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2364 ELDEN AVE - Building Permits
• 5582 FEE RECEIVED„ Q % `A� (T// /...- COSTA MESA BUILDING DEPARTMENT GC�-� / • P.O.BOX 317 FlNAN�. DEPT. COSTA MESA. CALIFORNIA �����COSTA MESA FOR APPLICANT/ TO FILL IN APP ION FOR PERMIT BUILDING a3 I1 kk,9E I V N' / E BUILDING ADDRESS (j W'.� 1G'r n V L. L.1rG COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY RECEIPT NO. PERMIT N OWNER 1. DWrPRy 4 14LIAN Nr E►diS s2 `/ �� _ 1 EWE !y jg"..5/11v�b/BY �y TE RECCEIVE y0OATE{'ISBUt ADDRES(�SSQ O�rr36It e k L N 11VEWE ���",� p 2IVE rATE V CITY `QJ I A tIE sA TNO.;U �_ )y60 ADDRESS P ,�.g'-6-(m/r� Ail( ARCHITECT LIC.OCOSTA MESA. CALIFORNIA- OR ENGINEER NO. FIRE ADD, S ZONE QR,, J� ZONE PLANS TYPV GROUP CONTRACTOR Owner /W'l..�C✓TY NI OC. or EL. ,y,'��PIAN` L � y�j < i ADDRESS_) (YVPL.� CCCC////��- TNO. • BY .DATE DATE O �'/-p-j,•1/ LEGAL LOT+,, • r' DESCRIPTION NO. 'S�79 BLOCK TRACT CORRECTIO J A.P.NO. / / y•- G / - APPROVED SIZE NO.OF SLOGS. One OF LOT NOW ON LOT CITY OF COSTA MESA USE OFEXISTING BLDG. PIANt NG DEPT. SETBACK LINE FROM .1UBJ ELI IU bL.Ula. utri. RCS. CENTER OF STREET ry/LSA REAR YARD IS //l/j `� /��(////,� }� (-4_ SI DE VA RD�(S RIGHT £(1LStFT 4:*IA%r• 8Y[Qi F/`-•r �pp�p�TEf } �/�� . DESCRIPTION OF WORK PLAN TLLO'' " / �f NEW ALTERATION ADDITION REPA, MOVING DEMOLISH BUILDING NO.OF SIZE ROOMS STORIES G��•(/�. EXTERIOR WALL ROOF J� _COVERING �j �,/JCCOVERING USE OF NEW I 6--r D „_.,,,Q BUILDING 1 I IO AAy fie(1 0-1.4-e c?...41 fie-ts) atiet.,.. ,- ' tairir I IEREBY THAT'I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT ANO AGREE TO COMPLY WITH ALL CITY ORDINANCES AND ST E LAWS REGULATING BUILDING CONSTRUC. TION. VALUATION �/ 0 O r� - ^- ' PERMIT FEE $ 1/c.i ,/ SIGNATURE OF 1 tans +��VJ PERMITTEE AAYa' //� I I �/ PLAN CHECK S /Vo V O"_ AUTHORIZED AGENTT,7g� / ;/� TOTAL FEE $ jZ 0 0 jai' r1 • • 9668 ' Lt. RLLEiti[u CCSTA MESA BUILDING-SAFETY DEPARTMENT /9/s9 C P.O.BOX 317 COSTA MESA,CALIFORNIA FINANCE DEPT.. C fOR APPLICANT TO HU IN COMPLETELY APPLIICAT�ONnSFOREPERMIT �•� TYPE OR PRINT / BUILDING ADILDING�Ege �J✓�� /Tj6j) �f) ADDRESS COSTA MESA. CALIFORNIA �` I • /�('. Pym(, y FOR Off/CE USE ONLY OWNER V O '• P YJu11I& • `F.1 I /9 RECEIPT CNO.C/ I /'PEftMITNO[a MAIL 4yt REFI IV DBY I VA�/rJED I in-- CITY 'EC//1 fibsMED. ADDRESS3� }/y�O aU{t .{p.. /��{/� l CITY C //f trE/i TNEOLks IdE( BUILDING �F-- ADDRESS ARC'- 'ECT LIG. COSTA MESA, CALIFORNIA OR 'NEER NO. '/ ADDRESS �,r�/f ,�/ Jap/ ZONE //sy, .e . 1� o/up CONTRACTOR• A7t ‘ lel L C NTQ��VIO�4'& APPROVED .41"IPL, �' DATE `/ Z $ ADDRESS 0730 ea`Opr RzUa, ZONING LEGAL LOT I ZONE NO.OF USE OF NEW DESCRIPTION /YN/O. BLOCK TRACT I PLANS BUILDING A.P.NO. Nes- .OJ' ..I - / APPROVED .H 76 62 E VE �' Q NO.OF BLDGB. / YARDS EVES OF LOT��JV �- /D NOWONLOT ` REQUIRED ALLOWED , USE OF 5 7 F/� ' tv z'L (CENTER LINE BT.) EXISTING BLDG. JfVI/ /r `I'P`V /�{� FRONT l'�O FT. • IN. SETBACK LINE FROM CENTER OF STREET REAR YARD R.SIDE AOFT. IN. SIDE YARD I LEFT I RIGHT �/L.SIDE FT. IN. DESCRIPTION OF WORK �/ REAR ./ FT. IN. N IV./`- II ALTERATION I II ADDITION I l/�,, tiaL� REPAIR I II MOVING I II DEMOLISH I �4 / / . V BUILDING / NO.OF L SIZE ��[� ROOMS STORIES / 7 ��i�17 s , /' re tilt /=� EXTERIOR WALL I COVE -4 �/S �i -- /j r Chet-ger-, COVERING COVERING / 6 2.-1., USE OF BUILDING AND WORK TO BE PERFORMED /� HL Ste/ sig fill 0a- ��� t% T / I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- THE AMOUNT SHOWN UNDER VALUATION IS FOR THE PLY WITH ALL CITY ORDINANCES AND STATE L 'S 'EGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. BUILDING CONS *TION. VALUATION SIGNATURE OF ,II / PERMIT FEE $ pr , — PERMITTEE F / $ J 356/ \PLAN CHECK $ //. AUTHORIZED AGENT . ! TOTAL FEE $ 33, .— • 9669 ftE RECtWUEU •COSTA MESA BUILDING-SAFETY DEPARTMENT ����/ U P.O.BOX 317 COSTA MESA,CALIFORNIA FINANCE DEPT. CIUY OF COSTA MESA fOR APPLICANT TO HU IN COMPLETELY APPLICATION FOR PERMIT }}eATYPE OR PRINT BUILDING BUILDING / f ,2bt 4R// ) ADDRESS lt.)COSTA MESA, CALIFORNIA • fOR Off/CE USE ONLY OWNER Iy)N al` RECEIPT NO., I YA; 7 9 _ \_ ED BY I ,DATERECEIVED_ DATE ADDRESI / 1I / ✓r (E C /9".' r.7 CV- CT6i5754 11L5-4 TNO.KIs...7W$, BUILDING • ADDRESS ARC"'TECT LIC. COSTA MESA,'CALIFORNIA OR INEER ' NO. R�,,., p `1/ FIRE ADDRESS (� /�� /' �/ • ZONE T,y_pe Groupe CONTRACTOR r /,•''/.I//y7d IMP L C NTO./aX? r� BYPROVED�`• „ n�� DATE t,�V ADDRESS kg0F LI �LUD ZONING (!�/� LEGAL I LOT 75 I I �r0-4 ZONERy NO.OF USE OP NEW t� DESCRIPTION NO. /, BLOCK TRACT GSI I PLA�N,S/ /(/\/�/) I BUILDING '/T✓VOMw/_ A.P.NO. // ? -•'9' S- p_ - / APPROVED LJ�!' Y (/ DATE //1 J SIZELOT OV J{.7��J)./lIo NOW ON LOTNO.OF E/ YAR REODU RED EVES ALLOWED OF az. (CENTER USE OF G-SCIO it re/) FRONT LIN 3E _I^ FT. IN. • EXISTING BLDG. J/!'E Mir: 6+'�+ 1J SETBACK LINE FROM7,. CENTER OF STREET Ac.... REAR YARD V R.SIDE J0 FT. IN. ld i r SIDE YARD LEFT IRIGHT L.SIDE , FT. IN. DESCRIPTION OF WORK REAR ..1.-2 Fr. IN. • N' X ALTERATION I ADDITION �Q„ a b // , REPAIR I MOVING II DEMOLISH � O / BUILDIN OIIO* 2/Ja RNO.OF OOMS ! / ,''��_y�''./—`• J� SIZE "tan � Jj�/7q/'/S�)TORRIIIES .C~%/i % aT�r 4>y��L+cH COVERING EXTERIOR WAL )/�"TiV COVERING/-•�'U'{�(, O - ' ` /// J USE OF BUILDING( AND WORK TO BE PERFORMED • K/ �g.U., -3-9 -7,ri in Debra f--7)B7`�'! ' I I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO CON. PLY WITH ALL ORDINANCES AND STATE LAW REGUL TING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. BUILDING CON U ION. - //RR��__'' VALUATION SIGNATURE OF ^.� TSA A _o 7 PERMIT FEE $ ,z,.3. - ' PERM ITTEE ((((! ���111////// ,,•••• /KKY//�ALtt� 7 7`-V ) // Qs $ �G-Q. _ PLAN CHECK $ / / •5._____ __„.AUTHORIZED AGENT /��(-'J// JJ � , � IQO Z _-,, TOTAL FEE $ J'3, 3145 7/01 /80 48.50 TL ..._ 4 - COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 i REC BY PERMIT N° - 5 0 3 2 3 For Applicant to Fill in Completely — Use Ink Only BUILDINGl( rr jj ADDRESS ��� / LcOQA/ A.P.NO. //y _ OWNER OR BUILDING 2 6 S e. TENANT /e, jeiCl ea_ iilf/J,[a{,S' ADDRESS `J(p ! vY./ UNIT OR MAILING SPACE NO. ADDRESS /61 Ur* rfit L at Tg�SQ LOT /7/� BLK- ��� I TEL. �/ l/JJ CITY/IrLJ/O,V 1.9C/{ No.4.73-2r23„, NEW ADD ALTEfj, REPAIR MOVING DEMOLISH CONSTRUCTION iv* LENDER BRANCH - • OWNER w a �-- / simar / /�� ,^, OR HITECT /`/�Y Y,�Oc✓nl TENOL'D.133112 1 ,ADDRESS USE o C .r, /�o.E$� ADDRESS 3722 a, 4 7-d ,f7 '601 ZONE YPE 'e GROUP �I�y- � APPROVED '7 CONTRACTOR ,Jf ar BY4/77.7....0.10".--- /�J, DATE / t e/) ADDRESS /}r//!��QFi a•CZr-I.LTI��c/ TEL. CITY NO. •-• STATE CITY APPROVED SETBACKS LIC. NO. LIC. NO. r 7 ia SIZE INO.OF BLOCS. (FROM C/1..STREET/ //J) 0. OF LOT NOW ON LOT FRONT FT. / Q USE OF A . /' .r.0 EXISTING BLDG. R.SIDE FT to F Separate permits are required for L.SIDE fr- � 6. electric,plumbing and heating work: R:A;, FT. 0.1 I--, USE OF BUILDING AND WORK TO BE PERFORMED P I• ING ACTION a DATE I AfNrok - i/(r/ooIL K/1G/71ty4J APPROVED 7 APPROVED _BV DATE a m aa• .hereby acknowledge that I have read this application and state n a that the above Information Is correct and agree to comply with 0. all laws regulating building construction, and I shall not employ i• Z any person in violation of the workman's compensation laws of 5 the State of California. m I hereby certify that I am properly licensed as a contractor under SQ. FT. N the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e am exempt from the provisions of the State of California Business f zt� w VALUATION PERMIT FEE $ Y and Professions Code,Division 3,Chapter 9. n Signature of DOO TAX PLAN CHECK $ /� tile 0 Permittee r $ / ` t �LL or / $ D `l Authorized Agent Date ?,moo TOTAL PAID $ ��r\• U APPLICATION FOR A BUILDING PF-'11T y BUILDING PERMIT NO. Electrical 03 C Tract ��� Block Lot Permit No. E, Plumbing C Building Permit No. 5. Address 23G ,L470n) to Cross ) � O 323 Mechanical G Area Street "V ,Z_-Seat) Permit No. 3- # Owner ,(' z51/(4,01._ Type of Project: 111 New El Alter El Addition • /` woitth:LJ1 Address /Of t.,/(ir ��LL� ID Repair III Convert ❑Demo CI Occupancy Pmt. City jaziwlo,(r 2,ticii ZIpS2LLJ Phone473-2f2_ 3 A.P. Sup.Dist./Area Architect/ A.ro / Designer A/jy Bf0..J1J License No. L (O/y Zone Spi.Pmt.No. Address 37407 ti, � 'r Sr Setbacks P/L Front C/L St. Street Width City Lel /fp/6.7L VA ' ZIP�O02 O Phonej/z"63yL Yards Left Right Rear ?� Eave Proj. Left - Hight I-.P. Engineer Aiir License No. Parking Spaces Required Provide Covered Na Address m City Zip Phone Struct No.of No.of Height Stories Family 0 LICENSED CONTRACTOR'S DECLARATION Park Fees Yes Fee re m I hereby affirm that I am licensed under provisions of Chapter 9 Required H No C.T. Receipt t (commencing with Section 7000 of Division 3 of the Business and Zoning Approved BY: Date Professions Code,and y,dlicense is in full force and effect). License Clam License Number _> Date ontractor Misc. E Address Proposed Use jL City and Zip Phone of Structure G CONSTRUCTION LENDING AGENCY 12 I hereby affirm that there is a construction lending agency for the Occ?- performance of the work for which this permit is issued (Sec. 3097, Class Const.TYPe Code Civ.C.). ,,/ Year gj Lender's Name (✓n USE/OCCUPANCY SIZE SO. FT. E Lender's Address OWNER-BUILDER DECLARATION Y I hereby affirm that I am exempt from the Contractor's License Law 1. f&r,,t'ha following reason: CI C I, as owner of the property, or my employees with wages as their 2. • sole compensation, will do the work, and the structure is not t tentletl or offered for sale. « 3, 3 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project. m0 I am eve pt under Sec. n , B&PC for this reason G 4. to Dat Owner 7 AX/r/cl ��4#sc✓c E RKERS'COMPENSATION DECLARATION Total Valuation 3 I hereby affirm that I have a certificate of consent to self-insure, ❑ NO or a certificate of Workers' Compensation Insurance, or a certified Encroachment Permit Required CI Vez c copy thereof- y Grading Pmt. Grading 8 Policy No fitCompanyRequired ❑Yes ❑No Pmt. No. G ❑ Certified copy is hereby furnished- Rough Grading y Q ❑ Certified copy is filed with Orange County,EMA. Approved by: Date m Date Applicant • CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATION INSURANCE 2 (This section need not bo completed if permit is for $100 or less). C I certify that in the performance of the work for which this permit is 3 issued, I shall not employ any person in any manner so as to become m subject to the Workers'Compensating Laws of California. PERMIT FEES Date Applicant /A'/-f/Y NOTICE TO APPLICANT: If, after making this Certificate of Structural $ Plan Check $ Exemption, you should become subject to the Workers'Compensation provisions of the Labor Code, you must forthwith comply with such ElectricalSpecial provisions or this permit shall be deemed revoked. $ Invest. $ I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. I AGREE TO Plumbing $ COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION,AND HEREBY AUTH- Mechanical $ ORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE BOV MENTION Ep PROPE RTV FOR INSPECTION PUR- Pre-Grade ////il// Inspection $ PO "'7 's-r �'' �! /� Pre-Grade Permit ig t of AppTican or Agent D to Rec.No. $ Issue $ /l f A9.aaa /.✓4,6:41 C Print Applicant's/Agent's Name All spaces within this box must be completed to process Plan Issuance Appr Check BY: Approvetl: CMF 033546(BU-28)rev.6/80 '/' Applicant to fill'm'airapecea .. ..i . ..,,in neavy border lines and sign all appropriate declarations. - O'FCOST'S ,ESA O S RUCTION PERMIT PERMIT NO. TRACT NO. L NO. UNIT NO. 2481 I/O4/B.. jaLvifr roject AddfQss " 7�L--,�,� • I'4n licant's Mailin Addr ss . eJIaai/ /!4f/ i TYPE OF CONSTRUCTION NEW U ADD U ALTERATION U REPAIR ) p ❑ CONVERSION ❑ DEMOLISH 0 OTHE: •Owner's Name / �' �/! nl 1d Qf1'i Phone f•Dry'1'Ke+96 .. . A.P.# 24., Ct '— 2(x'2.-- .— CO 1 Zone R7.— �(�7 DESC: PTIQN OF WORK/USE eF I eG ��//�7f�� JC�'Cy /��� L�f,r/ �5 `jlf/a y = / /�w� S Main Building: Accessory Building: Addiess �fC^�/'�'— L �f! .'fid fro f /..< `� Lie • E 2 -' Arch/Eng. icense No. . TYPE OF PERMIT I. GRA. NG Ir FOUNDATION �' ST- TURAL /- T Front 15, 3 0 Address /4r� ( :24( .�/• DIE TENANT El ELECTRICAL CI PLUMBING ❑ MECHANIC L'Ol ,�{/ BA Rear I tU f N ❑ OTHER ff' Convector's NameOM Phone — 3 C Right I Q • N Address(mailing) � PROJECT DESCRIPTION St Ia �/ia7 Y OCC A�//YI1 ��R�,,3�a S Left l5 f G - CONSTRUCTION TYPE s yam' VALUATION$ �i>TjLT.T'1 R City License No. LONE GRADING V.YDS/ A RES�/ Ping. Ref.# Pd — O/,—./g'3 Parking Req./Provided 2/2.. E LICENSED CONTRACTOR DECLARATION }�[y© / '/ CI I hereby affirm that I am licensed under provisions.of Charter 9 (commencing Remarks: a fD�. W/'f� p gf (J ( q7L Planning Notes: M with section 7000) of Division 3 of the Business.and.Professions Code, and JIJ 0 • my license is in full force and effect. w - ,v �}''� T License Class License No. cites_l y2 O $ Date signature - - PLUMBING FEES HOLD FOR SI&ECIAL REQUIREM 'N1j M WORKERS'COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL FEES `ereby affirm that IN have al certificate of consent to.seif insure or a certificate' Workers' Compensation insurance, or a certified copy thereof,(Section JO, Lab. C.) / Backflow Preventer Service Sink - Automatic Washer Transformer ❑ 15-50 KW . ! _ Policy No. Company - Backflow Irrigation Sewer Cap Construction.Pole Sub. ❑ 50+ KW 8 Certified copy is hereby furnished. v Certified copy is filed with the city Building Division. • Bathtubs Sewer Connection Cooking Unit Meter ❑tip to 100 amps Date Applicant - ` . EXEMPTION FROM WORKERS'COMPENSATION DECLARATIONClarifiers Solar Collectors Dishwasher Mete/Dover 100 amps (This section need not be completed If the permit is'for One hundred ($100)ori less). -t - .a Dishwasher Solar Piping Dryers ❑Gas ❑Electric Stib Panel 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any m ner so as to become subject to the: Drinking Fountains Solar Tank Fan .7 Motors 00.1 HP ❑1'/a-8 Date y/,f tion Laws f nly�y�:/�/ - ❑ DatelCJ 5/ I Signature �,ou•hy �iy.e sub•' Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 9-15 HP ❑16-15+ NOTIC after makinglthis declaratt5n, you S o debecome subject to the wc Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures .---- Microwave 114. comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY . Gas Service Outlets , Water Closet Device Boxes I hereby affirm that there is a construction lending agency for the performance 'Pole Light of the work for .which this permit is issued (Section 3097 Civ. C.) Interceptors Water.Heater Outlets .Range:- - a Lender's Name •- . a • Lender's Address Kitchen Sink WaterService Switches Sign OWNER BUILDER DECLARATION I hereby affirm that;Lam exempt from the Contractor's License Law for the Lavatories • Auto-Wash following reason (Section 7031.5 Business and Professional Code: Any city or Garbage Disposal Standing Sections county which requifes a permit to construct,alter,improve,demolish or repair P—TrapLaundry Trays Generator 00.5 KW 05-15 KW •• Trash Compactor any structure, prior to'its issuance, also requires the applicant for such permit - to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains • the Contractor's License Law(Chapter 9(commencing with Section 7000)of - Division 3 of the-Business and Professions Code) or that he/she Is exempt - 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 Ity of not more than five hundred dollars($500). I, as owner of the property or my employees with wages as their solo Reinspection Fee I 1 $15 Issue Fee $ 3 co pensation, will do the work,and the structure is not Intended or offered - Reinspection Fee $15 Issue Fee J $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES License Law does not apply to an owner of a property who builds or improves - DEVELOPMENT SERVICES REQUIREMENTS: thereon, and who does such work himself/herself or through his or her own Boiler Hood or Type I 0 O employees, provided that such improvements are not intended or offered forZoning Approved By 3 Date r—'2$_� sale. I however. the building or Improvement Is sold within one year of com- Canopy Type II 0 pletlon, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground Building Approved By 7 Date I 1 prove for the purpose of sale). U I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date I!/ s(,/ �jn fIl I - tractors to construct the project (Section 7044,Business and Professions Code: The Contractor'smproLicense Lawdoes not apply to an owner je isproperty who Duct-Ventilating ❑4100,000 BTU 0100,000 BTU SU MA •0_F FEES Z buildseor improves thereon,and so contractsaplyfor such projects tSwith a con- o tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ •5 SMIP $ 1. 3 proof of their Worker's Compensation Insurance should be provided to me. _ PLAN CHECK $ I2 PERMIT 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# I Fire Dampers PLUMBING § ISSUANCE $ 1 Date/ Owner 1/ . . _ _- M Heating System& Ducting Registers ENERGY P.C. S PLAN CHECK 25% $ I hereby certify that I have read t i appli atlon and state that the above 00-100,000 BTU 0100,000 BTI: ELECTRICAL $ GRADING S information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize repro- PLAN CHECK 50% $ MICROFILM § sentatives of this city to enter upon the above-mentioned property for SI /�•�� inspection rp. - / / MECHANICAL $ TOTAL FEE $ S3 Signatur ,>l� ... _ . f CMF 0865-46,rev. 10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor CONSTRUCTION AND PLANNING POOL& SPA APPROVALS Permit# Date Inspector APPROVALS Permit # Date ;Inspector i . 1. Temporary Electrical Servide 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 l�d/gr/ 411/ 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. L.' - 101 /_� 57. APPROVAL TO COVER-GUN ITE 7. Footings �IVreg lT / 58. Electrical Conduit-Undrgrnd. I 8. Foundation V 59. Gas Pipe, O Undrgrnd., Test i • 9. Water Pipe-Undrgrnd. 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 •' 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final ; 1-� 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 Ceiling69. POOL/SPA SYSTEMS FINAL"-1 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT - 20. Rough Factory Fireplace APPROVALS Permit# • - _ ' 21. Ducts, in Structure 70. Underground Hydro l' • 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil . _ 23. Gas Pipe-Rough & Test 72. Underground Flush -"I 24. Roof Framing ste J 73. Undergrnd.Storage Tank O GeOil, • • 25. Roof Sheathing '/ 6.-,--"" 74. Overhead Hydro 1 26. T-Bar Ceiling (Structural) & Monocoat (/ 75. Dry Chemical . , 27. Frame and Flashing 76. Dry Standpipe •• 28. Lathing & Siding win/�� 77. FIXED SYSTEM FINAL , : 29. Insulation I(•` 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 HOLD FOR SPECIAL REQUIREMENTS r 35. Final Gas Pipe-Test a4/kx i e,UiOuS C p ro.-L;r.Wt�;.� o•«< <: 36. Hood or Canopy ?Ala ok -Q c-/RAP £ G'.Ai. 37. Final Factory Fireplace f//a-j3 Cain'4/1 ICI"' Ate di art r7bOAP _ • 38. Final Plumbing Wit. 39. Water Service-Final j • 40. Gas Service-Final r 1r Ona . 41. Solar Domestic-Final • \` /I/I`/' I, 17• �1 42. Backflow Preventer • 43. Backflow Irrigation , 44. Landscape Irrigation System 45. Sound Attenuation , 46. Handicap Regulations ) 0011r . FINAL STRUCTURE & BUILDING //� ' - �- O. - Special Requirements Completed /i3'3 4 'I - 49. Electric Release to Edison - , 50. Gas Release to Southern California Gas Co . . 51. CERTIFICATE OF OCCUPANCY. 1 , No. -ii_ Date - i • • ��>• P....4.'�._ '�- Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. # 3/7 V ( _ CITY OF COSTA MESA CONSTRUG'... —ERITTIT PERMIT NO. TRACT NO. LOT NO.. UNIT NO. 4.7 •2a �� ► 319 0 3 a o 73 .1�1 �oQa Project Address y gyp" r Applicant's Mailing Address b RR N s L c� 14-f+U TYPE OF CONSTRUCTION U NEW ❑ ADD H ALTERATION H REPAIR r - r `!1 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# :1„ Zone kJ Owner's Name tea.-.1- "�. Phone DESCRIPTION OF WORK/USE OF BLDG. ' it-5-2 g 4 e- S Main Building: Accessory Building: -- . L'Cvl Addressw ??�+-*-�n ' . -.....".-,-„ Z E Arch/Eng. License No. TYPE OF PERMIT H GRADING ❑ FOUNDATION U STRUCTURAL T Front O Address - CITENANT El ELECTRICAL E:1 PLUMBING ❑ MECHANICAL B Rear N Contractor's Nan1Y"* X/- ^SeS[IoMB/ r-0.)(... Phone6750.- / ' El OTHER C Right - - N 83SWtit It', (}uF D-1 C'. PROJECT DESCRIPTION SQ. FT. OCCUPANCY K g Address 1mailingl/ yin ` G CONSTRUCTION TYPE VALUATION$ S Left City License No. 03 ISI 4 ZONE. GRADING CU.YDS. ACRES , R LICENSED CONTRACTOR DECLARATION Ping. Ref. # Parking Req./Provided • E ^ 0 I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: ' '[� 3�`-] l l Planning Notes: M with section 7000) of Division 3 of the Business and Professions Code, and - 4/ l [[ T my license is in full�n rce and effect. - License Class ' Li nsF_No. 9_ - S Date i'3-C-'X Signature .' V 7�. • . PLUMBING ' FEES WORKERS'COMPENSATION DECLA ATION • Bar Sink Showers ELECTRICAL FEES 'hereby affirm that I have a certificat f consent to self-insure or a certificate ' Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink 800, Lab. C.) .j Automatic Washer Transformer D 15-50 KW PolicyNo. Company Backflow Irrigation 0 50+ KW P y 9 Sewer Cap Construction Pole Sub. J2e rtified copy Is hereby furnished. X W Jl Cer died opvy1 filed with the city ...9.2.ZL{ Bathtubs Sewer Connection g ClipCooking Unit Meter Dup to 100 amps 1 Dale - sa Applicant I EXEMPTION FROM WORKERS'COMP SATION D ARATION Clarifiers Solar Collectors Dishwasher ,Meter Dover 100 amps (This section need not be completed''f permit is for one hundred ($100) or less), Z Dishwasher Solar Piping 17D Dryers DGas DElectric Sub'Panel Q I certify that in the performance of the work for which this permit is Issued, I Mshall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors DO-1 HP 01%-8 Workers' Compensation haws oRCalifornia. Date Signature, Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP ❑16-15+ NOTICE:If,after making this declaration,you should become subject to the - - - Workers' Compensation provisions of the Labor Code, you must forthwith I, Floor Sinks Urinal Fixtures Microwave p comply with such provisions or this p4cmit shall be deemed revoked. �/ - �\ CONSTRUCTION LENDING AGENCY `n i . rl.i• I-2:: Gas Service 8 Outlets L}- 7 Water Closet 62— 12w Device Boxes g ' \J I hereby affirm that there is a construction Iendi it agency for the performance Pole Li ht of the work .for which this permit is issue (Section 3097; Civ. C.) " Interceptors '_ Water Heater 4 t, Outlets ' Range Lender's Name' ' Lender's Address - ' r ii,.. Kitchen Sink Water Service 'L en. Switches Sign - - OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the LIy Lavatories a?_ / Auto-Wash 2%4- IU' 30 Garbage Disposal Standing Sections ' following reason (Section 7031.5 Business and Professional Code: Any city or -// _ ' county which requires a permit to construct,alter,improve,demolish or repair y P-Trap Laundr Tre s • any structure, prior to its Issuance, also requires the applicant'for such permit y y Generattir❑0-5 KW ❑5-15 KW Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of • f Roof Drains •- the Contractor's License Law(Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt . 'erefrom and the basis for the alleged exemption. Any violation of Section )31.5.by any applicant for a permit subjects the applicant to a civil alty of not more than five hundred dollars(S500). CenI, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 it compensation, will do the work,and the structure Is not intended or offered - Reinspection Fee I $15 Issue Fee ;$ 3 for sale' (Section 7044, Business and Professional Code; The Contractor's MECHANICAL FEES License Law does not apply to an owner of a property who builds or Improves thereon, and who does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS: , employees, provided that such improvements are not Intended or offered for Boiler • Hood or Type 0 • sale. It, however, the building or improvement Is sold within one year of corn- - Canopy Type I I 0 • Zoning Approved By Date 1 move the owner will-have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Dat J! move for the purpose of sale). r U s owner the project am exclusively sinesscontracting with of licensedioncon- Duct-Structural Refrigeration System Application Issued By Dat tM tractors construct the project foon 7e44, toBoSan and Professions rt DOde: The s Contractor's License Law does notapply for owner hta who Duct-Ventilating ❑0.100,000 BTU 0100,000 BTU SUMMARY OF FEES builds or improvesicense thereon,and who contractsac 'sce such w) Iprojects with e that - troof rs2 pursuantrkr'sto the a License be I ov aware that Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $ -. Droof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT ❑ i am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers I PLUMBING $ 4..... ..,,,,,,,..._ vol ISSUANCE $ Date Owner Heating System& Ducting Registers PLAN CHECK 25% $ �b tea ENERGY P.C. $ I hereby certify that I have read this application and state that the above 00-100,000 BTU ❑100,000BTELECTRICAL $ GRADING S information is correct. I agree to comply with all city and county ordinances and state laws relating to building co struction, and hereby authorize repro- PLAN CHECK 50% $ MICROFILM $ sentatives of this city to enter the above-mentioned property for IN inspection re use;� / / J '"82 MECHANICAL $ TOTAL FEE $ �J "�-' Signature - - .i Dat Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ ' Drivers' Li••ns=or SS# • CMF 0865-46,rev. 10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor -• CONSTRUCTION AND PLANNING POOL& SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd: -' �,g,7,/ % Alf 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation ! • , 59. Gas Pipe, O Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection !/TTbVi /i/l7 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 5CE No/C i 4 �j-��� 65. Electrical-Final 15. Rough Electrical-Conduit ��4' 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 Notesq-3, 4' ' 2. (1A&4 oe. $UBET- TU 34. Final Heating & Air Conditioning TEBr L CD 35. Final Gas Pipe-Test VA/ff.a 36. Hood or Canopy 37. Final Factory Fireplace . 38. Final Plumbing SAYS � �fiy"'� 39.-Water Service-Final //c//c/ICirf' " - 40. Gas Service-Final 4$o/cY-/1 41. Solar Domestic-Final J � 42. Backflow Preventer (� 43. Backflow Irrigation 44. Landscape Irrigation System 4- 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed - 1- 49. Electric Release to Edison - 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date l Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. MIT NO. TRACT NO. LOT NO. UNIT NO. CITY OF COSTA MESA/ CONSTRUCTION/ PERMIT q 1 A.P. •# Zone Project Address •236y 7 4e� J . . Building:• - Accessory g. • y� ',{ I 1 S Main Building: Applicants Mailing Addressm ! 5 p /9'�.f�s / TYPE OF CONSTRUCTION U NEW ❑ ADD Ll ALTERATION U REPAIR E Front • - Z Owner's Name /17.nree./ 64e.ary/1�Aylglabne 46 Ala-3"M ❑ CONVERSION ❑ DEMOLISH El OTHER TB N DESCRIPTION OF WORK/USE OF BLDG. A Rear I Address 45-'4r , �i/il5� Arch/Eng. __ License No. TYPE OF PERMIT CI GRADING CI FOUNDATION Ell STRUCTURAL C Right G Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL i S Left R Contractor's Name Phone ❑ OTHER .Ping. Ref.4 Parking Req./Provided E PROJECT DESCRIPTION SQ. FT. OCCUPANCYO Address(mailing) - - Planning Notes:- M CONSTRUCTION TYPE VALUATION$ T City License No. ZONE GRADING CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION I S. 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 .I my license is In full force and effect. ylf/�-5 ( ELECTRICAL FEES License Class License No. Date Signature PLUMBING FEES Automatic Washer Transformer 0 15-50 KW WORKERS'COMPENSATION DECLARATION �. / _ Construction Pole Sub. • 050+ KW ereby affirm that I have a certificate of consent to self-Insure or a certificate .,•ar Sink l /lnesShowers Z - Workers' Compensation Insurance, or a certified copy thereof (SectionCooking Unit Meter Oup to 100 amps , ..a00, Lab. C.) Backflow Preventer Service Sink Policy No. Company Backflow Irrigation Sewer Cap Dishwasher Meter Dover 100 amps 8 Certified copy is hereby furnis hetl. Dryers ❑Gas ❑Electric . Sub Panel Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Date Applicant Fan Motors 00-1 HP 011-8 EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors (Tleshis section need not be completed if the permit is for one hundred($100) or Dishwasher - Solar Piping F.A.U. - Inc.Solar 09.75 HP 016-15+ I certify that in the performance of the work for which this permit is issued, I Fixtures shall not employ any pers in any manner so as to become subject to the Drinking Fountains Solar Tank • Microwave Workers' C m ensation s of Califon y_p �}J Device Boxes • Pole Light Date �(/Lf, Signature Floor Drains Swimming Pool w/Spa 9 NOTIC If,after making this declaration,y u s out eome subject tot a Outlets Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Range comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCYSwitches Sign I hereby affirm that there is a construction lending agency for the performance Gas Service Outlets Water Closet 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 00-5 KW 05-15 KW Trash Compactor OWNER BUILDER DECLARATION ' I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/She is licensed pursuant to the provisions of Roof Drains • the Contractor's License Law(Chapter 9(commencing with Section 7000)of ivision 3 of the Business and Professions Code) or that he/she is exempt Fee Reinspection erefrom and the basis for the alleged exemption. Any violation of Section P $15 Issue Fee $ 3 031.5 by any applicant for a permit subjects the applicant to a civil en Ity 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 Zoning Approved By Date ompensation, will do the work, and the structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's • MECHANICAL FEES Building Approved By Date License Law does not apply to an owner of a property who builds or improves �\ .Q thereon, and who does such work himself/herself or through his or her own Application Issued ByC;ADate J^--1 3—(Jck employees, provided that such Improvements are not intended or offered for • 0 sale. If, however, the building or improvement is sold within one year of com- pletion, the_owner will have the burden of proving he/she did not build or im- eSUMMARY OF FEES prove foi The p*rpose of sale). BUILDING PERMIT $ SMIP $ 0 I, as owner of the property,am exclusively contracting with licensed con- e Refrigeration System tractors to - - tractorsto 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 a 00-100.000 B 0100,000 : PLUMBING $ 5� ISSUANCE $ builds or impro1is(es thereon:and who contracts for such oroiects with a con-• tractors) licens'lpursuant to the Contractor's License Law). I am aware that ■Exhaust p' Multiple PLAN CHECK 25% $ ENERGY P.C. $ proof o11 their Worker's Compensation insurance should be provided to me. 0 I am exempt under Section B.& P.C.for this reason -r :• ■ Fire Dampers ELECTRICAL $ GRADING $ '- PLAN CHECK 50% $ MICROFILM $ Date //F��' owner C!1/��.�/__ - a-- Heating System& Ducting Registers MECHANICAL $ TOTAL FEE $ I heresy ertify that I have read this-applicatlol1 and state that the above ❑0-100,000 BTU 0100,000BTL 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 this city to enter upon the above-mentioned op ty for InspeSignction purpose ..t�//�/. /Ji rd rDa[ L • Drivers' Licenstf r 5S `•�% Reinspection Fee $15 Issue Fee $ 3 01 00037E32-30037832 TOI `,.,1U DATE: 07/13/39 TIME: 15:22 • 0865-46,rev. 5/88 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor L. CONSTRUCTION AND PLANNING POS i SPA APPROVALS Permit Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location .2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3.. Electrical Conduit Utility-Undrgrnd. 54. Forms • 4, Electrical Conduit-Undrgrnd. 55. Electrical Bonding Steel Reinforcement 56. Rough Plumbing & Pressure Test 6.. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings , - 58. Electrical Conduit-Undrgrnd. - 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, ❑ Undrgrnd. 10. Structdral 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 t 16. Rough Electric Wiring g��, 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 c FIRE DEPT. REQUIREMENT .20. Rough Factory Fireplace ' APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating :,'-; 71. Product Piping 0 Gas ❑Oil 23. Gas Pipe-Rough & Test ;i 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas. El Oil 25. Roof Sheathing . 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Moriocoat 75. Dry Chemical 27. Frame and Flashing • 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final i . 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 I� 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final . .42. Backflow Preventer 43. Backflow Irrigation 44. .Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date , ..� " __ Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. . CITY Of COSTA,MESA..x �CO�NSTRUCTION PERMIT PE/q/�'M/J��,T NO. TRACT NO. LOT NO. UNIT NO. • . • Project Address -7 74 It---•1/ - " 33/5/4/ . • Xpplicant's Mailing Address • TYPE OF CONSTRUCTION ❑ NEW ❑ ADD Li ALTERATION Li REPAIR M.. , 1 t.--s �Nta,s4�a44 1 ♦2% eStk ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# - I Zone - -. Owner's Name Q Wit�s=L.` Vhblle G2' DESCRIPTION OF WORK/USE OF BLDG. Address (5E E s W tL. S Main Building: Accessory Building: Arch/Eng. _License No. TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION 1111 STRUCTURAL E Front i • - 0 Address• ' t ❑ TENANT i❑ ELECTRICAL ❑ PLUMBING MECHANICAL BA Rear - N Contractor's Na L. •.t M s -sem Pho ❑ OTHER I Gy «53 C Right • N Address(mailing) t S2- C� Fl— PROJECT DESCRIPTION SQ. FT. OCCUPANCY K G OC, �iyl ,'P� CONSTRUCTION TYPE VALUATION $ S Left City License NO. �- tZONE GRADING CU.YDS. ACRES R LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Il t��A �` �` /&�� Planning Notes: , _ • M with section 7000) of Division 3 of the Business and Professi'ns Code, and. LV ,moi l� v T my license is in full force an effect. �.1F ' Zi- S License Class C--i. License • - O - - _ Date fl ignature�11111.16.. _'cnL_ .. PLUMBING FEES WORKERS' COMPENSATION COMPENSATION DE • - •TION Bar Sink • Showers - . - ELECTRICAL FEES iereby affirm that I have a certificate of consent to self-insure or a certificate f Workers' Compensation Insurance, or a certified copy thereof (Section �>. 3800, Lab. c/) za. �-t ` Backflow Preventer Service Sink Automatic Washer Transformer 0 15-50 KW `\ Policy No.‘r ,7 d �. Lbm�dpy t-•••t a�`„—ti� Backflow Irrigation _ Sewer Cap Construction Pole Sub. 0 50+ KW Ce blied copy Is hereby furnished ert Ietl co y Is Ile with the ci B titling 'vision. Bathtubs Sewer Connection - Cooking Unit , Meter Cup to 100 amps Date ����{{��I{{ antt EXEMPT ON ROM WORKERS'COMP SATION DECLARATION Clarifiers - Solar Collectors Dishwasher Meter [Dover 100 amps (This, Dishwasher section need not be completed if the permit Is for one hundred ($100)or less). Solar Piping Dryers ❑Gas ❑ElectricSub Panel I certify that in the performance of the work for which this permit is issued, I • shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors 00-1 HP D1%-8 ' • Workers' Compensation Laws of California. _ Date Signature • Floor Drains Swimming Pool w/Spa F.A.U. NOTICE: If,after making this declaration, you should become subject to the _ Inc.Solar 09-15 HP 016.15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures Microwave comply with such provisions or this permit shall be deemed revoked. , CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet f.: Device Boxes . I hereby affirm that there is a construction lending agency for the performance POIe Light , of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater - Outlets . Lender's Name B . Lender's Address - - Kitchen Sink - Water Service . SwitchesSign • ' OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal following reason (Section 7031.5 Business and Professional Code: Any city or 9 P Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays Generator 00-5 KW 05-15 KW . Trash Compactor - any structure, prior to its issuance, also requires the applicant for such permit , to file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains the Contractor's License Law(Chapter 9(commencing with Section 7000) of _ Division 3 of the Business and Professions Code) or that he/she is exempt . - - - ' therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). - . • D I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 • Issue Fee $ 3 compensation, win do the work, and the structure is not intended or offered - Fee Reinspection for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES p $15 Issue Fee • $ 3 License Law does not apply to an owner of a property who builds or improves c. • thereon, and who does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0 Zoning Approved By Date sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 • pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By • Date • rove for the purpose of sale). O I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By • ' Dat tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who • Duct-Ventilating ❑0-100,000 BTU 0100,000 BTU SUMM OF FEES • builds or improves thereon, and who contracts for such projects with a con- _ tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust-System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ - PERMIT ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBO# Fire Dampers PLUMBING $ ISSUANCE $ Date OwnerHeating System& Ducting Registers - _ PLAN CHECK - 25% Si ENERGY P.C. $ l hereby certify that I have read this application and state that the above 100,000 BTU 0100,000 BTL— ARCO ELECTRICAL $ GRADING $ information is correct. I agree to comply with all city and county ordinances and state laws relating to build • co• uction and hereby authorize repre- MICROFILM $ sentative city to enter pi he above-mentioned property for PLAN CHECK 50% $ inspec n ose ,��— ell's MECHANICAL.$ er° TOTAL FEE $ cn Signet e '� -Accounting; Goldenrod - Assessor Ui UOU09399-00009399 TOT 33,00 +x CONSTRUCTION AND'PLANNING POOL &SPA APPROVAL'S Permit.# Date Inspector APPROVALS Permit# _ Date Inspector 1. Temporary ElectricatService or Pole , 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 'tet 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms , 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 1 i7., Footings _ 58. Electrical Conduit-Undrgrnd. , (88.•'Foundation 'c • 59. Gas Pipe, O Undrgrnd.,Test ittiWater Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK t�i Property Sewer Line & House Connection 62. Backwash & Receptor-Final !il 2.`Sewer Cap 63. Heater & Vent-Final 3. Roof Drains 64. Plumbing System - Final 4. Rough Plumbing 65. Electrical-Final 5. 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 119. Rough Heating & Air Conditioning (I.27,AY L#&p 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 .r 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 .L! 31. Plaster Brown Coat 79. FINAL INSPECTION - i 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED •!= 33. Final Electric Notes: tr 34. Final Heating & Air Conditioning 0747 jr 35. Finalr. Gas Pipe-Test 36. Hood or Canopy •1. 37.E Final Factory Fireplace , !-38 Final Plumbing a ,39.,Water Service-Final r' -• `•~ '40. Gas Service-Final f '.41. Solar Domestic-Final d ' • �4,, 42. Backflow Preventer (' i - , ' i ti 43. Backflow Irrigation - , - i 44. Landscape Irrigation System - '1' t 45. Sound Attenuation f-• f , i �, (.l 46. Handicap Regulations • - . 47. FINAL STRUCTURE & BUILDING - . . . v ;- r; 4 . I 48. Special Requirements Completed - t 49. Electric Release to Edison ( 1' 50.-Gas Release to Southern California Gas Co _t /`` ' • �� 51. CERTIFICATE OF OCCUPANCY 1 _/ No. Date ,ti . • Applicant to fill in alt spaces except those within heavy border lines and sign all appropriate declarations. • PEF�NyT NQS , �� TRACT NO. LOT NO. UNIT NO. CI . OF COSTA MESA CONSTRUCTION PERMIT• IN-, S A.P.,ie Zone Project Address �. .i :�- $ Main Building: Accessory Building: Applicant's Mailing Address /S..LC-4e4/r.sa et-* 9%(.2> TYPE OF CONSTRUCTION NEW U ADD U ALTERATION U REPAIR — Z ❑ CONVERSION El DEMOLISH El OTHER - T Front O Owner's Name . l tIlreferec.—.T-eserPhoneme;/ �'/6 DESCRIPTION OF WORK/USE OF BLDG. A Rear N Address C Right N Arch/Eng. License No. TYPE OF PERMIT U GRADING Li FOUNDATION El STRUCTURAL K G Address. El TENANT ❑ ELECTRICAL El PLUMBING MECHANICAL $ • Left R El OTHER Ping. Ref.# Parking Req./Provided E Contractor's Name a.rm2 /4,-=1 a-- Phone— PROJECT DESCRIPTION SQ. FT. OCCUPANCY 4,Address I mailingl Planning Notes: Q M CONSTRUCTION TYPE-. VALUATION$ .f City License No. ZONE GRADING CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION _ S. 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 is in full force and effect. • ELECTRICAL FEES 2 License Class - License No. ^'�''�'- • Date Signature PLUMBING I FEES Automatic Washer Transformer 0 15.50 KW •vORKERS•COMPENSATION DECLARATION Construction Pole Sub. 0 50+KW ereby affirm that I have a certificate of consent to self-insure or a certificate Bar$ink Showers Workers' Compensation Insurance. or a certified copy thereof (Section Backflow Preventer Service Sink Cooking Unit -. Meter ❑up to 100 amps 3800, Lab. C.) - s Dishwasher Meter ❑Over 100 Policy No. Company Backflow Irrigation amps Sewer Cap BCertified copy is hereby furnished. - .. — • Dryers ❑Gas ❑Electric Sub Panel Certified copy is Med with the city Building Division. Bathtubs Sewer Connection Date Applicant —- • _ _-- Fan EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Motors 00-1 HP 01%.8 (This section need not be completed if the permit is for one hundred ($100) or - - F.A.U. less). Dishwasher Solar Piping 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 beco e subject to te Drinking Fountains'' Solar Tank Microwave DrorRation Laws of California Date414✓fSignature ��2dd��2dd Floor Drains Swimming Pool w/Spa • - Device Boxes Pole Light NOTICE: If,after making this declaration,you ou bac a subject to the Outlets ,. Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Range comply with such provisions or oils permit shall be deemed revoked. _ - CONSTRUCTION LENDING AGENCY Gas Service OutletsWater 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 • Generator ❑0-5 KW ❑5-15 KW Trash Compactor Lender's Address Kitchen Sink Water Service OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash following reason (Section 7031.5 Business and Professional Code: Any city or . county which requires a permit to construct,alter,Improve,demolish or repair P-Trap Laundry Tra9s any structure, prior to its issuance, also requires the applicant for such permit - — 1 - to file a signed statement that he/She is licensed pursuant to the provisions of Roof Drains the Contractor's License Law(Chapter 9 r(commencing with Section 7000)of • ilvision 3 of the Business and Professions Code) or that he/she is exempt Reinspection Fee $15 Issue Fee $ 3 serefrom 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 oenalty of not more than five hundred dollars($500). DEVELOPMENT SERVICES REQUIREMENTS: LJ I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 compensation, will do the work,and the structure is not Intended or offeredZoning Approved By Date for salese (Section e Business and f aproperty Professional Code: The Contractor'smroves MECHANICAL FEES Building Approved By Date thereon,Law does not apply to an owner if a prolf who builds s or Improves thereon, antl who does such work ovem nts rrel f or through his or her own Application Issued By Dat employees, provided that such improvements are not within or of offered for Boiler Hood or Type I ❑ sale. If, however, the building or improvement is sold within one year of com- - Canopy Type II 0 ,pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground SUMMARY OF FEES 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 c tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑0-100,000 BTU ❑100,000 BTU ISSUANCE builds or improves thereon.and who contracts for such orolects with a con- PLUMBING $ $ tractors) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple 0 System Repair/Alteration PLAN CHECK 25% $ ENERGY P.C. $ proof of their Worker's Compensation insurance should be provided to me,, p /9S V ELECTRICAL $ GRADING $ ❑ 1 am exempt under Section B.& P.C.for this reason �iX Firepl/Fact.Blt. ICBO# Fire Dampers 'O OU MICROFILM $ _ X.79 PLAN CHECK 50% $ Date . V/ Owner � Heating System& Ducting Registers MECHANICAL $ 33. 0� 33.06 I hereby certify that I have read4ls app cation antl state that the above ❑O-100,000 BTU 0100,000 BT 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 repre- sentatives of this city to enter upon the above-mentioned property for inspection purposes. , / Signature - - K - DATE: 11/18/38 TIME: 08:56 0865-46,rev. 5/88 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor / CONSTRUCTION AND PLANNING POL 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 J. Electrical Conduit Utility-Undrgrnd. 54. Forms 4,Electrical ConduitLUndrgrnd. 55. Electrical Bonding 5jSteel Reinforcement 56. Rough Plumbing & Pressure Test 6.4Elecgical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE I I f 7:Ikootings 58. Electrical Conduit-Undrgrnd. &.'Foundation I 59. Gas Pipe, 0 Undrgrnd., Test • eWateriPipe-Undrgrnd. 60. Backwash Lines, P-Trap, Q Undrgrnd. 10`2Structural Floor System I 61. APPROVAL TO DECK 11.'Property Sewer Line & House Connection r .62. Backwash & Receptor-Final 12.cSewer'Cap i 63. Heater & Vent-Final 13: Roof Drains • 64. Plumbing System - Final 14.1,1Rough Plumbing • 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final - 16,_Rough Electric Wiring 67. Fencing & Access Approval 7.7--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 • 201 Rough Factory Fireplace Zf..yY LeV 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 ./'/0i'�I/�•'" 35. Final Gas Pipe-Test ��1, /, 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final - . 40. Gas Service-Final • 41. Solar Domestic-Final 42. Backflow Preventer ._1 43. Backflow Irrigation , - r 44. .Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY • .- No. Date j) I Applicant to fill in all spaces esicept those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA ' CONSTRUCTION PERMIT PERMIT NO. I .TRACT NO. LOT NO. UNIT NO. '�3 6'y �� ✓ 9 l 3 20 >33 4356 1/29/66 143,73 IL Project Address !/ /J ' ( Applicant'sMailingAddress 5 #O CP✓7PQ 46o. `a. . TYPE OF CONSTRUCTION j5'NEW LJ ADD Li ALTERATION LI REPAIR It Ii/NI ❑ CONVERSION 0 DEMbLISH El OTHER A,P.# Zone /111 Owner's Name /yCk IN,In Phone DESCRIPTION OF WORK/USE OF BLDG ,pe Address /5'8 E ' SCW Cos74 1/eysnn"¢• s"I cet..- ; 1V— R- - CstV' 9pve45.0 E Main Building: Accessory Building: Z Arch/Eng. �z � License No..7•5. e3ayc TYPE OF PERMIT GRADING ❑ FOUNDATION LJ STRUCTURAL �J -F Front - O Address 6''�� J 4-C 9 /yy -s(� ❑ TENANT rr ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N Contractor's Nam-/ — 6-(EC Te/C PfiOFje/,7/p0/c) ❑ OTHER r $ `Z 45 C Right - N Q �� 6 PROJECT DESCRIPTION SQ. FT. ..�" _ OCCUPANCY 473 g Address lmailing) ys514 CPMP/2 N�Co /, a tii-.'. i K r' L' CONSTRUCTION TVP VAL ATION $ S Left R City License No. 73829 ZONE GRADING CV.YDS. ACRES LICENSED CONTRACTOR DECLARATION J� ++�� Ping. Ref. # Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: /f E : , 3/ 7 O / L Planning Notes: M with section 7000) of Division 3 of the Business and Professions Code, and ,�/ / T my license is in full force and effect. j Li censr] ass g � 5t ''•.T Y32 VS-- "- PLUMBING FEES I S tiQ Date Signature i / Or• WOR ERS'COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL FEES I hereby affirm that I have a certificate of consent to se -insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink Automatic Washer Transformer 0 15-50 KW I� 3800, Lab. C.) y Policy No.//239t/5-7 Company�'+-7-47e /.o Backflow Irrigation ' Sewer Cap Construction Pole Sub. 0 50+ KW All ❑ Certified copy Is hereby furnished. iQ Certified co y is filed With the ci♦/,�,.`'''ys,�' Div' Bathtubs l Sewer Connection ._ Cooking Unit Meter Opp to 100 amps Date 1 Lq 1if Applican EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps (This section need not be Completed if the permit is for one hundred($100) or less). Dishwasher Solar Piping , Dryers ❑Gas ❑Electric Sub Panel I certify that in the performance of the work for which this permit Is issued, I shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors 00-1 HP 01%2-8 • Workers' Compensation Laws of California. - _ Date _Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP 016-15+ NOTICE:If,after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures Microwave comply with such provisions or this permit shall be deemed revoked. -• CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet /' Device Boxes .''Light I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is Issued (Section 3097 Civ. C.) Interceptors • Water Heater 4' Outlets Lender's Name _ Range Lender's Address Kitchen Sink Water Service OWNER BUILDER DECLARATION Switches Sign I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal Standing Sections following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a bermit to construct,alter,improve,demolish or repair -P—TrapLaundry Trays Generator 00-5 KW ❑5-15 KW Trash Com actor - • any structure, prior to It; issuance, also requires the applicant for such permitx P to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains y ,/ j p .the Contractor's License Law(Chapter 9(commencing with Section 7000)of 2 YSC ^ r� �r g;r ,Z Division 3 of the Business and Professions Code) Or that he/she Is exempt - _ _ therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil . enalty of not more than five hundred dollars ($500). $ 3 I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee compensation, will do the work,and the structure is not intended or offered - Reinspection Fee J $15 Issue Fee t { �sOO for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES License Law does not apply to an owner of a property who builds or improves thereon, and who does tuch work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such Improvements are not intended or offered for Boiler Hood or Type I 0 sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 Zoning Approved By Date diction, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Date rove for the purpose of sale). O I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Dat tractors to construct the project (Section 7044,Business and Professions Code: - The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU 0100,000 BTU SU MARY OF EES builds or Improves thereon, and who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT ❑ I am exempt under Section B. F. P.C.for this reason Firepl/Fact.BIL ICBG# Fire Dampers PLUMBING $ - ISSUANCE $ Date Owner Heating System& Ducting I Registers PLAN CHECK 25% $100n. ENERGY P.C. $ I hereby certify that I have read this application and state that the above ❑o-100,000 BTU 0100,000 BTL t ELECTRICAL $ GRADING $ information is correct. I agree to com•ly with all city and county ordinances and state laws relating to bui .'ng _tj ction,and hereby authorize repre- MICROFI LM $ sentative • ci ton rn the above-mentioned property for PLAN CHECK 50% $ /�/, r ?/ Q / ¢•� ? inspe � 29 8 t MECHANICAL $ TOTAL FEE $ Sign. S5 toiler Date Drivers' License or SS# - Applicant; Pink -Accounting;Goldenrod - Assessor , ICONSTRUCTION AND.PLANNING. POOL&SPA . 1APPROVALS Permit'# i1' 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. 'd gett 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement - 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grrid.' , With ` 04 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. B. Foundation '✓'I,' 59. Gas Pipe, 0 Undrgrnd.,Test 9. Wat i%Pipe-Undrgrnd4 . 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System- 61. APPROVAL TO DECK c 11. Property Sewer Lin q& 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 G 16. Rough Electric Wiring S_in G/6/wh 67. Fencing & Access Approval 17. Rough Wiring Sign �11/1t� ~"h `� 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL `r 19. Rough Heating & Air Conditioning • FIRE DEPT. REQUIREMENT ;� J - 20. Rough Factory Fireplace APPROVALS Permit# ' 7 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating • 71. Product Piping DGas DOiI 23. Gas Pipe-Rough& Test 72. Underground Flush it • , 24. Roof Framing • 73. Undergrnd.Storage Tank 0 Gas 0 Oil • , 25. Roof Sheathing - 74. Overhead Hydro ;1). 26. T-Bar Ceiling (Structural) '& Monocoat 75. Dry Chemical 1 L•f - 27. Frame and Flashing 76. Dry Standpipe 4,1-1 : • :r. 28. Lathing &Siding - 77. FIXED-SYSTEM FINAL CI ,' 29. Insulation 78. FIRE PREV. FINAL n1 30. Drywall Nailing HEALTH DEPT. REQUIREMENT r- (1') 31. Plaster Brown Coat n / '79. FINAL INSPECTION - rI 32. Electrical Power Meter-Final � �O IJ� /,/ _/ 80. FOOD CERTIFICATE ISSUED ;,"1 33. Final Electric 7 /C, �S'.rPF`f-- Notes: ) 34. Final Heating & Air Conditioning I 35. Final Gas Pipe-Test - ' • 36. Hood or Canopy • 37.'Final Factory Fireplace - 38..Final Plumbing '' !, 39. Water Service-Final . 40. Gas Service-Final , 41. Solar Domestic-Final , 42. Backflow Preventer • " - ,43. Backflow Irrigation r. - I _44,. Landscape Irrigation System '1 • 45: Sound Attenuation 7 46. Handicap Regulations , - 47. FINAL STRUCTURE & BUILDING ` r 48. Special Requirements Completed v - . •? 2. - .. . 49. Electric Release to Edison I , , , 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY , No. Date • i, .