p � �/ Backflow Preventer Service Sink Policy No. /�7 //� $f Company ^^ / Backflow Irrigation Sewer Cap Dishwasher Meter Dover 100 amps Certified copy is hereby furnished, Dryers ❑Gas ❑Electric Sub Panel Certified copy is filed with the city Building Division. Bathtubs Sewer Connection to Applicant - Fan Motors 00-1 HP ❑i X-8 EXEMPTION F ROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors (This section need not be completed if the permit is for one hundred ($100) or kA.U. Inc.Solar 09-15 HP 016-15+ less). Dishwasher Solar Piping I certify that in the performance Of the work for which this permit Is Issued I - Fi turas Microwave shall not employ any person In any manner so'as to become subject to the Drinking Fountains Solar Tank I _ Workers' Compensation Laws of California: -'v e Boxes Pole Li ht Date Signature Floor Drains Swimming Pool w/Spa r - \ - - 9 NOTICE: If,after making this declaration,you should become subject to the OUtI¢ Ran e Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal ,t 9 Comply with such provisions or this permit shall be deemed revoked. \ CONSTRUCTION LENDING AGENCY • ._. ! Switch:. Sign Gas Service Outlets' Water � ' I hereby a form that there is a construction lending agency for theperformanceCl v. illit ,\ Ga +••• is oral StandingSections of the work fory�Ich this r It 1 sygp�(5e<llon 3097 Clv. C.) Interceptors ' at:, e. er g p _ Lender's Name �N/`' p L" �� ILender's Address ` '7',3 1JJ, 1211 f �. Kitchen Sink j `i _ erator ❑0.5 KW ❑5.15 KW Trash Compactor — OWNER BUILDER'DeCLARATIO N x I hereby affirm that I am exempt from the Contractor's License Law for the' • Lavatories Au O-1 n 4 i ifollowing reason (Section 7031.5 Business and Professional-Code: Any city or . p .y - _ —_ county which requires a permit to construct,alter,Improve,demolish or repair ' P—Trap Lauty Trays n (9 �' �Ov any structure, prior to its Issuance, also requires the apPlIcantd 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 -11‘ /y Division 3 of the Business and Professions Code) or that he/she Is exempt \" �„'/�t� 't� Reinspection Fee $15 Issue Fee $ 3 therefrom and the basis for the alleged exemption. Any violation of Section S ji 7031.5 by any applicant for a permit subjects the applicant to a civil ' penalty of not more than five hundred dollars($500). $ •3 Zoning Approved By DEVELOPMENT SERVICES REQUIREMENTS: /1 O I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee n r Data /9,S 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 +I 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 Hood or Type I 0 1 Application Issued By Dat —'' 85 employees, provided that such improvements are not intended Or offered for BoileryP • sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 -' SUMMARY OF FEES pietlon, 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 $ t;c2 SMIP $ OW ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK $ Linqr 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 ❑0-100,0_0_0 BTU 0100,000 BTU PLUMBING $ ISSUANCE $ builds or improves thereon.and Who contracts for such oroiects 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 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 Firepi/Fact.BIt. ICBG* Fire Dampers I: ti Heating PLAN CHECK 50% $ MICROFILM $ in Registersr Date Owner S Ystem& Ducting MECHANICAL $ TOTAL FEE $ tngC" 1 hereby certify that I have reap this application and state that the above 00100,000 BTU 0100,00087E 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 thisiscititto enter Pon the above-mentioned pro erty for inspectloSignature � HATE. GC' 'i r' : •71 0865-46,rev. 5/88 White - BUiltling; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor 7 i • CONSTRUCTION AND PLANNING POOL& SPA Date Inspector Date Inspector .1 APPROVALS Permit# A . APPROVALS Permit# i ' 1. Temporary Electrical Service or Pole• , 52. Pool & Equipment Location - r x- 2. Soil Pipe-Undrgrnd. ir. 53. Steel Reinforcement 3: Electrical Conduitlytility-Undrgrnd. 54. Forms !/1 4. ElectricalrConduittUndrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test J 6.. Electrical UFER Grnd. -,1 • / - 57. APPROVAL TO COVER-GUNITE . 7--Footings t, ‘r •J( ' r i/�1e p� 58. Electrical Conduit-Undrgrnd. 8: Foundation ll 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 t- .r 13. Roof Drains 64. Plumbing System - Final i 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 Haating & 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 241 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 37. Frame and Flashing 76. Dry Standpipe 28. Lathing&'Siding 77. FIXED SYSTEM,FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing 1 - HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes:.VO2tj per;_cour olL- 34. Final Heating& Air Conditioning 35. Final Gas Pipe-Test - -36. Hood or Canopy C 317. Final FactbryiFireplacel 38. Final•Plurnbing ._ ' '39. Water Service,Final 1-:40. Gas Service-Final ) 741. Solar Domestic-Final- ,42. Backflow Preventer - 43. Backflow Irrigation - i 44. Landscape Irrigation System 45. Sound Attenuation. , -7 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirement's•Completed 1 49. Electric Release to Edison 1 ::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. .. PE����vvvv1111IT NO. TRACT NO. LOT NO. UNIT NO. C1TYTOFCOSTA ESA CON TRU/CTIyONPERMIT �Ay/�7� 11 A.P. Zone 9 Project Address�� �®L7N y✓G• n `� 1 1 a/1 S Main Building: Accessory Building: - Applicant's MallinAddress /77 f7• RieV�ribr 4e pi/ TYPE OF CONSTRUCTION X NEW U ADD U ALTERATION U REPAI R E z ..• El CONVERSION ❑ DEMOLISH CI OTHER ' T Front o Owner's Name ONE[-f `ce U:N/v PhonelLT_r�_LLZ DES IP IODLO WORK/USE OF BLDG. if OAD F6Nrc 6 h •' B Rear N Address .A2.q•! Mc.07,UF.P /C.ONF if, e -4 A I Arch/Eng. CO? License No. TYPE OF PERMIT L I GRADING U FOUNDATION STRUCTURAL I C Right • G Address ❑ TENANT ❑ ELECTRICAL 0 PLUMBING ❑ MECHANICAL S Left R Contractor's Name Phone ❑ OTHER M-( Ping. Ref.# Parking Req./Provided E Address(mailing) �/� PROJECT DESCRIPTION SQ. FT. OCCUPANCY tst- -Q M CON ST RUCTION TYPE �• VALUATION$ ,5 PlanningNotes: T City License No. ZONE GRADING CU.YDS. ACRES S. LICENSED CONTRACTOR DECLARATION I hereby i m that I am licensed under provisions of Charter 9 (commencing Remarks: with section of Division 3 of the Business and Professions Code, and my license is in full fo effect. ELECTRICAL FEES License Class License No. Date Signature PLUMBING I •FEES Automatic Washer Transformer 0 15.50 KW 0 WORKERS'COMPENSATION DECLARA ION Ba!Sink Showers Construction Pole Sub. 0 50+ KW 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 CookingUnit Meter Cupto 100 amps �0, Lab. C. Backflow Preventer Service Sink ' P 7 // -a�7r �„ olicy No. __r_-s__r____,_ _ompany�jATi� F1J,.✓O Backflow Irrigation Sewer Cap Dishwasher Meter ❑over 100 amps \. Certified copy is hereby furnished. Dryers ❑Gas DElectric - Sub Panel - C¢ftlfi¢tl copy is filed with the cit a ?Iviil00. Bathtubs Sewer Connection ateS/C t APPii .ht Fan Motors❑0.1 HP ❑1'6-8 EXE TIO FROM WORKERS'C•MP SA /•N • - LARATION Clarifiers Solar Collectors (This section need not be completed if the perm t is for one hundred($100)or Dishwasher F.A.U. Inc.Solar 09.15 HP ❑16-15+ I less). Solar Piping I certify that in the performance of the work for which this permit Is issued, I ill Fixture$shall not employ any person in any manner so as to become subject to te Drinking Fountains Solar Tank Mc.SolWorkers' Compensation Laws of California.Date Signature Floor Drains Swimming Pool w/Spa DeviceBoxes '• e Light NOTICE:If,after making this declaration, you should become subject to the Workers' Compensation provisions of the labor Code, you must forthwith Floor Sinks al ;J� •�� Outlets Range comply with such ENDiING or this permit Shall be tleemed rOvokOd. , CONSTRUCTION LENDING AGENCU Ges Service Outlet$ ' Watef ClOsgc'„_ j. } 1 . Sign I hereby aform that thero ii a is p rmit se issue (S c for the 97rfCiv. nCO of lha work for which this pormit Is issuetl (Section 3097 Clv. CJ `,•'b � �arbage Disposal Standing Sections Lender's Name Inter[eptors �� W�atfsater t � r Lender's Address Kitchen Sink sWater ... a L�iNGenerator ❑0.5 KW 05-15 KW Trash Compactor 1111 following OWNER BUILDER DECLARATION r' I t/ I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-W*5 , r following reason (Section 7031.5 Business and Professional Code: Any city or !1' }} C i r county which requires a permit to construct,alter,Improve,demolish or repair P-Trap S zLau0ory 'rays •' \ P / -, any structure, prior to its issuance, also requires the applicant for such permit cad' I t 1 nn . 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 pp Division 3 of the Business and Professions Code) or that he/she is exempt -1 �.+ Reinspection Fee $15 Issue Fee $ 3 -efrOm and the basis for the alleged exemption. Any violation of Section �S L5 by any applicant for a permit subjects the applicant to a civil ��- ,>'/ M1V�I i ' .Ity of not more than five hundred dollars($500)- t^ DEVELOPMENT SERVICES REQUIREMENTS: �!a I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 \Q:"ssue Fee $ 3 Zoning Approved By Date compensation, will do the work,and the structure is not Intended or offered ..4°. 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 u thereon, and who does such work himself/herself or through his or her own Application Issued By Date /l 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 O FE 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). BUILDING PERMIT $ S�• 00 •SMIP $ _5,, ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration S Stem 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 00-100,01: BTU 0100,000 BTU • PLUMBING $ ISSUANCE $ builds or improves thereon.and who contracts for such oroiects with a con- ENERGY P.C. $ tractor(s) license pursuant to me contractor's License Law). I am aware that Exhaust System 0 Multiple❑ • Repair/Alteration PLAN CHECK 25% $ 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. ICBG* Ire Dampers MICROFILM $ PLAN CHECK 50% $ Date Owner Heating System : Ducting PrRegistersMECHANICAL $ 1 hereby certify that I have read this application and state that the above 00-100,000 0100,000 s TOTAL FEE $ S�/7 S� _ information is correct. I agree to comply with all city and county ordinances PLAN CHECK 25% $ and state laws relating to building construction, and hereby authorize repre- sentatives of , y to enter upon the above-mentioned proper y for I IOu• pOSC Pink -Accounting; Goldenrod - Assessor CA TE: 09/13/E9 TIM: 42..1./ ''CONSTRUCTION AND PLANNING { POOI :PA APPROVALS Permit#, Date Inspector APPROVALS Permit# Date Inspector I 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 I 56. Rough Plumbing & Pressure Test 6. 'Electrical UF ER Grnd. v ,, 57. APPROVAL TO COVER-GUNITE 7C Footings \ 58. Electrical Conduit-Undrgrnd. V 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. • 10. Structural Floor System - r 61. APPROVAL TO DECK 1 C'Pr'operty Sewer Line & House Connection 62. Backwash & Receptor-Final - 12'.'Sewer Cap • 63. Heater & Vent-Final .i 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final (1;6. Rough Electric Wiring 67. Fencing & Access Approval 1,7_Rough.,Wiring Sign 68. APPROVED FOR PLASTERING 18t Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL d9. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough'Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure - 70. Underground Hydro 22._Ducts, Ventilating j.J 71. Product Piping 0 Gas 0 Oil - 23. Gas Pipe-Rough & Test 721 Underground Flush ` • 24. Roof Framing 73. Undergrnd.Storage Tank 0Gas 0Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar'Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing&'Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing U HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat I) • 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric .. Notes: /�f/LII to �r �.�1 PA/arc/an- 7 34. Final Heating& Air Conditioning /"� 447 C. r , 9 (ileyne 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 `;" iu 50. Gas Release to Southern California Gas Co -< 51. CERTIFICATE OF OCCUPANCY �' No. Date V' C/ I PROJECT ADDRESS: 2337 ELDEN AV UNIT: A CITY OF COSTA MESA — BUILDING PERMITPERM NO: M047858 - OWNEWS.NAME: RODNEY BROW ADDRESS: SjyMrE AS ABOVE PERMIT NO: M 047858 PLAN CHECK NO: • N GOVT: N SUPP : N . CONSTRUCTION TYPE: PERMIT TYPE: MEC PURPOSE: OTH 714/642-3812 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : A/C ADDITION TO EXISTING BUILDING / SQ FT: ADDRESS: - UNIT: • CLAIM VALUE: CALC—VALUE: • GROUP OCC : . / PERMITTEE: GRAHAM BROTHERS ( 714 ) 546-1653 ' ADDRESS: 2952 CENTURY COMMENTS : COSTA MESA CA 92626 ***** ********** ************** **dr****+t*x******+ * **N*****x***aEib+r*drdr*** ***** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ON ING R EQUIR E M ,E N TS 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. SETBACK S . caTYuc.: 05963el STATE uc.:2486D CLASS: C-20 `s Date: 1. 2• 0 §ignatu CS ear MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby a Ir a—have a certificate of consent to self-insure or a certificate of 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 IN LEFT: FT IN RGHT: FT IN %UCYNO.: WC2161030226018 mum: 08 /01 /90 • DMPANY: LIDERTY PARKING REQ: PROV: PARCEL : 43927123 ZNE: REF NO: ' • J Certified copy is hereby furnished, ® Certified copy the city Building ion. PLANNING NOTES> a 1 > Date: el •2 1 \O Mplicanc Ik ***** *******************************iE***************************************** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(5100)or less). DEVELOPMENT SER .-VICES REQUIREMENTS • I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California. , ZONING APPROVED BY DATE: - Date: Signature: BUILDING APPROVED BY : .DATE: - ode,NOTICE:It,after maldng this declaration,wiyouhshould become subjectemithe Workers' revoked. Compensation provisions of the Labor Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY• '. DATE: O ^9 which this permit is issued(Section 3097,Civ.C). ********************************************* *********************** ******** LENDER: ******************************************************************************* ADDRESS: LEGALIZATION :N F E E SUMMARY STRUCTURAL SEGMENT:N • • OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the fallowing reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 9,00 repair any structure,prior to Its Issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed •• 25% SM I P/NON—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN ' 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). ISSUE FEE 15 . 00 I, •as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID .DUE I tructure is not intended or offered for sate(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS————> 9 . 00 15 . 0 0 0 . 00 24 , 00 24 . 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.It,however the building or REVENUE DIVISION TOTALS--> COLLECTED: 24 , 00 OVER/SHORT• 00 improvement ose of sold e)hin one year of completion,the owner will have the burden of proving he/she did not build or Improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK for the purpose of sale). I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 24 . 00 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects vith a contractor(s)license pursuant to the Contractors'State License Law).l am aware *'*NNN'*' *fie*'N'**i('MMM*Mfit**iE'1E'N'**i!*M-SSM*1('MSS*'SE 3f'N'*'*N'*'****'YE*'N1E**N'*'N'*'N'NN'****************** that proof of their Worker's Compens,Eion insurance should be provided to me. IND IV IDUAL F E E B REAKD OWN ❑ I am exempt under Section: B.8 P.C. for this reason: I TYPE QTY DESCRIPTION . UNIT COST TOTAL COST Date: • Owner: MEC 1 REPAIR/ALT COOLING UNIT/SYS W/CNTLS 9 . 00 9 . 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 Quality Management Distdct.Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is correct.I.•ree i imply with all city and county • ordinances and state laws relating to building construction and hereby authorize representatives oft - h 0 r upon the above-mentioned Date: for inspection purposes. 6r c e Date: ` T•" Signature: Driver's License or Social Security Applicant;Pink—Revenue;Goldenrod—Assessor 01 DRTE: 07/10/900607/E0l90 TTIRE:InE T5_5" 11:2D0 2¢,00 v ... r • CONSTRUCTION AND PLANNING' F & SPA APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector I • 1. Temporary Electrical Service or Pole - 52. Pool & Equipment Location • 2. 'Soil Pipe-Undrgrnd. 53. Steel Reinforcement at/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, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System' r 1 - 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 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 / 7it,/�c (r 35. Final Gas Pipe-Test y 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumping .' 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. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co • 51. CERTIFICATE OF OCCUPANCY No. Date 1 City of Costa Mesa Development Services Department r�. y Building Safety Division C E R T I-F K A T E OF OCCUPANCY No. Otr 12 t P.O.Box 1200 Costa Mesa.California The Building located at 2337 Elden Avenue. Units A•Kir . has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group R1/Ml Occupancy. Use of Building Anartmenta Legal Description 439-271-23 (See reverse side for Metes and Bounds) • Building Permit Nonannll •ncc9A.1Q Electrical Permit No. F An761 Plumbing Permit No.tom fin onnngl_ Mechanical Permit No. M45379, M45642 Number of apartments 3 and/or guest rooms Fire Prevention Permit No. F 45539 .\ • ISSUED TO: Building Official Tony C'De Baca Rnrinnv Brnwn -2 \ 177 Riverside Dr., Ste. F by '_per Newnnrt Roach. CA 92B60 • Date Aoril 26, 1990 This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the _ • Building Official of the City of Costa Mesa under Sec. 307 lel U.B.C. CMF 1015-46 rev.1/63 White-Owner;Canary-Numerical File;Pink-Bldg.Permit File a 1 .- Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. - MI NO. TRACT NO. LOT NO. UNIT NO. CITY Oi COSTA MESA CONSTRUCTION PERAMIT! A-6-c- Ob 1 1 �� �•' A 6 C A.P.# 43/4-2:7( — 23 Zone g,2._ Project Address ,297 �Gp6�) AUE - S Main Building: Accessory Building: Applicant's • dress // •F` 77/./ 0,r/ph it TYPE OF CONSTRUCTION KNEW U ADD U ALTERATION LJ REPAIR E Z qqq �f ❑ CONVERSION ❑ DEMOLISH ❑ OTHER NGf✓ 7- 3 ]-or , T Front 0 Owner's Nam ePZlq 3�.� y7 101 B /'�'7 " • N ,U l/ �'Y 0' DESCRIPTION OF WORK/USE OF BLDG.Ts'ftT +, a !+ 4 Rear '`}J� }� �D �(�Jl mss,(, 'S I Address/����F p .3 et At •C 3 K Ipet 14f C Right N Arch/Eng. License No. TYPE OF PER GRADING ❑ FOUNDATION STRUCTURAL RAL - G Address ❑ TENANT 0 ELECTRICAL 0 PLUMBING ❑ MECHANICAL S Left 37 R ��S . 13- ❑ OTHER }\Ato, • . , 47 _ �p I Ping. Ref.# / / - ! • - Parking Req./Provided ts/(y• E Address Contractor's Nam ho O� - Q / /'I /� �j! PROJECT DESCRIPTION SQ. FT. t+`•Ar OCCUPANCY Planningid Notes: /� .{.s� t �1�. Address lnseN . ~� Ll�32. 3�(/�7C'Ca ��- - 'CONSTRUCTION TYPE is-Al VALUATION$ L / 1 -L /`�-'s+ �� �''bt i\&Ll�A /)� /1 �� l�Yl"` S/l M City License No. 4C711144,-,4-0 L Set ZONE' GRADING CU.YDS. ACRES `�QM e‘.2 W ^\.I.W�.e- i-Is71 �itll so�rVlr7l�SYl �l7ylL&a S. LICENSED p CONTRACTOR DECLARATION t Tn•� EIOLD FdR SPECIAL. RFn►mrF 1d� 1 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 my license is in full force aria -//act. & e2 ���. I s � 2 /Q) ^ A ELECTRICAL FEES License C "ss _ . ir' • `•_` Li en e j � 7� Date Signa . e _0 • PLUMBING FEES Automatic Washer Transformer 0 15-50 KW WO' ERS' OM`ENSATION • CLA- • 10 • Bar Sink $hOWer$ GOn$trUCtlpn Pole Sub. ❑ 50+ KW • I hereby affirm that I have a certificate of consent to self-insure or a certificate CookingUnit Meter ❑u to 100 amps Workers' Compensation Insurance, or a certified copy thereof (SectionPP 30, Lab. / r L �1 Backflow Preventer Service Sink Policy No.4 ,�7Gl/-. ?7.-Coinpanyrnr ���V/ Backf low Irrigation Sewer Cap Dishwasher Meter Dover 100 amps 9 Cert ifi tl copy is neretiy:furnishep: - - Dryers ❑Gas ❑Electric Sub Panel ti p d with.the ' •ivi io• Bathtubs Sewer-Connection �q • Motors❑0-1 HP ❑1'h-8 Dat O App!can n� Fan EXEMPTION ROM WORKERS' d �EN T.1•N DECLARATION Clarifiers Solar•Collectors - _ (This section need not be completed If the pe midis for one hundred ($100) or ', F.A.U. Inc.Solar'❑9.15 HP ❑16-15+ less). .�; Dishwasher - Solar Piping 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'manher so as to become subject to the Drinking Fountains Solar Tank Workers' Compensation Laws of California. Device Boxes Date "'Signature/ - • Floor Drains Swimming Pool w/Spa Pole Light NOTICE: If,after making this declaration, you shoulb 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 AGENCYGas Service Outlets Water Closet Switches Sign I hereby affirm that there is a construction lending agency for the performance of the work for ich s per It 's ie... (Sec '•n3097 Civ. C.) Interceptors Water Heater Garbage Disposal Standing Sections Lender's Name /thi • ` • n Lender's Address _ Generator 00-5 KW 05-15 KW Trash Compactor --// 'A-A o 9. �r' . , _..� OWNER BUILDEREE 'AION ' Kitchen Sink Water Service 1 I hereby affirm that I am exempt from the Contractor's License Law fortheLavatories 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 ,erefrom and the basis for the alleged exemption. Any violation of Section )31.5 by any applicant for a permit subjects the applicant to a civil enalty of not more than five hundred dollars($500). $ 3 DEVELOPMENT SERVICES REQUIREMENTS: �] ❑ I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee g' 5- g-/ compensation, will do the work,and the structure is not intended or offered Zoning Approved By y�� + Date for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL LFEES Building Approved By 1:7>\ Date -Z S"-- 85 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 s'�Application Issued By et Date -c —65 Hood or Type provided that such improvements are not intended or offered for Boiler I ❑ sale. If, however, the building or Improvement Is sold within one year of tom- Canopy Type II 0 - SUMMARY OF FEES pletl!n, the owner will have the burden of proving he/she did not build or im- Duct-Under GroundQ•�?6,prove for the purpose of sale). BUILDING PERMIT $ 1, tga•SD SMIP $ O I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK $ i oq. 7/ 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 $ builfiS or imoroves thereon. and who contracts for such oroiects with a con- - ENERGY P.C. $ tractors) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration I PLAN CHECK 25% $ proof o/ 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. ICBG# Fire Dampers MICROFILM $ PLAN CHECK 50% $ Date Owner Heating System& Ducting Registers MECHANICALSalo. 77 I hereby certify that I have read this application and state that the above ❑0-100,000 BTU 0100,000 BTU $ TOTAL FEE $ r information is correct. I agree to comply with all city and county ordinances PLAN CHECK 25% $ and state laws relating to building construction,and hereby auth rize r pre- sentatives • •to enter upon the above-mentioned p pert for ! - Signatur- .. - - Oat g7 / Driver License or Pink -Accounting; Goldenrod - Assessor s DA ) rl1-`,./E4 .1 iti( 11135 CONSTRUCTION AND PLANNING 1. POOI :PA >/ Date Inspector I Date Inspector' • • APPROVALS Permit# •�- APPROVALS Permit# I JI 1. Temporary Electrical Service or Pole' r, �l . 52. Pool & Equipment Location r 2. Soil Pipe-Undrgrnd.p53. Steel Reinforcement z1111 / W !/I / I IA /, - t t , , , V Lo Il.Z1 3./Electrical Conduit Utility-Undrgrnd. /1 1� A 54. Farms 4.;Elecjiicalk6ondu'i drgrnd. s� y�y, L 55. EIE�tfical Bonding Y_ A, rC i-YJ n 5l/Steel Rei force-raki, '�1z r 56. ou h Plumbing & Pressure Test / fiElectt cal UFER•Grnd9 " q) 7 7 577 QPP OVAL TOCOVER-GUNITE / .\ rr.• n J o _ 1/' ;i115/1;'I / V' I. i .' v .vV{� r p r / I 7. Footings/ �f 17 9/i1 / , 58. Electrical Conduit-Undrgrnd.MI ( .�• 8!Foundatron 0' ids j 59. s-Pipe, 0 Undrgrnd.,Test .lj 94/ater Pipe-Undrgrnd. Y 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. St ctural Floor Sy77 stem• l/5 r 61. APPROVAL TO DECK •/ -) ii.. . /J / X^ , 116P�ope y Sewer Line &-House Connection { 62. Backwash & Receptor-Final Y/ 12TSewaer•Cap %;c • t y i 63. Heater & Vent-Final X1.3: Rcyf Drains pS/ ' %J/ / 64.. Plumbing System - Final t '4. Rouge Plumbir� 0o 65. Electrical-Final 15. Ro�g� ca' ElectriNConduit 66. Solar System-Final 1.16. Rough Electric Wiring ' 67. Fencing & Access Approval • -1.7: Roughiring Sign 68. APPROVED FOR PLASTERING • ' ' - IA18. Rough Electrical-T Bar Ceilingd1- 69. POOL/SPA SYSTEMS FINAL ' 19.Li Rough eating & Air Conditioning FIRE DEPT. REQUIREMENT • 20. Rough Factory Fireplace- APPROVALS Permit# - n -. 21. Ducts, in•Struct re 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil -yrr 23.rGas Pipe-RougI t T�t V7 72. Underground Flush • 24. Roof Framing 14t ^ 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. RoofjSheathingg 1 zfg(e &t N• 74. Overhead Hydro 26. T-BarCeiling (Situctural) & M ocoat 75. Dry Chemical • - 277t Fran' and Flashing 76. rDry Standpipe . 28: Latpingl8)Siding /�7_96 p 77. FIXED SYSTEM FINAL 29. In ulaii/on -� �"T 78. FIRE PREV. FINAL 49 30. yw Drall Nailing 64, / HEALTH DEPT. REQUIREMENT 3? PI ter Brown Coat;Ni 79. FINAL INSPECTION -T 32. Electfical Power ...-•- er-Final 80. FOOD CERTIFICATE ISSUED • > .. 33. Final Electrics Notes: ��//�G ���� �� 34. Final Heating & Air Conditioning - t .>: 35. Final Gas Pipe-Test `,1) O i - m , ( 36. Hood or Canopy •f• r1 ul 37. FiLal.Factory/f}ryplaceer r' na •u 38. Final••PI`m)binae'ca 4c 739. Water Service-Final(i) no . • (40. Gas Service-Final' 2 1 r. i '' r X41. Solar..- ; , '4" - 42. Backflow Preventer-1 T- - U `. 43. Backflow Irrigation _, . i 44. Landscape'irrigation System ' . %, • 45. Sound'Attenuation , - 46. Handicap Regulations- . 47. FINAL STRUCTURE &BUILDING 00C (AL 48. Special Requirements Completed7-ay-OD MC1p 49. Electric Release to Edison • ' ' .- • .- 50. Gas Release to Souttfiern California Gas Co p.• 3- 1( . 4 - _ '51. CERTIFICATE OF OCCUPANCY 'Y ' C ' No. Date • "1 V r i/ _ Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. , CITY OF COSTA MESA CONSTRUCTION PERMIT/A/ Y PERMIT NO. �� TRACT NO. .LOT NO. UNIT NO.B • Project Address ? �3 ICLr-Qf� ALi�. /t FS 3J - • 4-e, 'Applicant's Mailing'Address /?7°F"Tdl//iefer/p E. Die TYPE OF CONSTRUCTION U NEW U ADD U ALTERATION LJREPAIR. Owner's Name �f)DA.Ify F or.J.J Phonr +�9 2'? Z ❑ CONVERSION DEMOLISH CI OTHER A.P.4 - - Zone SHE DES TION OF WORK/USSF B . • Address •S' t S Main Building: • Accessory Building: E Z Arch/Eng. License No. TYPE OF ERMIT - GRADING CI FOUNDATION CI STRUCTURAL T Front - D Address - r —� ❑ TENANT El ELECTRICAL CI PLUMBING CI MECHANICAL B Rear N Contractor's Name if. yore- f F<>/,/i Aft/iveYhone +11.*X°0 El OTHER — • A _ I Address(mailing) as _r Ay - $ r/ < PROJECT DESCRIPTION SCI. —� •CCUPANCY eo C Right N CityLicense No. .e� ` CONSTRUCTION TYPE_ VALUATIONS DOd •— S Left ' • . • _ 0 U n LK/ f S-J VJf - R ZONE GRADING CV.YDS. ACRES Ping. •Ref. # Perking 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 - my license is in f I force and effect. T License ass ' . - icense o% . . r ' ' - $ Date " ; Signatures PLUMBING • - FEES • Iv WOR ERS' COMPENSATION DECLARATION Bar Sink Showers ^, I hereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL, FEES Vk of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service S'nk • Automatic Washer Transformer ❑ 15-50 KW • \i 3600, Lab. CJ / _ M Policy No. �'7+� �/ "may Com panV.�O Backflow Irrigation / ewer , �O� Constructio• n Pole Sub. 0 50+ KW rU .❑ Certified copy is hereby furnished. CAA, )(] Certi 'ed cop' • /ll`filed with the cit �,;, inion, Bathtubs - Sewer Connection • Cooking Unit Meter Cup to 100 amps EXEMPTIO FROM WORKERS'C•MPENSATION D CLARATION( Clarifiers Solar Collectors _ Dishwasher Meter ❑Over 100 amps (This section need not pe completed if the permit is for one hundred ($100)or - - - - Iess). 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 te Drinking Fountains Solar Tank - • Fan Motors❑0-1 HP 01'14-8 Workers' Compensation Laws of California, — - __ Date Signature Floor Drains Swimming Pool w/Spa F..A.U: • NOTICE: If,after mak• ing 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 comply with such provisions or this permit shall be deemed revoked. Fixtures Microwave CONSTRUCTION LENDING AGENCY 'Gas Service Outlets Water Closet "Boxes r„- Pole - I hereby affirm that there is a construction tending agency for the performance of the work forlig eh� r�t i sue ction 3097 Civ. C.) Interceptors Water Heater Outlets -R Lender's Name Name SS !! /N9lC __ _— Lender's Address p..-r2--• P. Kitchen Sink Water Service - -- OWNER BUILDER DECLARATION Switches ' Sign I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal;' • Standing Sections following reason (Section 7031.5 Business and Professional Code: Any city or - county which req uires:a-permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays Generator ❑0.5 KW ❑5-15 KW any structure, prior twits 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 ,-.a • ' Division 3 of the B einess 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(S500). ' 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 Reinspection Fee $15 Issue Fee $ 3 erese Law does not apply to o owner f a property who builds s or Improves wn __ _ __ _ FEES thereon, and who does such work himself/herselfror through ntende his or her own - DEVELOPMENT SERVICES REQUIREMENTS: • le. If:employees, provided that such improvements imrvemare not intended or year of dc for Boiler Hood ano or Type I 0 motion, In,however,hewnthe building improvement of pro isg within one Yeur d rim- Canopy Type II ❑ Zoning Approved By Date plebs n, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground - _ Building Approved By Date prove for the purpose of sale). - ❑ I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System • Application Issued By . Date—W 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 • 00-1 D,000 BTU 0100,000 BTU SUMMARY OF ES 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 thatExhaust •System ❑ Multiple❑ Ystem Repair/Alteration • BUILDING PERMIT $ - C ••00 SMIP - $ . S-0• proof of their Worker's Compensation Insurance should be provided to me. PLAN CHECK $ PERMIT 0 l am exempt under Section -- B.& P.C.for this reason Firepl/Fact.Blt. ICBG 4 Fire Dampers • PLUMBING $ V. 00 ISSUANCE $ • Date Owner Heating System& Ducting Registers ENERGY P.C. $ - PLAN CHECK 25% $ .1 hereby certify that I have read this application and state that the above ❑0100,000 BTU ❑100,000 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 repro- MICROFILM $ sentry.•:• ,�d�+� to ent-r •.n the above-mentioned pr arty for PLAN CHECK 50% $ inspection p. �• 7 MECHANICAL $ Signatur- ii �". Data? t4 - • TOTAL FEE $ �/ • •+ted 'Drivers' icense or SS# _ _� Reinspection Fee '$15 Issue Fee $ 3 PLAN CHECK 25% $ • a �4F 0865-46,rev. 10/84 White Building; Canary - Applicant Pink - Accounting; Goldenrod - Assessor QI. QC.r.796(]0-00039602 TOT SJ. f:i DATF: nR/114/Ac TTnc: inn V. 'CONSTRUCTION AND PLANNING POOL &SPA APPROVALS .'�PeTmit# - Date Inspector APPROVALS Permit Date Inspector r+ i . 1la,Temporary Electrical Service or Pole 52. Pool & Equipment Location 2.:Soil Pipe-Undrgrnd.1 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 t. ., ;� i 58. Electrical Conduit-Undrgrnd. 8. Foundation ('. 2 f / 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe''-Undr rnd% 9 f4.4/ 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor Syste'm 61. APPROVAL TO DECK 11. Property Sewer Line t& House Connection 62. Backwash & Receptor-Final 12. Sewer Cap - -• .,1•00, %. �,/ . 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 C 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 (1) 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 7, _• ."12 31. Plaster Brown Coat 79. FINAL INSPECTION , 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED r. --f: 33. Final Electric - Notes: . ,t-'i 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test -'---� . 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing - 7. 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 J - • 47. FINAL STRUCTURE & BUILDING/20w 111 /,pv lc - _ 48. Special Requirements Completed �'frf' ' 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co I . 51. CERTIFICATE OF OCCUPANCY - Lo. Date - - , Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. PER I NO TRACT NO. LOT NO. NIT O. CITY R,4 COSTA MESA CONSTR UC/I•ION PERMIT A-'4 -c- A l5, i/ g C A•P•# Zone Project Address �37 G l lY� /f"D "C- • `f T ��y `- 'Ll S Main Building: Accessory Building: -(^ -f /1 tl TYPE OF CONSTRUCTION IJ NEW U ADD U ALTERATION LJ REPAIRZ •Applicant's Mailing dress2u � Or/ �4>ro- r Ad i. ❑ CONVERSION ❑ DEMOLISH ❑ OTHER • T Front 0 Owner's Name mod cin LA''1-) Phone DESCRIPTION OF WORK/USE OF BLDG. B Rear A Address s Ant l-[-ev- TYPE OF PERMIT ❑ GRADING U�FOUNDATION ❑ STRUCTURAL ' C Right N Arch/Eng. License No. � K G Address ❑ TENANT ❑ ELECTRICAL 'PLUMBING 0 MECHANICAL S Left R Contractor's Name r i-r PA. h/ -C Phone 5i."nig ❑ OTHER Ping. Ref.# Parking Req./Provided E �l 2.t-6/ / /f PROJECT DESCRIPTION SQ. FT. OCCUPANCY ' PlanningNotes: Q Addressense(mailing) •``� ryp � /� '�•G�°� 5 CONSTRUCTION TYPE VALUATIONS I M U p t ^ T City License No. � �a-0_p_p_` ZONE GRADING CU.YDS. ACRES ,, R. LICENSED CONTRACTOR DECLARATION /�g I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: -TOO ii with section 7000) of Division 3 of the Business and Professions Code,and my license is in full force aEl of act. [' u 1�_ ELECTRICAL FEES License Cies - n - 55 1/l Date •e Signature CIT dr - /.r� 1 e PLUMBING I FEES Automatic Washer Transformer 0 15-50 KW WORKE-5'C•MPENSATION OEC LARATIONBar Sink Showers Construction Pole Sub. ❑ 50+ KW 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 ,e /1� Cooking Unit Meter ❑up to 100 amps 3800, Lab.As /1, I T 1 D 4/ Policy No. /�)-i✓4-007Ss3 Company rah 0 N wI C`t X'rs - Backflow Irrigation Sewer Cap Dishwasher Meter Dover 100 amps — Certified copy is hereby furnished. Dryert ❑Gas ❑Electric Sub Panel CerSij+�ycyP 4pd with the city d' g f on 9 Bathtubs Sewer Connection l 92_OD Date 7(I ) `7 Applicant. / .LS Fan Motors❑0-1HP ❑1X-6 EXEMP ION F OM WORKERS'COMPENSATION DEC 'ARATION Clarifiers Solar Collectors _ (This section need not be completed if the permit is for one hundred ($100)or F.A.U.less). - 3 Dishwasher Solar Piping 6. op Inc.Solar 09-15 HP 016-15+ I certify that in the performance of the work for which this permit is issued .1 Fixtures i. shall not employ any person in any manner so as to become subject to t(si Drinking Fountains Solar Tank Microwave Workers' Compensation Laws of California. • Date ' Signature Floor Drains Swimming Pool w/Spa Device Boxes Pole Light 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 /2s /) a�/x • Switches Sign 3 Gas Service Outlets L Water Closet J W I hereby affirm that there is a permit lending (Section for the performance Of the work for which this permit is issued (Section 3097 Civ. C.) p 3 M Garbage Disposal Standing Sections Lender's Name Interceptors Water Heater W Lender's Address '3 Kitchen Sink Water Service ` DQ Generator 00.5 KW 05-15 KW Trash Compactor OWNER BUILDER DECLARATION �l. I hereby affirm that I am exempt from the Contractor's License Law for the )5— Lavatories 3 Auto-Wash 3(a.oD 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 i 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 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). DEVELOPMENT SERVICES REQUIREMENTS: U I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Foe $ 3 • Zoning Approved By compensation, will do the work,and the structure is not intended or offered _ - _ _ Date for sale (Section 7044, Business and Professional Code: The Contractor's .MECHANICAL FEES Building Approved ByDate`_ 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 ❑ Application Issued By Dat 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 SUMMARY OF FEES 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 $ SMIP $ O I,as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration SystemPLAN 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 00100,000 BTU 0100,000 BTU • PLUMBING $ f�3_OO ISSUANCE $ builds or improves thereon-and who contracts for such projects with a con- tractor(s) license pursuant to tne Contractors 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 e. ELECTRICAL $ GRADING $ ❑ I am exempt under Section B.b P. .for this rV•" Firepl/Fact.Bit. ICBO# Fire Dampers PLAN CHECK 50% $ MICROFILM $ Date Owner P. �v Heating System& Ducting Registers ❑0100,000 BTU ❑100,000 BTU MECHANICAL $ TOTAL FEE $ i�21 00 I hereby cerci y at I have read th' application and state that the above PLAN CHECK 25% $ Information is c• i . It agree toi Co p y with all dy ande y county ritordinances rr and state laws i .g t buil mg o tr with n, and hereby authorize repre- sentatives of ty e r p the above-mentioned pr overSy for inspection purl. P/ q9 - 03, Signature IA G ' Date 7 /� _.�_,. Drivers' License or$5 9f Pink -Accounting; Goldenrod - Assessor "1'• J7• • f•to TIL: i}7:y.-; y ' CONSTRUCTION AND PLANNING POOL& SPA �" Date Inspector Date Inspector n, APPROVALS Permit# APPROVALS Permit# 1., Temporary Electrical Service or Pole - 52. Pool & Equipment Location 2. Sdil Pipe-Undrgrnd. !' 9///17er `� f/L.?f 53. Steel Reinforcement - 3. Electrical Conduit Utility-Undrgrnd. ) 7J� 54. Forms ' 1 - 4. Electrical Conduit-Undrgrnd. •1 1 55. Electrical Bonding ii5. Steel.Reinforcemeni - . 56. Rough Plumbing & Pressure Test 6:'Elect?ical UFER Grrid.. 57. APPROVAL TO COVER-GUNITE 7:-Fobtingc91 58. Electrical Conduit-Undrgrnd. , • 81Foundation - • ,,,�. 59. Gas Pipe, 0 Undrgrnd.,Test 9.?Water Pipe-Undrgrnd. �j� <f��/g" 60. Backwash Lines, P-Trap, 0 Undrgrnd. i. 10.Structural Floor System ///,` ` 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 13.cSewer Cap :'. 4 - 63. Heater & Vent-Final 13rRoof Drains - I 64. Plumbing System - Final - 14.1RoughPlumbing) hal/P65. 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 1f3. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL r . 49' Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# t- r r 21. Ducts, in Structure • 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23./Gas Pipe-Rough & Test 747 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 i31-. Plaster Brown Coat 79. FINAL INSPECTION 32Electrical Power Meter-Final ;' t !l SOI,FQOD CERTIFICATE ISSUED 33. Final Electric ' c 1 ' n v E3tts)12 ' ' gr 34. Final Heating & Air Conditioning ' t, loll-e tan ` ts �,.Cy -�/rfr 35. Final Gas Pipe-Test -• ' 13/020/44 / 7 36. Hood or Canopy / 37. Final Factory Fireplace . �" ' 38. Final Plumbing Lfj�,/� 39. Water Service-Final /4001�! 40. Gas Service-Final r 41. Solar Domestic-Final . 42. Backflow Preventer •.4; 43. Backflow Irrigation (7j 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations • 47. FINAL STRUCTURE & BUILDING r 48. Special Requirements Completed 49. Electric Release to Edison 0- l 50. Gas Release to Southern California Gas Co -A./� V) 51. CERTIFICATE OF OCCUPANCY -.71 ."1 No. Date _ ,. 6 I Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. f " ' [USA P IT NO. TRACT NO. LOT NO, U4, Jl1' NCITYOFdress IIE- CONSTJ,CTIOsN P�RMIT/� 4 9/ A.P.# Zone Protect Address e� J 7 !� ��E vU` •rT/ S Main Building: Accessory Building: • .�1 z. TYPEOFCONSTRUCTION LI NEW ❑ ADD U ALTERATIONREPAIRApplicant'sMailingAddress /? ` dueeaye jarE Front Z -7� ❑ CONVERSION ❑ DEMOLISH ❑ OTHER T o Owner's Name �-r act D 7 /'Gw."Phone �." DESCRIP •. OF WORK/USE OF B = . A Rear N Address ✓ ��E -- -v _ . 0 TYPE OF PERMIT II GRADING FOUNDATION . STRUCTURAL I C Right N Arch/Eng. License No. fff��� K G Address "y ❑ TENANT 0 ELECTRICAL 1 PLUMBING ❑ MECHANICAL S Left v ❑OTHER ' \ ,Ping. Ref.# Parking Req./Provided R Contractor's Name Oy[7 Phone - - E Cy PROJECT DESCRIPTION SQ. FT. OCCUPANCY /' Q AddPlanning Notes: M City Licensess e ing) /1� .�•s �r� CONSTRUCTION TYPE , t2 �� VALUATION$ T City License No. eTir ZONE GRADING CU.YDS. ACRES S. LICENSED CONTRACTOR DECLARATION R I hereby affirm that I am licensed under provisions of .• - encing Remarks: sl/ 94901/ with sectio :: • • on 3 of .• t. - s and Professions Code,and 7 my license is in full force an. - . ELECTRICAL FEES License Class Licens- - Date Signature PLUMBING I FEES Automatic Washer Transformer 0 15.50 KW - WORKERS'COMPENSATION DECLARATION Construction Pole Sub. ❑ 50+KW IN 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 certifieds copy thereof (Section Backflow Preventer Service Sink Cooking Unit Meter ❑up to 100 amps Sol c Lab. C� 7� //i ✓l y �u/ IrrigationCap \-Policy ab / l?` ompan -/ - Backflow Sewer Dishwasher Meter Dover 100 amps Certified copy is hereby furnished. Dryers ❑Gas ❑Electric Sub Panel Cer tifietl Y f tl with the ng D' ivon. Bathtubs 3 Sewer Connection /6-2c,_ ate PTI N RO 7 WORKEApplicRS' . Clarifiers Solar Collectors Fan Motors 00-1 HP❑1'r5-8 EXEMPT/ N ROM WORKERS'C MPENSATI N D h RATION (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 shall no thatm In the performancepersoninof the work for which this permit is issued, I Fixtures rs' employ any person f any manner so as to become'subject to the Drinking Fountains Solar Tank Microwave • Workers' Compensation Laws California. Date Signature Floor Drains Swimming Pool w/Spa Device Boxes Pole t NOTICE:It,after making this declaration,you should become subject to the Outlets ange 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 t hereby affirm that there is a construction lending agency for the performance of the work for wh tlyis e�[ laViS ss �5a`y�gq 3097 Civ. C.) Interceptors Water Heater Garbage Disposal Standing Sections Lender's Name — Ll/51/u��5r� /t'a^'„ Lender's AddressKitchen Sink Water Service Generator 00-5 KW 05-15 KW Trash Compactor R D OWNER BUILDEC ION • t 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 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 DEVELOPMENT SERVICES REQUIREMENTS: C I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ _ 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 thereon, and who does such work himself/herself or through his or her own Boiler Hoo or Type I ❑ Application Issued By r Date 7— 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 0 FE 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). BUILDING 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 ❑4100,000 BTU 0100,000 BTU PLUMBING $ /$• ISSUANCE $ builds or improves thereon.and who contracts for such protects with a con- tractors) license pursuant to me Contractor's License Law). I am aware thatExhaust System 0 Multiple 0 Sy Repair/Alteration 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. ICBG#b Fire Dampers MICROFILM $ Date �LEyEy//ll,L�'�_ • •ne re- - PLAN CHECK 50% $ Heating System& Ducting Registers MECHANICAL $ rt?r I hereby ert y that I have r.ad this .plication and state that the above 00-100,000 BTU ❑100,000 TL TOTAL FEE $ , a Information is correct. I agree to comply with all city and county ordinances PLAN CHECK 25% $ and state laws relating to building construction,an reby authorize repre- sentatives of enter upon the ab -mentioned pro rty or inspects rp 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. I ! • 53. Steel Reinforcement • 3:-Electrical Conduit Utility-Unldrgrnd. • 54. Forms _ .4. Electrical Conduit-Undrgrnd., I 55.(Electrical Bonding • ' I5.•StetliReinforcernent. 1' 56. Rough Plumbing& Pressure Test 6. Electrical UFER Grnd. f 57. .-APPROVAL TO COVER-GUNITE i J:I Footings t 58. 'Electrical Conduit-Undrgrnd. 8/F undation : '' . ' 59. Gas,Pipe, ❑ Undrgrnd.,Test I ' 9:- Water Pipe-Undrgrnd. 60.CBackwash Lines, P-Trap, 0 Undrgrnd. • 10. Structural Floor System i 1, 61. `APPROVAL TO DECK • 1 ,Property Sewer Line & House Connection J4(///tt ���'f _ 62. Backwash & Receptor-Final . 12. Sewer Cap • i G 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 .171 Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough.Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL X1.9. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT ,t ri '20- Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 2' 70. Underground Hydro 22. Ducts, Ventilating I t'T 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough& TestN 72. Underground Flush 24. Roof iFraming ' /1 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 3,j,;;Plaster Brown Coat 79. FINAL INSPECTION 32: Electrical Power Meter-Final ,f 80. FOOD CERTIFICATE ISSUED 33. Final Electric 7f- 'r Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final ' 41. Solar Domestic-Final - .1 r 42. Backflow Preventer 11^' 11 43. Backflow Irrigation _, 44. Landscape Irrigation System • -•: ��_ 45. Sound Attenuation ,'• r ' •' 4./ 46. Handicap Regulations rJ 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 / •t, \\ 1 \-11. \ PROJECT ADDRESS: 2337 ELDFN AV,. UNIT: A, B , C ' CITY OF COSTA MESA - BUILDING' PERMIT PERM NO: M' 045379 OWNER'S NAME: RODNEY BROWN • ADDREss:'SAMF.. PERMIT NO: M 045379 PLAN CHECK NO: • N GOVT: N' SUPP: . N • CONSTRUCTION TYPE: PERMIT TYPE: . MEC PURPOSE: NEW ARCNIENGINEER: REG.NO.: JOB DESCRIPTION : NEW HEATING SYSTEM • SQ FT: ADDRESS: UNIT: CLAIM VALUE: CALC-VALUE: GROUP OCC: / PERMITTEE: NEWPORT AIRE SYSTEMS ' ( 714 ) 642-8575 • ADDRESS: 1539 MONROVIA AV G ' COMMENTS': REFER TO #1340011 • N. B . CA 92663 **** ***4****ye*�E*************yr************�r*********+Eat*************** _*********3 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under Provisions of Chapter 9(commencing with Section ZONING R EQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACK 'S - • CmuC.:029041 STATE LJ 00 sa:C20 y, // MAIN BUILDING ACCESSORY BUILDING Date: �Z'%� Signature: ` F FRNT: FT IN REAR: FT IN ' FRNT: FT IN REAR: FT IN • WORKERS'COMPENSATION OECLARATIO : I hereby affirm that I have a certificate of consent to sell-insure or a certificate of Worke ' LEFT: FT IN; RGHT: FT IN LEFT: FT IN RGHT: FT IN' • Compensation Ips Tail pppy thereof(Section WO,Lab. 1 POLICY NO.: 3� 1 �7 EXP.DATE: 7/0 1 /9 0 CGMPANY: STATE �i5 PARKING REQ: PROV: PARCEL: 43927123 ZNE': REF NO: . Certified copy is hereby furnished. CD Certified copy is Bed with the city Building Davis PLANNING NOTES> ' Date: / Z—/ Z—S�/ (app0eam: �� • ************************************�*************>E*******ser************le***• **** - , EXEMPTION FIIOM WORKERS'COMPENSATION DECLARATION: (Ito ec competed eted it the pendh,'s for One hundred(S100)err less. D E V E L O P M E N T S E R "\7 I C E S R E Q U I R E M E N T r 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 ' • subject to the Workers Compensation Laws of CaMomia. , ZONING APPROVED BY - _ DATE: Date: Signature: BUILDING APPROVED BY (� DATE: . NOTICE:If,after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor - Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. c-2_-4-&-yQQ CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: - i DATE: V 1 which this permit is issued(Section 3097,CN.C). . :************************************1f*9e**** * * ****7e************************. UNDER: *************************************s(:**************************************** ADDRESS: . LEGALIZATION:N - F E E SUMMARY 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 . 2700. repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed • 2 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 PLAN • and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by any applicant fora permit subjects the applicant to a civil penalty of not more than five hundred dollars(S500). ISSUE FEE 15 . 00 , BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE I. as owner of the properly or my employees with wages as their sofa compensation, will do the work, and the TOTALS----> 27 . 00 15 . 00 0 . 00 42 . 00 42 . 00 . 00 ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law , does not apply to an owner of a properly 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 REVENUE DIVISION TOTALS--> 'COLLECTED : 42 . 00 OVER/SHORT • . 00 Improvement theeppems sold within one year of completion,the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE •SMIP/TOT GRADING PLAN-CHECK for the purpose of sale): , as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 42 . 00 ❑ and Professions Code: The projectors'State License Law does not apply to an owner of property whoebuilds or improves thereon **********************_********************************************************* and who contracts for such protects with a coicense(s)license pursuant to toe of Contractors'State License Law).I am aware that proof of their Worker's Compensation insurance should be provided to me. - IND IV I. D U A L F EE ,BREAKDOWN o I am exempt under Section: B.S P.C. • for this reason: 'TYPE QTY DESCRIPTION ' UNIT COST TOTAL COST - • Date: Owner: MEC • • 3 'INSTALL FORC/AIR FURN <= 100 K BTU/H 9 . 00 27 . 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. ' , Date: Applicant: . I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county • ordinances and sate laws relating to building construction and Mreby authorize representatives of Thisj enter upon the above•mentiane - • property for inspection purposes. ' Date: /2—r2—Q 9. signature: mrierjar ' ' • n 01 00049575-00049575 TOT • 42.00 Drivers License or Social Security DATE: 12/12/89 TIME: 15:58 , 1641-46 White—Buildino:Green—Code Enforcement:Canarv—Applicant:Pink—Revenue:Goldenrod—Assessor - - 7/7 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 -_ 41 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE '` 7. Footings 58. Electrical Conduit-Undrgrnd. • t 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test / 9. Water Pipe-Undrgrnd. i 60. Backwash Lines, P-Trap, 0 Undrgrnd. /44 r, • 1 10. Structural Floor System . t:../ • 61. APPROVAL TO DECK r - 11. Property Sewer Line & House/Connection 62. Backwash & Receptor-Final t 12. Sewer Cap •'! '. 63. Heater & Vent-Final ‘ i 13. Roof Drains / ,r' 64. Plumbing System • Final • • 14. Rough Plumbing • I 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 757/41) a ARE 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 ://9/'�, • 35. Final Gas Pipe-Test - 36. Hopd or Canopy - - - . 37. Final Factory Fireplace _ •• 38. Final Plumbing - , - - 39. Water Service-Final . 40. Gas Service-Final • • 41. Solar Domestic-Ficial 42. Backflow Preventer - - ,:T 43. Backflow Irrigation - , 44. Landscape Irrigation System - it. 45. Sound Attenuation • ' 46: Handicap Regulations '-` -47. FINAL STRUCTURE& BUILDING • • 48. FINAL PLANNING • -- 1•- 49. Electric Release to Edison . , 50. Gas Release to Southern California Gas Co • 51. CERTIFICATE OF OCCUPANCY - - - ' No. Date PROJECT ADDRESS: UNIT: OWNER'S NAME: 2337 ELDEN AV A,B,C ' CITY OF COSTA MESA — BUILDING PERMIT PERM NO; M 045642 RODNEY BROWN ADDRESS: ' SAME PERMIT NO: M 045642 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: 5—N PERMIT TYPE: MEC PURPOSE: NEW ARCNIENCINEER: REG.NO.: - JOB DESCRIPTION : NEW. FACTORY FIREPLACES ( 3 TOTAL) SQ FT:' • ADDRESS: UNIT: - . • • ERMfREE CLAIM VALUE: - CALL—VALUE: • P _GROUP OCC: R-3 / ADDRESS:TEE. RODNEY BROWN ( 714 )642-3812 . 177 RIVERSIDE DR F COMMENTS: REFER 'TO #B40011 • N. B . CA 92663 *****************************sr+e+e+roritarar* •**srsr*aE*srsrsr*******lir************lir********4 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ON ING REQUIR EMENTS ' 70001 01 Division 3 of the Business and Professions Code,and my license is in full force and effect. S: E T B A C K S CITY LIC.: STATE UC.: CLASS: - ' Date: Signature: -- MAIN BUILDING — ACCESSORY BUILDING WORNERS'COMPENSATION DECLARATION: I hereby affirm than I have a certificate ot consent to self-Insure or a certificate of 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 IN . -LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: •- COMPANY: PARKING REQ: PROV: PARCEL: '43927123 ZNE: REF NO:' • . ❑ Certified copy is hereby furnished. ❑ Certified copy is flied with the city Bufd'mg Division. PLANNING NOTES> . - > • . . -. '* Date: Applicant: * ***************************************************************if************* ' E%EMPnDN FROM woRTJAS'COMPENSATION DECLARATION: (oris sectico need not be competed tithe permta for are hundred Is1031 or less). I. D E V E L O P M E N' T SERVICES R E Q U I, R E M E N T S 1 certify that in the performance of the work for which this permit is issued,I shag not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California. ZONING APPROVED BY - DATE: Date: -- Signature: - - . - .. - -- NOTICE:If,after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE: Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. • CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: i DATE: which this permit is issued(Section 3097.Civ.C). A, ***.*************************** ' * Sax ** * ,' * **** ***W********** *** * * * LENDER: **ir******************************************* ******************************* ADDRESS: -- - _ LEGALIZATION.:N ' , F E E ' S 'U ;M M -A RA Y ' STRUCTURAL SEGMENTiN -. 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 Buslness and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish.or PERMIT 19 . 50 repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 25% SMIP/NON—RES and Professions Code)or that Mahe is exempt oerefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN - , any applicant for a permit subjects the applicant to a civil penally o1 not more than five hundred dollars($500). ISSUE FEE 15 .00 do- • compensation,*win BUILDING—DIV—> - PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS————> ' 19 . 50 15 . 0 0 0 .00 3 4 . 5 0 34 . 50 , , 00 does not apply to an owner of a property who builds or Improves thereon,and who does such work himsell/hersell or through his or her awn employees,provided that such improvements are not intended or offered for sale.If,however the building or - ' improvement is sold within one year of completion,the owner win have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED : 34 . 50 OVER/SHORT: 00 for the purpose of sale). . - BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK • I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business . 34 . 50 . ❑ and Pmlessiau Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projectswlth acontractor(s)license pursuant to the Contractors'State License Law).I am aware ***4*******************. ****************************************44*************** that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOW N I am exempt under Section:7 04 4 B.s P.C. for us$reason: CONTRACTOR HAS OWN COMj3. • / • TYPE , QTY DESCRIPTIO N UNIT COST . TOTAL COST .--> Date: '/ _.--9 / Omer �—� MEC ' im FACTORY FIREPLACE 6. 50 1.9 . 50 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 wit it 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. /� • . ✓ t Date:/ 7-- 5.0 APP • I hereby certify that I have read this application and state that the above int•nation is correct.I agree to comply with an city and county , ordinances and state laws relating to building construction and he a representatives of Ods city to enter upon the above-mentioned . property for inspection purposes. Date/ s•-• -7 -'5 a Sgnatu . �' 01 00051326-00051326 TOT 34.50 Driver's License or Social Security Applicant;Pink—Revenue;Goldenrod—Assessor --- IP 1 ttae _ -- POOL & SPA x- - - • CONSTRUCTION AND PLANNING APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector- I A Temporary Electrical Service or Pole • 52. Ppol & Equipment Location . 2.:LSoil Pipe-Undrgrnd, 53.-Steel Reinforcement -3t Electrical ConduirUtility-Undrgrnd. 54. Forms ...,<., r Electrical ConduiitUridrgrnd. 55. Electrical Bonding _' `s. Steel Reinforcement56. Rough Plumbing & Pressure TeatC :•-•r- ±-:1 . .it. Electrical UFERtrnd. 57. APPROVAL TO COVER-GUNItE M Ør_ Footings _ 58. Electrical Conduit-Undrgrnd. ti 8. Foundation t''% • 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgjnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. , 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line:& House Connection ,62. Backwash & Receptor-Final 12. Sewer Cap r:., 63. Heater & Vent-Final ce 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 • o17. Rough Wiring Sign - 68. APPROVED FOR PLASTERING n18. Rough Electrical-T Bar Ceiling • 69. POOL/SPA SYSTEMS FINAL • 19. Rough Heating & Air Conditioning FI RE_P:EPT. REQUIREMENT 20-Rough F`actoley Fireplace s' c -- //147"5j =%/1� APPREWAL5„.-,Permit# u 21.-_Oudts, in Stru`ctdie* ' •• --_ 3: s ,r-y' I, ; '=70. C der round:H tro 22.;Dudts, Vent Jatin�' '.;_ S C* .s .;-'1 Ventilating:* * O < HX x -71. Product:PMing OGas O10i1 23. Gas-Pipe•RoU h & Test _ Mr- 4 r' 'ti Or * _q2. Underground FISsh-, " 24.`ROof Framing _ti • - . - k - ti * r' S C •;* * ..73r Undergrn8.Storag`Tank O Gas O -il _ 25. Roof Sheathing c1* c rs ` '_i 5. iter k 74 'Overhead Hydros•, a 26.70T-Ba} Ceiling (St u5tural) & Monocoat . o ".`K * 75,`7:Dry Chemical p-S a r- 27.aFrame arid Flashing: ' g r t" �• c'k * 76. Dry Stanc4tfide i^. k X28. Lathing=& Siding'-'; t." C . - '.I "t* .` 77-FIXED SV.Sit ENil,FINALr r, ^29. Insulatid'n -24 5 - I L- by t 78r,FIRE PREY. FINAL 'k _ ,:, 30. Drywall-Nailing * j; _ b it •c• HEALTI-DEPT;.IFEOUIREMENT 031. Plaster Brown Coat; S 1 * I ' r *t- ^79. FINAL INSP_ECTIO'N L.t_ r I y- a r-.. . it - 32.`_Electricaj Ponder Meter Final * is 1,1/7 1, ,*, 7$055FOOD CERTIFI&ATE IStlWD'_ 4 '. ,., • C .. t Ir,Ie ♦ '-I =33._Final Electric- * r: _ C At a; * Notes: `it- v -' C- n r _ ✓ 11.• * -•r. * �345^Firrei He�tir..& Aii* c., itioning- c A: : I ' &: X li 1-'<4 * r I,135:Ficial Ga q Pipe-Testi 31,--. •• * r A A, * 'To Jr:-;^.. pg ',:'.'236.,..)-100 or canopy -' 'i:'� c n I / ! H: g. g no * r• ^37"Final Factory Fireplace:. •L err rime/Pp ' - c r * rr I i :; Y <' '"38. FinaI Pli'mbing r 1 x W ' 39. Water Service-Final; r _* ! ' 0 1tr 1 >, X. * '40. Gas Service-Final - a;•"T 5 t -,!" ' 'tit * o - arc.: .. :Ftr 1t-+-• `I x •* * E• . OS 1,' a. : - �41. Solar Domestic-Final" '7:4 •• .�. " a : 1/4-.0,1 c r - 42.-Backflow Preventers c. ^• a: I I8 1: :1 * C.-•-_ *: t, P. 4 ., r!" .t- - r. r- 1! :S i ; # x •..r •n c., 43. Backflow Irrigation; y _ * * .t .-a * f_: • r;44^Landscape IRigatidn Systerryt�- 1E e t, ^G C'x 4cc =ft :a C..1 t1" t - --_. r r ` n r• r x -! C' -' u'�-• F...C N `45.RSound Attenuation 4: .,, m r* t -. r C 0< • ;- * C46!-Handicap Regulations '- * -_- S t S S '-%o S 1 .. r• Y r .. s. c; I I .t6 a. C . . C C) < .47`FINAL STRUCTURE & BUILDING :4' D` "� # r I��: r w �. VO 487FINAL PLANNING ' `'� t' VI G * r 7 c, * - X * I I • .Y. 1- C. CJ S * 'C ?49`EIeGlric Release to'Edison ;. �� * { r ^n * - • t50:SGas_Release to Southern California Gas Co .f t - " •O • Otr. X r l ' • r - c^ is eX ti • S DO n is :3 V L151. CERTIFICATE OPOCCUPANCY T. A: = t., - - 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 N CITY of COSTA MESA CONSTRUCTION PERMIT E. ¢0 2._6 I A- €NO A.P.# TZone / ,‘ Project Address 27.` -1 -,.1 QJI� - Main Building: Accessory Building: `� si, Applicant's Mailing®ddrgss &(.c, I at�Artf aF 4J[- i'3 TYPE OF CONSTRUCTION EW pH� ADD UALTERATION ❑ REPAIR E 2 iii!)` ❑ CONVERSION ❑ DEMOLISH LJ OTHER T Front o Owner's Name ' O e4 Phone Aria./ y r B N a DESCRIPTION OF/W'ORK/USE OF BLDG. 2 T� I Rear Address � 1� • IJ{i(15.41a f`4/ ' - Ovv.. - V'� / I TYPE OF PERMI S GRADING • FOUN ION 10 RUCTURAL I C Right . N Arch/Eng. _License No. K - G Address - ^ ❑ TENANT ❑ ELECTRICAL ❑ LUMBING ❑ MECHANICAL S ,a Left Contractor's Name Me4'gR `! V11� C.I IC Phone, -Lb ❑ 'OTHER �j/6/y 404. R! /// I Ping. Ref.# Parking Req./Provided Q s�'� ,� _ PROJECT DESCRIPTION SQ. FT. la'3.-€1 54✓tr OCCUPANCY // , Planning Notes: _ M Address(mailing) �LID([Ip 0f�?sAn/(� q✓k� Q CA CONSTRUCTION TYPE...=„4„,,L_ VALUATION$ T City License No. ��JU a-1 ZONE GRADING CU.YDS. ACRES $- LICENSED CONTRACTOR DECLARATION � r+� I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: ,'r [f Q V // with section 7000) of Division 3 of the Business and Professions Code,and `Y L my license is in full ace and effect. ELECTRICAL FEES1,, License�Class a — 10 License No. i gj-,.t — PLUMBING I FEES Automatic Washer Transformer 0 15-50 KW Date MT'7ti7"—tsg. Signature y� 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 _ Showers of Workers' Compensation Insurance, or a certified copy thereof (Section Cooking Unit 11 Meter Duo to 100 amps 1I��`, 3800, Lab. C. Backflow Preventer Service Sink V" Dishwasher Meter Dover 100 amps \ Policy No. C �����' C an-arrL Backflow Irrigation Sewer Cap Certified copy is hereby,'f urnishetl• Dryers ❑Gas DElectric Sub Panel \V D Ce pL;,� tl cop is filed+ with the cityDivision Bathtubs Sewer Connection ' ' ,\ Date y >O+ 8',' APPlicanl' : •lit A Fan Motors 00-1 HP ❑1%-8 E(This TION FROM WORKERS'COMP SATION DECLARATION Clarifiers Solar Collectors section need not be completed if the permit is for one hundred ($100) or Dishwasher Solar Piping F.A.U. Inc.Solar ❑9-15 HP❑16-15+ less). • ' I I certify that in the performance of the work for which this permit is Issued I Fixtures (/ shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Microwave Workers' Compensation Laws of California. Date ` Signature • Floor Drains Swimming Pool w/Spa - Device Boxes Pole Light - 6 7,5--- 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 ST)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.) interceptors Water Heater Garbage Disposal Standing Sections Lender's Name - Lender's Address Kitchen Sink Water Service Generator ❑O-5 KW ❑5-15 KW Trash Compactor OWNER BUILDER DECLARATION / ' I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories • Auto-Wash / NQ../ Tr'a•%X a D p VA_ following reason (Section 7031.5 Business and Professional Code: Any city or — t— ., county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays 1/6lrr( 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 _� ./`-./tea 7� Division 3 of the Business and Professions Code) or that he/she is exempt Reinspection Fee I $15 Issue Fee I y 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). $ 3 DEVELOPMENT SERVICES REQUIREMENTS: 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 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 - __.-. _ . . . .. _ q1 'G�fJ thereon, and who does such work himself/herself or through his or her own BoilerApplication Issued By Date/ �� employees, provided that such improvements are not Intended or offered for Hood or Type I 0 I —� �`-`m' sale. If, however,the building or improvement is sold within one year of com- Canopy Type II 0 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). • BUILDING PERMIT $ SMIP $ D 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- ENERGY P.C. $ tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration I PLAN CHECK 25% $ proof of their Worker's Compensation insurance should be provided to me. - ELECTRICAL $ th9. /7 GRADING $ ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers MICROFILM $ PLAN CHECK 50% $ Date Owner Heating System& Ducting Registers MECHANICAL $ J�a9 t I hereby certify that I have read this application and state that the above ❑0-100,000 BTU 0100,000 BT TOTAL FEE $ G`�/ 17 information is correct. I agree to comply with all city and county ordinancesPLAN CHECK 25% $ and state laws r,s ting to building construction,and hereby authorize repre- sentatives of t y�,cit to enter upon the above-mentioned property for inspection purpi(y{ I O - - - Accounting; Goldenrod - Assessor 1 CONSTRUCTION AND PLANNING POOL &SPA APPROVALS Permit# Datey Inspector APPROVALS Permit# Date Inspector .> 1. Temporary Electric& Service or Pole v 52. Pool & Equipment Location 2�.Soil Pipe-Undrgrnd. ' 53. Steel Reinforcement • • 3,".iElecvical Conduit Utility-Undr9rnd- in, 54. Forms 4.:EIettrical Conduit-Undrgrnd. - rphad 55. Electrical Bonding et.r 5..'Steel,Reinforcement '3 56. Rough Plumbing & Pressure Test 6.' ElectriealUFER.Grnd: - 57. APPROVAL TO COVER-GUNITE _. 7�; g,Footin s' 1 r"1 =,� ti _w, 58. Electrical Conduit-Undrgrnd. -i ✓1 B.dFoundation tr I :k 11 '1.-7N 59. Gas Pipe, 0 Undrgrnd., Test ' 9:.Water'Pipe-Undrgrndi l i,. ti 60. Backwash Lines, P-Trap, D Undrgrnd. ,I . . 10.'SVuctural Floor System ' s 6 1 61. APPROVAL TO DECK -.S. 11. Property Sewer Line'8: House Connection ' ;t •-S 62. Backwash & Receptor-Final 12. Sewer Cap vi- j 63. Heater & Vent-Final 13. Rbof Drains 5 . r 64. Plumbing System - Final • - 14. Rough Plumbing,;, 4 65. Electrical-Final 'tet 15. Rough Electrical-Conduit 66. Solar System-Final 16; Rough Electric Wiring Viiigg cea""' 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 1 14. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19! Rough Ideating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough,Factory Fireplace /J APPROVALS Permit# 21. Ducts, inStructure ,y 70. Underground Hydro 22. Ducts, Ventilating (' c 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Roughti&i-Test �\ 72. Underground Flush 24. R of Framing t tis 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing" " 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frameand Flashing 76. Dry Standpipe 28. Lathing&rSiding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL a 30: Drywall Nailing HEALTH DEPT. REQUIREMENT 31! Plaster Brown Coal 79. FINAL INSPECTION I. 3 . Electrical Power Meter-Final 0z/lorn_ 80. FOOD CERTIFICATE ISSUED 33.3. Final Electricii. Notes: 34. Final Heating & Air Conditioning !i,_c'r 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 Qa -' ie j a . 43. Backflow Irrigation - .� 44. Landscape Irrigation System - a .• - 45. Sound Attenuation t-e 46. Handicap Regulations e. V 1 47. FINAL STRUCTURE & BUILDING �.R s 4l. Special Requirements Completed 49. Electric Release to Edison ' 59. Gas Release to Southern California Gas Co -"� r '� 51. CERTIFICATE OF OCCUPANCY '" ' ' s '-' � i .. No.' Date - I i i ' 2- �� •/' a _ ' PROJECT ADDRESS: ' UNIT: OWNER'S NAME: 2337 ELDEN AV . ABC • CITY OF COSTA MESA – BUILDING PERMIT, PERM NO:, F1 045539 RODNEY. BROWN ADOR se: L77 ' F' RIVERSIDE DR PERMIT. NO: F 0,45539 PLAN CHECK NO: 02097-89 S GOVT: N• SUPP: N• NEWPORT BEACH CA 92660 t CONSTRUCTION TYPE: 5–N SPRINKPERMIT TYPE: FIRPURPOSE: NEW , ( 714 ) 548-7102 ' ARCH/ENGINEER: HEARD/PROVENCHER & ASSO. . ,nEa.xo.:UNISUpWN JOB DESCRIPTION : RESIDENTIAL FIRE SPRINK. SYSTEM SQ 'FT: ADDRESS: 1240 N JEFFERSON ST Q ' - PEPMRTEE: ANAHEIM CA 92807-1632 CLAIM VALUE: . 8, 000 ,00 CALL—VALUE: ' ' - 'GROUP OCC: 'R-1 / AogflEss: T&T PLUMBING - ( 714 Y58.6-9254 ' • - 23261 DEL LAGO . COMMENTS: RE: 840011 PRIMARY BLDG. PERMIT. LAGUNA HILLS 1 CA 92653 • *****44*******+r*************x-*+E****;tr**************+r«***************+r*********r* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code,and my license is in lull force and effect. S E T B A C K S ' Date: . .: 04,8667 STATELIC.:379808 /CLA C�)6��� • Date: /�-6/.277$` Signature: �1 (/ MAIN BUILDING • ACCESSORY BUILDING , • WORKERS'C MPENSATION DEC RATION: I hereby affirm that I have a certificate of consent toselt-insu or a certificate_o'f Workers' FRNT: FT 'IN REAR: • FT IN FRNT: • FT' IN REAR: FT IN Compensation Insurance.or acertified copy thereof(Section 3800,lab.C). • LEFT: ' FT IN RGHT: FT IN 'LEFT: FT ; IN RGHT: • FT IN POucYNo.: 73WC0073530001 EXP.DATE: 05/07/90 , COMPANY: NATTONWIDE PARKING REQ: PROV: , PARCEL:43927123 ZNE: REF NO: � � ❑ unified copy is hereby famished. IN Certified coPY is tit top city Building DIS PLANNING NOTES> y�— / > • Date: �2?/r9 Applicant: D ��—• , ***************************, *************************************************** EKEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed If the pemeti a ane hundred($100)or less). D E V E L O P M E N• T SERVICES REQUIREMENTS I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California. ZONING' APPROVED BY' DATE: •Date: " ' Signature: ' • . - NOTICE:If,after malting this declaration,you should become subject'to the Workers'Compensation provisions of the Labor BUILDING 'APPROVED BY : DATE: /'2' 2.7 Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: ' � '-7 DATE: C...2./.23(.7 which this permit is issued(Section 3097,Civ.C). ********.*****.*********** * * * **��#ff iF if iF **if iF 3F iF 5f if iF iF if iE ik iF iE ik** * *** iF if iF LENDER: ********************************************* *******4****************** ADDRESS: — , — - LEGALIZATION c N ' • F E. E S U M, M A- R Y . ' –STRUCTURAL SEGMENT e N OWNER BUILDER DECLARATION: I hereby affirm that I am exempt irom,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: Any city of county which requires a permit to construct,alter;improve.demolish,or PERMIT - 99 .00 repair any structure,prior to its issuance,also requires the applicant far such permit to file a signed statement that he/she is licensed -. pursuant to the provisions of the Contractors'Sate License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 65% SMIP/NON–RES and Professions Code)or that he/she Is exempt therefrom and the bask for the alleged exemption.My violation of Section 7031.5 by PLAN ' ' ' 64 . 35 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE - - • ' I, as owner of the property or my employees with wages as their sole,compensation, will do the work.'and the BUILDING–DIV–> . PERMIT ISSUE PLAN—CHECK TOTAL PAID . DUE ❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS–--–> " - 99 . 00 0. 0 0 - 64 . 35 163. 35 163 . 35 ' .00 does not apply to an owner of a properly who builds or Improves thereon,and who does such work himself/herself or through , This 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 wilbhave the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> • COLLECTED: 99 .00- OVER/SHORT: 00 • 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 ' - 99 .00 ❑ and Professions Code: The Contractors'Sate License Law does not apply to an owner of property who builds or Improves thereon • . and who contracts for such projectswith acontactor(s)license pursuant to the Contractors'Sate License Law).I am aware **************************{F**************************************************** that proof of their Worker's Compensation insurance should be provided to me. - - INDIVIDUAL F E E B R E A K D O W N I ❑ I am exempt under Section: B.&P.C. for this reason: , 'TYPE • QTY . D E S C R I P T I O N ' UNIT COST TOTAL COST • • Date: Owner: • FIR • 99 FIRE ;• FEE (FROM BLDG VAL TABLE) 1 .00 • . 99 .00 I do hereby certifythat I am aware of and understand the requirements of California Health and SafetyCode Sections 25505,25533,and 1 I 25534 and that I r any future building occupant will/will not(circle one)need to comply with said stae codes and the requirements for a .. - ' END OF FEES , permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from , these provisions. , , , I Date: Applicant: i 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 / ' . . r ordinances and sate laws relating to building COnSPONon and heauthorize repreienZ ,*-.r1 ' this city to enter upon the above-mentioned • for inspection purposes. Date:/VA?/O9 Signature: M •D I _ ' Drivers License or Social Security ApplicanC Pink-Revenue:Goldenrod-Assessor - - . CONSTRUCTION AND PLANNING POOL & SPA • _ Date - Inspector Date Inspector - APPROVALS Permit# - i'. - - _ APPROVALS Permit# 1, Temporary Electrical Service orPole-S . j-- 52. Pool & Equipment Location 2,*Soil-Pi• pa.Undsgrpth_ �S" } l 53. Steel Reinforcement '� 4J31LEI'actrrca$ ora-bit-•Uiility-Urdrgrnti^-S c'' • - 54. Forms U • •.,S r rn,4, <•T cr.--; - m - - ..Elect-r,rea r}At-4drgrnd 3/ 0 55. Electrical Bonding ` n51 SteebRergforceinetttt. ox 56. Rough Plumbing & Pressure Test ri . tmm.r. , n_ n'-,4-, ,.t .n -. " 2-i_ectriia7 UFEti GraH.' a - ti - 57. APPROVAL TO COVE R-GUNITE . co Q'7. aotings4'' c 58. Electrical Conduit-Undrgrnd. - c) 8. oundatNo .r , _- 59. Gas Pipe, 0 Undrgrnd., Test 9.`Water PipetIndrgrnd. - - .i - 60. -Backwash Lines,P-Trap, 0 Undrgrnd. .. -- 10.Structur5i Floor System "1-- 61..APPROVAL TO DECK _- 11. Property Sev,�er Line& Hou'se'Conn`j tion ;� • 62. Backwash & Receptor-Final 12. Sewer Cap o.• a, n _ 63. Heater & Vent:Final - 13. Roof Drains 0... ;9 - 64. Plumbing System - Final 14. Rough PlumbinCI -g '; y ./ 65. Electrical-Final • l'_ 15. Roughect�k.0T-Conduit " 66. Solar System-Final 1 16. Rough Efectric'4.Viring i67. Fencing & Access Approval • .fir "re", - 7:17. Rough VgSign `•' - ' 68. APPROVED FOR PLASTERING . ,V 18. Rough Electrical.-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Roygh Heating &,Air.Conditioning y- FIRE DEPT. REQUIREMENT '7 * . ..,:a C.'- + s .� .. .c ['- •� 'r+ '- 20.4Rough Ftjctory F lace _ c-1• r; ;APPR - - errtiit # r. 21.'-,Duats, in-Str'ctuce* • ' S O C`a* * '7,70. lzderoun�dHydro t (-, u, to _r * tJt. i-4- •R L, [- p , �,GOaO 122.•cDuazfs, Vvntiiting.a n. * 4 0 471, ProductrPaI 23.-GasPipe-Rotigh &Test �n cr!,r� '� ti g C* ^-72. Undergrot d.FltC3h� x c• 24 r'Ro6f Fri' n . _-1x ��. ••`� * O w * = m .� afn 9 ••r _ -+ ��* * -73nUndergrna.SLoragezTank ]Gas OOII 25. Root Sheathing m* �: " ' * O ri* 74.:Overhead Hydro2- x 26`f-Bal Cej)ing (Sti@4tural) &'Moriocoat * -. '� '- O :: 0x 75",Dry Chea_.. --- 27:_Frameand Flashing,: 'tom s C { 'K 76. Dry Standpipe L-! Y n T _ - ru '-28. Latg' .: c: -a;� c: S -• �^ S' >- ` ing','� Stiin9�;� nyc. " � f j � �� 77.��jFIXEDSY.'`sTEMit�tNAL< - ;t m �}-� ,S-q0 (,1,,� 29. Insolation '. E* _ .. + 7$SFIRE PREV. FINeS�1 ' > •r. r c r, n•v r * c I .� -'art z tTr . '^`t- x V• Et-.7, '� "1�-q �`U - ?`30. Drywall; Vailmg �,* r * r-, j fir r /iK * S k1EA LTF#DEPTy REQGIRENIENT 4 S '" �_ x ,79.-FINAL INSKECTIO;N * v J 031. Plaster Btowli;Co-'K ^r � �� �` .Tr 1 .r• - r 4 r • r..c - * :- cH32SElectricaJ.Power .eter'-Final; * I i e. t* * 80.400D CERTIFI2ATE ISr. xL}EDr, S33SFinal Electric,. * .1 _ 'Cr. t • 1 j a� '.•* * 'Noies: `:n .* '7 0 Or '•34CFinal Hendting& Air*C,on'ditionmgr- `^ x' 17,11 j :i:!.f* * S x S cri- 135,-Final Gas Pipe-Te`stx. cz •• * + i 1 * = x. a- x ' Cr^ 36.rHo&1 oFCanopy •••'; ` ? �' x n j';!;jl �% *�, E n , x * n ter; u * I " lid.--'.: _ ti �v * n >^ ^37 JFinat Factory Firepface� E * a� ii,t .1 38CFinq PIO/,bing * ri~V -' . * + * Cu W ✓ I , r H C * 39�Va[r Service-Finaly s Ij ril„ W >. _ _ o * 7 -.• x r-.r, • * .r. -r; 1140.IGas Service-Final * rTi 'CTr S * rt., ; * . " On -- : * * (1E-t- * I/ ; . J .* r • oS * 4 `-pl.r`'Solar Domestic-Fin?'S rl it `n i /� Ir trig n ^_n: * z S _ - „ Iv x •. .•• a ,n . ;r t- 42. Backflow Prevente,R r 6.1 * I ! l* * tr; •n - F * C r. . * n: O r-,:-; le i-4 * * m0 v c: m 0 * x * ss * � T ,. . ._• -. 43. Backflow Irrugationg * * * Al * n • -.C. * , t _. n t- , -,- r, 44. Landscape IFrigati System ,rQ',`_', M r; * j C * C- " • .` ( a _ • 45,Sound Attenuatlor * ;. in in* * :- ; c, . *y . C46.' andicap Regulatidns O * x * .-.•,- w sc-,..., S x .. x . r ., * S /1 . 1* * Q to 0 C7 * * 1 ' ` * ru _. x -7cfI2ALSTRJCTUtiE & BUI•LDING * I r * ?- Z' _ < r i ,* r. -11 rt. .- n • ..• 48. FINALPLANNING' ' ''r' * `J ' 1,1* :* .:?;* T' t" `, "` / * 1, r ti s * r i 249.';Flectric Release to Edison • * ;i l / * -•n * ' c. ru50=Gas`-Release to Southern Califorrj_ta Gas th * 1' mea * t-i 0 . otrl * O ' °'51. CERTIFICATE OF°OCCUPANCY a fin - '° •-, ^ No. • Date Al_• �: a IIIII CITY OF COSTA MESA e r • 'ellaQQ BUILDING DIVISION a. 14 ,1 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.costamesaca.gov k FOR INSPECTIONS CALL: 714 754-5626 Nbibmion PERMIT NUMBER: M12-00143 n. PERMIT TYPE MECH STATUS: ISSUED APN: 93068478 DATE ISSUED: 10/10/2012 ISSUED BY: KJB ;•'.1. JOB ADDRESS: 2337 D ELDEN AV CM Suite/Unit: D Vicinity: - , SO. FT: 0 - - I:, SCOPE OF WORK:CHANGE OUT FURNACE AND NC IN SAME LOCATION. CHANGE OUT DUCTS ALSO, SAME LOCATION NOTE: FINAL APPROVAL OF PERMIT SHALL NOT BE GRANTED UNTIL ACCESS TO DWELLING UNIY(S)IS PROVIDED FOR VERIFICATIO OF SMOKE AND CARBON MONOXIDE ALARMS BY THE CITY INSPECTOR.SEE ATTACHEMENT WITH INSPECTION CARD.(RESIDENTIAL ONLY) OWNER: HINOJOSA,ARNOLDO. l, . Address: 2337 ELDEN AVE#D Unit: PHONE: GRETY,TRISTAN ' - City/State/Zip: COSTA MESA,CA APPLICANT: GRETY,TRISTAN Address: 10 MCLAERN ,Unit: PHONE: 949481.7995 City/State/zZip: IRVINE,CA CONTRACTOR: MCMASTER AIR AND HEAT License No. 726607 Address: 10 MCLAERNUnit: PHONE: 949-481-7995 City/State: IRVINE,CA ZipCode: 92618 - r CELL: Ail MECHANICAL PERMIT-FEE SUMMARY - , I11IECH ITEM FEE: $66.80 P,LAN CHECK FEE: - $0.00 INVESTIGATION FEE: ' $0.00 REINSPECTION FEE: - $0.00 • . TOTAL FEES: $66.80 N_C 3M • Pv • Ph. AP PF 0 t :+c 611 IY i NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related mutations.(Ord. No.92-28,§ 1, 12-21-92) E,1XPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. I1 SPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all iquired inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODE L INSPEC1ION TYPE PEI INnTIAI$ CODE t INSPEc110N TYPE MI MAL4 m n 189412.Fixed System Final Fire Prevention 206 Final Mechanical ��/3.Ov� atAP SW 1266 Pool Spa Final 208 Final Plumbing 200Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention QS 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy WORKERS'COMPENSATIONpECLARATION: Owner ID verified by driver's license. ❑Yes ❑No I hereby affirm under penalty of perjury one of the following declarations: Drivers License No. Expires: O I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownershi compensation, as provided for by section 3700 of the Labor Code, for the P b Y(type of document,Vie.-property tax bill or deed): performance of the work for which this permit is issued. IQ 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: n n �� person is required to descend,will be made in connection with work authorized -(•J_V_r-v„e/%/ Y by this permit,and that no building structure,scaffolding,falsework,or demolition Carrier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (Ths secaonnot/en��� /7 oeddthe ZZpermlu atdnee hundred mbrs(sfo0)or less 2Art 2,Sec.341,Title 8,California Administrative Code). Policy Number: ICA) /J( )- -1-)> ❑ 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 workers'compensation provisions of Section 3700 of Applicants Signature Date the Labor Code,I shall forthwith complywith these provisions. 4 ri2 (0 -(U ,Z Division of Industrial Safety Permit Number: Applicants nature Data HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE O SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AN 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 isinlfull force and effect. a registration form for acutely hazardous materials? ❑Yes 0 No 72-6C0-7Lic.# 76� Class# (Section 25533 of the California Health and Safety Code, with some - f0 �O�'•L exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely Contra es 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 is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lenders Name: hazardous materials)? 0 Yes 0 No (Section 25534 of the California Health and Safety Code provides that the Lenders Address: Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? ❑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 famished 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 properly, 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 employees, provided that such improvements are not intended or offered for 8. (If yes',attach certificate of compliance from the appropriate air pollution 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 am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. properly,❑ I, as owner of the 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: 1 a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature of Legal Owner(s) Date Signature • Date • a 1 70AK yp, .(O—(Z 305]-06(3N]) And/or Authjzed Applicant Date PROJECT ADDRESS: 2337 ELDEN AV UNIT: D CITY OF COSTA MESA - BUILDING PERMIT PERM NO: M 048073 OWNER'S NAME: RODNEY BROWN ADDRESS: SAME AS ABOVE PERMIT NO: M 048073 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: MEC PURPOSE: NEW 714 /642-3812 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : ADD HVAC SQ FT: ADDRESS: UNIT: CLAIM VALUE: • CALC-VALUE: GROUP OCC : / PERMmU: GRAHAM BROTHERS ( 714 ) 546-1653 ADDRESS: 2952 CENTURY COMMENTS : NO STRUCTURAL WORK BEING DONE COSTA MESA CA 92626 *******>t******at***+e>Ear>f*+r*x-***x# *TE*er*7ETE>F+r**+refer+ ********+r***TE*TE*>E*TE******** **** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ON INC REQU IR EMENTS 7000)of Division 3 of the Business and Professions Code . d my s ' in full force and effect. SETBACKS CITY uc.: 005963 STATE UC.:24 ' •04i1 ss: T' ' 0 -Date: "7-./o- ° ./ • MAIN BUILDING ACCESSORY BUILDING 1- 9 Signature:_— FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN WORKERS'COMPENSATION DECLARATION:cony I hereby affirm at ve a certificate of consent to self-insure or a certificate of Workers' LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POUCY N0. CoInsurmpensation l 2 L b(cgor 1 b cC7 J1eV thereof l E%P.(Sectis• 3800.Lab.G)$ /01 /9 0 tl DATE: U PANrLIBERTY PARKING REQ: PROV: PARCEL : 42709110 ZNE: REF NO: ' stifled copy is hereby furnished. © Certified• r a c' wilding D. on. PLANNING NOTES> 7,41 n > ^Data: f, Q• 7d Applicant: **************************************:***************************************** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This ••P.. not be completed U the permit's fa one Mildred($100)or less). DEVELOPMEN T SERVICES REQUIREMEN TS I certify that M the performance of the work for which this permit is Issu ,I shall not employ any person in any manner so as to become subject to the Workers Compensation Laws ofCatlomia. ZONING APPROVED BY DATE: Date: Signature: BUILDING APPROVED BY : DATE: NOTICE:y:II,after making thiswith declaration,you should become subject toshall the be dedrvoked.Compensation provisions of the Labor Code,you must forthwith comply wth such provisions or this permit snob deemed revoked. 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: ///�� ,10 ?2. which this permit eQwed(Section 3037,Civ.C). ************ ********* LENDER: ******************************************************************************* ADDRESS: LEGALIZATION:N F E E SUMMARY 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 9 , 0 0 repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she Is licensed 2 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 PLAN and Professions Code)or that he/she Is exempt therefrom and the basis for the alleged exemption.My 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). ISSUE FEE 15 . 00 I as owner of the property or my employees with wages as their sole compensation, soul 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 Code: The Contractors'State License Law TOTALS----> 9 . 00 15 . 00 0 . 00 24 , 00 24 . 00 . 00 410 does not apply to an owner of a property who builds or Improves thereon,and who does such work Nmself/herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however the building or REVENUE DIVISION TOTAL S--> COLLECTED• 24 . 00 OVER/SHORT : OO improvement rof el). one year of completion,the owner will have the burden of proving he/she did not build or Improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK L as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 24 . 00 ❑ and Professions Coda: The Contractors'State License Law does not apply to an owner of property who bolus or Improves thereon and who contracts for such projecagth acontractor(s)license pursuant to the Contractors'State License Law).l am aware ******************************************************************************* that proof of their Worker's Compens:hon insurance should he provided to me. INDIVIDUAL F E E BREAKDOWN ❑ I.am exempt under Section: B.&P.C. for this reason: TYPE QTY DESCRIPTION UNIT COST TOTAL COST Date: Owner MEC 1 REFRIGERATION SYSTEM <= 100 K BTU/H 9 . 00 9 . 00 I do hereby cenify 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 1 or any future building occupant wiMvill not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Quality Management District.Residential oxistn ction applications are exempt from these provisions. • Date: Applicant: I hereby certify that 1 have read this application and state t.. :above infor '.n is correct.1 agree to comply with all city and county ordinances and state laws relating to building constru a .-. iir... ...o this city to enter upon the above-mentioned property for inspection purposes. / // i, Date; /O• o' /a Signature: Driver's License or Social Security 01 00054853-00004858 TOS 24.L 164146 White—Building;Green—Code Enforcement;Canary—Applicant;Pink—Revenue:Goldenrod-Assessor DATE: _07/10/90 TIME: 11:45 . CONSTRUCTION AND PLANNING * PCIIIP SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector I/ 1. Temporary Electrical Service;or Pole 52. Pool & Equipment Location ,f 2. Soil Pipe-Undrgrnd. J 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 . ri 59. Gas Pipe, 0 Undrgrnd.,Test J ' / 9. Water Pipe-Undrgrnd. - • 60. Backwash Lines, P-Trap, ❑ Undrgrnd.• ✓ �� 10. Structural Floor System in - i 61. APPROVAL TO DECK 11. Property Sewer Line & Hoti Connection "/ 62. Backwash & Receptor-Final z 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: 34. Final Heating& Air Conditioning 1 /Z�,en C 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. FINAL PLANNING ' 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY •/ No. Date City of Costa Mesa Development Safety s Division Department Building Safety CERTIFICATE OF OCCUPANCY No. 003129 P.O.Box 1200 ' Costa Mesa,California The Building located at 2337 Elden Avenue, Units D,E,F , has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto • for a Group Rl/M1 Occupancy. Use of Building Apartments • Legal Description 439-271-23 (See reverse side for Metes and Bounds) B39620 • E 40262 P40141,1f40492 Building Permit No A40012.&39619 Electrical Permit No. _ Plumbing Permit No. Mechanical Permit No. M45643, M45380 Number of apartments 3 and/or guest rooms ISSUED TO: Building Official Tony C'Da Baca Rodney Brown / 177 Riverside Dr., Ste. F by �.. , 2" r .7!" Newport Beach, CA 92660 Date April 26, 1990 This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 lel U.B.C. CMF 1015-46 rev.1/83 White-Owner;Canary-Numerical File;Pink-Bldg.Permit File Applicant to fill in all spaces except those vlIthin heavy border lines and sign all appropriate dec art atlons. CITY OF COSTA MESA 'CON TR UC ION PERMIT PERM T NO. TRACT NO. LOT NO. UNIT NO. A P # Zone OLE ;'L;; Z o •22 D ,ey F , 439 - 2r/( - 23 TZZ • Project Address �.. -_ 9 ,/ G. S Main Building: Accessory Building: • Applicant's Ma' -.dress/ e. • r v/ ,r. " I TYPE OF CONSTRUCTION EgNEW Li ADD. Li ALTERATION J REPAIR E ,• L� /� y L - Z Aor ❑ CONVERSION ❑ DEMOLISH ❑ OTHER �ra✓ 2. - Tbry T Front � fte /.IA_A- ( uu,y, O Owner's Na . Pho�� r TTT'''��• ,� g 1 r•.� / / // l - N _ DESCRIPTION OF WORK/USE OF BLDG. lIt 1p lL g-l�-/4I Rear 10 Address ` i1 �L 1 '4 Arch/Eng. - . License No. TYPE OF PER�OI T '. RADING U FOUNDATION .STRUCTURAL C Right S - G Address ❑ TENANT ❑ ELECTRICAL ❑ PLV BING ❑ MECHANICAL y $ Left q ' R ❑ OTHER }•1_pf L (�} A r t • I3Zq`/ rte, Contractor's Nam Phon:C Si D � Ping. Ref.# (��_ vR" rl 3 Parking Req./Provided 5A5. E �- , Y PROJECT DESCRIPTION SQ. FT.SbT DCC UPANCV h Q Address(mailing) e� /� 00 Planning Notes: Kat% M �, -s CON STRUCTION TYPE VALUATION$ �•�(a�s ` ^ ��'```��,,��, ��I}}}... ` f—�' _ /1 T City LNSED -- - ZONE GRADING CU.YDS. ACRES Vyet'I,l C� y' ..tbe er p4[•7s S'LL +�y�(.\.SG7sr-tX�•(Y� y410 S. LICENSE TR4CTOR DECLARATION"• I E_/YU.L\/ �V� 1`JJJlIISI•IEa AGI�tllf�r']1J�('��a 1 hereby aff that I am licensed under provilons of Charter 9 (commencing Remarks: with • sense is•n00 e(Divisiondof 3 of theBusiness and Professions•� Tis 74/2—— 1$� my license n in full rce and of ect. ELECTRICAL FEES License •1. s N License DatePLUMBING FEES Automatic Washer Transformer 0 15-50 KW L ,I Signet.ri ' salr WO- ERS' • -ENSATION D AR— • r Construction Pole Sub. 050+ KW • --ereby affirm that I have a certif ate of consent to Self-insure or a certificate Bar Sink Showers • Workers' Compensation Insurance, or a certified copy thereof (Section Cooking Unit Meter Cup to 100 amps a0, Lab. 1,, - - Backflow Preventer Service Sink s ��/I•• ?y 7,-/,6 FIf'IA 'J Dishwasher Meter Dover 100 amps — Policy No. s ,Company K/ Backflow Irrigation Sewei Cap Certifiedcopy is rebyturnished. �. •'1 Dryers ❑Gas ❑Electric Sub Panel - C •fi o�y with the ' - Ion. �/J ' Bathtubs Sewer Connection _ Date�s/y, • C/ Applican .4171/------------- '` Fan Motors 00-1 HP 01%-B EXEM ION F OM WORKERS' OMPENSki N DECLARATION Clarifiers Solar Collectors ' (This section ed not be completed if the permit is for one hundred ($100)or F.A.U. Inc.Solar 09-15 HP:016-15+ less). - - Dishwasher Solar Piping ,• I certify that in the performance of the-wbrk IOr which this permit is issued, - - Fixtures Microwave shall not employ any person in anyf California. so as to become subject to the Drinking Fountains Solar Tank Workers' Compensation'Laws of rnia. .� Date Device Boxes Pole Light Signature Floor Drains Swimming Pool w/Spa 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. 1 CONSTRUCTION LENDING AGENCY Switches Sign Gas Service Outlets Water Closet g I hereby affirm that there is a permit lending ue agency for the performance Ca of the work for .hith this permit U¢d .a•action 3097 Civ. CJ Garbage Disposal Standing Sections Lender's Name / i A. , • / Interceptors Water Heater - _ Generator 00-5 KW 05-15 KW Trash Compactor Lender's Address '" r; Kitchen Sink Water Service _ -� OWNER BUILDER Cr CL• R-T • I hereby affirm that ham 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 exemptReinspection Fee $15 Issue Fee $ 3 erefrom and the basis for the alleged exemption. Any violation of Section J31.5 R. any applicant for a permit subjects the applicant to a civil enalty of-not more than five hundred dollars($500). DEVELOPMENT SERVICES R EQUENTS: Zoning Approved By Date/] I, as owner of the property or my employees with wages as their sole Reinspection Fee ! $15 Issue Fee $ 3 5 89 1 I • 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 L FEES Building Approved By (� I pS 1 Date Co--LC-1st, License ball/ 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 Dat - employees, provided that such improvements are not intended or offered for Boiler Hood or Type I ❑ sale.le, If,I/, however, the building or improvement is sold within one year of com- Canopy Type II 0 SUMMARY OF FEES pfor 2.-.91:2.-10-0, the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground / prove the purpose of sale). BUILDING PERMIT $ !f 2.-.91:2.-10-0Mo aIP $ 19• / ❑ I,as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK $ .Z q• 7� RMIT 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 PLUMBING $ ISSUANCE $ builds or improves thereon.and who contracts for such oroiects with a con- 1 tractors license pursuant to ane Contractors License Law). 1 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.Bit.ICBO# Fire Dampers PLAN CHECK 50% $ MICROFILM $ 7 Date - Owner • Heating System& Ducting n Registers MECHANICAL $ TOTAL FEE $ 1.,SZ°Z7 I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000 BTL information is correct. •e to comply with all city and county ordinances PLAN CHECK 25% $ and state laws �.s��-�j�•►•')ding construction, and hereby author' e rep e- sentatives -� • en r up n above-menti ed pro•-rty or inspect'' ur•: /q�1t� ��_� ,Signature ar v _Date AV Reinspection Fee $15 Issue Fee $ 3 01 9C0fj177$-Ci1�•;".,72: 1.---" ' Drivers' ' ense or 55 - Accounting; Goldenrod - Assessor (1e - 1 _,d • CONSTRUCTION AND PLANNING . POO SPA . - APPROVALS Permit# DateInspector APPROVALS Permit# • Date Inspector e i. Temporary Electrical Serf^e or Pol� i"• if� 52. Pool & Equipment*ocatiogr / / 2.lSojl�Pipe Undrgrnd. V Aft Gt/ P;V' 53. Steel Reinforcement //;I :1rElectriicalcConduit Utility-Undrg(nd. /fr 54. Forms / /{ .. T D 7.fr 4v£IectcicalYJ ,CondI+ta-Undrgrnd` " '✓ i L 55. Electrical Bonding I/ hn t• 5!siel1Reinforcement'L; 6 56. R."o5ghPlumbing & Pressure Test pl,�/y ti re v . nl lJa r ' 62Elec{ical UFER/Grnd.1 /ft f 5 / '/y 57. APHROVALTOCOVE R-GUNITE - ,-,7 •Ii VA' ." // . .. / ...` 0 w, T 1 I 7:7Footings v / / 1 n 58. ectrical Conduit-Undrgrnd. // r I f l rf �`l rIl ..I hr. 9 �/ 11 �`T r 8i Fu4 al ion 5.tese f✓e r 59.vG.npe, 0 Undrgrnd.,Test 1 . I 2q ,° _ ter Pipe-Und rgr'i54."1 � � Oaf 60. Backwash Lines, P-Trap, 0 Undrgrnd. I t�a 10rStructural Floor System tit/ N / 61. APPROVAL TO DECK / l) 11. Property Sewer Line& House Connection 62. Backwash & Receptor-Final 12?SdWer('Cap (y� N ' 9, ( 63. Herter & Vent-Final 2' 13;Roo Drains 7• lv. a ' 64. Plumbing System - Final r , 14. Rough Plumbing%U` boo65. Electrical-Final /lf/ 15. Rough Electricaltonduit 66. Solar System-Final . 1.6? Rough Electric Wiring 67. Fencing & Access Approval -1T Rough Wiring Sign 68. APPROVED-FOR PLASTERING - 18. Rough Electrical-T Bar Ceiling 69. POOI./SPA SYSTEMS FINAL 19. Rough Welting & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# a ' 21. Ducts, in.Structute .1 'r; '- 70. Underground Hydro L 1 i _ 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23:Gas Pipe-Rough'T&ETeC 72. Underground Flush 24'. Roof Framing - r ((( 73. Undergrnd.Storage Tank 0 Gas 0 Oil - 25. Rooft Sheathing 1y `g/' gf &r) 74. Overhead Hydro 26. T-Bar'Ceiling ISMtural) & Monocoat , 75. Dry Chemical . n . 2Z. fne'and Flashing ' ' 76. Dry Standpipe •. I 28. LaThi}g +Siding /// I -9-96 77. FIXED SYSTEM FINAL p 29. Insulation _. 78. FIRE PREV. FINAL aq. DrywallNailing ti cl /-2E-S) '�"f"' HEALTH DEPT. REQUIREMENT 31}., Plaste�Brown coet-1"_ it.... ��� 79. FINAL INSPECTION 32. Electrical Powey.1,ter-Final j 80. FOOD CERTIFICATEERISSUED. IS 33. Final Electric -�i _ Notes: y� I�/g0 C t64f�_�M / - 34. Final Heating & Air Conditioning ,,`- Sif ��� I f\ O ry- 35.- Final Gas Pipe-Test-: 2 ry 16.•Hood or Canopy "• o C. _ 67. Final_F.aetore F!jplac,, + 38. F al,Plumbing�n '2' 09. Wates.Service-Final:2 40. Gas Service-Final .^ r -.- ' I . . 3). Solar Domestic-Flinal � • -'42. Backflow Preventer : ' -- `'4 •f 43. Backflow Irrigation- r J < 44. Landscape Irrigation System - - 1 i .., 45. Soucnd Attenuationt • .. 46. Handicap Regulations . . 47. FINAL STRUCTURE &'BUILDING (2S--4 C✓ ,,, rt 48. Special Requirements Completed -all-90 ^7�''-erlep e 49. Electric Release.to Edison 6:;' -. "i t LI 50. Gas Release to Southern n California Gas Co r�r - !� '..{ - '51. CERTIFICATE OF OCCUPANCY ,- j 1\No. Date - - L, f Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. P RMIT NO. TRACT NO. LOT NO. UNIT NO. CITY OF COSTA MESA CONSTRUCJ) PERMIT 3 �6 Z� A.P.if I zone Project Address _♦ 7 6L0. ii.Y/r F_ + Building: Accessory Building: i TYPE OF CONSTRUCT ON Li NEW S Main Applicant's �.. ��-dress % / /_ �L U ADD U ALTERATION U REPAIR E Z / ❑ CONVERSION DEMOLISH ❑ OTHER ' T Front O Owner's Name - Phone 2 - DESCRIP OF ORK/USE OF$L.D A Rear N Address yrs__ --blues— �_ t -Arch/Eng. License No. • TYPE OF PERMIT U GRADING LJ FOUNDATION IJ STRUCTURAL C Right G Address ❑ TENANT ❑ ELECTRICAL 0 PLUMBING 0 MECHANICAL s Left • R r I �6x(s• '7IG-s- ' Ati ❑ OTHER p Ping. Ref.# Parking Req./Provided E Contractor's Nettle/40r /� �O Phone � / / �" PROJECT DESCRIPTION SG. FT.1:57Z)JZ) OCCUPANCV_R_+% Address(mailing) Cl'i JtMu6-- /Uc' --nbenei n. ...V.-.../V rj p 0 J• o Planning Notes: Ir CONSTRUCTION TYPE IV VALUATION§ 14 - - City License No. C'' -3 el D -5-`)--S-72i ZONE GRADING CU.YDS. ACRES S. LICENSED CONTRACTOR DECLARATION 1 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 fu • ce and effect. i Licen • Cl ss / - Licens- N•• • • — Date /•!7 Signet • s - PLUMBING I FEES Automatic Washer Transformer 00 50 15-50 KW WOR ERS' •MP NSATION D A 0' Construction Pole Sub. ' hereby affirm that I have a certi Irate of co ent to self-insure or a Certificate Bar$ink $hOW¢fa P Workers' Compensation Insurance, or a certified copy thereof (SectionBackflow Preventer Service Sink Cooking Unit Meter Our,to 100 amps 300, Lab- ;12, / / ernes ,, Policy No� �j/ „-2f company�T/y Tl- }-bNh Backflow Irrigation Sewer Cap Dishwasher Meter Dover 100 a Certified copy is hereby furnished. Dryers ❑Gas ❑Electric —J Sub Panel \ Ce fi cop is fled with t • ' • = ion. Bathtubs Sewer Connection • Date '� Applicant —�••�•�• - AV ATION Clarifiers Solar Collectors Fan Motors 00-1 HP Ons-8 (This section need PTIO Onot beM e completed ifs the permit I or one hundred ($100) or less). Dishwasher Solar Piping F. Inc.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 manner so as to become subject to the Drinking Fountains Solar Tank Microwave Workers' Compensation Laws of California. .Device Boxes Pole Light Date Signature Floor Drains Swimming Pool w/Spa g NOTICE: lf,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 1 hereby affirm that there is a construction lendi • .gency for the performance - of the work for hick this •e mit •--Or., •n 3097 Civ. C.) interceptors Water Heater Garbage Disposal Standing Sections Lender's Name - /-„ Lender's Address Aar ...ri Area / a • 04 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 Trots 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 ieretrom 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 I pretty of not more than five hundred dollars($500). $ 3 DEVELOPMENT SERVICES REQUIREMENTS: LJ I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee Zoning Approved By compensation, will do the work,and the structure Is not Intended or offered 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 a Application Issued By _Dat 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 pletlon, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground move for the purpose of sale). BUILDING PERMIT $ '1 S-Oa' SMIP § TO LJ 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. and who contracts for such oroiects 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 PLAN CHECK 25% $ ENERGY P.C. $ proof of their Worker's Compensation Insurance should be provided to me. ELECTRICAL $ GRADING $ — ❑ am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBO d6 Fire Dampers PLAN CHECK 50% $ MICROFILM $ Date owner Heating System& Ducting Registers MECHANICAL $ 2-S-.SO I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000 871- TOTAL FEE $ Information is correct. I agree to comply with all city and county ordinances PLAN CHECK 25% $ and state laws relating to building construction,and hereby authorize repro- sentatlr • •i 0 en r ••n the above- entioned p •pert for In pp ''7 01 0120395V2-00039599 TOT 25.50- Drivers' icense or 55 - - Applicant; Pink -Accounting; Goldenrod - Assessor f- •- �, r , CONSTRUCTION AND PLANNING ! POO. SPA APPROVALS Permit # Date Inspector APPROVALS Permit#- Date Inspector t 1. Temporary Electrical Service or Pole t• i 52. Pool & Equipment Location 2. SoilcPipe Undrgrnd. - �" - 53. Steel Reinforcement '. r 3:'Electrical Conduii.Utility-Undrgrnd r 54. Forms . a' 4'-Electrical Conduit;Undrgrnd. 55. Electrical Bonding - ,t/ dev 5. Scteel-Reinforcement ir �, i I. 1 . 56. Rraugh Plumbing & Pressure Test . /• 6.�Elecfrical UFER-Grrid. t 57. APPROVAL TO COVER-GUNITE 7. •Footings - 58. Electrical Conduit-Undrgrnd. -7 •8; Foundation .! 59. jGas-Pipe, 0 Undrgrnd.,Test 9.'Water•Pipe-Undrgrnd. i c,)r' 60 Backwash Lines, P-Trap, 0 Undrgrnd. 10. Str}ictural Floor System 61. APPROVAL TO DECK 11T.Property Sewer Line'& House Connection - / 62. Backwash & Receptor-Final 12: Se'w'er Cap - ;' . ', 63. Heater & Vent-Final - ,1 13! Roof Drains 64. Plumbing System - Final 14. Rough Plumbing . • 65. Electrical-Final 15. Rough Electrical:Conduit 66. Solar System-Final 116. Rough Electric Wiring 67. Fencing & Access Approval 17i. Rough Wiring Sign 68. APPROVED FOR PLASTERING 187 Rough)Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. RoughtHeating& Air Conditioning FIRE DEPT. REQUIREMENT 20_ Rough Factory Fireplace APPROVALS Permit# 21. Ducts, inVStructure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 00n 23. Gas Pipe-Rough & 1d t 72. Underground Flush 24. Roof Framing fi 73. Undergrnd.Storage Tank 0Gas DOil 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 Cost.' 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 --t' � 4. 41. Solar Domestic-Final 42. Backflow Preventer • 43. Backflow Irrigation -�r � 44. Landscape Irrigation System 1.,„! 1 45. Sound Attenuation r• 1 ,r . 46. Handicap Regulations / � ���� t 47. FINAL STRUCTURE & BUILDINGa /1/46, j9Q , /1/" ., k 48. Special Requirements Completed t 49. Electric Release to Edison ✓' 50. Gas Release to Southern California Gas Co e. - 51. CERTIFICATE OF OCCUPANCY ;• ._' _, No. Date - 44' /' Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. - a• PERMIT NO. TRACT NO. LOT NO. UNIT NO. CITY OF COSTA MESA7CON/S�TRfIU(>'TTII•ON PERMIT�s3 96+ 2—d Ci A.P.# • Zone .T- Project Address��1 eLII�/" at ri�J! 13_ •n TYPE OF CONSTRUCTION U NEW LI ADD U ALTERATION REPAIR S Main Building: Accessory Building: Applicant's Mailing Address 777"1— �/U 6•a1l,Ds D2• `rf7�K i E Front J Z Arr /�/ �7 ❑ CONVERSION DEMOLISH ❑ OTHER T O Owner's Name J- �/ / Phonh J'Z�i�/i DESCR IP N OF WORK/USE 0 BLRGy� IA Rear N Address 7,444 e i..t � /"—[/ Arch/Eng. License No. C TYPE OF PERMIT GRADING FOUNDATION U STRUCTURAL I K Right N Address ❑ TENANT 0 ELECTRICAL ❑ PLUMBING ❑ MECHANICAL S Left R Contractor's Name/&Jf/Te.r .<*1v/ A 7 hone?V21'V"a ❑ OTHER I Ping. Ref.# Parking Req./Provided E Address(mailing)A / PROJECT DESCRIPTION SQc T. -? OCCUPANCY �•3 J6 �� �Jf ��JF/Lfid/, Planning Notes: 0 /}�•s CONSTRUCTION TYPE ,L- ✓ VALUATION$ !� 000 • . T M City License No.C//— Dd f�Z�Uf 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 my license isin force and effect. �J _ ELECTRICAL FEES Ucen e ass s - _ Licen e No %�� Automatic Washer Transformer 0 15-50 KW Date Ai C Signal re e�� , /— PLUMBING FEES O WOR ERS'COMPENSATION c ECLAR• O Bar Sink Showers Construction Pole Sub. 0 50+.KW 'hereby affirm that I have a certificate of consent to self-insure or a certificate - Workers' Compensation Insurance, or a certified copy thereof (Section Cooking Unit Meter ❑up to 100 amps .00, Lab. C. _/ Backflow Preventer Service Sink ��76"//"'R7 fin. "two Backflow IrrigationDishwasher Meter (Dover 100 amps Policy No. Company Sewer Cap �❑❑ Certifi d copy is hereby furnished. - Dryers ❑Gas ❑Electric Sub Panel �— iKl Ce ifi co y ' filed with the ••-•I 'sten. _ Bathtubs Sewer Connection • ate Applicant — - Fan Motors 00-1 HP 011/2-8 EXE TION RO WORKERS'C• PENSA 10 DECLARATION Clarifiers Solar Collectors (This section eed not be completed if the permit is for one hundred($100)or F.A.U. Inc.Solar 09-15 HP❑16-I5+ less). Dishwasher Solar Piping I certify that in the performance of the work for which this permit is issued, IFixtures Microwave shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Workers' Compensation Laws of California- Device Boxes ^ / Date Signature - Floor Drains Swimming Pool w/Spa Pole Light • 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. $witchea CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Sign 1 hereby affirm that there is a Construction lending agency for the performance - of the work fora, ich,is •permit r- -s l (Section 3097 Civ. C.) interceptors Water Heater Garbage Disposal Standing Sections Lender's Name Lender's Address .. _ _ _ _ Kitchen Sink Water Service Generator 00.5 KW 05-15 KW Trash Compactor OWNER BUILDER DELL• -A ION ' I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash foowing 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 'livision 3 of the Business and Professions Code) or that he/she Is exempt Reinspectkon Fee $15 Issue Fee $ 3 om and the basis for the alleged exemption. Any violation of Section 331.5 _ 031.5 by any applicant for a permit subjects the applicant to a civil eenalty of not more than five hundred dollars($500). DEVELOPMENT SERVICES REQUIREMENTS: LI i, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 compensation, will do the work, and the structure is not intended or offered Zoning Approved By Date for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved By Date thereon, Law does not apply to an owner if a property who guilds or improves e 7 3 to and who does such work hi em nts himself/herself or through his or her own Boiler Hood or Type I 0 Application Issued By Dat employees,le. provided that such improvements eves aIe not intendedor ofyear ed corn- motion, If, te however,wthe have ng improvement of pro i g within one yeur of Im- Canopy Type II 0 SUMMARY 0 F plebe f the owner will ie the burden of proving he/she did not build or im- Duct-Under Ground prove for the purpose of sale), BUILDING PERMIT $ Z -t--- no SMIP $ SAO ❑ 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, and who contracts for such orolects with a con- ENERGY P.C. $ tractors) license pursuant to the Contractor's License Law), I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration I PLAN CHECK 25% $ proof o 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.Bit. ICBO# Fire Dampers MICROFILM $ PLAN CHECK 50% $ Date Owner Heating System& Ducting Registers MECHANICAL $ - I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000 BTL TOTAL FEE $ 7-3-; .$b information is correct. i agree to comply with all city and county ordinances PLAN CHECK 25% $ and state laws relating to building construction, and hereby authorize repre- sentatives of - to enter ypon the above-mentioned p pert for inspec •o - - //". Signature Sr Dat fl, 00239,94-00039597 TOTr� 25•5J Drivers' icense or 55$ - Reinspection Fee $15 Issue Fee $ 3 + n 5c 0865-46,rev.5/88 White - Building; Canary -Applicant; Pink - Accounting; Goldenrod - Assessor GATE: 08/04/29 T IIlE: Ll1Or - ' -\\ a \.t\ .. CONSTRUCTION AND PLANNING r POO. SPA Date Inspector Date Inspector APPROVALS Permit# _ I .r APPROVALS Permit# 1. Temporary Electrical Service or Pole v, r, 52. Pool & Equipment Location .f r �` 2.,Soil,PiPre-Undrgrnd. 253. Steel Reinforcement J 3'.JElectlical Conduit'Utility-Undrgrnd. '; „ 54. Forms Ili! 4. Electrical Conduit-Uhdrgrnd. '' 55. Electrical Bonding ,. 5,�Steel Reinforcement ' y./ (1-- 56. Rough Plumbing & Pressure Test 6:r Electrical UFER Grnd.7 11 11 57. APPROVAL TO COVER-GUNITE 1 /7 7:'Fodtgs r I '` ':,r! 58. ,Electrical Conduit-Undrgrnd. • 8. Foundation - r•�` 4, 59. Gas'Pine, 0 Undrgrnd.,Test Y' 9.'Water Pipe-Und rg"rrd. • r - V / 60. Backwash Lines,P-Trap, 0 Undrgrnd. , 10.:Structural Floor Sys(em, .••• / 61. APPROVAL TO DECK 11)Property Sewer Line!& House Copnection n 62. Backwash & Receptor-Final 12. Sewer Cap " 63. Heater & Vent-Final ,.. 13. Roof.Drai6s Je 64. Plumbing System - Final " 14. Rough Plumbing-' • 65. Electrical-Final F 15. Rough Electrical-Conduit 66. Solar System-Final •-•• •16. Rough Electric Wiring 67. Fencing & Access Approval 17) Rough Wiring Sign 68. APPROVED FOR PLASTERING 1.8^ RoughfElectrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough'Neating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# , t 21. Ducts, in/Structure 70. Underground Hydro 22. Ducts, Ventilating if, 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-'Rough &Test 72. Underground Flush ' 24. Roof Framing 1J 73. Undergrnd.Storage Tank O Gas 0 Oil 1 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 PREV. FINAL 30: Drywall Nailing 'i HEALTH DEPT. REQUIREMENT 31' Plaster Brown Coat q 79. FINAL INSPECTION 32, Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric it 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 (0'1i i 41. Solar Domestic-Final Y 42. Backflow Preventer /j{ ei 43. Backflow Irrigation -' V ,• . r 44. Landscape Irrigation System ./- 45. Sound Attenuation / )p' 46. Handicap Regulations S 47. FINAL STRUCTURE & BUI LDING,�91� 74Qy a 48. Special Requirements Completed 0 49. Electric Release to Edison !re • 1 , • 50. Gas Release to Southern California Gas Co �.. +'' •. 51. CERTIFICATE OF OCCUPANCY '/W r1 ', No. Date V C) Applicant to fill in all spaces except those within heavy border Tines and sign all appropriate declarations. MIT NO. TRACT NO. LOT NO. UNIT NO. CITY OF COSTA MESA CONSTRUCTION PERMIT I p 2�y era__ UNIT N' A.P.4h • Zone Project Address Lfl 7 F/-DFS "D-E-A - J T / �( 1� S Main Building: Accessory Building: Applicant's Mailin. Address J f 17 L f '" / TYPE OF CONSTRUCTION ..I NEW Li ADD Li ALTERATION LLLi REPAIR . E Front Z Owner's Name A as U� Phon•• .• -;"2„_, ❑ CONVERSION ❑ DEMOLISH ❑ OTHER T — O DESCRIPT ON OF WORK/USE •F BLDG. I B Rear N Address i .� - n + A . Arch/Eng. - - License No. TYPE OF PERMIT . GRADING III FOUNDATION . STRUCTURAL I C Right N Address ❑ TENANT ❑ ELECTRICAL PiZPLUMBING ❑ MECHANICAL § . Left R Contractor's Name e Phone ❑OTHER ' Ping. Ref.# Parking Req./Provided E �/ PROJECT DESCRIPTION SQ. FT. OCCUPANCY 1 7 Vativi Q Address(mailing) �j CONSTRUCTION TYPE �,�___ VALUATION $ Planning Notes: T City License No. ��J ZONE GRADING CU.YDS. ACRES M S. LICENSED CO TRACTOR DECLARATION i I hereby affirm t a .-• tensed under provisions of Chart ommencing Remarks: (' L/OQ/Z with section 7000) of Divislo - e a . • •rofesslons Code, and VVVV )))) • my license is in full force and of - . ELECTRICAL FEES License Class License No. - Date Signature PLUMBING FEES Automatic Washer Transformer 0 15-50 KW O WORKERS' COMPENSATION DECLARATION Bar Sink Showers • Construction Pole Sub. 0 50+ KW 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 Cooking Unit Meter [pup to 100 amps )0, Lab. �i�jq ,( �5j Backflow Preventer Service Sink \\ olicy No. / J 7 `//✓tCom pony J-7-04 T� �U.�p Backflow Irrigation Sewer Cap _ Dishwasher Meter Dover 100 amps — It�y Certified copy is hereby furnished. Dryers ❑Gas ❑Electric Sub Panel �S Certified c y i hereby with the .. • $fA.lon /� / Bathtubs Sewer Connection �S•> ' Date -Applicant Vl/ Fan Motors -1 HP ❑1%-8 EXEMPTION FROM WORKERS'C• the permit T •N DECLARATION Clarifiers Solar Collectors (This section need not be completed if the peris for one hundred($100)or Dishwasher Solar Piping F.A.U. less). Inc lar 09-15 HP ❑16-15+ I certify that in the performance of the work for which this permit is issued, I - Fixtures shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank icrowave Workers' Compensation Laws of California. Date Signature Floor Drains Swimming Pool w/Spa Device Boxes Pole Light NOTICE: If,atter making this declaration, you should become subject to the Outlets Ran e Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal g 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 perritt i ZejiA,Oeon 3097 Civ. C.) ItlterC¢p[Of5 Water Heater Garbage Disposal Standing Sections Lender's Name C[J/0PGdiA Lender's Address - - - _ - ... Kitchen Sink Water Service Generator 00-5 KW 05-15 KW Trash Compactor OWNER BUILDER •- A-'• °ON •• s - 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 trefrom 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 DEVELOPMENT SERVICES REQUIREMENTS: I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee I Zoning Approved By Date compensation, will dof the work,and the ofstructureproperty wh i n tuildstl roretl for sale (Section 7044, Business antl Professional Cotle: The Contractor's MECHANICAL FEES Building Approved By Date thereon Law does no[apply to o owneria through builds s or improves - - _ _ _. - _ __-_- - --<-� oy, andwho does such work ovem himself/herself arelf or in ends his or err own Hood or Type I ❑ Application Issued By_ ` Date G �/ le. If,employees,o ever, that such or proes are ootld intitletl or roredf c for Boiler sale. if, however, the building improvement is g within one year of m- Canopy T ¢II 0 SUMMARY OF FEES pletien, 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 $ SMTP $ ❑ I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refriger ton System _ PLAN CHECK $ PERMIT tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to anowner of property who Duct-Ventilating 0 ,000 BTU 0100,000 BTU PLUMBING $ i . ISSUANCE $ builds or improves thereon.and who contracts forr such oroiects �with a con- tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 ystem Repair/Alteration PLAN CHECK 25% $ ENERGY P.C. $ proof oftheir Worker's Compensation Insurance should be provided to me. ELECTRICAL $ GRADING $ _ ❑ I am exempt under Section B.& P.C.for this anon Firepl/Fact.Bit. ICBO# Fire Dampers MICROFILM $ PLAN CHECK 50% $ yt Date`�'_4( /_�� O er Heating System&Ducting Registers MECHANICAL $ TOTAL FEE $ • I(/ • 00 I hereb cer fy that I have re appli tion antl state that the above ❑O-100,000 BTU ❑100,000 BTL PLAN CHECK 25% information is correct. I agree to comply wit all city and county ordinances $ and state laws relating to building construction,and'hereby authorize repre- sentatives to enter upon the above-mentioned pro ert for inspect lo aur // 01 00044624-00044684 TOT 18.00 1\ Signature �r�' �� / Datg//� Reinspection Fee $15 Issue Fee $ 3 DATE 10/11/89 TIME: 14:10 Drivers' License or SS# Pink - Accounting; Goldenrod - Assessor .._.�N.......12-2::\ \ CONSTRUCTION AND PLANNING POO ;FA APPROVALS Permit# Dat•e, Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil•Pipe-Undrgrnd. L 53. Steel Reinforcement •/: 3: Electrical Conduit Utility-Undrgrhd. 54. Forns , • 4. Electrical Conduit-Undrgrnd. II 55. Electrical Bonding 5..Steel Reinforcement ' ; � 56. Rough Plumbing & Pressure Test , • 6.' Elaarical UFER Gr44• 1,.I / , 57. APPROVAL TO COVER-GUNITE i , 7.I Footings ' I 58. Electrical Conduit-Undrgrnd. + 8. Foundation i4 59. 'Gas;Pipe, 0 Undrgrnd., Test 9.•Water Pipe-Undrgrnd.,' 7 1 '"'' 60- Backwash Lines, P-Trap, 0 Undrgrnd. 10. St?uctural Floor System I 4 61. APPROVAL TO DECK 11 Property Sewer Line & Houie Connection vafra, n 62. Backwash & Receptor-Final 12. I Cap Sewer r•l , l$ 63. Heater & Vent-Final 13:'Roof'Drains 64. Plunbing System - Final 14. Rough Plumbing 65. Electrical-Final a 15. Rough Electrical-Conduit 66. Solar System-Final Li6. Rough Electric Wiring 67. Fencing & Access Approval 41;7- Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL '19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT `20. Rough,Factory Fireplace APPROVALS Permit# A 21. Ducts, in Structure Jv 70. Underground Hydro 22. Ducts, Ventilating F i �e 71. Product Piping 0 Gas 0 Oil 23. Gas PipegRough& Yest .41 C.) 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 j 80. FOOD CERTIFICATE ISSUED 33. Final Electric P. 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-Finalell- 41. Solar Domestic-Final / I 42. Backflow Preventer / :% 'o 43. Backflow Irrigation / ✓� C 5- 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations ' ?..-- 47. FINAL STRUCTURE & BUILDING +'. 48. Special Requirements Completed 49. Electric Release to Edison a ' 50. Gas Release to Southern California Gas Co � -•i 51. CERTIFICATE OF OCCUPANCY "t%; No. _ Date ✓• ,a r _ Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. PE IT O TRACT NO. LOT NO. NIT Up. C1Tl'•OF COSTA MESA 0j CONSTRUCTION PERMIT�^ �' 410/r// p A.P.# Zone . Project Addresst ' P-y3 7 aI,✓i.r D^F -F 7 S.-NEW (I ' S Main Building: Accessory Building: ` Applicant's Mailing dress Sr TYPE OF CONSTRUCTION ❑ ADD LJ ALTERATION (J REPAIR E Front iZ ter✓ ❑ CONVERSION ❑ DEMOLISH ❑ OTHER • T Owner's Na me d rPhone DESCRIPTION OF WORK/USE OF BLDG. A Rear Address uM fie' ��II�f'3V/Y TYPE OF PERMIT U GRADING CCOUNDATION ❑ STRUCTURAL K Right Arch/Eng. License No. sem/❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL $ . LeftAddress y+ �j �y I '-r P'1'' f/'w_ Phone 5 L g3sy ❑OTHER ping. Ref.# Parking Req,/ProvidedContractor's Name } y Y`tPROJECT DESCRIPTION SQ. FT. OCCUPANCY Planning Notes:Address(mailing) ��6y� 0tt�1 L4s� s CONSTRUCTION TYPE VALUATION$City License No. _Q4_3i 6 7 ZONE GRADING CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION . I hereby affirm that I am licensed under Provisions of Charter 9 (commencing Remarks: yet' 2_ with section 7000) of Division 3 of the Business and Professions Code,and 6 -1 my license is in full force and effect. ELECTRICAL FEES License CI ss —IA 3.F i i ens= No. •s / DateJLy" fl Signature _L._ •/ /•/a,.......,—La—Las. PLUMBING FEES Automatic Washer Transformer 0 15-50 KW / WORK RS' C MPENSATION DECL• RATION Construction Pole Sub. 0 50+KW 'I hereby affirm that I have a certificate of consent to self-insure or a certificate Bar$ink Showers of Workers' Compensation Insurance, or a certified copy thereof (Section $ I/t •D Cooking Unit Meter ❑up to 100 amps ,rJ Backflow Preventer Service Sink D 3800, Lab. ) Dishwasher • Meter Dover 100 ems -- Policy No. 3'uv4-Qo,3r3 Company Pal IOr Ifvl�K Backflow Irrigation Sewer Cap - p 8 Certifie copy Is hereby furnished. �<0D Dryers ❑Gas ❑Electric _ Sub Panel Cerny �, p fypd with the city , wisi bathtubs Sewer Connection Date Y _ 7 Applicant - Fan Motors 00-1 HP ❑1'-8 Clarifiers Solar Collectors EXEMP ION ROM WORKERS'COMPENSATION DECLAR ION - -- i (This section need not be completed if the permit Is for one hun red($100) or Dishwasher Solar Piping OD F.A.U. Inc.Solar ❑9.15 HP ❑16-15+ less). I certify that in the performance of the yrk for which thi .- mit is issued, I Fixtures Microwave ' shall note ployany person in any yl z• as t• •- o -• subject to te Drinking Fountains Solar Tank Work Laws of Cal �r Device Boxes Date • Signature s7s,i��em,�fa•—!t Floor Drains Swimming Pool w/Spa -. . - Pole Light NOTICE f,aft r making this declaratiot ,you should become su/ect to the Outlets Ran ¢ Workers' Compensation provisions of the Labor Code, you mu t forthwith Floor Sinks Urinalg comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY 5 Gas Service Outlets Water Closet 30OD Switches Sign 1 hereby affirm that there is a construction lending agency for the performance . of the work for which this permit Is issued (Section 3097 Civ. C.) interceptors Water Heater �1h Garbage Disposal Standing Sections Lender's Name V Lender's Address 3 Kitchen Sink Water Service G 00 _ Generator 00.5 KW ❑5-15 KW Trash Compactor OWNER BUILDER DECLARATION - I hereby affirm that I am exempt from the Contractor's License Law for the ,Lavatories 3 Auto-Wash 34, •• 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 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 DEVELOPMENT SERVICES REQUIREMENTS: LJ I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 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 _ thereon, and who does such work himself/herself or through his or her own Application Issued By Dat Q 2 employees, provided that such improvements are not intended or offered for Boiler Hood or Type I ❑ 777""" sale. If, however, the building or improvement is sold within one year of tom- Canopy Type II 0 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). BUILDING PERMIT $ SMIP $ ❑ 5, 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: 1 The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00.100,000 BTU 0100,000 BTU PLUMBING $ /a3, DO ISSUANCE $ 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 that. System 0 Multiple 0 System Repair/Alteration I I PLAN CHECK 25% $ ENERGY P.C. $ proof of their Worker's Compensation Insurance should be provided e. ELECTRICAL $ GRADING $ ID1 am exempt under Section B.& P .for th' son Firepl/Fact.Bit.ICBG dk Fire Dampers PLAN CHECK 50% $ — MICROFILM $ 22 \ Date ner Heating System&Ducting Registers MECHANICAL $ TOTAL FEE $ �°Na-OL/ I hereby certify that I have read this application and state that he above El 0-100,000 BTU 0100,000 BTL 25% information is c. rect. I agree to C. ply with all City and county ordinances PLAN CHECK $ and state laws ating to b 'Idi nstruction,and hereby authorize repre- sentatives of • s] it t On the above-mentioned Pr,pert for inspection re p AS /� ' /• d _ •, Signature I, Pink -Accounting; Goldenrod - Assessor --� ' };CONSTRUCTION AND PLANNING POOH &SPA • Date Inspector Date Inspector • :APPROVALS Permit# APPROVALS Permit# 1. Temporary Electrical Service or Pale •I ' sly- 52. Pool & Equipment Location ' 2, Soil Pipe-Undrgrnd. - 9//,fin- 53. Steel Reinforcement .%�_' 3. Electrical Conduit Utility-Undrgrnd 111,/// z• 54. Forms - 4!;ElectricalConduit-Undrgrnd. ' 55. Electrical Bonding Imo? 5•..Steel;Re nforcem_enr ' �'� 56. Rough Plumbing & Pressure Test •�� !6. EPecfr cal UFERiG.rnd" 57. APPROVAL TO COVER-GUNITE _ (mss:, ri Y:/Footings 7-- S-tb �`,- 58. Electrical Conduit-Undrgrnd. Z.,, 8^Foundation ,; l -1�• 59. Gas Pipe, 0 Undrgrnd.,Test ., t? ,1 9)Water Pipe-Undrgrnd. • #erf AY 60. Backwash Lines, P-Trap, 0 Undrgrnd. - i L '� Ji�t J 10. S•tructural Floor System .9 �)• 2 61. APPROVAL TO DECK (� 11,...1 10 Property Sewer Line & House Connection ;�/ 62. Backwash & Receptor-Final 12l.ISepver Capes ,`y:: i{ 4- 1;l � 63. Heater & Vent-Final • 13lRy n gof Drains 1, ' �� ;i( 64. Plumbing System - Final 14. Rough Plumbing - Z• 65. Electrical-Final • v 15. Rough Electrical-Conduit 4 � g6 .- .l Solar System-Final 1:6- Rough Electric Wiring 67. Fencing & Access Approval .., .17, Rough Wiring Sign 68. APPROVED FOR PLASTERING X78. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL ;1�Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT - 20. Rough Factory Fireplace APPROVALS Permit# l , ; - 21. Ducts,in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil ; / 23/Gas Pipe-Rourgh & Test 72. 'Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank ❑Gas DOil 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 . 30t Drywall Nailing HEALTH DEPT. REQUIREMENT 311. Plaster Brown Coat 79. FINAL INSPECTION 32) Electrical Power Meter-Final �j Z� �., 80. FOOp'CERTIFICATE ISSUED t , 33. Final Electric r) C) .., o tif7 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 3/Vfrac 36. Hood or Canopy 37. Final Factory Fireplace • 38. Final Plumbing 41f44Ip y�%T ' • • 39. Water Service-Final /0/1/14^/Or 40. Gas Service-Final /�R 41. Solar Domestic-Final . 2 - l. 42. Backflow Preventer ,t y 43. Backflow Irrigation . 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison ?" i 50. Gas Release to Southern California Gas Co IJ I./. 51. CERTIFICATE OF OCCUPANCY /,n ft No. Date �0 a A .6,P-23 PROJECT ADDRESS: sex r: 3D.3 5c/ 2337 ELDEN• AV D, E., F CITY OF. COSTA MESA - BUILDING PERMIT PERM NO: M 045643 OWNER'S NAME: RODNEY BROWN ADDRESS: SAME PERMIT NO: M 045643 PLAN CHECK _NO: . N ` GOVT: N SUPP: N , CON• STRUCTION TYPE: • PERMIT TYPE: MEC PURPOSE: NEW ' • ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION NEW FACTORY FIREPLACES ( 3 TOTAL) - SQ FT: i ADDRESS: UNIT: • CLAIM VALUE: CALC—VALUE: GROUP OCC: ' / PERMITTEE: RODNEY BROWN • ( 714 ) 642-3812 - ADDRESS: 177 RIVERSIDE DR • F COMMENTS: REFER •TO #B40012 N. B . CA 92663 ***************+E*TF******aE*****x*TFT6EFEHTH****+riF**rT6******TF*TE**T6EraE******aETF*a6e+6****** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commendng with Section ZONING REQUIREMENTS 0 . . 7000)of Division 3 of the Business and Professions Code,and my license is in full farce and effect. S E T B A C K S ' • CITY UC.: . STATE UC.: CLASS: • - • Date: Signature: • MAIN BUILDING ---- ACCESSORY BUILDING ' WORKERS'COMPENSATION DECLARATION: Ihereby affirm that)have a certificate of consent to self-insure or acenifiate of 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 IN LEFT: FT. IN RGHT: FT IN . POLICY NO.: • EXP.DATE: 1 COMPANY: • PARKING REQ: , PROV: PARCEL: 43927123 ZNE: 'REF NO: ❑ Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES> ' > . • . . ... -. .. .. Date: Applicant: ***'******************************iF************************,****1f**************** ' EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This 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 i S , 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 'y .'' subject to the Workers'Compensation Laws of California. ZONING APPROVED BY . is DATE: ' Date: - Signature: - • - - - -. -. . - NOTICE:If,after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY . DATE: Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. ;�• CONSTRUCTION LENDINO AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for ' APPLICATION ISSUED{ B Y: a' . .�i - DATE: -derilwhich.this permit Is issued(Section 3097,Civ.C). ************************** *******i� E**** * '***** ************ � LENDER: *********************************************** f****************************** ADDRESS: - LEGALIZATION: N ' F E E ' SUMMARY STRUCTURAL SEGMENT:N ' I' - • • OWNER BUILDER DECLARATION: I hereby affirm that)am exempt from the Contractors'State License Law for tie following reason BLDG PM_ T .• PLUMBING ELECTRIC MECHANIC FIRE, SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT ' . . 19 , 50 ' repair any structure,prior to its Issuance,also requires the applicant for such permit to file a signed statement that he/she Is licensed •, - I252 SM I P/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.Any 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.(S500). . , ISSUE FEE • ,, 15 . 00 BUILDING PERMIT , ISSUE . PLAN—CHECK TOTAL PAID 'DUE • I. as owner of the property or my employees with wages as their sole,compensation;•will do the work, and the . ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors State License Law • TOTAL S————> 19 . 50 15 . 00 0 .00 3 4 . 5 0 34 . 50 ' • . 00 - does not apply to an owner of a property who builds or Improves thereon,and who does such work NmseWherselt or through ' . i . - 'his or her own employees.provided that such Improvements are not intended or offered for sale.If,however the budding or REVENUE DIVISION TOTALS--> COLLECTED: 34 . 50 OVER/SHORT: - 00 improvement is sold within one year of completion,the owner wit have the burden of proving he/she did not build or improve - '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 - 3 4 . 5 0 ❑ and Professions Code: 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 acontractor(s)license pursuant to the Contractors'State License Law).I am aware •*****************************************************ie************************* that proof of their Worker's Compensauon'insurance should be'provided to me. I N D I V I D U A' L F E E BREAKDOWN ® lam exempt under Section:704 4 B.&P.C. ' for this reason: CONTRACTOR HAS TYPE QTY D E S C R I P T I O N • UNIT COST - TOTAL COST Date: _ 1 S °Pe MEC 3 FACTORY FIREPLACE 6 . 50 19 . 50 i I do hereby certify that I am aware of and understand the requirements of California Health dh d Sate ns 25505,25533.and END OF FEES ' 25534 and that I or any future building occupant MUM'not(circle one)need to comply with said state codes and the requirements for a - . - • permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from these provisions. . - • ' ' r I I • Date: / v --ti ApDliant:. / / _ . I hereby certify that I have read this application and stile that the above information is correct.I agree to comply with all city and county • ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned . . . _ , v� property for inspectionrpurposes. - . • y Date:/✓ X ""3". d - Pink—Revenue:Goldenrod—Assessor - - CONSTRUCTION AND PLANNING - r POOL & SPA x 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 • c • ..>3Electrical Conduit-Utility-Undrgrnd. 54. Forms • --4.uElectrical CondfriYUhdrgrnd. •- 55. Electrical Bonding s • ` - e.5. Steel Reinforcement 56. Rough-Plurnbing & Pressure T s - t ; (.8. Electrical UFE_B,Grnd. 57. APPROVAL TO COVER-GUNITE " -• 7. Footings - • 58. Electrical Conduit-Undrgrnd. • 6- - 8. Foundation ?% 59. Gas Pipe, 0 Undrgrnd., Test C • 9. Water Pipe-Undrg`.rnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. • 10. Structural Floor System 61. APPROVAL TO DECK = • 11. Property Sewer Linc& House Connection • 62. Backwash & Receptor-Final `� . 12. Sewer Cap 63. Heater & Vent-Final ' 13. Roof Drains ,_, 64. Plumbing System - Final . 14. Rough PlumbingV. 65. Electrical-Final 15. Rough Electrical-Conduit 66.. Solar System-Final • - 16. Rough Electric.Wiring 67.• Fencing & Access Approval • 7 17. Rough Wiring Sign • 68. APPROVED FOR PLASTERING • T -r18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL - 19. Rough Heating & Air Conditioning-- _ - ,FIRE DEPT. REQUIREMENT 20.•'�flough Eacto%y F r place - V ,01,-, -APPRQVALS_.;_Permit# r' 21 t-Ducts, in•Structdre< •• •• -•S x !YS •/_-. 7-.. , = - t' • c _ rr ^z r-- n r �. X70. Underground Hlidro y 22. -Ducts, Vent�ating' '-a * : ro --.a ` X71. Product-Piping Deas 0-Oil 23 Gas-Pipe-Rough & Test �^ `r�-: a :✓ a; < --' ? 72. Underground Flush. * y 24!Roof Framing r< ▪ "•r J =i ;` -73=Undergrnd.Storagg_Tank,�O Gas 0Oil 25. Roof Sheathing Gx _ ••• • w ... 7 C. :* x -7q-Overhead Hydro; 26,4" -Bar Ceiling ISt`uatural) &-Monocoat x n- 75 Dry Chemical - 'n a, 27aFrame and Flashing. ••7. ▪ - . c .- ,7,x ,: 76 Dry Standpipe ;.E x ^28. Lathing'& Siding' =M_ C * - r rc 77r,... FIXED $YSTE[yl FINAL! - 29. Insulation -+ R 78`FIRE PREV. FINNL = [r30. Drywall`Nailing i_ :� _ .x * Ti EALTH:DEPY, REQUIREMENT -m31. Plaster Brown Coati [r,. + r. -'79. FINAL IN_SPECT{ ON 2 -- •-+ '32C'Electriral Power Meter-Final' * re ' .1i' .K "80171FOOD CERTIFICATE ISSUED,,, T'' 14 '4: z335`Firtal Electric I a, r* • !,/ t .* 1 Notes: - ;?': C _ • (34nFi HI ating& AiTContlitioning• i * .1-2-1,4, Cr � r. C. O _cH _ r ` ,35rial G Firas Pipe-Testa •• A r % 7...0.x ' C;�.z, rl 036�Hood or Canopy * tr.`: " .t n I �It. :x ` :.--7:r‘ x r, r" �37`�Fina1 Factory Fireplaces7.- ce '1/4 L6 i ., ., '-�38. Firrel Plumbing c" I y -; ^ z.TS.1..: K • H `: t' :/i l: '39. Water Service-Finali. z s ,-. I / .", ., t. 740. Gas Service-Final t t n SFr;- S a: ,r, %I j* * . pa yr^u * ` •e - c, t �: T X41. Solar Domestic-Final * i. - <;,.--, .-:0 x z _I 42 Backflow Preventer. • ^l 1 ' ix r: .:- * Zi +-+ ;,I cc.. _, l... :FH Y * 7 LiD N . ,.. 43. Backflow Irii atio" ""'-'. It .{ 1: +44 Landscape litigation System•ri 0 4 ri C _'^ * ° ,! =7 % , n: a ,-. n : 1.-::"▪.1.- Y: r-. i--•t: # r, ,--., M., 4 `45•�>Sound Attenuatio4, . .. * a .^* * C: : E-Ci y' ; C46.-Handicap Regulations '- 4. . • * * r" 5 :77 0 *- �' m47:SFINAL STRUCTURE & BUILDING _ 12 �] ` r F. _ ce.... .. _. ,. 487-FINAL PLANNING • i :g t; pp q T '. q: 49Electric Release to:Edison P r y -y o50SGas_Release to Southern California Gas Co • (..4.4i ;. - 0 • ems; r - -• At g-t lk .. S Jt - r CU i '--51. CERTIFICATE OF'OCCUPANCY * •• ` > :-.1 ':-' '� A " •� No. Date • p "PROJECT ADDRESS: 2337 ELDEN AV UNIT: D, E, F CITY OF COSTA MESA - BUILDING PERMIT PERM NO: M 045380 • OWNER'S NAME: RODN&Y BROWN . SANO: ' GOVT: NSUPP : ADDRESS: ME PERMIT M 045380 PLAN CHECK NO: N N • • • CONSTRUCTION TYPE: PERMIT TYPE: MEC ' ' PURPOSE: NEW • ARCH/ENGINEER: i • RHINO.: JOB DESCRIPTION : NEW HEATING SYSTEM " SQ -FT b • ' ADDRESS: • UNIT: • - • CLAIM •VALUE: CALC—VALUE: '. ' GROUP OC• C : / • PERMITTEE: NEWPORT AIRE SYSTEMS ( 714 ) 642-8575 ' ' ' ADDRESS: 1539 MONROVIA AV • G COMMENTS : REFER TO #B40012 N. A. CA . 92663 • *****************************dEya*>E*ya********yr+EyFaa*****N**** **3*******rt*xitrt+tx***** •LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commendng with Section Z O N I N G R E Q U I R E M E N T S' • 7000)of Division 3 of the Business and Professions Code,and my license ljiss iinn full force and effect. S E T B A C. K S Dm tic.:0`g U 41 STATE U :QO ve4 Fe r� Date:— 7—/2/ Signature' MAIN BUILDING ACCESSORY . BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that l have rti eofconsent to self-insure or a certificate of Workers( FRNT: FT IN REAR: FT IN FRNT: ,FT IN REAR: FT IN Compensation Insurance or a certified copy thereof(Section 3804 Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT ' IN RGHT: • . FT IN - POUCYNO.: 1137581-89 EXP.DATE: 07/01 /90. ' COMPANY: STATE PARKING REQ: PROV: PARCEL : 43927123 ZNE.: ' ,REF NO: L ❑ Certified copy:ls hereby furnished.• 20 Certified copy is filed with the city Building Division. PLANNING NOTES> , , Date: `Z—I2--J / ( Applicant: i�2iie / ` . •*******************************if*****:*.*he. *** *** * * ie 3E **** * *it********* ************* EXEMPOON FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed it the permit is for one hundred($100)or 1- • ). DEVEL OPMENT S E R• V, I ,C E S REQUIREMENTS • I certify that In the performance of the work for which this permit is issued,I shall not employ any person In any manner so as to become • - • subject to the Workers'Compensation Laws of California. , ZONING APPROVED BY DATE: ' Date: signature: - BUILDING APPROVED BY : DATE: NOTICE:IL aking after mthis declaration,you should become subject to the Workers'Compensation provisions of the Labor Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. • _• /� • CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for SAP PL I CAT I ON ISSUED BY: • �< DATE: L-- which which this permit is issued(Section 3097,Civ.C). . v.********************************44X)4* , I • • ****44**********�4- ** *14*)4444(*. LENDER: • , **********************)E**************1E**************************************** ADDRESS: • - ' LEGALIZATION:N ; F- E "E ' S U M M A R Y ' - '' ' - STRUCTURAL SEGMENT: - ' 1 OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from.the Contractors'State License Law for the followingreason - BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve.demolish,or PERMIT • - 27,00 , repair any structure,prior to its issuance,also requires the apptcant for such permit to file a signed statement that he/she is licensed25% 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 live hundred dollars(3500). ISSUE FEE - - 15 . 00 I, as owner of the property or my employees with wages as their sole compensation, will do •thewok. and the BUILDING—DIV—> PERMIT ; ISSUE ' PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contactors'State License Law TOTALS—' ——> ' r ,- 27- 00 115 . 00 0 . 00 42 . 00 42 . 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 ' • - hisorherownemployees,provided that such improvements are not intended or offered for sale.If,however the building or REVENUE DIVISION TOTALS--> r COLLECTED: • 42. . 00 OVER/SHORT: 00 improvement sold within one year of completion,the ownenwilfhave the burden of proving he/she did not build or improve foror the purpose of sate). " 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 - 42 . 00 ' ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon ' and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware *****'***********************************************************************44** that proof of their Worker's Compensation Insurance should be provided to me. IND I , V I- D U A L F E E B R E A K D O W N o I am exempt under Section: B.&P.C. ' for this reason: . TYPE QTY DESCR I: P T I O N • • UNIT COST TOTAL COST Date: Owner: MEC 3 INSTALL FORC/AIR FURN G= 100 K BTU/H 9 . 00 t 27. 00 t I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505.25533,andEND 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 thell Tuohy Management District.Residential Construction applications are exempt from I • - these provisions. Date: • Applicant: I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county • . ordinances and state laws relatingNh to building ganstruction and Hereby aa rem lathes of the city to a er upon the above-mentioney' - t property for inspection purposes. I (/ • Date: 2_47-97 Signature: �' . • Drivers License or Social Security Applicant:Pink—Revenue;Goldenrod—Assessor - - - - . . DATE: 12/12/89 TIME: 15:58 J ell CONSTRUCTION AND PLANNING - POOL& SPA APPROVALS Permit# • Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Serviceor Pole V - 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. �' 53. Steel Reinforcement 3.,Electrical Conduit Utility-Undrgrnd. 54. Forms Q 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 • 58.1 Electrical Conduit-Undrgrnd. 8. Foundation 59.-Gas Pipe, 0 Undrgrnd.,-Test ' -a 9. Water Pipe-Undrgrnd. ' 60. Backwash Lines, P-Trap, 0 Undrgrnd. 7, 10. Structural Floor System ,',.'• 61. APPROVAL TO DECK /. 11. Property Sewer Line & House Connection `^s 62. Backwash & Receptor-Final 12. Sewer Cap _ r- 63. Heater & Vent-Final t 13. Roof Drains j,': ,� 64. Plumbing System - Final • 14. Rough Plumbing 65. Electrical-Final . ! 15. Rough Electrical-Conduiti : , 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 - J 69.`POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning - 7 FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS - Permit # 21. Ducts,in Structure _70. Underground Hydro 22. Ducts, Ventilating - 71. ProductPiping 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-Bdr Ceiling (Sfructural) & Monocoat 75. Dry Chemical , 27. Frame and Flashing 76. Dry Standpipe ' ,28. Lathing & Siding , - . '' , , 77. FIXED SYSTEM FINAL . • 29. Insulation - - ^ 787,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& Aii Conditioning & /J�_�S L14// - a. 35. Final Gas Pipe-Test - - 36. Hood or Canopy - - - t. • - 37. Final Factory Fireplace-. - - 38. Final Plumbing - 39. Water Service-Final -: • 40. Gas Service-Final - ;41. Solar Domestic-Final _ 42. Backflow Preventer ' " .�i • 43. Backf low Irrigation - ,�•, 44. Landscape Irrigation System' - _. � + ' 45. Sound Attenuation - . ' _- 46. Handicap Regulations 47:FINAL STRUCTURE & BUILDING - " 48. FINAL PLANNING -- • . ' 49. ,Electric Release to Edison ) _ = ' 50. Gas Release to Southern California Gas Co -'- • __ 51. CERTIFICATE OF OCCUPANCY - . , No. Date Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. I PERMIT O. TRACT NO. LOT NO. UNIT NO. CITY OF COSTA MESA�•]� CON�S+TRUCTIOIt PERMIT I E UO. fa_ E F A.P.# zone • -J Project Address_ '233-1 91 CFS {�S J I I t •t S ' Main Building: Accessory Building: r Applicant's Mailin ddre55 34.o(at OJiy r �s/L- TYPE OF CONSTRUCTION C4 NEW LkADD L=1 t' IJ REPAIR E Front • - Z ��••ff � ❑ CONVERSION ❑ DEMOLISH ❑ OTHER il T 0 • Owner's Name CO t. � + Phone DES RIPTIO OF WORK/US OF BLDG. � / Z •sfir B Rear N `.,Address i`n �•�' cur-4_54N; • A - " a^ = g C Right N Arch/Eng. License No. - " TYPE OF P'RMIT N GRADING il FOUNDATIO N STRUCTURAL K G Address ❑ TENANT XELECTRICAL ❑ PLUMBING ❑ MECHANICAL I S • Left R Contractor's Name M�An.Tety _ -- it Phone�� 40013 ID -OTHER 4 4/¢J. Ping. Ref.# Parking Req./Provided E $ A PROJECT DESCRIPTION SQ. FT. /_2 OCCUPANCVJ�S_F,-SL'-. Planning Notes: M Address(mailing) a r2(Q 0�1^)c 42e- tis `•M CA 's.� ALU / p CONSTRUCTION TYPE v VALUATION$ T City License No. 3S .Z 1 ZONE GRADING CU.YDS. ACRES / S. LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: �DD/Z with section 7000) of Division 3 of the Business and Professions code, and my license is in full force(and effect. p-�,� ' III ECTRICAL FEES License Class ``�`�/� license o. t1�/sig Date �7—�G�9s� Signature - �'� - 4� PLUMBING FEES ■ s WORKERS' COMPENSATION DECLARATION ■ s e I hereby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink Showers 'if Workers' Compensation Insurance, or a certified copy thereof (Section ■ ss • amps 3800, Lab. CJ _ q �Z�.�.�, /- Backflow Cooking Service Sink mg N. Policy No. /064,2.2-1 `t Com•.ny vta-2 /r•�++ Backflow Irrigation Sewer Cap Dishwasher Clover e1 amps \ F��{I Certified copy is hereby furnished. e ■ ■ . \ y�Cer • i cop }�fi d with the city B Divisio Bathtubs Sewer Connection bite �1�M7 'Applicant ■1 • ■ EXEM ION FRO WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors _ (This section need not be completed if the permit is for one hundred($100) or Dishwasher Solar Piping less). 09-15 HP ■ ' I certify thatm in the performancepersonin the work for whichsothis permit is C Fixtures Microwave - Wor not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Workers' Compensation Laws of California. Date •Signature ,Floor Drains Swimming Pool w/Spa .. q Device NOTICE: If,after making rthis declaration,you should become subject to the • Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal - OutletRange s _1..I with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCYSwitches Gas Service Outlets ' Water ClosetSign ' 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 Interceptors Water Heater Disposal Lender's Name Lender's Address Kitchen Sink Water Service Generator 00-5 ■ 5-15 KVV Trash Compactor OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash / ./- A/Lf,s//{� ltX *If-. /38 q following reason (Section 7031.5 Business and Professional Code: Any city or j77 /� T county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays 6f/ 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 $ - 00 terefrom 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: ❑ 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 Zoning Approved By �%�///� bate for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved By /� Ill I Date License Law does not apply to an owner of a property who builds or Improves �1 thereon, and who does such work himself/herself or through his or her ownApplication Issued By_ - s �`�-�.... Dat / _ 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 0 MARY 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). BUILDING 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 DO-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 the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration PLAN CHECK 25% $ ENERGY P.C. $ proof oftheir Worker's Compensation Insurance should be provided to me. I ELECTRICAL $ `l7/9� •�7 GRADING $ ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers • PLAN CHECK 50% $ MICROFILM $ Date Owner Heating System& Ducting Registers • MECHANICAL $ TOTAL FEE $ /67. 17 I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000 BTU - PLAN CHECK 25% $ information is correct. I agree to comply with all city and county ordinances and state laws r- ing to building construction, and hereby authorize repre- sentatives of thy to - ter •on the above-mentioned• property for . inspection purpo I f35 _ Signature Pink -Accounting; Goldenrod - Assessor DATE: 09/25/89 T RIE: :31337 . .\ . --� ,` >' \\\\ CONSTRUCTION AND PLANNING i\ POO. SPA ' APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole T 52. Pool & Equipment Location 1 2. ,Soil Pipe-Undrgrnd. ti 7 i- 53. Steel Reinforcement i 3.,Elecefal Conduit Utihity-Undrgrnd' •1 �� 54. Forms 4..•Elecvicail conduit-Undrgrnd. / 4.afta4 55. Electrical Bonding ..Steef Reinforcement)'6 56. Rough Plumbing & Pressure Test _ t, 6:.,Electrical UFER•Grnd. 57. APPROVAL TO COVER-GUNITE C" 'J ., 7.9 Footings :C' -....1� -1 58. Electrical Conduit-Undrgrnd. d 8.`Foundation ti„ -, } % • • • PROJECT ADDRESS: - UNIT: OWNER'S NAME: 2337 ELDEN AV �= DEF • CITY OF COSTA' MESA BUILDING PERMIT PERM NO: F 045538 RODNErBROWN - ADDRESS: •�77 ,'.F' RIVERS . IDE DR • PERMIT NO: F 045538 • . PLAN CHECK NO: 02098-89 S GOVT: N SUPP : N ' NEWPORT BEACH • CA 92660CONSTRUCTION TYPE: 5—N SPRINK PERMIT TYPE: FIR . PURPOSE: NEW ( 714 ) 548-7102 - ARCH/ENGINEER: BEARD/PROVENCHER 6 •ASSO. REG.NO.:UNKNOWN - JOB DESCRIPTION : RESIDENTIAL FIRE :SPRINK. SYSTEM _ SQ FT: ' ADDRESS: 1240 N JEFFERSON ST UNIT: Q ANAHEIM CA 92807-1632 CLAIM VALUE: 8, 000. 00 CALC—VALUE: 'GROUP OCC: R-1 / r PERMITTEE: TCT PLUMBING ( 714 ) 586-9254 ' • - • . r . - ADDRESS: 23261 DEL LAGO COMMENTS: ;RE: B40012 PRIMARY BLDG. PERMIT. ' LAGUNA HILLS CA 92653 • ************;tr*********Erx*er******it****x•*EH**if**+t*Er r**********x+sitar****i<•*****x***** ' LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section . Z O N I N G REQUIREMENTS • 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. S E T B A C K S • ' CITY LIC.: 04 667 STATE LIC.:379808/ C SS: ,1j � - - Date:42 2 Jl S`7 Signature: / 4A..✓ $" /L�.�. L • MAIN. BUILDING -- ACCESSORY BUILDING • • WORKERS'C PENSATION DECLARATION: (hereby affirm that)haveacertificete of consent to -insurearacertiticate of Workers' • ' FRNT: FT IN REAR: . FT IN . FRNT: FT IN REAR: • FT ' , IN Compensation Insurance,ora certified cop thereof(Section 3800.Lab.C). , LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT . IN • POLICY NO:: 73WC0073530001 EKP.oATE: 05/07/90 . COMPANY: NATIONWIDE •• PARKING REQ: PROV: . • PARCEL : • 43927123 ZNE: REF NO: ❑ Certified copy,is hereby furnished. ( Certified copy' with the city BuildJr, /inyA0/MS�onn.. r ' PLANNING NOTES> ' ' I • • Crate / ! / - Applicant: ,,,,,,t.,_•..., dip LLQ • ***************4****4********************************************************** EKEMPRON FROM WORKERS'COMPENSATION DECORATION: (Pis section need not be completed d the per B for ane hundred(5100)or less). • DEVELOPMENT .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 • • subject to the Workers'Compensation Laws of California. • ZONING APPROVED BY I DATE: _ Date: Signature: . -- • . - NOTICE:II,after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY /. �•� .; ,� e — / t DATE: /a�-2.7Act Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. or i CONSTRUCTION LENDING AGENCY: hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION I CAT ION ISSUED. B Y: - � �16� DATE: /o . which this permit w issued(Section 3097,Civ.C). ************************ * * * * **** ** ******************** * *** ** • LENDER: - ********************4d********************* *********************************** • ADDRESS: - - ' - 'LEGALIZATION: N ' F E 'E "SUIM MARY ' ' 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 SHIP/RES GRADING (Section 7031.5 Business and Professional Code: My city of county which requires a permit to construct,alter,improve,demolish,or PERMIT - . ' 9 9 . 0 0 • repair any structure,prior to its Issuance,also requires the applicant for such permit to file a signed statement that he/she Is licensed - I pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business . ' 64 . 35 65% SM I P/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN • _ , _ - 6 4 . 3 5 . any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars($500). ISSUE FEE , I, as owner of the property or my employees with wages as their sole.compensation. will do the work, and the I BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID • DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code:. The Contractors'State License Law TOTALS.————> 99 . 00 0 .0 0 64 . 35 ' 163 . 35 16 3 . 3 5 . 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: 99. 00 OVER/SHORT: . 00 • 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 • - 99 .00 , ❑ •and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware **K-**************************************************************************** that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BR EAKDOW N • ' ❑ I am exempt under Section: B.&P.C. I , for this reason: TYPE DESCRIPTIO N UNIT COST TOTAL COST • • Date: owns • FIR 9.9 'FIRE EQUIP FEE ( FROM BLDG VAL TABLE) 1 . 00 99 . 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 uahty Management District.Residential construction applications are exempt from ' - y • ' these provisions. • -I , Date: Apptcam: • • . . . ' • I hereby certify that I have read this application and state that the a e information is correct.I a e to comply with all city and county . .\ ordinances and state laws relating to building construction and he m fail re resentatives of th c to enter upon the above-mentioned property for inspection purposes. [(���/7 Date:/a/ .z7e9 Signature: • 01 000`ObDS D4050605 TCST • 99.DD +ver's license or Social Security Applicant;Pink—Revenue:Goldenrod—Assessor - - .- _ .. 1 CONSTRUCTION AND PLANNING �N ' POO LaPA • APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Sernce orPoLe.s - . 52. .Pool & Equipment Location /• .2. Soil-Pjpe_Undrg;nd- • l 3F 53. Steel Reinforcement -J4:.ElfictriealCoslduit^.Utility-UndrgrndSS 54. Forms n..' . ter; .-..... Laa 4..Electhica�•Cor it`-t-1 drgrnd',.• /- 55. Electrical Bonding y/ t=•&. SteeUReiinThrcattettt: o -s.• 56. Rough Plumbing & Pressure Test ' 6. ect;feltYpFE$,Gnd. J o 57. APPROVAL TO COVER-GUNITE ( .•�7.t -, 1oting -; , ,-1"?1S" ?1S" m p L. 58. Electrical Conduit-Undrgrnd. '74 8.GFoundaiy'- 59. Gas Pipe, 0 Undrgrnd., Test -'`-' ,tl J - 9 +Nater Pige Undrgrnd. • .t - _ 60. Backwash Lines, P-Trap, 0 Undrgrnd. --�� 10.'5StructufaJFFloor System I r,; 61. APPROVAL TO DECK [ i 11. Propert J-SeVier Lire& House Connjction - 62. Backwash & Receptor-Final • 12. Sewer Cap c., cJ Ti -, C' ' 63. Heater & Vent-Final '4 rn 1. n . 13. Roof Drainsj,-- S it - 64. Plumbing System - Final 14. Rough Plumbing w i 65. Electrical-Final -- 15. Roughtect, %-Conduit - 66. Solar System-Final 16. Rough Eieciii4Viring - 67. Fencing & Access Approval , ?17. Rough UWring Sign - 68. APPROVED FOR PLASTERING LA 18. Rough Electricaal-T Bar Ceiling ' - 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating &iir Conditioning y * . m ,c* r : ,^FIRE I�.EPT. FaEDUIRcMENT _f. 20 fioagh f ctoFY R raplace _t �; ,, S CPA * %. ... -APPROVALS -Permit- # _ _ r ".-2 r..v :F= _ -t-:I: C, =D' r * 21 -Outs, iRStrZictutri se* •• •• �� * S 7 I* * _70. l7hdergTo n'a Hpdro r r-.* CJS * S c;x x i M" nig < 22.-Ducts, Ventilating* 0 * ti < 0 E...,* :c ,:71. Product,Thoing 0 s ET • 23.•Gas-Pipe^Rottgh & Test _ fnS * r- T ' rr * r72, Underground FIQshP t. �. n, 24:Roof Fuming "`�* `y- -'r- 0 * * '73pUnder rn3.Storl `Tank,'OGas ❑Oil 7 M rl* x 7 9 13giL 25. Roof Sheathing .r* d v ,"* a 7 N* * 74c.Overhead Hydrd0I * {_g�0 �,y,� l * ✓ ^ ti! �,x' 1 ,T X 264T-Bar Ceiling (Statural) �nccoat ,*r 0 .„ 0 et: . 75 Dry Chemical _;p * " `�T, 27•:...Frame and Flashing; q_,-_ _ * c >• Ta* 4 76. Dry Stan ipe _.a * - ,- • Y Tat .M C•....1 Y: 1 4-, r28. Lathin iSuing:* " ^•c;, t^ * E " •'` .* 77,c,,, FIXED S`.Y TEMFINAI H • 29. Insnlatmh • £* S •• ! I ; 78EFIRE PREY. FIN&L W > ^ '- - ,..,. < ,. - j{ -.1 i++tet�r y -209J r'30. Dry�valFNaitfng �* I * :, ' ' 'X * s tJ EALTFLDEPT: FrEOUIRE_MENT i Cx. . .v - r, 031. Plaster Brown Coate s I mt- x: I (I ,;i * "79. FINAL IRtSBECTlbN * v Pi --! .s .: r-n $.- * _. r32E,Electrigip Power +le ar'-final.! * C•7 i I �SOt?FOOD CERTIFj TE IS'S�JED,-.I M t 1 J,. \J _ ''�' • 33=Fina;l Efeetrlc * t.; < * It .. Notes: 1.1 ^I * -3 0 (Jr. "•'34cFina1 Hptirig& i7 C itditicirAF 0 - `* * I~ S FS E 35'=Final Gas Pipe-Test* ,mow . q I b * * C- * t X36. Hood onCanopy * IS ! C'"" m * n ; /q1F[,;. * E m u * ;r• - L. * it i .1, tJ * 1 ! - .$t* ., 1, 'k.. ^ i T Cv- 1-;;37.`..Final Factory Firep1acem ! f,=-1 <, t - • I %i 1'* x - ^ ` - d �- . _ .. . . .. _, t FI * r' Tr-. * _ `38• `Final PCvmbing * C.7 * ! "I- it II 5 1-c, 'e t-. cI _J .s , I '1N. S I. I v.':� •n -a.. C"39_�Water Service-Fina` < I * m. { I c. * r a, c * r..n - * .71 -C'40`I Gas Service-Final * fl S. S Cr,t * Cl I M: 4: - 0u :c- * . * rIF - t, .s ) I Ix * H - oS a; 'G t41:`Solar Domestic-Fin IS 1 * a I 1 x x: w,w _ T _ - 1 . c. -.a - - - , .` fr 42.VBackflow Preventer4 ^J * II * * I%. •^- • =i- F O - , • n * n fi'-o- x .y * * -;crl:... i c; .. r_73 43. Backflow Irtigation j SS * c * * V. 0,ej"J - * `� �, 4- C."_ m44. Landsctl$e ITrigatidh Systerr'rico C+ * m O C O* * c.1 cv -, `"CJ * c. o - r. * t^ * c c* T. f to Or S - I▪- 0Sound auatio, * �S� r * < i- c, r'* * • r" I- L.'.-•... _`d. .' t.Att g •* :-1 t, frit * -• C G; • HO lc • 1. ~ 1 • * - . * * = <- Cir./ S * :r546.-Handicap Regulations '. 0 x - I 1 KK is r n Q 0 * _ c * r -•'1* * 7 PJ ,,,,47rFIhtAL STRUCTU*iE & BUILDING = ^, i �;- .,,q * C t:r. C. si ^ FINI 48 AL PLANNING ! HE-4 * tt' C,1!'"i•q'*, * t q v < * C -49l,EldEtric Release to Edison ;r V j v ,4 .�. K - , rj50 LGasIielease to Southern California Gas Co * ti i ‘,/x. * - I-' `' • ern * 0 ' * - • - * . - * x Co r. *. cti C) =51. CERTIFICATE OPOCCUPANCY * * * = (5) MC-) • No. Date ' • • PROJECT ADDRESS: 2337 ELDEN AV UNIT: B CITY OF COSTA MESA — BUILDING PERMIT PERM NO: M 048627 ` OWNER'S NAME: RODNEY BROWN . ADDRESS: SAME "A" PERMIT NO: M 048627 PLAN CHECK NO: N GOVT: N SUPP : N CONSTRUCTION TYPE: V—N PERMIT TYPE: MEC PURPOSE: OTH ARCH/ENGINEER: 642-3812 REG.NO.: JOB DESCRIPTION : ADD AC UNIT SQFT: ADDRESS: UNIT: PERMITTEE: CLAIM VALUE: CALL—VALUE: GROUP OCC : R-3 / ADDRESS: GRAHAM BROTHERS ( 714 ) 546-1653 2952 CENTURY COMMENTS: ADD AC UNIT COSTA MESA CA 92626 xeF*it*****eF***e<*********+e*>Fe<**+r+rN*****eF*****ateF*******yf*eterer**** etaeet******IFN*erel*er* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I a I 'tensed under provisions ot C apter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code.an. se is in full force and effect. Z O N I N G R E Q U I R E M E N T S cm Llc.: STATE tic.: S E T B A C K S einue60599._63 24860 • ".0-20 Date: L� �� Signature: .%WV it- MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-Insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN • Compensation Insurance or a certified copy thereof(Section 3884 Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT : FT IN ) DucYNo.: WC2161030226018 1P1" 8 EXP.DATE: 08101 /91 PARLIBERTY PARKING REQ: PROV: PARCEL : 43927123 ZNE: REF NO: i 'ed copy is/�heexrreby furnished. C Certified cagy' a the city Bruising D 'on. PLANNING NOTES> • Ot-�B er-0• 1° Applicant: ************************************** '*******************************i(******** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (this section reed not be oamgkeo 8 the pemit 5 for one hundred($100)or less). DEVELOPMENT SERVICES R EQUIREMENTS I certify that in the performance of the work for which this permit is Issued,I shall not employ any person in any manner so as to become subject to the workers'Compensation Laws of California. ZONING APPROVED BY ' • DATE: Date: Signature: . NOTICE:II,after maldng this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE: • Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. _— J CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of Na work for APPLICATION ISSUED BY : J1 _�� DATE: Z..Q /( which this permit is issued(Section 3097,Civ.C). *********************** * m - tF , LENDER: ************************************ *** ************************************* ADDRESS: LEGALIZATION:N F E E S MMARY STRUCTURAL SEGMENT:N OWNERBUILOER 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: Any city of county which requires a permit to construct,alter,improve,demolish,er PERMIT repair any structure.prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed 9 . 00 pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 25% SMIP/NON—RES and Professions Cade)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation al Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than hue hundred dollars($500). ISSUE FEE 15 , 00 I, as owner of the property or my employees with wages as their sole compensation, v411 do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered far sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS————> 9 , 00 15 , 00 0 , 00 24 , 00 24 , 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 f, his or her own employees,provided that such improvements are not intended or offered for sale.If,however the building or I improve ant Is soldswithin one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED : 24 , 00 OVER/SHORT: 00 • 1 v BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I,as owner of the propert,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 24 , 00 - ❑ and Professions Cade: Tie Contractors'State License Law does not apply to an owner of property who budds or Improves thereon and who contracts for such projects oath a contractor(s)license pursuant to the Contractors'State License Law).l am aware ********.**.*.**.****.*.*.****.**.*.*.*.*.*.*.*.*****.*****.*.*.**.****.***.**.**.***,**,***************** that proof of their Worker's Compens¢Lon Insurance should be provided to me. IND IV IDUAL F E E BR EAKDOWN ❑ I am exempt under Section: B.S P.C. far this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner: I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and MEC 1 REFRIGERATION SYSTEM <= 100 K BTU/H 9 . 00 9 , 00 25534 and that I or any future building occupant wilUwill not(circle one)need to comply with said state codes and the requirements for a END OF FEES permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state th. information is correct.I a to comply with all city and county ordinances and state laws relating to building construction. representatives of th' c' to enter upon the above-mentioned property for inspection purposes. • Q �j1, a Date:_T`7 •9-7 •— O Signature: 1 0100067851-0001/7851, TOT 24.00 Drivers License or Social Security . : DATE:. 08/20/90 TIME: 09:44 154146 white—Building;Green—Coda Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor !/ il i CONSTRUCTION AND PLANNING POC PA APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector t 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. = e. 53. Steel Reinforcement ,1 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 • • --,1 59. Gas Pipe, ❑ Undrgrnd.,Test ; 9. Water Pipe-Undrgrnd. I j 60. Backwash Lines, P-Trap, 0 Undrgrnd. - 10. Structural Floor System ,, 1 61. APPROVAL TO DECK 1 11. Property Sewer Line & House:Connection 1 62. Backwash & Receptor•Final - I 12. Sewer Cap L \ 63. Heater & Vent-Final . 13. Roof Drains - :-,-t -.1 64. Plumbing System - Final - 1 14. Rough Plumbing ...1 65. Electrical-Final ' 1 15. Rough Electrical-Conduit I 66. Solar System-Final I 16. Rough Electric Wiring i 67. Fencing & Access Approval 17. Rough Wiring Sign 1 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) & Monocoat1 75. Dry Chemical ' 27. Frame and Flashing 76. Dry Standpipe . 28. Lathing& Siding I ` 77. FIXED SYSTEM FINAL r , 29. Insulation 1, 7 78. FIRE PREV. FINAL 30. Drywall Nailing :' HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final1 80. FOOD CERTIFICATE ISSUED 33. Final Electric . ! , Notes: • 34. Final Heating& Air Conditioning 51/Mb "/. P "35. Final Gas Pipe•Test ;'j / 36. Hood or Canopy • i , 37. Final Factory Fireplace C _ 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. FINAL PLANNING • 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co •_' ' 51. CERTIFICATE OF OCCUPANCY No. Date T CITY OF COSTA MESA :, ►\ BUILDING DIVISION Olti F il ..t) DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER his • PERMIT e" M03-00598 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 MECHANICAL PERMIT Job Address: 2337 ELDEN AV Status: ISSUED Suite No UA/%r F Applied: 11/13/2003 Issued: 11/13/2003 Vicinity: Parcel Number: 93068480 ISSUED BY: a Applicant: GONZALEZ, DENISE , Address: 6250 PARAMOUNT BL Phone: (562)984-5511 , LONG BEACH CA Zip: 90805 • Owner. LAVIN, DANA Address: 1500 CHESTNUT ST APT 3G Phone: PHILADELPHIA,PA Zip: 19102-2744 Contractor: ! n . ,, . yn-"L CAA1 am Address: (:j 2_50 eaktu u t N I ,,, . _ Q„n _1_ , Phone: 502 - `10q ' 555I {.l1UlSJJ b'YS/.�11\ Zip: Q O: 05 License:704414 SCOPE OF PERMIT REPLACE EXISTING 3 TON NC UNIT. MECHANICAL TO INCLUDE: 1 COMPRESSOR/ABSORPTION SYSTEM UP TO 3HP/500K BTU. FEE SUMMARY ' Quantity Quantity _ ISSUE FEE $23.50 Repair/Alt Absorbtion Unit 50.00 0 Inst FAU<100 k BTU $0.00 0 Repair./Alt Refrigeration Unit $0.00 0 Inst FAU>100 k BTU $0.00 0 Ventillation System $0.00 -0 Repair/Alt Cooling/Heat $0.00 0 Evaporative Cooler $0.00 0 Inst/Rep.Recess Wall Htr $0.00 0 Commercial Incinerator $0.00 0 Refrig Sys<100 k BTU $0.00 0 _ Domestic Incinerator $0.00 0 Refrig Sys>100 k BTU $0.00 0 Compressors/Absorption Systems , Gas Piping $0.00 0 Up to 3 hp/100 k BTU $0.00 0" Factory Fireplace $0.00 0 3 To 15 hp/500 k BTU.- - $0.00 0 Hood w/Mech Exhaust $0.00 ' 0 - 15 To 30 hp/1,000 kBTU . $0.00 0 VAV Box $0.00 0 30 To 50 hp/1,750 k BTU $0.00 0 Vent Fan/Single Duct $0.00 0 Over 50 hp/Over 1,750 BTU - $0.00 0 Appliance $0.00 0 Boilers Fire Dampers $0.00 0 Up to 3 hp '$14.70 1 Smoke Dampers $0.00 -0 3 To 15 hp . ' , , $0.00 0 Inst or Relocate Appl Vent $0.00, 0 - 15 to 30 hp " . $0.00 0 Air Handlers< 10000cfm $0.00 0 30 to 50 hp $0.00 0 Air Handlers> 10000cfm _ ' $0.00 0 Over 50 hp ' $0.00 0 Floor Furnace $0.00 0 Other Mechanical Fee Floor or Suspend Heater $0.00 0 Investigation Fee $0.00 Plan Check Fee - $0.00 • Reinspection Fee $0.00 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 2448-46(else) - 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. 71 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'corn ensatlon Insurance �caarder�antl Icy numper are: Cem6r.,, 25/713t Cccn, I r'/+4- �UntI Policy Number: n(--// —74/4l5— (This`section need not be completed i the permit Is valued et one hundred dollars($100)or less.) '✓ ❑ I certify that in the performance of the work for which this•• t is Issued,f shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree tit if I - o I. •ecome subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provi 410.c 'Applicant Signature: '4. .. DI ateT .� `THOUAN:'FAILURE ARE($1 CUR,I�'^• PE SO'T:t GE IS PENSAMONLDWFUL AMAGESAND SPROLSUBJECT IN EEMPLOYER 60F THE AL RSAND OT,AND FINES ATP HUNDRED THOUSAND DOLLARE(5100,000), `AODM•- O THE COST O-~�-� PENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37060F THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I herebyaffirm.that 1 am licensed und:r p • i•ns of Chapter a(commencing with Section 7000)of DMslon 3 of-the Business, d Professions Code,and my license is in full Carce_and effect.LIc.0 O rt• 1—Class Contmctors'Signemre: .✓�Wra ` a- _ inr CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its Issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such Improvements are not Intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ' ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 No Drivers License No. Expires: Verification of Ownership by(typo of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person Is required to descend,will be made In connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 if an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes ❑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? U Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 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 all South Coast Air Quality ed Management eal or other airpollution coon 4l 3been or agency is requiretl for the work which is the subject of this application,have all of the disclosures prescnbetl by Californiala Health and Safety Code Section 42303 bmatlel 0 Yes ❑No 8 (Ii yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct.I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signa`ure`Of L-'.l • ner(s) pate �•r Au�ltl Applicant // P/1 aI CODE t INSPECTION TIP( PALE I{i10d1o9 PPPE! INSPECTION TYPE ^ 28Th 1616 Fixed System Final Fire Prevention 208 Final Mechanical 1 03 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Well 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy i PROJECT ADDRESS: 2337 ELDEN AV UNIT: E CITY OF COSTA MESA — BUILDING PERMIT PERM NO: M 052764 pi OWNER'S NAME: SCOTT NICHOLS ADDRESS: SAME PERMIT NO: M 052764 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: MEC PURPOSE: OTH ARCNIENGINEER: 650-8151 REG.NO.: JOB DESCRIPTION : A/C ADD—ON , ON THE GROUND SQ FT: ADDRESS: UNIT: PER DRESS: CLAIM VALUE: CALL—VALUE: GROUP OCC: R-3 / • ADDRESS: GRAHAM BROTHERS ( 714 ) 546-1653 2952 CENTURY COMMENTS: X COSTA MESA CA 92626 +PSE***arlt*4********************* ******+PAF***tr*****r**************** Fac*,FBF********* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of C. net 9(commencing with Section Z ONING REQUIREMENTS 7000)0l Division 3 of the Business and Professions Code. ... .. .ense is in lull torte and : SETBACKS CITY LIC.: 005963 STATE uc24(in E4 6. 5: C-2e Date: —1• IZ • `lt Signaler — _ it. ea MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATIN: I hereby affirm t . ave a ceniticate of consent to sell-insure or a certificate of 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 IN LEFT: FT IN RGHT; FT IN POLICY ND.: WC2161030226018 EXP.DATE: 08/01/91 COMPANY: LIBERTY PARKING REQ: PROV: PARCEL: 42701104 ZNE: REF NO: frit Cenilied copy is hereby furnished. EX Ce ((dgy�pp//pp�iss�1demo�nw the city Building Division. PLANNING // PLANNING NOTES> APPlicaX0t1 l' `� / > Dale: x12. x �l -- ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need rot be completed if the permit is for one hundred($100)or less). DEVELOPMENT SERVICES REQUIREMENTS I certify that in the performance of the work for which the permit is issued.I shall not employ any person in any manner so as to become subject to the Workers Compensation Laws of California. ZONING APPROVED BY DATE: Date: Signature: - NOTICE:If.after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE: Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY• • DATE• ` which this permit is issued(Section 3097.Civ.Cl. ******************************************** E *******************7J I iP ‘4 **** LENDER: ************************************)4***************************************** ADDRESS: LEGALIZATION:N F E ' SUMMARYY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby altirm 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 Processional Code: Any city 01 county which requires a permit to construct,alter.improve,demolish,or PERMIT 9 00 repair any structure.prior to its issuance,also requires the applicant for such permit to lite a signed statement that he/she is licensed 5% SHIP/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.Any 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(S500). ISSUE FEE 15.00 I. as owner of the property or my employees with wages as their sole compensation, will do the work. and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or altered or sate(Section 7044,Business and Prolessional Code: The Contractors'State License Law TOTALS----> 9 . 00 15. 00 0 . 00 24 .00 24 . 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 or sale.If,however the building or REVENUE DIVISION TOTALS--> COLLECTED. 24 . 00 OVER/SHORT: 00 4 lorptheement is purpose of sold at9 hat one year of cdmpletien,the owner will have the burden at proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SHIP/TOT GRADING PLAN—CHECK I.as owner of the properly,am exclus/veq contracting witch licensed contractors to construct Ina project(Section 7044,Business 24 .00 ❑ and Professions Code: The Contractors'State License Law Ones not apply to an owner of grope y who builds or impro es thereon contracts l am aware ******************************************************************************* that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.&P.C. . for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: OwnerMEC 1 REFRIGERATION SYSTEM <= 100 K BTU/H 9 .00 9 . 00 I do hereby certify that lam 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 Quality Management District.Residential construction applications are exempt from 'L/// these provisions. Date: Applicant: I hereby certify that I have read this app/ Ion and state that the above information is con t.I agree to comply with all city and ounty ordinances and stale laws relating to buildin conslructi ereby authorize representat eso his city to enter upon the abovemttoned Date: for inspection purposes. � 01 {i..�071L 12/9_vi 170 1 Ti DATE: 6711_'19? TICE:L;E1i:2� •Dale: tg. Driver's license or Social Security a: Applicant;Pink—Revenue:Goldenrod—Assessor 7 I CONSTRUCTION AND PLANNING . [/\^ P001 -.PA APPROVALS Permit# t Date Inspector APPROVALS Perm;rt# Date Inspector 1. Temporary Electrical Servite or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. . 53. Steel Reinforcement It `-'3.�Electrical CondQiI U ility-Undrgrnd. 1. 54. Forms •,4,Electrical Condtj•U-Undrgrnd.- - 55. Electrical Bonding ' '- 5. Steel Reinforce end- [• 56. Rough Plumbing & Pressure Test • •-'¢; Electrical UF ER Gina. c 57. APPROVAL TO COVER-GUNITE - 7. Footings r 58. Electrical Conduit•Undrgrnd. ' 8. Foundation ,4: 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 r• 13. Roof Drains r 64. Plumbing System - Final 14. Rough Plumbing ' 65. Electrical-Final 15. Rough Electrici1-Conduit 66. Solar System-Final 16. Rough ElectricWiring 67. Fencing & Access Approval ec ".17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling l 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT ' 20.�Rough Factocy Fireplace - r� . • - I... 0 • APPROVALS:rt ;Permit # 21."Ducts in Structure ; " - ,; ?70. Underground Hyearo ' 22: Ducts, Ventilating . - • ;xr.71, ProduU'R^p?ng D.Ges 0Oil 23:Gas Pipet Rough & Test < 72. Undergr`ounb F11]sh C' _ 24::Ropt Framing • _ - w s.73.-Undergrnd•.StoragrrTank'0 Gas ❑Oil 25. Roof Sheathing • �,, a r a _ ': . : "74,---Overhead Hydrq-'• h 26`T-Bar Ceiling (Structural) &,Monocoat _ �+ v.. 75. Dry Chemical s i �•, S • 27t-Frame and Flashing - +. ; 76.try Stantspipe t',i 4 28: Lathing"& Siding . n_- ?. • .-• � 77.- FIXED SYSTEM FINAL X29. Insulatcon -- ' ' • 1 ` 78.'FIRE PREV. FINAL i= , .--30. Drywall Nailing HEALTHDEPT.. REQUIREMENT j 31. Plaster Brown Coat ' 79. FINAL INSPECTIQN • - 32._ Electrical Power Meter-Final. - �[ . r 80... FOOD CERTIFICATE ISSUED .- C. 33\Firial Electric •• r .r f ` Notes: . 34( Final Heatin"g'& F,ir Conditioning. L ",( /f . - . �� y 35::Final Gas Pipe•Test a = +^ " C: _C_ T.--- Vic• :. 036.' Hood of Canopy ' ' it . [' P. ,r •r'-_ . -� . • ` -•37•C-Finhl Factory Fireplace_ N y `- : ' ' S. c- ` T .1 _ - 38. Final Plumbing .• - " 2'•,. y ^39. Water Service-Final • j .* 7=� : [ • a Cr•40. Gas Service-Final ti I " i C4,40. I. 1..,..." •T p v V' 0.; ' ,'41. Solar Domestic-Final< •t-i - • 42.'Backflow Preventer 43. Backflow Irrigation - v . u.t _ . -. + ,. +1 44. Landscape Irripatign System-,-,I t 1 _ _ .-.r .,, 1 n- •0 `i•: ' " :i; -1. 45,.Sound Attenuation s >. • 3 .. . .n Y .r • _ ?46 Handicap Regulations - - ; t �, _ C - - :, • 47,FINAL STRUCTURE & BUI'LDING . • F : • tiM r 48Yn FINAL PLANNING ' r 1 I ' - , i t r [ ;49: Electric Release to Edison r 4 I • �r + +: . - ' 50; Gas-Release to Southern California Gas Co '" I rg - " t x , c.---,:i.. T51. CERTIFICATE OF OCCUPANCY 'r _ No. Date