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HomeMy WebLinkAbout2336 ELDEN AVE - Building Permits 4 - CITY OF COSTA MESA tBUILDING DIVISION o,� F ( ��� I� DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER PERMIT - 401.01228 bonito(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 2336 ELDEN AV Status: ISSUED Suite: I Applied: 08/07/2001 Vicinity: I Issued: 08/07/2001 Parcel Number: 43926401 Zoning: /am Applicant: KIM,ROBERT ISSUED BY: V "— • Address: 1835 WHITTIER AVE - ' - . UNIT F12 ; „„/ Phone: (949)645-3917 - COSTA MESA,CA-'.. ' Zip: 92627 ,, " Owner BURSHTYN, LEA ' , , - . Address 2336"ELDEN AVE#A - - / Phone: . ' COSTA MESA;CA7, " : Zip: 92627 Contractor: 21STCENTURY ROOFING Address: 1835-WHITTIER AVE , , UNIT F12 , Phone: -(949)645-3917 COSTA MESA,CA , Zip: 9262i, -License:- 750385 • • Arch : - Eng: Address: • Address: i • Phone: Zip: -License: 'License: SCOPE OF PERMIT ' TEAR OFF INTALL 1/2"CDXr AND LITE WEIGHT TILE 5.5 PSF ICBO#'4660.CAPISTRANO TILE. UNITS I&J. FEE SUMMARY Plan Check: $0.00 -. Calc Valuation: , •$5,800.00 Permit. $125.25 - - - -- Claim Valuation: $5,800.00 SMIP Res: $0.58 . " SMIP Com: $0.00 Other $0.00 Inspection: $0.00 Total: $125.83 . PLANNING & ZONING SETBACKS , MAIN STRUCTURE Front 0-0 . Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front - 0-0" ' 7 Rear.. 0-0 Left 0-0 Right 0-0 ' • // PARKING Existing: . 0 : Required: 0 Proposed: 0 , NOTES: ( • NOTICE: The work authorized by this permit shall comply with ail 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(600) DECLARATIONS Coo 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 perfornencb of the work for which this permit is Issued. `/ 6d' Ave 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. MyWvorkers'compensationInsuran�carrier and policy number are: / Carder: 5tcrTC r Cu"— Policy Number: (This section need not be completed ll the permitis valued of one hundred dollars(5100)or less.) ❑ 1 certify that In the performance of the work for which this permit is Issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provi ns. Appllcant.Signature. Date:--2—h4 1 WARNING:FAILURE TO SECURE WORKERS'COMPEN ATION COVEMOE IS UNLAWFUL AND SHALL SUSJECT,AN EMPLOYERTO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED ✓� -THOUSAND DOLLARE(S100.000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37060F THE LABOR CODE.INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: 1 hereby affirm that I enlace ed under provis_ i res of Chapter 9(commencing with Section 7000)of Division 3bfih rausiness and Professions Code,and my license is in full force and.effect U :1 J'�� ",3 \Cllass a C_.7 ContractoraSignature: " /l: X 11 C` CONSTRUCTION LENDING AGENCY: -� ❑/thereby affirm that there is a construction lending agency for the performance of the work for which this permit Is Issued.(Sec.3097,Civil Code). Lender's Name: _ Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business end 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 porn-4i subjects the applicant to a clvil 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 en owner of property who builds or Improves thereon,and who contracts for such project with a contractors) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑Yes 0 No 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 fNe(5)or more feet In depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Flre 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 tho 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 0 N (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 en RMPP is presently required,has Section 25534 of the California Health and SafetyCode been fully complied with? 0 Yes 0 No _._ ..__ ._ for such construction 5 Does or will the applicantsAir present n buildingsoccupant requiretr for the work ontch the subject of this 8�J estion a ertnit such constructor modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes �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 the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ..._._ Management _ ._ h i h _._of..t.hi_... 7 a a permit from—the—South Coast s Quality ed Healtheal or other airtCodeeion contra district3 been agency is required for the work which is the subject of this application,have all of the disclosures prescribed by Californiaia and Safety Section 42303 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. 'gas urs IOwner(s) Date R - -) r -o And/Or Au orized Apprlcant Date — ODE P INSPECTION TYPE ......... ------- RAIL itMtla CODE! INSPECTION TYPE �� RAIL N1mIIAL6 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final A 208 Final Plumbing 200 Final Re-Roof Jt)/LY/Q( l 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 '---/� s.G'— City of Costa MesaQ Development Services Department CERTIFICATE OF OCCUPANCY No. U U b i J Building Safety Division P.0.Box 1200 Costa Mesa,California The Building located at 71'if, crfcM nttpVntc MITT t.0 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 CONDOMINIUM Legal Description 439-261-23 (See reverse side for Metes and Bounds) Building Permit No B-11701 Electrical Permit No. E-13475 Plumbing Permit No P-12189 Mechanical Permit No. 14-13301 Number of apartments /and/or guest rooms ISSUED TO: Building Official /26/ Cat-id E. OLRICH by----1// -i r/:- 2881 EUROPA, COSTA MESA, CA. Date � 7 nbh/ //9(Y This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 le) U.B.C. CMF 1015-46 rev.1/83 White-Owner;Canary-Numerical File;Pink -Bldg.Permit File PRDJECTA DREss: 2336 ELDEN AV UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 047673 OWHEWNAME: 2336 ELDEN AV ADDRESS: 2336 ELDEN AV PERMIT NO: E 047673 PLAN CHECK NO: N GOVT: N SUPP: N COSTA MESA CA 92627 CONSTRUCTION TYPE: 5—N PERMIT TYPE: ELE PURPOSE: OTH (714 ) 241-1946 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : INSTALL UG WALKWAY LIGHTING SQ FT: ADDRESS: UNIT: CLAIM VALUE: CALC—VALUE: GROUP OCC : R-1 / PERMITTEE: MCCARTHY ELECTRIC (714 ) 241-1946 • ADDRESS: 3100 SUMATRA PL COMMENTS : NO "B" PERMIT TO REFERENCE. COSTA MESA CA 92626 ***et*It***x*****er*******et***e<*et**aE********+t**et**et***at**eEat***et** *******x**atat+t**et LICENSED CONTRACTOR DECLARATION: I hereby affirm that I icensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code,and y le a is In full force and effect. SETH ACK S cm uc.: 0 3 5 8 2 9 STATE LIC.:461872 s: C 0 Date:—re, -'��7_0 Signature: I r • MAIN BUILDING ACCESSORY BUILDING �'� •� - - '.9' —— an: FRNT: FT IN REAR: FT IN FRNT: • FT IN REAR: FT IN WORKERS'COMPENSATION DECLARATION: Ihereby affirmthat . e acemhcateof • . m• t - -insure or a.- - .ofWorkers' LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN Compensation LQsga c rtiBe4�Qpy thereof(Section 3800,Lab. PQuCY NO.: +V�� �� J`r EXP.DATE: 1 /O1 /91 9MPANY: STATE FUND PARKING REQ• PROV: PARCEL : 00000000 ZNE: REF NO: a Certified copy is hereby furnished. 21 Certified cop is Q h the city Building Div to PLANNING NOTES> 6 �7 e > Date: ` / - Applicant: it if it it"*****************************it********************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: n n a et if mit is for ono red(5100)or less). DEVELOPMENT ICES R E Q U I R E M E N T S • I certify that in the performance of the work for which this permit is issued.I shall not employ any person in any man r so as to become subject to the Workers'Compensation Laws of California. ZONING APPROVED BY DATE: Date: Signature: BUILDING APPROVED BY – DATE: NOTICE:If,after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor Code,you must forthwith comply with such provisions or thus permit shall be deemed revoked. : CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY : L.' DATE: 7 --(0 wash this permit is issued(Section 3097,Civ-Cl **** ** *** *****************)t** ..it**** LENDER: * ** ******************************** ADDRESS: LEGALIZATION:NFSE E SUMMARY STRUCTURAL SEGMENT:N eNER 7031.5 B DECLARATION:rI herebyl affirm that i am exempt ho thee Contractors'rs'Stateonstnse Law for the ve,odem reason BLDG HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/•RES GRADING (Section 7031.5 Business and Professional Code:r Any city county which requires a permit to construct,alter,Improve,demolish,Bien d PERMIT 12 , 75 - 7, repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed S 0% SMIP/NON—RES ' pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN and Professions Code)or that he/she Is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 15_ —CHECK 5 „00 I. as owner of the property or my employees with wages as their solecompensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID �y' DUE 'J structure is not intended or offered for sale(section 7044 ,Business and Professional Code: The Contractors'State License Law TOTALS— > 12 . 75 15 . 00 0 , 0 0 27 . 75 2 7 , 7,517 fj 0 0 does not apply to an owner of a property who builds or improves thereon,and who does such work himsefimersell or through ��p his or her own employees,provided that such improvements are not Intended or offered for sale.If,however the building or REVENUE DIVISION TOTALS--> COLLECTED • 27 . 75 OVER/SHORT: t improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve0 0 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING' P�liIAN—CHECK I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 27 ' 75 .( ; ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon _JI) Ai W and who contracts for such projects with a contractors)license pursuant to the Contractors'State License Law).I am aware ******************************************************************.****it**it***** that proof of their Worker's Compensation insurance should he provided to me. ' INDIVIDUAL F E E BREAKDOWN 7 ' ❑ I am exempt under Section: 8.8 P.C. • J ,7) for this reason: TYPE • QTY • D E S C R I P T I O N UNIT COST. TOTAL COST i Date: Owner: ELE 15 RECEPT/OUTLET 1 ST 20 EA. , 75 11 . 25 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and ELE 2 POLE/PLATFORM MOUNT LIGHT FIXT, EA. , 75 •j 1 . 50 25534 and that I or any future building occupant wiNwill not(circle one)need to oomph,with said state codes and the requirements for a END OF FEES permit for construction or modification from the Air Ouali fy Management District.Residential construction applications are exempt from thesegi provisions. Date: Applicant: I hereby certify that I have read this application and state that th. .,•ve Information Is correct.I agree to comply with all city and county `�\ v,J ordinances and state laws relating to building construction and her•i Drize representatives of this city to enter upon the above-mentioned /_w`y\`\\ Q properly for inspection purposes.se • I ' • / �4 N tw `Q, Date: l� .7 J Signature: . . _ Drivers License or Social Security 01 00062734-0006273g T O T 27.75 1641.46 White—Building;Green—Code Enforcement;Canary—Applicant;Pink—Revenue:Goldenrod—Assessor DATE: 06/07/90 TIES: 15:28 1CONSTRUCTION AND PLANNING - Pt & 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 UFERGrnd. 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-FinalI` 15. Rough Electrical-Conduit - 66. Solar System-Final • = - 16. Rough Electric Wiring -J 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, Ventilati g •71. Product Piping 0 Gas OOil 23. Gas Pipe-Rough & Test - 72. Underground Flush 24. Roof Framing - .73. Undergrnd.Storage Tank 0 Gas ❑Oil 25. Roof Sheathing - 74. Overhead Hydro . 26r T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical • c 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 '_ grit/waal.30. /n • --79. FINAL INSPECTION. 32.• Electrical Power Meter-Final 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. Fina( Plumbing - . 39. Water Service-Final I - - 40. Gas Service-Final - 1. , • 'Al. Solar Domestic-Final - , 42. Backflow Preventer - 43. Backflow Irrigation • \ . 44. Landscape Irrigation System . ' - ' '\45. Sound Attenuation - - - - _ t16.•Handicap Regulations +� O. FINAL STRUCTURE & BUILDING . - - - /148.;.FINALPLANNING _ /49. Electric Release to Edison T[50:Gas Release to Southern California Gas Cu - /51. CERTIFICATE OF OCCUPANCY - ' o. Date -'VCosta.Mesa Bdtlding Department ` �AY xist Af'IONCC ERIiUT Z 'y. P. O. Box 317. x$255 BUILDING ,` • ' COSTA MESA, CALI NIA FOR OFFI,...USE ONLY . . FOR APPLICANT TO FILL IN Receipt No. Permit No. •Building / Address 2' b 6 G..-f) :g.2 2 Costa Mesa, California Received by / Date Recd. Date Issuedss Nearest £ .r_ ./22 ,p (O /07--.3 &—.4 --�� Cross St. Z--/ti 'S Building �0 })4 R Es Address Owne U Mail EL- ��� Costa Mesa, California Address 2—3Nearest Tel. Cross St. City Ca-StA M,ebiz} No. Zone 1pJ� No.of ' / Group Architect or Lic. /l� I Plans I Type // Engineer - - No. —' Approv �/J' by • Date Address '� - \ City Lic. Contractor'3,1.; A rNT-z- No. \( ' i I I • Address 47 C ( hLava eG . 1 ' . - Description I Lot 4'G I Block I Tract306 CITY OF COSTA MESA PLANNING DEPT. (Attach Metes and Bounds)/// d -�' • /� V 7 No.of Bldgs. / r Size of Lot ��X ,��-S Now on Lot By l _ _-. Dat O 6 O Use of No.of ,}No.of _ pL,N.TE-ri 73 Existing Bldg. I Families I Rooms rrir Setback Line from . Rear Yard .-) ' { Center of Street 5� Side Yard ,f Ili j i c=� D DESCRIPTION OF WORN •„�, y f I'..0 T-r.,,� r New I Ic I Alteration I I Addition I I E- :VI -5- A '. f I. ?1 II Repair I Moving I I Demolish Building ` No.of 1 0 +fuze Size 6 S 7, d T Rooms %Stories `� "”" -_ __ Exterior WallRoof as — Covering rtu 'ty I Covering U rtpb APPROVALS Use of New actor Buildings g 'Dec) (+ q- Forms;Materials,For Location USI' Ins R f • Date , Under-Pinning Frame: Fire Stops, Bracing,Bolts _ I hereby acknowledge that I have read this Application and state that the above is correct and agree to comply Lath.Int. with all ' Ordin. ices and State Laws regulating building co Vi• coon/ Lath.Ext. Signature of t____ Permittee f �� Plaster,Int Authorized .1 t Plaster,Ex valuation Y I0O I Permit Fee $ 02 0 — Masonry Reinforced • Plan Check $ / O — Bond Beam ' $ 1 3 Total Fee $ 3 o FINAL FORM 204 10-55 O.P.&S. .• .1 .1) t. _ 7.1 d. 0 a. cr. JUN 18-55PD-,Wis'Oi *f,*-•:,30.no , . - . . t ; • • (. .r.(Th s: • •••, •-• . yr' nv.::::titA • • t• '2 4' PLOT PLAN Show location and distances from ( property line and between buildings. • • • r .• • • • 9990 .....L 301959 COSTA MESA BUILDING-SAFETY DEPARTMENT j-Hi\INCE DEPT. P.O.BOX 317 COSTA MESA. CALIFORNIA CH : OF COSTA MESA FOR APPLICANT TO f/LL IN COMPLETELY APPLICATION FOR PERMIT TYPE OR PRINT BUILDING BUILD ING 2710 fiii)OP dig, l ADDRESS L(•( cA COSTA MESA, CALIFORNIA - MR OFFICE USE ONLY #A 7 aYc oib I RECEIPT NO. I PERMIT NO. ' MAILOWNER (/���/�/�f/�� �f/ J SUED ADDRESS ? 33.0 �Cf✓�ie RECEIV I / Lo p 57 I gDAr`TE B,7 Ain //to TEL �/r/ BUILDIN i/ ///J 1 CITY C•+�PJ�/� (�f/' NO. s I ADDRESS ARCHITECT LIC. OR ENGINEER NO. COSTA MESA. CALIFORNIA • . ADDRESS FIRE P pK� ZONE TYPE GROUP II I/�7 3%, STATE/J' < 1. /. . CONTRACTOR • /�/ /�,�CLIC.NO BYPROV ED DATE ADDRESS �'T iftaT' ZONING • LEGAL LOT //_ J//��� x'11 ZONE NO.OP U8E OF NEW y/�J DESCRIPTION I NO. }"/ IIBBLLOCK ITRACr V /IPLANS BUILDING /q) A.P.NO. /j C L�/ `y�'1 L� //^ 9 APl'..".. •' ej BYPROVE //� DATE 7-s C0`s/ OF LOT Y } `ATG- 3 d `C I NOO/Wf ON LGGB ` YARDS 6 �� REQUIRED ALLOWED • USE OF Q�J/7n //,�(��� �f/ I CENTER LINE ST.) EXISTING BLDG. / 't E l P'"' 2ua4 FRONT 9 / FT. 4 . IN. SETBACK LINE FROM CENTER OF STREET REAR YARD R.SIDE iCSFT. IN. SIDE YARD I LEFT I RIGHT L.SIDE ,02 2J FT. IN. DESCRIPTION OF WORK �ra��� /��� NEW I SII ALTERATION I I ADDITION I R V4c1 r `-CI \ 194 f f. ay REPAIR I II MOVING I ' I DEMOLISH I HOLD FOR SPECIAL REQUIREMENTS BUILDING1069 NO.OF c / )1/ � /� SIZE (,{/q ROOMSOF T STORIES (///��� / 'I/ EXTERIOR WALIII///���//p�T��� ROOF .�i+n� COVERING COV ERINC � USE OF BUILDIN AND WORK TO BE P ERFOR ED L/ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION • AND STATE THAT THE ABOVE IS CORRECT AND AGREE • -M• THE AMOUNT SHO UNDER VALUATION IS FOR THE PLY WITH ALL CITY O-DINANCES AND STATE •-r, R,.• j NG PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. ,. BUILDING CDNSTRU•�• VALUATION SIGNATURE OF - /, PERMIT FEE $ ,0j„% -- , , PERMITTEE '�� c:7 (J S Ol Q yD — PLAN CHECK S /0 AUTHORIZED AGENT' AmiLi r• TOTAL FEE S .i 9991 . COSTA MESA BUILDING-SAFETY DEPARTMENT I Fii!le6F36 19' P.O.BOX 317 COSTA MESA. CALIFORNIA • CITY OF OCT r-61'. FOR APPLICANT TO f/LL IN COMPLETELY APPLICATION FOR PERMIT TYPE OR PRINT C BUILDING BUILDING j336 o A/ //11$4e � ' ADDRESS I l I A r • �1� COSTA MESA, CALIFORNIA FOR OFFICE USE ONLY �^ Hp reici/sop I RECEIPT NO. I PERMIT NO. re OWNER V I / {/f/7(/ /// MAIL ADDRESS 0336 ,e-j Pe/�)� •�// RE 1 fiD 9Y] I ���EC 1 I -{1=TE 188UED� CITY 'Croy- beii•A TND/'/ �d7�/ ADD ESS �,{/r-_ /f•/ (Ai S S ARCHITECT LIC. OR ENGINEER NO. COSTA MESA, CALIFORNIA FIRE e/� ADDRESS /�// [� // )) ZONE TYPE ROUPC2 1-41 CONTRACTOO�RT/''pio rip LIC.NO.011gig APPROVED ✓� DATE .A Oi ADDRESSO�•l O f&I�///C( '1/o) �✓Z)ONING LEGAL LOT /y�/ O U ZONE NO.OF USE OF NEW ` DESCRIPTION I NO. / L(�ILOCK TRACT ( I.PLA/NS /��I BUILDING / / SIZE NO 4/240-.2, ,- ,���—! O Si-C^ NO. B •LDG,2BYPROVE�/i 7 C( `�/"p,�EVE��DATE 7 -e0-37 OF LOT �T I YARDS NowpOrv�LOT REQUIRED Y'^ Y ALLOWED USE OF �^L/f7 ¢/y jl/(U,a,,9 FRON(CENTS LINE eT.) / 0 FT > n IN. EXISTING BLDG. / • SETBACK LINE FROM CENTER OF STREET REAR YARD R.SIDES,-3 FT. IN. SIDE YARD I LEFT I RIGHT L.SIDE 7S-FT. IN. DESCRIPTION OF WORK /" ,// REAR• EA // /a--F,�T.., ////C p-'/C/(/-• IN. NEW kill ALTERATION I II ADDITION 4V/) C/`/ d.9i (/ 0 .,57 REPAIR //nI II MOVING I II DEMOLISH HAI ' "OR SVC".(/ RFQIIJPF*4F*1•*c • BUILDING '/O� ROOMS r STORIES / _ EXTERIOR WALLL�YY/V///1//� ROOF L ���,y COVERING ✓/'^ DOVER ICG `/,[• //(/�{!!/(J USE OF BUILDING AND WORK TO BE PERFORMED • 507 fillra �6‘ - J O D -_ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION . AND STATE THAT THE ABOVE IS CORRECT AND AGREE''•• COM- THE AMOUNT SHO N UNDER VALUATION IS FOR THE PLY WITH ALL CITY O-- CES AND STATE LAWS AT NG PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. - BUILDING CONSTRUCT • . VALUATION SIGNATURE OF 1,40 / PERMIT FEE $ 3 7.---- PERMITTEE .04 /40 $ � O/V Oj 0.� PLAN CHECK $ 76 �j �,/ In AUTHORIZED AGENT .` TOTAL FEE $ C e 14890 FEE RE' :IVSD ' CQSTA MESA BUILDING-SAFETY DEPARTMENT ti � ? - b I —'S 0 1 P. O. BOX 317 COSTA MESA. CALIFORNIA FINANCE DEPT. For Applicant to Fill In Completely APPLIMIC9k cQ & \- TYPE OR PRINT �I BUILDING BUILDING ASf/ 8 net, n V 4 • ADDRESS „./S COSTA MESA. CALIIFFO/R`NNIA/' !Tq /' For Office Use Only PErtRAla OWNER 20.,(44 // /{ /Pe//1( 6.71 y AT - +REC¢IPi NO. j I ,v Naa/.p_. ADDRESS � .7 J (? g/4 E/I/ // / L RECEIVED M I DATE RECEIVED! -12 -4, 1 I 1171-I DATE 1.- f CITY l.- p ! /1 /PIG �2 N tf .'.3iA DRE68G C J�`O—{.7 • ARCHITECT IA/ e! /� TEL. OR ENGINEER 61 {�(�C /\ NO.q/►(r 4t3/d COSTA MESA. CALIFORNIA FIRE ADDRESS (J - ZONE TYPE GROUP CONTRACTOR B, /( e fci . APPRO D 4 G / ABYP DATE ADDRESS 45 b O v!� ZONING � l / �/ ZONE NO.OF USE OP N /' �'G`'� CITY fl}- 04 BY kr•�7 PLANS- I BUILDING « STATE y, r , TEL. LEGAL P 3' an 9 LIC.NO. - NO. DESCRIPTION TXC SIZE 1 / NO. OF SLOGB.� or// it?OF LOT S.6:x ,3 0 a NOW ON LOT A.p,NO. // • USE OF iris LM a4j G EXISTING BLDG, GJ 4 f APPROVED ALLOWED SETBACK LINE FROM ! (CENTER UNE ST.) CENTER OF STREET /' REAR YARD '''� FRONT �LT• FT. IN. i �J / _ SIDE YARDII LEFT A0 _RIGHT �C. R.SIDE a 3 FT. IN. DESCRIPTION OF WORK L.SIDE 3c FT. IN. NEW I II ALTERATION I II ADDITION I ! REAR / Y t FT. ” 2 IN. REPAIR I II MOVING I II DEMOLISH I BYAPPROVED Lf/h DATE 7/ /z/2/ BUILDING /71 V 9;`/I ROOMS ( STORIES i Aee 1 SIZE ( it EXTERIOR WALL •' / ` ROOF �A' n COVERING 4/Q1447 COVERING &M USE OF,BUILDING AND RK TO BE PERFORMED _p lit( 1)17 ES f rs. In tt•-•"fesX s-/7c,13 CALot_ 1-s nom., • I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- THE AMOUNT SHOWN UNDER VALUATIONMIIS FOR ONLY. PLY WITH ALL CITY ORDINANCES/SND ��TT/// ___///4---''^AAB^^I///WWB---B RBOULATINO PURPOSE OF ESTABLISHING A PERMIT PE8 ONLY. BUILDING CONSTRUCTION.rg ,. Jf qfQr VALUATION CO Q GSL SIGNATURE OF ///J —w'{J�4/j✓F///�/// - !�7C7O,- PERMIT FEE $ (} PERM ITTEF 'MZ ` �`• ' B / , o $ .ie V PLAN CHECK $ �P � O� AUTHORIZED AGE A/�.�`/i/� / aa• � TOTAL FEE - 0 — \� 4 CTA MESA BUILDING ETY DEPARTMENT ;127 8/10/61 8,01' P. 0. BOX 1200 Costa Mesa, California • . .ELECTRICAL PERMIT;APPLICATION - TRACT NO. $— PERMIT NO. RECD BY --- '-5L59 fr ELECTRICIAN Ntl'T'i'rk G1 HAM PACLnC co. LOT NO..___ __ DATE ISSUED ADDRESS pp BoX 435 BUILDING USE A. CITY QA►RAEylptEft . TEL. NO.'2LV11112fl ^l •n td LV I 7 — 31 —F/ \1 STATE LICENSE NO. 'aQK7 CLASS. C—IO \ BUILDINGDDRESS ^ 336 EL.r4eh Acta• �`gnjl� CITY LICENSE NO.Oo8S32 ADDRESS NO. ITEM UACH Fill COSTA MESA, CALIFORNIA t Dwelling, Sq. Ft. f NEAREST (1 GI MAC •�� �� CROSS sr. l/ , 1 (11� �Fly�Sy El��S W Garage, Sq. Ft. OWNER OWE' 11 T (4 ri JQ ti /Lev.. I— TTT Q First 20 Outlets, each MAIL !"A e o ADDRESS %$Ooa Spicy) PAgt(¢,CRL-�rce IPwv 1�!' N. J Outlets, Additional CITY 7N AY 11 4 —556 2 CC Zrv1n .> First 20 Fixtures. each I HEREBY' CKNOWLEDGE THAT I HAVE READ THIS APPLI- } CATION ANDySTATE THAT THE ABOVE IS CORRECT AND AGREE —I Fixtures, Additional TOOCOMPLYPWITH ALL CITY ORDINANCES AND STATE LAWS REG- CC ,L ULLATING ELECTRICAL WIRING. W, Dryer LR.NA CERTIFY THAT I POSSESS THE ABOVE VALID STATE OF O 0 . CALIFORNIA CLASSIFICATION OR I AM THE LEGAL OWNER OF A (r Fan THE SINGLE FAMILY RESIDE/ PROPERTY DESCRIBED ABOVE. CC aLY _ -.�'((r PERMITT of �� Z Heater .4 Y' PERMITTEE Ill V Oven, Domestic NO. 1 !M SACH Fill I— VPale, Construction 1il- A-o 0 Sign 6 1 Trans. 2.00 ccRange, Domestic Transformers KW Wil/ CC \ Misc. CC 0 8/ Generators KW O } N Motors (See Schedule) N_ I HP I— - -, HP Sub-Total Fees HP APPROVALS r I INSFECTOR 1 DAT! . Meters, ea. TEMP. POLE I UNDERGROUND CONDUIT I I Permit Fee 3 00 ROUGH I I Sub-Total Fees 5 00 FIXTURES 7 POWER 1 I Total Fees : 00 UTILITY CO. NOTIFIED I g"— FINAL I i / CMF 0313-46,rev.7/75 For items not listed refer to Fee Schedule BLDG. PERMIT NO. AiC 1- / Applicant to fill in all spaces within heavy border lines and.sign all appropriate declarations, C7igr �Vr7 CITY OF COSTA MESA ( c RMI NO. TRACT 11 . i NO. •BLDG.NO. CONSTRUCTION PERMIT ` ' /c,O2, /C3 , - Project Address Y.233& �g.'.L{�te+,i AU? TYPE OF CONSTRUCTION 7719 I/0201 54e 12 IL. Owner...ivK�T w�` �N l� Phone / 0 NEW ❑ ADD. - ❑ AL—TE RATION - Address - - 0 REPAIR 0 CONVERSION ❑DEMO ISH Arch/Eng, - License No. 0 OTHER � ����`` 'S ZONING/REGULATIONS Address DESCRIPTION OF WORK OA T��LC.�Crf.�A"P't 1Y—�0/ -- 11- - ZONE fl Z PLNG. REF.* . Contractor Phone j - . - BUILDI G do sul MNG /.{S riff L;NF �t) SN�rO 4I TYPE OF PERMIT SETBACKS/LST. ROPE YLINE Address 1'� 'W sy $�- - • 0 GRADING 0 FOUNDATION 0 STRUCTURAL LIDS YARD tr`e� LEFT LICENSED CONTRACTOR DECLARATION 0 TENANT 0 ELECTRICAL ❑PLUMBING OMECHANICAL siDE YARD Q� ` ' I hereby affirm that I am licensed under provisions of Charter 9(corn- RIGHT L/ mencing with section 7000) of Division 3 of the' Business and 0 OTHER Professions Code, and my license is in full force and effect. PROJECT DESCRIPTION REAR YARD(TO P/L) RO License Class CI ?y License No.37.?'6-� PKG.SPACE REQ. PROVIDED Date • Signature - SO. FT. - - _ .. WORKERS'COMPENSATION DECLARATION OCCUPANCY CONSTRUCTION TYPE STREET WIDTH PARK FEE$ I hereby affirm that I have a certificate of consent to self-insure or a VALUATION 4 D-0 6 'ZONE A A . - • ZONING APPROVED BYny�/ &/J- DATE/6_2-8 ) certificate of Workers' Compensation Insurance, or a certified copy SPECIAL CONDITIONS: r+-��'S?l�� / thereof(Section 3_800, Lab. C.). GRADING CU.YDS. - ACRES • Policy No. - Company - _ Certified copyis hereby furnished. - - - REMARKS: - -. . + - ' ertified copy Is filed with the city Building Division. , EXEMPTION FROM WORKERS' COMPENSATION DECLARATION . . • . - - . - - - " - - "• (This section need not be-completed if the permit is for one hundred .- . . . , _ - . . . . - • ($100) or less). - I certify that In the performance of the work for which this permit is. - issued, I shall not employ any person In any manner so as to become PLUMBING - ' . PLAN CHECK ELECTRICAL PLAN CHECK subject to the Workers'Compensation Laws of California, UW tLLING - GARAGE Date Signature BATHTUBS SHOWERS iSO FT. Sia FT . - - NOTICE: If afte/ making this declaration, you should become subject TOILETS ,- , URINALS ' GENERATOR 0-1 KW_1-10 KW to the Workers' Compensation provisions of the Labor Code,you must - - .TRANSFORMER - forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS APPLIANCE 10-50 KW_50+KW revoked- - ... . . - CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS MOTORS 0.1 HP 1-10 HP • • I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS • SUMPS (INC.SOLAR) 10-50 HP 50 +HP formance of the work for which this permit is issued (Section 3097 - - Civ. C.). FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES Lender's Name - - Lender'sAddress DRINKING FOUNTAINS • GAS TUBE SIGNS OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS 'POLE LIGHTS - I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031,5 Business and Professions Code: SWIMMING POOL P TRAP LUNO I NUL I IUN Any city or county which requires a permit to construct, alter, POLES METERED SUB - Improve, demolish or repair any structure, prior to its Issuance,also re- WATER SERVICE ALTERATION PANELS -MAIN - ' SUB . - quires the applicant for such permit to file a signed statement that he Is licensed pursuant to the provisions of the Contractor's License law GAS SERVICE OUTLETS SERVICE • . - AMP (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code)-or that he is exempt therefrom and the WATER HEATERS BTU OUTPUT ' - • - ' basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS . - of not more than five hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS - sole Compensation, will-do the work,and the structure is not intended or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE ' Contractor's License Law does not apply to an owner of a property APPLICATION APPROVED BY DATE who builds or improves thereon, and who does such work himself or ISSUE FEE through his own employees, provided-that such improvements are not Intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK UMMARV OF FEES • is sold within one year of completion, the owner will have the burden of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU - BUILDINGERMIT $ n SMTP $ • 00 licensed cowner of the ontractors co tractors to construct the projec, am t(Section 7044,Business ss with AND DUCTING 100,000+BTU - PLAN CHECK S 4%4 /a PERMIT and Professions Cade: The Contractor's License Law does not apply to - ISSUANCE $ an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ ' tracts from such projects with 'a contractor(s) licesned pursuant to SYSTEM - GRADING $ the Contractor's License Law). 100,000 +BTU PLAN CHECK S ❑ 1 am exempt under Section B.& P.C.for this ELECTRICAL S S ' BOILERS BTU reason PLAN CHECK $ MICROFILM $ ' SYSTEM REPAIR,ALTERATION Date Owner - MECHANICAL 5 TOTAL FEE$ I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE LESS AD- • information is correct. I agree to comply with all city and county - PLAN CHECK $ VANCE PC $_ ordinancesand state laws relating to construction,and hereby authorize ' - representatives of this city to enter upon the above mentionedtip property icseT2 for/! s54Xtion p4�d-- ISSUE FEE L- - - - CMF 0865-46 White-Building; Canary-Applicant;Pink-Accounting;Goldenrod-Assessor CONSTRUCTION AND PLANNING ' ' • POOL&SPA Date Inspector - Date Inspector. It APPROVALS �r`„t , I Permi•IIt# APPROVALS Permit# - 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location . 2. Soil Pipe-Undrgrn • 44. Steel Reinforcement - • 3. Electrical Conduit Utility-Undrgrn • 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel Reinforce 47. Rough Plumbing & Pressure Test 6. Electrical LIFER Grn - .. 48. APPROVAL TO COVER-GUNITE - - r 7. Footings 49. Electrical Conduit-Undrgrn 8. Foundation 50. Gas Pipe, ❑Undrgrn,Test 9. Water Pipe-Undrgrn 51. Backwash Lines. P-Trap. ❑Undrgrn - ' 10. Structural Floor System • 52. APPROVAL TO DECK 11: Property Sewer Line & House Connection 1),,c. 11--6.-8j 53. Backwash & Receptor-Final 12. Street Sewer Connection 54. Heater & Vent-Final 13. Rough Plumbing - 55 Plumbing System -Final - - - 14. Rough Electric-Conduit - •56. Electrical-Final - 15. Rough Electric-Wiring - 57. Solar System-Final 16. Rough Heating & Air Conditioning 58. Fencing & Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING ' 18. Ducts, Ventilating • - 19. Gas Pipe,Rough &Test • _ 60. POOL/SPA SYSTEMS FINAL • 20. Roof Framing - _ . . - • • ' 21. Roof Sheathing • ' 22. Frame and Flashing NOTES: 23. Insulation _ 24. Lathing &Siding _ 25. Drywall Nailing ' . 26. Plaster Brown Coat . 27. Electrical Power Meter-Final - • 28. Final Electric 29. Final Heating & Air Conditioning ' 30. Final Gas Pipe-Test . 31. Final Plumbing 32. Water Service-Final 33. Gas Service-Final 34. Solar Domestic-Final 35. Landscape Sprinkling System . 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed _ 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY ' No Date • Applicant to fill 17 all spaces within heavy border lines and sign all appropriate declarations. . 3269 B/I P/f)j \` • CITY OFcOSTA MESA PERMIT NO. TRACT NO. LOT NO. BLD J(IIIe(/) -� • CQI TRUCTION PERMIT $ Fj 2 • I /,375 / •. Project Address 03a" E L ' L TYF OF CONSTRUCTION T ' ,Owner O L2/Cf}"itin�'�/ 1.�T��,O. PhoneS96- 3(T/7 NEW 0 ADD 0 ALTERATION _, Address an, (,�Q/C� - 0 REPAIR 0 CONVERSION ED DEMOLISH. •1 yAich/Eng. r, lZnw License No. C OTHER - •� 1ir ZO,NING R�E,G/ULATIONS — DESCRIPTION OF WORK • A'•P-t <•�. 7� A.Lk-�a•Y Address (go^� ��psi.r 3_ �jy �, ZONE R y PLNG. REF.* 2g -Jr/ -5 ` Contractor Q/7Z '� Phongs'�i.X 7C TYPE OF PERMIT BUILD NG ,.y_ 7'O,BI�I,LDIf•IG• Address W SETBACK C/L ST. 02� `s!/ Reda k7'2JQJE ❑GRADING s FOUNDATION �'FTRUCTU RAL SIDE YARD SI - LICENSED CONTRACTOR DECLARATION - C TENANT C ELECTRICAL CPLUMBING CMECHANICAI. 9IiiDpET YARD / I hereby affirm that I-am licensed under provisions of Charter 9(corn- - _�,]-\ RIGHT 7 Ill mencing with section 7000) of Division 3 of the Business and C OTHER / ) /v'��`�/ Professions Code, and my license is In full force and effect. - REAR YARD(TO P/L) 6 PROJECT DESCRIPTION -. , e- License Class License No. //i// } --.' \ti \:, PKG.SPACE REO. r� PROVIDED' CJS Date Signature . T•r N. �{,+ c 'ORKERS'COMPENSATION DECLARATION . ''OCCUPANCY CONSTRUCTION TYPE- Ws�� STREET WIDTH Jq(� ' PARK FEE $�$/r(�� ereby affirm that I have a certificate of consent to self-Insure or a VALUATION ' al .ZONING APPROVED /� D rtiflcate of Workers' Compensation Insurance, or a certified copy 1 /�^ I � j thereof(Section 3800, Lab.C.). _ GRADING CU.YDS. ACRES SPECIAL CONDITION Policy No. - Company - . ❑ Certified copy Is hereby furnished. - REMARKS: - I �9� FOR SPECIAL R:. • • C Certified copy is tiled with the city Building Division. Qulg�MtN 5 EXEMPTION FROM WORKERS' COMPENSATION DECLARATION • rig' Thy' - - �e h ,: c. , • • (This section need not be completed If the permit Is Tor one hundred �" / /- ($100) or less). P• /4A�c— �1(5.5� cert((fy 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 PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK/� �1a subject to the Workers'Compensation-Laws of California. BATHTUBS 7_ SHOWERS? / '�_ -- U .L INb/I 4 Ca FTUE Zet J <[/ ,5� Date • SignatureFT NOTICE: If after making this declaration, you should become subject TOILETS 31 ' URINALS / L+ GENERATOR 0-1 KW_1-30 KW to the Workers' Compensation provisions of the Labor Code,you must ` TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES / DOUBLE LAYS y 7 APPLIANCE 10-50 KW 50+ KW revoked. CONSTRUCTION LENDING AGENCY KIT.SINKS / DISHWASHE_RS_ l �•, 'MOTORS 0.1 HP 1-10 HP . I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS - SUMPS =,;� •L. • \'. (INC.SOLAR) 10-50 HP 50 + HP • formance of-the work.for.which-this permit is issued (Section 3097 • - Civ. CJ: gu 4, T9 A ��(P� z Lender'd Name °•'e•-r!!•��'�A^'✓a t^r C..•.`�.w•- .r -- -1 FLOOR SINKS-r. �� FLOOR DRAINS_. , i FIXTURES OUTLETS SWITCHES . ,. r _Lenders Addre iZtdQ� Xtt venw s 970"1 DRINKING FOUNTAINS c- GAS TUBE SIGNS \•-I .\ OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS c -. S t POLE LIGHTS I hereby affirm that I am exempt from.the Contractor's License Law for < . . the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP - LUNb I NUL I ION Any city or county which requires a permit-to construct, alter, POLES METERED SUB I^prove demolish or repair any structure, prior to its issuance,also re- WATER SERVICE ALTERATION 2 — PANELS MAIN SUB rp,.xes the applicant for such permit to file a signed statement that he ensed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS - SERVICE AMP :?apter 9 (commencing with Section 7000) of Division 3 of the - -'.�"� Business and Professions Code) or that he Is exempt therefrom and the WATER HEATERS/ BTU OUTPUT' ' 2 basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS 2_ i of not more than five hundred dollars ($500). - / - L. caw ,(1 C I, as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS - ��'�l"Q �` ` / �Ys/1G� • sole compensation, will do the work, and the structure is not intended - - - ((IEEE /7�� or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. I SUE FE 3 �- who builds License Law does not apply wh to an such a prims if ty APPLICATION APPROVED BY DATE g_,/�8/ who builds or ploy es,thereon, and adoes mph work himself or ISSUE FEE through his own employees, provided that such improvements are not - - intended or offered for sale. If, however, the building or Improvement MECHANICAL PLAN CHECK . SUMMARY OF FEES is sold within one year of completion, the owner will have the burden _ of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU/ BUILDINGPERMIs t)� 0 I, as owner of the property, am exclusively contracting with E 3 3 — SMIP S licensed contractors to construct the project (Section 7044, Business AND DUCTING - - 100,000 + BTU PLAN CHECK E PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE E an tracts fromr- such p projects with who builds a contractovr(s)s t hlicesonetl pursuant and who con- to 5y 1�ION 0-100,000 BTU PLV MBING $ y�' GRADING E the Contractor's License Law). _ p�l� •toick100.000+BTU - A PLAN CHECK $ C I am exempt under Section B.& P.C.for this 1` C�^gTU — _ 3r' . $ alfffey 6) /-{ ELECTRICAL $ S1 reason tiff' f T J Q PLAN CHECK $ MICROFILM E /� L(� Date i//'/V Ow e /_ ` . SYSTEM REPA R,ALTERATION - (� TOTAL FEE E ggO'✓-/ I M1erecertify - MECHANICAL $ .0- y that I have rea• h .a•• .tion and ate t at the above EXHAUST SYST M MULTIPLE LESS AD • - information is correct. I agree to comply with all city and county PLAN CHECK E VANCE PC $ ordinances and state laws relating to construction,and hereby authorize- el- r� y — . representatives •f this cityto e ter cup the above/ane boned / Dropert• for pectin • rpy4ey. - ISSUE FEE 3 r '—CM`0865-46 White-Building; Canary-Applicant; Pink-Accounting;Goldenrod-Assessor CONSTRUCTION AND PLANNIN QQ _ SPOOL& SPA .. }" I APPROVALS Permit# 5"j' Date Inspector APPROVALS` Permit# Date Tnspec' ' ' _ a 1. Temporary Electrical Service or Pole43. Pool & Equipment Location " - - - • ' 2. Soil Pipe•Undrgrn f.7•?St /71744. Steel Reinforcement - - • 3. Electrical Conduit Utility-Undrgrn 45. Forms - • • - - • 4. Electrical Conduit-Undrgrn 46. Electrical Bonding .. - ' c, 5. Steel Reinforce }- 47. Rough Plumbing& Pressure Test 6. Electrical UFER Grn .- 48. • APPROVAL TO COVER-GUNITE 7. Footings 2- /g: S/ re,"-- 49. Electrical Conduit-Undrqrn 8. Foundation . - 50. Gas Pipe, ❑Undrqrn,Test 9. ' Water Pipe-Undrgrn , 4:71.21-$/ t . 51. Backwash Lines. P-Trap. ❑-Undrgrn - 10. Structural Floor System , g.1.41 gj -. - 52. APPROVAL TO DECK • 11. Property Sewer Line & House Connection • 53. Backwash & Receptor-Final 12. Street Sewer Connection 54. Heater & Vent-Final . . ' 13. Rough Plumbing V•Z✓' //.-g!') 55. Plumbing System • Final -- . - - 14. Rough Electric-Coriduit "' - 56. Electrical-Final 15. Rough Electric-Wiring -- /0-23 %j co • - 57. Solar System-Final - _ • 16. . Rough Heating & Air Conditioning e..o j 1✓}721 - 58.., Fencing&Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating - 19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL 20. Roof Framing - . 21: Roof Sheathing /p/(k' ,•4E . • _ • 22. Frame and Flashing • '• //4,g NOTES: • 23: Insulation // 2�R/ • C erf-r t_c÷ •�_ -P , �t,,,�.k • 24. Lathing & Siding • • . . . ��_ 25. Drywall Nailing / -2 .sI( p 26. Plaster Brown Coat , 41--.22/47 ()J ( e e 27. Electrical Power Meter-Final 28. Final Electric 7/z4 t 29. Final Heating &Air Conditioning 3 ��z 30. 1 Final Gas Pipe-Test . • 7/Jo/(z. j 31. Final Plumbing , . . 3/1-d/1" 7,174` 32. Water ServiceFinal - •33. Gas Service-Final - 34. Solar Domestic-Final • ' 35. Landscape Sprinkling System - - • • 36. Sound Attenuation 37. Handicap Regulations - • 38. FINAL STRUCTURE & BUI LDING 7,2.-YDS 39. Special Requirements Completed -• _ , 40. Electric Release to EdisonT/jy,S7 1 - - • 41. Gas Release to Southern California Gas Co. 'f /jy/R1 i-0 - 42. CERTIFICATE OF OCCUPANCY / - • - i.. No Date - . - - • _ 1 • • Applicant to fill in all spaces within heavy border lines andsign all appropriate declarations. 58.35 9/17/81 F1e1 11 ' CITY OF4ASTA MESA PERMIT NO. TRACT NO, LOT NO. •BLDG 0. • • CISI\'STRUCTiON PERMIT L IOD 3 • C • ,Project Address 2-,34 b' oeiv a TYPE OF CONSTRUCTION Owner /)9 G� W Phone 0 NEW ❑ ADD 0 ALTERATION ( .n Q • Addr Kso ! _ ❑ REPAIR 0 CONVERSION ❑DEMOLISH 1'(J �O'B r ( ����P� r�� 0 OTHER -- ZONING REGULATIONS ' Arch4Eng. License No. Address DESCRIPTION OF WORK A.P, _ ZONE PLNG.REF.' P.ContractOr.�(/e„.'�c$1t�e .,d �f Phone TYPE OF PERMIT- BUILDING. �'��t�i L.DIf�G L/ f! C� SU�I.r O!L- /4� SETBACK C/L$T. R'iV INE • _ Address L ❑ GRADING 0 FOUNDATION ❑ STRUCTURAL . SITE YARD LICENSED CONTRACTOR DECLARATION e7 (J 0 TENANT .ELECTRICAL ['PLUMBING ❑MECHANICAU VEDA.QM YARD I hereby affirm that I am licensed under provisions of Charter 9(tom- - RIGHT mencing with section 7000) of Division 3 of the Business and ❑ OTHER Professions Code, and my license Is In full force and effect. ' REAR YARD(TO P/L) PROJECT DESCRIPTION License Class C --/0 License No ' 7-,.-3 , PKG.SPACE REQ. PROVIDED Date Signeture/jC•s" ESQ-FT' • STREET WIDTH PARK FEE§ i WORKERS'COMPENSATION DECLARATION OCCUPANCY_CONSTRUCTION TYPE - S 'ray,affirm that I have a certificate of consent to self-Insure or'a ZONING APPROVE- BY DATE 'A ;Beate of Workers' Compensation Insurance, or a certified copy VALUATION ZONE scot(Section 3800,Lab.C.). . _ . _ GRADING,CU.YDS. ACRES SPECIAL CONOITIONS: Policy No. Company - p ❑Cerf if led'<o Py IS hereby furnished. REMARKS: .-J��a—zA d2_ - - - ❑Certified copy is filed with the city Building Division. - - • EXEMPTION FROM WORKERS' COMPENSATION DECLARATION _ r '. (This section-need not be completed if'the•permlt is for one hundred - _ - - . - - - - ($3001 or less). - • Certify that In the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become PLUMBING ' ' PLAN CHECK , -ELECTRICAL PLAN CHECK • subject to the Workers Compensation Laws of California. - _. - - - - • .UW tLLIN(� 6/MAULBATHTUBS SHOWERS Date Signature ' GO.FT S2 FT , NOTICE: If after making this declaration, you should become subject TOILETS URINALS GENERATOR 0-1 KW_1-10 KW - ' ' to the Workers' Compensation provisions of the Labor Code,you must - TRANSFORMER - - forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS APPLIANCE 10-50 KW 50+ KW ' revoked. ' - KIT.SINKS DISHWASHERS MOTORS 0. CONSTRUCTION LENDING AGENCY 1 HP 1-10 HP • I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS (INC.SOLAR) 10-50 HP 50 + HP formance of the work for which this permit is issued (Section 3097 ' Civ. C.). FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES • Lender's Name - Lender'sAddress DRINKING FOUNTAINS GAS TUBE SIGNS , • • OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS ,\ l POLE LIGHTS I hereby affirm that I am exempt from.the Contractor's License Law for the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP I LUNS I NUI.I!UN Any city or county which requires a permit to_ construct, -alter, _ POLES METERED •SUB • _ improve, demolish or repair any structure, prior to its Issuance,also re- WATER SERVICE ALTERATION • PANELS MAIN ,SUB ' O•"as the applicant for such.permit to file a signed statement that he - _ nsetl pursuant to the provisions of the Contractor's License Law GAS SERVICEOUTLET$ _ • 7 ( • ; SERVICE ( AMP S ter 9 (commencing with Section 7000) of Division 3 ofthe `> - I' L .,ess and Professions Code) or that he Is exempt therefrom and the WATER HEATERS BTU OUTPUT Ar basis for the-alleged exemption. Any violation of Section 7031.5 by _ , any applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS of not more than five hundred dollars ($500). . - ❑ I, as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS sole compensation,will do the work, and the structure is not Intended • or offered for sale. (Section 7044. Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE Se' l_ I Contractor's License Law does not apply to an owner of a property APPLICATION APPROVED BY DATE who builds or Improves thereon, and who does such work himself or through his own employees, provided that such Improvements are not Intended or offered for sale. If, however, the building or Improvement ISSUE FEE MECHANICAL PLAN CHECK is sold within one year of completion,the owner will have the burden SUMMARY OF FEES of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100.000 BTU BUILDING PERMIT § SMIP - E ❑ 1, as owner of the property, am exclusively contracting with AND DUCTING licensed contractors to construct the project (Section 7044, Business 100,000+BTU PLAN CHECK $ PERMIT IL} and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ an owner of property who builds or improves thereon,and who con- REFRIGERATION 0-100.000 BTU PLV MBING $ tracts from such projects with a contractor(s) licesnetl pursuant tocry SYSTEM GRADING' $ ❑el am exempt underlSec Ion B.& P.C.for this BOILERS 100,000.f.BTU BTU PLAN CHECK § - 9 - , _ ELECTRICAL $ e- - - r reason - - - PLAN CHECK E _ r'MICROFILM E- • .SYSTEM REPAIR.ALTERATION Date - Owner TOTAL FEE'$' VI I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE r ..\.__ i• MECHANICAL $ Hi information is correct. I agree to comply with all cit and county PLAN CHECK $ LESS AO- ordinances and state laws relating to construction,and hereby authorize VANCE PC $ representatives of this City to enter upon the above mentioned ' property forns t on urposes. • Signature (/ Date S---/7P,/ _ FINAL FEE.$l —` Drivers'License or SS ISSUE FEE r-..v once we ..,,.,.-,e...na,-._..-an.-,,_nen,..anr. pin L-Gre•nunM1nn.rnl,inn.nA-Decode-.� CONSTRUCTION AND PLANNING . POOL&SPA APPROVALS Permit# eri 603 Date Inspector w ` APPROVALS Permit# Date I InspeStorli 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Soil Pipe-Undrgrn - - 44. Steel Reinforcement - 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46, Electrical Bonding 5. Steel Reinforce 47. Rough Plumbing & Pressure Test • 6. Electrical VEER Grn 48. APPROVAL TO COVER=GUNITE - 7. Footings 49. Electrical Conduit-Undrgrn 8. Foundation 50. Gas Pipe, ❑Undrgrn,Test 9. Water Pipe-Undrgrn 51. Backwash Lines. P-Trap.-❑Undrgrn 10. Structural Floor System 52. APPROVAL TO DECK • 11. Property Sewer Line& House Connection 53. Backwash& Receptor-Final ' 12. Street Sewer Connection 54. Heater & Vent-Final 13. Rough Plumbing 55. Plumbina System - Final 14. Rough Electric-Conduit - •56: • Electrical-Final 15. Rough Electric-Wiring Jo .1-s( Q-e 57. Solar System-Final 16. Rough Heating &Air Conditioning 68. Fencing &Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING I 18. Ducts, Ventilating 19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL 20. Roof Framing 21. Roof Sheathing 22. Frame and Flashing NOTES: • 23. Insulation - 24. Lathin & Siding 25. Drywall Nailing 26. Plaster Brown Coat • 27. Electrical Power Meter-Final _ 28. Final Electric - •3 •19..52 C < , • ' 29. Final Heating & Air Conditioning 30. Final Gas Pipe-Test 31. Final Plumbing . • 32. Water Service-Final 33. Gas Service-Final 34. Solar Domestic-Final 35. Landscape Sprinkling System - 36. Sound Attenuation • 37. Handicap Regulations -- . . 38. FI NAL STRUCTURE & BUILDING • 39. Special Requirements Completed - - 40. Electric Release to Edison J /tWBY J (- 41. Gas Release to Southern California Gas'Co. i/7y/pk '-0 - ' 42. CERTIFICATE OF OCCUPANCY - No Date Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. • CITY OF COSTA MESA PE MIT NO. - TRACT NO. i LOT NO. ' .BLD).NO. - - -- CONSTRUCTION PERMIT —/S03f� Project Address a 33l E.1 in TAE TYPEYPOF CONSTRUCTION r - • ' 7395 10/223/8 1 i 1 3.00 TL( _ Owner OLl? IGH/Mir-i At Zhooe . NEW 0 ADD 0 ALTERATION Address /COQ i 5 (7 / „c,.1 t' i 4 Q. ❑ REPAIR ❑ CONVERSION- ❑DEMOLISH ArchlEng. / - License No. • 0 OTHER ZONING REGULATIONS • Address DESCRIPTION OF WORKS ,s,, 7�}-7/4_ /5— A.P.$ Contractor - 6 U/ Matz Phone TVP/OF PERMIT g-/7- t$19-774 -BUILDING To gt/I INC SETBACK C/LST. PROPERTY LINE Address - • 0 GRADING 0 FOUNDATION 0 STRUCTURAL SIDE YARD - - LICENSED CONTRACTOR DECLARATION ' 0 TENANT.0 ELECTRICAL ❑PLUMBING ECHANICAI/ LSIIDEE YARD I hereby affirm that I am licensed under provisions of Charter 9(tom- RIGHT mencing with section 7000) of Division 3 of the Business and 0 OTHER Professions Code and my 'cense Is In full force and effect REAR YARD(TO P/L) - PROJECT DESCRIPTION. License Class - - en-- o �_ PKG.SPACE REQ. • PROVIDED Date 1,^.-Y 7 S I g n a t u r e -.V../. -4.. SQ.FT. - • STREET WIDTH PARK FEE$ WORKERS'COMPENSATION DECLARATION _OCCUPANCY_CONSTRUCTION TYPE - - ''ereby affirm that I have a certificate of consent to self-Insure or a VALUATION • ZONE ZONING APPROVED BY • -DATE , - ilficate of-Workers' Compensation Insurance, or-a certified copy . . - - • ereof(Section 3800, Lab.C.). GRADING CU.YDS. ACRES SPECIAL CONDITIONS: Policy No. - - Company - - - - - • -- - - ❑ Certified copy Is hereby furnished. .-_ - REMARKS:' - +g� _ _ _ - - , • 0 Certified copy is filed with the city Building Division. J EXEMPTION-FROM'WORKERS' COMPENSATION DECLARATION - - '• ' • - - -- • (This section need not.be completed if the permit is for one hundred :. - ' r: $100) or les). certify that in the performance of the wo for which this permit is issued, I shall not employ any person in y ne o as to ome " PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK ' ' subject to the Work¢r5Compensation 5 of • UWELLI N(. - .GAHAOG - Date �B-a;3 ted'/s Signature e BATHTUBS SHOWERS SD FT SO FT NOTICE: If after making this declaration, ou sho d become-�subject TOILETS URINALS - GENERATOR ' 04 KW_1-10 KW - to the Workers' Compensation provisions o the Labor Code,you must TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS- - - - ' APPLIANCE 10-50 KW_50+ KW- • - - revoked.. _ • ' CONSTRUCTION LENDING AGENCY 'KIT.SINKS' -" ' DISHWASHERS ' ' - - MOTORS - • 0-1 HP'_1-10 HP • r . I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS SUMPS ,(INC .SOLAR) 10-50 HP 50+ HP - formance of the work for which this permit is Issued (Section 3097 - Civ. C:). - FLOOR SINKS FLOOR DRAINS - FIXTURES OUTLETS— SWITCHES - ' Lender's Name - . Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS - OWNER BUILDER-DECLARATION - INTERCEPTORS CLARIFIERS POLE LIGHTS' - • - I hereby affirm that I am exempt from the Contractor's License Law for • the following reason (Section-7031.5 Business and Professions Code:- - SWIMMING POOL P-TRAP- -- - _ t_UNS I HULNUN ' Any city or county which requires a permit to construct, alter, 'POLES METERED SUB Improve,demolish or repair any structure, prior to Its issuance,also re- WATERSERVICEALTERATION PANELS - MAIN SUB ?r'!:x s the applicant for such permit to file a signed statement that he ;i^- nsetl pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS - SERVICE AMP ' ?:?k ter 9 (commencing with Section 7000) of Division 3 of the iz'::iiyhess and Professions Code) or that he is exempt therefrom and the WATER HEATERS BTU'OUTPUT bails for the alleged exemption. Any violation of Section 7031.5 by - - - • any applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS - of not more than five hundred dollars ($500). - ❑ I, as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS - - - • solo compensation,will do the work,and the structure is not intended _ ISSUE FEE or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. Contractor's License Law does not apply to an owner of a property - - APPLICATION APPROVED BY DATE who builds or Improves thereon, and who does such work himself or ISSUE FEE through his own employees, provided that such improvements are not Intended or offered for sale. If, however, the building or Improvement MECHANICAL PLAN CHECK - SUMMARY OF FEES is sold within one year of completion, the owner will have the burden BUILDING Of proving he did not build or Improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU / PERMIT $ SMIP Si ❑ I, as owner of the property, am exclusively contracting with AND DUCTING licensed contractors to construct the project (Section 7044, Business 100,000+ BTU PLAN CHECK $ PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ an owner of property who builds or improves thereon,and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts from such -projects with a contractor(s) •Iltesned pursuant to SYSTEM • • GRADING $ the Contractor's License Law). 100,000+BTU PLAN CHECK $- - - -al am exempt under Section B.& P.C.for this BOILERS BTU ELECTRICAL $ • $ reason - • PLAN CHECK $ s MICROFILM E - - Date Owner SYSTEM REPAIR,ALTERATION MECHANICAL $ /^_ TOTAL FEE E I.hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE e+ PLAN CHECKVP aciis at • I agreeito comply with all city and th ri county I C r jG $ VANCE PC $_ representatives ordinances and state • s r' :ting to construction,and hereby authorize d /� / /` represents roves •f is y enter the above menliornea/ /yam/� - �-}� Signatuty re for L..ect � - - ISSUE FEE 3 - - CMF 0865-46 White-Building;Canary-Applicant;Plnk-Accounting;Goldenrod-Assessor b _ CONSTRUCTION AND PLANNING - • - POOL&SPA Ann •PPROVALS 1«\esOIPeimitC# A-13.03Date Inspector V Date Inspector APPROVALS Permit# - 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Soil Pipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn • 45. Forms • 4. Electrical Conduit-Undrgrn 46. Electrical Bonding • 5, Steel Reinforce 47. Rough Plumbing & Pressure Test - 6. Electrical UFER Grn _ 48. APPROVAL TO COVER-GUNITE 7. Footings - . 49. Electrical Conduit-Undrgrn 8. Foundation 50. Gas Pipe, ❑Undrgrn,Test , • 9. Water Pipe-Undrgrn 51. Backwash Lines, P-Trap, ❑ Undrgrn - - 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection - 53. Backwash & Receptor-Final 12. Street Sewer Connection 54. Heater & Vent-Final 13. .Rough Plumbing , 55. Plumbing SvstPm - Final 14. Rough Electric-Conduit - -56. Electrical-Final 15. Rough Electric-Wiring - 57. Solar System-Final 16. Rough Heating & Air Conditioning - - P-0 ( (_ g-B I ba. Fencing & Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating • 19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL • 20. Roof Framing 21. Roof Sheathing 22. Frame and Flashing NOTES: ' 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat • 27. Electrical Power Meter-Final 28. Final Electric 29. Final Heating & Air Conditioning ria 30. Final Gas Pipe-Test 31. Final Plumbing 32. Water Service-Final 33. Gas Service-Final 34. Solar Domestic-Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FI NAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. • 42. CERTIFICATEOFOCCUPANCY - No Date Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA P MIT NO. /� TRACT NO. LOT NO. 'BLDfi.NO. - ' CONSTRUCTION PERMIT rj/� 7436 10/26/81 74 TU . , Project Address t �G%.- ` TYPE OF CONSTRUCTION . • Owneeffil_ t/y,`s�'`'' ' Phone7BVJns p 0 NEW 0 ADD ❑ ALTERATION , - • _.. Addres s 7j�_][� at': 1•Utt ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ZONING REGULATIONS Arch/Eng / ' License'No. - ❑ OTHER Address ... - DESCRIPTION OF WORK ^ A'P"ye ZONE PLNG. REF. Contractor 5 - • Phone TYPE OF PERMIT - BUILDING TTo]?gLIJtILLppING SETBACK C/LST. Pf3(7PE17TV LINE Address - ❑ GRADING ❑ FOUNDATION 0 STRUCTURAL L DFE VARD . LICENSED CONTRACTOR DECLARATION ❑ TENANT 0 ELECTRICAL ❑PLUMBINGECHANICAL SIDE YARD I hereby affirm that I am licensed under provisions of Charter 9(corn- RIGHT ' Inencing with section'7000) of Division 3-of the- Business and 0 OTHER - -. -" REAR YARD(TO P/L) Professions Code, and my license Is in full force and effect., PROJECT DESCRIPTION. _ _ License Class License No. t• Sq.FT. • - PKG.SPACE REQ. PROVIDED ' Date Signature • - •- STREET WIDTH PARK FEE S. '•'ORKERS'COMPENSATION DECLARATION OCCUPANCY—CONSTRUCTION TYPE / DATE ereby affirm that I have a certificate of consent to self-insure ora VALUATION - ZONE tificate of Workers' Compensation Insurance,-or a certified copyZONING APPROVED BY' - - . _ .. ,nereoi (Section 3800,Lab. C.). SPECIAL CONDITIONS: ,, .s - GRADING CU.YDS. ACRES Policy No. Company. ._ - - . . . ' - - - - . - _ _ ❑ Certified copy is hereby furnished. - - REMARKS: . /t _ .Si 0_ - . • ❑ Certified copy is filed with the city Building Division. JC l• . EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - • - • - •- - ((This section need not be completed if the permit is for one hundred _ _ ($100) or less). • - - . `�1`• _ - --- issued, that n the performance of the work for which this permit is _ _ _ issued, I shall not employ any person in any manner so as to.become PLUMBING.' PLAN CHECK ' 'ELECTRICAL PLAN CHECK - subject to the Workers Compensation Laws of-California. UWELLINI, - (.AHAUh Date Signature - BATHTUBS SHOWERS • SG FT SQ FT NOTICE: If after making this declaration, you should become subject -TOILETS . URINALS- - GENERATOR 0-1 KW_1-10 KW • to the Workers' Compensation provisions of the Labor Code,you must TRANSFORMER - forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS - APPLIANCE 10-50 KW 50-4- KW revoked.. — . - - _ _ - ' CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS • .MOTORS ' - 0-1 HP_1-10 Hf? ' I hereby affirm that there Is a construction lendi agency for the per- SERVICE SINKS • SUMPS • (INC.SOLAR) 10-50-HP50+HP - - - formance of t ork f•r w a chi mkt Is sued (Section 3097 • Civ. C X )'s Name -,/ �! / FLOOR SINKS FLOOR DRAINS • FIXTURES OUTLETS SWITCHES LenLender's Address OO firA i f/f DRINKING FOUNTAINS • GAS TUBE SIGNS • OWNER BUILDER DECLARATION - . INTERCEPTORS CLARIFIERS POLE LIGHTS - - I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP- _ CONS KUL I ION - Any city or county which requires a permit to construct, alter, POLES METERED SUB tove,demolish or repair any structure, prior to Its issuance,-also're-' WATER SERVICE ALTERATION PANELS -MAIN - SUB s the applicant for such permit to file a signed statement that he tt.t 4 nsed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS SERVICE - - - ' AMP - - a.8Wipter 9 (commencing with Section 7000) of Division 3 of the Ba'tlness and Professions Code) or that he is exempt therefrom and the WATER HEATERS 'BTU OUTPUTS\ S - - " basis for the alleged exemption. Any-violation of Section 7031.5 by - - - _ any applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS - -of not more than five hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS ' • sole compensation, will do the work, and the structure is not intended or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE ' • Contractor's License Law does not apply to an owner or property - APPLICATION APPROVED BY DATE who builds or Improves thereon, and who does such work himself or ISSUE FEE through his own employees, provided.that such improvements are not intended or offered for sale. If, however,the building or improvement ,MECHANICAL PLAN CHECK SUMMARY OF.FEES is sold within one year of completion, the owner will have the burden 'o- f.s roving he did not build or improve for the purpose of sale). BUILDING n,�" s,I HEATING SYSTEM 0-100,000 BTU PERMIT $ SMIP $ 7' as owner of the property, am exclusively contracting with AND DUCTING cenietl contractors to construct the project (Section 7044,not Business 100,000+ BTU PLAN CHECK $ PERMIT and Professions Code: The Contractor's License Law does not apply to • ISSUANCE $ an owner of property who builds or improves thereon, and who ton- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts from such projects with a contractor(s) Iicesnetl pursuant to SYSTEM GRADING $ the Contractor's License Law). 100.000+BTU PLAN CHECK $ ❑ I am exempt under Section B.& P.C.for this •BTU ELECTRICAL $ $ reason PLAN CHECK $ MICROFILM $ Date Owner SYSTEM REPAIR,ALTERATION -- _ TOTAL FEE$ I herebycertifythat I have read this application and state that the.above EXHAUST SYSTEM MULTIPLE MECHANICAL $ PP LESS AD- Information is corre t. I agree to comply with all city and county , 5-42_...t..., A r 1 y PLAN CHECK $ VANCE PC $_ represe ordinances and st .•• aws :Janne to t construction.and hereby authorize � �[�(•y . as-' vas t / to enter upon the above ent ned /9 (/J/)�/[{Ln.J/•bfe!'� . pro pert wt. as�.e�--•- •urposes. Xl, Signet c r/A * ISSUE FEE '8 / -- ^e`d 115 White-Bulltling; Canary-Applicant; Pink-Accounting;Goldenrod-Assessor _ 1 J1 :,poi CONSTRUCTION,AND;PLANNING POOL&SPAM • . . APPROVALS Permit# /K /5)4 Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - 2. Soil Pipe-Undrgrn - _ 44. Steel Reinforcement - 3. Electrical Conduit Utility-Undrgrn 45. Forms - . • 4. Electrical Conduit-Undrgrn 46. Electrical Bonding ' - • 5. Steel Reinforce 47. Rough Plumbing & Pressure Test . 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE - - 7. Footings - 49. Electrical Conduit-Undrqrn 8. Foundation . . • - - 50. Gas Pipe, ElUndrgrn,Test 9. Water Pipe-Undrgrn 1 51. Backwash Lines. P-Trap. ❑ Undrgrn 10. Structural Floor System 52. APPROVAL TO DECK" 11. Property Sewer Line & House'Connection 53. Backwash& Receptor-Final 12. Street Sewer Connection 54. Heater &Vent-Final 13. Rough Plumbing 55. Plumbing System -Final ' 14. Rough Electric-Conduit - ' -56. Electrical-Final . 15. Rough Electric-Wiring - - 57. Solar System-Final 0 16. Rough Heating &Air Conditioning ,q , f' 5B. Fencing &Access Approval 17. Ducts, in Structure - . ��__'YY ' 59. APPROVED FOR PLASTERING .. 18. Ducts, Ventilating - - . 19. Gas Pipe-Rough &Test • 60. POOL/SPA SYSTEMS FINAL 20. - Roof Framing ' 21. Roof Sheathing . 22. Frame and Flashing NOTES: • 23. Insulation - 24. Lathing & Siding - . - 25. Drywall Nailing . 26. Plaster Brown Coat 27. Electrical Power Meter-Final - 28. Final Electric - - _ 29. Final Heating & Air Conditioning ?(j o z. � ri- � _ - - 30. Final Gas Pipe-Test 31. Final Plumbing _ 32. Water Service-Final -33. Gas Service-Final 34. Solar Domestic-Final • 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING - 39. Special Requirements Completed 40. Electric Release to Edison - 41. Gas Release to Southern California Gas Co. _ 42. CERTIFICATE OF OCCUPANCY No Date y . t. (� CITY OE COSH.MESA 4' '' BUILDING DIVISION ' • > __ __fetDEVELOPMENT SERVICES DEPARTMENT PE IT NUMBER 4 4 PERMIT + ,tct B01-01225 brio(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 2336 ELDEN AV Status: ISSUED Suite: A Applied: 08/07/2001 Vicinity: A Issued: 08/07/2001 Parcel Number: 43926401 Zoning: / Applicant: KIM,ROBERT ISSUED BY: l_/`-^ Address: 1835 WHITTIER AVE - - . ' - UNIT F12 .-i . •Phone: (949)645-3917 - COSTA MESA,CA - - Zip: 92627 _ i , i Owner BURSHTYN;LEA ' N Address 2336 ELDEN AVE#A - - - - �A ;COSTA MESA CA Zip: 92627 Contractor: 21ST CENTURY ROOFING Address: 1835- WHITTIER/AVE ;N UNIT F12 , Phone:..(949)645-3917 � - COSTA MESA,CA - - . Zip: ,' 92627 - 'License:- 750385 - ` .. • Arch : - - - Eng 1 • Address: - - - :, Address:; Phone: - - ..::,\, : N. Phone: . . Zip: License: ` ' 'License: ' SCOPE OF PERMIT TEAR OFF INTALL 1/2"CDX:AND LITE WEIGHT TILE'5.5 PSF ICBO#4660.CAPISTRANO TILE. UINITS A,B,C D. FEE SUMMARY Plan Check: $0.00Calc Valuation: 85,800.00 Permit -, $125.25 777..---:,lir- ' _- - -`- - ,, Claim Valuation: . s5;600.0o SMIP Res: . $0.58 ' / .' 'SMIP Corn: $0.00 Other: $0.00 Inspection: '$0.00 Total: $125.83 1:„..:±.._ <__ - . .-. _ PLANNING &ZONING , SETBACKS-J—, ' MAIN STRUCTURE Front 0-0 : - -Rear -0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0' ' " Rear. 0-0 - • Left 0-0 . Right -' 0-0 ' PARKING Existing: 0 Requited: '0 Proposed: 0 NOTES: - NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1,12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(WOO) DECLARATIONS WORKERS'COMPENSATION DECLARATION: ' I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the �/work for which this permit is issued. E4 I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Is issued. �My workers'compensation Insurance carrier and policy number are: .Cartier: j'fcrf a ?"rUna Policy Number: (This sect on need not be completed if the permit is valued at one hundred dollars($100)or less.) O I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these Ion AppliceritSigna .ture: '" DateOqq /- rb i v 10.4 -WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm.thatl.am.icensed under provisions of Chapter 9(commencing with Section 7000)of Dirvision 3 of.the Business and Prgqfassions Code,and my license is in full -force and,effectrticrr 75Th 3BS' �Classx C3`) Fit 4.' r— / �Contra ss Signature: s Date: 2 /1 to CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,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 perrra. subjects the applicant to a civil penalty of not more than five hundred dollars($500).): O 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.). O 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,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Wilt 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 11 en RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑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 apermit for such construction or modification from the South Coast Alr Quality Management District or from any other air pollution control district or agency? L)Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits), 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes 0 No 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. Si ere 01 Legal Owner(s) to And/Or-Authorized,Applicant" ,/ Date CODE pISPECIION TYPF DATE INTBIAL5 CODE( INSPECTION TYPE PATE INTTIIALs 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final � NN 20 Final Plumbing 200 Final Re-Roof (Ca- 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 Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. • F TA MESA PERMIT NO. TRACT NO. LOT NO. •BLD 0. C/ ,RUCTION PERMIT Cr S7 d / /.375— / /� / r ject redress a S 3� e �N A TVP F CONSTRUCTION • 1 I ) . ner 1.1.. 21C .”079 �Q/t_ P h o n -zp71 NEW ❑ ADD ❑ ALTERATION (l,(-/(-/`V - •. dress ant !`.l1er)CA- Privy—. 0 REPAIR 0 CONVERSION ❑DEMOLISH 0 OTHER . , •. ZONING REGULATIONS h/Eny. Fr QQ - License N0. /T� DESCRIPTION OF WORK A.P'dress I,TOOe2 ..ScVGA,eJZ .'2Y1/VC, �"���t '".��v 1. —..2'•4- . ZONE n-� T1s PLNTG.. • gRUEF`.pyp 7¢ -7/%70 Contractor s^-%/TC Phones•�6�7C TYPE OF PERMIT_,.... SETBACK CIL ST. .,7s-'/ PROPEIRTv uNE 20/ Address / ❑GRADING R' FOUNDATION TRVCTVRAL SIDE YARD 'O/ - - - i LICENSED CONTRACTOR DECLARATION • -0 TENANT 0 ELECTRICAL PLUMBING ❑MECHANICAL LEFT YARD /I hereby mencIng affirm with s section 7000)m ied of under sionov3sl of of the r 9 c and Business0 OHER • d\ Zi'<' t Z' ••t RIGHT r• • Professions Code, and my license is in full force and effect. - REAR YARD(TO P/L) / PROJECT DESCRIPTION • License Class Ucense No. v • (]y�• /� • - • PKG.SPACE REQ. r PROVIDED SQ.FT. 1174. A .r-r•490, - �r ..;s:, 't 2ll� .a-1, Date Signature _ 0 \ �` ,� - i i r WORKERS'COMPENSATION DECLARATION• OCCUPANCV9--t_CO.NSSTp UCTION TVPE �,�.i�• STREET WIDTH (co ARK FEE$ �� r57 I `areby affirm that have aCompensation certificate Of consent to self-insure or a VALUATION 9& ZONE ZONING APPROVED BYrj)�� DA /i•s / Icate of Workers' Compensation Insurance, or a certified copy `__ ( 'V Y(X L� •j' of(Section 3800, Lab.C.). . GRADING:CU. YDS. ACRES ,SPECIAL CONDITIONS. - Puncy No. • - Company ' - - - - - - ❑ Certified copy Is hereby furnished. -- REMARKS: - /..— FN - GOLD FOR SPECIAL REQUIREMTc ❑ Certified copy is filed with the city Building Division. . EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (� ° . pAr b �V G_ - (This section need not be completed if.the-permit is for one hundred - / _ • , ($100) or less). P.C• �i y X37 nit., O - 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 - PLUMBING PLAN CHECK ' 7 Z. -- ELECTRICAL - PLAN CHECK subject to the Workers'Compensation Laws of California. - _ _ _ __ /��i - n Date Signature BATHTUBS 7� $HOWERSZ SO.FT iNu /flee, SO FT E ty/ • 27 66 NOTICE: If after making this declaration, you should become subject TOILETS 3, URINALS - - - - rf .. GENERATOR 0-1 KW_1-10'KW. - to the Workers' Compensation provisions of the Labor Code,you must • TRANSFORMER - ' forthwith comply with such provisions or this permit shall be deemed LAVATORIES / DOUBLE LAVS-Z, 7.., APPLIANCE 10-50 KW 50 + KW . • - revoked. . - CONSTRUCTION LENDING AGENCY KIT.SINKS / - DISHWASHERS,/ , •A e„ . MOTORS 0.1 HP 1-10 HP ' I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS • (INC.SOLAR) 10-50 HP 50+ HP - - - formance of the work for which this permit is issued (Section 3097 'T_ y \ _ . . Civ. C.). S St' ,V) z% C •- •FLOOR SINKS FLOOR DRAINS ' - I,; .� , '\ FIXTURES OUTLETS SWITCHES Lender's Name A. w�� Lender's Address2-900 - "'- - /14623e X, �OH/!vq'/x-27 DRINKING FOUNTAINS - y , •• - s 'GAS TUBE SIGNS OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS, POLE LIGHTS - - - ' I hereby affirm that I am exempt from.the Contractor's License Law for - r . • . the following reason (Section' 7031.5 Business and Professions Code: ' SWIMMING POOL 'PTRAP LUNo1KULI lury - Any city or county which requires a permit to construct, alter, - - t POLES METERED SUB . improve, demolish or repair any structure, prior to its Issuance,also re- WATER SERVICE / ALTERATION 2_ .r PANELS - ' MAIN -' SUB quires the applicant for such permit to file a signed statement that he - V --.ensed pursuant to the provisions of the Contractor's License Law GAS SERVICE / OUTLETS)\, ,$,-,:', ,SERV ICE - AMP - iter 9 (commencing with Section 7000) of Division 3 of thei :ess and Professions Code) or that he is exempt therefrom and the WATER HEATERS/ . BTU OUTPUT..., '2. ... Fe (I) - I 17.....s'17..17.....s'.. , for the alleged exemption. Any violation of Section 7031.5 by . • any applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS/ ' • ' ' y ".� (� '•p of not more than five hundred dollars ($500). -" - 2•— e)vua_ I lets/ ai (.7 Vet e.4- '� ^ ❑ I, as owner of the property, or my employees with wages as their SOLAR TANK - COLLECTORS-, 7 / ' sole compensation, will do the work,and the structure is not Intended - — or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE ' Contractor's LicenseLaw doesnot apply to an owner of a property .--• APPLICATION APPROVED BY DATE -r�•.�/ who buildsor Improves roves therereoo n, and who does such work himself or ISSUE FEE through his own employees, provided that such improvements are not Intended or offered for sale. If, however, the building or Improvement MECHANICAL PLAN CHECK is sold within one-year of completion, the owner will have the burden SUMMARY OF FEES f�p roving he did not build or Improve for the purpose of sale). BUILDING HEATING SYSTEM 0-100,000 BTU 1 o / as owner -of the property; am exclusively contracting with _ PERMIT $ .Z2 /.'! SMIP. $ y` ` ticen,ed contractors to construct the project (Section 7044, Business AND DUCTING 100,000 + BTU / -- PLAN CHECK $ PERMIT Li and Professions Code: The Contractor's cense Law does not apply to / ISSUANCE $ - an owner of property who builds or Improves thereon, and who con- PerITI 'ON 0-100,000•BTU PLUMBING $ y7• r tracts from such projects with a contractor(s) licesned pursuant to 5 ML �� s - GRADING.. $ - the Contractor's License Law). T R' 1100,,000+BTU_ - [eI •••••'' PLAN CHECK $ r • O I am exempt under Section B.& P.C.for this $ Q ELECTRICAL $ 37+ reason BOsI„GRfi Qws'J�flTV (4) IOr-• • 'MIC • ROFILM $ S - SYSTEM REPAI R,ALTERIIATION PLAN CHECK $ /'• Date Own Own. _ _ ,'- _ TOTAL FEE$3�J IS 7 �� MECHANICAL $ y�'� r.here y ce :fy that I have read . is .•.• on and s .e that the above EXHAUST SYSTEM MULTIPLE LESS AD- • Information is correct. I agre- to o •ly with all city and county' - ^ 'PLAN CHECK $ • VANCE PC $_ - rdinancesantl state laws relating Pan and hereby authorize aKC 7f- / Iii-,+/it a 1/) li - representatives�•f this ch o enh .on the above me coned 7 ��-///tt� _ 7 • proPerlY •' iP'j •n •u •ores. tee ` niter tor �CC•S p/��1NV�/ • �l , FINAL FEE $ 5-�r�/ Slgnatur -�._.- . � ISSUE FEE -' 3 - - -. CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting:Goldenrod-Assessor . CONSTRUCTION AND PLANNI G POOL'&SPA • - �(J ,.APPROVALS Permit# -5 70 Date Inspector - Date I4tSp APPROVALS Permit.# 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - _2. Soil Pipe-Undrgrn •• p,/5-JI ffd 44. Steel Reinforcement • - 3. Electrical Conduit Utility-Undrgrn- _ 45. Forms - - 4.. Electrical-Conduit-Undrgrn - . . _ 46. Electrical Bonding , ' .. . . . • 5. Steel Reinforce - . - 47; Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings - 9./g, g/ ...At ,,,_,4 49. Electrical Conduit-Undrgrn 8. Foundation ` .- a. 50. Gas Pipe, ❑ Undrgrn,Test _ 9. Water-Pipe-Undrgrn - - - f-,21-h ' • 51. •Backwash Lines, P-Trap. ❑ Undrern 10. Structural Floor System ifgt2-4-2/ 1 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection I .53. Backwash & Receptor-Final 12. Street Sewer Connection 54. Heater & Vent-Final 13. Rough Plumbing . - - „ r d t'Ss67 55 Plumbing System - Final 14. Rough Electric-Conduit - i . . •56. Electrical-Final 15. Rough Electric-Wiring ' J0.2, . • 0,e0 57. Solar System-Final 16. Rough Heating & Air Conditioning •l;,,o f 1--1 - . b8•. Fencing-8e Access Approval . 17. Ducts, in Structure . 59. APPROVED FOR PLASTERING 18. • Ducts, Ventilating - ' 19. Gas Pipe-Rough &Test •• 60. POOL/SPA SYSTEMS FINAL 20. Roof Framing • . _ 21. Roof Sheathing - /p //_Z/ ,,413' 22. Frame and Flashing ,, /6 .8/ NOTES: 23. Insulation - 1/ ZS.!I - - 24. Lathing & Siding /5 / .a - - 25. Drywall Nailing 2. `,Cf/ . . 26. Plaster Brown Coat 1,0-079-61 /; Y/lr r 27. Electrical Power Meter-Final `' . 28. Final Electric . 3\-1,-152.. CC- 29. Final Heating & Air Conditioning a• is ..tier P /ft-30. - Final Gas Pipe-Test ' . /f . 31. Final Plumbing V fPt MO 32. Water Service,-Final 33. Gas Service-Final _ 34. Solar Domestic-Final 35: Landscape Sprinkling Sysiem 36. Sound Attenuation 37. Handicap Regulations" 38. FINAL STRUCTURE & BUILDING 0j/42- LLL 39. Special Requirements Completed •. . 40. Electric Release to Edison _ 41. Gas Release to Southern California Gas Co. left Vi . 42. CERTIFICATE OF OCCUPANCY r No Date , • SCI*4 y,� ' Applicant to fill in all spaces within heavy border lines and.sign all appropriate declarations. �F STA MESA PERMIT NO. TRACT NO. -LOT NO. •BL G.NO. - ' •• • CONSTRUCTION PERMIT r_- 999 �� ' Project Address�-33 6 £/ger, Iii- - TYPE OF CONSTRUCTION ( 5231 •LJ'/ %/'"-' Eels' ., Owner Q� R IC.H Phone 0 NEW 0 ADD 0 ALTERATION -/[3 - • Address "a(t '21 � _ - 0 REPAIR 0 CONVERSION ❑DEMOLISH ZONING REGULATIONS Arch/Eng: License NO. b OTHER • A.P.*$ Address - DESCRIPTION OF WORK ZONE PLNG. REF.4a Contractorrr;t j4e4S "ELEC._Phone 7C4c;sRi4 TYPE OF PERMIT BUILDING Tp gl���plryG $ TBAC}C C/LST PROPERTY LINE r'/ Address 2-171 2_ .5 vflcee O.c.. La} 0 GRADING -0 FOUNDATION 0 STRUCTURAL - S YARD LICENSED CONTRACTOR DECLARATION 0 TENANT IS ELECTRICAL ['PLUMBING ['MECHANICAL 5 p ARD I hereby affirm that I am licensed under provisions of Charter 9(Com" RIG T _I mencing with section 7000) of Division• 3 of the Business and DaOTHER Professions Code, and my license is In full force and effect. PROJECT DESCRIPTION REAR YARD(TO P/L) \ License Class G y h License No. '3033 95 _ PKG.SPACE REQ. PROVIDED • f Date Signature ��� �s C. - SQ" FT. - RAl - STREET WIDTH PARK FEE$ \` WORKERS'COMPENSATION DECLARATION - OCCUPANCY—CONSTRUCTION TYPE -.. . 'ereby affirm that I have a certificate of consent to self•Insure Or a VALUATION ZONE ZONING APPROVED BV DATE Ificate of Workers' Compensation Insurance, or a certified copy ;eof(Section 3800;Lab.C.). _ GRADING CU._ YDS. • ACRES SPECIAL CONDITIONS: Policy NO. -- - Company - r ❑ Certified Copy is hereby furnished. - REMARKS: -. -` - - - - . ❑ Certified copy is filed with the city Building Division. p . 8 EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - . 6- 4r 7 - , -' - (This section need not be completed If.the permit is for one hundred - - + -_. - _ S$100) or leu). •- Certify that.ln theperformance of the work for which this permit Is • _ _ _ Issued I shall not employ any person in any manner so as to become PLUMBING, - PLAN CHECK ELECTRICAL • •- PLAN CHECK " subject to the Workers Compensation.Laws of California. : - - UWbLLING GARAGE Date Signature BATHTUBS SHOWERS SO FT. CO FT - NOTICE: If after making this declaration, you should become'subjectTOILETS;i. URINALS '" " - ' -GENERATOR 0-1 KW=1-10'KW ' to the Workers' Compensation provisions of the Labor Code,you must` �. ,_ .TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS - APPLIANCE '10.50 KW-50+KW revoked. - _ .. 'CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS MOTORS • '0-1 HP • 1.10 HP 'I hereby affirm that there Is a construction lending agency for the per SERVICE SINKS ' SUMPS -' i ' ' (INC.SOLAR) - 10.50 HP 50+HP - . formance of the work for which this permit Is issued (Section 3097 - Clv. CJ! -' -- FLOOR SINKS FLOOR DRAINS FIXTURES - ' OUTLETS SWITCHES " " Lender's Name _ _ Lender's Address DRINKING FOUNTAINS •- GASTUBE SIGNS ` OWNER BUILDER DECLARATION - - -"" POLE LIGHTS - - ' " . I hereby affirm that I am exempt from.the Contractor's License Law for INTERCEPTORS CLARIFIERS the following reason(Section 7031.5 Business and Professions Code: SWIMMING POOL-- P TRAP -- - - ' LUINSI KUL I IUPI _ - - . Any city or county which requires a permit to construct, alter, POLES METERED •SUB Improve,demolish or repair any structure, prior to its Issuance,also re- WATER SERVICE ALTERATION ,, ., .i PANELS .- MAIN SUB . . r ouires the applicant for such permit to file a signed statement that he - — 'Icensetl pursuant to-the provisions of the Contractor's License Law GAS SERV ICE_ - _ OUTLETS• • ;SERVICE ' l AMP ' 's spter 9 (commencing with Section 7000) of Division 3 of the iness and Professions Code) or that he is exempt therefrom and the WATER HEATERS BTU OUTPUT - - - ' - 1..5i5 for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS + - - of not more than five hundred dollars ($500). - ❑ I, as owner of the property, or my employees with wages as their SOLAR TANK-- - COLLECTORS ' • - ' sole compensation,will do the work,and the structure is not intended _ or offered for sale. (Section 7044, Business and Professions Code:The SOLAR PIPING SYS. ISSUE FEE -- -- .3' Contractor's License Law does not apply to an owner of a property _ _ - - - APPLICATION APPROVED BY . DATE who builds or improves thereon, and who does such work himself or ISSUE FEE • • through his own employees, provided that such.Improvements are not - _ Intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK SUMMARY OF FEES is sold within-one year of completion,the owner will have the burden of proving he did not build or improve for the purpose of sale). ' BUILDING - - - HEATING SYSTEM 0-100,000 BTU PERMIT $ - SMIP.. $' • W ❑ I, as owner of the property, am exclusively contracting with AND DUCTING- . " ' ' licensed contractors to construct the project (Section 7044, Business 100,000 +BTU PLAN CHECK $ , PERMIT . and Professions Code: The Contractor's-License Law does not apply to -ISSUANCE $ an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts'from such projects with a contractor(s) licesned pursuant to. SYSTEM - GRADING $ ..) the Contractor's License Law). ' 100,000+BTU , PLAN CHECK $ �> �( ❑ I em exempt under Settlors B.6 P.C.for this BOILERS BTU ELECTRICAL $ d $ reason -- ,PLAN CHECK $ MICROFILM $ ' - y Date-'_ Owner - - SYSTEM REPAIR,ALTERATION . TOTAL FEE$ I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $ PLAN CHECK ' $ LESSANEP a ordinaes information is tateela I agree to comply with all cityand county - 'VANCE PC S. ' • - repiesenta i and state laws relating touponconstruction,and hereby authorize . representatives of this city to enter upon the above mentioned _ propertyfor/Insy///aOOOtttIIIon urposes. �_ 7 • FINAL FEE $ Slgnatu' Lit ns �— - /� `465-46 White"Bulltling;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor CONSTRUCTION AND PLANNING q -" POOL&SPA � APPROVALS Permit# E `.77 Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole , - 43. Pool & Equipment Location -- 2. Soil Pipe-Undrgrn 44. Steel Reinforcement • . 3. Electrical Conduit Utility-Undrgrn _ 45. Forms . . 4. Electrical Conduit-Undrgrn - 46. Electrical Bonding - - 5. Steel Reinforce, _ - 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE ` - ' 7. Footings - 49. Electrical Conduit-Undrgrn - 8. Foundation . . 50. Gas Pipe, ❑Undrgrn,Test 9. . Water Pipe-Undrgrn- 51. Backwash Lines, P-Trap. ❑Undrgrn - - . - - ' - - 10. Structural Floor System 520 APPROVAL TO DECK - _ . ' - - . 11. Property Sewer Line & House Connection - - .. _ 53. Backwash & Receptor-Final - . .. 12. .Street Sewer Connection ., _ _••_ - _• •_ • _. . -_ . _ _ _ .54.. Heater & Vent-Final 13. Rough Plumbing _ - - - - 55: Plumbing System -Final -- -- - - ' 14. Rough Electric-Conduit / - - -- - - - -_ -56. - Electrical-Final , 15. Rough Electric-Wiring - - /0.03-St- --- P-_ C - - 57. Solar System-Final , , ,'; 16. Rough Heating & Air Conditioning: - ._ - _ _ . 58. Fencing & Access Approval . 17. Ducts, in Structure - . . - 59. APPROVED FOR PLASTERING . _ " . , • 18. Ducts, Ventilating . . . . _. - _ •_ 19. Gas Pipe-Rough &Test . __ - . _ '60. , POOL/SPA SYSTEMS FINAL �� • '• 20. Roof Framing . __ . • 21. Roof Sheathing . - _ - - ' 22. Frame and Flashing - NOTES: 23. Insulation - - ' . . " _ - • . 24. Lathing & Siding . - 25. Drywall Nailing - . 26. Plaster Brown Coat . . . . .' 27. Electrical Power Meter„-Final - �`�_Iq_ha C. &. . 28. Final Electric 29. Final Heating & Air Conditioning ' 30. Final Gas Pipe-Test 31. Final Plumbing . . 32: Water Service-Final • 33. Gas Service-Final 34. Solar Domestic-Final • . 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING ' 39. Special Requirements Completed �,' 40. Electric Release to Edison (��p.��- . 41. Gas Release to Southern California Gas Co. / - ' 42. CERTIFICATE OF OCCUPANCY • No Date Applicant to fill in all spaces within heavy border lines and sign all appropriate _—_ ~ • t ' ' / D 9 declarations. W. " ../STA MESA PERMIT NO. - TRACT NO. LOT NO. ' •BLDG.NO. - ' �175TRUCTION PERMIT' 7'g —/ I� I,� Project Address 0.,334 CLOD/ sr TYPE OF CONSTRUCTION 7399 0/23/81 ! 13.00 T�' Owner a g,Gh /LPBoa�e f 6L — Oeth„Phone KNEW ❑ ADD ❑ ALTERATION -• ---- .. ._ - , , .... Address / OO I -5Ky p,9,e,� e,ct - /❑ REPAIR ❑ CONVERSION ❑DEMOLISH ZONING REGULATIONS r Arch/Eng. - — s - License No. - ❑OTHER C/ -s _ _ DESCRIPTION OF WORK 1ICA•T/N sS +SjJTt'-1 . A.P.AP Cont Addractor' 'Phone if 6).-17— _Dtic-77;s. )'r 4 2 n.. ZONE PLNG. REF. Ow n%�L.' A,,,t.0 v. TYPE OF PERMIT i . BUILDING T'p gUlt pINC Address - • - • SETBACK C/L ST. PROPERTY LINE ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL YARD LICENSED CONTRACTOR DECLARATION 0 TENANT ❑ ELECTRICAL OPLUMBING MECHANICAL BIDE YARD - I hereby affirm that I am licensed under provisions of Charter 9(com- RIGHT mencIng with section 7000) of Division 3 of the Business and ❑•OTHER - -- Professions Code and my license Is in full force and effect. REAR YARD(TO P/L) PROJECT DESCRIPTION _ License Class if/ llc se IK: PKG.SPACE REQ. PROVIDED. • Date 10—..)3`D/ Signature f- /' v'`y'''`�'� ��• - SQ.FT. . WORKERS'COMPENSATION DECLARATION - ! - OCCUPANCY—CONSTRUCTION TYPE STREET WIDTH PARK FEE$ _ - reby affirm that I have a certificate of consent to self-Insure or a ' VALUATION ZONE ZONING APPROVED BY , DATE licate of Workers' Compensation' insurance,-or a certified copy - . aof (Section 3800, Lab.C.). • _ _ - GRADING CU.YDS. ACRES SPECIAL CONDITIONS: ,z " Policy No. Company - - - - ❑Certified copy is hereby furnished. • REMARKS: • - - - . - ' ❑ Certified copy is filed with the city Building Division. , EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - - - • -_ - - (This section need not be completed•if the permit is for one hundred - - •- S$100) or less). , 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 PLUMBING PLAN CHECK .ELECTRICAL PLAN CHECK subject to the Workers'-Compensation ws of II ornia. uwtcu rvc.- - GARAbE Date /o- T7 I BATHTUBS SHOWERS . O Signature SQ FT G A NOTICE: If after making this declaration, you should becomes bject TOILETS • , URINALS GENERATOR 0-1 KW_1-10 KW ' to the Workers' Compensation provisions of the Labor Code,you must - - - - -- TRANSFORMER S forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVi - APPLIANCE 10:50 KW 50+ KW' revoked. - -. -- _ CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS MOTORS - 0-1 HP 1-10 HP • ; ' I hereby affirm,that there is a construction lending agency for the per- :SERVICE SINKS ' . SUMPS '(INC.SOLAR) • 10-50 HP 50 +HP formance of the work for which this permit is Issued (Section 3097 - - - Civ. C.). FLOOR SINKS ' FLOOR DRAINS - FIXTURES ' OUTLETS SWITCHES • ' Lender's Name • - Lender's Address DRINKING FOUNTAINS �• M.-v- _—• GAS TUBE SIGNS -- ' OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS POLE LIGHTS - I hereby affirm that 1 am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP - - • LUNSI KUL I Any city or county which requires a permit to construct, alter, POLES METERED SUB improve,demolish or repair any structure, prior to its Issuance,also re- WATER SERVICE ALTERATION PANELS MAIN SUB -'•fres the applicant for such permit to file a signed statement that he • i • 'tensed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS SERVICE ' • AMP i. spter 9 (commencing with Section 7000) of Division 3 of the - -siness and Professions Code) or that he Is exempt therefrom and the WATER HEATERS BTU OUTPUT ' - - basis for the alleged exemption. Any violation of Section 7031.5 by _ - any applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS of not more than five hundred dollars ($500). . ❑ I, as owner of the property,or my employees with wages as their SOLAR TANK COLLECTORS . sole compensation, will do the work, and the structure is not intended or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. , ISSUE FEE " - Contractor's'License Law does not apply to an owner of a property who builds or Improves thereon, and who does such work himself or ISSUE FEE APPLICATION APPROVED BY DATE through his own employees, provided that such improvements are not intended or offered for sale. It, however, the building or improvement MECHANICAL PLAN CHECK SUMMARY OF FEES Is sold within one year of completion,the owner will have the burden of proving he did not build or Improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU 'J BUILDING ^� PERMIT ❑ I, as owner of the property, am exclusively'contracting with AND DUCTING b SMTP $ licensed contractors to construct the project (Section 7044, Business 100,000+BTU PLAN CHECK $ PERMIT and Professions Code: The Contractor's License Law does not apply to - - - ISSUANCE S- an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts from such projects with a contractor(s) Iicesned pursuant to SYSTEM - GRADING $ the Contractor's License Law). 100,000+BTU PLAN CHECK $ ❑ 1 am exempt under Section B.8 P.C.for this BOILERS BTU ELECTRICAL $ $ • reason - MICROFILM $ SYSTEM REPAIR,ALTERATION PLAN CHECK $ Date - Owner TOTAL FEE$ 1 hereby certify that I have read this application and state that the above EXH UST SYSTEM MULTIPLE MECHANICAL $ Information is correct. I agree to comply with all city and county '�e� 4L PLAN CHECK $ LESS AD- ordinances and state laws relating to construction,and hereby authorize /TpyK- 1 Q� F/4At VANCE PC $- a f Ives f this city to enter n the above mentioned �1 ��� I — .s property for specti rp y�r�dT� II— FINAL FEE $�/a�= ' Signature. • Date/0 J f/ ISSUE FEE • Drivers'License or - - • ' CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor - - ✓1 . CONSTRUCTION AND PLANNING ,\,\ _ SPOOL&SPA t APPROVALS •rye• Permit# �-It/g9 Date Inspector APPROVALS • Permit#T _ _ Date Inspector---... \` 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location ' �• ' 2. Soil Pipe-Undrgrn ' 44. Steel Reinforcement - - 3. Electrical Conduit Utility-Undrgrn . . • 45. Forms 4. Electrical Conduit-Undrgrn - - • 46. Electrical Bonding 5. Steel Reinforce 47. Rough Plumbing & Pressure Test- • - . - - 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE - 7. Footings - 49. Electrical Conduit-Undrgrn• . 8. Foundation - - • 50. Gas Pipe, ❑Undrqrn,Test 9. Water Pipe-Undrgrn _ - - _ _ 51. Backwash Lines, P-Trap, D Undrgrn __ 10. Structural Floor System 52. APPROVAL TO DECK ' • • -- - - 11. Property Sewer Line & House Connection • 53. Backwash & Receptor-Final ' - . 12. Street Sewer Connection - - _ . 54. Heater &Vent-Final . 13. Rough Plumbing - 55.- Plumbing System -Final - - 14. Rough Electric-Conduit ) ..-.56. Electrical-Final . 15. Rough Electric-Wiring - '57.. Solar System-Final . • 16. Rough Heating &Air Conditioning - Ita.. f[4Al b8. Fencing&Access Approval - 17. Ducts, in Structure 59. APPROVED FOR PLASTERING - 18. Ducts, Ventilating . . . • . _ - __,J., i . . 19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL • 20. Roof Framing 21. Roof Sheathing - //� i � 22. Frame and Flashing - NOTES: l 1M40v„jFti.. 04;. &we U4# - vast- 44cI- crlo vrcn, . 23. Insulation 4 .4Itp.4C.4. sn *44C, PO n-'3..-fl - 24. Lathing & Siding . 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter-Final 28. Final Electric 29. Final Heating & Air Conditioning 1;14a 16, 8 a 30. Final Gas Pipe-Test 31: Final Plumbing 32. Water Service-Final 33. Gas Service-Final 34. Solar Domestic-Final 35. Landscape Sprinkling System \- \ 36. Sound Attenuation 37. Handicap Regulations 38. FI NAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. • • 42. CERTIFICATE OF OCCUPANCY \ No Date �: •. ._ , Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. T AN CITY OF COSTA MESA PE MIT NO. TRACT NO. LOT NO. BLDGA.NO. CONSTRUCTION PERMIT Is/7 T Project Address -7L I (rant4...._ TYPE OF CONSTRUCTION - 7432 10/26/8 7,00 IL' OWneeor/E/E✓✓�'iG`/f_ J'• 4Y1' Ph0neltr5O 0 NEW 0 ADD 0 ALTERATION •• •• -•• Address/ roZ s4pv-./c GA 0 REPAIR 0 CONVERSION ❑DEMOLISH • Arch/Eng.�Q( / License No. 0 OTHER ZONING REGULATIONS Bowe ���� DESCRIPTION OF WORK A.P- Address _ • - ZONE PLNG. REF.vit , Contractor p • Phone TYPE OF PERMIT BUILDING TO Bt1It DING - - SETBACK C/L ST. PROPERTY LINE Address 0-.,_ • ❑ GRADING 0 FOUNDATION 0 STRUCTURAL IDE YARD LICENSED CONTRACTOR DECLARATION 0 TENANT la ELECTRICAL ❑PLUMBING CSMECHANICAL 51EDE YARD - • I hereby affirm that I am licensed under provisions of Charter 9(corn- RIGHT mencing with section 7000) of Division. 3 of the Business and ❑OTHER - REAR YARD(TO P/L) Professions Code, and my license is In full force and effect. pROJECT:DESCRIPTION _ , License Class /�,�/ License No. - PKG.SPACE REQ. - PROVIDED - , Date Signet - • SQ.F7: - - _ - • 1KERS'COMPENSATION DECLARATION OCCUPANCY—CONSTRUCTION TYPE STREET WIDTH PARK'FEES - eby affirm that I have a certificate of consent to self-Insure or a VALUATION ZONE ZONING APPROVED BY f DATE -' thereof(Sectiote of n)3800, Lab.orkers' Compensation Insurance, or a certified copy GRADING CU.YDS. ACRES • SPECIAL CONDITIONS: Policy No. Company - ^- .- . - - - - ' '- ' 0 Certified copy Is hereby furnished. REMARKS: U _ 6-7Y - - ' ❑Certified copy is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION ' '- - • (This section.need not be completed if the permit Is for one hundred - , - t _ - - (3100) or less). . . - - 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 PLUMBING PLAN CHECK - - ELECTRICAL - PLAN CHECK - subject to the Workers Compensation Laws of California. • - UWtLLiNG - -GAKAbt Date Signature — BATHTUBS - SHOWERS SO.FT SO FT _ - NOTICE: If after making this declaration, you should become,subject TOILETS URINALS - - GENERATOR .0:1 KW�1-10 KW " to the Workers' Compensation provisions of the Labor Code,you must - - - - TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE-LAYS -- APPLIANCE 10-50 KW - 50+KW-_ - revoked. . - - - - CONSTRUCTION LENDING AGENCY KIT:SINKS DISHWASHERS - MOTORS- 0-1 HP HP' - , • I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS ' SUMPS - ' ' - (INC.SOLAR) 10-50 HP 50+HP _ - - formance of thorn for w i h th15 pGLmit I5iIssued (Section 3097 - . •• Civ. C.). 6 . FLOOR SINKS - 'FLOOR DRAINS • " FIXTURES " OUTLETS - SWITCHES ' Lender's Name ��)) s�-/ , /q _ Lender's Address 2900 .f /fys,f'Ayt /�GG4i1.7t'tcZc.. - DRINKING FOUNTAINS • - - - 'GAS TUBE SIGNS- - OWNER BUILDER DECLARATIONINTERCEPTORS CLARIFIERS - POLE LIGHTS - - - - - I hereby affirm that 1 am exempt from the Contractor's License Law for • - 1 the following reason '(Section 7031.5 Business and Professions Code: SWIMMING POOL '" P TRAP . ' - - Limas KU4,I IUN Any city or county which requires a permit to construct, alter, _ , POLES METERED SUB- • _ •ove,demolish'or repair any structure, prior to Its Issuance,also re-' WATER SERVICE 'ALTERATION - PANELS MAIN SUB s the applicant for such permit to file a signed statement that he - • ensetl pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS - SERVICE - AMP f pter 9 (commencing with Section 7000) of Olvision 3 of the Business and Professions Code) or that he Is exempt therefrom and the WATER HEATERS'- - BTU OUTPUT- �\ „t. -' basis for the alleged exemption. Any violation of Section 7031.5 by - - _ _ - any applicant for a permit- subjects the applicant to a civil penalty SEWER CONNECTIONS ' -' • - - - - -- . ' Of not more than five hundred dollars (5500)• -' _ ❑ 1, as owner of the property,or my employees with wages as their SOLAR TANK COLLECTORS - Sole compensation, will do the work,and the structure is not intended - - - ISSUE FEE Or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. Contractor's License Law does not apply to an owner of a property - APPLICATION APPROVED BY DATE Who builds or improves thereon, and who does such work himself or ISSUE FEE through his own employees, provided that such Improvements are not _ Intended or offered for sale. If, however, the building or Improvement MECHANICAL PLAN CHECK SUMMARY OF FEES is sold within one year of completion, the owner will have the burden - bl proving he did not build or improve for the purpose of sale). BUILDING - HEATING SYSTEM 0-100,000 BTU PERMIT $ SMIP $ I, as owner of the property, am exclusively contracting with AND DUCTING icensed contractors to construct the project (Section 7044, Business 100,000+BTU PLAN CHECK $ PERMIT and'Professions Code: The Contractor's License Law does not apply to ISSUANCE $ art owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ _ tracts from such projects with a contractor(s) Iicesned pursuant to SYSTEM - GRADING S the Contractor's License Law). 100,000+BTU PLAN CHECK $ ❑ 1 am exempt under Section_ B.& P.C.for thisBOILERS BTU ELECTRICAL $ $ _ reason •' '_- -- - MICROFILM $ SYSTEM REPAIR,ALTERATION PLAN CHECK $ ..y 4Dat Ow - ! 4k - - 7 TOTAL FEE$ MECHANICAL $ ti here y c rti y that I have read �a• at•n and e t . the above XHAUST SYSTEM MULTIPLE ,r� LESS AD- information is correct, I agree to omp with all city and county �.� p / PLAN CHECK- $ VANCE PC $_ ordinances and s to laws relating to con uction,and hereby authorize E f q� /hs.J .Q.0 p1, 4 _ repre •- atives 4, thl o •nt on the above ent"onetl Pgaty f� 5Pe •. P • es. C-,1370 Cf ✓j FINAL FEE $ n Sig a , ISSUE FEEDriverscen I . •.• .-- ISSUE r�� -- ____-_� /F - 1 CONSTRUCTION AND PLANNING POOL&SPA - : _ - .- t&I.S/7 • Date Inspector a Date Inspector !- APPROVALS It\%'s\plPermit.# APPROVALS Permit. • 1. Temporary Electrical Service or Pole, 43. Pool & Equipment Location 2. Soil-Pipe-Undrgrn- 44. Steel Reinforcement - .3.. Electrical Conduit Utility-Undrgrn 45. •Forms 4. - Electrical Conduit-Undrgrn _ 46: Electrical-Bonding - - ' • 5. Steel Reinforce47. Rough Plumbing& Pressure Test 6. Electrical UFER Grn - - 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undrgrn 8. Foundation - - - 50. Gas Pipe, ❑Undrgrn,Test - 9. Water Pipe-Undrgrn - 51.- Backwash Lines, P-Trap. ❑Undrnrn • 10. Structural Floor System • 52; APPROVAL TO DECK - 11. Property Sewer Line & House Connection 53.- Backwash & Receptor-Final ' 12. - Street Sewer Connection - . - - . - 54. Heater &Vent-Final 13. Rough Plumbing _ -55. Plumbing System - Final • - 14. Rough Electric-Conduit - - - • '56.- Electrical-Final 15. Rough Electric-Wiring - - 57. Solar System-Final - . 16. Rough Heating & Air Conditioning /d le/ . 1r b8. Fencing & Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING -18. Ducts, Ventilating - - _ - . 19. Gas Pipe-Rough &Test _ 60. POOL/SPA SYSTEMS FINAL 20: Roof Framing - . 21. Roof Sheathing - NOTES: 22. Frame and Flashing . 23. Insulation x - • ' 24. Lathing & Siding 25. Drywall Nailing ' 26. Plaster Brown Coat ' 27. Electrical Power Meter-Final ' 28. Final Electric 29. Final Heating & Air Conditioning 3/2Z7iY frPg 30. Final Gas Pipe-Test _ 31. Final Plumbing 32. Water Service-Final 33. Gas Service-Final 34. Solar Domestic-Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE &BUILDING 39. Special Requirements Completed 40. Electric Release to Edison ' - - 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY • - No Date - • iv Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA CO STRU TIO PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO. IJ�� M 3 e)1 3� A.P.# Zone Project Address a33� �y� � (l�Ph "/J��,',s /�/"�r.��•/�Oka Li S Main Building: Accessory Building: Applicant's Mailing Address(� ,PSNO DS Ian\ Ave. art TYPE OF CONSTRUCTION NEW U ADD U ALTERATION REPAIR Name �a ur5h h Phone`s - in? 0 CONVERSION 0 DEMOLISH ❑ OTHER T Front —^ O Owner'sddres (-73367 fi n AuE acid, rte .0 ries then Eel I B N Address A _Elden !l' �0. DESCRIPTION OF WORK/USE OF BLDG. K �l A Rear I Arch/Eng. License No. — TYPE OF PERMIT U GRADING ❑ FOUNDATIIOONyyy U STRUCTURAL• I C Right N Address - 0 TENANT 0 ELECTRICAL 0 PLUMBING 'q� MECHANICAL s Left G a e,p 7�.� ❑ OTHER / I Ping. Ref.# Parking Req./Provided E Contractor's Nam• /. lin Q 0 r Or• Phone S ��1y 11 p ry din PROJECT DESCRIPTION SO. FT. OCCUPANCY Q Address lmailinglrr�` �)s �I�UL� . l� Ain nrQ. a Planning Notes: M 1 ' ! CONSTRUCTION TYPE VALUATION$ T City License No. lS !rte ZONE GRADING CU.YDS. ACRES S. LICENSED CONTRACTOR DECLARATION y1�� I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Radcattier 'JJR-I'i„..1O mc. `, (p Q(X) Diu with section 7000) of Division 3 of the Business and Professions Code,and ELECTRICAL FEES my license is in full force a • • feet. (j License la It I I Li.ense No -{ ( '4 MS/ Signature XPJG 1.,-4 PLUMBING I FEES Automatic Washer Transformer 0 15.50 KW AKERS'COMPENSATION DELLA!ATION , Construction Pole Sub. 0 50+ KW I hereby affirm that I have a certificate of consent o self-Insure or a certificate Bar Sink Showers - of Workers' Compensation nsurance, or a certified copy thereof (Section Cooking Unit Meter ❑Up to 100 amps 3800, Lab. C. ^�1 //�1//11 D �'L '�a! Backflow Preventer Service Sink , Policy No. 1 S 9'0 Company Pax. St,00.5' Backflow Irrigation Sewer Cap Dishwasher Meter Dover 100 amps 8 Certifiec copy Is hereby furnished. Dryers ❑Gas ❑Electric Sub Panel Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Date Applicant Fan Motors 00-1 HP 0115-8 EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors _ (This section need not be completed if the permit Is for one hundred($100)or Dishwasher Solar Piping F.A.U. Inc.Solar 09.15 HP 016-15+ less). I certify that In the performance of the work for which this permit Is issued, I - Fixtures shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Microwave Workers' Compensation Laws of California. t---Ne Signature Floor Drains Swimming Pool w/Spa Device Boxes Pole Light ht is,- NOTICE:Compensation making this ions of h,you shouldCode,becomeusubject forthwith te Outlets W\ orpCom s ch pr provisions th the Labor eou et reked. Floor Sinks Urinal Range 1 comply with such LENDING ons or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Switches Sign 1 hereby affirm that there is a construction lending agency for the performance --- of the work for Which this permit Is issued (Section 3097 Civ. C.) Garbage Disposal Standing Sections Interceptors Water Heater Lender's Name - Gene • rator ❑05 KW❑5-15 KW Trash Compactor Lendder's Address Kitchen Sink Water Service • s� OWNER BUILDER DECLARATION r1 - 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 'ounty which requires a permit to construct,alter,Improve,demolish or repair P—Trap Laundry Trays ti' /3/4.W, structure, prior to its issuance, also requires the applicant for such permit p - _ -:file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains 'Contractor's License Law (Chapter 9(commencing with Section 7000) of 'DlVt`cion 3 of the Business and Professions Code) or that he/she is exempt - .Riinspection Fee $15 Issue Fee $ 3 therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). DEVELOPMENT SERVICES REQUIREMENTS: ❑ 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 2gning Approved By Date for sale (Section 7044, Business and professional Code: The Contractor's MECHANICAL FEES -' Building:Approved By License Law does not apply to an owner of a property who builds or improves a - - Date _ / _i thereon, and who does such work himself/herself or through his or her own Application Issued By Date !v1 IIS_ I�'(� 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 cpm- Canopy Type II ❑ -' SUMMARY OF FEES pletion, the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground prove for the purpose of sale). 'BUILDING PERMIT $ SMIP $ ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System • 'PLAN CHECK $ PERMIT I tractors to construct the project (Section 7044,Business and Professions Code: , The tontractor's License Law does not apply to an owner of property who Duct-Ventilating :4.100,000 BTU 0100,000 BTU 9. -' ,PLUMBING $ ISSUANCE $ builds or improves thereon.and who contracts for such oroiects with a con- i tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple 0 System Repair/Alteration I • PLAN CHECK 25% $ ENERGY P.C. $ proof of their Worker's Compensation Insurance should be provided to me. 1.11 ELECTRICAL $ GRADING $ GRAD!N 0 I amSection exempt under B. & P.C.for this reason Firepl/Fact.alt. ICBO dk Fire Dampers LM $ PLAN CHECK 50% $ HeatingSystem& DuctingRegisters ^ ti Date Owner Y r MECHANICAL $ TOTAL FEE $ I hereby certify that I have read this application and state that the above ❑0-100,000 BTU ❑100,000 BTU : PLAN CHECK 25% $ Information Is correct. I agree to comply with all city and county ordinances _ • .and state laws relay : to building construction, and hereby authorize repre- t 'sentatives of this en : CONSTRUCTION AND PLANNIN 1L&SPA ti APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector 41 ,1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. , : 53. Steel Reinforcement 34 Electrical Conduit.Utility-Undrgrnd. t 54. Forms •4: Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5''Steel-Reinforcernent 56. Rough Plumbing & Pressure Test r6-,Electrical UFER.Grfld�- 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 ' • _ JI• 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 r 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-Ba-Ceiliri,t(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 ' I 33. Final Electric Notes:7_.3/.gct L E -Cqizo 6 co 34. Final Heating& Air Conditioning r. 35. Final Gas Pipe-Test 10- i q , Cj fitema- apf ) .G_ peg__ 36. Hood-or Canopy .3000 b c.- C. CD 37. Final Factory Fireplace • 38. Final Plumbing .39. Water Service-Final • 40. Gas Service-Final 41. Solar Domestic-Final 42. Backf low Preventer r•i -1 43. Backflow Irrigation \, I 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 .4- 51. CERTIFICATE OF OCCUPANCY ,'1 No. Date .. -' Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. \ :VI; -il/ :. I • i eCITY OF COSTA MESA y PERMIT NO. TRACT NO. LOT NO. BL• • •. . CONSTRUCTION PERMIT 7 130 I Project Address 2 33 & s-L•, j1/41 TYPE F CONSTRUCTION / Owner eie j p/'rlt � Sj' Phone -t ' U &/ ❑ ADD 0 ALTERATION " . Address nes, ti 1,✓/✓,_OPA- 0p'. ❑ REPAIR 0 CONVERSION ❑DEMOLISH s i e ,-f. ZONING REGULATIONS 0 OTHER ac"� Arch/Eng. F j0 ✓7� . License No. - C'7 �r DESC RIPTION OF WORK _..��'e laMtred Address - '$'5 S/iy/faA•• / mala tr •ZONE / PLNG. REF.qs - -; /�� Contractor Phan, cr--2a r TVPE OF PERMIT 'a ' 77 1 I G O� - ,�� SETBACK C/LST. .lP�1.bNE Address 0 GRADING FOUNDATION L75TRVCTURAL SIDE YARD �•.Y LICENSED CONTRACTOR DECLARATION - 0 TENANT 0 ELECTRICAL PLUMBING OMECHANICA I YARD �./ I hereby affirm that I am licensed under provisions of Charter 9(com• \ T_•:.,.,- ♦.' +•-\ ' RIGHT .2#7/mencing -with section 7000) of Division 3 of the Business and 0 OTHER - --` y Professions Code, and my license is In full force and effect. PROJECT DESCRIPTION REAR YARD(TO P/1-) la, � L(}.2_r/r License Class License No. / //Lli _�`.. •�,` , it .. I . PKG.SPACE REQ. OAkc- PROVIDED 2.N SO.FL n 44 ` - Nits,/Date Signature . STREET WIDTH y PARK FEE E i COMPENSATION DECLARATIONateofc • - VAOCLUPANCYATION � L RUCTION TYPE `V , c ZONING APPROV ED j/�/ --1- �'� ,+ ieby affirm that I have a certificate consent to self-Insure or a ZONE. S/ _ S C/ �1� . e'of Workers' Compensation Insurance, or a certified copy SPECIAL CONDITION J thereof(Section 3800,Lab.C.). 'GRADING CU.YDS. ACRES Policy No. - Company • - O Certified copy Is hereby furnished. - REMARKS: - ALA FAR SPF!'7A1, RFQrROPha a O Certified copy is filed with the city Building Division. /•1 EXEMPTION FROM WORKERS' COMPENSATION DECLARATION . C0M.� eel; TyY,PL ` . (E100) orioessneed not be completed if the permit Is for one hundred vet. S/vier-' f✓i //o. TO ' • certify that In the performance of the work.for_which this permit is J issued, I shall not employ any person in any manner so as to become PLUMBING PLAN CHECK ELECTRICAL. PLAN CHECK subject to the Workers'Compensation Laws of California. BATHTUBS SHOWERSZ. UWhLLINU Y/r bAHAbt v 7t v Date - Signature 50.FT. Sn FT 26 3 NOTICE: If after making this declaration, you should become subject ' TOILETS `LAS ,' URINALS L GENERATOR 0-1 KW_1-10 KW to the Workers' Compensation provisions of the Labor Code,you must N TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES, DOUBLE LAVS • q — APPLIANCE 10-50 KW_50+KW revCONSTRUCTION - Y CONSTRUCTION LENDING AG EfICV KIT.SINKS DISHWASHERS / f . 6 MOTORS 0.1 HP 1-10 HP _ I hereby affirm that there Is a construction lending ages(yectiothe per- SERVICE SINKS '. SUMPS ' (INC.SOLAR) 10-50 HP 50+HP Civ. C.ce of the work for which-this permit is issued (Section 3097 • . Clv. C.). • - FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES Lender's Name FY9 /����~'`bs 48 5 - _ kY.S. . \ • Lender's AtltlresF9�to y7y -.JY.C4 V4IY�i1 f/.I'✓'I DRINKING FOUNTAINS , '• GAS TUBE SIGNS OWNER BUILDER DECLARATION -' INTERCEPTORS CLARIFIERS•_ -' POLE LIGHTS I hereby affirm that I am exempt.from.the•Contractor's'Llcense Law for \O-. r the following reason (Section 7031.5 Business-and Professions Code: SWIMMING POOL. PTRAP - LUNSI HUL!TUN • Any city or. county'which requires a:permit'to-construct,.alter, •• - POLES METERED SUB . Ir-;glove,demolish or repair any structure, prior to Its Issuance,also re- WATER SERVICE./.' ALTERATION 2.. PANELS MAIN SUB the applicantLfor.-such'permit to:filea'signed,statement that.he - . s z'.insed pursuant to the provisions of the•Contractor's License Law • GAS.SERVICE }\ OUTLETS :T i♦ ,.u2 . SERVICE - AMP ' (& riter49.(commencing•with -Section 7000)f`of Division-3 Of the. / - r business and•Professions Code) or that he is exempt therefldm'and the WATER HEATERS/ BTU OUTPUT . , ;' ' .— . FSM-(-,( basis for the alleged.exemption.•Any violation of:Section.7031.5 by _ IO ''''��ss any.,applicant for a•permit subjects the applicant to a civil penalty , SEWER CONNECTIONS/ - \. , . 1 27 . vile., Yo#s a Dray-w . 3 of not more-than'five hundred dollars ($500 . . . .•• .. Y / . O 1, as'owner of.the property, or my employees with wages as,their SOLAR TANK \ COLLECTORS.,•• .� ` sole compensation,will do the-work, and the structure is not intended - or offered for sale. (Section 7044, Business and Professions Code:The SOLAR PIPING SYS. ISSUE FEE - Contractor's License Law does not apply to.an owner of a property who builds or improves thereon, and who does such work himself or ISSUE FEE 3 r APPLICATION APPROVED BY DATE ..-11-.• / through his own employees, provided that'such impiovements are not • Intended or offered for sale. If. however, the building or Improvement MECHANICAL PLAN CHECK SUMMARY OF FEES • Is sold within one year of completion, the owner will have the burden f proving he did not build or improve for the purpose of sale). BUILDING 1 / ,. /� $� HEATING SYSTEM 0-100,000 BTU PERMIT $ 9 2 I SMTP E 4T Fa IVL'I as owner of the property, am exclusively contracting with AND DUCTING licensed contractors to construct the project (Section 7044, Business 100,000+ BTU PLAN CHECK 5 PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE S an owner of property who builds or improves thereon, and who con- sieWRR,�A,ITION 0-100,000 BTU PLUMBING $ i tracts from such projects with a contractor(s) licesned pursuant to a�l�t'fLY -w.9 • GRADING S the Contractor's Ucense law). /]C ( 00, 00. BTU PLAN CHECK E I ❑ I am exempt under Section B.& P.C.for this BOtiERe ep.'(Lr BTU - t , ELECTRICAL $ 3� 3 E reason ' Mme( C" MICROFILM $ 07.61 ' ♦ SYSTEM REP R,ALTERATION • PLAN CHECK E Q j Date Own• .r' - _ MECHANICAL E-11/4TOTAL FEE E I n I hereby rt sty that I have read is a•• r�i'n and ate t at the above EXHAUST SYSTEM MULTIPLE • LESS AD- Information is correct. I agree to o p y with all city and county l PLAN CHECK E VANCE PC E_ ordinances and state laws relating to construction,and hereby authorize �• /��(�i • • representatives. ' this <i y o inter u•on the above mentioned -a7 nni.'arYagErai'.a�: Property ce •Pe ftl•—•u� i i - y r 18,9 ISSUE FEE Slgnatu Accounting;Goldenrod-Assessor .- .. f. CONSTRUCTION AND PLANNI G . , -POOL&SPA APPROVALS Permit# -57 Date Inspector APPROVALS Permit _ • Date Inspectors • 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location ' - • , 2. Soil Pipe-Undrgrn p/r-d'f ,/fLirL 44. Steel Reinforcement ' ' - 3. Electrical Conduit Utility-Undrgrn- ` ' 45. Forms - • :\ 4. Klectrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel Reinforce ., . 47. . Rough Plumbing & Pressure Test • - 6. Electrical USER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings g /q• 3/:og. 49. Electrical Conduit-Undrgrn , 8. Foundation - 50. Gas Pipe, ❑Undrgrn,Test 9. Water Pipe-Undrgrn- _ - .Q-a 1-2 1 , ter . •. • •51. Backwash Lines. P-Trap, ❑Undrgrn 10._ - Structural Floor System • e 2!4 S/ .- • 52.• APPROVAL TO DECK 11. Property Sewer Line & House Connection '53. Backwash & Receptor-Final ' 12. Street Sewer Connection - 54. Heater & Vent-Final 13. Rough Plumbing 12_"ia L1-r--. '1 55. Plumbina System -Final - - 14. Rough Electric-Conduit -56. Electrical-Final 15. Rough Electric-Wiring / 03-5.1 '9 P (^ 57. Solar System-Final • 16. Rough Heating & Air Conditioning • .sA t. p_S / . bd. fencing &Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating .. 19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL • 20. Roof Framing • 21. Roof Sheathing /OA:-I/ 22. Frame and Flashing F/ g/ NOTES: 6....57C-6....57C- I d Dli - 23. Insulation 8 2. Cdoteccfc,v-c 24. Lathing & Siding /Z .1 fj - (/J `y/,2 'avie/0 Ajoat Gvr >1' OPA-o'/'Oj< O/C 25. Drywall Nailing /2., y ,�/ ��7 •pQ/�q�.¢I ,,3' / sc "inn / /oic yr 26. Plaster Brown Coat I1-int f 1 I' A 7 ',op eA' / " .$Lo y/To ecu?7✓/!e s O y 27. Electrical Power Meter-Final C ;cc' . OS , q yt�4�'wq/ `Acpf. 28. Final Electric ?j -19-E� 41 . t1 /PAC//cam.- fiA,, ,, zf/i2S o4 4tj/ S'J,ar.-4r 29. ' Final Heating & Air Conditioning 5/.t4,/gti � grie.-s4 yL/Ly;p�jsq• �$ ,feat .4t.fipt e/30. Final Gas Pipe-Test : Y// 6/S� )✓isNs SA•err or-,t .Q/n¢d 1,7 Or C^���at, 31. Final Plumbing 3/241y2-' ill? J- / 5"Z 7gine..4L Coe e•scrylrS wSr -W -/8� 3effi (vet a4 32. Water Service-Final `1 /.3/S' 1e eerieO•ec'is:ef - 33. Gas Service-Final FIC/^ G1q,✓c/the;44 IV P` to nodie ?nes 34. Solar Domestic-Final 35. -Landscape Sprinkling System• 36. Sound Attenuation - 37. Handicap Regulations - ' 38. FINAL STRUCTURE& BUILDING 4 '- �'���yC? 39. Special Requirements Completed ?/Q�JJ�(i /J�Gl.7 • .40..;.Electric Release to Edison, -1 _ ` / . 41. "-Gas Release to Southern CaliTornia Gas Co. 42. ,CERTIFICATE OF OCCUPANCY ' • 'yt'Jo Date - - • Applicant to fill in all spaces within heavy border lines andsign all appropriate declarations. • 'CITY OF QOSTA MESA PERMIT NO. , TRACT NO. LOT NO. ••BLDG.NO. ,v- 2+•'` ' • CONSTRUCTION PERMIT ��ll /600 - • B • , Project Address 2,3i (q b �'lJt-61J - • TYPE OF CONSTRUCTION x Owner o C. A 1 C,l-f Phone - 0 NEW ❑ ADD 0 ALTERATION - /)/}.S . `5232 9/1 7/81 Beor TL Z'9 Address 1 (Jto/�-104 0 REPAIR D CONVERSION ❑DEMOLISH —,r - ' S • El ZONING REGULATIONS Arch%Eng. OLP,cu License No.� 3 C3Tjpp A-p- cOESCRIPTION OF WORK Address 79fa'7/-fi,s, s _t Irv/ ZONE - PLNG. REF.14 I' Contractdr 4 / 4 cbd +` ((CoIdale 76.9Pfj? TYPE OF PERMIT BUILDING To pT I G Address / SETBApKC/LST• PROPERTY LINE Z(�(T S .di0 /t OA- �. �I 1tQ6J GRADING (] FOUNDATION 0 STRUCTURAL SIDE YARD LICENSED CONTRACTOR DECLARATION -' ❑ TENANT.❑ ELECTRICAL ❑PLUMBING ❑MECHANICAL SIDHVARD • I hereby affirm that I am licensed-under provisions of Charter 9(corn-' RIGG TT mencing with section 7000) of Division 3 of 'the Business and ❑ OTHER Professions Code, and my license Is In full force and effect. __ REAR YARD(TO P/L) / �� '3 333 $ PROJECT DESCRIPTION; !License Class_C�(Sn Lic se No , PKG-SPACE REQ. PROVIDED' - , 49n /7 Signature - SQ- FT, - ` • - • - - / ZKERS'COMPENSATION DECLARATION -' ' -' ' 'OCCUPANCY_CONSTRUCTION TYPE • -- STREET WIDTH PARK F££$ , " 4 , Araby affirm that I have a certificate of consent to self-insure or a . VALUATION ZONE ZONING APPROVED BY ; I DATE •- certificate of Workers' Compensation Insurance, or a certified copy' • thereof(Seaton 3801) Lab.C.). GRADING CU. YDS. ACRES SPECIAL CONDITIONS: '. Policy No. 9/o1 tb Company S'7?3r, fc t'' , 1 0 Certified copy is hereby furnished. --- - REMARKS: G '7 S9 rtified copy Is filed with the city Building Division. __ j. _ - EXEMPTION FROM WORKERS' COMPENSATION DECLARATION r. . <-a • ' 1 (This section need not be completed if-the permit is for one hundred - , -- - - - -- - -- - -- ($100) or less). • • I certify that in the performance of the work for which this permit is Issued, I shall not employ any person in any manner so as to•become PLUMBING ' - PLAN CHECK •ELECTRICAL PLAN CHECK • subject to the Workers Compensation Laws of California. - UW ELLING GARAGE - - Date Signature BATHTUBS SHOWERS , SQ.FT. SO FT • NOTICE: If after making this declaration, you should become'subject TOILETS ' • URINALS GENERATOR 0-1 KW_1-10 KW - I to the Workers' Compensation provisions of the Labor Code,you must -• TRANSFORMER - . forthwith'comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS APPLIANCE 10-50 KW 50+KW • • . - ' revoked. -. - - - CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS • 'MOTORS 0-1 HP_1-10 HP I hereby affirm that there is a construction lending agency for the per- 'SERVICE SINKS - SUMPS (INC.SOLAR) 10-50 HP 50 +HP ' , formance of.the.work for which this permit is issued (Section.3097 - - ' `Civ. C.).. , • `.`)'( yc•\� G`—c -1 - 1.\Mk\ s,`-i `.FLOOR SINKS\C \� FLOOR DRAINS FIXTURES OUTLETS SWITCHES ,Lender's Name-'_ - Lender's:Address s " `' DRINKING FOUNTAINS .GAS TUBE SIGNS , OWNER BUILDER DECLARATION ) INTERCEPTORS CLARIFIERS 'POLE LIGHTS • • I hereby affirm that I am exempt from.the Contractor's License-Law for • the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP LUNsl Kut-I IUN city or county which requires a.permit to construct, alter, POLES METERED SUB we,demolish or repair any structure, prior to its issuance,also re- WATER SERVICE ALTERATION • PANELS MAIN SUB • s the applicant for such permit to.file.a signed statement that he ♦ • • is tensed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS ' . ,j',, -t i /,SERVICE AMP 1 S l (Chapter 9 (commencing with. Section 7000) of Division 3 of the - ) Business and Professions Code) or that he is exempt therefrom and the WATER HEATERS BTU OUTPUT basis for the alleged exemption. Any violation of Section.7031.5 by • any applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONSy, of not more than five hundred dollars ($500). ' ❑ I, as owner of the property,or my employees with wages as their SOLAR TANK COLLECTORS • sole compensation, will do the work,and the structure is not intended or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE Contractor's License Law does not apply to an owner of a property who builds or Improves thereon, and who does such work himself or ISSUE FEE ,APPLICATION APPROVED BY DATE • • through his own employees, provided that such improvements are not - „ . intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK SUMMARY OF FEES Is sold within one year of completion, the owner will'have the burden - - _ ' of proving he did not build or Improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU - BUILDING - ❑ I, as owner of the property, am exclusively contracting with AND DUCTING PERMIT $ SMIP - '$'' licensed contractors to construct the project (Section 7044, Business - 100,000 + BTU 'PLAN CHECK $ PERMIT and Professions Code: The Contractor's License Law does not apply to - ISSUANCE $ • an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU _ PLUMBING tracts from such projects with a contractor(s) licesned pursuant to SYSTEM $ - ' GRADING the Contractor's License Law). -- - 100,000 +BTU 'PLAN CHECK $ -- . ' ❑ I am exempt under Section B.& P.C.for this BOILERS _ BTU 'ELECTRICAL $ �� $ reason • PLAN CHECK '$ -' MICROFILM S - Date Owner - .. -- SYSTEM REPAIR•ALTERATION _. TOTAL FEE$ I hereby certify that I have read this application and state that the above •EXHAUST SYSTEM MULTIPLE MECHANICAL $ •information Is correct. I agree to comply with all city and county PLAN CHECK $ -VANCE PC ordinances and state laws relating to-construction,and hereby authorize • - - • ' - $ representatives of this city to enter upon tine e above mentioned property for Jnsp t�io�ny urg oses. -� - - - - • •- Signature / lyV� Date 7/Z^.e-I ' - FINAL FEE $ �, Drivers'License Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor , - - CONSTRUCTION AND PLANNING - POOL&SPA - 1 ' Date APPROVALS Permit# i� Date Inspector- . ' _I Inspector., • APPROVALS Permit# 1. Temporary Electrical Service or Pole " • • ' 43. Pool & Equipment Location . '• ' -- - - - _ _ _ . 2.- SoifPipe-Undrgrn - ' 44. Steel Reinforcement ._ .. - ,_. . ___ - 3: " Electrical Conduit Utility-Undrgrn - - - ' ' 45. Forms . ..'. _ . - -- 4. Electrical Conduit:Undrgrn - 46. Electrical Bonding ' - _ . - . _ --_ -. - _ -.- 5. Steel Reinforce - - - _ , 47. Rough Plumbing & Pressure-Test• '- - _, . - -- - - . - 6: Electrical UFER Grn _ ' 48. APPROVAL TO COVER-GUNITE -- _ _ _ _ . 7- Footings - - 49. Electrical Conduit-Undrgrn ' " ' -. . .. 8. Foundation 50: Gas Pipe, ❑Undrgrn,Test , 9. Water Pipe-Undrgrn • 51. Backwash Lines, P-Trap.-D Undrgrn • 1 . . --_ - ? 10. Structural Floor System 52: APPROVAL TO DECK • - - - • - - - ' 11. Property Sewer Line-84 House Connection - 53. Backwash & Receptor-Final .- '-12. Street Sewer Connection 54. Heater &Vent-Final - 13. Rough Plumbing _ 55. Plumbing System - Final ' • - ' 14. Rough Electric-Conduit '• -56: Electrical-Final - - 15. Rough Electric-Wiring • Je-,23-Tri (l a 57. Solar System-Final - • ' . 1.6. . Rough Heating &Air Conditioning . - 58. Fencing & Access Approval - 17. Ducts, in Structure • . 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating _ 19. Gas Pipe-Rough &Test -60. POOL/SPA SYSTEMS FINAL - 20. Roof Framing - .� . E 21. Roof Sheathing - 22. Frame and Flashing NOTES: - 23. Insulation - - �e Ca, -e i - dr At- .!• 41-€t, 24. Lathing & Siding . . ./Y•cw 7771.. De� 25. Drywall Nailing C 26. Plaster Brown Coat I - .. 27. Electrical Power Meter-Final • ' 28. Final Electric 3 -19-21)- C--C. * _ - r 29. Final Heating &Air Conditioning . _ - - . 30. Final Gas Pipe-Test - • - 31. Final Plumbing _ 32. Water Service-Final 33. Gas Service-Final - _ - _ 34. Solar Domestic-Final c - - 35. Landscape Sprinkling System - - 36. Sound Attenuation - - 4• , 37. Handicap Regulations _ - t I 38. FINAL STRUCTURE & BUILDING • - , - - ' • ' 39." Special Requirements Completed r '^ - -- - - I 40. Electric Release to Edison _ - - - - ' i 41. Gas Release to Southern California Gas Co. - - • 1 - -- - ' • _ ' -' -, . - ' - - - "' -- -`- -'--- - 42. CERTIFICATE OF OCCUPANCY I � NoDate I r --- - -- - - - - . . _ . - - Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. • CITY OF COSTA MESAPE MIT NO. ' • TRACT NO. LOT NO: •BLDG.NO. - ' ! CONSTRUCTION PERMIT WS/� $ r 7G33 10/26/81 7.00 TIS C Project Address r ? ' ' " TYPE OF CONSTRUCTION - . "' _ ' Owner' perS,, - A . 2PhonefVJfl T• -1:1-' NEW ❑ ADD ❑ ALTERATION Address/, OZ A i / •1 _ 0 REPAIR--❑CONVERSION ❑DEMOLISH • Arch/Eng. ^ a - License No. 0 OTHER. ZONING REGULATIONS DESCRIPTION OF WORK A.P.9F Address ' _ - ZONE PLNG. REF. Contractor (�/}t Phone TYPE OF PERMIT BUILDING SETBACK L T. PRTp O Bpl�l �`JvU NE Address ,`,5�'.c - ❑ GRADING ❑ FOUNDATION 0 STRUCTURALs�, IDE YARD ' FT LICENSED CONTRACTOR-DECLARATION - 0 TENANT 0 ELECTRICAL ['PLUMBING 72FMECHANICA EIDE YARD I hereby affirm that I am licensed under provisions of Charter 9 (corn- RIGHT mencing with section 7000) of Division- 3 of the Business•'and ❑OTHER - Professions Code, and my license is In full force and effect. REAR YARD(TO P/L) , .PROJECT DESCRIPTION License Class License No. - I PKG.SPACE REQ. PROVIDED . --ee Signature - SQ. FT. s _ - , RKERS'COMPENSATION DECLARATION .00CUPANCY_CONSTRUCTION TYPE STREET WIDTH PARK FEE$ .ereby affirm that I have a certificate of consent to self-Insure or a VALUATIONZONE ZONING APPROVED BY ( DATE certificate of Workers' Compensation Insurance, or a certified copy - - thereof(Section 3800, Lab.C.). -GRADING CU.YDS. ACRES SPECIAL CONDITIONS: Policy No. Company - _ ' - - - - - ❑ Certified copy is hereby furnished. - - REMARKS: S79 o Certified copy Is filed with the city Building Division. • EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - ' (This section need not be.completbd If the permit Is for one hundred . .-. - •- - .. . ($100) or less). - •'� - I Certify that in the performance of the work.for which this permit.is _ • 't - Issued, I shall not employ any person In any manner so as to.become PLUMBING - , - r ,PLAN CHECK ' ELECTRICAL PLAN CHECK _ subject to the Workers'Compensation Laws of California. .- . _ - - UW ILLINV Date Signature BATHTUBS SHOWERS e e NOTICE: If after making this declaration, you should becomesubject '-TOILETS , '•r URINALS GENERATOR 0-1 KW_1-10 KW to the Workers' Compensation provisions of the Labor Code,you mustTRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS - APPLIANCE 10-50 KW' 50+KW - • revoked. . - - .. ._ _ ._. . CONSTRUCTION LENDING AGENCY • KIT.SINKS DISHWASHERSMOTO RS - 0-1 HP 1-10 HP "" I hereby affirm that there isa construction lending agency or the per- SERVICE SINKS • SUMPS '(INC.SOLAR) -10-50 HP50+HP - forCiv. C.ce of the w0 k fo hich t perms is ued ction 3097 -FLOOR SINKS FLOOR DRAINS • FIXTURES OUTLETS SWITCHES Civ. C.). `—/for s/ Lender's Name /z�y'q�) �� � //'' � �L - _ Lender's Address /!9t So/Yas& -pre .�[ti • DRINKINGFOUNTAINS -GAS TUBE SIGNS OWNER BUILDER DECLARATION - INTERCEPTORS CLARIFIERS POLE LIGHTS - ' I hereby affirm that I am exempt from the Contractor's License Law for ' the following reason (Section 7031.5 Business'and Professions Code: SWIMMING POOL P TRAP LUNS i I<UL i lury _ - r-V city or county which requires a permit to construct, alter, POLES METERED SUB i • ove,demolish or repair any structure, prior to its Issuance,also re- WATER SERVICE ALTERATION PANELS -' MAIN SUB - " - is the applicant for such permit to file a signed statement that he - .tensetl pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS SERVICE -- ' AMP -- (Chapter 9 (commencing with Section 7000) Of Division 3 of the Business and Professions Code) or that he I5 exempt therefrom and-the WATER HEATERS BTU OUTPUT r.,,v - - - - basis for the alleged exemption. Any violation of Section 7031.5 by _ any applicant for a permit subjects the applicant to a'civil-penalty SEWER'CONNECTIONS - 1 of not more than five hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS sole compensation, will do the work,and the structure is not intended ' or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE • Contractor's License Law does not apply to an owner of a property - APPLICATION APPROVED BY who builds or Improves thereon, and who does such work himself or ISSUE FEEDATE _ through his own employees, provided that such improvements are not •intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK SUMMARY OF FEES .. is sold within one year of completion,the owner will have the burden f provi .BUILDING - as ng ownerhe ofdid thenot property,buildor amImprove exclusivelyforthe contractingpurposeof with HEATING SYSTEM 0-100,000 BTU PERMIT $ • SMTP • $ ' licensed contractors to construct the project (Section 7044, Business AND DUCTING 100,000+BTU - PLAN CHECK $ _ PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING S ' tracts from such projects with'a contractor(s) litesned pursuant to SYSTEM GRADING $ the Contractor's License Law). 100,000+BTU PLAN CHECK $ _ ❑ 1 am exempt under Section B.& P.C.for thisBOILERS BTU ELECTRICAL $ $ reason PLAN CHECK $ MICROFILM $ ' Date Owner _ . SYSTEM REPAIR,ALTERATION 7- TOTAL FEE$. 1 hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $ PLAN CHECK LESSANEAD- information is correct. I agree to comply with all city and county — $ VANCE PC $_ • ordinances and state laws relating to construction,and hereby authorize as r, \ - .. _ ' representatives •f thl� city to e• er •• '!h- t/ tl property for �.e r puns... / n F //� ' �C./. 0,4 QS-_ 7• Signature __ / D1ta� 2< FINAL FEE $ Drivers'License • SS - -. - ISSUE FEEEA _ .. CMF 0865-46 White-Building;Canary-Applicant: Pink-Accounting;Goldenrod-Assessor • CONSTRUCTION AND PLANNING POOL& SPA' _ •I1IG�dri UI td;U\ APPROVALS Permit# Ut "WSDate Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Soil Pipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms • 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel Reinforce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings - - 49. Electrical Conduit-Undrgrn 8. Foundation 50. Gas Pipe, ❑Undrgrn,Test • 9. Water Pipe-Undrgrn 51. Backwash Lines, P-Trap. ❑Undrgrn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line& House Connection 53. Backwash & Receptor-Final ' 12. Street Sewer Connection " ' 54. Heater & Vent-Final 13, Rough Plumbing '55 Plumbing System - Final 14. Rough Electric-Conduit .56. Electrical-Final • 15. Rough Electric-Wring - - • 57. Solar System-Final 16. Rough Heating & Air Conditioning -_- ff/g7- . 47C 58. Fencing & Access Approval 17. Ducts, in Structure. . • 59. APPROVED FOR PLASTERING - .. 18. Ducts, Ventilating 19. Gas Pipe-Rough &Test - 60. POOL/SPA SYSTEMS FINAL • 20. Roof Framing 21. Roof Sheathing • - - ' 22. Frame and Flashing _ NOTES: 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter-Final 28. Final Electric 29. Final Heating & Air Conditioning V..J7tyf,�/ 1 30. Final Gas Pipe-Test -�/ 31. Final Plumbing 32. Water Service-Final 33. Gas Service-Final 34. Solar Domestic-Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FI NAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY - No Date - Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PERMIT NO. - TRACT'NO. LOT NO. •BLDa`IO. ' - - - • CONSTRUCTION PERMIT >h -/,j�7 o/ Project Address (9-32/ EL 0pN -S A TYPE OF CONSTRUCTION - • . _ Owner W 1 1 / 6,„,,,6„A ,c� ,, Phone ' :0 NEW 0 ADD 0 ALTERATION - 7398 10/23/81 ' 1 13.00 TI. - .511<y.Address /S co/ .511<y PACz K e. L. - O-REPAIR 0 CONVERSION -ODEMOLISH ,^ Arch/Eng. • - License No. ❑OTHER ZONING REGULATIONS• , Address DEDESCRIPTIONPTION OF WORK /Ant /.4.) U SY$71%-t"._ _ A'13',, • r . /� Lkel-tAJ CJ purr ! T r .ZONE PLNG. REF.* Contractor ow'-tC .- /�,J s+a L,0 C C. Phone _ TYPE OF PERMIT BUILDING TTpp gt(1lL�ppiNG SETBACK C/LST. PROPERTY LINE Address - - - 0 GRADING O FOUNDATION 0 STRUCTURAL $IDE YARD LICENSED CONTRACTOR DECLARATION 0 TENANT 0 ELECTRICAL' OPLUMBING OMECHANICAL LS IiDET YARD - - - - ' I hereby affirm that I am licensed under provisions of Charter 9(corn- RIGHT ' mencing with section 7000)' of Division '3 of the Business and 0 OTHER - _ Professions Codf'_ nd my license is In full force and effect. REAR YARD(TO P/L) • PROJECT DESCRIPTION License Class 0 ens No.� PKC.SPACE REQ. PROVIDED Date - Signature �� yLG_ SQ.FT. ._ - ON , STREET WIDTH PARK FEE$ • I.ORKERS'COMPENSATION DECLARATION - OCCUPANCY_CONSTRUCTION TYPE . ereby_affirm that I have a certificate of consent to self-Insure or a VALUATION ZONE_ ZONING APPROVED_BY PARK. :Iflcate of Workers' Compensation Insurance, or a certified copy - ...ereof(Section 3800, SPECIAL CONDITIONS: Lab.C.). _ _ GRADING CU.YDS. ACRES - -. Policy No. • - -- Company - - - ' ' - - - - 0 Certified copy is hereby furnished. • REMARKS: G. S 7 Cs , O Certified copy is filed with the city Building Division. / - - - - , EXEMPTION FROM WORKERS' COMPENSATION DECLARATION .. • - -' . - - ' - - • r. (This section need not be completed if the-permit is-for one hundretl _ • ($100) or less). - 'I .-- - _ I-certify that.n the performanceof the ork for which this permit Is _ _ _ issued, I shall not employ any person I ny anne so.as t9 becoo le PLUMBING ,- , PLAN CHECK - - _ ELECTRICAL PLAN CHECK subject to the WOrj(¢fe Compensation WS Calif pia. UwtLLINt. • -- (aMNMGE Date /0' i)` X/ BATHTUBS SHOWERS Signature ' SO FT SO-FT, NOTICE: If after making this declaration, you should becomes ject _TOILETS , URINALS - - . ' 'GENERATOR - 0-1 KW_1-10 KW - - • to the Workers' Compensation provisions of the Labor Code,you must _ _ TRANSFORMER - • , forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS ' I - APPLIANCE 10-50 KW 50+ KW '�, revoked.- - - -- - .. _ _ - _ CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS - - _ MOTORS - -0-1 HP_I-30 HP I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS -I ,' SUMPS • . - (INC.SOLAR) 10-50 HP_50+HP - formance of the work for which this permit is Issued (Section 3097 _ Civ. C.). FLOOR SINKS FLOOR DRAINS 'FIXTURES OUTLETS SWITCHES Lender's Name _ ' Lender's Address DRINKING FOUNTAINS - - 'GAS TUBE SIGNS - "' - OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS POLE LIGHTS - I hereby affirm that_I am exempt from the Contractor's License Law for - the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL ' .. P TRAP "" - .- . . LUNL I Hut-I fun. _ , Any city or County which requires a permit to construct, alter, .POLES METERED SUB - Improve,demolish or repair any structure, prior to Its Issuance,also re- WATER SERVICE ALTERATION PANELS 'MAIN ' . .SUB r 's the applicant for such permit to file a signed statement that he , - . ;nsed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS SERVICE - 'AMP - ,,ter 9 (commencing with Section 7000) of Division 3 of the L....ness and Professions Code) or that he is exempt therefrom and the WATER HEATERS - _ BTU OUTPUT - r ' I I - - - - - basis for the alleged exemption. Any violation of Section 7031.5 by - - • any applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS - . - - - ' - - of.not more than five hundred dollars ($500). ' 0 I, as owner of the property,or my employees with wages as their SOLAR TANK COLLECTORS • - - .- . - ' sole compensation, will do the-work, and the structure is not intended . or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE - - ' Contractor's License Law does not apply to an owner of a property _ _• who builds or improves thereon, and who does such work himself or ISSUE FEE - - APPLICATION APPROVED BY ' - - DATE - - - through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or Improvement MECHANICAL PLAN CHECK i SUMMARY OF FEES Is sold within one-year of completion,the owner will have the burden , . of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU / • BUILDING - - - O I, as owner of the property, am exclusively contracting with PERMIT $ SMIP $ AND DUCTING Y • licensed contractors to construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK $ PERMIT and Professions Code: The Contractor's License Law does not apply to - - - - ISSUANCE $ an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts from such projects with a contractor(s) licesned pursuant to SYSTEM GRADING $ ' the Contractor's License Law). 100,000+BTU - PLAN CHECK 5 O I am exempt under Section B.& P.C.for this BOILERS BTU ELECTRICAL $ - $ reason - MICROFILM $ SYSTEM REPAIR,ALTERATION PLAN CHECK $ �qy Date Owner MECHANICAL $ /3,. TOTAL FEE$ ' I hereby certify tha I have read this application and state that the above EXHAUST SY TEM MULTIPLE LESS AD- information Is co act. I agree to comply with all city and county / (,/ - PLAN CHECK $ VANCE PC $- ordinances and st e law relating to construction,and hereby authorize / /T ,€,c4- (fP L I • representative f th ci o ante pon the above mentioned -rJ r.(�A'f- - /3 2- property for spa l♦♦` (�/ / 197/7 �PFINAL FEE § Signature ISSUE FEE' - - _ 2', CMF 0865-46 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor CONSTRUCTION AND PLANNING , - POOL& SPA.. 154 0 Date Inspector - Date Inspector APPROVALS Permit* M APPROVALS Permit • # 1:" Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Soil Pipe-Undrgrn - 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn • 45. Forms 4. Electrical Conduit-Undrgrn - - . 46. Electrical Bonding 5. Steel Reinforce 47. Rough Plumbing & Pressure Test • 6. Electrical UFER Grn • 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undrgrn • 8. Foundation 50. Gas Pipe, ❑Undrgrn,Test 9. Water Pipe-Undrgrn - 51. Backwash Lines. P-Trap. ❑Undrgrn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash& Receptor-Final 12. Street Sewer Connection • 54.. Heater & Vent-Final 13. Rough Plumbing 55. Plumbing System -Final 14. Rough Electric-Conduit '56. - Electrical-Final 15. Rough Electric-Wiring 57. Solar System-Final 16. Rough Heating & Air Conditioning ¶o ((- 4/-56 ( 58. Fencing &Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING • 18. Ducts, Ventilating 19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL 20. Roof Framing • 21. Roof Sheathing 22. Frame and Flashing NOTES: 23. Insulation 24. Lathing & Siding - 25. Drywall Nailing - 26. Plaster Brown Coat 27. Electrical Power Meter-Final - 28. Final Electric 29. Final Heating & Air Conditioning 31 L-Pi- 30. Final Gas Pipe-Test 31. Final Plumbing 32. Water Service-Final 33. Gas Service-Final 34. Solar Domestic-Final 35. Landscape Sprinkling System • 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE& BUILDING 39. Special Requirements Completed 40. Electric Release to Edison _ 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date ' Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. ••CIYY Cr COSTA MESA PERMIT NO. TRACT NO. LOT NO. BLD . NO. 233C,Q -L .- .. - - CONSTRUCTION PERMIT //‘ /` ag I � �a 8 • 5504 3/O7/64 344.63 • TL Project Address _� -'sl __ I_____l TYPE OF CONSTRUCTION deq NEW ADD ALTERATION [� REPAIR • • Applicant's Mailing Address `- ❑ CONVERSION ❑ DEMOLISH ❑ OTHER - A.P. 6 ``''�� nn Zone p C I 0l Tion Phone`557'451 DESCRIPTION OF WORK - EPA' -' Z4r l- 2.3 I 1!Z- - Owner's Name 1 / S Main Building: Accessory Building: • Z Address I/ ?8I Gut-n� DT. Cn S1-c, Auz.owT9� E 1L O TYPE OF PERMIT U GRADING LI FOUNDATION `c\ST RUCTV RAL T Front -f 1 N Arch/Eng. tOt Lt+l\ C. is 9 License No. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear if fti 64 -I •Address • Ai . - at. S •• ❑ OTHER A N Contractor's Naine aC.OnVa2 Phone PROJECT DESCRIPTION SO. FT.• I L & OCCUPANCY C Right �D t3/r- G Address(mailing) CONSTRU TION TYPE F a S VALUATION $. (oclwdv S Left Z-7 1 R • E ZONE —a.- GRADING CU.YDS. a Si ACRES 0 City License No. � r•_ sea_ Ping. Ref.# Z� �'Z -p$ Park.Fees $ �"(P� �-L LICENSED CONTRACTOR DELLA- . ION r ' • / U 1 • Remarks:PC o2.old r co v Parking Req./Provided Z L I hereby affirm that I am licensed un•:r provisl• 's •f i ha I er 9 (commencingR with section 7000) of Division 3 of t•e Busin's .n• Pr. essions Code,and - Use of Building: ( O h CIO$ - my license Is In full fo e and effect. - - M Jcense Cla T."' ' . - is ns N:/ 33p nea a . PLUMBING FEES Planning Notes: E • _tate • : Signature ' - ° • - Bar Sink l Showers • HOLD.FOR SPECIAL. REQIUo a r.• N WORKERS COMPENSATION DELLA• • 10 , J ,( +s�••I_NT(I T ' I hereby affirm that I have a certificate of conse t o self-I sure or a certificate Backflow Preventer • Service Sink S • of'Workers' Compensation Insurance, or a certi led copy thereof (Section • - - - . 3800, Lab. C.) tip p I Backflow Irrigation Sewer Cap ' ,!, '- ELECTRICAL ' Jij FEES Policy No. barb q 1 'Q?D4 Company ' osS• . - . ., • ACertified copy is hereby furnished,. • • Bathtubs Sewer Connection 'Ail ,' . Automatic Washer Transformer 0 15-50 KWr.' - - Cer Ified copy is filed with the city7B ilding Division. rt ❑'50+KW • Date Applicant- Clarifiers Solar Collectors• Construction Pole Sub EXHM PT ION FROM WORKERS'C_MPENSATIONDECLARATION - • Dishwasher ' Solar Piping - CookingUnit ' '.+ I- ,Meter pup to 100 amps (T ssection need not be complete if the permit is for one hundred ($100) or • - • - 1 '_' , less). DrinkingFountains '�' ' • ' I certify that,in the performance of the work(or'which thli permit is Issued I Solar Tank [, + •" Dishwasher Meter ❑over 100 amps .. shall not employ any person In any•manner so as to become subject to the - '1 Workers' Compensation Laws of California. Floor Drains, I Swimming Pool kid/Spa • ''1 ( Dryers ❑Gas ❑Electric Sub Panel ; f( - • `i Date Signature ' • NOTICE: If;after making this declaration,you should become subject to the' Floor Sinks - Urinal i Fan Workers' Compensation provisions of the Labor Code,- you must forthwith' "' -. - - - - - - _ Motors❑0-1 HP ❑1 X-8 , comply with such provisions or this. permit;shall bedeemed revoked. Gas Service- Outlets • Water Closet ' - . F.A:U. Inc.• Solar ❑9-15 HP ❑ie-i 5+ ' CONSTRUCTION LENDING .AGENCY- - , I hereby affirm that there is a construction lending agency for the performance Interceptors • _ - Water Heater Fixtures Microwave of the work for which this permit Is issued (Section 3097 Civ. C.) • - Lender's Name - Kitchen Sink . - • Water Service Device Boxes Pole Light Lender's Address " Lavatories - OWNER BUILDER DECLARATION . - - . �' - ' . f�• Outlets Range I I hereby affirm that I am exempt from the-Contractor's License Law for the _ - • 'nllowing reason (Section 7031.5 Business and Professional Code: Any city or P—Trap_ I - - . - _ Switches Sign unty which requires a permit to construct,alter,improve,demolish or repair • y structure, prior to its-issuance, also requires the applicant for such permit Roof Drains - ' . ' Garbage Disposal Standing Sections . .o file a signed statement that he/she Is licensed pursuant to the provisions of _ - • the Contractor's.License Law (Chapter 9(commencing with Section 7000)of • Generator ❑65 KW❑5.15 KW Trash Com actor Division 3 of the Business and Professions Code) or that he/she is exempt - - P 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 . Reins Reinspection Fee $ 3 eenalty of not more than five hundred dollars($500). Pa I $25 Issue Fee LJ I, as owner of the property or my employees with wages as their sole MECHANICAL Reinspection Fee $25 Issue Fee $'3 compensation, will do the work,and the structure is not Intended or offered - I FEES for sale (Section 7044, Business and Professional Code: The Contractor's PUBLIC SERVICES REQUIRE ENT : ' License Law does not apply to an owner of a property who builds or Improves Boiler ,, Hood or Type I 0 N] / Ityt-...17 thereon, and who does such work himself/herself or through his or her own Zoning Approved By " L Date 3�/ ! i4 employees, provided that such improvements are not intended or offered for Canopy Type II ❑ W !!sale; If,-however, the buildin or im rovement is sold within one ear of com- Duct-Under Ground A lication A roved BD9 P Y _ PP pp yate •pletiof the owner will have the burden of proving he/see did not build or im •- r ve for the purpose of sale), Duct-StructuralRefrigeration System Appliption Issued By Date ���/� I, as owner of the property,am exclusively contracting with licensed con- t, ctors to construct the project(Section 7044,Business and Professions Code: Duct-Ventilating 00-100,000 BTU 0100,000 BTU • S OF FEES The Contractor's License Law does not apply to an owner of property who I // 8:3 builds or Improves thereon,and who contracts for such projects with a con- Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ ' SMIP $ T� tractor(s) license pursuant to the ontractor's License Law). PLAN CHECK $ PERMIT 0 lam exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# PLUMBING $ • ISSUANCE $ Date • ne 1 • Heating System&Ducting PLAN CHECK $ ENERGY P.C. $ I hereby certify t-at 1 hay/re•d th 1 cation and state that the above 6100,000 BTU 0100,000 BTL GRADING $ information is cornt.'I agr:I[- t•- co • all city and county ordinances - ELECTRICAL $ - - and state laws relatl g to b Id nc•1LG. • ion,and hereby authorize repre- MICROFILM $sentatives of this ci y to'. nt r u--.' Jth above-mentioned property for PLAN CHECK . $ // Inspection purposes. .416.4.416.41 ,,, 7 -��� MECHANICAL $ • TOTAL FEE $ 444T� �� Signature Pink'-Accounting;Goldenrod -Assessor • -0. • CONSTRUCTION AND PLANNINu - OL &SPA - APPROVALS :Permit# Date Inspector' 'APPROVALS Permit# Date Inspector 4. 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 LIFER Grnd. • 4/S ;j-, _ 57.-APPROVAL TO COVER-GUNITE 7. Footings 7 • _ - 58. Electrical Conduit-Undrgrnd. • 8. Foundation - ,SC4i_-s • •1 , ✓ 59. Gas Pipe, O Undrgrnd.,Test 9. Water Pipe-Undrgrnd. - •- 60. .Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System • 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection - • - 62. Backwash & Receptor-Final 12. Sewer Cap • 63. Heater & Vent-Final - - 13. Roof Drains . 64. Plumbing System - Final 14. Rough Plumbing - - 65. Electrical-Final 15. Rough Electrical-Conduit- • 66. Solar System-Final ' 16. Rough Electric Wiring 67: Fencing & Access Approval 17. Rough Wiling Sign- I - - 68. APPROVED FOR PLASTERING 18. Rdugh 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 ii 22. Ducts, Ventilating , i 71. Product Piping O Gas OOiI 23. Gas Pipe-Rough&Jest , 72. Underground Flush 24. Roof Framing - , • ,. - 73. Undergrnd.Storage Tank 0 Gas 0.011 , 25. Roof Sheathing - . . 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 4/,y(gy //l 76. Dry Standpipe 28„ Lathing& Siding ,7/7/gy ,qrJ 77. FIXED SYSTEM FINAL , 29. Insulation ' • 78. FIRE PREV. FINAL 30. Drywall Nailing - - , 7� fi! • HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 'It•l )/d_ 79. FINAL.I NSPECTION 32. Electrical Power Meter-Final / 80. FOOD CERTIFICATE ISSUED 33. Final ElectricNotes: •0„�' ` /' _ � 34. Final Heating & Air Conditidning4_' /5)74:26....n.4.„ 35. Final-Gas Pipe-Test ,. - • - - . ' 36. Hood or Canopy 37. Final Factory Fireplace 1 - - 38. Final PlumbiAg " ' - • - _ ' 39. Water Service-Final • - 40. Gas Service-Final ' T ` 41. Solar Domestic-Final "� 42. Backflow Preventer ' , I 43. Backflow Irrigation .• • , 44. -Landscape Irrigation System 4,; • 45. Sound Attenuation 46. Handicap Regulations . - . ' • 47. FINAL STRUCTURE&.BUILDING ' f ..7 (i ' 4k - 48. Special Requirements'Completed �•I/ I - atp v 49. Electrie�Release to Edisoo - ' - . 50. Gas Release to Southern California Gas Co ;, 51. CERTIFICATE OF OCCUPANCY • - ' c No. : /4-% ' Date- 1 3 � / - r 'C • City of Costa Mesa Development Services Department CERTIFICATE OF OCCUPANCY No. 000131 Building Safety Division P.O.Box 1200 Costa Mesa,California The Building located at 2336 BTd7E1.N AVENUE UNIT #13 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto fora Group R-1 Occupancy. Use of Building CONDOMINIUM Legal Description 439-261-23 (See reverse side for Metes and Bounds) Building Permit No H-11695 Electrical Permit No. E-13470 Plumbing Permit No. P-12184 Mechanical Permit No. t-13296 Number of apartments and/or guest rooms ISSUED TO: Building�^� Official 11, kit E.S. OLRICH by f �`_''T1iLuGC��r� 2881 E.UIOPA DR., COSTA MESA, CA. Date 1 /c// �I/ This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises/and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 lel U.B.C. CMF 1015-46 rev. 1/63 White-Owner:Canary-Numerical File;Pink-Bldg.Permit File Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. _ ' CITY OF COSTA MESA • PERMIT NO,• _v,, TRACT NO.' LOT NO. •BLIP.NO: � --- CONSTRUCTION PERMIT C .S de' r -/50/ • 7397 10/23/81 13.00 TL! Project Address al 3 3 ec o,c) -- '� ( , • TYPE OF CONSTRUCTION ^ •• •- - -• Owner OGQ7 C� Gs, / U Phone NEW -❑ ADD 0 ALTERATION ,Address- i Root gc- ❑ REPAIR 0 CONVERSION ❑DEMOLISH ZONING• Arch/Eng.- - - -- ' - License No. - ❑ OTHER REGULATIONS Address - -- - D CRIPTION OF WORK se'a,7 �� Contractor 0 •i z .._air ..001/ nfflilireMliall= ZONE •PLNG. REF..* - , / Phone - =. • ` TTpO BBtt�1ILLpDINC - .r / TYPE OF PERMIT • SETBACK C/L ST. PROPERTY LINE ' Address -- ' , ❑ GRADING 0 FOUNDATION 0 STRUCTURAL SIC�Fq YARD - LICENSED CONTRACTOR DECLARATION- - • 0 TENANT ❑ ELECTRICAL ❑PLUMBING-❑MECHANICA Ld DE YARD - - ' - - ' I hereby affirm that I am licensed under provisions of Charter 9 (com- ' • RIGHT mencing with section-7000) of Division 3'of the-Business and ❑ OTHER - . Professions Codeand my license Is in full force and effect. REAR YARD(TO P/L) . , License Class a -2•0 license No. rre,sI teZ PROJECT DESCRIPTION , -. - - -PKG.SPACE REQ. PROVIDED Date Signature' " - SQ: FT. _ _ .. WORKERS''COMPENSATION DECLARATION - - - OCCUPANCY—s--.CONSTRUCTION TYPE, STREET WIDTH PARK FEE$ , -4reby affirm that I have a certificate of consent to self-insure or a VALUATION ZONE ZONING APPROVED BY , I 'DATE - Ificate of Workers' Compensation Insurance, or a certified copy -- - - - - -- • -- - eof(Section 3800, Lab.C.). • -GRADING CU.YDS. ACRES SPECIAL CONDITIONS: , ,. misty No. .. - Company - . - - - /�.. - - - • _ - ❑ Certified copy is hereby.furnished. - -. -- - • REMARKS: G _ce0 - - - -. . ❑ Certified copy is filed with the city Building Division. _ EXEMPTION FROM WORKERS' COMPENSATION DECLARATION' -i.'. - - • -- ` -- - - - (This section need.not be completed If the.permit is for one hundretl _ •. ($100) or less). • _ .-- .- _ -._. . -- • I certify.that In the-performance Of the w k f wh ch this p rriilt is _ Issued, I shall not employ any person in y nn s s e ;PLUMBING ' PLAN CHECK` _'ELECTRICAL - PLAN CHECK_ subject to the Wogkel •Compensation s ^. - - ._ UWELLIN(. - -- L.AHAlet . - --- - - i Date /d^'j^is Signature BATHTUBS SHOWERS • • , • NOTICE: IfIfafter making this declaration, you should b me su ect -TOILETS 'URINALS- GENERATOR- 0-1 KW_1-10-KW to the Workers' Compensation provisions of the Labor Code,you must TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE ' 10-50 KW=50+KW _ revoked. • - -- CONSTRUCTION LENDING AGENCY KIT.SINKS • DISHWASHERS- MOTORS 0-1 HP 1'40 HP '- - I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS I • SUMPS - -(INC.SOLAR) 10-50 HP=50+HP -- formance of the work for which this permit is issued (Section 3097 - • - ' Civ. C.). FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES '- Lender's Name _ _ Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS -' - - OWNER BUILDER DECLARATIONINTERCEPTORS CLARIFIERS ' POLE LIGHTS ' • I hereby affirm that 1 am exempt from the Contractor's License Law for •the following reason (Section 7031.5 Business and Professions Code:' SWIMMING POOL P TRAP - -t-UN5 I.(UL.I IUN . , Any city or county which requires a permit to construct, alter, POLES METERED SUB Improve,demolish or repair any structure, prior to its issuance,also re- WATER SERVICE ALTERATION PANELS MAIN - - SUB - ' • quires the applicant for such permit to file a signed statement that he ' -ensed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS 1 SERVICE" AMP -ater 9 (commencing with Section 7000) of Division 3 of the .less and Professions Code) or that'he is exempt therefrom and the WATER HEATERS BTU OUTPUT;; . • basis for the alleged exemption. Any violation of Section 7031.5 by - any applicant for a permit' subjects the'applicant to a civil penalty SEWER CONNECTIONS - - - of not more than five hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS - - - - sole compensation, will do the work, and the structure is not intended or offered for sale, (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE -' Contractor's License Law does not apply to an owner of a property - APPLICATION APPROVED BY - DATE who builds or improves thereon, and who does such work himself or ISSUE FEE through his own employees, provided that such improvements are not intended or offered for sale. It, however, the building or improvement MECHANICAL PLAN CHECK SUMMARY OF FEES Is sold within one year of completion, the owner will have the burden of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU / PERMIT BUILDING $ SHIP $ El I, as owner of the property,'am exclusively contracting with AND DUCTING licensed contractors to construct the project (Section 7044, Business 100,000-+ BTU PLAN CHECK $ • PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ - - tracts from such projects with a contractor(s) licesned pursuant to SYSTEM GRADING $ the Contractor's License Law). 100,000 +BTU PLAN CHECK $ • •• ❑ 1 am exempt under Section B.& P.C.for this -BOILERS BTU ELECTRICAL $ $ reason - PLAN CHECK $ MICROFILM $ Date • Owner SYSTEM REPAIR,ALTERATION TOTAL FEE$ ' I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $ LESS PLAN CHECK '$ VANCE - Int ordinaaces is corre . I agree to •iy with all cityerand county VANCE PC $_ representatives. and st. e 'i feting to o- truction,and hereby authorize -���� ��_- prorerty fives •f )I 6� too r••n the above mentioned ` _ ©: FINAL FEE $ /� Property for s•., - PO /O o' `r Signature - •�✓ Lr� Date VX,/ Drivers' Lic-nse or ISSUE FEE CMF 0865-46 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor CONSTRUCTION AND PLANNING POOL&SPA- __ OPEI I`.;\EFAril CPE\ Date Inspector Date Inspector APPROVALS Permit# M(5o� APPROVALS Permit# _ 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - • 2. Soil Pipe-Undrgrn 44. Steel Reinforcement • -- . 3. Electrical Conduit Utility-Undrgrn - . • 45. Forms 4. Electrical Conduit-Undrgrn • . .46. Electrical Bonding• _ 5. Steel Reinforce 47. Rough Plumbing& Pressure Test - ' 6. _ Electrical UFER Grn _ • 48. APPROVAL TO COVER-GUNITE - - 7. Footings _ 49. Electrical Conduit-Undrgrn 8. Foundation 50. Gas Pipe, ❑Undrqrn,Test 9. Water Pipe-Undrgrn _ ._ . . • 51. Backwash Lines, P-Trap. ❑Undrgrn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection _ .53. Backwash & Receptor-Final - ' ! 12. Street Sewer Connection . 54. Heater & Vent-Final - 13. Rough Plumbing - 55. Plumbing System - Final - I 14. Rough Electric-Conduit .56. Electrical-Final • 15. Rough Electric-Wiring . -_ 57. Solar System-Final ' ' n ' 16. Rough Heating & Air Conditioning - - �..p . (U_q_77 58. Fencing & Access Approval 17. Ducts, in Structure ' 59. APPROVED FOR PLASTERING ,. , 18. Ducts, Ventilating . ' ) - , 19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL - 20. Roof Framing 21. Roof Sheathing - 22. Frame and Flashing NOTES: 23. Insulation - 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter-Final 28. Final Electric - • 29. Final Heating & Air Conditioning 'RC 3.- 16 �t 2- 30. Final Gas Pipe-Test 31. Final Plumbing 32. Water Service-Final 33. Gas Service-Final 34. Solar Domestic-Final • 35. Landscape Sprinkling System • 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY ' No_ Date - - . Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. _- CITY OF COSTA MESA PERMC/75110.NO. TRAC19NO. LOT NO. - •BLDCytNO. - , �,— CONSTRUCTION PERMIT ,y/�-/g/9 �-� - Project Addres ,r- Zr_ � (/Gi/ • TYPE OF CONSTRUCTION �G34 1,0%26_/61 7.00 TU ' Owner/7), r� t� ppp- Pho/n!q}/,.�,5/9 0 NEW ❑ ADD ❑'ALTERATION • Address 2. � s.� - ❑ REPAIR 0 CONVERSION 0 DEMOLISH - - ❑ OTHER ZONING REGULATIONS Arch/Eng. - License No. A P 7P - Address ._ DESCRIPTION OF WORK ZONE PLNG. REF. Contractor Phone TYPE OF PERMIT ' BUILDING Tp gU1LpI�y9 • _ SETBACK C!1 ST. PROPEf2TY LINE _ Address -' 0 GRADING 0 FOUNDATION 0 STRU TURAL 0 SIDE YARD • LICENSED CONTRACTOR DECLARATIONSIDE ❑ TENANT 0ELECTRICAL OPLUMBING MECHANICAL SIDE YARD I hereby affirm that I am licensed under provisions' of un 9 (corn- RIGHT emg with section 7000)myof Division- 3 theforce-Business and t. ❑ OTHER - - REAR YARD(TO P/L) Professions Code, and my license Is in full force antl effect. PROJECT DESCRIPTION License Class License No. ` PKG.SPACE REQ. PROVIDED Date - Signature_ - 50.FT. - tKERS''COMPENSATION DECLARATION - - - - - OCCUPANCY_CONSTRUCTION TYPE STREET WIDTH _ PARK FEE$' eby affirm that I have a certificate of consent to self-Insure or a - 'ZONING APPROVED BY I ,DATE .,flcate of Workers' Compensation Insurance, or a certified copy VALUATION ZONE _ thereof(Section 3800, Lab. C.). . GRADING CU.YDS. - - ACRES SPECIAL CONDITIONS: Policy No. Compaby - - - --- - ❑Certified copy is hereby furnished. - REMARKS: /^ _ a a . ❑ Certified copy is tiled with the city Building Division. - - - EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - - - - • , (This section need not be completed if the permit is for one.hundred - . ($100) or less). - . _ _ .. - - _ • _ _ [-his that In theperformance of the work for which this permit Is Issued, I shall not employ any person In any manner so as to become • PLUMBING - PLAN CHECK ELECTRICAL -- PLAN,OHECK, - -` t subject to the Workers Compensation Laws of California. .. - - - _-. UW tLLING - -C MHAUS ' Date Signature_ BATHTUBS SHOWERS •'SO FT SO FT - r NOTICE: If after making this declaration, you should become subject TOILETS I URINALS - - - - GENERATOR 0-1 KW_1-10 KW . to the Workers' Compensation provisions of the Labor Code,you must TRANSFORMER :. - forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS - APPLIANCE 10-50 KW_50+KW ' revoked. - - _ _ CONSTRUCTION LENDING AGENCY -KIT.SINKS • DISHWASHERS - ,MOTORS 0-1 HP 1-10 HP -' I hereby affirm that there Is a construction lending ag cy for the per- SERVICE SINKS -- SUMPS - (INC.SOLAR) 10-50 HP 50+HP - formance of_thevy,�/y 1 f whirr his perm/�s iss (Section 3097 - ' Civ. r' (IrCr �• - FLOOR SINKS FLOOR DRAINS - FIXTURES' • OUTLETS SWITCHES - - C.).'t Name ,i`+ '/ _ - Lender's Address/WC-Mt,' ddress/X�M L Un YAC DRINKING FOUNTAINS _ GAS TU BE'SIGNS" - OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS POLE LIGHTS _ - ' • I hereby affirm that I am exempt frOm.the Contractor's License Law for . the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL . P TRAP- . " _ LUNSI Hut.IIUN . Any. city or county which requires a permit to construct, alter, POLES METERED SUB lf',ove,demolish or repair any structure, prior to its Issuance,also re- WATER SERVICE ALTERATION - PANELS MAIN SUB s the applicant for such permit to file a signed statement that he Qi'S7,iaintinsed pursuant to the provisions of the Contractor's License Law GAS SERVICE - OUTLETS - SERVICE '- 'AMP - 6k:tinter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the WATER HEATERS - BTU OUTPUT- ...,,.,,t,- - - basis for the alleged exemption. Any violation of Section 7031.5 by - ' any applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS - - . of not more than five hundred dollars ($500). _ ❑ I, as owner of the property,or my employees with wages as their SOLAR TANK COLLECTORS - - - sole compensation, will do the work,and the structure is not Intended or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. - - ISSUE FEE ' Contractor's License Law does not-apply to an owner of a property - .- - APPLICATION APPROVED BY - DATE who builds or improves thereon, and who does such work himself or ISSUE FEE through his own employees, provided that such improvements are not • intended or offered for sale. If, however,the building or improvement MECHANICAL PLAN CHECK SUMMARY OF FEES is Id within one year of completion,the owner will have the burden proving he did not build or improve for the purpose of sale). BUILDING as owner of the property, am exclusively contracting with HEATING SYSTEM 0-100,000 BTU PERMIT $ SMIP $ licensed contractors to construct the project (Section 7044, Business AND DUCTING 100,000+BTU PLAN CHECK $ PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE S an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING S tracts from such projects with a contractor(s) Ilcesned pursuant to SYSTEM - GRADING $ the Contractor's License Law). 100,000+BTU PLAN CHECK $ ❑ l am exempt under Section B.& P.C.for this ELECTRICAL. $ $ BOILERS BTU reason - - .MICROFILM 5 SYSTEM REPAIR,ALTERATION PLAN CHECK $ Date Owner / TOTAL FEES MECHANICAL $ _7 I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE • LESS AD- information is correct. I agree to comply with all City and county ( _ r >j ` /J PLAN CHECK S VANCE PC '$_ ordinances and st. - laws relating to co,struction,and hereby authorize fA Lh.r. \,...../A.at. vas this ty -r pon the abo2 e I /etl e j a.5.- S-- - _ property (�sPe ." r se �I �`�rY FINAL FEE 7 Signet .a./ Accounting;Goldenrod-Assessor ./ 1' _ - ti • CONSTRUCTION AND PLANNING POOL&•SPA J 1 .\ .r \d'.\-- I •`'wds: C7 A Date . Inspector APPROVALS Permit# .44 I' i J APPROVALS ' Permit# -Date Inspector 1. Temporary Electrical Service or Pole - 43. Pool & Equipment Location - ' • 2. Soil Pipe-Undrgrn 44. Steel Reinforcement . _3. Electrical Conduit Utility-Undrgrn 45. Forms - 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel Reinforce 47. Rough Plumbing& Pressure Test - 6. Electrical UFER Grn48. APPROVAL TO COVER-GUNITE 7. Footings • 49. Electrical Conduit-Undrgrn . 8. Foundation 50. Gas Pipe, ❑Undrgrn,Test 9. Water Pipe-Undrgrn - 51. Backwash Lines, P-Trap. ❑Undrgrn ' 10. Structural Floor System 52. APPROVAL TO DECK . 11. Property Sewer Line & House Connection _ _ _ 53. Backwash & Receptor-Final -, _ 12. .Street Sewer Connection _ 54. Heater &Vent-Final 13. Rough Plumbing 55. Plumhina System -Final 14. Rough Electric-Conduit - - -56. Electrical-Final ' 15. Rough Electric-Wiring 57. Solar System-Final 16. Rough Heating & Air Conditioning 7/79/,( 4,.c bb. Fencing & Access Approval 17. Ducts, in Structure - . 59. APPROVED FOR PLASTERING • 18.- Ducts, Ventilating . 19. Gas Pipe-Rough &Test - 60. POOL/SPA SYSTEMS FINAL 20. Roof Framing _ • _ 21. Roof Sheathing - ' 22. Frame and Flashing - NOTES: ' 23. Insulation I . 24. Lathing &Siding - . ' • 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter-Final 28. Final Electric 29. Final Heating & Air Conditioning I/2449,1 ,4/7C 30. Final Gas Pipe-Test 31. Final Plumbing 32. Water Service-Final 33. Gas Service-Final 34. Solar Domestic-Final 35. Landscape Sprinkling System • 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY - - No Date Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. 3271 n/ I VG I •. o . ,• 1 CITY O fCOSTA MESA PERM17 NO` ^O TRACT ACT r•10. LOT NO. .BLDG O. ,y dON TRUCTION PERMIT Ld— J 8[ 37C / • I Project Address ..2 . 3tA aJ C • TYPE ONSTRUCTION • . �/�_ Owner � c -04/p b'lCQ Phone 97-4 Ew 0 ADD 0 ALTERATION Address SR) ¢IJi eser• • Q,4,(,K� 0 REPAIR 0 CONVERSION ❑DEMOLI� r` ` ZONING REGULATIONS Arch/Eng. /� / License No. 0 OTHER ,�//�` Address p�s i��.�F}I 4 DESCRIPTION OF WORK P All dO A.P.t eq--22.1. —.24 DL". ` AXNf/C / i,eOhlJ2Al�r ZONE Q,, PLNG. REF.9P22--Iii 20 Contractor !� /((-'( YYY Phones -JO TYPE OF PERMIT BUILDING �T�g�J)Lp 1J _ t 6 ,.,� ,�,/�s SETBACK C/LST. to �ii 131BL1fX' E.6 • Address 0 GRADING IG FOUNDATION L`7 STRUCTURAL I YARD / (� LICENSED CONTRACTOR DECLARATIONu ❑ TENANT 0 ELECTRICAL PLUMBING �MECHMl(G SID / I herebycig affirm that I am licensed under provisionsfof Charter 9 (Cam- - •'A RI GH y�f (com- mencing s with section 7000)myof Envision 3 the Business and 0 OTHER �- T� Professions Code, and my license Is In full force and effect. • REAR YARD(TO P/L) PROJECT DESCRIPTION License Class License No. / '•`'r�\ \S .1S Y PKG.SPACE REG. ,2,.(c- PROVIDED 3r� Dale - Signature - 50.Ff. �-• ` I _ •'KERS'COMPENSATION DECLARATION OCCUPANCY ONST UCTION'TYPE 1LG' w' STREET WIDTH (� / PARK FEE S WSJ eb affirm that I have a certificate of_consent to self-Insure or a ` /1 ZONING APPROVED /` I DAT ., ..Aicate of Workers' Compensation Insurance, or a certified copy VALUATION Cl 'sf Z/t- ZONE - �C/ �1 ice' / thereof(Section 3800,Lab.C.). GRADING CU. YDS. ACRES -. SPECIAL CONDITIONS: • Policy No. CompanyImmix Hain F PFP►A1. RF f F ❑ Certified copy Is hereby furnished. - • REMARKS: 1 >` FOR QU R MSNTS ❑ Certified copy Is filed with the city Building Division. �Of1Al'l�7 ?Tic- [his EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit Is for one hundred D,is „,..,4,,,�! "O ($100) or less). r r.� certify that In the performance of the work for which this permit is Issued, I shall not employ any person in any manner so as to become PLUMBING PLAN CHECK 7 ELECTRICAL //••�a PLAN CHECK'I .s / j subject to the Workers Compensation Laws of California. BATHTUBS 7 SHOWERS • 2 U L I Nu�y�fl 50 FT E y / /KJ / Date Signature C.� NOTICE: If after making this declaration, you should become subject TOILETS 4 URINALS / — GENERATOR 0-1 KW_1-10 KW to the Workers' Compensation provisions of the Labor Code,you must p TRANSFORMER - - forthwith comply with such provisions or this permit shall be deemed LAVATORIES 3 DOUBLE LAYS 9 ., APPLIANCE 10-50 KW 50+KW revoked. ' CONSTRUCTION LENDING AGENCY KIT.SINKS / DISHWASHERS/- ` a — , MOTORS 0-1 HP 1-10 HP • I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS SUMPS ! ,' . s v♦ (INC.SOLAR) 10-50 HP 50+HP formance of the work for which this permit is Issued (Section 3097 Civ. C.). FLOOR SINKS FLOOR DRAINS s•., '� - FIXTURES OUTLETS SWITCHES • Lender's Name e r./ZIC �Jy�jy¢x"�,,�' ,L — - \� Lender's Address 7-9OOS•,q(,6GeSba'$+49,44g2 DRINKING FOUNTAINS -`fl' v� N. -• GAS TUBE SIGNS OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS..., .9 .--A Cv POLE LIGHTS I hereby affirm that I am exempt from.the Contractor's License Law for the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP LuNS IKut(SUN Any city or county which requires a permit to construct, alter, - POLES METERED SUB Ir -,ve,demolish or repair any structure, prior to its issuance,also re• WATER SERVICE/ ALTERATION 2_ — PANELS MAIN • SUB the applicant for such permit to file a signed statement that he - • ised pursuant to the provisions of the Contractor's License Law � % - 2 SERVICE AMP l ter 9 (commencing with Section 7000) of Division 3 of the GAS SERVICE OUTLETS '1 s� r / Business and Professions Code) or that he Is exempt therefrom and the WATER HEATERS BTU OUTPUT .) - . • , - �r _,(r „ 1 — basis for the alleged exemption. Any violation of Section 7031.5 by - any applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS - ''-' q "�r�V YQ _/lam / V,,r y er s of not more than five d dollars ($500). l - 2 ye AA, ^'i-x rale ❑ I, as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS ' sole compensation, will do the work,and the structure is not Intended ` - or offered for sale. (Section 7044, Business and Professions Code:The SOLAR PIPING SYS. ISSUE FEE ,f — whotbuilds License Law does not apply to ansuch owner a ipropertyifor 3 r,- APPLICATION APPROVED BY /ii ,( DATE //4/ who builds or oy thereon,roand who does mph work t rel lot ISSUE FEE s^'T///"` Intended his own employees, If,provided that, improvements are not Intended or one year for sale. If, however, the arbuildingwill or Improvement MECHANICAL PLAN CHECK /ISt�UMMMARY OF FEES Is sold withinasownerrleofa theproperty,Propertyoamhe exc usivelyllicontrethe actirngurden wlth HEATING SYSTEM 0-100,000 BTU � PERMIT $ / 2/'-- SMTP $ L/'6s �o(i proving� he did not build or improve for the purpose of sale). BUILDING r' VC2nsed contractors to construct_the project Section 7044, Business AND DUCTING ' ' ( 100,000 +BTU PLAN CHECK S PERMIT and Professions Code: The Contractor's License Law tloes not apply to ISSUANCE S an owner of property who builds or improves thereon, and who con- R ION 0-100,000 BTU PLUMBING $ ' tracts from such projects with a contractors) licesned pursuant to SY co........ - GRADING S the Contractor's License Law). f „kemp,000+.BTU 6 PLAN CHECK S I ❑ I am exempt under Section B.`.C.f•or this BGIGYRS /`` JJ.Frs�BTU ..7., •,-:! ELECTRICAL E y 3 $ reason /� T . PLgN CHECK $ MICROFILM S DateA��'s -O - / --4.� SYSTEM REP ,ALTERATION /fes TOTAL FEE S I her by certify that I have re-.• his:1 . ion and - . e t at the above EXHAUST SYSTEM MULTIPLE MECHANICAL E `� LESS AD- information is correct. I agree t• omply with all city and county / PLAN CHECK S VANCE PC S ordinances and state laws relating to construction,and hereby authorize s representatives o this city to enter upon the above mentioned www propert fort.1- • •o s. - •� � ISSUE FEE ? - CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor J CONSTRUCTION AND PLANNING - - - .POOL& SPA t .. y /� Date Inspector - - Date ' Inspectot eel,APPROVALS Permit# le;"- - APPROVALS Permit 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location -. . 2. Soil Pipe-Undrgrn Q-77_21 yf/a ' 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn , 45. Forms - - ‘. 4. Electrical Conduit-Undrgrn 46. Electrical Bonding • . - _---_ • - 5.' Steel Reinforce 47. Rough Plumbing& Pressure Test . 6. Electrical UFER Grn - 48. APPROVAL TO COVER-GUNITE 7. Footings gS g .- 2 49. Electrical Conduit-Undrgrn - 8. Foundation - 50. Gas Pipe, 0 Undrgrn,Test ' 9. Water Pipe-Undrgrn .Q-Li-Sir 51. Backwash Lines. P-Trap. 0 Undrern - -10: • Structural Floor System g. 2 i--$/' ` '52. APPROVAL TO DECK - - 11. Property Sewer Line & House Connection 53. Backwash & Receptor-Final 12. Street Sewer Connection - 54. Heater &Vent-Final ' 13. Rough Plumbing . . . 2.-0 Ur-5 01 - 55 Plumbina System-Final 14. Rough Electric-Coriduif JO_23-%i t.( - -56. Electrical-Final - 15. Rough Electric-Wiring - - 57. Solar System-Final • ' 16. Rough Heating & Air Conditioning fl...., ('(-]j41 bd. . Fencing.&Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING .- 18. Ducts, Ventilating - - 19. Gas Pipe-Rough &Test - 60. POOL/SPA SYSTEMS FINAL - - - . . 20. Roof Framing • 21. Roof Sheathing /O;/6: 8f ,- e.. � - 4 . 22. Frame and Flashing //./6- 8/ ,4- NOTES: l o - I �r,-e.. U,-K--S 0 1QSP O h 23. Insulation // 2C37 _4. wwv4-c, yq--rri r 5I,-,', 24. Lathing &Siding /_ / ,Lys ,) ~v /.7 - e V 25. Drywall Nailing /2,/s ' 26. Plaster Brown Coat /,1-29.9/ 14f - • 27. Electrical Power Meter-Final • 28. Final Electric 3,19-$Z °L, _ __29. Final Heating &Air Conditioning 1/.14/".2C' - 30. Final Gas Pipe-Test 5/24/#"- Fre 31. Final Plumbing 7/-"/gt. 5' • . 32. Water Service-Final • • 33. Gas Service-Final 34. Solar Domestic-Final 35. Landscape Sprinkling System 36. Sound Attenuation •_ 37. Handicap Regulations 38. FINAL STRUCTURE & BUI LDI NG .7-7 7 '- O4 4 39. Special Requirements Completed Y 40. Electric Release to Edison - 41. Gas Release to Southern California Gas Co. - 42. CERTIFICATE OF OCCUPANCY . No Date aL'N. p/ I //UI . n. i4 Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. CITY OF,COSTA MESA i PERMIT NO. TRACT NO. LOT NO.. PBLDG.NO. GONVehUCTION PERMIT $ /00/ • Project Address 2 3� Evel� -�'` TYPE OF CONSTRUCTION �1 - Owner ac/Z id/L/W (-116"""'''Rber Phone 0 NEW 0 ADD 0 ALTERATION �6 Address 2_ Rpt poferi¢ em .01 i 0 REPAIR 0 CONVERSION ❑DEMOLISH ZONING REGULATIONS Arch/Eng. . - License No. "❑OTHER . DESCRIPTION OF WORK A.P.Tp " Address ..L ZONE PLNG. REF.gF Contractorse,,,, Phone `7699 f� TYPE OF PERMIT TTppggstl1����pp��Lf.�i r — SETBACK C/LST. PROPERTYLINE Address 21%7/ L s` l[• t0/1- * ) 7�/I GRADING,,y1, 0 FOUNDATION 0 STRUCTURAL SIDE VARD - - LICENSED CONTRACTOR DECLARATION ❑ TENANT' i,ELECTRICAL OPLUMBING ❑MECHANICAII SIDE YARD I hereby affirm that I am licensed under provisions of Charter 9(corn- RIGHT ,.../ mencing with section 7000) of Division 3 of the Business and 0 OTHER ' - ( Professions Code, Land my license is In full force and effect. REAR YARD(TO P/L) . - - - PROJECT DESCRIPTION - License Class License No. PKG.SPACE REQ. - PROVIDED Date Signature SQ.FT. STREET WIDTH PARK FEE$ 'RICERS'COMPENSATION DECLARATION OCCUPANCY_CONSTRUCTION TYPE _ N. 'eby affirm that I have a certificate of consent to self-Insure or a. VALUATION ZONE ZONING APPROVED BY I DATE ( ,ficate of Workers' Compensation Insurance, or a certified copy SPECIAL CONDITIONS:ONDITIONS:thereof(Section 3800, Lab.C.). - GRADING CU. YDS. ACRES ' Policy No. Company ❑�C�ertified copy is hereby furnished.- - REMARKS: GSed - . C Certified copy Is filed with the city Building Division. ' EXEMPTION FROM WORKERS' COMPENSATION DECLARATION a -. - ' (This section need not be completed If the permit is for one hundred . -. • - - - - ($100) or less). - . I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK subject to the Workers Compensation Laws of California. . ' BATHTUBS SHOWERS UWt LLINta LAHAIat Date -- Signature SO FT SO FT ' NOTICE: If after making this declaration, you should become subject TOILETS URINALS 'GENERATOR 0-1 KW_1-10 KW to the Workers' Compensation provisions of the Labor Code,you must TRANSFORMER - - forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS APPLIANCE 10-50 KW 50+KW revoked. - - CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS MOTORS 0-1 HP_1-10 HP - - I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS (INC.SOLAR) 10-50 HP 50 +HP formance of the work for which this permit is issued (Section 3097 - - Civ. C.). FLOOR SINKS FLOOR DRAINS FIXTURES .OUTLETS SWITCHES Lender's Name. Lender's Address DRINKING FOUNTAINS • .GAS TUBE SIGNS P , OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS POLE LIGHTS ' I hereby affirm that I am exempt from.the Contractor's License Law for • the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP •LUNCI HUt.I RAN Any city or county which requires a permit to construct, alter, POLES METERED SUB ' inr--nve,demolish or repair any structure, prior to its Issuance,also re- WATER SERVICE ALTERATION ,PANELS MAIN • SUB r the applicant for such permit to file.a signed statement that he -, • i pled pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS - • SERVICE (- •Ser 9 (commencing with Section 7000) of Division 3 of the, ') ') \ {• a, / AMP - ,S Business and Professions Code) or that he Is exempt therefrom and the WATER HEATERS BTU OUTPUT basis for the alleged exemption. Any violation of Section 7031.5 by ' any applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS • of not-more than five hundred dollars ($500). - • ❑ I, as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS sole-compensation, will do the work, and the structure Is not Intended - ' or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE 3 — Contractor's License Law does not apply to an owner of a property - APPLICATION APPROVED BY DATE who builds or improves thereon, and who does such work himself or ISSUE FEE through his own employees, provided that such improvements are not . I Intended or offered for sale. If, however, the building or Improvement MECHANICAL - PLAN CHECK . Li/ SUMMARY OF FEES is sold within one year of completion,the owner will have the burden of proving he did not build or improve for the purpose of sale). BUILDING 0 I, as owner of the property, am a%cl usively contracting with HEATING SYSTEM 0-100,000 BTU PERMIT $ SMIP $ licensed contractors to construct the project (Section 7044, Business AND DUCTING 100,000 +BTU PLAN CHECK $ PERMIT • and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ N.4 tracts from such projects with a contractor(s) Ilcesned pursuant to SYSTEM GRADING $ the Contractor's License Law). - 100,000 +BTU PLAN CHECK $ - p 0 1 am exempt under Section B.& P.C.for this BOILERS _ BTV ELECTRICAL $ 71' — $ In reason PLAN CHECK $ MICROFILM $ ' - WSYSTEM REPAIR,ALTERATION - - Date Owner - TOTAL FEE E I hereby certify that I-have read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $ information is correct. I agree to comply with all city and county PLAN CHECK $ • LESS AD- ordinances and state laws relating to construction,and hereby authorize VANCE PC $ representatives of this el y to enter upon the above mentioned O� property for ns c o s. ,7 �f FINAL FEE $ o signet ure Accounting;Goldenrod-Assessor • CONSTRUCTION AND PLANNING POOL&SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector • 1. Temporary Electrical Service or Pole • 43. Pool & Equipment Location ' 2. Soil Pipe-Undrgrn 44. Steel Reinforcement _ 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel Reinforce 47. Rough Plumbing& Pressure Test - • 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE . • 7. Footings 49. Elecirical Conduit-Undrgrn 8. Foundation 50. Gas Pipe, ❑Undrgrn,Test 9. Water Pipe-Undrgrn 51. Backwash Lines. P-Trap. ❑Undrgrn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor-Final 12. Street Sewer Connection 54. Heater &Vent-Final 13. Rough Plumbing 55. Plumbing System -Final 14. Rough Electric-Conduit - •56. • Electrical-Final 15. Rough Electric-Wiring /0 23_$( C.. ( 57. Solar System-Final 16. Rough Heating &Air Conditioning b8. Fencing &Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 19. Gas Pipe-Rough &Test E0. POOL/SPA SYSTEMS FINAL 20. Roof Framing 21. Roof Sheathing 22. Frame and Flashing NOTES: 23. Insulation _ 24. Lathing &Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter-Final 28. ' Final Electric .j9j-$2_ e �. 29. Final Heating &Air Conditioning 30. Final Gas Pipe-Test ' 31. Final Plumbing 32. Water Service-Final • 33. Gas Service-Final 34. Solar Domestic-Final • 35. Landscape Sprinkling System 36. Sound Attenuation . 37. Handicap Regulations • - - 38. FI NAL STRUCTURE & BUI LDI NG 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY _ No Date - - • II __ r _ Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. q CITY OF COSTA MESA PE MIT NO. TRA T N LOT NO. BLD O. 23 3C, 'l� - CONSTRUCTION PERMIT I //6�'� ���Ijii( Q� S G ,, • • Project Address L s- U sv i r/'y 11 u- • - TYPE OF CONSTRUCTION IEJ NEW ❑ ADD ❑ ALTERATION ❑ REPAIR - PJ�J0S 3/07/B4 - 3k4.83 TL Applicant's Mailing Address C El CONVERSION El DE OLISH ❑ OTHER A.P. # // -j q - •L ' I- a 3 - Zone - ]� Owner's Name t0 S 0 L._ra (C bi Phone ` S74515 DESCRIPTION OF WORK ii.sq - r t� S Main Building: Accessory Building: 2 Address 2--?ICC Z-lrl a--Uoft V2 c0 �} m5.5?A' E _/. - 0 r �2 •II�l1J / TYPE OF PERMIT ❑ GRADING LI FOUNDATION STRUCTURAL T Front C-H _ N Arch/Eng. Y� P License No. ❑ TENANT 0 ELECTRICAL ❑ PLUMBING ❑ MECHANICAL • B b 1A. 6U2 4S2 OA'/L(�. Gs2. -ftt)t"`rri CI A Rear ` '� Address / Contractor's Name ���O`� Phone • • PROJECT DESCRIPTION 50. F 5I L OCCUPANCY(R_'S C Right 51 �j /� - G •7�. ( l I N( R Address(mailing) •s ! • CONSTRUCTION TYPE it--"k• VALUATION$ O 000 $ Left 35 E ZONE GRADING CU.YDS. ALJ ACRES Ping. Ref.'//' 52. .a 5 Park.Fees $ ��i, 7/_ U City License No. - C `Oo LICENSED CONTRACTOR DECLAR: • • / Remarks:/?C 2��J A.".../, 0 0 Parking Req./Provided Z/Z - I I hereby affirm that I am licensed and• provisi• s •f Cha er 9(commencing JJ R with section 7000) of IsIon of the eosin pr• essions Code,and Use of Building: C b IA/y0 - my license is in full for d4Lf ct ((^^ �1 �tE icen s Or e•-e �6�ZZ PLUMBING FEES Planning Notes: M Date �( Signature / I NQLU FOR SPECIAL REQUIREMENTS -E WORKERS'COMPENSATION DECLARATION Bar Sink Showers N I hereby affirm that I have a certificate of conse to self-Insure or a certificate Backflow Preventer • Service Sink .'S. of Workers' Compensation O Insurance, or a ce tified--copy thereof (Section - - • - - - - 3800, Lab. C.)I,2.S 1q 1-O L . s'T 9a �—u.NO Backflow Irrigation Sewer Cap , - s- ELECTRICAL " ' FEES Policy No. Company -[] Certified copy is hereby furnished.. . . . Bathtubs Sewer Connection . •-r. ; ,, • Automatic Washer ,Transformer 0 15-50'KW'.- I 'Tb)� C tilled copy is filed with the cit uiltling Division. + /� 1 ate Applicant/may\g Clarifiers Solar Collectors, 1' • Construction_Pole Sub. 0 50,n W•,.••• EXrMPTION FROM WORKERS'CO MPENSATION'DECLARATION- - • - - - E..._ - .- - _. .. Dishdasher " Solar Piping CookingUnit - Meter '❑u to 100 am §-- (This section need not be completed if the permit Is for one hundred ($100yor P P - •-- ...- I less). DrinkingFountains • ✓_ r .,,' 7 I certify:that in the performance of the work for which this permit is t to ,I Solar Tank - _ Dishwasher 'Meter ❑over 100 amps - shall not employ any person In any mnia. 5o as to become subject to the , - "'s - Workers' Compensation Laws of California- ' Floor Drains Swimming Pool-w/Spa ' Dryers ❑Gas ❑Electric Sub Panel ` I Date Signature ''• — - ,r NOTICE:If,'af ter making this declaration,you should become subject to the Floor Sinks Urinal Fan • Motors❑0.1 HP 011-8 • Workers'. Compensation provisions of the Labor Code, you must'forthwith - . - - -- - comply with such provisions or this permit shall be deemed revoked. Gas Service Outlets • Water Closet F.A.U. inc. olar ❑9-15 HP ❑16-15+ ,s CONSTRUCTION, LENDING AGENCY- - -- . I hereby affirm that there Is a construction lending agency for the performance Interceptors r'-' Water Heater I Fixtures Microwave of the work- for which this permit• is'issued (Section 3097 Civ. CO - • - ' Lender's Name ' - Kiichen Sink - Water Service - Device Boxes Pole Light ' • Lender's Address, - - . - • - OWNER BUILDER DECLARATION Lavatories • • . . Outlets • Range • 1 hereby affirm that I am exempt from the Contractor's License Law for the p-Tra - mIlowing reason (Section 7031.5 Business and Professional Code: Any city or p. - • Switches Sign - ' unty which requires a permit to construct,alter,improve,demolish or repair - •. • .y structure, prior to its Issuance, also requires the applicant for such permit Roof Drains , Disposal Standing-Sections .o file a signed statement that he/she Is licensed pursuant to the provisions of - the Contractor's License Law(Chapter 9(commencing with Section 7000)of • , Generator ❑0.5 KW 05-15 KW Trash Compactor Division 3 of the Business and Professions Code) or that he/she is exemptPa 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 e.nalty of not more than five hundred dollars($500). -Reinspection Fee $25 Issue Fee $ 3 • LJ I. as owner of the property or my employees with wages as their sole Reinspection Fee $25 Issue Fee $ 3 compensation will do the work, and the structure is not intended or offered MECHANICAL FEES for sale (Section 7044, Business and Professional Code: The Contractor's PUBLIC SERVICES REQUIREME TS: License Law does not apply to an,owner of a property who builds or Improves ' Boiler Hood or Type I 0 • - - / y I/ thereon, and who does such work himself/herself or through his or her own Zoning Approved By �/S KL nate 3/// `1 employees, provided that such improvements are not Intended or offered for - Canopy Type 11 0 7/')d V sale. If, however, the building or improvement Is sol• within one year of com- Duct-Under Ground Application Approved By l IY .Qµ • Date pletion, the owner will have the burden of proving :/she did of build or im- • •ve for the purpose of sale). Duct-Structural • Refrigeration System •• Application Issued By r Date Y r�� ci k•4 I, as owner of the property,am -xclus, ely • ract g ,/th licensed con- r. tors to construct the project(Sec ion 70-4, ness: ❑0.100,000 BTU ❑100,000 BTU - T ne •f property Code: Duct-Ventilating SUrry1'ry�/Appp^y OF FEES ,/ �(J The Contractor's License Law does of apply I• an o ne/of property who BUILDING PERMIT $ r J 41-U. SMIP $ •'*�, U builds or Improves thereon,and who contract -.r su• p'•)ects with a con- Exhaust System ❑ Multiple 0 System Repair/Alteration tractor(s) license pursuant to the •ntr c or' / -rise .w), - PLAN CHECK $ PERMIT ❑Jam ex-mp neer Section j I ' & •.C.for this reason Firepl/Fact.Bit. ICBG# 1111111.51111I l PLUMBING § ISSUANCE $ • Date IlliJrcting PLAN CHECK $ ENERGY PC.- $ I hereby certify t •t d 'Ipp a••Ilca ion an • ate that the above ❑0-100,000 BTU ❑100,000BT GRADING $ Information Is corre•t. c•7 pl ith :II city and county ordinances' ' - ELECTRICAL $and state laws relati gngons r ctio .and hereby authorize repre- ' MICROFILM $sentatives of,this r ff po he wove-mentIonetl rq rty for PLAN CHECK $ /,'/ Inspection purposes• �t l I �3 - TOTAL FEE $ .� L- :L3 Signature Pink-Accounting;Goldenrod -Assessor - - . - 4 CONSTRUCTIONAND PLANNING' - - - - ,i - JOL&SPA - •' • APPROVALS- Permit , Date .Inspector' APPROVALS Permit# Date Inspector lit1. Temporary Electrical Service or Pole' 52. Pool & Equipment Location • • 2. Soil Pipe-Undrgrnd. , ' - 53.E Ste•el 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. (Ws/mac 57. APPROVAL TO COVER-GUNITE s 7: Footings : • • ' .. .. ' I / c 58. Electrical Conduit-Undrgrnd. • - .. -• 8. -Foundation ' in- ,/ 59. Gas Pipe, E Undrgrnd.,Test - - 9: Water Pipe-Undrgrnd. 60. •Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural,Floor System' - . : - • - ' 61. APPROVAL TO DECK ' 1'1. Property.Sewer Line & House Connection i Y . 62 : Backwash & Receptor-Final 1- . 12, Sewer Cap ' 63.1;Heater & Vent-Final ' 13: Roof Drains64.=Plumbing System -Final . 14. Rough-Plumbing • . '65. Electrical-Final 15. Rough Electrical-Conduit - . - - . - 66: Solar System-Final • - 16. Rough Electric Wiring " i I " ;-I ' " 67: Fencing& Access Approval -- - '. 17, Rough Wiring Sign - - 68. -APPROVED-FOR PLASTERING '• 18. Rough Electrical-T Bar Ceiling - . S. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning • • ' FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating - 71. Product Piping 0 Gas 0 Oil • 23. Gas Pipe-Rough & Test. 72. Underground Flush - 24. Roof Framing • - • - • 73. Undergrnd.Storage Tank O Gas 0 Oil - 25. Roof Sheathing I ' ' 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat - 75. Dry Chemical 27. Frame and Flashing ^ 6�3I5 r A� 76. Dry Standpipe 28. Lathing&S7/iding "`�'''*� j,,/cv , ,!1,47 77. FIXED SYSTEM FINAL 29. Insulation, - , ' ; rVSAY , �/h� 78. FIRE PREV. FINAL • 30. Drywall Nailing . , '3/ / I 7/� ✓ti , HEALTH DEPT. REQUIREMENT '31. Plaster Brown Coat' ' / ( 1 79. FINAL-INSPECTION ?2. Electrical Power Meter-Final - • 80. FOOD CERTIFICATE ISSUED 33. Final Electric I i Notes: / eVI Q i /v/_ 34. Final Heating& Air Conditioning' I ! ��""'� • 35. Final Gas Pipe-Test - 36. Hood or Canopy - . , 37. Final Factory•Firepla,c6H - - - _ 38. Final Plumbing..' " ' • ' - - ' 39. Water Service-Final , . . 40. Gas.Service-.Ficial: " - I . • I . 41. Solar•Domestic-Final •tri' ' ' - ' _ , - ' • 42. Backflow Preventer . - 43. Backflow Irrigation ,' , 1 u- , r , I - - 44. .Landscape Irrigation System ' • . ' . , s , 45. Sound Attenuation , ; I " 46. Handicap Regulations c . ,�-/ i 47.-F,INALSTROCTURE"&}BUILDING ' `cy/)( ���; I 48. Special Requirements'Completed /010...-( Cy,c , ; + . , 49. Electric Release to Edison , -- . - - -- . . • ' 50. Gas Release toISouthern California Gas Co I " • , 51. CERTIFICATE OF OCCUPANCY / ' -- - No - ` '8-. Date ( 3 `71 i c , City of Costa Mesa Development Services Department CERTIFICATE OF OCCUPANCY No. QC3168 Building Safety Division P.O.Box 1200 Costa Mesa,California The Building located at 2336 ELOEN AVENUE MITT 4!C' 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 CONCTIMTNTC}M • Legal Description 439-761-23 (See reverse side for Metes and Bounds) Building Permit No 8-116`36 Electrical Permit No. E-12471 Plumbing Permit NoP-12185 Mechanical Permit No. M-1 V47 Number of apartmentsand/or guest� roomsro ISSUED TO: Building Official /.L/!/l r g�r/f ! -a0-41— ,f E.S. OLRICH b— / 2881 EUROPA DR., COSTA MESA, CA. Y �/' `�.� /92,/ Date J �/ '/ This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises amid SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 lel U.B.C. CMF 1015-46 rev.1/a3 White-Owner;Canary-Numerical File;Pink-Bldg.Permit File Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. _ Y OF COSTA MESA PERMIT NO. TRACT O. LOT NO. •BLDGs NO. • • - CONSTRUCTION PERMIT (?' S S /1 v / (J/� - IL Project Address D.. ate C.12�87�) b TYP CONSTRUCTION 3270B/12/81• 343e96 TL Owner CL/al CJj- K/5tne,/i(f7 PhOnr�d�akm NEW 0 ADD ❑ALTERATION J., Address ;I,g�-1 t,AJ�. , .. : CM ❑ OTHER0 REPAIR ❑ CONVERSION ❑DEMOLISH s--•\ ZONING REGULATIONS Arch/Eng. �.�A,_ License NOS A.P.IIIIIIII QI DESCRIPTION OF WORK n-ZACI .fig 'off-InI ��� Address i Or�Q'� L . ,n f +�1t 11E ZONE -� PLNG. REF. sF Zg /-?•Q Contractor C D / ""7/ Phon f, )7t TYPE OF PERMIT_„/ ,,��..��•• r BUILD/ c, LL11IIL�Dp ryry Address ( 0 GRADING FOUNDATION I STRUCTURAL S5EpTES YA D/LST.S ERTV LGNE LICENSED CONTRACTOR DECLARATION 0 TENANT 0 ELECTRICAL OPLUMBING OMECHANICAL LEFT ��/ I hereby affirm that I am licensed under provisions of Charter 9(corn- - -- - +-t 6 • ,�, C RIGHT '2'2 7 ' - mencing with section 7000) of Division 3 of the Business and O OTHER G r - - Professions Code, and my license Is In full force and effect. REAR YARD(TO P/L) PROJECT DESCRIPTION _ +, License Class _ License No. ////1 y : .\. tt- �' y PKG,SPACE REQ. l PROVIDED ar�� SQ:FT. �7'Y Date Signature ' . I v•rl - STREET WIDTH ��r PARK FEE $�y1 (li KERS'COMPENSATION DECLARATION - - OCCUPANCY ONSTRUCTION TYPE` Ir.; / S v, •-•eby affirm that I have a certificate of consent to self-insure or a ZONING APPROVED rj ls/A DF14 E/r'-R/ Icate of Workers' Compensation Insurance, or a certified copy VALUATION /3�+�ZONE /�(/'n� X C/-7S tttt eof(Section 3800,Lab.C.). - GRADING CU.YDS. ACRES SPECIAL CONDITION Policy No. Company O Certified copy Is hereby furnished.- - - ' ' - -- -REMARKS:- - —^ Hl(1LI] FflP copCrgr-'P QU }v±NT5 O Certified copy.is.filed with the city Building Division. _ •//�� qq • EXEMPTION FROM WORKERS' COMPENSATION DECLARATION • ( "b td -r eF �J • • • • _• , (`This section need not be completed if the permit is for one hundred n �I Z[ s.- -L..-- /�� i�or_�� .. ($100) or less). (i (�•P>' ' {This 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 PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK subject to the Workers'Compensation Laws of California: _ UW GLLING OHHAGL o Date Signature BATHTUBS 7_ SHOWERS-2e / SO.FT /4G0 50_FT tile/ 26 ! I NOTICE: If after making this declaration, you should become subject -TOILETS ,, J. URINALS ... GENERATOR 0-1 KW_ KW' to the Workers' Compensation provisions of the Labor Code,you must TRANSFORMER . forthwith comply with such provisions or this permit shall be deemed LAVATORIES 'Y DOUBLE LAVS 47 APPLIANCE 10-50 KW 50 + KW - revoked, KIT.SINKS // DISHWASHERS CONSTRUCTION LENDING AGENCY r 6 — MOTORS 0-1 HP 1-10 HP I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS ' .tom -,t • . \(INC.SOLAR) 30-50 HP_50+HP formance of the work for-which this permit is issued.(Section 3097 J !-4 - Liv.en Landers �/'' `m� FLOOR SINKS FLOOR DRAINS,, � •-s ♦ '� FIXTURES OUTLETS SWITCHES C.). Lender's NamaT/`f� ��'f'�s�H'I/K \ - Lender's Addresa S MV€t 'OWb 7K/t17,314',*,7 W/9 DRINKING FOUNTAINS •ri• 'jy t ct GAS TUBE SIGNS - OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS', - -• POLE LIGHTS I hereby affirm that I am exempt famine Contractors License Law for the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOLPTRAP Lurid I KW..I IUN - Any city or county which requires a permit to construct, alter, - POLES METERED -SUB improve, demolish or repair any structure, prior to its issuance,also re- WATER SERVICE/ ALTERATIONPANELS MAIN SUB r s the applicant for such permit to file a signed statement that he _22 ^ _ I used pursuant to the provisions of the Contractor's License Law GAS SERVICE / OUTLETS St \ :•2 '�. SERVICE AMP i ,der 9 (commencing with Section 7000) ofDivision 3 of the -••Business and Professions Code) or that he is exempt therefrom and the WATER HEATERS/ BTU OUTPUT II ;2•i basis for the alleged exemption. Any violation of Section 7031.5 by -- ram. �1� '- any applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS/ s1 frdg rr of not more than five hundred dollars ($500)• - - _ - • 2 `• '., O V* / .M. . Phe herr- : O I, as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS'•- r sole compensation, will d0'the work,and the structure Is not Intended - '' or offered for sale. (Section 7044, Business and Professions Code:Tile SOLAR PIPING SYS. ISSUE FEE 'P� — Contractor's License Law does not apply to an owner of a property a- who builds or improves thereon, and who does such work himself or ISSUE FEE 3 .APPLICATION APPROVED BY DATES.(/8r through his own employees, provided that such improvements are not or�• - L • intended or offered for sale. If, however, the building or Improvement MECHANICAL PLAN CHECK SUMMARY OF FEES pJ is sold within one year of completion,the owner will have the burden f proving he did not build or improve fpr the purpose of sale). BUILDING �s as owner of the property, am exclusively contracting with HEATING SYSTEM 0-100,000 BTU .PERMIT $_ j. ••••• SMTP $ AND DUCTING PLAN CHECK $ PERMIT censatl contractors to construct the project (Section 7044, Business 100,000 +BTU. and Professions Code: The Contractor's License Law does not apply to - ISSUANCE E - an owner of property-who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ �a tracts from such projects with a contractor(s) Ilcesnetl pursuant to SV T y . -r t • '(^ GRADING $ - • the Contractor's License.Law), � � ����((((CCCC��'�fflf����L 110--00,,000 +BTU - ` 'G' .., PLAN CHECK 'S ❑ 1 am exempt untler Section B.& P.C.101 this p s ,/ / $ BGiLERST BTU( /��y7 ELECTRICAL E ,7J 3f reaso. ��' ``� " ' MICROFILM $ � '� �� SYSTEM REP IR,ALTERATION PLAN CHECK $ Dat+ Own- �� ' MECHANICAL S ••••••• TOTAL FEE E 1 h• eby -rtify that I have rea• Is ..•• ton and st that the above EXHAUST SYSTEM MULTIPLE • LESS AO- Information is correct. I agr - to co •ly with all city and county /! •PLAN CHECK S VANCE PC E ordinances and state laws relating to construction,and hereby authorize Mj,[, - rr�l • y , •, - represent,tives�•f this city t• enter upon the above mentioned -7 - r propert ' spectior Pur•• : - ""- /o�A ofi ff as pis bv, .2 - , _ /, FINAL FEE $ 1'90% Signal ISSUE FEE 3E - - j CMF 0865-46 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor ..„ CONSTRUCTION AND PLANNING - POOL,&SPA ' ..- APPROVALS Permit# Cs-58/ Date Inspector APPROVALS Permit# ' Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - 2. Soil Pipe-Undrgrn a•lr-pr 4-(?f 44. Steel Reinforcement - - 3. Electrical Conduit Utility-Undrgrn 45. Forms . • 4. .Electrical Conduit-Undrgrn _ 46. Electrical Bonding ,. . . - _ - - - -, 5. Steel Reinforce 47. Rough Plumbing& Pressure Test _ • "6. Electrical UFER Grn . - - 48. APPROVAL TO COVER-GUNITE 7. Footings g,eft,gj �._ 49. Electrical Conduit-Undrgrn ' 8. Foundation •, _ - 50. Gas Pipe, ❑Undrgrn,Test 9.- Water Pipe-Undrgrn - • 2r.Z./.S/ . 'z 51. Backwash Lines, P-Trap. ❑ Undrern -- - 10: Structural Floor System B Zq-.R/ 52: APPROVAL TO DECK ." ... 11.- Property Sewer Line & House Connection ,- 53. Backwash & Receptor-Final , • 12. Street Sewer Connection _ ' 54. Heater-&•Vent-Final , 13. Rough Plumbing I• /(��Q] - 55. phimhinc System •,Final - - - - 14. Rough Electric-Conduit - __ . .. . -56. Electrical-Final ' 15. Rough Electric-Wiring - /0- ')--.31 0 ,..t . 57. - Solar System-Final - • >' 16- Rough Heating& Air Conditioning P_-, (I-9..,41 :_ b8.' 'Fencing &-Access Approval 17. Ducts, in Structure . - 59. APPROVED FOR PLASTERING - " ' 18. • Ducts, Ventilating • - - - - 19. Gas Pipe-Rough &Test • 60. POOL/SPA SYSTEMS FINAL 20. Roof Framing . • - , • • 21. Roof Sheathing /p•/ .2l ;� _ - 22. Frame and Flashing ' • 7/-/L- V A - NOTES: - 23. Insulation //a<RI ' 24. Lathing&Siding /-2-it *V - 25. Drywall Nailing (2,87 RJ 6/> • • 26. Plaster Brown Coat /j- .9'iY7 'l41. 4 • 27. Electrical Power Meter-Final . -28. Final Electric 3-j -C_ L° _ - , -.29.• Final Heating & Air Conditioning '/ /y2el/PC • • 30. Final,Gas Pipe-Test _ Vo /y1 [`+ • 31. Final Plumbing 7/itayO �f- . 32. • Water Service-Final - • • 33. Gas Service:Final 34: Solar Domestic-Final • - • ^ 35. Landscape Sprinkling Systim' is - - 36. Sound Attenuation • • 37. Handicap Regulations . . • 38. FINAL STRUCTURE & BUILDING L/a//$p_- cue [ ' 39. Special Requirements Completed 40 . Electric Release to Edison. , '• - ' 41. Gas Release to Southern California Gas Co. (p,/�.V/� a . - 42. CERTIFICATE OF OCCUPANCY - • r ... t No_ Date 1 ' Applicant to fill in all spaces within heavy border lines and.sign all appropriate declarations. •CI,OF.CiaSRA MESA PERMIT NO. TRACT NO. LOT-NO. BLDG.NO. ._ • CONS'I-4RUCTION PERMIT ff/OOZ _ D Project Address 9 ca 14 e d'Az n TYPE OF CONSTRUCTION • Owner Q/„/Q /e,F( W�/(y�T 'Phone 0 NEW 0 ADD 0 ALTERATION �l� Address O7tS'/ E co to/214- 0 REPAIR 0 CONVERSION 0 DEMOLISH 1.5. ZONING REGULATIONS Arch/Eng. License No. -❑ OTHER - - - DESCRIPTION OF WORK A.P. Address ZONE PLNG. REF.#. Contractor 2445.4/490/A'e Phone 76A81' TYPE OF PERMIT BUILDING To BUILDING - SETBACK C/L ST. PROPERTY LINE Address Z/7/Z. Cj // cliff I,/a 1.- ../ - - 0 GRADING ❑ FOUNDATION ❑ STRUCTURAL SIDE VARO LICENSED CONTRACTOR ECLARATION 0 TENANTD ELECTRICAL OPLUMBING ❑MECHANICAL/ 5IQE YAR ' I hereby affirm that I am licensed under provisions of Charter 9(corn- mencing with section 7000) of Division 3 of 'the Business and .❑ RIGHT OTHER - - "- Professions Code ntl _my license is in full force and effect. REAR YARD(TO P/L) License Class �"'e O 1�4�ese���'' A . PROJECT DESCRIPTION License No. 2L PKG.SPACE REQ. PROVIDED Date 47---- 7 fp Signature ,'/2-:— SQ. FT. • RKERS'COMPENSATION DECLARATION OCCUPANCY—CONSTRUCTION TYPE STREET WIDTH PARK FEE$ reby affirm that have a certificate of consent to self-Insure or a ZONING APPROVED BY •- DATE dficate of Workers' Compensation Insurance, or a certified copy ' VALUATION ZONE -- thereof(Section 3800, Lab. C.). - _ GRADING CU.YDS.. ACRES SPECIAL CONDITIONS: Policy No. • Company '. 0 Certified copy is hereby furnished. - - ' ' REMARKS: Sc-'?'f /- - ' 0 Certified copy is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - . - • n r� (This section need not be completed if-the permit is for one hundred - - - - - - , . . -. ($100) or less). .• . . . . • I certify that in the performance of-the-work for which this-permit is - - - ., issued, I shall not employ any person in any manner so as to become .PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK ' subject to the Workers Compensation-Laws of California: - -- - uwtLLlrvG c,A KAGt Date - Signature BATHTUBS SHOWERS SO.FT 50 FT • • NOTICE: if after making this declaration, you should become subject• TOILETS t URINALS i GENERATOR 0-1 KW_1-10 KW • to the Workers' Compensation provisions of the Labor Code,you must -TRANSFORMER - forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS 'APPLIANCE 10-50 KW 50+ KW _ ' revoked. ' - - . CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS MOTORS 0-1 HP 1-10 HP - - • I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS . SUMPS -.(I NC.SOLAR) -10-50-HP 50+ HP - formance of the work for which this permit is issued (Section.3097 - • Civ. C.). FLOOR SINKS FLOOR DRAINS ,FIXTURES OUTLETS SWITCHES - Lender's Name _ Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS . OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS POLE LIGHTS - thereby affirm that I am exempt from.the Contractor's License Law for ' the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP LOINS.Kut.I IUN • Any city or county which requires a permit to construct, alter, POLES METERED 'SUB - ' i, y'_ove, demolish or repair any structure, prior to its issuance,also re- WATER SERVICE ALTERATION • ?= he PANELS MAIN SUB ^'?nsed s the lpursuant tothesuch of•the Contractor's License ned statement that Law •• 'k= provisionsGAS SERVICE OUTLETS _ l) �'{�,•. -� _ • 'SERVICE7 AMP l 9 (commencing_with Section. 7000) of Division 3 of the. Business and Professions Code) or that he is exempt therefrom and the WATER HEATERS BTU OUTPUT basis for the alleged exemption. Any violation of Section 7031.5 by • • any applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS . of not more than five hundred dollars ($500). ❑ I, as owner of the property,or my employees with wages as their SOLAR TANK COLLECTORS 3 sole compensation, will do the work, and the structure is not intended - - or offered for sale. (Section 7044, Business and Professions Code:The SOLAR PIPING SVS. ISSUE FEE Contractor's License Law does not apply to an-owner of a property APPLICATION APPROVED BY who builds or.improves thereon, and who does Such work himself or ISSUE FEE DATE through his own employees;provided that-such improvements are not - - intendetl or offered for sale. If, however,the building or Improvement MECHANICALPLA - -N CHECK _ SUMMARY OF FEES • is sold within one year of completion,the owner will have the burden - •- -- - -- - - _ of proving he did not build or improve for the purpose of sale). - BUILDING • . - HEATING SYSTEM 0-100,000 BTU - PERMIT.. $ SMTP $ Li 0 I, as owner of the property, am exclusively contracting with AND DUCTING Y -licensed contractors to construct the project (Section,7044, Business _ 100,000+BTU PLAN CHECK $ PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ Qan-owner of property who builds or improves thereon, and who con- REFRIGERATION_ 0-100,000 BTU . PLUMBING $ • tracts from such projects with a contractor(s) Ilcesned pursuant to SYSTEM • -GRADING $' - - the Contractor's License Law). 100,000•+BTU PLAN CHECK Si' k. 0 I am exempt antler Section B.& P.C.for thisBOILERS_ _ BTU ELECTRICAL $ C7 --- $ vJ reason " •' - - MICROFILM $ 111 SYSTEM REPAIR,ALTERATION t' PLAN CHECK $ 'N Date Owner - - TOTAL FEE$ • 3 MECHANICAL•$ - ' • I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE LESS AD- - - - ordinaation is correct. I agree to comply with all city and county 'PLAN CHECK $ . . - -VANCE.PC $ representatives es ofstate-lawsthis relating to construction,and hereby authorize - - - ,. representatives of°�tthis^city to enter upon the above mentionedtiEf - - -- - ' Property Signature a� ISSUE FEE •- - CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor / CONSTRUCTION AND PLANNING ��''yy�� 11. POOL&SPA s .• .�"' APPROVALS Permit# E-ILq�Z Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole r - 43. Pool & Equipment Location _ 2. Soil Pipe-Undrgrn - 44. Steel Reinforcement , - , 3. Electrical Conduit Utility-Undrgrn _ 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding _ . 5. Steel Reinforce 47. Rough Plumbing & Pressure Test - 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE - . • . . .. ' 7. Footings - 49. Electrical Conduit-Undrgrn ' 8. Foundation 50. Gas Pipe, ❑Undrgrn,Test • 9. Water Pipe-Undrgrn 51. Backwash Lines.P-Trap. ❑Undrgrn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor-Final- 12. Street Sewer Connection 54. Heater &Vent-Final 13. Rough Plumbing 55. Plumbing System - Final - ' 14. Rough Electric-Conduit s56. `-Electrical-Final . , 15. Rough Electric-Wiring to al-'Wl 0 C 57. Solar System-Final . 16. Rough Heating & Air Conditioning b8. Fencing & Access Approval • 17. Ducts, in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating _ . 19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL . 20. Roof Framing . 21. Roof Sheathing 22. Frame and Flashing - NOTES: 23. Insulation • 24. Lathing &Siding 25. Drywall Nailing • - 26. Plaster Brown Coat ' 27. Electrical Power Meter-Final 28. Final Electric 3 ./6/S2- C.0 . - _ 29. Final Heating & Air Conditioning - 30. Final Gas Pipe-Test ' 31. Final Plumbing 32. Water Service-Final 33. Gas Service-Final - 34. Solar Domestic-Final • .. ' 35. Landscape Sprinkling System 36. Sound Attenuation 37: -Handicap Regulations -- - ' 38. FI NAL STRUCTURE & BUILDING "- _ 39. Special Requirements Completed ' - • - . 40. Electric Release to Edison - 1.9(22-p3Z 0. - - - - . - - 41.. Gas Release to Southern California Gas Co. - -- _' ' ' 42. CERTIFICATE OF OCCUPANCY - _ No Date - . - " J Applicant to fill In all spaces within heavy border lines and.sign all appropriate declarations. CITY OF-COSTA MESA ' - PERMIT-NO - - TRACT NO. -LOT NO. •BLD NO. ' - -' -'. CONSTRUCTION PERMIT /Sot Project Address pi336 et e_-t- v e,, D ` TyPEOF CONSTRUCTION ' __ 1 , 7396 10/23_/8_1 i 1.3.00 TU Owner (DLit/CH (i(J/Li5.4�OC79hb"¢ Sri ❑ ADD '-❑ ALTERATION" - - - - - Address /fp0/ 5K-ypz.c •4 / .0//(e -❑ REPAIR 0 CONVERSION ❑DEMOLISH ZONING REGULATIONS Arch/Eng. -- - - License No. . . ❑ OTHER A.P.# . -- DESCRIPTION OF WORKn2G" Address' - ' - J- - - �_vM _. ,._' � � ?sU LT%71 L— Kit- ZONE --PLNG.. RtE�F. $ - ,`Contractor - OL.�net— e.u;IkP. .,-Phone -TYYP OFF PGE+REMIT KA.42-1fs/ _SETBACK C/L ST. �ROPEIRTVNLINE _ -_2- CI GRADING' 0 FOUNDATION --❑'STRUC URAL S DE,rYARID- • '- - '- - • LICENSED-CONTRACTOR-DECLARATION •❑ TENANT ❑-ELECTRICAL ❑PLUMBINGMECHANICAV- SIDE YARD'- - - - . I hereby affirm that I am licensed under provisions of Charter 9 (com- - RIGHT ' mencing with section 7000) of Division 3 of- the Business and ' ❑ OTHER - - Professions Code, and license Is In full force an effec - ' REAR YARD(TO P/L) ' n + PROJECT.DESCRIPTION _. __ ___ _ License Class -S, License No. PKG.SP-ACE REO. PROVIDED Date TC 2 4�/'^'Signature - .SG.FT. _ __ _-. , WORKERS'COMPENSATION-DECLARATION . -___ . . OCCUPANCY_CONSTRUCTION TYPE .STREET WIDTH ,r-- PARK FEES,-", _ 'tray affirm that I have a certificate of consent to self-insure or a, VALUATION • ZONE • ZONING APPROVED BY .I DATE • -- of Workers'Compensation Insurance, or a certified copy .- -- - ,•eof(Section 3800,Lab.C.). ; GRADING CU.YDS. ACRES SPECIAL CONDITIONS: - Policy No. - -- - _Company -_ - - .. . . - _ - _ _ . - - - CD-Certified copy Is hereby-furnished.- ' • -REMARKS: e- • ..,---,,,,,,/ . .. _. _- .- 0 Certified copy is filed with the city Building Division, _ EXEMPTION FROM WORKERS' COMPENSATION'DECLARATION _ - . - - - - - . .. - - • (This section.need.not be completed if-.the permit is for.one hundred _ _. - _ _ - - - ($100) or less). f_. certify that In theperformance otthe ork J,r which this permit is - , _ ._ _ _ _ Issued, I shall not employ any perso anyA.,. r s• as s .ecome i PLUMBING PLAN-CHECK ELECTRICAL PLAN CHECK — - • , • - subjecto-the Wo ke 5 Compe05at1o, .w i e%%i.,/ - _ • _ _ _ Date jo'd5-i-/ _����y/��� BATHTUBS • SHOWERS SQ FT DWELLING SO FT -• - - -- - Signature NOTICE: If after making this declaration, you sho.Id become subject TOILETS •, ,:rl _ URINALS - - - GENERATOR ` 0-1 KW_1-10 KW - to the Workers' Compensation provisions of the Labor Code,you must TRANSFORMER - , , forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS ' - '- APPLIANCE-- 10-50 KW 50+ KW: ' • CONSTRUCTION LENDING AGENCY KIT:SINKS DISHWASHERS- "'- -- MOTORS -- -0:1-HP' 1-10 HP - ' - -- I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS r. 'SUMPS-. " (INC.SOLAR)--10-50 HP=50-+-HP - - formance of the work for which this permit is issued (Section 3097 - Civ C.). FLOOR SINKS FLOOR DRAINS . .. FIXTURES OUTLETS SWITCHES - - - • ' ,Lender's Name _ _ _ _ _ _ '- Lender's Address DRINKING FOUNTAINS ,GAS TUBE SIGNS _' - - - OWNER BUILDER DECLARATION - INTERCEPTORS CLARIFIERS POLE LIGHTS - - I hereby affirm that I am exempt from.the Contractor's License Law for the following reason (Section 7031.5 Business-and-Professions Code: SWIMMING-POOL P TRAP ' - -- LONSI KUL.IIUry _ Any. city or,county which requires a permit to construct, alter, 'POLES METERED SUB improve, demolish or repair any structure, prior to Its issuance,also re- WATER SERVICE - ALTERATION - ' PANELS- MAIN 'SUB - '+ IrL,:ipS the applicant for such permit to file a Signed statement that he - - . - -- -+ •nsed pursuant to the provisions of the-Contractor's License Law GAS SERV ICE OUTLETS SERV ICE - - ' AMP --- - - - 1'r'-`T ter 9 (commencing with Section 7000) of Division 3 of the ht - ,:-.,ness and Professions Code)-or that he Is exempt'therefrom and the 'WATERHEATERS - BTU OUTPUT „,. ' '- - -' -- basis for the alleged exemption. Any violation of Section 7031.5 by - • any applicant for a'permit subjects the applicant to a civil penalty SEWER CONNECTIONS - ' - -' of not more than five hundred dollars ($500). - ❑ I, as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS - - • - sole compensation, will do the work,and the structure is not intended _ ' ' - • or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. • ISSUE FEE ' - Contractor's License Law does not apply toanowner of a property - ,APPLICATION APPROVED BY - DATE who builds or Improves thereon, and who does such work himself or ISSUE FEE through his own employees,.provided that such Improvements are not _ intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK SUMMARY OF FEES Is sold within one year of completion, the owner will have the burden - BUILDING of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU / PERMIT $ _ - SMIP ' ' $ .0 I, as owner of -the property, am exclusively contracting with AND DUCTING • - -- licensed contractors to construct the project (Section 7044, Business • 100,000 +BTU PLAN CHECK $ PERMIT and Professions Code: The Contractor's'License Law does not apply to - ISSUANCE $ an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ ' tracts from such projects with a contractor(s) Ilcesned pursuant to - SYSTEM GRADING $ ' the Contractor's License Law). 100,000+BTU PLAN CHECK $ ❑ I am exempt under Section B.& P.C.for this .BOILERS BTU "ELECTRICAL-S - - $ reason - ' - • - PLAN CHECK $ MICROFILM $ Date' - - Owner -- SYSTEM REPAIR,ALTERATION TOTAL FEE$ I herebycertifythat.I ha a read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $ - PP LESS AD-F information Is coast I agree to comply with all city and county PLAN CHECK -$ • VANCE PC $_ ordinances and state ws r:.atin• o constru tion,and hereby authorize / iT' ve:+-f S1 , representatives his /y . e Cr .. the above mentioned. /La ,� /3 — property for i ec i'••,. / G/ Signature / Accounting;Goldenrod-Assessor / CONSTRUCTION AND PLANNING 1 • POOL&SPA ___. _ - . 11 APPROVALS 16\F'�� Permit# t'J 1� Date Inspector APPROVALS ' Permit# - Date Inspector • 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - 2. Soil Pipe-Undrgrn 44. Steel Reinforcement • - - - ' • 3. Electrical Conduit Utility-Undrgrn . • 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel Reinforce - _ 47. Rough Plumbing& Pressure Test - 6. Electrical UFER Grn - N 48. APPROVAL TO COVER-GUNITE • 7. Footings - 49. Electrical Conduit-Undrgrn 8. Foundation • 50. Gas Pipe, Undrgrn,Test 9. Water Pipe-Undrgrn 51. Backwash Lines,P-Trap. D Undrgrn 10. Structural Floor System . 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor-Final . • ' 12. Street Sewer Connection 54. Heater & Vent-Final 13. Rough Plumbing 55. Plumbing Svstnm -Final 14. Rough Electric-Conduit - 56. Electrical-Final 15. Rough Electric-Wiringn- ^ 57. Solar System-Final 9..016. Rough Heating & Air Conditioning - b. -S 58. Fencing & Access Approval 17. Ducts, in Structure _ 59. APPROVED FOR PLASTERING . . 18. Ducts, Ventilating 19. Gas Pipe-Rough &Test • 60. POOL/SPA SYSTEMS FINAL 20. Roof Framing ' 21. Roof Sheathing - 22. Frame and Flashing NOTES: , • 23. Insulation _ 24. Lathing & Siding - . 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter-Final 28. Final Electric . 29. Final Heating & Air Conditioning 1 lb., 3.-1L •. 1- 30. 30. Final Gas Pipe-Test . 31. Final Plumbing 32. Water Service,Final 33. Gas Service-Final • 34. Solar Domestic-Final 35. Landscape Sprinklinq System 36. Sound Attenuation 37. Handicap Regulations 38. FI NAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison • 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY ' No Date - -r Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. 7((35 10/26/13I 74�� CITY OF COSTA MESA PERMIT NO. TRACT NO. - LOT NO. BLDG.NO. _ _ _ • CONSTRUCTION6/13I 7op D Project Address. / L..w ` TYPE OF CONSTRUCTION = - OWner//�y,-f S /�. _ hOntj�fy ► 0 NEW 0 ADD 0 ALTERATION Address(((fff'S1s_2 0REPAIR 0CONVERSION ❑DEMOLISH //�S>(..l`^.'1L s�����•••aaa . ZONING REGULATIONS Arch/Eng-1 yu.e,L License No. 0 OTHER A.P.sP Address DESCRIPTION OF WORK u—'--'- ZONE PLNG. REF.4, • Contractor f/��q - - Phone - - - BUILDING 1 I G �.` _ TYPE OF PERMIT SETBACK C/L ST. X2DBP10 k��LI NE Address _ - 0 GRADING 0 FOUNDATION 0 STRUCTURAL SIDE YARD - - LICENSEfJ'CONTRACTOR DECLARATION 0 TENANT 0 ELECTRICAL ❑PLUMBING MECHANICAL LSIEDFET YARD - - - 1 hereby affirm that I am licensed under provisions of Charter 9(corn- sVVVVV/������ RIGHT mencing with section 7000) of Division 3 of the Business and ❑OTHER - _ Professions Code, and my license Is In full force and effect. PROJECT DESCRIPTION REAR YARD(TO P/L) - License Class Clcense No. PKG.SPACE REQ. PROVIDED ' Date Signature SQ.FT. - RKERS'.COMPENSATION DECLARATION OCCUPANCY— CONSTRUCTION TYPE STREET WIDTH PARK FEE$ eby affirm that I have a certificate of consent to self-insure or a VALUATION ZONE ZONING APPROVED BY DATE note of Workers' Compensation Insurance, or a certified copy - .- - - thereof(Section 3800,Lab, C.). GRADING CU.YDS. ACRES - - - SPECIAL CONDITIONS: PolicY No. Company - - - - - - • • ❑Certified copy is hereby furnished. REMARKS: _ 5O . , ❑Certified copy is filed with the city Building Division. d - EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - -(This section need not be completed If the permit is for,one hundred - ' ($100) or less). r. . • - - - - - - - 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 -PLUMBING PLAN CHECK - ' ' ELECTRICAL - PLAN CHECK subject to the Workers Compensation Laws of California. UW ELLINI. 6AHA0t Date Signature _ BATHTUBS SHOWERS' SO FT SO FT NOTICE: If after making this declaration, you should become.subject TOILETS. URINALS - - - GENERATOR 0-1 KW__1-10 KW to the Workers' Compensation provisions of the Labor Code,you must - TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE 10-50 KW_50+ KW - revoked. CONSTRUCTION LENDING AGENCY KIT.SINKS - DISHWASHERS MOTORS 0-1 HP 1-10 HP _ I hereby affirm that there is a constructiot lending ag u cy for the per• SERVICE SINKS SUMPS - (INC.SOLAR) 10-50 HP 50+HP formance of .rk •r • .. his yr s.-5 issuj- (Section 3097 Civ. C.). . be. FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES Lender's Name g- _ ' Lender's Address/ WO , a /A .'�I wr .f- -- DRINKING FOUNTAINS GAS TUBE SIGNS OWNER BUILDER DECLARATION - INTERCEPTORS CLARIFIERS POLE LIGHTS ' • I hereby affirm that 1 am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP Luno I HUL I IUN - Any city or county which requires a permit to construct, alter, POLES METERED SUB imorove,demolish or repair any structure, prior to its issuance,also re- WATER SERVICE ALTERATION PANELS MAIN SUB •s the applicant for such permit to file a signed statement that he - ensed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS SERVICE AMP Ater 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is'exempt therefrom and the WATER HEATERS BTU OUTPUT'„ . - • basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil' penalty SEWER CONNECTIONS • - • - of not more than five hundred dollars ($500). ❑ I, as owner of the property,or my employees with wages as their SOLAR TANK COLLECTORS - sole compensation, will do the work,and the structure Is not intended or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE • Contractor's License Law does not apply to an owner of a property APPLICATION APPROVED BY DATE who builds or improves thereon, and who does such work himself or ISSUE FEE through his Own employees, provided that such Improvements are not - intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK SUMMARY OF FEES is sold within one year of.completion,the owner will have the burden BUILDING \of(9roving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU PERMIT $ SMIP S I--as owner of the property, am exclusively contracting with kAND DUCTING ensed contractors to construct the project (Section 7044, Businessi. 100,000 + BTU - PLAN CHECK $ PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ ' ' an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts from such projects with a contractor(s) licesned pursuant to SYSTEM - GRADING $ the Contractor's License Law). 100,000+BTU_ PLAN CHECK $ ❑ l am exempt under Section B.8 P.C.for thisBOILERS BTU ELECTRICAL $ $ reason PLAN CHECK $ MICROFILM S. Date Owner SYSTEM REPAIR,ALTERATION ,yI TOTAL FEE$ - I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $ information Is correct. I agree to comply with all cityand countyPLAN CHECK $ LESS AD- information ) VANCE PC $- presnces and state laws relating to o str tion, hereby authorize pa q�, f O{• P/ Signature representatives o is ci •r o nJd1r� the abov m tionetl i property f•r in • cti•:f_••.rp• / j _ ,�/,�3�T 7_ — Signature -. -1.--;--. FINAL FEE E Drivers Lie�se -,� ^ ISSUE FEE a — CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor • t..c i;. aFnC CONSTRUCTION AND PLANNING POOL& SPA \ • I APPROVALS Permit# /`J Xo Date Inspector APPROVALS Permit# Date Inspector 1.• Temporary Electrical Service or Pole 43. Pool & Equipment Location • 2. Soil Pipe-Undrgrn 44. Steel Reinforcement • • 3. Kcal Conduit Utility-Undrgrn • 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel Reinforce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undrgrn 8. Foundation 50. Gas Pipe, ❑Undrgrn,Test 9. Water pipe-Undrgrn 51. Backwash Lines. P-Trap. ❑Undrgrn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor-Final 12. Street Sewer Connection 54. Heater & Vent-Final 13. Rough Plumbing 55 Plumbing System- Final 14. Rough Electric-Conduit - - -56. Electrical-Final 15. Rough Electric-Wiring 57-. Solar System-Final • 16. Rough Heating & Air Conditioning NAM -/A.- C 58. Fencing&Access Approval • • 17. Ducts, in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL 20. Roof Framing 21. Roof Sheathing 22. Frame and Flashing NOTES: 23. Insulation - . . 24. Lathing & Siding 25. Drywall Nailing • 26. Plaster Brown Coat 27. Electrical Power Meter-Final 28. Final Electric 29. Final Heating & Air Conditioning 1/u/j'tv J? 30. Final Gas Pipe-Test I 31. Final Plumbing 32. Water Service-Final 33. Gas Service-Final 34. Solar Domestic-Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed - 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY • No Date City of Costa Mesa Development Services Department CERTIFICATE OF OCCUPANCY No, Q G V j 6 3 Building Safety Division P.O.Box 1200 Costa Mesa,California The Building located at 2336 KADEN AVENUE UNIT GD has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group 1:2.-1 Occupancy. Use of Building CONI ]IUM Legal Description 439-261-23 (See reverse side for Metes and Bounds) Building Permit No I3-11692 Electrical Permit No. E-13472 Plumbing Permit No.P-12186 Mechanical Permit No. M-1"" Number of apartments - and/or guest rooms ISSUED TO: Building Official Z), ,4' e-44^4 E.S. OLRIC EI c--)h/ E%.4271;;:.--- 2821 /!.�/� by �/� /moi c,.�-- 2821 EUROPA DR. . COSTA MESA. CA. Date / // /fr This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 lel U.B.C. CMF 101546 rev.1/83 White•Owner;Canary-Numerical File;Pink-Bldg.Permit File Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA - P RMIT N _ TRACT NO. LOT NO. BLD�J'1O. CONSTRUCTION PERMIT TY�-/� S/ /� • Project Address A 3.34, C j�p�,-s}. • E' t1� TYPE OF CONSTRUCTION • /394 I0/23/8I , . 13.00 .TLI Owner D1 icif (,0ye .Cf1 EI s_ehone _ EW 0 ADD 0 ALTERATION - - •Address 5.001 ,, ! vI /tom -ElREPAIR 0 CONVERSION -❑DEMOLISH - - ZONING REGULATIONS - Arch/Eng. - --/ - -License No. 0 OTHER �s op'� � S e A P DESCRIPTION OF WORI$ /' $I n 575 1-Ami , Address 1/Q/Yl-� 11 LTL I T-1—//3 R-�}! , ZONE PLNG- REF.t Contractor wne#f/blit 104e4/ Phone r BUILDING TTp g�/��plf.�G -- -TYPE OF PERMIT SETBACK C/L ST. P ROPERT.V LINE Address • ❑GRADING 0 FOUNDATION • 0 STRUC ID URAL -SE YARD LICENSED CONTRACTOR DECLARATION ❑-TENANT 0 ELECTRICAL ❑PLUMBING MECHANICAL SIDE YARD - - - - I hereby affirm that I am licensed under provisions of Charter 9 (corn- - RIGHT mencing with-section 7000) of- Division 3-of the Business and - 0 OTHER Professions Code, Iasi rw license is in full force andof ct - 'REAR YARD(TO P/L) s License Class License No. `/ PROJECT DESCRIPTION• - - PRO.SPACE REQ. PROVIDED Date //-01341 Signature - - - SQ.-FT. _ • WORKERS'COMPENSATION DECLARATION OCCPANCY CONSTRUCTION TYPE STREET WIDTH PARK FEE$ U 'screw affirm that I have a certificate of consent to self-insure or a VALUATION ZONE ZONING APPROVED BY " I DATE 'screw tificate of Workers' Compensation Insurance, or a certified copy - ' . - SPECIAL CONDITIONS:areof(Section 3800,Lab.C.). GRADING CU.VOL ACRES - --. Policy No. - Company - • ' ❑ Certified copy Is hereby furnished. - REMARKS: Lr5 fi 3 . ❑Certified copy Is filed with the city Building Division. - , EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - - - - - - - ((This section need not be completed if the.p mit is for one hundred _ - • ' ($1001 or less). . certify that in the performance of the w f which this mit Is Issued, I shall not employ any person i y nags • - PLUMBING PLAN CHECK ' ELECTRICAL ' - PLAN CHECK _ /0-424-41subject to the Workers'Compensation sDW — LLLI NIa GARAUL Date /O'423' Signature BATHTUBS SHOWERS - SO FT SO FT NOTICE: if after making this decla ation, ou should become subject TOILETS URINALS ' ' GENERATOR 0-1 KW_1.10 KW to the Workers' Compensation provisions of the Labor Code,you must TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS - ' - ' APPLIANCE 10-50 KW 50+ KW - revoked. - -. CONSTRUCTION LENDING AGENCY KIT.SINKS ' DISHWASHERS- MOTORS - 0-1 HP_1-10 HP I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS SUMPS (INC.SOLAR) 10-50 HP- 50+ HP formance of the work for which this permit is issued (Section 3097 Civ. C.). -- - FLOOR SINKS - FLOOR DRAINS - FIXTURES OUTLETS SWITCHES • - Lender's Name Lenders Address DRINKING FOUNTAINS - - ' - ' GAS TUBE SIGNS - - - - . . • OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS - r POLE LIGHTS I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP LUNsI Kul-I lurk Any city or county which requires a permit to construct, alter, POLES METERED SUB Improve,demolish or repair any structure, prior to its issuance,also re- WATER SERVICE ALTERATION PANELS MAIN SUB motes the applicant for such permit to file a signed statement that he AtC9nsed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS SERVICE AMP _ -• Vi evo1er 9 (commencing with Section 7000) of Division 3 of the L.�``vaftn and Professions Code) or that he is exempt therefrom and the WATER HEATERS BTU OUTPUT - - ba3ls for the alleged exemption. Any violation of Section 7031.5 by ' any applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS - - - - - of not more than five hundred dollars ($500). ❑ I, as owner of the property,or my employees with wages as their SOLAR TANK COLLECTORS • - - sole compensation, will do the work, and the structure Is not intended or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE Contractor's License Law does not apply to an owner.of a property APPLICATION APPROVED BY DATE who builds or Improves thereon, and who does such work himself or ISSUE FEE through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK SUMMARY OF FEES is sold within ono year of completion, the owner will have the burden BUILDING of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU iPERMIT E SMTP S ❑ I, as owner of the property, am exclusively contracting with AND DUCTING licensed contractors to construct the project (Section 7044, Business 100,000+ BTU PLAN CHECK S PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts from such projects with a contractor(s) licesned pursuant to SYSTEM GRADING S the Contractor's License Law). 100,000+ BTU PLAN CHECK S ❑ I am exempt under Section 8.& P.C.for this BTU ELECTRICAL S S reasonPLAN CHECK S MICROFILM $ Date - Owner SYSTEM REPAIR,ALTERATION / ' -- TOTAL FEE S - MECHANICAL S I hereby certify that I hay- re.• this application and state that the above EXHAUST SYSTEM MULTIPLE LESS AD- information Is correct .lee to comply with all city and county / PLAN CHECK $ VANCE PC S ordinances and state s r1'ti_- to construe ' nd hereby authorize /s2 rl-'i,ei(,J vP/2.� y representatives o I ' e e he above mentionedr / JP Z. ) properly for I -..ctl,• P e /A's�3-r ! 9r- t Signature Aa- 023FINAL FEE S Drivers' Lice se or S- / ./ ! ISSUE FEE 3 CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor CONSTRUCTION AND PLANNING �•, % POOL& SPA A PArmi PROVALS Ia�r•1;w0I Pc# L 1�/ • Date Inspector Date Inspector APPROVALS Permit# p 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location . 2., Soil Pipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn •_ . . • 45. Forms 4. Electrical Conduit-Undrgrn - •- 46. Electrical Bonding 5._ Steel Reinforce 47. Rough Plumbing & Pressure Test • 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undrgrn_ 8. Foundation 50. • Gas Pipe, ❑ Undrgrn,Test 9. Water Pipe-Undrgrn 51. Backwash Lines. P-Trap. ❑ Undrgrn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor-Final • 12. Street Sewer Connection 54. Heater&Vent-Final 13. Rough Plumbing 55. Plumbina System - Final 14. Rough Electric-Conduit '56. Electrical-Final 15. Rough Electric-Wiring 57. Solar System-Final • 16. Rough Heating & Air Conditioning R- 9X151 58. Fencing &Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating - • 19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL 20. Roof Framing - • 21. Roof Sheathing / 22. Frame and Flashing NOTES:��AA.tT s% ) �11, p CIL% 1rt.f.,1•5 23. Insulation �sre it co . r2e+ pro•in UQa 4s Rd� aiw. 1- 24. Lathing & Siding rp0C4 w S fl, R® ter (r+ chi 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter-Final 28. Final Electric ((�� -� . 29. Final Heating & Air Conditioning f--"' 3^2s. .N."- 30. Final Gas Pipe-Test 31. Final Plumbing 32. Water Service-Final 33. Gas Service-Final N\ 34. Solar Domestic-Final 35. Landscape Sprinkling System • 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date t Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. i CITY OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. BLOCyNO. •. CONSTRUCTION PERMIT M r/ b . 7437 10%26%81 7.00 T4 Project dress377[#72.1(� e TYPE OF CONSTRUCTION • _. . -- - •• •- - -.• . . OWneia /LLL//--CC7.04617 Phonn ❑ NEW ❑ ADO 0,ALTERATION Address Z , Z - ❑ REPAIR 0 CONVERSION ❑DEMOLISH ArchlEng.�.sem / License No. 0 OTHER A P ZONING REGULATIONS Address - DESCRIPTION OF WORK ' ���iii...,,, ZONE PLNG. REF.46 Contractor O//5 Phone • TYPE OF PERMIT - - BUILDING TTpp gg�t/JI LLpDING' r/ - SETBACK C/L ST. PROPE RTV LINE Address - ❑ GRADING 0 FOUNDATION 0 STRUCTURAL WARD • LICENSE CONTRACTOR DECLARATION 0 TENANT 0 ELECTRICAL ❑PLUMBING ❑MECHANICA1, SIQE YARD I hereby affirm that I am licensed under provisions of Charter 9 (corn- RIGHT meriting with section 7000) of Division 3 of the Business- and 0 OTHER _ - . Professions Code, and my license is In full force and effect. REAR YARD(TO P/L)PROJECT DESCRIPTION - - . License Class License No. 'PKG.SPACE REQ. PROVIDED • Date Signature - SQ.FT. - --• WORKERS'COMPENSATION DECLARATION - . OCCUPANCY_CONSTRUCTION,TYPE STREET WIDTH PARK FEE $ ;-hereby affirm that I have a certificate of consent to self-insure or a I VALUATION ZONE ZONING APPROVED BY DATE •atificate of Workers' Compensation Insurance, or a certified copy - _ .. . . >~'76reof(Section 3800, Lab. C.). GRADING CU. YDS. ACRES SPECIAL CONDITIONS: Policy No. Company - ❑Certified copy is hereby furnished. • REMARKS: 'J'y.�- '�73 _ ' ' ' ❑ Certified copy Is flied with the city Building Division. -REMARKS:. ' • EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - ' (This section need not be completed If the permit is for one hundred .r. ($100) or less). - ' • ` - - I certify that in the performance of the work for which this permit 11 - issued, I shall not employ any person in any manner so as to become PLUMBING , PLAN CHECK N. - ELECTRICAL PLAN CHECK - subject to the Workers Compensation Laws of California. - uwtLLirvb • GA HA(at Date Signature BATHTUBS SHOWERS 50 FT SO FT NOTICE: If after making this declaration, you should become subject TOILETS ' URINALS' - GENERATOR 0-1 KW_1-10 KW to the Workers' Compensation provisions of the Labor Code,you must TRANSFORMER - forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE'LAVS - - APPLIANCE 10-50 KW 50+ KW revoked. - CONSTRUCTION LENDING AGENCY - KIT.SINKS DISHWASHERS - MOTORS 0-1 HP 1-10 HP I hereby affirm that there is a constructio lending agency for the per- SERVICE SINKS SUMPS (INC.SOLAR) 10-50 HP 50+HP • formance of the f. p i ' 'sued ection 3097 - - - Civ. C.). v I ' FLOOR SINKS FLOOR DRAINS • FIXTURES - OUTLETS SWITCHES Lender's Name _ Lender's Addres Os - ��� // - / w DRINKING FOUNTAINS GAS TUBE SIGNS - OWNER BUILDER DECLAR• ION INTERCEPTORS CLARIFIERS POLE LIGHTS • I hereby affirm that I am axe pt from the Contractor's License Law for the following reason (Section 7031,5 Business and Professions Code: ' SWIMMING POOL P TRAP LUNbi Hut-I ION Any city or county which requires a permit to construct, alter, , POLES METERED SUB Improve,demolish or repair any structure, prior to its Issuance,also re- WATER SERVICE- ALTERATION - PANELS MAIN SUB a ires the applicant for such permit to file a signed statement that he tensed pursuant to the provisions of the Contractor's License'Law GAS SERVICE OUTLETS - SERVICE AMP pier 9 (commencing with Section 7000) of Division 3 of the .ness and Professions Code) or that he is exempt therefrom and the "WATER HEATERS - 'BTU OUTPUT,. . . - - • basis for the alleged exemption. Any violation of Section 7031.5 by _ , • any applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS - - of not more than five hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their SOLAR TANK - COLLECTORS sole compensation, will do the work,and the structure Is not Intended or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. • ISSUE FEE Contractor's License Law does not apply to an owner of a property APPLICATION APPROVED BY DATE who builds or Improves thereon, and who does such work himself or ISSUE FEE through his own employees, provided that suchimprovements are not - intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK SUMMARY OF FEES is sold within one year of completion, the owner will have the burden BUILDING f roving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU _ PERMIT $ - SMIP $ as owner of the property, am exclusively contracting with AND DUCTING licens ntractors to construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK $ PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts from such projects with a contractor(s) licesned pursuant to SYSTEM GRADING $ the Contractor's License Law). 100,000+BTU PLAN CHECK $ 0 1 am exempt under Section B.& P.C.for thisELECTRICAL $ $ BOILERS BTU reason - - PLAN CHECK $ MICROFILM $ Date- Owner SYSTEM REPAIR,ALTERATION �f — TOTAL FEE$ I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $ / ' LESS AD- Information is correct. I agree to comply with all city and county j ^ PLAN CHECK $ VANCE PC $_ ordinances and$t.td laws rel. in to cons tion,and hereby a tjorize � r(//y •r"f ) representatives• fo . this 1,4 nt .•n the above nt >� U// a may) ` s Proper • f"t.' J= P i. -lazy) dJ�7,� FINAL FEE $ SiDrivers' ' ISSUE FEE 2 `�CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor CONSTRUCTION AND PLANNING 'POOL& SPA II APPROVALS It \:,5\(i I Permit# M ��� Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location . • 2. Soil Pipe-Undrgrn 44. Steel Reinforcement • 3._ Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding • 5. Steel Reinforce 47. Rough Plumbing & Pressure Test 6. Electrical LIFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undrgrn _ 8. Foundation 50. Gas Pipe, 0 Undrqrn,Test 9. Water Pipe-Undrgrn 51. Backwash Lines.P-Trap. 0 Undrqrn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor-Final 12.. Street Sewer Connection 54. Heater & Vent-Final 13. Rough Plumbing 55 _Plumbinc Svctem -Final 14. Rough Electric-Conduit •56. Electrical-Final 15. Rough Electric-Wiring - 57. Solar System-Final 16. Rough Heating & Air Conditioning �J ,¢� f� ' �• Fencing &Access Approval _ 17. Ducts, in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL 20. Roof Framing 21. Roof Sheathing 22. Frame and Flashing NOTES: 23. Insulation • 24. Lathing &Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter-Final 28. Final Electric 29. Final Heating & Air Conditioning q/u7f'2 6/C 30. Final Gas Pipe-Test 31. Final Plumbing 32. Water Service-Final 33. Gas Service-Final 34. Solar Domestic-Final • 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison . . 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date • A4pllcant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OE COSTA MESA PE.IAIT NO.. �'TR�NO. LOTTIO. •BLD . V / CONSTRUCTION PERMIT l/7+ Jam` Project Address �'�IL,n4 •7" D! I w,�lv0 I .,_ I TVP F CONSTRUCTION ////� Owner e[ lt.-I ��IC ��' O• Phon�af_[ NEIN ❑ADD ❑ALTERATION /, y _ 3266 8/12/3I J7/oIt: Address an) tu op7`t Or. 0 REPAIR.0 CONVERSION ❑DEMOLISH (•*/�/� 0 OTHER ` ` ZONING REGULATIONS Arch/Eng. �67) i.er License No. ' P.(+ DESCRIPTION OF WORK A. 439- at,t `-.24AddrC55 • •�'n-I L /Mhc..Is/ ZONE 1C25§,.. PLNG. REF. w' Za�, -DO Contractor Phone ZO7S TYPE OF PERMIT • BUILDING T p t I G � /��� ,,���� SETBACK CA_ST. PROPERTY LINE Address - 0 GRADING L.J�FOUNDATION E'lSTRUCTURAL I YARD / � - LICENSED CONTRACTOR DECLARATION 0 TENANT 0 ELECTRICAL PLUMBING ❑MECHANICAL 1I YARD I hereby affirm that I am licensed under provisions of Charter 9(com- R GGGmencing with section 7000) of Division 3 of the Business and 0 OTHER Professions Code, and my license is In full force and effect. REAR YARD(TO P/L) PROJECT DESCRIPTION "",�'�"'' ; �� License Class _ License No. - / t � - •••: PKG.SPACE REQ. ��S PROVIDED 2�r -SQ.FT. • Date Signature .1.t....„N` • STREET WIDTH ten ! PARK FEE S RT• .(5-/ IKERS'COMPENSATION DECLARATION - OCCUPANCY 7t ONSTRUCTION TYPE reby affirm that I have a certificate of consent to self-Insure or a VALUATION 72n- ZONE ZONING APPROVEDe•, �_ I DATrr'/��/ .JAn-of Workers' Compensation Insurance, or a certified copy ..��lC ccrr thereof(Section 3800, Lab.C.). - GRADING CV..YDS. ACRES • SPECIAL CONDITIONS: Policy No. Company o -- HOLD FOR SPECIAL REQUIREMENTS Certified copy Is hereby furnished. REMARKS: _ . ❑Certified copy Is filed with the city Building Division. •`� EXEMPTION FROM WORKERS' COMPENSATION DECLARATION mHV0 t/�( .�Cf , _ • - S10 section need not be completed if the permit is for one hundred n ,• AC5-/y/� //� 5-z-)• • - I certify or less). (' l- rrr���JJJ"' that in the performance the work for which this permitecois issued, I shall not employ any person any manner so as to become PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK'l subject to the Workers Compensation Laws of California. -- UWELLI rvty/LL t.AHAOE 4/T J ri Th"-- NOTICE: Data Signature youBATHTUBS SHOWERS �/ ^ 50.FT P SO FT T 771P� TI to the Worrf kers'er Comapensatiols n declaration, of theLabor Code,you mustjTOILETS , URINALS 4 �' TRANSFORMER ENERATOR 0-1 KW_1.10 KW forthwith comply with such provisions or this permit shall be deemed LAVATORIES/ DOUBLE LAYS Z 9 a" APPLIANCE 10-50 KW 50+ KW . revoked. CONSTRUCTION LENDING AGENCY KIT.SINKS / DISHWASHERS/ 6 — MOTORS 0-1 HP 1-10 HP I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS - ' SUMPS �„ �. v • • (INC.SOLAR) 10-50 HP 50+HP - • formance of'the.work for which this permit is issued (Section 3097 - - • Civ. C.). _ �c• - 4c ,FLOOR SINKS . . , FLOOR DRAINS-. ,s•-, . \` FIXTURES OUTLETS SWITCHES Lander's Nam -at- �q(yr� �s/C Lentler.'s•Atld, -a r -%na- = =,•.. •• ' i-�/ DRINKING FOUNTAINS -G A. t'\ GAS TUBE SIGNS OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS n s• ' POLE LIGHTS I hereby-affirm that 1 am exempt from.the Contractor's License Law for, v. + t - . . the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP • - LUNb I NIA-Hunt Any'city. or:county.which requires a permit to•construct, alter,- ' POLES METERED SUB Ir' 'nve,demolish or repair any structure, prior to its issuance,also re- WATER SERVICE] ALTERATION ..• PANELS MAIN I SUB the'appitcant for such permit to file a signed statement that he L used pursuant to the provisions of the Contractor's License Law GAS SERVICE / OUTLETS ' +'• '. SERVICE AMP (L.-iota(L.-iota9 (commencing with.Section 7000) of Division 3 of the '+ ' Business and Professions Code) or that he Is exempt therefrom and the WATER HEATERS/ BTU OUTPUT• . - ,.- basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS/ . - ��fs C / of not more than five hundred dollars (§500). -L •-' / /.l 1 ^ ❑ I, as owner of the property,or my employees with wages as their SOLAR TANK COLLECTORS • - t I' t Mt Dyalte. �/ ,•� sole compensation, will do the work,and the structure is not Intended ��.� I or offered for sale. (Section 7044. Business and Professions Code: The SOLAR PIPING SYS. ISSUE FE3 — Contractor's License Law does not apply to an owner of a property (�)t who builds or improves thereon, and who does such work himself or ISSUE FEE 3 -- APPLICATION APPROVED BY 6.4 x DATE g_/� / through his own employees, provided that such improvements are not - ��CIi, intended or offered for sale. If, however, the building or Improvement MECHANICAL PLAN CHECK is sold within one year of completion,the owner will have the burden SUMMARY OF FEES _ f proving he did not build or improve for the purpose of sale). / BUILDING I, as owner of the property, am exclusively contracting with HEATING SYSTEM 0-100,000 BTU R�sF�MssIT I S 233, SMTP S •� d AND DUCTING (lr H,SEQ•M•KS' $ c— -`-p ERMIT lice ed contractors to construct the project (Section 7044, Business 100,000 +BTU ^ U0. bM /' , and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who con- REF•RIr-ION 0-100,000 BTU PL BIN 3 S /lg.• ISSUANCE S tracts from such projects with a contractor(s) licesned pursuant to 5 GRADING' S the Contractor's License Law). 0 000+BTU `y PLAN CHECKkf �� E ❑ I am exempt under Section B.& P.C.for this C - $ BfXEf'RS lilt !r BTU 1 6) /� ELECT 0.ICAL E 3S reason - (R \ l I PLAN CHECK E • MICROFILM S y �lLziXl 1� SYSTEM REPA ALTERATION TOTAL FEE E, y77// I hereby certify that I have rre% his . ✓ MECHANICAL E Q• •� yt •, tion an• state that the above EXHAUST SYSTEM MULTIPLE LESS AD- information is correct. I ag ee t comply with all city and county / / PLAN CHECK $ VANCE PC S ordinances and state laws relating to construction and hereby authorize H re 1 1 t i/--- representatives representatives f this cityyyy to ante pen the above en toned ` ///III 7 �J • Properr peXuzeos<s. nd ©!heti. /O" ?' %o//9IM,N a FINAL FEE E y/7'/Y Signature �' /�/(l Dat VUE E/ r V'/- / Drivers'L ISSUE F E `/ --- CMF 086546 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor J - /• If CONSTRUCTION AND PLANNING - - POOL&SPA ,;: APPROVALS Permit # Date Inspector APPROVALS Permit# Date litspector, - ` 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location. - - - --s - '2. Soil Pipe-Undrgrn _ 4s„t-Si ,6c asi44. Steel Reinforcement - - - ' 3. Electrical Conduit Utility.-Undrgrn - - 45. Forms . '1 4_ Electrical Conduit-Undrgrn _ 46. Electrical Bonding . . _ . - - � '- _ 5. Steel Reinforce ._ - 47. Rough Plumbing & Pressure Test ' - . - 6. Electrical UFER Gm : • • - 48. • APPROVAL TO COVER-GUNITE .- 7. Footings - g;/f.? n 49. Electrical Conduit-Undrqrn - - ' . . • • 6. Foundation • - - -- 50. Gas Pipe, ❑Undrqrn,Test • ' ' • -• 9. Water Pipe-Undrgrn e' 2/-d/ /�J _ 51. Backwash Lines, P-Trap. ❑ Undrgrn - 10: _ Structural Floor System - - $ 2d-.81 52. ', APPROVAL TO DECK- ----- -- --• -- - - •- ---- - 11. - Property Sewer Line & House Connecti • on •- •• 53. Backwash & Receptor-Final - - • 12. Street Sewer Connection 7 . - , 54. Heater & Vent-Final - - 13. Rough Plumbing - 12Z,•0 - / (-cam 55. Plumbing Svctem-=Final - -- - - • - - - 14.- Rough Electric-Conduit ' - : • Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PERMIT NO. / TRACT NO. LOT-NO. BLDG A(NO. CONSTRUCTION PERMIT (-, l • Project Address 2'J3 £(De/.! /2 TYPE OF CONSTRUCTION - 5236 9/I 7/61 Con' TI ,Owner oc ,.c.�(-t Phone 0 NEW 0 ADD 0 ALTERATION 1/4:11.6 n_ ,[ - "' Address 2,Ag( VA(JPf9- G ,en - 00 OTHEIR 0 CONVERSION 0 DEMOLISH -/�(J ZONING REGULATIONS f ArchlEng. License No, A.P. Address DESCRIPTION OF WORK ZONE PLNG. REF.R Contractor - Phone - BUILDING I G �I�Y�L,r4'r^-�- TYPE OF PERMIT XRai1 UNI SI yp,no ST INE Address /7i Z LL�� :c ' - era/La 0 GRADING 0 FOUNDATION 0 STRUCTURAL" E Slpp�YA no LICENSED CONTRACTOR 0 CLYARA ION 0 TENANT 0 ELECTRICAL OPLUMBING ❑MECHANICAI�E YARD I I hereby affirm that I am licensed under provisions of Charter 9(com- R G T (Y meriting with section 7000) of Division 3 of the Business and 0 OTHER Professions Code, anng{..r my license Is In full force and effect. REAR YARD(TO P/L) License Class C." (O Uconso No. 9A1� PROJECT DESCRIPTION -. - _- 5Q.FT- ��L PKG.SPACE REQ. PROVIDED Date Signature .I STREET WIDTH PARK FEE$ RKERS'COMPENSATION DECLARATION - OCCUPANCY_CONSTRUCTION TYPE r reby affirm that I have a certificate of consent to self-Insure or a • ZONING Ai?PROVED BY ' DATE .. cate of Workers' Compensation Insurance, or a certified copy VALUATION ZONE _ \ Ifithereof(Section 3800,Lab.C.). GRADING CU'.YDS, ACRES SPECIAL CONDITIONS: Policy No. Company - — — ❑ Certified copy is hereby furnished. - - REMARKS: ' G SR 3 - - ❑Certified copy is filed with the city Building Division. • EXEMPTION FROM WORKERS' COMPENSATION DECLARATION _ - _ - - ((This section need not be completed if the permit is for one hundred - , -- /4-C- ' _ ) _ ' ($100) or less). 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 PLUMBING - PLAN CHECK ELECTRICAL PLAN CHECK subject to the Workers Compensation Laws of California. - UWbLLING - VHNHL.t- - Date Signature • BATHTUBS SHOWERS SO.FT. SO FT NOTICE: If after making this declaration, you should become subject TOILETS ,• URINALS • - -GENERATOR 0-1 KW_1-101KW to the Workers' Compensation provisions of the Labor Code,you must _ - -_ -_ TRANSFORM_ ER - - forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS 'APPLIANCE 10.50 KW-50+ KW revoked. - - _ CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS MOTORS- 0-1 HP 1-10 HP hereby affirm that there Is a construction lending agency for the per• SERVICE SINKS SUMPS ' -- (INC.SOLAR) 10.50 HP 50+ HP , formance of the work for which this permit is Issued (Section 3097 Civ. C.). FLOOR SINKS FLOOR DRAINS I FIXTURES ' OUTLETS SWITCHES Lender's Name _ Lender's Address DRINKING FOUNTAINS - • GAS TUBE SIGNS , OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS POLE LIGHTS - . - - I hereby affirm that I am exempt from the Contractor's License Law for • I the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP - WINS I NUL 1-IUN - _ _ Any, city or county which requires a permit to construct, alter, POLES METERED SUB - I, -ova,demolish or repair any structure, prior to its Issuance,also re- WATER SERVICE ALTERATION • PANELS MAINSUB - t the applicant for such permit to file a signed statement that he " - -Awed pursuant pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS {�. R , - , . SERVICE -'- --j AMP (L..apter 9 (commencing with Section 7000) of Division 3 of the _ - _ Business and Prolesslons Code) or that he Is exempt therefrom and the WATER HEATERS BTU OUTPUT - '- basis for the alleged exemption. Any violation of Section 7031.5 by _ - - - any applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS ' - . . - . - of not more than five hundred dollars ($500). _ ❑ I, as owner of the property,or my employees with wages as their SOLAR TANK COLLECTORS _ sole compensation, will do the work, and the structure Is not Intended _ or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE 3 — Contractor's License Law does not apply to an owner of a property - APPLICATION APPROVED BY DATE who builds or Improves thereon, and who does such work himself or ISSUE FEE , through his own employees, provided that such Improvements are not Intended or offered for sale. If, however, the buildingor Improvement MECHANICAL PLAN CHECK SUMMARY OF FEES is sold within one year of completion, the owner wilhavetheburden W of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU PERMIT BUILDING S SMTP E Y ❑ I, as owner of the property, am exclusively contracting with AND DUCTING - licensed contractors to construct the project (Section 7044, Business 100,000 +BTU PLAN CHECK $ PERMIT and Professions Code: The Contractor's License Law does not apply to -- - ISSUANCE S Q an owner of property who builds or improves thereon, and who ton• REFRIGERATION 0-100,000 BTU PLUMBING $ r• tracts from such projects with a contractor(s) llcesned pursuant to SYSTEM GRADING S ' the Contractor's License Law). 100,000+BTU PLAN CHECK $ S 0 I am exempt under Section B.& P.C.for this BOILERS BTU ELECTRICAL $ 2— reason "PLAN CHECK $ MIC ROFILM.E W Date Owner ' SYSTEM REPAIR,ALTERATION TOTAL FEE$ 3 I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $ LESS AD- information Is correct. I agree to comply with all city and county PLAN CHECK $ VANCE PC S_ ordinances and state laws relating to construction,and hereby authorize representatives of this city to enter upon te above mentioned C Property rj rfT$9 P Pp- yV "i/7� 5 property C/L�Mso Data - FINAL FEE S Drivers' License or ISSUE FEE CMF 0865-46 White-Buliding;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor CONSTRUCTION AND PLANNING POOL&SPA ; .- APPROVALS Permit# E---1C011 Date Inspector APPROVALS Permit# Date lilspecto . -• 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location _ 2. Soil pipe-Undrgrn 44. Steel Reinforcement • 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding • 5. Steel-Reinforce • 47. Rough Plumbing& Pressure Test - • . 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE - ' 7. Footings 49. Electrical Conduit-Undrqrn 8. Foundation • - 50. Gas Pipe, ❑Undrgrn,Test 9. . Water Pipe-Undrgrn _ 51. Backwash Lines, P-Trap, ❑Undrgrn 10. Structural Floor System - 52..' APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor-Final 12. Street Sewer Connection _ - -_ 54. Heater & Vent-Final 13. Rough Plumbing • • 55. Plumbing System-Final 14. Rough Electric-Conduit - - -56. Electrical-Final 15. Rough Electric-Wiring 10-a'�_°L e-F 57. Solar System-Final 16. Rough Heating & Air Conditioning _- bB. Fencing &Access Approval 17. Ducts, in Structure - 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating _ 19. Gas Pipe-Rough &Test • 60. POOL/SPA SYSTEMS FINAL 20. Roof Framing 21. Roof Sheathing 22. Frame and Flashing NOTES: 23. Insulation _ 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat • 27. _Electrical Power Meter-Final n 28. Final Electric 3j-A-5V ` C 29. Final Heating & Air Conditioning 30. Final Gas Pipe-Test. • 31. Final Plumbing 32. Water Service-Final 33. Gas Service-Final 34. Solar Domestic-Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FI NAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No_ Date - 1 c5 CITY OF COSTA MESA .'i BUILDING DIVISION C 4,titinr..ii F ( � ) DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER IPA PERMIT 06-01827 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.c$ItgLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 2336 ELDEN AV Status: ISSUED Suite: F Applied: 10/30/2006 Vicinity: FLAT ROOF AREA OF UNIT F Issued: 10/30/2006 Primary Occ: R-1 Hotels/Apts/Res>10 Occ Type of Construction: V-N Parcel Number: 43926405 Zoning: Applicant: JORDAN, STEVE Address: 915 W COLLINS AV Phone: 714-744-6577 ISSUED BY: /4C ORANGE,CA - - Zip: 92867 Owner: FUERTES, CENMAR Address 2336 ELDEN AVE#F-" Phone we/ „COSTA MESA,CA / Zip 92 ans4ins Contractor JORDAN ROOF COMPANY • Address:,/-915 W COLLINS AV ' % A ^..>rc rri ' / ) /2/;,-/2'' Phone: 714-744-6577 NORANGE,CA- Zip: 92867,;6`/ License: 406783 "Arch :/ ,'-- % Eng: Address' '%-; • Address: Phone: Phone: Zip: ' , . / _License: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF,APPLY-HOT MOP TO FLAT AREA ONLY.APPROX 600 SQ FT. FEE SUMMARY- Plan Check: $0.00 .ct", ' 7 in v j ', Calc Valuation: $3,000.00 Permit: $83.25 -'--i- 2- -%- ' " ' - % - - - Claim Valuation: $3,000.00 SMIP Res: $0.50 , SMIP Com: $0.00 Other $0.00 Inspection: $0.00 -- Total: $83.75 PLANNING &ZONING SETBACKS - `�` MAIN-STRUCTURE Front1/0-0 . Rear. ;”0- , ` Left 0-0-:- Right 0-0 ACCESSORY - Front 0-0 2 '-:Rear 0-0 Left 0.0 Right 0-0 PARKING .Existinq: 0 �'� :Required: 0 i Proposed: 0 NA �� Y �' r - . - - NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12.21-92) EXPIRATION: This permit shall automatically expire and become void If work Is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46 WOO) I - ' . DECLARATIONS t' WORKERS'COMPENSATION DECLARATION: • - I hereby affirm under penalty of perjury one of the following declarations: ❑ I hve and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Coda,for the performance of the rk for which this permit is Issued. I have and will maintain workers'compensation Insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers' omas-sation Insurance caller and policy number are: �y / Cartier: 5-44p4- /%VL' Policy Number. Z f 1//(/t alp (This section need not be completed ll the••mat valued at one hundred dollars($100)or less.) ❑ 1 certify that in the performance of e 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 auto - .7:n•.:• at if I should become subject to the workers'compensation provisions of Section 3700 o the La r Code,I shall forthwith comply with these pro ions. ea_ I Applic nt WARMNG FAILURE T: E ''S'. TION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES �FINES UP TO ONE HUNDRED WARMNG:FAILURE TO SECURE WORKERS'��• THOUSAND DOLLARE($100,000),IN ADDITION 9 E COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed d yr pr• cions •f •r 9(commencing with Section 7000)of Division 3 of the Business ergP ,fessions Code,and my license is in full 4 force and effect.Lic. IIClass a CA Contractor's Signature: 1n/►tir Date: LO0/19_____ IP 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:My city or county which requires a permit to construct,alter,Improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty et not more than five hundred dollars($500).): ❑ I,as owner of the properly,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or Improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.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.-properly tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth Into which a person Is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,Califomia Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the Califomia Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). _ 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 if an RMPP is presently required,has Section 25534 of the Califomia Health and Safety Code been fully complied with? ❑Yes in No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a.aermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes U No (Section 65850.2 of the Califomia Govemment Code requires that the requested information be furnished on applications for non-residential building permits). __._ _...._ _. ........_.... Y.__... — _ 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑No (if'yes',the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Cale). 7 II 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 o1 this application,have all of the disclosures prescnbed 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 Ls correct. I agree to comply with all state la - end city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspe•i/•, .-:s.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. S:A.= . Owner(s)i /jy// f)D�/O�nAn•ro r .thodzed Applicant Date r coot I, INSPECTION TYPE PAIL ITU 900Et INSPECTION TYPE MI PALE 1618 Fixed System Final Fire Prevention fy/�`v 206 Final Mechanical 1266 Pool Spa Final /`.(/ 208 Final Plumbing . 200 Final Re-Roof /i�0– 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 BuildingrOccupancy ' City of Costa Mesa R Development Services Department CERTIFICATE OF OCCUPANCY No. OCLq G Building Safety Division P.0.Box 1200 Costa Mesa,California • The Building located at 211F, wrnr.;u tlivT'r iin has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group A..l Occupancy. Use of Building Crvnrwi NTTTvt Legal Description 439-261-23 (See reverse side for Metes and Bounds) Building Permit No 13-11700 Electrical Permit No. P.-1147d Plumbing Permit No.P-191,4N Mechanical Permit No. .4-1"nil Number of apartments and/or guest7247e.-24- rooms ISSUED TO: Building Official )1), A / ,Q G E.S. f?T,RTCR 2Rx1 FTTRt)PA- OCTA MBCA. 3-a Date S? --)78//99C/ 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 (e) U.B.C. CMF 1015-46 rev. 1/83 White-Owner;Canary-Numerical File;Pink -Bldg.Permit File ' 'F- CITY OF COSTA MESA a 4 • BUILDING DIVISION > q-„,,,. -1 DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER ft In"P . 4 lirira PERMIT StsORInn e B01-01227 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 2336 ELDEN AV Status: ISSUED Suite: G Applied: 08/07/2001 Vicinity: G Issued: 08/07/2001 Parcel Number: 43926401 Zoning: Applicant: KIM,ROBERT _ ISSUED BY: Address: 1835 WHITTIER AVE _ - UNIT F12 . .Phone: (949)645-3917 COSTA MESA,CA I Zip: 92627 Owner BURSHTYN, LEA • ' • . Address 2336/ELDEN AVE#A - - / - - - - Phone: - ,COSTA MESA,CA 1 - Zip: 92627 ' A .” ‘. � . / 7 Contractor: 21ST CENTURY ROOFING C " Address: 1835 WHITTIER AVE -' UNIT F12'- Phone:- (949)645-3917 A COSTA MESA,CA Zip: 92627 ' License: 750385 Arch _ • Eng: _ • Address: Address:- . - • , . Phone: - _ Phone: Zip: License: 'License: SCOPE OF PERMIT TEAR OFF INTALL 1/2"CDX.AND LITE WEIGHT TILE 5.5 PSF ICBO#'4660.CAPISTRANO TILE. UNITS G,H. • FEE SUMMARY Plan Check: $0.00 ' ' Calc Valuation: -$5,800.00 Permit: $125.25 - -- � Claim Valuation: ; $5,800.00 SMIP Res: $0.58 'SMIP Corn: $0.00 • Other: $0.00 Inspection: $0.00 • Total: $125.83 , • PLANNING &ZONING ' SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0. - , NOTES: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void If work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. ` , INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2448-48(8'00) DECLA2AT7,QNS WORKERS'COMPENSATION DECLARATION: P . • I hereby affirm under penalty of perjury one of the following declarations: . ❑ have and will maintain a certificate of consent to sell-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the for which this permit is issued. 6 w I have and will maintain workers'compensation insurance,as required by section 3700 of the tabor Code,for the performance of the work for which this permit is issued. My workers'compeniation Insurance carrier and policy number are: Carrier 5-f av'P f FVn-4. Policy Number: (This section need not be completed if the permit Is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit Is Issued,I shall not employ any person In any manner so as to become subject to the workers' compensation laws of California,and agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these ApplicantC2eg Date: 7/1/d j�� _--� ,WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL RISES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN ADDiON TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed underrprovislygs of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is In full force and etfect..Uccea SD .7 a5 Class a C, 3 Contractor Signature: t — , Date: 2 /71I0 -CONSTRUCTION LENDING AGENCY: =%"/ ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that 1 am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors license Law(Chapter 9(commenting 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 pertk subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or Improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement Is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractors) 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. 0 Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,I.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I Will the applicant or present or future building occupant need to file end certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be 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? ❑Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No _.sent_.._.__.._.-_ _cier ..._.._which —_ such construction _. . 5 Does or willo the oast or present ar emen building occupant at any other for the work ontch districtIs the subject of this a Yesestion e0 Nnit for such construction or modification from the South Coast Air Quality Management District or from other air pollution control or agency? � 8 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 part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If"yes-,the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes ❑No 8 (If yea,attach certificate of compliance from the appropriate air pollution control officer). u 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 end city ordinances relating to building cnstruction,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. igm fur Of Le Owner(s) Date A� ed'Appiicant ..,,,,....-:I-- Date--1 - gen r gISPECTIGN TYPE PATh EMS CODE! gj$JECTNIN TYPE PATE ILLS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa FinalQs 206 Final Plumbing 200 Final Re-Roof Q0 (lJ(i 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Flre Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy City of Costa Mesa Development Services Department CERTIFICATE OF OCCUPANCY No. 000620 Building Safety Division P.O.Box 1200 Costa Mesa,California The Building located at 2336 kLAl1?N AVENUE UNIT 43 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 CONix)MTNTINi • Legal Description 439-261-2.3 (See reverse side for Metes and Bounds) Building Permit No R-11f4Q Electrical Permit No. u'-11/171 Plumbing Permit No.P-12187 Mechanical Permit No. 14-13299 Number of apartments //and/or guest rooms 'SSUED TO: Building Official / /� (?� .� LS, OT.RTC'H by , F.0n 2881 ROPA. CDSr1yt MFSA. CA. �l L Date �D�.�. /9i This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises atXd SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. CMF 1015-46 rev. 1/83 White-Owner;Canary-Numerical File:Pink-Bldg.Permit File — .. City of Costa Mesa Development Services Department CERTIFICATE OF OCCUPANCY No. 000821 Building Safety Division P.O.Box 1200 Costa Mesa,California The Building located at 2336 ELDEN AVENUE UNIT $K has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group R-1 Occupancy. Use of Building CONDOMINIUM Legal Description 439-261-23 (See reverse side for Metes and Bounds) Building Permit No R-11 69A Electrical Permit No. R-1-14FQ Plumbing Permit No.1D-191 RI Mechanical Permit No. M-132°5 Number of apartments and/or guest rooms ISSUED TO: Building Official 10, / �& �N`�- R.S. f11.Rrrt•r by 7RR1 R.f1RfPA, MAMA MRSA. rA Date /La ' /9r7 This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 lel U.B.C. CMF 1015-46 rev.1/83 White-Owner;Canary-Numerical File;Pink-Bldg.Permit File I. - Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.vJ ,,�� 'v'• CI'•Y OFwST P MIT NO. _ TRACT NO. LOT NO. BLDG.NO. (�;�t-(' ti CONSTRUCTION PERMIT L R //� F4� I k -St 1 i— A f �. _,,L !� 5503 3/07/84 375.52 Project Address ' 1.7-1- ' " TYPE OF CONSTRUCTION E( NEW ❑ ADD U ALTERATION U REPAIR ;A P # >-�-39 - Z(n - 23 Zone R �— Applicant's Mailing Address 0 CONVERSION ❑ DEMOLISH 0 OTHER Owner's Name S S (Dc-AZ cc- H-( ' Phone S' / 519 DESCRIPTION OF WORK S Main Building: Accessory Building: Z Address 2U\ �1..L. -o P D✓_ C.63T/rtiri5€b} // O P - TYPE OF PERMIT 0 GRADING ❑ FOUNDATION ''STRUCTURAL ' T Front 20 O N Arch/Eng. g���R C\taw P License No. 0TENANT ❑ ELECTELECTRICAL 0PLUMBING ❑ MECHANICAL AB Rear /r // • atL 1.200 2- Say L Ct(L rail; vF;_Address ❑ OTHER - - 1 _ N (; C Right2 2/T— Contractor's Name r� 0 - Phone PROJECT DESCRIPTION SQ. S` O O VALUATION$AN 7 8 a� S Left Zyy F CONSTRUCTION TYPE .E ACity ess License ling) a �i ZONE R -"'L GRADING CU.YDS. h Z.C. ACRES Ping. Ref.# Z,E �L�d s Park.Fees $ Q City License No. • !�- !7 l 2/2_ / �� • L - U LICENSED CONTRACTOR DECLARATION Remarks:p 1t Parking Req./Provided [ Z r I hereby affirm that I am licensed un•:r •rovision of hart-r 9 (commencing ` , •�'�� 4 0. D R with section 7000) of Division 3 o- the :urine an• Prof-inions Cotle,and A p• # 9 ? G-C3 ,, • Use'of Buildit{g: ` �hd0 • • ,-E. my license Is in full y e a tl effect. p /" l O^J O • • 'ionise I.. ��` IL e e N4 a 6O2'Z PLUMBING FEES Planning Notes: M • ate Signature . �� A HOLD FOR SPECIA). R t t • EN \ _ _Bar Sink Showers F WORKER •COMPENSATION DEC LA RATI• 4J+�Cuaa]yj� T I hereby affirm that I have a certificate of conse t to self-insure or a certificate Backflow Preventer _ Service Sink S ''t) •of Workers' Compensation Insurance, or a c rtified copy thereof (Section 3800, Lab. C.)4)Z qq_c, - -fp.' N p Backflow Irrigation Sewer Cap + - - - ELECTRICAL _ FEES Policy No. X ;Company • •e,-, - -' 8 Certified copy is hereby furnished.-• "1/4• Bathtubs Sewer Connection - Automatic Washer Transformer ❑ 15-50 KW rtified copy is filed with the city unsling Division. 0 50+ KW Dat Applicant • Clarifiers • • Solar Collectors Construction Pole Sub. r-• E MPTION FROM WORKERS'C MPENSATION DECLARATION - Dishwasher - - - Solar Piping - Cooking Unit , ' 'Meter ❑up to 100 amps k (This section need not be completed if the permit is for one hundred($100)or l - . less). Fountains Solar Tank ' I Dishwasher Meter Dover 100 am s I certify temp) the person once of.the work for which this permit is issued I Drinking tP - shall not employ any person in any manner/so as to become subject to•tlle Workers' Compensation Laws of California,' ' Floor Drains Swimming Pool w/Spa -) Dryers ❑Gas ❑Electric Sub Panel , _ Date - Signature NOTICE: If,after making this declaration,you should become subject to the • Floor Sinks , • Urinal Fan Motors 00-1 HP ❑1X-8 Workers' Compensation provisions of the Labor Code,-you must forthwith - - comply with such provisions or .this permit shall be deemed revoked. , Gas Service "Outlets Water Closet ' F.A.U. Inc.Solar ❑9-15 HP 016-15+ ' CONSTRUCTION. LENDING'AGENCY I hereby affirm that there is a construction lending agency for the performance Interceptors. - Water Heater Fixtures • Microwave of the ,work for which, this permit Is Issued (Section. 3097 Civ. C.) ' - - ' • Lender's Name' ' Kitchen Sink ' Water Service . Device Boxes Pole Light . Lender's Address Lavatories -- OWNER BUILDER DECLARATION - - . Outlets ' Range , . I hereby affirm that I am exempt from the Contractor's License Law for the , following reason (Sectibn 7031.5 Business and Professional Code: Any city or P-Trap - ' Switches Sign ',Linty which requires a permit to construct,alter,improve,demolish or repair - - r structure, prior to Its Issuance, also requires te applicant for such permit Roof Drains - - ' ' - Garbage Disposal Standing Sections • file a signed statement.that he/she is licensed pursuant to the provisions of - te Contractor's License Law (Chapter 9 (commencing with Section 7000)of • Generator ❑0.5 KW 0515 KW Trash Compactor 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 Reinspection Fee $ 3 enalty of not more than five hundred dollars($500). Pe I $25 Issue Fee ,D as owner of the property or my employees with wages as their sole Reinspection Fee $25 Issue Fee $'3 compensation, will do the work,and the structure is not intended or offered MECHANICAL FEES for sale (Section 7049, Business and Professional Code: The Contractor's PUBLIC SERVICES REOUIREM NTS: l at e License Law does not apply to an owner of a property who builds or improves Boiler Hood or Type I ❑ / thereon, and who does such work himself/herself or through his or her own - ❑ Zoning Approved By •�/n - Date '3//` OO employees, provided that such improvements are not intended or offered for Canopy Type 11 _ Duct;Under Ground _ sale. If, however, the will have the or Improvement is sold within one year of con.- Application Approved By - Date pletion, the owner have burden of proving he/she did not build or in.- I Date AI��rI ve for the purpose Of sale). Duct-Structural Refrigeration System .'�' Application Issued By U ab I, as owner of the Property,am exclusively contracting with licensed con- i - llll!!!!'"'ddddbbbb ❑0-100,000 BTU ❑100,000 BTU '3-- builds r tors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating . SUMMARY OF FEES e .The Contractor's License Law does notapplyto an owner je property who - - BUI LDING PERMIT $ 370.. SMIP $ 5 builds or improves thereon,and who contracts for such projects with a con- i Exhaust System 0 Multiple❑ System Repair/Alteration ' tractor(s) license pursuant to the Cont actor's License Law). - PLAN CHECK $ PERMIT 0 I'amexempt under Section MS B.& P.C.for this reason Firepl/Fact.Bit. !CBO# ' PLUMBING $ ISSUANCE $ Date • ne !7 Heating System& Ducting , PLAN CHECK $ ENERGY P.C. $ - I hereby certify that I h: - re •i. application and state that the above ❑0-100,000 BTU ❑100,000 BTU GRADING $ • Information is co rect. I 't• •ly with all city and county ordinances -- - -- - • - • - - ELECTRICAL $ and state laws re ating t%ir• lid 0 struction;and hereby authorize repre- MICROFILM $ sentatives of, thi ty • ,n p•p• the above-mentioned Ipro rty r • PLAN CHECK $ Inspection purpo c . - 1 MECHANICAL $ TOTAL FEESP— Signature Pink-Accounting;Goldenrod-Assessor - - - - - N CONSTRUCTION.AND PLANNINL •- - _ . - >L& SPA ! ' APPROVALS `Permit# • - Date• Inspector, APPROVALS Permit# Date .1 nspector • 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. T - - 55. Electrical Bonding . - • 5. Steel Reinforcement ', . - . 56. Rough Plumbing &Pressure Test 6. Electrical-UFER Grnd. . • '/�`q OS ..57. APPROVAL TO COVER-GUNITE - - 7:- Footings '. - !.. t'l58- Electrical Conduit-Undrgrnd. //77 8: Foundation ; ' S : 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 177 Rough Wiring Sign . . • • . '68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bac 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 : r - 72. Underground Flush 24:Roof Framing , , i 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 - "Tht/ - ,u .; , 77. FIXED SYSTEM FINAL 29. Insulation, - ' , 7/2.61 .L° 78. FIRE PREV. FINAL • 30. Drywall Nailing `] x/ HEALTH DEPT. REQUIREMENT / Pi f'"' G,y9'L ,31. Plaster Brown Coal:',: ' .]/i�/i.( •,e(/ 79. FINAL INSPECTION - 32. Electrical Power Meter-Final Wk.( •l�l 80. FOOD CERTIFICATE ISSUED ' • 33. Final Electric Notes: t .12 6 ` 34. Final Heating & Air Conditioning' i ' ' 35. Final Gas Pipe-Test - •.• - - 36. Hood or Canopy I - " i . • 37. Final Factory Fireplace , • • 38. Final Plumbing ' ' �,� c • V _ . 39. Water Service-Final ; • 40. Gas Service=FinaI -^ 41. Solar Domestic-Final . : _ - - , 42. Backflow Preventer . • , • 43. Backflow Irrigation . - i _ . 44. ,Landscape Irrigation System . .t 45. Sound.Attenuation ' • - _ 46. Handicap Regulations ' ' ' 47. FINAL STRUCTURE & BUILDING f/'/z/ir ��c- 48. Special Requirements Cpmpleted ' ( l q .t./ • 49. Electric Release to Edison -' �"// .. - 50. Gas Release tolSouthern Caffornia,Gas Co •i ' - 51. CERTIFICATEF 000UPA�N9`� it -cy"), No. - ' 6 21 Date --fel :Y i I Y�- (:�--- - - 11 - "- . . .7 .1` CITY OF COSTA MESA 4 �� BUILDING DIVISION >:l -1 DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER :�: .i • PERMIT so® B01-01229 (714)754-5273 • Fax(714)754-4856 • www.cl.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 2336 ELDEN AV Status: ISSUED Suite: Applied: 08/07/2001 Vicinity: K Issued: 08/07/2001 Parcel Number: 43926401 Zoning: Applicant: KIM,ROBERT ISSUED BY: Address: 1835 WHITTIER AVE UNIT F12 Phone: (949)645-3917 - COSTA MESA,CA Zip: 92627 . - - Owner: BURSHTYN, LEA ' Address 2336 ELDEN AVE#A ' - _ - Phone: COSTA MESA,CA Zip: 92627 - - - Contractor: •21STCENTURYROOFING Address: 1835 WHITTIER AVE - UNIT F12 Phone: (949)645-3917 ' COSTA MESA,CA Zip: 92627, License: 750385 ' Arch : - Eng: • Address: Address: - Phone: - , - Phone: - Zip: -License: - License: , SCOPE OF PERMIT ' TEAR OFF INTALL 1/2"CDX.AND LITE WEIGHT TILE 5.5 PSF ICBO#'4660.CAPISTRANO TILE.UNITS K.L.M. - FEE SUMMARY , Plan Check: $0.00 ' Calc Valuation: $5,800.00 Permit: $125.25 Claim Valuation: $5,800.00 SMIP Res: $0.58j' SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $125.83 - PLANNING & ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 . Right 0-0 • ' ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right . 0-0 PARKING Existinq:_ 0 Required: - 0 Proposed: 0 i , . NOTES: • • 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 fora period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain Inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2448-48(WOO) DECLARATIONS -- ' WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the ��work will for which this permit Is issued. 5p I have and wmaintain workers'compensation Insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Is Issued. " My workers'compensation Insurance carrier and policy number are: Cartier: Policy Number: (This section need nor be completed I/the permit is valued et one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit Is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith fy-vn tae provisions. can Signature: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLd.ARE($100,000).IN ADDfI1ON TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES, LICENSED CONTRACTORS DECLARATION: I hey elft 4hat:t:ala" cad under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is In full forceen d,eff�`u (Class—) Contra(( �Sk)mture: \Data: • 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 perm+' subjects the applicant to a civil penalty of not more than five hundred dollars(5500).): ❑ 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 Ls 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 Lew 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,Le.-properly tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file end certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be 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 O7 present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this , plication agpernit 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 finder this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If yes",the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 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. Signature Of Legal Owner(s) Date And/Or Authorized Applicant Dati a CODE F INSPECTION TYPE DISE MONA SODEt INSPFCTION TYPE DAIS ILLS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final I 208 Final Plumbing { 200 Final Re-Roof CS /�/O/ r-C210 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 #weer' Cei 1 Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITt1 COSTA MESA PERMIT NO- TRACT NO. - LOT NO. -BLDG.NO. CONSTRUCTION PERMIT /00-C Project Address 2 436 f' Loren) (`tion_ s) TYPE OF CONSTRUCTION - Owner iM C A' 1SG t/ - Phone 0 NEW 0 ADD 0 ALTERATION Lie w.sfl - - Address V2�/ Fuca pacer" C1 /y1- 0 REPAIR ❑ CONVERSION ['DEMOLISH -7 F•� _ P ❑ OTHER ZONING REGULATIONS Arch/Eng. - License No. - - Address - 3�a DESCRIPTION OF WORK A.P.$ . ZONE PLNG.REF.y Contractor��� 4_. l - Phone 76005' TYPE OF PERMIT - BUILDING -. - Tp9UILpINC Address _ ,p SETBACK CA..ST. PROPERTY LWE • Z,7f L S red? /4 j7 fl r 0 GRADING 0 FOUNDATION I 0-STRUCTURAL 51DF)YARD • LICENSED CONTRACTOR DE ARATION ❑ TENANT*ELECTRICAL ❑PLUMBING'N. T.-, MECHANICAV LSI E YAML - - I hereby affirm that I am licensed 'under provisions of Charter 9 (com- RIGHT mencIng with section 7000) oft Division 3 of the Business and ❑OTHER _ Professions Code, and my license Is In full force and effect. REAR YARD(TO P/L) Ucen Class G.`-l0 - License No. p1333 A? PROJECT DESCRIPTION - sa�7�f �C ./'V SO PKG.SPACE REQ. PROVIDED i Date KE Signature ter -� . STREET WIDTH PARK FEE S V'-"KERS'COMPENSATION DELON OCCUPANCY—CONSTRUCTION TYPE iby affirm that I have a certificate of consent to self-Insure or a VALUATION ZONE rZONING APPROVED BY. ( DATE Icate of Workers' Compensation Insurance, or a certified copy thereof(Section 3800,Lab.C.)- GRADING CU. YDS- ACRES SPECIAL CONDITIONS: mm' Policy No. Company - • - • _ V` 0 Certified copy Is hereby furnished.- - REMARKS: ' . . ,. .0 Certified copy Is filed with the city Building Division. j EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - " (This section need not be completed if the permit Is for one hundred '' ' ($100) or less). - - - - - -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 tobecomePLUMBING PLAN CHECK - - ELECTRICAL " PLAN CHECK -, - subject to the-Workers Compensation Laws of California. . ' - UW tLu NU - •- bANAGt Date Signature BATHTUBS - SHOWERS 50 FT SO FT NOTICE: If after making this declaration, you should become subject TOILETS , i URINALS - GENERATOR 0-1 KW_1-10-KW to the Workers' Compensation provisions of the Labor Code,you must TRANSFORMER . forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS ' APPLIANCE 10.50 KW_50+KW . revoked. _ . . - CONSTRUCTION LENDING AGENCY KIT.SINKS • DISHWASHERS - ' • MOTORS 0.1 HP -1-10 HP I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS " ' SUMPS -' (INC.SOLAR) 10-50 HP 50 +HP • formance of the work for which this permit is issued (Section‘3097 ' (S Civ. C.). FLOOR SINKS ,, FLOOR DRAINS - FIXTURES OUTLETS/ SWITCHES - ' ' Lender's Name - -' Lenders Address DRINKING FOUNTAINS - •- - GAS TUBE SIGNS - . OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS - POLE LIGHTS -' • I hereby affirm that I am exempt from the Contractor's License Law for - the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL ' P TRAP • (-UN&I NUL I ion/ - , Any city or county which requires a permit to construct, alter, POLES METERED SUB improve,demolish or repair any structure, prior to its Issuance,also re- WATER SERVICE' ALTERATION PANELS- MAIN SUB quires the applicant for such permit to file a signed statement that he :ensetl pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS - - V ' SERVICE' " - ' / - AMP ' -" pter 9 (commencing with Section 7000) of Division 3 of the ' .ness and Professions Code) or that he is exempt therefrom and the WATER HEATERS -BTU OUTPUT ' ' • ''tt • basibasisafor the hetallleged exemption. Any tvi violation of ft Section to tl70 1.5 by SEWER CONNECTIONS - v IJ U�w- �'IP Tt�1r S of not more than five hundred dollars ($500). Q Qi'✓e0j77-- eYT_ ❑ I, as owner of the property,or my employees with wages as their SOLAR TANK COLLECTORS - sole compensation, will do the work,and the structure Is not Intended ISSUE FEE or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING 5Y5. Contractor's License Law does not apply to an owner of a property APPLICATION APPROVED BY DATE who builds or Improves thereon, and who does such work himself or ISSUE FEE through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or Improvement MECHANICAL PLAN CHECK SUMMARY OF FEES is sold within one year of completion, the owner will have-the burden of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU BUILDING PERMIT $ SMIP S. -I1 0 I, as owner of the property, am exclusively contracting with AND DUCTING V licensed contractors to construct the project (Section 7044, Business 100,000+BTU PLAN CHECK $ . PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ • an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts from such projects with a contractors) licesned pursuant to SYSTEM GRADING $ the Contractor's License Law). 100.000+BTU PLAN CHECK $ • J ❑ I am exempt under Section B.& P.C.for this BOILERS BTU ELECTRICAL $ if— S L reason PLAN CHECK $ MICROFILM $ ,�` _ SYSTEM REPAIR,ALTERATION , Date Owner TOTAL FEE$ WI hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $ Information Is correct. I agree to comply with all cityand countyPLAN CHECK $ VAN E P 3 ordinances and state laws relating to construction,and herby authorizVANCE PC $- representatives of this city to enter upon the above mentioned • property for ins ions purposes- q p % Signature% `rel' / ISSUE FEE - CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor r • CONSTRUCTION AND PLANNING \r� POOL&SPA ' APPROVALS Permit# L-- 1`lJ Date Inspector APPROVALS Permit# Date Inspector • 1. Temporary Electrical Service or Pole • 43. Pool & Equipment Location ' 2. Soil Pipe-Undrgrn. 44. Steel Reinforcement • .3. Electrical Conduit Utility-Undrgrn - 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel Reinforce 47. Rough Plumbing & Pressure Test • 6. Electrical UFER Grn a3/J//j' Crr. 48. APPROVAL TO COVER-GUNITE 7. Footings - !-- 49. Electrical Conduit-Undrgrn 8. Foundation - . , 50. Gas Pipe, ❑Undrgrn,Test 9. Water Pipe-Undrgrn_ _ • 51. Backwash Lines, P-Trap. ❑Undrgrn 10. Structural Floor System 52. APPROVAL TO DECK _ 11. Property Sewer Line& House Connection 53. Backwash & Receptor-Final 12. Street Sewer Connection 54. Heater & Vent-Final 13. Rough Plumbing _ 55 Plumbino Svstem,- Final 14. Rough Electric-Conduit - - -56. Electrical-Final 15. Rough Electric-Wiring - 57. Solar System-Final 16. Rough Heating & Air Conditioning 58. Fencing&Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 19. Gas Pipe-Rough &Test • 60. POOL/SPA SYSTEMS FINAL 20. Roof Framing _ 21. Roof Sheathing _ • 22. Frame and Flashing NOTES: 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter-Final q_l J/8� C. 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe-Test 31. Final Plumbing ' 32. Water Service-Final 33. Gas Service-Final 34. Solar Domestic-Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison /-'--/(,•3at 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date • I Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PEAMIT Nfl TRACT NO. LOT NO. BLDG.NO. CONSTRUCTION PERMIT �.0 3 ' Project Addressa3' EL 04,—A) -AarTYPE OF CONSTRUCTION 3853 3%29/82 _• C TL' Owner U' arc orf-ii Phone4?)-71.3L '❑ NEW D ADD 0 ALTERATION - . _/) ) - - • -Address .2.2 -i C q-rt/Ira. ',lir ' ❑ REPAIR,0 CONVERSION 0 DEMOLISH `�f'�(� ZONING REGULATIONS d Arch/Eng. - , License No. 0 OTHER _ DESCRIPTION OF WORK • A.P. • Address • - - ' , •- ZONE - ' .PLNG, REF.14 • - Contractor A f t (�� crow; 5.WC Phone TYPE OF PERMIT - - • BUILDING - - TO gL�ILpING - D `1B SETBACK MST. PROPERTY LINE • `VV4.. Address -v - - -.❑ GRADING 0 FOUNDATION --❑ STRUCTURAL r SIDE YARD ( LICENSED CONTRACTOR DECLARATION. " ❑ TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHANICAL IDE YARD - - _ •p I hereby affirm that I am licensed under provisions of Charter 9 (tom- -. • RIGHT • - mencing with section- 7000) of Division 3 of the. Business and : ❑ OTHER Professions Code, and my license is in I I force and effect. I REAR YARD(TO P/L) • O L - I ( PROJECT DESCRIPTION N ,License Class ns o.U" - - PKG.SPACE REQ. - -PROVIDED Date 3-2-Cs Signature 's 4): -- 'SQ. FT. . . __ .^. - ORKERS'COMPENSATION D LARATION_ _ OCCUPANCY_CONSTRUCTION TYPE - STREET WIDTH � . PARK FEES ., lereby affirm that I have a rtilicate of consent to self-Insure or a s ,ZONING APPROVED BY '' -- -I DATE - VALUATION rtificate of-Workers' Compensation Insurance,-or_a certified.copy _ • ZONE - A - thereof(Section 3800, Lab.C.). 1 GRADING CUgYDS. ACRES SPECIAL CONDITIONS: Policy No. 'FO?a, )- ' Company rArCvl.-crOf _ _ _ _ .. - - ._ _ . . ._. . ❑ Certified copy is hereby furnished. - - . . REMARKS: ' ' ' ' "' ' '❑Certified copy is flied with the city Building Division. { ,EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - — . -' - - - •- - ' -• (This section need not be completed if the permit is for one hundred . ($100) or less). i - _ , _ • _ __ - _ -_ _ _ _ _ - _. certify that in the performance of the work for which this permit Is Issued, I shall not employ any person in any manner so as to'become PLUMBING; '_ -•• - ,PLAN CHECK " - .ELECTRICAL - PLAN CHECK ' - -- - - subject to the WorkersLCOmpensation Lawspf California. . ' • - BATHTUBS - 'SHOWERS - UWELLINO - .(.A KM&t Date Signature - - - - SO FT- SO FT ,NOTICE: If after making this declaration, you should become subject TOILETS - ,URINALS -- • - GENERATOR 0-1 KW_1-1'6'KW ' - - - to the Workers' Compensation provisions of the Labor Code,you must TRANSFORMER f ) ! ' forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS - - - - 'APPLIANCE - 10-50 KW 50+ KW - - - revoketl. _. -. - KIT.SINKS - - -' DISHWASHERS-- - MOTORS - CONSTRUCTION LENDING AGENCY _ 0-1 HP=1-10'HP �- f' I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS ., SUMPS- - __. - — (INC.SOLAR). - I0-50 HP=50 +-HP -- formance of the work for which this permit Is Issued (Section 3097 - - ' - n '• Civ:C.).- - - - - - - - •- - - - - - ' FLOOR SINKS -- - --- FLOOR DRAINS ' ' - 'FIXTURES- OUTLETS- SWITCHES - 'Lender's Name _ ' -Lender's Address ._DRINKING FOUNTAINS' - - •GAS TUBE SIGNS- - - •- - - - OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS - POLE LIGHTS • - - -- - - •- • - I hereby affirm that I am exempt from the Contractor's License Law for - the-following reason-(Section 7031.5 Business and Professions Code:- SWIMMING POOL P TRAP - - _ LON51 nut I IUN - - Any city or county which requires a permit to construct, alter, POLES METERED SUB - improve,demolish or repair any structure,-prior to its Issuance,also re- - WATER SERVICE ALTERATION --" - ' ' - PANELS MAIN SUB -- quires the api.licant for such permit to file a signed statement that he . • s licensed-pursuant-to the provisions of the•Contractor's License Law GAS SERVICE OUTLETS' -- - - . ;SERVICE -- -- - - AMP - ^ - - Chapter 9 (commencing with Section 7000) of Division 3 of the - • Business and-Professions Code) or that he is-exempt therefrom anddbe- WATER HEATERS - BTU OUTPUT — - '- -- - - - - - basis for the alleged exemption. Any violation of Section 7031.5 by usC any-applicant for a permit subjects the applicant to a civil Penalty - _ - - - ' OUCYDrr'!.'E9'f�- 3 la ._ _ _ - _ ._ of not more than five hundred dollars ($500). .Q lj Ar lei/e ) Tf-V:r/kO ' -- tr❑ I. as dsJaer of the property, or my employees-with wages as their -ReirsieR~TOIN - 'GgBQ6 - sole compensation, will do the work,and the structure is not intended • AilIc C or offered for sale.-(Sedtion 7044,-Bdslness"and Professions Cotle(The- ' SOLAR PIPING SYS. �:--, --1 . . - ISSUE FEE'- - - - - , -- 1 Contractor's License Law does not apply to an owner of a property .. V qPp LICATI.. ' ED BY,' - - < who builds or Improves thereon, and who does such work himself or ISSUE FEE 3Q)DDATE-•-IN through his own employees, provided that such Improvements are not - J - -,{ intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK SUMMARY OF,FEES - NOis sold within ono year of completion, the owner will have the burden s. of proving he did not build or improve for the purpose of sale). - -- -- - - BUILDING - - - -- - - -- - - ❑ I, as owner of the property, am-exclusively usively contracting with HEATING SYSTEM 0-100,000 BTU 'PERMIT $ SMTP. -b • - AND DUCTING - ' • licensed contractors to construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK S. PERMIT - -1 and Professions Code: The Contractor's License Law does not apply to - _ _ _ D ISSUANCE $ an owner of property-who builds or Improves thereon,and who con- REFRIGERATION 0-100,000 BTU 'PLUMBING 5-4• / 1 s, Q tracts from-such projects with a contractor(s) licesned-pursuant .to SYSTEM - - - - - _ GRADING.. $ c the Contractor's License Law). 100,000+BTU PLAN CHECK -S .- , - 1 it; 0-1'am exempt under Section - -- -B.&P.-Crier this' BOILERS BTU ELECTRICAL S -- -- -- .-- . '$ - I• reason MICROFILM S - r.: NaV SYSTEM REPAIR,ALTERATION PLAN $ • Date Owner - .- - - •_ TOTAL FEE$ IliltI hereby certifythat I have read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $ VQ • PP 'LESSAD. , __ • _• ' _ jil ordinances Is Correa: I la In to comply with all cityerand countyauthorize PLAN CHECK y VANCE PC $_ 7 representative and state la vela Ing to t [upon ,and hereby authorize , representativ0 f t ci to ant upon the above mentioned proparty f I on poses. - 2i O.� Signature - Date L - FINAL FEE S G. /0 Drivers' ' enso or SS 7F ' - ISSUE FEE - - - _ CMF 0865-46 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor CONSTRUCTION AND PLANNING POOL& SPA • n' l.'i1. FOE,; ,3oa Date Inspector • Date Inspector APPROVALS Permit k APPROVALS Permit# 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location -2. Soil Pipe-Undrgrn 44. Steel Reinforcement - • 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel Reinforce 47. Rough Plumbing & Pressure Test - •• • - - • - - 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undrgrn 8. Foundation 50. Gas Pipe, ❑Undrgrn,Test 9. Water Pipe-Undrgrn 51. Backwash Lines. P-Trap, ❑Undegrn - - - - 10. Structural Floor System 52. APPROVAL TO DECK - 11. Property Sewer Line & House Connection 53. Backwash& Receptor-Final 12. Street Sewer Connection 54. Heater &Vent-Final 13. Rough Plumbing 55 Plumbina System - Final 14. Rough Electric-Conduit 56. Electrical-Final 15. Rough Electric-Wring - 57. Solar System-Final 16. Rough Heating & Air Conditioning 58. Fencing &Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL 20. Roof Framing 21. Roof Sheathing ' 22. Frame and Flashing NOTES: 23. Insulation 24. Lathing & Siding - 25. Drywall Nailing 26. Plaster Brown Coat• - 27. Electrical Power Meter-Final 28. Final Electric 29. Final Heating & Air Conditioning - - - 30. Final Gas Pipe-Test 31. Final Plumbing 32. Water Service-Final cre</feh... JVC%) 33. Gas Service-Final 34. Solar Domestic-Final • 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations -- - 38. FINAL STRUCTURE & BUILDING • 39. Special Requirements Completed 40. Electric Release to Edison • 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY • No Date Pr Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. _ /CITY OF COSTA MESA PERMIT NO. • 'f TRACT NO. LOT NO. BLDG.NO. ' CONSTRUCTION PERMIT B P , �a2_ 3cO ,QR.Y0 Project Address �Jµ)336 1 ow TYPE OF CONSTRUCTION • 8258 /0 /81 34.37 TL Owner �n!Ln CN — {{J/ ltur Phone p' 0 NEW' 0 ADD 0 ALTERAT N Address .a , co( 6 JND 5% /(O7PE&`Atm 0 REPAIR 0 CONVERSION EMOLISH ZONING REGULATIONS Arch/Eng. License No. 0 OTHER A P $ /JJ DESCRIPTION OF WOR{Q� ;^T �59 — LNG. R•2.4- Address g+ C Y'_/� _ - • Arai / ZONE Z. Contractor gomit p Drf C D Phan 193Z 7l< Y OF PERMIT - f :1 ' G - TQ gg��tJJJI -P' G _ SETBACK C/L 5T. PROPE RTV LINE Address •f/),_3 £ 3rtG sr 4e Nb J,Sfft9Uhr, ❑ GRADING 0 FOUNDATION 0 STRUCTURAL SIDE YARD 1/,ll''n,Yil///—�J' LICENSED CONTRACTOR DECLARATION 0 TENANT 0 ELECTRICAL ['PLUMBING•❑MECHANICAL LS IEDFET YARD • I hereby affirm that I am licensed under provisions of Charter 9 (comm RIGHT ,....... mencing with section 7000) of Division 3 of the Business and 0 OTHER Professions Code and my license Is In full force and effect. REAR YARD (TO PROJECT DESCRIPTION P/ / License Class u n .Lo 311/1 PKG.SPACE REQ. • PROVIDED Date •7-7`k/ Signature -SQ.FT. - - ' KERS'COMPENSATION DECLARATION - - OCCUPANCY CORTRUCTION TYPE STREET WIDTH PARK FEES eby of fir th t I ay certif talo pkponsent to self-insure or a VALUATION/P(90 ZONE • ZONING APPROVED BY /�✓7 ,t5,5tt3 DATE _ cu.•dlcate n 4.45an , or a certified copy - ��/ thereof (Se n iy[lO . t �� ��• GRADING CU.YDS. _ ACRES - - SPECIAL CONDITIONS: poliby No. �A 111 8S Company � /�. ��.••PP,�•�}} . ertlfied copy is hereby furnished. visIou.n"`•" REMARKS: • ❑ Certified copy is filed with the city Building D vision. , EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - - - . • (This section need not be completed If the permit Is for one hundred - _ _ - _ ($100) or less). • - I certify that In the performance of.the work for which this permit is Issued, I shall not employ any person in any manner so as to become PLUMBING _ PLAN CHECK ELECTRICAL - - PLAN CHECK subject to the Workers Compensation Laws of California. UWELLIN(a GARAGE - - Date Signature • BATHTUBS SHOWERS 50.FT- SO FT NOTICE: If after making this declaration, you should become subject TOILETS` URINALS -- GENERATOR 0-1 KW_1-10 KW to the Workers' Compensation provisions of the Labor Code,you must TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE - 10-50 KW_50+KW _ • revoked. - - CONSTRUCTIONKIT.SINKS DISHWASHERS MOTORS 0-1 HP_1-10 HP - LENDING AGENCY I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS . ' . . (INC.SOLAR) 10-50 HP 50-+HP formance of the work for which this permit is issued (Section 3097 Civ. C.). - FLOOR SINKS FLOOR DRAINS ' FIXTURES OUTLETS SWITCHES "_ Lender's Name . Lender's Address DRINKING FOUNTAINS - GAS TUBE SIGNS OWNER BUILDER DECLARATION - INTERCEPTORS CLARIFIERS POLE LIGHTS -' I hereby affirm that I am exempt from the Contractor's License Law for • the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP - LUNbI NUL I IUN Any city or_ county which requires a permit to construct, alter, POLES METERED SUB , Inlprovo,demolish or repair any structure, prior to its Issuance,also re- WATER SERVICE 21RATIV ' PANELS MAIN SUB . ' ^'gi;''res the applicant for such permit to file a signed statement that he ",tiicensed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUT SERVICE' AMP i'hapter 9 (commencing with Section 7000) of Division 3 of the usiness and Professions Code) or that he is exempt therefrom and the 'WATER HEATERS O TPUT _ basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit Subjects the' applicant to a civil penalty SEWS C6NN CTI �. - of not more than five hundred dollars ($500). /82 ❑ I, as owner of the property,or my employees with wages is their SOL RTA K COLLECTOR sole compensation, will do-the work, and the structure Is not intended or offered for sale, (Section 7044, Business and Professions Code: The SOL PI SYS. ISSUE FEE who builds License Law tlreo not apply to an her of a propertyif • r APPLICATION APPROVED BY l+n Q DATE 7/Q who builds or Improves pro and who does suchmwork himself or ISS t EE X1.17 7 through his owndforemployees, If,provided that, such Improvements areenot _ Is soldldetl or offered for sale.completion,, tionthe nein l ha improvement MECHANICAL PLAN CHECK SUMMARY OF FEES Io prwithiningh ono yenr of ui dorimthe ownerfor will have rpo the sale). _ �/ of proving he did not build or improve for the purpose of sale). BUILDING SMTP $�al� ❑ I, as owner of the property, am exclusively contracting with HEATING SYSTEM 0-100,000 BTU PERMIT $ / �•� litensetl contractors to construct the project (Section 7044, Business AND DUCTING 100,000 +BTU _ PLAN CHECK $ PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE S •J an owner of property who builds or improves thereon,and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ — tracts from such projects with a contractor(s) licesned pursuant to SYSTEM - - GRADING S the Contractor's License Law). 100,000+BTU PLAN CHECK § / ❑ I am exempt under Section B.& P.C.for this BOILERS BTU ELECTRICAL § S ^6/ reason PLAN CHECK $ MICROFILMS n Date Owner SYSTEM REPAIR,ALTERATION - TOTAL FEE'S Naga I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $ PLAN CHECK § LESS AD- Information is correct. I agree to comply with all city and county VANCE PC $_ repres ordinances and state laws relating to construction,and hereby authorize representat of this y to enc upon t•e above mentions 3 V 31 ^ property SPeca�urpos _ N CONSTRUCTION AND PLANN � I I . . , POOL& SPA APPROVALS Permit# Ll J_L�- Date Inspector APPROVALS Permit#• Date .Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - • 2. Soil Pipe-Undrgrn • 44. Steel Reinforcement ' 3. Electrical Conduit Utility-Undrgrn , . 45. Forms 4. Electrical Conduit-Undrgrn • • • ;'46. Electrical Bonding. 5. Steel Reinforce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings - • - 49. Electrical Conduit-Undrgrn • 8. Foundation - . - 50. Gas Pipe, ElUndrgrn,Test 9. Water Pipe-Undrgrn 51. Backwash Lines. P-Trap. ❑ Undrqrn 10. Structural Floor System • 52. APPROVAL TO DECK • 11. Property Sewer-Line &-Honse-Geer+ection7,6 i//4/31) �/%,L 53. Backwash & Receptor-Final 12. Street Sewer Connection . . 4 54. Heater & Vent-Final - 13. Rough Plumbing - 55. Plumbing System -Final 14. Rough Electric-Conduit -56. Electrical-Final ' 15. Rough Electric-Wiring - 57. Solar System-Final 16. Rough Heating & Air Conditioning 58. Fencing & Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING ' 18. Ducts, Ventilating 19. Gas Pipe-Rough &Test • . 60. POOL/SPA SYSTEMS FINAL 20. Roof Framing 21. Roof Sheathing - NOTES: • 22. Frame and Flashing 23. Insulation 24. Lathing & Siding 25. Drywall Nailing . 26. Plaster Brown Coat . 27. Electrical Power Meter-Final 28. Final Electric - - 29. Final Heating & Air Conditioning - . 30. Final Gas Pipe-Test - - - •• '• , 31. Final Plumbing • . 32. Water Service-Final _ 33: Gas Service-Final 34. Solar Domestic-Final 35. Landscape Sprinkling System 36. Sound Attenuation . - . • 37. Handicap Regulations - , 38. FI NAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY ' No Date . Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PE T N . TRACT NO. rt#T0NO. BLDG.NO. ' FS oTRUCTION PERMIT 3.� 3O ./ ziZA • 8461 7/09/81 Project Addrres�/�07354, FLJF_ /1./ .S'7 TYPE OF CONSTRUCTION I . • 64.02 TL Owner-r/.R /e/!—Je'/ffdler LZEU Phone.y-j�,5j-e-2^J(• 64 NEW 0 ADD 0 ALTERATION • ' Address /$CC? S/(y/AR/f CMeLe -ZNn]/c'a 0 REPAIR 0 CONVERSION DDEMOLISH Arch/Eng. J License No. 0 OTHER L� A nONING REGULATIONS DESCRIPTION OF WORK /IET�J/T7�/fit- G�'A« A.P.AP * Air2-419!^Z0‘51-' Address p ZONE PLNG. REF.of Contractor �'SJ LA, Poll mkt ledCOw/'reine e1 - W/'TYPE OF PERMIT 1 - BUILDING Tp g�/I .PING JIJ/d'rCE/ raR A/vd/�^4)11¢s,vc n/r❑GRADING 0 FOUNDATION I STRUCTURAL SSETBACKRD/L$T. PROPERTY LINE Address •s D 7 122. LP' /34-0Lei q (�/ LICENSED CONTRACTOR DECLARATION 0 TENANT 0 ELECTRICAL' ❑PLUMBING ['MECHANICAL Si YARD !/ I hereby affirm that I am licensed under provisions of Charter 9(cum- .�.\- ,•_Zr- - •t n, 1,� t� RIGHT meneisi s C section 7000)myof Division3 o the Business and ❑ OTHER ' REAR YARD(TO P/L) C� LFAL ,t, PL_ Licenssions Code, and my license Is in full force and effect. PROJECT'DESCRIPTION License Cl.ss •? Ices a E PKG.SPACE REQ. •PROVIDED Date Signature •—/J •r SQ. FT. .. .. KERS'COMPENSATION DECLARATION -. OCCUPANCY CONSTRUCTION TYPE. STREET WIDTH PARK FEE $ , eby affirm that I have a certificate of consent to self-insure or a VALUATION 2'P-c•0 ZONE ZONING APPROVED Enerienst DATE?9—A/ ficate of Workers' Compensation Insurance, or a certified copy thereof(Section 3800, Lab.C.). GRADING CU.YIDS. ACRES SPECIAL CONDITIONS: ' Policy No. Company - - r-^'� - - . ❑ Certified copy Is filled. El Certified copy is by withrthehe .clty Building Division. REMAR KS:�' .."'`icfJJ - - EXEMPTION FROM WORKERS' COMPENSATION DECLARATION , ' (This section need not be completed If the.permit is for one hundred . .. _ ,- . . ($ 100) or less). •certify that n the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become PLUMBING PLAN CHECK ELECTRICAL -PLAN CHECK subject to the Workers'Compensation Laws of California. _ - UWELLING bAHAGE - Date Signature BATHTUBS SHOWERS SO FT SO FT NOTICE: If after making this declaration, you should become subject TOILETS URINALS GENERATOR 0-1 KW_1-10 KW to the Workers' Compensation provisions of the Labor Code,you must TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE 10-50 KW_50+KW revoked. - .- CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS MOTORS 0-1 HP 1-10 HP • Ihereby.afflrm that there is a.construction lending agency for the per- SERVICE qiNKS SUMPS (INC.SOLAR) 10.50 HP50+HP formance of-the:work-for whichvthis)permit is issuetl\(Section 3097 r Cly. C.). \ r l s FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES ' L.ender's Name - ' _ - ' Lender's Address - • -I- DRINKING FOUNTAINS: GAS TUBE SIGNS ' OWNER BUILDER DECLARATION - INTERCEPTORS CLARIFIERS POLE LIGHTS Thereby affirm that I ani exempt from the Contractor's License Caw fr ' the following reason (Section 7031.5 Business,and Professions Code: SWIMMtNG'POOL P TRAP ' LUNSI Hui_I SUN Any city.or county which requires, a permit to construct, alter • - - POLES METERED SUB Improve,demolish or repair any structure, prior to its issLance,also re WATER SERVICE ALTERATION PANELS MAIN SUB autres the applicant for Such permit to file a signed statement that he r • • • - licensed pursuant to the provisions of the Contractor's License Law GAS.SERVIOE 4,8 OUTLETS SERVICE AMP hapter 9t(commencing with Section 7000) of Division' 3 of,the '13 usiness and Prb/essions Code) or that he is exempt therefrom and the WATER HE'ATE.RS BTU OUTPUT - • ' basis for-the alleged exemption..Any.violation of Section 7031%5 by any applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS ' of not more than live hundred dollars ($500). ❑ I, as owner of the property,or my employees with wages as their SOLAR TANK: . • 'COLLECTORS sole compensation, will do the work, and the structure is not Intended ' • or offered for-sale:.(Sectlon 7044, Business and Professions Code: The SOLAR PIPING SYSj\ ISSUE FEE Contractor's License Law does not apply to an owner of a property •APPLICATION APPROVED BY DATE who builds or improves thereon, and-who does such work himself or , ISSUE FEE '•\ through his own employees, provided that'such Improvements are not Intended or offered for sale. If, however, the building or Improvement .MECHANICAL • PLAN CHECK ?SUMMARY OF FEES ofis urden s provingld within the did ear notibuild port improve forer thea-purrposeBUILDINGIl have he sale). HEATING ofYSTEM 0-100,000 BTU- PERMITS ler SMTP S aro ❑ I, as owner of the property, am exclusively contracting with AND DUCTING licensed contractors to construct the project (Section 7044, Business 100,000+ BTU - PLAN CHECK $ 25• 7 PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ _ - an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts from such projects with a contractor(s) licesned pursuant to SYSTEMGRADING $ the Contractor's License Law). 100,000+BTU ' '' • (tc•,\1 -\ PLAN CHECK �$ di . ❑ I am exempt under Section B.8 P.C.for this BOILERS BTU • ELECTRICAL E $ •S• reason PLAN CHECK $ MICROFILM $ Date Owner SYSTEM REPAIR,ALTERATION ,TOTAL FEE$ I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $ PLAN CHECK $ LESSANEAD- Information Correct. I eaten l• comply with all city and county VANCE PC $_ represnces ndes 5 LC I4i citytln• e on t tion,and hereby authorize .� reoresents v¢s f i city en ;/-.on the above mentioned '1.492 property or insp n our.. es..././ 4- s \- / Date 7/2/" FINAL FEE $ Drivers' License or • ISSUE FEE CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor CONSTRUCTION AND PLANNI • ,. POOL&SPA APPROVALS Permit# - Date Inspector APPROVALS • Permit# Date inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - 2. Soil ii e-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility,-Undrgrn - 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel Reintorce - . 7•-17--`f /s m 47. Rough Plumbing& Pressure Test c:;•-.6':, '_ ' ‘ - 48. APPROVAL TOCOVER-GUNITE - 7. Footings 7,11,// ,. 49. Electrical Conduit-Undrgrn 8. °iFoundaiion, - • '•, _ 50. Gas Pipe, ❑Undrgrn,Test 9. Water Pipe-Undrgrn 51. Backwash Lines, P-Trap. 0 Undrgrn 10. Structural Floor System - 52. APPROVAL TO DECK - - 11.* Property Sewer hire & House.Connection 53.-• Backwash & Receptor-Final • 12. Street Sewer Connection 54. Heater & Vent-Final 13. Rough Plumbing - 55 Plumbina System - Final ' 14. Rough Electric-Conduit .56. Electrical-Final 15. Rough Electric-Wiring 57. Solar System-Final • 16. Rough Heating & Air Conditioning 58. Fencing & Access Approval 17. Ducts, in Structure •. APPROVED FOR PLASTERING 18. Ducts, Ventilating 19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL 20. Roof Framing • 21. Roof Sheathing 22. Frame and FlashingNOTES: Er'na( St& oczt 7-.) t-ni em i/1 Q.4-5 LPl�2t+ 23. Insulation Q- cede. S e .% `T-l�`� , (J 24. lathing & Siding �-r/- 8'Z -- ,,k;et CortR'-oc7`.one.s 25. / Drywall NailingRovr't/ lfwyvd/twit C kir +- L0C7" 41L 26! Plaster Brown Coat 'brtaweir SLop-e TO <l)- cr--t 011 One its 27. Electrical Power Meter-Final eu.dY to e I 62.e r 28. Final Electric et Rowe/$ MEt2 7-et c as 47Th; q#&-. (3 29. Final Heating & Air Conditioning /O,p/Or4/✓ liciasNuA-4,t-e'CS 41-1 Unv/Y 30. Final Gas Pipe-Test 31. Final Plumbing S 7- t .. 2e .d.-€ tc'aite,„cPec2' S 32. Water Service-Final r7tt/81- ;i- c e"" <r-fr-8't te/r tic, 33. Gas Service-Final (1. fed vref ie fJiv., K#i?s i:.J'.•1-S.e 1- 34. YS �.. x!-•ec/er to D,cii r Solar Domestic-Final l� i..i ' 35: ' Landscape Sprinkling System “49. 36. Sound Attenuation . 37. Handicap Regulations ] *38. FI NAL STRUCTURE & BUILDING(SPo4004-311-/r%L 37139. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. - 42. CERTIFICATE OF OCCUPANCY . - No Date