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2370 ELDEN AVE - Building Permits
COUNTY OF ORANGE - BUILDING DEPT. Permit No. /... Y 636 No.Broadway Santa Ana,California Application for Building Permit Phone:KI 2-6211 AND FOR A Certificate of Use and Occupancy �^� n s Date...0/�..2,e t[ 1� !�,l-.Q...! I. OWNER'S NAME /�X"/%1 ad r.. 2 '�. .. �pCL. /PHONEt�G=f\" " 'C_- MAILING ADDRESSt: . +7.04 aleiraft....r�..b!d.'.n1..yj CITY..S , .S Ly/ Name. .a.fr--44{' Name �a.Nt_..�! glia�.- C- _("-Arcceineer) (Contractor) Add e ./Eed6/L444. . Addres ' City City State State Lic. No ...... Phone ,/,/�, Lic. NO J Phone , PROPOSED USE' - Cl(,/. frattLiti erNie, Ct j 2. JOB LOCATION....lair 3 ... +�.�2 ..r..e C %/-.[//u,(//ii t�.L' .. ... ,...lt- (House No.) // / (Name of Street) (Town orrSchool District) 3. LEGAL DESCRIPTION: Lat..S.W 4.. 72..:..Block Tract 30 (Metes and Bounds Description—Use reverse side off arm) G e 4. ::R: 4, E; # 7 E OF LOT:f71'J -�.Ll..i7 t1KEA L� l /r�!t G. HEIGHT OF BLDG ,,,c2 �" 9.,r CEILING HEIGHT:.)//1,4.0(... .f� NO. OF STORIES) • 7. NO. FAMILIES J'y.. i.,_ Size of Smallest Bedroom )f./ }yr-.�vj Size of Kitchen )./164tH A_ S. EXTERIOR WALL CONSTRUCTION: f?t Lt. I4116 "W'{ALL COVERING )...44'..::.:Z.:(_,_ (Frame, Stucco, Etc.) � • (Plaster.Drywall,Etc.)/ 9. SETBACKS: Front Yard From Center Line of Stre@t....�Q.Q- rt yr, +--- Nearest Side Yard...:.1. 1.'.,, Rear Yard...Xl._.e'.L_r Distance in Feet Between Bldgs. on Same Lot.....�*`"r 10. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH. r 11. For (a) Footing: Width Q.,f1�Ji.............Depth in Ground....Q,......._.44-` Width of Wa11.... vv.....,_._ .,... • Accessory • . I //// Similarand (b) Size of Studs: (, =r`Spacing...,(�? "CC Material of Floor - Structures: (c) Size of Floor Joists:....... 4n;1i1 p__ Spacing "CC (d Size of Rafter= . S acin . . t e4 � ) •� st P g. .. . .e.a t . 12. VALUATION OF P OPOSEE WORK: Including all labor, plumbing, electrical wiring, heating, fire sprinklers, painting and sewage disposal $.. OV.Q.,e.." .. - 13. I HEREBY CERTIFY.THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION IN THIS APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OF THE COUNTY OF ORANGE AND THE STATE OF CALIFORNIA APPLICABLE THERETO. Signed j.(�f/i7`^�-�—• (Owner) Plans Filed By. - -(Authorized Agent) - . FOR DEPARTMENTAL USE ONLY . FEES: C�HjE�C�KING BY Bldg. Permit - $ ' /- ©2 ° GROUP S! APPLICATIO�9//�/e.v' HEALTH Plan Check - $ ' 570. 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IMM II ...nnn.■ ian:an.a ::a M n:::■•a.a.. a• M _• ••n:::gg;■EMM•:aWE :gaggg:a•n a:a: ::a n:nnan9:aE -- - E:::.....:: :. a:.1.n11:11:11 :E:.: 11. - _ _ 1:••-. . . .. 1:a:1:::1:::1:::gga .....11...111 9 n .:.a.: �_. ....:.....■n g......■......g 1 :•.naaaaa.0 ••m••:•.n MOME : .....g.■■g. g. ■ .■■n ■ : a -� .■ ■nn. n.Eu:::a■:::.:a.:E• a:::�:a::a: n.n • W i 1- I I I _ L_!I_L1-LI 1 f I I I- HMI I I IOg1e 1 I I -�_L _n. iRaiiria Ssaa ..n.■■... •■ •■ ■ .n L I _, _n. ■:tion.■.■. : ..■•■.. ■ ■ ■ m■■ r - I� � illis�il! 1 MINIM mu 1911111 IJ 1 ___:+:....v.....1,41.11.I ■ M ga...■ ■ ■ T. i1 i .1 -�_-L-- _ a i i' Old aiillaai i: :aiiiaim 11 1 ----I_ ■ n. .■.■■■ ■ .g .. .. . ■ ■ ■ --- I- g... .. g..■■. . . .■1■g. . . ■g.. • 1111 .. �: :.... _ ..a.. a. Illialle ... . .. -_�_4_� :aE• :•1 •1111:: •lin •:•gg a g.;E a. ... __LL- L L::11• II 11111E1:na.a11.1aa•a:nla:la:aalaaa• o I I I I I I I 1 I 1 I I I I P Costa Mesa Building Department APPLICATION FOR PERMIT � „ P. O. Bee 317 359+y BUILDING 1 • COSTA MESA, CALIFORNIA FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY Building - Receipt No. Permit/No.�/ AddressJe2J7o c/ afr 3StP / vl Costa Mesa, California Rec ve by Date Reed. figte Issue!! Nearest eC C� Building(% ���d S� _(Hi7 C Cross 6t. dres Address Owner Mail /- Costa Mesa, California Addre .2.37o /.; l Nearest Tel. Cross St. City ,Qr No. Zone, !�/I No.of I Type GrouPPTT y Architect or Lie. pj Plans s (/1,Engineer No. pp ove % O/tp, APP& Y I) Date 3 _ Address ' S ' City Lie. ic CITY OF LOS IA MtSA PLuactoq Q .(' No. Address jaia) A Si 5,,.,k� ccr To INQG DEPT. /� ✓l�Y W,� SU DJFCr TO e�pr. nFf-T RFC Legal I Lot Q�n Oj I Description No.Z Block I Tract.aOp (Attach Metes and Bounds)// (J—CS;a— C BY G - DAT: `�'' 3°25-1? 1 1 No.of Bldg%%qq • PLAN T Crl.�/J/ Size of Lot (�/A. �US Now on LotoO .-- 4se of 0 fl eJ I No. it I No.of a Existing Bldg. Families Rooms Setback Line from ,� r Rear Yard /O9' % — Center of Street a41, Side Yard f'a'.37 DESCRIPTION OF WORK/Do/ J3at w rune R/C!fs New X I I Alteration I I Addition I Repair I I Moving I I Demolish I Buildin No.of - Size / yX�% 0 Rooms _Z — Stories / — • tiior ingea p I Roof ring0/►v y � APPROVALS Use of New K (i (1 S Building J al-wt..( �-� Foundation Location inspector • Date Forms,Materials, Under-Pinning Frame: Fire Stops, 1J Bracing,Bolts P I hereby acknowledge that I have read this Application ,f. and state that the above is correct and agree to comply Lath. Int. v with all City Ordinances and State Laws regulating - n building construe on• p Lath.Ext. 92 Signature of ' ++ . Permittee ,' �/ t.t�.�� Plaster, Int. : Authorized Agt./� Plaster,Ext. PR valuation Permit Fee $ a 0 — Masonry Reinforced ,,,go / Plan Check $ /0 ,• Bond Beam $ // Total �j •" Fee $ -} a -- FINAL - FORM 204 10.55 D. P.a S. .. r, •.: 2 • I -- • • ci. • , o. o a. . t • -‘ - • . _ • • ; t it . fU ) , • /.1,1.1'3, { cc-1 k\i . -, , •. • , • Street PLOT-Par- • • • ", Show location and distances from property line and between buildings. •- ._ . • • (. • • PCity of Costa Mesa Development Services Dep Building Safety Divisionartment CERTIFICATE OF OCCUPANCY No. 002330 P.O.Box 1200 Costa Mesa,California '\ The Building located at 2370 Elden Avenue, Units A thru F has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group R-1 Occupancy. / Use of Building 6 Unit Condominium 1 ii Legal Description 439-262-04 ISee reverse side for Metes and Bounds) K. E 31185 P33082 Building Permit No B 30822 Electrical Permit No31632, E364 plumbing Permit NoP311967P33069 Mechanical Permit No. [4 32588, [434272 Number of apartments and/or guest rooms ISSUED TO: Building Official William T. Howard `_ Donald C. McHone / 17702 MltchelitN. by �/J ,.. �7- — G% .9 , Irvine, CA 92714 Date January 8, 1988 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 CO U.B.C. CMF 1015-46 rev.1/83 White-Owner;Canary-Numerical File;Pink-Bldg.Permit File 1 • 11111.1! _ a =` _....$1,,,,,_-----. >" Ap1 fill in all spaces except those within heavy border lines and sign an appropriate declarations. PERMIT NO. T TACT NO. - LOT NO. "UNIT NO. fJ� F,COSTA MESA CONSTR1,--• N PERMIT 133 O$Z7-, 3042 1 7578 10/22/87 1739,56 It. Project Address 2370 El „Ica i,.venue �1s,,,,�� �r . D/�'•�'_ _ • i1?2TYPE OF CONSTRUCTION KNEW L� ADD EALTERATION REPAIR Applicant's Mailing Address "' M1tChell- N. Irvine ❑ CONVERSION El DEMOLISH ❑ OTHER _rf C. McHone Phone 863-6969. A.P. 'pi #3-304E 43 Zea-Oq-1 zone RZ Owner's Name Don?' s - DESCRIPTION OF WORK/`USE OF BLDG. Residential- _ - J 17�yr1 t r`hel l N. Trvi ne 92714 - v ( wer Uy r ww�AO 5 > S Main Building: Accessory Building: Address �'aes—Manshade - 6-30407 \ E z T+_� License No. TYPE OF PERMIT ❑ GRADING I� FOUNDATION '] STRUCTURAL T Front 2. Aj _ O Arch/Eng._r- p� '1 ��/732 Irvine' Blvd 8115 ,Tustin 9268C•,' ❑ TENANT ELECTRICAL CA PLUMBING MECHANICAL B Rear (AC/ / N ontractor's Name Owner/Builder Phone ❑OTHER s C Right G� - N i Address(mailing) • •PROJECT DESCRIPTION SQ. FT. 9,015 Y �J7�aiolPANCV IL' ( K g ✓ G • ,C ONST RUCTION TYPE V-N 'V'7lCLATION$ , • $ Left City License No. .. ZONE R-2 GRADING CU.YDS. ACRES . 462R • ' LICENSED CONTRACTOR DECLARATION l Ping. Ref.# _ FIG:, -sp sotar l g Req./Provided E •I hereby affirm that I am licensed under provisions of Charter 9(commencing -Remarks: Planning Notes: (y1 with section 7000) of Division 3 of the Business and Professions-Code,and P )) I��� 7 1n , ` -.{y my license is in full force and effect. „ 1 'ff � t - p % - (0 uielA Cpm I✓(4 V W7 c'vC t'ac T License Class License No. ' - r U /J _ '�r`�1 S nate Signature - 'r PLUMBING FEES (cK loi—/2-4A-ok ow F)R SPECIAL1REQUIBEmpos •RKERS'COMPENSATION DECLARATION - ' ' Bar •Sink • Showers ' ELECTRICAL - FEES areby affirm that I have a certificate of consent to self-insure or a'certificate • of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink 3800, Lab. C.) Automatic Washer Transformer 0 15-50 KW �', Policy No. _ Company - ' ' -' Backflow Irrigation • Sewer Ca - .❑ 50+ KW 8 Certified copy is hereby furnished. , ', p Construction Pole Sub. , Certified copy is filed with the city Building Division. _ Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps Date Applicant _ EXEMPTION FROM WORKERS'COMPENSATION DECLARATION- ' e. Clarifiers - Solar Collectors Dishwasher Meter Clover 100 amps (This section need not be completed if the permit is for one hundred ($100) or less). Dishwasher - Solar Piping Dryers OGas ❑Electric Sub Panel I certify that in the performance of the work for which this permlt,is issued, I shall not employ any person in any manner so as to become subject to.the Drinking Fountains Solar Tank - Fan Mot s❑0-1 HP ❑1%-8 Workers' onmognsagpn Laws of Calify�lyy - - I — Date n-7`'1-ti'/ signature fl����7 iii 'd�� J Floor Drains Swimming Pool w/Spa - F.A.U. NOTICE: If„after-makin this declaration, you should become subject to the I .Solar ❑9-15 HP ❑16-15+ 9 - Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures Microwave• ` comply with such provisions or this permit shall be deemed revoked. _ CONSTRUCTION LENDING AGENCY Gas Service Outlets ` ' Water Closet Device Boxes Pole Light I hereby affirm that there is a construction lending agency for the performance 9 of the work fori'io the this permit is issued (Section 3097 Civ. C.) • . Interceptors _ t Water Heater Outlets Ran e . Lender's Name 1V it „ r 9 Lender's Address --- . _ _ Kitchen Sink - Water Servicet ” OWNER BUILDER DECLARATION - Switches - - Sign - - I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories -x. Auto-Wash �-, following reasonr(Sectlon 7031.5 Business and Professional Code: Any city-or ( Garbage Disposal Standing Sections county which-requires a permit to construct,alter,improve,demolish or repair P-Trap ."-.� Laundry Trays Generator ❑0-5 KW ❑5-15 KW ' any structure, priori tbllts issuance, also requires the applicant for such permit _ 'T'Trash.Compactor to file a signed statement that he/She is licensed pursuant to the provisions of Roof Drains' ' f • the Contractor's-License Law(Chapter 9(commencing with Section 7000) of _ t s . _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 - oenalty of not more than five hundred dollars($500). , O I, as owner of the property or my employees with wages as their sole Reinspection'Fee I $15 Issue Fee $ 3 compensation, will do the work, and the structure is not intended or offeredReinspection Fee $15 Issue Fee $ 3 - for sale (Section 7044, Business and Professional Code; The Contractor's MECHANICAL FEES - License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own - DEVELOPMENT SERVICES REQUIREMENT ' provided that such improvements are not intended or offered for Boiler Hood or Type I 0 • An .__jAS - y7-2 employees, p a .✓ sale. If, however,wthe willbuilding the improvement fro issold within one year of rim- Canopy Type II 0 Zoning g Approved By Date / l wive the owner have burden of proving he/she did not build or im- Duct-Under Ground S pBuilding Approved By Date ' �3 wive for the purpose of sale).as owner of the property, am exclusively contracting with scions con- Duct-Structural Refrigeration System - Application Issued By ..��� -. i- Date CIL -•2{ST'a, tractors to construct en project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 5-100,000 BTU 0100,000 BTU SUMMARY OF FEES builds or improves thereon, and who contracts for such projects with a-con- tractor s license pursuant to the Contractor's License Law). I am aware thatBUILDING PERMIT $ • MIP $ as (� Exhaust System 0 Multiple 0 ' System Repair/Alteration -y ' ciy proof o their Worker's Compensation insurance should be provided to me. - _ - J.� CopLAN CHECK • $ $•IrPER MIT 0 I am exempt under Section B. •& P.C.for this reason - Firepl/Fact.Blt. ICBG# Fire Dampers - rPLUMBING 4 $ ISSUANCE $ Date Owner - Heating System& Ductin• Registers PLAN CHECK 25% $ ENERGY P.C. $ ' I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000 BT GRADING $ - - information is correct. I agree to comply with all city and county ordinances ' ELECTRICAL • $ , and state laws relating to building construction, and hereby authorize repre- $ MICROFILM $ ..sentatives of this city to after upon the above-mentioned property for - PLAN CHECK 50% •Inspection purposes..., ., � 6-29-87 MECHANICAL $ TOTAL FEE $ I,739'st Signature l�-/7/ Date Drivers' License or SS#' • Reinspection Fee $15 Issue Fee • $ 3 PLAN CHECK 25% $ CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor 'n t 2 I CONSTRUCTION AND PLANNING POOL& SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location • 2. Soil Pipe-Undrgrnd. ' 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms _ 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding �' 5. Steel Reinforcement izi _..�•7t/� 56. Rough Plumbing & Pressure Test f- 6. Electrical UFER Grnd. ��XI/ 57. APPROVAL TO COVER-GUNITE' 7. Footings - ' ?LW ay 6r--- 58. Electrical Conduit-Undrgrnd. .' • 8. Foundation 1 y,8r 6._iv. 59. Gas Pipe, 0 Undrgrnd.,Test , 9. Water Pipe-Undrgrnd..' 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System //S, 4 Al. 61. APPROVAL TO DECK ' 11. Property 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 • ) 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 '��/�/u� �yr 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat / ( - 75. Dry Chemical 27. Frame and Flashing 6/(,/ GN' 76. Dry Standpipe r 28. Lathing & Siding `�7r' / (1y 6 �77. FIXED SYSTEM FINAL ....1-0,6,... 29. Insulation (Q 78. FIRE PREV. FINAL 30. Drywall Nailing �/J /+�� /6 it} HEALTH DEPT. REQUIREMENT , 31. Plaster Brown Coat i//7_,,, 07 rg.r 79. FINAL INSPECTION - • 32. Electrical Power Meter-Final f (�0 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: • 9LD FOR SPECIAL. B 34. Final Heating& Air Conditioning I 3IS/ CaC d roe- Sl.a4` „E'�Dl,.#oTor r`T3 4- • • IY . • , ,i •J 35. Final Gas Pipe-Test (7)e. W efr- •rts GAZAA.P ii 36. Hood or Canopy 37. Final Factory Fireplace Ai` /0 Kit ��' ra 38. Final Plumbing /fr/P3f Ade.. � Ira_Irt c a-5--V 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 1 46. Handicap Regulations - 47. FINAL STRUCTURE & BUILDING (1sfel s / 48. Special Requirements Completed , j _-3c .� /)b / -,; 49. Electric Release to Edison 4/6 50. Gas Release to Southern California Gas Co . , r 51. CERTIFICATE OF OCCUPANCY / -- .� // No. Date I t 1 a -f' 3 '• t 9'6- Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 9826 I I 607 204a 25 -I L, CITY OF COSTA MESA • CONSTRUCTION PERMIT ` PERMIT NO. TRACT NO: LOT NO. UNIT NO. • - • ' • Project Address .2`/i 70 rtUoei✓ 5r' lryye� Applicant's Mailin Address 3//0/ L✓ /hi' . �<7��g .5.,.4, a TYPE OF CONSTRUCTION Jas NEW U ADD H ALTERATION U REPAIR - - `.l �4 / l 4 ❑ CONVERSION ❑ DEMOLISH ❑OTHERZone Owner's Name ?vne Acle 7..,-f•e'S PKoie le-" f DESCRIPTION OF WORK/USE OF BLDG. Address 1771— M/CA4 4- y• 1/.1.re a" Arch/Eng. License No. , TYPE OF PERMIT U GRADING Ell FOUNDATION [1:1 STRUCTURAL 1 Address (S)(�--- S PI•,...r�p) A LI TENANT LI ELECTRICAL g PLUMBING ITh MECHANICAL ' Contractor's Name )44'447 5.,A*-1A Q4 PhongeyZY/42gt 6 ❑ OTHER Addresslmailinglx/°y e'••a iAL �'� t/Ww• oh* /Q".( fr./709 PROJECT DESCRIPTION SQ. FT. OCCUPANCY 709 7 CONSTRUCTION TYPE VALUATION$ S Left City License No. l / ZONE ' GRADING CU.YDS. ACRES • LICENSED CONTRACTOR DECLARATION (j I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: 1"F33 O$ Z Z 1 with section 7000) of Division 3 of the Business and Professions Code, and • my license is in full orce and effect. 3L / License Class - ' • cen - N.. Date — Signature ����■�� &' . PLUMBING _ - FEES WORKERS'COMPENSATION DEC LA RATIO$V - Bar,Sink Showers J I hereby affirm that I have a certificate of consent to self-Insure or a certificate ' `_ of Workers' Compensation Inscurance, or a certified 1copy/thereof (Section ., KW `10 3800, Lab. C.) 71 c 777 `.eV J/4.0 f+/ ; 1 III-' ■I AutOrnatic Washer Transformer ■ 1 Policy No. / Company ■ 1 any.Certified copy is hereby furnished. \% Certified copy is filed with the city Bu 'o Jl�/ • /I ■ • • 11 - (Thi [I—n a Applicanteth�/'dre IlL � ! ••• .■ ■ ' ®� EXEMPTION FROM WORKERS'C PENSAT DECLARATION • ■• 11 amps • Solar Piping , ryers Gas Electric . Sub Panel (This section need not be completed if the permit is for one hundred ($100) or I certify that in the performance of the wo f r which t Is per it is issued, I I. .snail not employ any person in any ma a as to tom object to the • Motors❑0- ■ poo Worker Compen ion Laws of Califor Date,/—,d" ' Signature �!2 ,Floor Drains• ' � ■. ■ :- NOTICE:Compensation makingnthis ions declaration, you r becomeuustto th . ■ MI . . ®� 16-15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks . , Urinal Fixtures . comply with such provisions or this permit shall .be deemed revoked. M•• owave CONSTRUCTION LENDING AGENCY .-/. • q P. 4 Gas Service • MOO •- �vice Boxes I hereby affirm that there is a construction lending agency for-the performance of the work for which this permit is issued (Section`-3097 Civ. C.) interceptors Water Heater Lender's Name - 41 Outlets , Range . Lender'sAddress Y� OWNER BUILDER DECLARATION - , .t• r,; o • I hereby affirm that I am exempt from the Contractor's License Law for the // Lavatories 6 To If IILL..__ lE'L ... following reason (Section 7031.5 Business and Professional 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 Generator 005 KW 05-15 KW, Trash Compactor to the a statement that he/she is licensed pursuant to the provisions of DrainsRoof ' �rays � - 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 I 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 - • compensation, will do the work,and the structure is not intended or offered for sale (Section 7044; Business and Professional Code:'The Contractor's . MECHANICAL • FEES Reinspection Fee $15 Issue Fea $ 3 License Law does not apply to an owner of a property who builds or improves _ thereon, and who does such work himself/herself or through his or her own Boiler ■ DEVELOPMENT SERVICES REQUIREMENTS: , employees, provided that such improvements are not Intended or offered forZoningApproved sale. If, however, the building or improvement is sold within one year of com- ■ PP By Date 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 Approved, Bye Date p� 0 I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural - • Application Issued By Date Date (/--1 r J 7 •-•-•-•- tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 ■ 11 111 - SUMMARY FE f, builds or improves thereon,and who contracts for such projects with a con- tractors) license pursuant to the Contractor's License Law). I am,aware that Exhaust System ❑ Multiple ❑ BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation insurance should be provided to me. Re... CHECK $ ♦� PERMIT ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# . Fir- 5 mpers PLUMBING $ t7 ISSUANCE $ Date owner Heating System& Ducting eglsters PLAN CHECK 25% $ V •,...„yrENE RGV P.C. $ I hereby certify that I have read this application and state that the above ❑o-100,000 BTU 0100,000 BT ' GRADING $ information is correct. I agree to comply with all city and county ordinances - ELECTRICAL $ - and state laws relating to building con ructio ,and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ sentatives of this ci to me opo the bove-mentioned property for inspection purpo /rZei�7 MECHANICAL $ . TOTAL FEE $ 2,0 Signature • Date Reinspection Fee $15 Issue Fee $ 3 ' PLAN CHECK 25% $ Drivers' License or 55# . /� CMF 0865-46,rev. 10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor ' "1 POOL&SPA ,CONSTRUCTION AND PLANNING Date Inspector Date Inspector ,'APPROVALS Permits# APPROVALS Permit# i 1''Temporary Electrical Service or Pole 52. Pool & Equipment Location ' 2. *Soil Pipe-Undrgrnd. .7/M4/2 ._ :1;E3-° 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 . r • 7. Footings." yet ' . 58. Electrical Conduit-Undrgrnd. 8. Foundati&n . ,' : /' 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd/, > 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 4'r 61. APPROVAL TO DECK • 11. Property Sewer Line &IHouse Connection i 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final • , 15. Rough Electrical-Conduit - 66. Solar System-Final , 16. Rough Electric Wiring 67. Fencing & Access Approval 17: Rough Wiring Sign cc , 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceilingti et. 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 OGas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical , - 'N rI 27. Frame''and Flashing g. Q.41,. 76. Dry Standpipe n1 28. Lathing & Siding / 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 1 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 16; i 31. Plaster Brown Coat 79. FINAL INSPECTION 17 - 111 . 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUEDi', i 33. Final Electric Notes: •!i 34. Final Heating & Air Conditioning !;'i 35. Final Gas Pipe-Test - �y7` �%'„_� e i , , 4 'l 36..Hood or Canopy U/, : '. • k 37. Final Factory Fireplace - 38. Final Plumbing /5/A761ff�i,' _ i r 2 . 39. Water Service-Fe&-- - f/. /8e el { 40. Gas Service-F.iaf31 i/ /cr• y / Ye./�7/�9C i 41. Solar Domestic-Final ¢ •"42. BackflowPreventer ,,. , 43. Backflow Irrigationfi I ,/ ;. y• 21'•44. Landscape Irrigation System r.. .: % 1 ,2 % . 11. ' r 45. Sound Attenuation • '.1 ) „I � `. .. . j 46. Handicap Regulations ; 47FINALSTRUCTURE & BUILDING �"0 '..f , , 7 48r Special Requirements Completed L.., • S ' 49. Electric Release to Edison i `- P • • 50. Gas Release to Southern California Gas Co f = - 51. CERTIFICATE OF OCCUPANCY . )• No. i, Date . . .- Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY COSTA MESA CO�NS� T_R UCTIp N PERMIT PDERMIT NO.�,Io TRACT NO. LOT NO. UNIT NO • . f �N - 3Jv D2^ IDj17P- 8811 4/I /BU 55e50 TI Proj¢ct Address /� � y'J ' y1/ v QL ['J'tjs¢j(C� <� �� TYPE OF CONSTRUCTION LJ NEW U ADD L, ALTERATION REPAIR 'Applicant's Mail' Address4000 G` m ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P-# Zone • - Owner's Name Phoneng DESCRIPTION OF WORK/USE OF BLDG. Address ' '• S Main Building: Accessory Building: • g "frienc.ie 'f043i SC TYPE OF PERMIT L I GRADING U UNDATIOryZ Arch/En License No. 0 STRUCTURAL E Front � • O Address ❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL B Rear • N �{ 1❑ OTHER A I Contractor's Name © y Phone PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right N Address(mailing) K CONSTRUCTION TYPE VALUATION S S Left G City License No. ZONE GRADING CU.YDS. ACRES R LICENSED CONTRACTOR DECLARATION - Ping. Re(.4 Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: r/ Z O 3 2- 2, Planning Notes: M Q with section 7000) of Division 3 of the Business and Professions Code, and �- J (� my license is in full force and effect. - T License Class License No. S Date Signature PLUMBING FEES WORKERS'COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL FEES I hereby affirm that I have a certificate of consent to self-Insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section ", Backflow Preventer Service Sink 3800, Lab. C.) - Automatic Washer Transformer 0 15-50 KW Policy No. Company . Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+ KW 8 Certified copy is hereby furnished. Certified copy is filed with the city Building Division. BathtubsA- ewer Connection 3 0 Cooking Unit Meter ❑up to 100 amps Date Applicant /' — EXEMPTION FROM WORKERS'COMPENSATION DECLARATION ' Clarifiers $Olay 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%-8 Workersy mgeon}tbtt.Laws of Can nes i/q__ _ - Date If�ft f/aki ideclaration, v �^'"'� Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar ❑9-15 HP Di 6-15+ , NOTIC (If,afte making this declaration, you should become subject to the , Workers' Compensation provisions of the Labor Code, you/must forthwith Floor Sinks Urinal Fixtures r Microwave comply with such provisions or this permit shall be/deemed revoked. CONSTRUCTION LENDING AGENCY % : ..�/ �, AC Gas Service Outlets Water Closet Device Boxes -/ " Pole Light I hereby work that there is a construction lending ag(Secti o ct performance.) /T� of the work for which this permit is issued (Section 3097 Clv. C.) C Interceptors Water Heater Outlets . Range Lender's Name / — Lender's Address • .- Kitchen Sink /n /]i Water Service - Jt. Switches Sign OWNER BUILDER DECLARATION J. I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash following reason (Section 7031.5 Business and Professional Code: Any city or - Garbage Disposal •• Standing Sections , county which requires a permit to construct,alter,Improve,demolish or repair P—Trap Laundry Trays Generator 00-5 KW 05-15 KW any structure, prior to Its issuance, also requires the applicant for such permit Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains v the Contractor's License Law(Chapter 9 (commencing with-Section 7000)of Division 3 of the Business and Professions Code) or that he/she Is.exempt therefrom and the basis for the alleged exemption. Any violation of Section , 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500)- $ 3 ❑ I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee • compensation, will do the work,and the structure Is not intended or offered Reinspection Fee I $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES ' License Law does not apply to an owner of a property who builds or improves • thereon, and who does such work himself/herself or through his or her own Boiler Hood or Type I ❑ DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for yp Zoning Approved By - Date sale- If, however,the building or improvement is sold within one year of com- Canopy Type II ❑ pleb° the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground • Building Approved By / Date r as the r of he pf ope). ;_�,is .• /r erg I, owner construct thet project Se tion 7 44, sinesscontracting with licensedioncon- Duct-Structural Refrigeration System Application Issued By - - .�/�.�_ cafe �(] h Iasu L the project (Section oSIn and Professions rt COtle: ' The Contractor's License Law aweh notapply toforan owner je is hta who Duct-Ventilating ❑0.100,000 BTU 0100,000 BTU S ARV OF F ES builds or improves thereon,and who contractsac 'sce such w).I as with e that of licenseeipursuantrk 'so the Compensation insurance License be I aware that Exhaust System ❑ Multiple❑ System Repair/Alteration BUILDING PERMIT $ SMIP $ proof off their Worker's Co mpen cotton 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# Fire Dampers PLUMBING $ • ISSUANCE $ Date Owner Heating System& Ducting Registers f ENERGY P.C. $ PLAN CHECK 25% $ I hereby certify that I have read this application and state that the above 00.100,000 BTU 0100,000 BTL • ELECTRICAL $ GRADING $ information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize repre- sentatives of this city to enter upon the above-mentioned property for inspection pu�ses. e / Date Y/5/9"€ MECHANICAL $ TOTAL FEE $ FSC) - Signature sir .a.- Drivers' Li en -'' 9* _ , Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ in CMF 0865-46,rev. 10/84 white - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor 1 CONSTRUCTION AND PLANNING _ _ ' POOL &SPA APPROVALS Permit# _ Date Inspector APPROVALS Permit # Date Inspector 1.,Temporary Electrical'Service or Pole 152. Pool.& Equipment Location 2. Soil Pipe-Undrgrnd. i 53. Steel Reinforcement : 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-U ldrgrnd. 55. Electrical Bonding ' 5. Steel Reinforcement 7 __,,,, 56. Rough Plumbing & Pressure Test 6. Electrical UFER•G nd.: 57. APPROVAL TO COVER-GUNITE 7. Footings t,' • 58. Electrical Conduit-Undrgrnd. 8. Foundation ( ) 59. Gas Pipe, 0 Undrgrnd.,Test • 9. Water Pipe=Undrgrnd r 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Linei&House Connection '//ter- , .-- 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 r • 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 D Gas 0 Oil • 25. Roof Sheathing 74. Overhead Hydro In 26. T-Bar Ceiling (Structural) & Monocoat - 75. Dry Chemical in 27. Frame and Flashing 76. Dry Standpipe • r.•. 28. Lathing& Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL ri 30. Drywall Nailing HEALTH DEPT. REQUIREMENT Irt 31. Plaster Brown Coat 79. FINAL INSPECTION ~ / 1 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED C. 33. Final Electric Notes: ,rte/x /'p 7t SAwm� T 2L1 34. Final Heating & Air Conditioning J -/ t !1 /// +���C • 2t t ,.se�7(i/�UL 641 fel 35. Final Gas Pipe-Test • f �' 36. Hood or Canopy ' 37. Final Factory Fireplace ' 38. Final Plumbing . 39. Water Service-Final. � 1,40. Gas Service-Final 400/02S/� ' : 41. Solar Domestic-Final 42. Backflow Preventer '43. Backflow Irrigation .. - 44. Landscape Irrigation System • 45. Sound Attenuation fi • 46. Handicap Regulations 47. FINAL STRUCTURE & BU I LDING , 48. Special Requirements Completed - $ ' -. 49. Electric Release to Edison -, .. / 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY A No. Date Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 8701 4/14/80 70450 TL CITY OF.COSTA MESA CONSTRUCTION PERMIT PE IT NO. TRACT NO. LOT NO. UNIT NO. <Projedtlddress _et370 *sew T'en 3306`) 1�1reI p'�«P , Applicant's Mailing Address 6 9/ `Jh•Y�f'ee5 /'/✓`e - TYPE OF CONSTRUCTION CEW ❑ ADD U ALTERATION LI REPAIR . , fit.72,7i q �/?/a? ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.#, i I Zone Owner's Name �.� rt�!!!!////Q'V� tit N i70��Phone D 7t U (O DESCRIPTION OF WORK/USE OF BLDG. Address r S Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING FOUNDATION ❑ STRUCTURAL E Front • O Address -7 ❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL B Rear N Contractor's Nam f 7. Ph e ' s'7 / 63 ❑ OTHER - A Right N Address(mailing) 4 Sir'/ _7Yj#4 ;de '5� PROJECT DESCRIPTION SQ. FT. OCCUPANCY �l K G /� q .l .t CON ST RUCTION TYPE OCCUPANCY VALUATION S Left •City License No. /�D R ZONE GRADING CU.YDS. ACRES Ping. Ref.# Parking Req./Provided E LICENSED CONTRACTOR DECLARATION Q I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks:' rZ 3 O $' _ z . Planning Notes: M with section 7000) of Division 3 of the Business and Professions Code, and fJ T my license is in full f•r�sa and effect. +� •' License Class C- -/. icense No. o "1 • S A - �� .;_ Wr. PLUMBING FEES - `, Date � f' Signature :1 YORKERS'COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL FEES \ i hereby affirm that I have a certificate of consent to self-insure or a certificate • - of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer. Service Sink Automatic Washer • Transformer 0 15-50 KW �^-}± Folic No. 106//73-T� Company •1/0•�� Backflow Irrigation Sewer Cap Construction Pole Sub. ❑ 50+KW ertifietl copy I5 hereby furnished. _ Certified copy is filed with the cit ufld' 9 Dlvisi n. Bathtubs 4 Sewer Connection 39 OO Cooking Unit Meter 0 u to 100 amps i,_ Date 4—I fr ti? Applican , E.::: larifies Solar Collectors _ - Dishwasher Meter Dover 100 amps EXEMPTION RO be ORKERS'COdO ENSATION DECLARATION hundred ( V (This section need not completed if the permit Is for one (8100) or , ll� Iecer Dishuvdsher Solar Piping Dryers ❑Gas DElectric _ Sub Panel I ltno that in the performance f the work for whichstothis permit is Issued,t shall i. rs' employompeanyipersonos inf any manner so as to become subject to the Drinking Fountains .Solar Tank { Fan Motors 00-1 HP ❑1%-8 - Workers' Compensation Laws a California. - _ f_ Date Signature Floor Drains Swimming Pool w/Spa F.A.U. In . alar 09-15 HP ❑16-15+ h NOTICE:If,after making this declaration,you should become subject to the - ,I•z Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures Microwave •• KK comply with such provisions or this permit Shall be deemed revoked- N CONSTRUCTION LENDING AGENCY to Gas Service Outlets Water Closet /a. Cd Device Boxes kr Pole Light ' k I hereby affirm that there is a construction lending agency for the performance tC of the work for Which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater _ Outlets Range �l Lender's Name /_ I t( Lender's Address _ - Kitchen Sink - (D Water Service- `7_oV Switches Sign - - ). OWNER BUILDER L,EC LA RATION - - ♦ I hereby affirm that i am exempt from the Contractor's'License Law for the Lavatories Auto-Wash - Garbage Disposal Standing Sections v following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct,alter,improve,demolish or repair P-Trap ' LaundryTrays any structure, prior to its issuance, also requires the applicant for such permit . y Generator ❑0-5 KW ❑5:15 KW Trash Compactor %. to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains he Contractor's License Law(Chapter 9 (commencing with Section 7000) of )i q )ivision 3 of the Business and Professions Code) or that he/she is exempt ' therefrom and the basis'for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil - - - - penalty of not more than five hundred dollars($500). $ 3 D I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee compensation, will do the work, and the structure is not intended or offered Reinspection Fee I $15 Issue Fee $ 3 for sale (section 7044, Business and Professional Code: The Contractor's • MECHANICAL FEES ^^�� License Law does not apply to an owner of a property who builds or Improves •til thereon, and who does such work himself/herself or tnrough his orf her own DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements ora not intended or offered for Boiler Hood or Type I ❑ sale. If, however,the building or improvement is sold within one year of corn- Canopy Type II ❑ Zoning Approved By Date pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By a /i, Date • prove for thwe purpose the sale). �1�S/%r - e. yJ ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By L/ Dat F] s? tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑0-100,000 BTU ❑100,000 BTU SUMMARY OF FEES builds or improves thereon, and who contracts for such projects with a con- -` tractor(s) license pursuant to tee Contractor's License Law). I am aware that Exhaust System ❑ Multiple ❑ ystem Repair/Alteration BUILDING PERMIT . $ SMIP $ ' proof off their Worker's Compensation insurance should be provided to me. _ ❑ I am exempt under Section B. & P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers PLAN CHECK • $ PERMIT PLUMBING $ • CO ISSUANCE $ Date Owner Heating System&Ducting Registers PLAN CHECK 25% $ • ENERGY P.C. $ I hereby certify that have read this application and state that the above ❑0.100,000 BTU 0100,000BTU ELECTRICAL $ `L • 50 GRADING , $ information is correct. I agree to comply with all city and county ordinances J and state laws relating to building construction, and hereby authorize repre-V PLAN CHECK 50% $ MICROFILM $ sentatives of this ci to e ter upon to ...above-mentioned roperty fo inspection purposes. MECHANICAL $ TOTAL FEE $ 74 .•049 Signature _ Date Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ 7 r. v Drivers' License or 5$# _ - CMF 0865-46,rev.10/84 White - Building: Canary - Applicant; Pink -Accounting; Goldenrod - Assessor L t POOL &SPA V CONSTRUCTION ANDPLANNING • " 'APPROVALS Permit# -• Date Inspector APPROVALS Permit# Date Inspector I • cr1'.jTemporary1 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-Uniirgrnd. 55. Electrical Bonding 5. Steel Reinforcement:'- 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd�:;- 57. APPROVAL TO COVER-GUNITE 7. Footings •' ! ` ;58. Electrical Conduit-Undrgrnd. • 8. Foundation _ 59. Gas Pipe, Undrgrnd.,Test 9. Water Pi�{e-1Undrgrndit''1 F. 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10. Structural Floor System ��y,� 61. APPROVAL TO DECK 11. Property Sewer Line& �J,House Connection O/,/e.p i '/f 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 �c 68. APPROVED FOR PLASTERING " -u 18. Rough Electrical-T Bar Ceiling �. 1, 69. POOL/SPA SYSTEMS FINAL _ co 19. Rough Heating & Air Conditioning FIR EIDEPT. REQUIREMENT " .y C-, 20. Rough Factory Fireplace APPROVALS Permit# - 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 1n t r-128. Lathing &'Siding 77. FIXED SYSTEM FINAL 4` 29. Insulation 78. FIRE PREV. FINAL v 30. Drywall Nailing - HEALTH DEPT. 14EQUIREMENT .T. 31. Plaster Brown Coat 79. FINAL INSPECTION t - `J 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED v n1 33. Final Electric Notes:(1-1-xy N) One a- }gyp Lco /1l 34. Final Heating & Air Conditioning /^ 35. Final Gas Pipe-Test 1/7. . 36.•Hood or Canopy ,/1' ..; 37. Final Factory Fireplace -s" Pr }` -../u r, - 1/ 38. Final Plumbing t P --';.;; l:'; 39c Water Service-Final /�/�U���- //// - ` i40. Gas Service-Final ',hi WI r - ' 7[ f }41. Solar Domestic-Final V- +:;+ ,-- e -1. v 421-Backf low Preventer r ,�. :rl% , '. rev ; , -1.--. / ..1-'43. Backf low Irrigation ... J • •� ! :` ti 44. Landscape Irrigation System /-I*, - � • ' ''� /" ''y45. Sound Attenuation c...,--, .../, r 'v Y• - V 46. Handicap Regulations ".., ,» : 'j - • • 47. FINAL STRUCTURE & BUILDING •�+ n • }; '� lr 13-J . 48. Special Requirements Completed r ,- , t� I n 1/ 49. Electric Release to Edison ..i, 5.d i'k • 50. Gas Release to Southern California Gas Co y 51. CERTIFICATE OF OCCUPANCY _, No. Date .\ \ i '1 i.�\ _ Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. . -- - 6778' 3/15/90 92050- TL CITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT gada�N � a TRACT NO. LOT NO. UNIT NO. • , Project Address 2,370 E Idea• 1y�' 'PSVe• _ - Applicant's Mailing Address •190L61_'B'PowOwa C.net, 9262] 'TYPE OF CONSTRUCTION LS NEW U ADD. U ALYE RATION U REPAIR• Owner's Name Dave flf C 4 NG Phone 714-263 49A3 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# - . . t - - - Zone L770Z rylsttL c� NGY{� Zl�rt se �l DESCRIPTION OF WORK/USE OF BLDG. Qes�clebt-ho I Address C . 92714 S Main Building: I Accessory Building: E Z j Arch/Eng. • • License No. TYPE OF PERMIT ❑ GRADING ❑ FOUNDATIO�'Ny❑ STRUCTURAL T Front I - O Address . / 1� ❑ TENANT �❑ ELECTRICAL ❑ PLUMBING _ MECHANICALN Contractor's Nam.Sle el EUIVIVIVtbstet441( Sys. Phone 714-ff15-i v ❑ OTHER I -- C R ght 1 - - - - N Address(mailing) (900 ythu.tc s4 St- G'1�'�• 92627 PROJECT SQ. FT. OCCUPANCY K - - G •Z491L • • CO NISTRUCTION TYPE • VALUATION$ 10)000.On $ Left R City License No. ZONE - GRADING CU.YDS. ACRES Ping. Ref.# ' I - , •'Parking Req./Provided E LICENSED CONTRACTOR DECLARATION I Q I hereby affirm that I am licensed under provisions of Charter 9 (commencing ''Remarki' /[ 3,nzB . Planning Notes: , • M with section 7000) of Division 3 of the Busi.-55 and Pro essions Code, and +V . my license is in full force and effect. 651 �Y • . _ TS License Class C- 20 �! 5C O • ')ate 3� Signature -If �--4� .r_ cr PLUMBING ,•I FEES • % ..ORKERS' COMPENSATION ENSATION DEC ' RATION Bar Sink Showers (fir- I hereby affirm that I have a certifi . e of consent to self-insure or a certificate - - ELECTRICAL FEES 1 of Workers' Compensation Ins .nce, or a certified copy thereof (Section 1 r Backflow Preventer Service Sink , • Q, 3800, Lab. C.) - - Automatic Washer Transformer 0 15-50 KW \ Policy No. R101071230ti(!C Company iV(At'in - .Backflow Irrigation Sewer CapL• t 0.50+ KW Construction Pole Sub. ❑ Cerf filed copy is hereby furnished. _ • _ ert�'1ie co filed with the city Bu'Itling . ,•r,/ //' Bathtubs _ Sewer Connection Cooking Unit. Meter ❑up t0.100 amps Date 3,15 Applicant EXEMPTION FROM WORKERS'COMPED ATION DECLARATION Clarifiers Solar Collectors • Dishwasher Meter Dover 100 amps' ' (This section need not be completed if th' permit Is for one hundred ($100) or . less). z Dishwasher , Solar Piping Dryers OGas DElectric ' Sub Panel I certify that in the performance of e work for which this permit is issued I • - shall not employ any person in a y manner so as to become subject•to the / ' Drinking Fountains Solar Tank - Fan Motors 004 HP ❑1'/-8 Workers' Compensation Laws of California. - - - - . — Date • Signature - • Floor Drains Swimming Pool vii/Spa' i F.A.U. • NOTICE:If,after making this declaration,you should become subject to the - Inc.10Solar ❑g-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 AGENCYG`s Service • Outlets , Water Closet Device Boxes • I hereby affirm that there Is a construction lending agency for the performance - t _ Pole Light ( of the work for which this permit is issued. (Section' 3097 Civ. C.) - - • I Interceptors Water Heater Outlets Lender's Name' Range . Lender's Address • Kitchen-Sink- - •' - - Water Service , - -r Switches Sign -' - • - OWNER BUILDER DECLARATION - • I hereby affirm'that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal , following reason (Section 7031.5 Business and Professional Code: Any city or - s 9 P Standing Sections . county which requires a permit to construct,alter,improve,demolish or repair P2--Trap Laundry Trays , • - Generator ❑0-5'KW ❑5-15 KW any structure, prior to its issuance,'also requires the applicant for'such permit Trash Compactor 'o file a signed statement that he/she is licensed pursuant to't he provisions of Roof Drains , se Contractor's License Law(Chapter 9(commencing with Section 7000) of - ' • • Avision 3 of the Business and'Professions Code)'or that he/she-is exempt ' , ' - - - - ' . - - - therefrom and the basis for the alleged exemption. Any violation of Section ' • ' 7031.5 by any applicant for a permit subjects the applicant to a civil - - ' - • malty of not more than five hundred dollars($500). U I, as owner of the. property or my employees with wages as their sole Reinspection Fee ' V $15 Issue Fee $ 3 1 compensation, will do the work, and the structure is not intended or offered • - Reinspection Fee $ 3 fore sale (Section'7044, Business and Professional Code: The Contractor's MECHANICAL FEES p 1 $15 Issue Fee ' License Law does not apply to an owner of a property who builds or improves - . thereon,-and who does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0 - . sale- If, however, the building or improvement is sold within one year of corn- Canopy Type II 0 • Zoning Approved By Date pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground - - _ I Building Approved By •' Date Crove for the purpose of sale). _ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural • I Refrigeration System Application Issued By • Dat 3 tractors to construct the project (SeCtion 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU ❑100,000 BTU • - SUMMARY OF FEES • • builds or improves thereon, and who contracts for such projects with a con- - . tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration •• BUILDING PERMIT $ _ $MIP _ $ - proof of their Worker's Compensation insurance should be provided to me. • PLAN CHECK $ _ PERMIT ' • 0 I am exempt'under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBO# Fire Dampers PLUMBING $ ISSUANCE $ • Date Owner • Heati g System& Ducting Registers I' PLAN •CHECK 25% $ - ENERGY P.C. $ •I hereby certify that I have read this application and state that the above 6utTil00,000 BTU ❑100,000 BTL 5')•a0 ELECTRICAL $ _ GRADING $ • information Is correct. I a ree to co wi II city and county ordinances - - and state laws relating_ buimin9 fru to and hereby authorize repre- . PLAN CHECK 50% $ - MICROFILM - $ sentatives of this cit .to e r • e • bove-m • ned propert for - - • w,� �• Inspection p rposes ' MECHANICAL $ 'y K 'l ' Signature_ _ Date 3 1 1'� TOTAL FEE $ gag() Drivers' License r SS$ l - Reinspection Fee ' $15 • Issue Fee ISr $ S. PLAN CHECK 25% $ M CMF 0865-46,r . 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 Electrica6Service or Pole 52. Pool & Equipment Location ' 2. Soil Pipe-Undrgrnd. ' 53. Steel Reinforcement 3. Electrical Conduit Utility"Undrgrnd. 54. Forms r 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. - 57. APPROVAL TO COVER-GUNITE 7..Footings • 58• . Electrical Conduit-Undrgrnd. '8. Foundation , 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. ' . 60. Backwash Lines,P;Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final ' 12. Sewer Cap63. 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 `j 19. Rodgh 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 D Gas ❑Oil • 25. Roof Sheathing 74: Overhead Hydro U 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding r 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: 11 9:22Z csi t X 34. Final:Heating& Air Conditioning LISIW g � ginr//sr_ aTj. r/arr ZC:•'.35. Final-Gas Pipe-Test /3�! iii / FR.�,f Si 57 7:- 36. 36. Hood or Canopy fi. y i_ 3,7 Final Factory Fireplace 1. • :38.',Final Plumbing _ - •C •39.'Water Service-Final ' -140. Gas Service-Final • .. '" • . '41. Solar Domestic-Final ,• -: • •42. Backflow Preventer -• • C • i 3. Backf low Irrigation - '44; Landscape Irrigation System -:to •45. Sound Attenuation i• ! -46.-Handicap Regulations _ 47. FINAL STRUCTURE & BUILDING '- - tU Z. 48. Special Requirements CompletedII - • 49.-Electric Release to Edison . - - - 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY ' - • No. Date • I • �; - Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA CONSTRUCTION PERMIT — PET NO. ,/ �y T.11 rf�la0. LOT NO. UNIT NO. Project Addresc93)0 ICtG& ,& C/� -t Ma7az 01/4 (/ TYPE OF CONSTRUCTION ;KNEW U ADD D ALTERATION H REPAIR Applicants Mailing Address 0_is/C n�7G{� neS�,4��5�,,7� 2 ❑ INVERSION ❑ DEMOLISH ❑ OTHER ern 0�cL A.P.# Zone Owner's Name POW a/ eHGlVC Phone84/4" DESCRIPTION OF WORK/USE OF BLDG. Address ¶7,kia't 4Z... S Main Building: Accessory Building: Arch/Eng. d'c License No. )� TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL T Front Z �a o Address ' p� ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING yc•MECHANICAL BB Rear N Contractor's Namel' 05 _ Phone/`c..?G 9 ❑ OTHER / r�i C Right N x PROJECT�DESCRIPTION SD. FT. Aa/c'' OCCUPANC'f K - g G Address(mailing) CONSTRUCTION TYPE U' �' VALUATION $ Left R City License No. GRADING CU.YDS. ACRES S • E LICENSED CONTRACTOR DECLARATION Ping. Ref. # Parking Req./Provided I hereby affirm that I am licensed under provisions of Charter 9 (commencing r Remarks-: 5 3Q 8'Z.-Z.— Planning Notes: aM with section 7000) of Division 3 of the Business and Professions Code,and - 1. my license is in full force and effect. • S License Class License No. Date Signature / Lr, PLUMBING FEES WORKERS' COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL FEES , hereby affirm that I have a certificate of consent to self-insure or a certificate ' • of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink - " 3800, Lab. C.) Automatic Washer Transformer 0 15-50 KW Policy No. Company Backflow Irrigation Sewer Cap • Construction Pole Sub. 0 50+ KW Certified copy Is hereby furnished- - Certified copy is filed with the city Building Division. Bathtubs Sewer Connection - Cooking Unit Meter pup to 100 amps Date Applicant EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps (This section need not be completed if the permit Is for one hundred ($100)or less). Dishwasher Solar Piping Dryers ❑Gas DElectric Sub Panel I certify that in the performance of the work for which this permit is issued, I , shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors 00-1 HP 011/2-8 Workers' q e Laws of Calif i Date /I Signature ' Floor Drains Swimming Pool w/Spa F.A.U, Inc.Solar 09-15 HP 016-15+ NOTIC : , f r ing this declara , �h�li a esu lett to the — Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal - Microwave comply with such provisions or this permit shall be deemed revoked. ' ' CONSTRUCTION LENDING AGENCY r Gas Service Outlets Water Closet (.04Device Boxes Pole Light 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 1/ Outlets Range Lender's Name 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 . following reason (Section 7031.5 Business and Professional Code: Any city or ` Garbage Disposal Standing Sections county which requires a permit to construct,alter,improve,demolish or:repair P-Trap Laundry Trays a' Generator ❑0-5 KW ❑5-15 KW any structure, prior to its issuance, also requires the applicant for such permit Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains j 'he 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 nerefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). $ 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 I $15 Issue Fee $ 3 for.sale (Section 7044, Business and Professional Code: The Contractor's • MECHANICAL • FEES License Law does not apply to an owner of a property who builds or improves _ thereon, and who does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS: ' employees, provided that such improvements are not Intended or offered for Boiler Hood or Type I ❑ .. sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 Zoning Approved By Date pletion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground Drove for the purpose of sale). / "ilS/ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date tors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU 0100,000 BTU SUMMARY OF FEES builds or improves thereon,and who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System El Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation Insurance should be provided to me. G Qj� PLAN CHECK% $ PERMIT 0 I am exempt under Section B.& P.C.for this reasonc:X Firepl/Fact.Bit. ICBG#.30Fire Dampers ✓`� PLUMBING $ ISSUANCE $ Date .eit/Za Owner ‘ /� Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above ❑o-i00,000 BTU 0100,000 BTL ELECTRICAL $ GRADING $ information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize repre- sentatives of. this city to enc r upon the above-mentioned property for -7 inspection p po es- Com- ..c-' 4/23/$13 MECHANICAL $ D TOTAL FEE $ 43 !S Signature e n 'T Date Drivers' License or SS� Reinspection Fee I $15 Issue Fee 16 S $4 PLAN CHECK 25% $ t 7 .,. tauti ed ac-000U/2114 f U ! 63.75 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. 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 Grkd.) 57. APPROVAL TO COVER-GUNITE -7: Footings 58. Electrical Conduit-Undrgrnd. :8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9., Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62._ Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 48. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT I X20. Rough Factory Fireplace Wn, _Or APPROVALS Permit# I r ' 21. Ducts, in Structure 70. Underground Hydro -- I. - 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 1 - 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas O Oil 25. Roof Sheathing 74. Overhead Hydro •26. T-Bar Ceiling (Structural) & Monocoat - 75. Dry Chemical 4.i 27. Frame and Flashing 76. Dry Standpipe i ' 1 :' t' 28. Lathing &.Siding 77. FIXED SYSTEM FINAL ,: ;( 29. Insulation- 78. FIRE PREV. FINAL "ifel 30. Drywall Nailing HEALTH DEPT. REQUIREMENT `' r. 31. Plaster Brown Coat 79. FINAL INSPECTION .-i 0/ 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electricalie Notes: - r 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37, Final Factory Fireplace /2/ft94r A� 38. Final Plumbing 39. Water Service-Final , 40. Gas Service-Final 1, . 41. Solar Domestic-Final , '42. Backflow Preventer 43. Backflow Irrigation -44. Landscape Irrigation System 45. Sound Attenuation . . 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING • 48. Special Requirements Completed 49.• Electric Release to Edison -I I. 50. Gas Release to Southern California Gas Co - 51. CERTIFICATE OF OCCUPANCY No. Date . Applicant fill except those within heavy border and sign all appropriate declarations. • ..�+£IT;Y 65 COSTA MESA CONSTRUCTI PERMIT PER11N2 N.Q./ l TRACT NO. LOT NO. UN0 NS. g nn `�✓I• 'f 2025 12/22/87 587. 18 TL • Project Address 2J 7� ��dE'/�jy( dFs /1 �j , Applicant's Maihng A ess 1/6.-5 / (-R"N ,5 42€ ,� ' ' TYPE OF CONSTRUCTION LI NEW U ADD LJ ALTERATION REPAIR r� G� m(1'''' � /I ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A,P.# • I Zone Owne�:s Name ^•1-�, M(J�t&- Phone. • DESCRIPTION OF WORK/USE OF BLDG. Andress —1Lab2 /1,i011C-t.C,'t42,' '. c/ _ S Main Building: Accessory Building: Arch/Eng. License No. ',TVPE OF PERMIT �❑ GRADING ❑ FOUNDATION E o • 7/X U STRUCTURAL Front Address ^ys •-� • ❑ TENANT ELTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear• N •, M '2 As —c _ Phone/L2 OTHER C Right N Contractor's am= � Address(mailing) . ai airreo46 1 • • PROJECT DESCRIPTION SQ. FT. OCCUPANCY KLeft S(� G z� • CONSTRUCTION TYPE VALUATION$ $ City License No. :ZONE GRADING CU.YDS. ACRESE LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided I hereby affirm that I am licensed under provisions of Charter 9 (commencing f Remarksl3 _t' 8 8 Z i Planning Notes:. M with section 7000) of Division 3 of the Business and Professions Code,and my license is in full ••rce a • effect. T License C .5s - License No. / . •/ I' ~ - S Date -4W/ Signature SG , -sr.' • • PLUMBING FEES . 'ORKERS'COM' NSATION DE LARATION Bar Sink Showers ELECTRICAL FEES ;reby affirm t at I have a certificate of consent to self-Insure or a certificate Workers' Compensation Insurance, Or a certified copy thereof (Section Backflow Preventer Service Sink 3800, Lab. C.) •• Automatic Washer Transformer 0 15-50 KW _ Policy No. • Company Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+ KW B Certified copy is hereby furnished. �^ - Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Cooking Unit `0 Meter up.to.100 amps ' " 1.'00 Date Applicant_ EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher • Meter ❑over.100 amps (This section need not be Completed if the permit is for one hundred ($100)or, less). , Dishwasher Solar Piping Dryers ❑Gas. DElectric Sub Panel I certify that In the performance of the Worlk for which this permit is issued,•I, shall not employ any person in any marl so as to be a subject to the - Drinking Fountains Solar Tank Fan Motors❑0.1 HP 01%-8� Workers' c/ rX/Pe, ti aws of Califom' _ _ Date ,va-' Signature _ w� floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP 016-15+ NOTICE: If,after ma ng this declaration, you should become subje t0 the Workers' Compensati n provisions of the Labor Code, you must rthwith Floor Sinks Urinal Fixtures Microwave comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes I hereby affirm that there is a construction lending agency for the performance _• Pole Light of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Range Lender's Name . Lender's Address - Kitchen Sink Water Service - - Switches Sign - OWNER BUILDER DECLARATION hereby affirm reato that I am 7031.5 from the Contractor's l e Law for the Lavatories Auto-Wash •! Garbage Disposal Standing Sections • following reason (Section 7031.5 Business and Professional Code: Any city or ' county which requires a permit to construct,alter,improve,demolish or repair P-Trap, Laundry Trays Generator 00-5 KW 05.15 KW any structure, prior to its Issuance, also requires the applicant for such permit Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains' the Contractor's License Law(Chapter 9 (commencing with Section 7000)of ._ _ , Ia n l l L+.lr a70t 15 wlsion 3 of the Business and Professions Code) or that he/she is exempt Y11y� .amu-�O�rd e,1.• erefrom and the basis for the alleged exemption. Any violation of Section i .i31.5 by any applicant for a permit subjects the applicant to a civil 7 - penalty of not more than five hundred dollars($500). $ 3 ' U I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee ��U( compensation, will do the work,and the structure is not intended or offered - - Reinspection Fee I $15 Issue Fee / /S. DU ]WC for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0 sale. If, however, the building or improvement is sold within one year of corn- Canopy Type II ❑ Zoning Approved By Date pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Date 1 Rry 7 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 Dat tractors to construct the project (Section 7044,Business and Professions Code: 00-100,000 BTU ❑100,000 BTU The Contractor's License Law does not apply to an owner of property who Duct-VentilatingSUMMARY OF FEES builds or improves thereon,and who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation insurance should be provided to me. _ PLAN CHECK $ PERMIT 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBO# Fire Dampers PLUMBING $ PERMIT ISSUANCE $ Date Owner - Heating System & Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000 BTL - y f GRADING $ information is r ct. I agree to comply with all city and county ordinances ELECTRICAL $ �O.lr . and state laws ala ng to building co ruction,and hereby authorize repro- - PLAN CHECK 50% 0/X171/:• MICROFILM $ sentalives of is to anter up n the above-mentioned property for - our se Signature Date d-a-t $ use TOTAL FEE $ � 'g Drivers' License Reinspection Fee $15 Issue Fee S 3 PLAN CHECK 25% $ CMF 0865.46.rev. 10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor SI _CONSTRUCTION AND•PLANNING --- i� POOL& SPA APPROVALS Permit# :r Date Inspector. APPROVALS Permit# -. Date Inspector 1.'Tymporary ElectricaCService or Pole (:, 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. " 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd'. 54. Forms 4. Electrical Conduit-Undrgrnd. Shiva!': 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grind:, 57. APPROVAL TO COVER-GUNITE r _ 7.,'F inas 58. Electrical Conduit-Undrgrnd. 8. Foundationi"). A 59. Gas Pipe, ❑ Undrgrnd., Test 9.-Wate?:Pipe-Undrgrnd. ;.:v 60. Backwash Lines, P-Trap, ❑ Undrgrnd. 10. Structural Floor System 'c.-11.i. 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection .' 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13;' Roof Drains 64. Plumbing System - Final 14.,Rough Plumbing 4.: 65. Electrical-Final 15:' Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 5-÷eig 5-÷ VW`,'04 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 ❑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 . 1/1 29. Insulation 78. FIRE PREV. FINAL ' 30. Drywall Nailing HEALTH DEPT. REQUIREMENT - ..h 31. Plaster Brown Coat 79. FINAL INSPECTION / (7) 32. Electrical Power Meter-Final /2-9-89 01 80. FOOD CERTIFICATE ISSUED rr.� f ,,,• I 33. Final Electric /z 8'6B I/� / Notes: � 2 '' � 34. Final Heating& Air Conditioning /�� `�{/I. J / n / /0 4E56 ROZA UU�(.r cSe d f '�•- 35. Final Gas Pipe-Test 12 8-SR Bad GFt ,'/and-- /5°- unef' 4�/ 36. Hood or Canopy afhet ua lS "-nista an -- 37. Final Factory Fireplace • 38. Final Plumbing - 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer - • 43. Backflow Irrigation • 44. Landscape Irrigation System 45. Sound Attenuation - 46. Handicap Regulations • 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed • • • 49. Electric Release to Edison . 50. Gas Release to Southern California Gas Co :1 I. t 51. CERTIFICATE OF OCCUPANCY - No. Date iS I 4c- , Applicant to fill In all spaces except these within heavy border lines and sign all appropriate declarations. • CITY OF COSTA A3CONSTRUCTION PE F IT PERMITNO.'-36 A-37 ,TRACT NO. LOT NO. UNIT NO. 4a CC'sICR 3 LLl _r A.P.qW Zone Project Address - /'T U NEW 0 ADD U ALTERATION U REPAIR (Ott/ • - I TYPE OF CONSTRUCTIONS Main Building: Accessory Building: Z Applicant's Mailing Address - AAb0 CONVERSION 0 DEMOLISH ID OTHER T Front o N L Phone ❑ -?-(�r,' Owner's Name �O9 DESCRIPTION OF WORK/USE OF BLDG. B Rear N Address Ill in.-. hen CS Com` IJOO-Ts-I SyI J,Nt A 1 Arch/Eng. License N0. TYPE OF PERMIT'7 U GRADING LI FOUNDATION U STRUCTURAL I C Right G Address ❑ TENANT ELECTRICAL 0 PLUMBING 0 MECHANICAL S Left Contractor's NameMC 14� �V—✓Af2-`C- Phone 7'7--Cti33 0 OTHER Ping. Ref.# Parking Req./Provided E 2 r'tn PROJECT DESCRIPTION SQ.FT- OCCUPANCY Q Address(mailing) � ��`q( Qad �'7L' B' Planning Notes: M ��,x l• CONSTRUCTION TYPE VALUATION$ T City License No. 6vl 1 ZONE GRADING CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION S. ereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: a /�[iA t (6 3 h section 7000) of Division 3 of the Business and Professions Code, and -3CAPI ...y license is in(u force and effect. ll � ��ts-.�ff ELECTRICAL FEES License Cla s ,Y • License NO. �t oL2- Date -11- Signature �J�^^`•--en "' PLUMBING FEES Automatic Washer Transformer 0 15-50 KW 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 of Workers' Compensation Insurance, or a certified copy thereof (Section Cooking Unit Meter ❑up to 100 amps 3800, Lab. COI* Backflow Preventer Service Sink V Policy No. 10. 1 a Odik a Company !e v �""�� ✓'� tC- Backflow Irrigation Sewer Cap y - Dishwasher Meter Dover 100 amps Certified copy is hereby furnished. Dryers ❑Gas ❑EI¢ttr is Sub Panel /, ♦a re rti)) tl$,oppy i f}led with the city Builng Division. e Bathtubs Sewer Connection , D to 1 'ejM.�L' Applicantiw.(.v��� t'. �; Fan Motors 00-1 HP❑1%-8 EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors (This section need not be completed if the permit is for one hundred($100) or F.A.U. Inc.Solar ❑9-15 HP ❑7g.75+ less). Dishwasher Solar Piping , 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 r - Microwave Workers' Compensation t.aws of California. Device Boxes Date - _Signature Floor Drains Swi ool w/Spa S Pole Light 3 OTICE:II,after making this declaration,you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal / ✓ Outlets Range comply with such provisions or this permit shall be deemed revoked. 1 CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Switches Sign I hereby affirm that there isa Construction lending agency for the performance • of the work for which this permit id issued (Section 3097 Clv. C.) interceptors Water Heater Garbage Disposal Standing Sections Lender's Name Lender's Kitchen Sink Water Service Generator 00.5 KW 05.15 KW Trash Compactor OWNER BUILDER DECLARATION I hereby affirm that Se I ant exemptBusiness the Professional License for the Lavatories Auto-Wash following e (Sectionpermit 7031.5tRons ru and, Professional Code: Any cityear county r which requiresriota s Issuance, c ,construct,alter,improve, such or repair P-Trap Laundry Trays any structure, titthe/, alai requiresicesthe tapplicant for rovi perm It to file a Tactor' statementLnse that hapte is pursuant to the provisions of Roof Drains Li the Contractor's License sLaw(Chapter 9 Co(commencing with Section 7is x)of — _ - thereon 3 of the Business and Professionssaxe Code) or that he/she Is exempt Reinspection Fee 70 therefrom and the basis for the alleged exemption. Any violation of Section P $15 Issue Fee $ 7031.5 by any applicant for a permit subjects the applicant to a civil �tanally of not more than five hundred dollars($500). $ 3 DEVELOPMENT SERVICES REQUIREMENTS: m U I, as owner of the property or y 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 1 . a ._ 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 � ���IIII act, )- 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 ❑ • , pletion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground FEE' prove for the purpose of sale). BUILDING PERMIT $ SMIP ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Igeration 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 ❑0-100,000 BTU ❑100,000 BTU ISSUANCE $ builds or Improves thereon. and who contracts for such oroiects with a con- PLUMBING $ tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple Er System Repair/Alteration I PIAN CHECK 25% $ ENERGY P.C. $ proof oftheir Worker's Compensation Insurance should be provided to me, ELECTRICAL $ c. ?...0 • de----GRADING $ ❑ I am exempt under Section B.d P.C.for this reason Firepl/Fact.Blt. ICBO dk Fire Dampers MICROFILM $ PLAN CHECK 50% $ Date Owner Heating System& Ducting Registers $ t� akJ I hereby certify that I have read this application and state that the above 00400,000 BTU 0100,000 BTL— TOTAL FEE $ p-r7` Information is correct. I agree to comply with all city and county ordinances PLAN CHECK 25% $ and state laws re . ing to building construction, and hereby authorize repre- sentatives of th' Icy to entgr up s�p the above-mentioned property for Inspection purpo S.. )) II -,aq-tt Signature ,o � Reinspection Fee $15 I Issue Fee $ 3 • 01 00020b78-OpOTOb78 TOT 0865-46,rev.5/88 White - Building: Canary - Applicant; Accounting: Goldenrod - Assessor DATE: 11/29/33 TIME: ZL�.Q✓✓ / g; Pink - 1o:3b . . .. s \.\'\ \ CONSTRUCTION AND PL .ING ?• ` POOL& SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector • 1. Temporary Electrical Service or Pole - 52. Pool &-Equipment Location 2. Soil Pipe-Undrgrnd. ...pe- 53. Steel Reinforcement - 03.•tt Electrice4 Conduit Utility-Undrgrnd. _54. Forms , 441 Electrical Conduit-Undrgrnd. 55. Electrical Bonding 1 5:f Steel Reinforcement • 56. Rough Plumbing & Pressure Test 6: Electrical UFER-Grnd 57. APPROVAL TO COVER-GUNITE I • 7-. Footings J : i 58. Electrical Conduit-Undrgrnd. 8, Foundation , '' 59. Gas Pipe, 0 Undrgrnd.,Test • 9. Water Pipe-Undrgrnd. - 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10: Structural Floor System61. APPROVAL TO DECK 11•: Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains - 64. Plumbing System - Final 14. Rnugh•Plumhing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final - . 6• Rough Electric Wiring 67. Fencing & Access Approval II 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING . t Y81. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 1,20. Rough Factory Fireplace APPROVALS Permit# t21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 1 ,72. Underground Flush 24. Roof Framing - t ' 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing74. Overhead Hydro 26. T-Bar Ceiling (Structural) &-Monocoat 75. Dry Chemical • 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 1.": 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-Finals A91-88,40( 80. FOOD CERTIFICATE ISSUED 33. Final Electric ' /2-8'93/ 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 r- 40. Gas Service-Final 41. Solar Domestic-Final 1 ,1\, 42. Backflow Preventer , �, 1 7( 43. Backflow Irrigation I 1 . 44. Landscape Irrigation System l_ ' • I 45. Sound Attenuation 46. Handicap Regulations /- 47. 47. FINAL STRUCTURE & BUILDING ' 48. Special Requirements Completed 49. Electric Release to Edison ice• 7 50. Gas Release to Southern California Gas Co J 7 51. CERTIFICATE OF OCCUPANCY v- '+ . : • ' No. Date r • ( A i ••• Applicant to fill in all spaces exceptthose within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA O CONSTRUCTIONIPERMIT . " PERMIT�IP. '�/ I�� TRACT NO. LOT NO. UNIT NO. 19�{�]_ /I '2/B] I BoDO TL P;oject Address �70 .&JC / C �-Y/ ' Applicant's Mailing Address C 702- m�reH /I jCVA TYPE OF CONSTRUCTION rvEW U ADD U ALTERATION LI REPAIR ' �7�,��� z� G ❑ CONVERSION CI DEMOLISH- El OTHER A,P,# Zone • Owner's Name .7)efN mC (MM Phoneh63 40 / ��s. DESCRIPTION OF WORK/USE OF BLDG. 'Andress .5" "4.' S Main Building: Accessory Building: Z Arch/Eng. P14tC-✓1G/e. License No. TYPE OF PERMIT_ /U GRADING ❑ FOUNDATION ❑ STRUCTURAL E Front • O Address 7} ,,//11 ❑'TENANT LECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N Contractor's Name DON �oN � Phone ❑ OTHER • C Right N ( V/ PROJECT DESCRIPTION 5Q FT. 70/ OCCUPA CY Address(mailing) St/'n� / 2.CG CON STRUCTION TYPF/reOnn - �yT'� VALUATION 5 S Left G City License No. ZONE - 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: -�� Ok'a� Planning Notes: 0 with section 7000) of Division 3 of the Business and Professions Code,and ii»YY M my license is in full force and effect. T License Class License No. S Date Signature PLUMBING I FEES WORKERS'COMPENSATION DECLARATION Bar Sink Showers I hereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL FEES ' of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink 3800, Lab. C.) . Automatic Washer . Transformer 0 15-50 KW Policy No. Company Backflow Irrigation Sewer Cap Construction Pole Sub. nr / 0 50+KW 5 Ve. 8 Certified copy is hereby furnished. Certified copy is filed with the city Building Division. Bathtubs Sewer Connection. Cooking Unit , Meter ❑up to 100 amps Date Applicant — EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher r 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 Do-i HP 01%-8 Workers' ymo 5a ion Laws of Calif '� //. _ — _ Date flint" Signature xn��/�1�/�'� Floor Drains Swimming Pool w/Spa F.A.U. NOTICE:If,after making this declaration, you should become subject to the - — Inc.Solar ❑9-15 HP 016-15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures Microwave comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes ' Pole Light I hereby affirm that there is a construction lending agency for the performance 9 of the work for which this permit Is Issued (Section 3097 Clv. C.) Interceptors Water Heater Outlets Lender's Name - Range Lender's Address Kitchen Sink Water Service Switches Sign OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal following reason (Section 7031.5 Business and Professional Code: Any city or 9 P Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P-Trap 1 LaundryTrays any structure, prior to its issuance, also requires the applicant for such permit - Generator ❑0-5 KW ❑5.15 KW Trash Compactor to file a signed statement that he/she Is licensed pursuant to the provisions of Ro6f Drains '' r the Contractor's License Law(Chapter 9 (commencing with Section 7000)of — 923 71)W-CS /9 00 Division 3 of the Business and Professions Code) or that he/she Is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil LIenalty of not more than five hundred dollars($500). I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 compensation, will do the work,and the structure is not intended or offered - Reinspection Fee ' $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES License Law does not apply to an owner of a property who builds or Improves _ -- thereon, and who does such work himself/herself or through his or her own Boiler Hood or Type I 0 DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for yp ZoningApproved sale. , however, the building or Improvement is sold within one year of com- Canopy Type II 0 pP By Date ple • n, the owner will have the burden of proving he/she did not build or IT- Duct-Under Ground Building Approved By Date ve for the purpose of sale). - /} /i I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Dat• ffnir7 t ctors to construct the project (Section 7044,Business and Professions Code: Th Contractor's License Law does not apply to an owner of property who Duct-Ventilating 0o-100,000 BTU 0100,000 BTUSUMMARY OF FEES builds or Improves thereon,and who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple❑ System Repair/Alteration BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT . ❑ 1 am exempt under Section B.�&(P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers DatePLUMBING $ ISSUANCE $ Date / owner Heating & Ducting Registers ENERGY P.C. $ PLAN CHECK 25% $ OD I hereby ertia that I have read this application and state that the above DO-100,000 BTU 0100,000BT ELECTRICAL $ IS GRADING $ information Is correct. I agree to comply with all city and county ordinances ,_ and state laws relating to building construction, and hereby authorize repre- PLAN CHECK 50% $ MICROFILM •$ sentatives of y�is city to note u op the above-mentioned property for inspectiongnatu ; ��1 � /�?./97 MECHANICAL. $ TOTAL FEE $ - laza Signature P Date 7 - Drivers' License or SS# .) - Reinspection Fee ' $15 Issue Fee $ 3 PLAN CHECK 25% $ CMF 0865-46,rev.10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor -'- POOL &SPA (CONSTRUCTION AND';PLANNING APPROVALS Permit,# J Date Inspector APPROVALS Permit # Date Inspector 1;f-Temporary Electrical•Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms • 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement, 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd;i 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Fourufetion 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater& Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring - 67. Fencing & Access Approval • 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING t 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-BarPCeiling (Structural) & Monocoat - 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL (I 29. Insulation 78. FIRE PREV. FINAL ) 30. Drywall Nailing HEALTH DEPT. REQUIREMENT \•. 31. Plaster Brown Coat 79. FINAL INSPECTION ✓ 32. Electrical Power Meter-Final80. FOOD CERTIFICATE ISSUED / 33. Final Electric 1/14.6/ / Notes: UI 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 f • 48. Special Requirements Completed 49. Electric Release to Edison . - - 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY - No. Date ._ t ` Applicant to fill In all spaces except those within heavy border tines and sign all appropriate declarations. V- - PERMIT NO. TRACT NO. LOT NO. UNIT NO. CITY OF COSTA �JMESA CONSTRUCTION PERMIT 3.215 I /14/88 134915 TL Project Address s 3 7Q /�'a� fZ 3 I c 5-� Applicant's Mailing AddressfS'�/ dad'"Mr/4z'''�&o. .faEyn/tA �A/P TYPE OF CONSTRUCTION' [4-NEW U ADD U ALTERATION 0 REPAIR �ONp12O/ /,C.4'uv4- ph,0,26.7- n, 0 CONVERSION 0 DEMOLISH 0 OTHEAR A.P.# I Zone Owner's Name DESCRIPTION OF WORK/USE OF BLDG A `ms y• 'r'c Address /772 *Sae Z. A C/"."-r1"1 kIeo Sy (NriA- -D S Sk++, . S Main Building: Accessory Building: Z Arch/Eng. License No. TYPE OF PERMIT U GRADING LJ FOUNDATION LJ STRUCTt/RAL T Front 0 Address s'�S �L., TENANT 0 ELECTRICAL 0 PLUMBING 0 MECHANICAL B Rear N l t�� e./ �IA��y/'7QjQ Ly/OTHER Firms SIA-13tr-es.. ;e Y A I Contractor's Namb/ fafA Phone C Right N Address(mailing) 3,09 4/' ' a. /'Q.d� 3q•.' a 'sawsPROJECT DESCRIPTION 50. FT. OCCUPANCY KLeft • G CONSTRUCTION TYPE VALUATION$� $ City License No. (7 y 51 7 ZONE 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: 2 "'I-•4d F' S ,r t „�`• Cys.-r- Planning Notes: M with section 7000) of Division 3 of the Business and Professions Code, and / s r I'q s l �{ T �s•�•• T my license is In lull,alta and effect 31.3/TL 5 License Class 4 Lic se Date /4-frq Signature PLUMBING FEES _ WORKERS'COMPENSATION DECLARATIO Bar Sink Showers ELECTRICAL FEES I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof Section Backflow Preventer Service Sink Automatic Washer Transformer ❑ 15-50 KW 3800, Lab. C. �,p/ Policy No gy • 77 &7 Company ��. ,v Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+KW Certified copy is hereby furnished. e - -- Certified copy Killed with the city Buil 6 isi Bathtubs Sewer Connection Cooking Unit Meter Dup to 100 amps Date I-14�p% Applicant _ EXEMPTION FROM WORKERS'COM PE NSAT 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 OGas ❑Electric Sub Panel I certify that in the performance of the work for which this permit Is Issued I shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank _ - Fan • Motors 00-1 HP DM-8 Workers}Colnpenyal(on Laws of California. • Date -tn.' i'P Signature Floor Drains - Swimming Pool w/Spa F.A.U. NOTICE: If,after making this declaration,you should become subject to the In tar ❑9-15 HP 016-15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Nnal Fixtures comply with such provisions or this permit shall be deemed revoked. — Microwave CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes 1 hereby affirm that there is a construction lending agency for the performance Pole Light of the work for which this permit is Issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Lender's Name Range Lender's Address Kitchen Sink Water Service Switches Sign OWNER BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash following reason (Section 7031.5 Business and Professional Code: Any city or Garbage Disposal Standing Sections county which requires a permit to construct,alter,Improve,demolish or r¢ air P-Trap any structure, prior to Its Issuance,also requires the applicant for such permit _ Laundry Trays Generator 00-5 KW ❑5-15 KW Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains the Contractor's License Law (Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section , 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ❑ I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ 3 compensation, will do the work, and the structure is not intended or offered - Reinspection Fee $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL ) FEES License Law does not apply to an owner of a property who builds or Improves thereon, and who does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such Improvements are not intended or offered for Boiler Hood or Type I ❑ sale. if, however, the building or Improvement is sold within one year of com- Canopy Type II ❑ Zoning Approved By Date pletlon, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By �� Date 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 a / ' . - Date /-/ `/—es tractors to construct the project (Section 7044, Business and Professions Code: 4111 The Contractor's License Law does not apply to an owner of property who Duct-Ventilating - 90-100.000 BTU 0100,000 BTU SUMMARY OF FEES builds or Improves thereon, and who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Law). I am aware thatExhaust System 0 Multiple❑ /System Repair/Alteration BUILDING PERMIT $ 71 •OV SMTP $ • 5—e>proof of their Worker's Compensation insurance should be provided to me. ! PLAN CHECK $ _ ✓��--bs PERMIT ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# / Fire Dampers PLUMBING $ ISSUANCE $ Date Owner Heating System&Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above 00.100,000 BTU ❑100.000BTL— information Is correct. I agree to comply with all city and county ordinances and state laws rel. Ing to building con tructi•n,and hereby authorize repre- MICROFILM $ sentatives of m'. to nter u•% th• above-mentioned property for PLAN CHECK 50% $ inspection pur•'s- V MECHANICAL $ 4.tic Signature �/ �.L i Date.N 47 - TOTAL FEE $ t Drivers' License or SS • ' " - • Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ _ CMF 0865-46,rev. 10/84 White - Building: Canary -Applicant; Pink -Accounting; Goldenrod - Assessor "CONSTRUCTION AND PLANNING POOL&SPA APPROVALS Permit # Date Inspector APPROVALS Permit# Date Inspector 1. .Temporary Electrical Service or Pole 52. Pool & Equipment Location • 2. Soil Pipe-Undrgrnd.' 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms • 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement-, 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd: 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation, ' - 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd.y - • • -60. Backwash Lines,P-Trap, O Undrgrnd: 10. Structural Floor System 61. APPROVAL TO DECK _ 11. Property Sewer Line.& House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING • 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL • 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT - J 20. Rough Factory Fireplace APPROVALS Permit# _ �; 21. Ducts, in Structure 70. Underground Hydro - +r ' • 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil f':.. 23. Gas Pipe-Rough & Test 72. Underground Flush - _ i 24. Roof Framing 73. Undergrnd.Storage Tank O Gas ❑Oil ' 7 i , 25. Roof Sheathing 74. Overhead Hydro '-V ., 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical .- •. 27. Frame and Flashing 76. Dry Standpipe -_ , 28. Lathing& Siding 77. FIXED SYSTEM FINAL / r'2s" // '_� 29. Insulation 78. FIRE PREV. FINAL 4/n•OCd�' ! ' 30. Drywall Nailing HEALTH DEPT. REQUIREMENT li 31. Plaster Brown Coat 79. FINAL INSPECTION - 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED IV T 1 ' 33. Final Electric Notes: ' 1 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 t 40. Gas Service-Final .' 1 41. Solar Domestic-Final 4 • • . 42. Backflow Preventer s 4 1 43. Backflow Irrigation r .,, / ' 44. Landscape Irrigation System tr . 45. Sound Attenuation - -- 46. Handicap Regulations 47. .FINAL STRUCTURE & BUILDING - • 11 ' 481-Special Requirements Completed ti• I 49. Electric Release to Edison - • • 50. Gas Release to Southern California Gas Co - 51. CERTIFICATE OF OCCUPANCY No. Date , ‘ • - , - I Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA COWBUCTION PERMIT PEVRMIITT NO. r,¢S TRACT NO. LOT NO.,L UNIT NO. Project Address 2370 r- evi Ave, -Comte 1O c V1x C 9 9846 6/17/87 243.14 IL 17tZ iYJ/Z#e , NO/-n, TYPE OF CONSTRUCTION Lth NEW IJ ADD IJ ALTERATION Li REPAIR Owner's Applicant's Mailing Address .❑ CONVERSION ❑ DEMOLISH ❑ OTHER Owner's(Vame'��///�L7 G• /ntf/0/1�I Phonea�//o/�' DESCR I PT ION OF WOR K/USE OF BLDG. AP # 4.3� � v7Gi2�0¢ Zone �^L Address Vt7702 /22/fG/F,000 /VQ/LTi,z",erm/E 9/17/SL • S Main Building: • Accessory Building: 1// '�� II// • E / - Z Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING Ltd FOUNDATION IW STRUCTURAL T Front - o Address ❑ TENANT ❑ ELECTRICAL 0 PLUMBING ❑ MECHANICAL B Rear u (\ _ , N A Contractor's Name .1' �/2 Phone/�3-GS�/� CI OTHER C Right -4 o 0. -• �+ CL-- N PROJECT DESCRIPTION .50. FT. OCCUPANCY Address(mailing) CONSTRUCTION TYPE VALUATION$20 290,OL) s Left 4, .Krr R City License No. ZONE - GRADING CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION / PMg. Ref.# Parking' Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: G,•,G I �O 4 W� Planning Notes: • Q with section 7000) of Division 3 of the Business and Professions Code, and �'U�•U 77. f���w - - M ' my license is in full force and effect. P b.. License Class License No.. Glu L&14%- ^7 rc"# TR Steil tin, 4S Date Signature - - PLUMBING FEES ,Af runt L(}'�� CZ/ , WORKERS'COMPENSATION DECLARATION Bar Sink Showers (1 reby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL FEES Workers' Compensation Insurance, or a certified copy thereof (Section • -,d0, Lab. C.) Backflow Preventer Service Sink _ Automatic Washer Transformer ❑ 15-50 KW Policy No. Company Backflow Irrigation - Sewer Cap Construction Pole Sub. 0 50+ KW RCertified copy is hereby furnished. B •- - ' Certified copy is filed withththethe city Building Division. Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps Date - Applicant EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps (This section need not be completed If the permit is for one hundred ($100)or Dishwasher less). 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 bete a subject to the Drinking Fountains Solar Tank Fan Motors❑0-1 HP ❑1 h-8 Workerrs o}tnRer�fon Laws of Califolrnia ii _- _ Date/ 4,1/7/'.c� Signature/.(y1l sle(7 Floor Drains Swimming Pool w/Spa F.A.U. olar ❑9-15 HP 016-15+ NOTICE:If,after making this declaration,you shoul become subject to the. — - - Inc.. Workers' Compensation provisions of the Labor de, 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 • P 12 Light I hereby affirm that there is a construction lending agency for the performance 9 of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Healer 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 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—Trap7/LaundryTrays ' any structure, prior to its. issuance, also requires the applicant for such permit y Generator ❑0- ' ❑5-15 KW Tiash 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 �- - fivision- 3 of the Business and Professions Code) or that he/she is exempt - -wefrom 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 natty of not more than five hundred dollars ($500). ❑ I, as owner of the property or my employees with wages as their sole Reinspection Fe Issue Fee $ 3 compensation, will do the work, and the structure is not Intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Reinspection Fe� $15 Issue Fee $ 3 License Law does not apply to an owner of a property who builds or improves __ _ _ thereon, and who does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not Intended or offered for Boiler - Hood or Type I ❑ - ate 41/17/K+ � q C�•L sale. If, however, the building or improvement is sold within one year of com- Canopy Type Ii ❑ Zoning Approved By 1 Date &7i//K+ ',teflon, the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground Building Approved By 1 ,/� Date - prove for the purpose of sale). - K/ / n I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System . Application Issued By 7 Data 1T —Y 7. tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑0.100,000 BTU 0100,000 BTU builds or improves thereon, and who contracts for such projects with a con- SUMMARY OF FEES tractor(s) license pursuant to the Contractors License Law). I am aware that Exhaust System ❑ Multiple 0 ,System Repair/Alteration BUILDING PERMIT $ 14G.4� SMIP $ I. 47i proof oftheir Worker's Compensation insurance should be provided to me. CHECK $ 95• 2-2-- PERMIT • PLAPLAN MBING ISSUANCERMIT 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# / Fire Dampers $ $ Date/�,�/7�A/— Owner te-% Heating System& Ducting Registers • PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have read this application and state that t - .•ove ❑o-100,000 BTU 0100, 0BTL • ELECTRICAL $ GRADING $ information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize repre- sentatives of this city to ente upon the above-mentioned property for • inspectiongnatreour p• 's. .— e' /(7/i7 /1 Signature - d _�is Dat Z+ MECHANICAL $ TOTAL FEE $ j3• Drivers' License or SS Reinspection ee • $15 • Issue.Fee $ 3 PLAN CHECK 25% $ . • a 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. 53. Steel Reinforcement •`. 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding ' 5. Steel Reinforcement 4;124/k/ &eI 56. Rough Plumbing & Pressure Test ' 6. Electrical UFER Grnd. 57. APPROVAL TO COVEREGUNITE 7. Footings • 64647 g(fri 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test • 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, P 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 7'• 13. Roof Drains 64. Plumbing System.- Final - - 14. Rough Plumbing • 65. Electrical-Final 1 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 OGas ❑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 lectric 33. Final Heating No es• f9ry~ 34. Final Heating & Air Conditioning 6O /�_/� /VDe�y,[ / !�.cCGVT/ 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 l 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 • - A No. Date �', Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. • CITY OF COST )�ESp'j;yCONSTRUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. ,UNIT NO. 1t q . Project Address O'-3 /a - aAi ' 7 S 99 - . v• 'Applicant's Mail'.. Address - �1 // SLS / / TYPE OF CONSTRUCTIOf1L I_I NEW U ADD L I ALTERATION U REPAIR - gyjQA�`^- / ,.� 69 ❑ CONVERSION DEMOLISH ❑ OTHER A P # ± MA's �' I IV0/ One Owner's Name.' li. / / • Phone dL� 1 - 't ' t DESCRIPTION OF WORK/USE OF BLDG. Address /7792'�? .LL• p/ 2/CV//‘( s„$ ]J" ' S Main Building: e`, Accessory MESA Arch/Eng."TOt1/" , U144-PC i License No. ' TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION El STRUCTURAL I ' T Front 'en r it, i•f)S1A 1t' ESA O Address - CI/� CI OTHERAT ❑ ELECTRICAL'CI PLUMBING ❑ MECHANICAL BRear N Contractor's Namey� -1) • B C Phone • - - • • - - �y n PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right N Address(mailing) C./� 00. O , K G CONSTRUCTION TYPE VALUATION.$�'OO $ Left City License No. ZONE - GRADING CU.YDS. ACRESR LICENSED CONTRACTOR DECLARATION Ping. Ref.# • Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: • 'Planning Notes: • Q with section 7000) of Division 3 of the Business and Professions Code, andM my license is In full force and effect. _ - T License Class License No: S Date Signature PLUMBING - ' FEES • WORKERS'COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL FEES 1 hereby affirm that I have a certificate of consent to self-insure or a certificate • • Workers' Compensation Insurance, or a certified copy thereof (Section - . . • 10, Lab. C.) B. kflow Preventer Service Sink Automatic Washer Transformer ❑ 15-50 KW olicy No. • Company Irrigation I. Sewer Cap . - � BCertified copy is hereby furnished. Construction Pole Sub.- . Certified copy is filed with the city Building Division. Bathtubs_ . , ' Sewer Connection ' Cooking Unit Meter 0 u to 100 amps Date Applicant . . - ' EXEMPTION FROM WORKERS'COMPENSATION DECLARATION - Clarifiers _ - 4 Solar Collectors, - • Dishwasher m Meter ❑over 100 amps ' ' (This section need not be completed if the permit is for one hundred ($100)or • less). : • Dishwasher _ 4� , Solar Piping ' . - -. - Dryers ❑Gas ❑Electric , Sub Panel I certify that In the performance of the work for which'this permit is issued, I - - . • shall not employ any person in any manner so as to become subject to the Drinking Fountains ' Solar Tank Fan • Motors 00-1 HP ❑1'/=-8 Worker> or g4dtion Laws'of Califo - , • Date �f����`` ��//Jl�a Signature iJ 't/4O 41/-/ -�'' Floor • Drains im Ip • Pool vv/Spa aF.A.U. - - - NOTICE: If,after making this declara ion, you should become subject to the_ -- - - - r_ p Inc.Solar 09-15 HP ❑16-15+' • Workers' Compensation provisions of the Labor Code, you must forthwith - ' Floor Sinks C Fixtures • comply with such provisions or this permit shall :be deemed revoked. }"-; Microwave'. CONSTRUCTION LENDING AGENCY Gas Service OutletsDevice Boxes I hereby affirm'that there is a construction lending agency for the performance a Wate • et Pole Light • of the work for which this permit' is issued (Section 3097 Civ. C.) Interceptors Water He-g Outlets ' Lender's Name Range Lender's Address - - Kitchen Sink Water Service .. Switches - Sign OWNER BUILDER DECLARATION I hereby affirm that'I am exempt from the Contractor's License Law for the Lavatories Auto-Wash • Garbage Disposal Standing Sections following reason (Section.7031.5 Business and Professional Code: Any city or - - - 1 I county which requires a permit to construct,alter,improve,demolish or repair P-Trap L¢Undry Trays ` Generator ❑0-5 KW❑5-15 KW any structure, prior to/its issuance, also requires the applicant for such permit Trash Compactor to file a signed statement that he/she Is licensed pursuant to the provisions of 7: D s . the Contractor's'License Law(Chapter 9 (commencing with Section 7000) of ' . Division 3 of the Business and Professions Code)5or that he/she is exempt - .. • therefrom and the basis for the alleged exemption. Any violation of Section • , 71.5 by any applicant for a permit subjects the applicant to a civil _ ' alty of not more than five hundred dollars($500). '. . I, as owner of;the property or my employees with wages as their sole , Reinspection Fee I $15 Issue Fee $ l' compensation, will do the work, and the structure is not intended or offered - Reinspection Fee I $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's - MECHANICAL I FEES_ License Law does not apply to an owner of a property who builds or improves - thereon, and who does such work himself/herself or through his or her ownDEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for Oiler Hood or Type I ❑ • • . sale. If, however,-the building or improvement Is sold within one year of cow- Canopy Type II ❑ Zoning Approved By Date ' / plena n, the owner will have the burden of proving he/she did not build or im- Duct- der Ground • Building Approved By rove Date — for the purpose of sale). ' /^t ' as owner of the property, am exclusively contracting with licensed con- Duct-Struct Refrigeration Syste Application Issued By (�//'j Date tractors to construct the project (Section 7044,Business and Professions Code: - The Contractor's License Law does not apply to an owner of property.who Duct-Ventilating , ❑0-100,00 U ❑100,000 BTU SUMMARY OF FEES builds or improves thereon, and who contracts for such projects with a con- - .Sa tractor(s) • Contractor's License license.pursuant.to the ContractoLicense Law). I am aware that Exhaust System El Multiple S m Repair/Alteration T • • BUILDING PERMIT $ 3 SMTP $ 0. 50 proof of their Worker's Compensation insurance'should be provided to me. PLAN CHECK 'V$' / /3 `PERMIT a ' ❑ I am exempt under Section .& P r this reason Firepl/Fact.Blt. ICBG# - Dampers • ' J- / - - ' - PLUMBING ' $ S. 00 ISSUANCE $ Date 7Ajfl er • Owner ez/_���refri ' Heating System& Ductin. • Register PLAN CHECK 25% •$ ENERGY P.C. $ I hereby certify that I have read•this application and state that the above 00-100,000 BTU • 01,000 Br .ELECTRICAL $ GRADING $: information is correct. I agree to comply with all city and`county ordinances . and state laws relating to building construction, and hereby authorize repre- PLAN CHECK 50% .$ MICROFILM ,$ sentatives of this city to enter upon the above-mentioned propert for inspection roses.. "' /�, - - - MECHANICAL • $ TOTAL FEE $ • Signature{/!lJ/y� DateS�/'l7 • -, J b t CMF 0865-46,rev.10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor - -. CONSTRUCTION AND PLANNING POOL& SPA APPROVALS i Permit# Date Inspector APPROVALS Permit# Date Inspector 1.'Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation' -f , 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water PipCIJndrgrnd. 60.-Backwash Lines,P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final • 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign - 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling' 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# _ 21. Ducts, in Structure • 70. Underground Hydro ' 22. Ducts, Ventilating 71. Product Piping 0 Gas O Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing • 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing . 74. Overhead Hydro • 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation • 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final - 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning )• ' 35. Final Gas Pipe-Test • 36. Hood or Canopy 37.,Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final - 41. Solar Domestic-Final • 42. Backflow Preventer • • '143. Backflow Irrigation - 44. Landscape Irrigation System ' 45. Sound Attenuation - - 46. Handicap Regulations / sit�]sit47. FI NAL STRUCTURE & BUILDING C * - 48. Special Requirements Completed ((((���- 'rrr 49.,Electric Release to Edison 50. Gas Release to Southern California Gas Co cait 51. CERTIFICATE OF OCCUPANCY No. Date _ t r CITYOF COSTA MESA. 4` - 4 � BUILDING;DIVISION Y ft-Jan.-A , DEVELOPMENT SERVICES:DEPARTMENT i PERMIT NU BER f ' PERMIT O i P05 00 88 (714y754.5273:••Fax(714)i764,'-4856'••www.ci:costa-mesa:ca:us. 77'FAIR DRIVE;COSTA MESA,CA 92626 PLUMBING PERMIT ' -Job Address: 2370 ELDEN AV Status:- ISSUED Suite No B Applied: 05/19/2005 • Issued: 05/20/2005 . - - - Vicinity: .. _ Parcel Nunmber: 93068487 - �'��'" :'_•_F'_ '`" ISSUED•BY: • - - � Applicant: ALFREDO CRUZ - t t Address: 4952 WARNER AV F. �i"`l i } t 't L'I'll :,�... 's. SUITE 104 \ --"1 c ---Phone: -714-377-7527 - 1 ! ,A��N , J ..-;,..- HUNTINGTON BEA i--- ....<---.-.--.,-_-_--.Zip: 9264.9=--c: - -�- `�'.. �" - s -. -.� -i v .; tip:•-,��a = 'w ' ' Owner: MC HONE;DONALD C TR �. > �`,`- j ,�, • Address . 2400 W COAST HWY STE D '-'----N,v 7' " - Phone: ?, '�\� f 'NEWPORT BEACH,CA Zip: •92663-4731 "' " u; I _ - Contractor !TECH ONE,PLUMBINGt ' '7-::::"11 ' s Address. ' :4952•WARNER AV., T t,'- i- � . i -kJ 'SUITE 104 - Phone: 714-377-7527 _ _ : ,HUNTINGTON-BEACH;CA Zip: 92649 `-� �� • - -- _-- --=-License::-823413- __ _ __ . _ i s, 'r•-r ''tx n , 'n ' kL d I. ( ! J '+ zi (Li .f 11. i ,SCOPEOFPERMIT ` - ._ - ' ` NEW WATER SERVICE FOR UNIT BV �y! - , • ' - - FEE SUMMARY-TY -=_-. -' AMTQTY% AMT .4 QTY ,'•- AMT ' act ISSUE FEE '.$23.50 Laundry Tub/Washer $0.00,,; 0 Sump Pump i. / - $0.00,x- 0 Backflow irrigation • \ ', ,$0.00 0 ' Landscape Inigation '`$0.00_'_.0- Swimming Pool -' .$0.00:, , 0 Backflow Preve'nter' • $0.00 0 . P-Trap . $0.00 0 Trap Primer,/,/j t -,$0.00 ' 0 Bathtub ?• ' 10.00 0 ' Pressure Regulator -c•,---,,,'. $0.00 0 Urinal ,r%t�-, -, %$0.00 ' 0 Clarifier System $0.00 0 Process'Piping(per 10 ft) '$0.00 0 Vacuum Brkr,Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc)'-,' $0.00 0 Receptors'.- :-;•,. . $0.00 x;to Vacuum;Brkr Bkflow(5+) ,'$0.00 0 Dental Units '':A� - , $0.00, 0 t ,Septic Tank - 2:1;').$0.00,„;14-0g- J.X.-- Wash:Basin !' $0.00 0 Dishwasher `..;. $000 'x,00 ,.Sewer Cap,for,Demo� `'x :$000 0-``- ^�-'Wash-Basin Set $000 0 Drain, Floor x.‘,. ..`\ /$0 00 .:d.:.,- -:Sewer Connect ft $0.00.1'„‘z0,,.1 2 Waste and-Vent System', ;'$0.00 0 Drain,Rainwater ' ' ' $0.00",,,, 0 -Sewer Private Line :, $0.00 u 0 � Water Closet(Toilet) '2 i, $0.00 0 Drain,Roof $0.00''' '-0? ��Shower - - .$0.00_ ..-0:-----7---,->.-- Water Heater./vent $0.00 0 Drinking Fountain '. ',F-.$0.00.1.1.'„ 0,/,�� ''Sink,bares;. . - !Water Piping(Inst or Rep.) $0.00 0 Expansion Tank -.,'.$0.00 di 2/!`Sink,commercial-- ..`1,.-,$0.00-'- 0 .�;.Water Re-pipe,/ $0.00 0 Gas Earthquake Valve $0:00;x-1. b'C /I Sink;Floor,_ $0.00 0-`-,'` \ Water Service! $9:80 1 Gas(1-4 outlets) $0:00.- '�0_ - t S"Sink,kitchen j _ . e -"`$0.00 c 0\, \ Water%Softener $0.00 0 Gas(Over 4 outlets) $0.00 0_w-,, "'Sink,service%mop ' I r., : $0.00 c 0,% .OTHER' $0.00 Gas Repipe $0.00 'O-.0 J.> -.Spa(private) t. "„_; .-i$0.00--'-0 !^6VIOLATION $0.00 Gas Service $0.00 0 `- Spa(public),, $0.00--,--0-7;.!"---1----- PLAN CHECK $0.00 Interceptors(Grease,Oil) $0.00 0 - .Gam?��--"- -- -- REINSPECTION $0.00 0 Interceptors(Sand Auto) $0.00 0 -- TOTAL CALCULATED FEES: $33.30 NOTICE: The•work authorized by this.permit shall comply with all applicable.handicap access requirements.under California statutes and related regulations. (Ord.No:92-28,§1, 12-21-92) I EXPIRATION:' This-permitshall automatically expire.andibecome.void.ifiwork is notcommenced:within 180-days,or if worlds suspended or abandoned for a.periodof'180,days. INSPECTIONS:. In,orderfor the work.authorized under this,permit to be considered,legal; such work must comply with,all-applicable codes, and all .requfred'Inspectlons and final approvai'must'.be.obtained.Failure to-obtainiinspectionsiandfinalappmval:will'resultin'theexpiration of this permit. FOR.INSPECTIONS CALL:. (714)754.5626 2446-46(8'00) DECLARATIONS • ---, • WORKERS'COMPENSATION DECLARATION: - ' , I hereby affirm under penalty of perjury one of the following declarations:' ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of;the Labor Code,for the performance of the work for which this permit is issued. _O—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. �Ay.wdrkers'comb/pe atlonTnsuranca carder tl policy number are: / /� 2 r7 - `,� nCemet-c•.. • R .Y 11/4 C `V• C-Policy ! V /. 0 f�0 `� CJJJ ..able section need not be completed it the permit is va/ d at one hundred dollars($100)or less.) ❑ I certify that in the performance of"I' :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 Callfoml=,a,' ag -e that if I should become subject to the workers'compensation provisions'of Section 3700 of the Labor Code,I shall forthwith comply with these provision . 0 y 9,,, yappnb'ant SI / tr Dater- -_ 'ACI ^ 0 5 WARNING:FAILURE TO SECURE WORK:' 'COMPENSATION COVERAGE-IS UNLAWFUL AND SHALL SUBJECT AN EMR-OYER-TOCRIMINAli PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,003),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,ANO ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am license nder rovisiopq of Chapter 9(commencing with Section 7000)of Division 3 of the Business a • Prole io s C•.e,and my license is in full force find rs Slg LLIc:-#_ ,E-(j� /)'7 n Date:_ . ■ actbr� a Slghatur'e.. . �r�,y('//jj-"y�{`�^�' �,�5..�• Date: t. • • 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 toe civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not Intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). • ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet In depth Into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,faisework,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 Safely,as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I Wit 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 ❑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? 0 Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes ❑No (If yes',the facility must meet tho requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by Califomia Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If yes',attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. n re Of Lege wner(s) Date 5- 00-o5 -A d1Or Authorized Applio t C-!Dale ' CODE I INSPECTION TYPE ' ' PATE RMALS - ' . CODEE' INSPECTIONTYPE PATF It�LE 1616 Fixed System Final Fire Prevention . ' . . 206 •Final Mechanical . /_ • 208 Final PlumbingW- 6_S 1266 Pool Spa Final 200 Final Re-Roof ' • ' . ' ' 210 • 'Final Electrical - ' • 201 Final Block/Retaining Wall 212 Final Fire Prevention • 202 Final Factory Fire Place I" ' ' ' 220 Final Planning Approval • 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupanby ' " - ` CITY OF COSTA MESA 4 ow; BUILDING DIVISION F ( • imp".�..., DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER /JPERMIT �`+,.o,,,oec p�In{{gyp 1 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA�IvTES/C,C A 92626 MECHANICAL PERMIT Job Address: 2370 ELDEN AV Status: ISSUED Suite No C Applied: 01/28/2005 Issued: 01/28/2005 Vicinity: Parcel Number: 93068488 ISSUED BY: Applicant: ABC HEATING AND NC Address: 2282 ORCHARD DR Phone: 949-456-0064 NEWPORT BEACH,CA Zip: 92660 Owner: MC HONE, DONALD C TR Address: 2400 W COAST HWY STE D Phone: NEWPORT BEACH,CA Zip: 92663-4731 Contractor: ABC HEATING AND NC Address: 2282 ORCHARD DR Phone: 949-456-0064 NEWPORT BEACH,CA Zip: 92660 • License:810481 SCOPE OF PERMIT REMOVE AND REPLACE FAU WITH<100K BTU FAU.SAME LOCATION. FEE SUMMARY Quantity - Quantity ISSUE FEE $23.50 Repair I Alt Absorbtion Unit $0.00 0 Inst FAU<100 k BTU 514.80 1 _ Repair/Alt Refrigeration Unit $0.00 0 Inst FAU>100 k BTU $0.00 0 Ventillation System $0.00 0 Repair/Alt Cooling/Heat $0.00 0 Evaporative Cooler $0.00 0 Inst/Rep.Recess Wall Htr $0.00 0 Commercial Incinerator $0.00 0 Refrig Sys<100 k BTU $0.00 0 Domestic Incinerator $0.00 0 Ref rig Sys>100 k BTU $0.00 0 Compressors/Absorption Systems Gas Piping $0.00 0 Up to 3 hp/100 k BTU $0.00 0 Factory Fireplace $0.00 0 - ' 3 To 15 hp/500 k BTU $0.00 0 Hood w/Mech Exhaust $0.00 0 15 To 30.hp/1,000 k BTU $0.00 0 VAV Box $0.00 0 30 To 50 hp/1,750 k BTU $0.00 0 Vent Fan I Single Duct $0.00 0 Over 50 hp/Over 1,750 BTU $0.00 0 Appliance $0.00 0 Boilers Fire Dampers $0.00 0Up to 3 hp - $0.00 0 Smoke Dampers $0.00 0 ' 3 To 15 hp . $0.00 0 Inst or Relocate Appl Vent $0.00 0 15 to 30 hp $0.00 0 Air Handlers< 10000cfm $0.00 0 30 to 50 hp. . • ', $0.00 0 Air Handlers> 10000cfm $0.00 0 Over 50 hp - - $0.00 0 Floor Furnace $0.00. 0 _ Other Mechanical'Fee . Floor or Suspend Heater $0.00 0 Investigation Fee $0.00 Plan Check Fee $0.00 Reinspection Fee $0.00 - TOTAL CALCULATED FEES $38.30 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or If work Is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result In the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(WOO) DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the r work for which this permit Is issued. - 1 :and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for theperformance of the work for which this permit Is issued. • • s'co ipensation Ins ance carrier and policy number are: // 7 �,.` C+rder. 1 a ••!icy Number: /V /7 s S 99-Gri1C (TMs sect!• eed not be-• Feted it the pa 1 is valued at one hundred dollars($100)or less.) certify that in the performance of the work for which this permit Ls Issued,I shall not employ any person In any •-ner so as to become subject to the workers' compensation laws of California,and agree that If I should become subject to the workers'compensation provisl..s of Section 3700 of the Labor Code,I shall forthwith prov cions • ••plicant Signet e: - Date: g G T ING:FAILU: TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPL• RTO -IMINAL PENALTIES AND CML FiNES UP TO ONE HUNDRED • • •• RE($10G000),IN ADDRION TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION •.•' THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affi rr. •:t I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 o ' ass and Professions Code,and my license Is in full force yam...-.--- .a gd1 (� cl W-/ - 2 G /moi �— ^ Z fr --C-C CON -I ON'LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Soc.3097,Civil Code). Lenders Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031,5,Business and Professions Cale:Any city or county which requires a permit to construct,alter,Improve,demolish,or repair any structure,prior to Its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors Ucense Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business end Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a cMl 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 drivers license. ❑Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(38)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title B,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the DivIslon 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 en RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP Is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or willo thehoast or present a future building ist o from at require for the work ntch Is the or age of this a estion appertnit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? �Yes LJ No (Section 65850.2 of the California Government Code requires that the requested Information be furnished on applications for non-residential building permits). 6 Will any pan of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑No (If yes',the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other-Jr pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescnbed by California Health and Safely Code Section 42303 been made? 0 Yes 0 No 8 (If yes',attach certificate of compliance fromrom 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 COMPUANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all slate laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-desc' ed property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. I SI/magna e f Legal Owner(s) Date 6G69'•'>U And/Or cant Date C00E IN INSPECTION TYPE PATE gCEMELS LODEft INSPECTION TYPE 11 q MIL 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1- O j -0 1266 Pool Spa Final 208 Final Plumbing 200 Final Re•Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy