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Home My WebLink About1017 EL CAMINO DR - Building Permitself Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. PERTRACT NO. LOT NO. - CIT oSTA MESA CONSTRUCTION PERMIT MhN'O '1 � ny T UNIT NO. Applicant's Mailing Al�ddress� L -(.C/ / I L_y14/ Owner's Name —��l _Phonel�L_L_ILLq(O Address P Arch/Eng. License No. Address Contractor's Name Phone Address (mailing) - City License No LICENSED CONTRACTOR,DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing W ith section 7000) of Division 3 of the Business and Professions Code, and l my license Is in f r e and eect. License Cl a s LI - e Dale gnature 'ORKERS'COMPENSATION DECLARATION ereby affirm that I have a certificate of consent to self -Insure or a certificate �i Workers' Compensation Insurance, or a certified Copy thereof (Section 3800, lab. C� n / ff Policy No./h(.7 / 7 �T /Company edified Copy is hereby furnished. Cerlifjedrep Py 1�11Md withthe1 sl n /^ Date : h / CS C> �_ EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (Thi.ctloo 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 subject to the Workers' Compensation Laws Of California. Date Signature NOTICE: If, after making this declaration, you should become subject to'the Workers' Compensation Provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. 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 (Section 3097 Civ. C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional Code; Any'city or county which requires a permit to Construct, eller, Improve, demolish or repair any structure, prior to its Issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of -•e Contractor's License Law (Chapter 9(commencing with Section 7000) of vision 3 of the Business and Professions Cotle) or that he/she is exempt .n refrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil enalty of not more than five hundred dollars ($500). 1, as owner of the property or my employees with wages as their sole cc mpensation, will do the work, and the structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's License law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that Such Improvements are not intended or offered for sale. If, however, the building Or improvement is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or im- ra for the purpose of sale). ,'as owner of the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044, Business and Professions Code: .The Contractor's License law does not apply to an owner of property who builds or Improves thereon, and who contracts for such projects with a con. traclor(s1 license pursuant to -the Contractor's License Law). I am aware that proof off their Worker's Compensation insurance should be provided to me. ❑ 1 am exempt under Secllon B. & P. C. for this reason Date Owner inhereby certify that I have rea formation is correct. I agree to and slate laws relating to build, sentatives Of this city to enter Inspection puygpsgp2/J Signature /Sv �Y�(L�(.Y Drivers' License or SS !P this application and state that the above empty with all city and county ordinances construction, and hereby authorize repre. upon the above-mentionedpropert/y foor/rr/ Date / —, /'66— TYPE OF CONSTRUCTION L NEW 'LJ ADD' L ALTERATION _J REPAIR' ❑ CONVERSION- ❑ DEMOLISH ❑ OTHER A.P. qts DESCRIPTION OF WORK/USE OF BLDG. S Main Building: TYPE OF PERMIT GRADING:k❑ STRUCTURAL T Front El TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL B Rear ❑ OTHER A PROJECT DESCRIPTION SO. FT. ' OCCUPANCY C Right CONSTRUCTION TYPE VALUATION$ S Left ZONE GRADINGCU.YDS. ACRES PIng. ef.+ Remarks: 1 Planning Notes: 0949 3/13/06 Accessory Bui 5.1L TL zone' , Z' O N, I N G R E O M T S Bar Sink Showers $ 3 ELECTRICAL FEES Backflow Preventer Service Sink Automatic Washer' Transformer ❑ 15-50 KW Construction Pole Sub. ❑ 50+ KW ' Backflow Irrigation Sewer Cap 9 Reinspection Fee Bathtubs Sewer Connection $ 3 Cooking Unit Meter ❑up to 100 amps Clarifiers Solar Collectors - Dishwasher '' - Meter ❑over 100 amps- -. Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel i Drinking Fountains Solar Tank Fan Motors 00.1 HP 01 h-8 Floor Drains Swimming Pool w/Spa F.A.U. Inc. Solar ❑9-15 HP 016-15+ Floor Sinks - Urinal Fixtures Microwave Gas Service Outlets Water Closet Device Boxes . Pole Light Interceptors Water Heater - - Outlets Range Kitchen Sink Water Service Building Approved By Application Issued By Switches Sign Lavatories Auto -Wash Date Date Garbage Disposal I'Standing Sections IP—Trap - Laundry Trays Generator 00-5 KW 05.15 KW Trash Compactor Roof Drains - Reinspection Fee I $15 Duct- Under Ground Duct - Structural Duct- Ventilating — Exhaust System ❑ Multiple Firepl/Fact. Bit. ICBG+ Heating System & Ducting ❑0.100,000 BTU ❑ 100,000 Reinspection Fee , 1 $15 h, CMF 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting: Goldenrod - Assessor Issue Fea -. $ 3 - Reinspection Fee $15 Issue Fee $ 3 iANICAL FEES Hood or Type ❑ DEVELOPMENT SERVICES REQUIREMENTS: Canopy Type l l ❑ • Zoning Approved By Date - Building Approved By Application Issued By Date Date Refrigeration System ❑0-100,000 BTU ❑100,000 BTU i BUILDING PERMIT PLAN CHECK SUMMARY OF $ $ FEES SMTP PERMIT $ System Repair/Alteration Fire Dampers PLUMBING PLAN CHECK 25% ELECTRICAL PLAN CHECK 50% $ 1' $ $ $ ISSUANCE ENERGY P.C. GRADING MICROFILM $ $ $ $ Registers • MECHANICAL $ TOTAL FEE $ Issue Fee $ 3 PLAN CHECK 25% $ PLANNING Date # Inspector PO t SPA APPROVALS Permit# Date Inspector Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd: 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation i 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. _ 60. Backwash Lines, P -Trap, ❑ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final ' 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign. 68. APPROVED FOR PLASTERING 18. -Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final (Tj 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer 43. Backflow Irrigation -zj rx 44. Landscape Irrigation -System 45. Sound Attenuation 46. Handicap Regulations =? " 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed , 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co \51. CERTIFICATE OF OCCUPANCY 'o. Date IIJCONSTRUCTION AND VPOVALS hermit City of Costa Mesa Building Safety Department CERTIFICATE OF OCCUPANCY N? 2316 C P. O. Box 317 Costo Mew, California - The Building located at = • 10M EL COMIM WIV40 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group 1'2 Occupancy. Use of Building U ti44 Coleerrmsal n•tlAigg Legal Description 14106mol (See revise side for Metes and Bounds) Building Permit No. 2XII64 Electrical Permit No. a4ft Plumbing Permit No. 435ft Floor Load Signs have been installed as Room Capacity Signs have been instaled as required under Sec. 2308 U. B. C. required under Sec. 3301 (1) U. B. C. 17050. CERTIFICATE OF OCCUPANCY. (a) No apartment house, hotel, or lodging house shall be used or occupied until the owner or operator has been issued a valid certificate of occupancy by the enforcement agency. (b) A new certificate of occupancy shall be obtained whenever there is a change in: 1) Occupancy classification of a building or portion thereof 2) The number of apartments or guest rooms 3) Ownership If Group H Occupancy, number of apartments and/or guest rooms as required under Sec. 17050.1 (d), California Administrative Code, Title 8, Chapter 9, Article 8. Number of apartments and/or guest rooms EXTERIOR L GWALL COVERING N:OOd Shake By V1" DATE -y -� BUILDING AND WORK TO BE PERF TRMED l L-- ghborhood Shopping Center •L}i 1j , ,� . � f.Rcizr `bMG.H. I.DuY i- to • N O. FT. G ACKNOWLIDO! THAT I HAV! qFl O THIS APPLIGTION TN8 AMOUNT SHOWN UNDER VALUATION IB FOR THE z TE THAT THE ABOVE IB CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT PER ONLY. O ALL CITY OR ANCHH AND BTArB LAWS REGULATING m G CONRTR U ON.� VALUATION PERMITTEE 3.S U RE OP�L�1 ��L��/��y, /�/y _TEP /// O C OIZED AGENT _ u TOTAL FEE S 9.�i G7.5 RECEIVED 9Y 4 196<, . r�31AsMESA BUILDINCrSAFETY DEPARTMENT ='iANCE DEPT, O.�BOja ] COSTA MESA. CALIFORNIA AY OF COSTA MESA A. .` l l Fort{?�Ap 1 cont to Fill tl. compl4fe } APPLICATION FOR PERMIT Ti rilT�vv, A _ '.IT*�1%^541TYPE OR PRINT C. t BUILDING /0-:u ' For Office Use Only BUILDING ADDRESS 1011- El Camino Drive 1 ,q¢C[Irt NO. PjlIMI� , COSTA MESA, CALIFORNIA R[C[IVO [Y DATE R[C IV DA ISSUE Inc. - -6- " OWNER Triple D MAIL ADDRESS 1598 Monrovia Avenue BUILDING ADDRESS FIRE /,/ "Y CITY Neerport Beach No`846-3958 ZONE TYPE GROUP Ie APPROVED CRC NIGIER Ray 1.evanas Np1673-7010 BY DATE ONING ADDRESS 3432 Via Oporto, N.B. NO. IF� vsR or Lw• Puna BUILD CONTRACTOR Don K011 Coo, Inc. rx r �(Z ADDRESS 1598 Monrovia Avenue LEGALEBCRIPTION -� 11II A,P.NO. L)O t 551 �+• 14 ��' �'L� CITY Newport Beach, C` llf. NOTE: NO EAVE OVERHANG SHALL BE LESS THAN STATE NO. ND. 646-3958 90' TO SIDE 3 REAR P. L SIZE NO. OF BLDGB. OF LOT -0- EAVES ALLOWED (U. B. C. REQUIREMENT) Now on LOT YARDS APPROVED YARDSAPPROVED USEOF - EXISTING BLDG, MAIN BUILDING ACCESSORY BUILDING (FROM C/L TREE SETBACK LINE FROM FR O .FT. FT. CENTER OF STREET REAR YARD SIDE YARD I LEFT I RIGHT R. SIDE FT. FT. DESCRIPTION OF WORK [��() L. SIDE 0, Fr. FT. ALTERADITION I X I REAR I DISTANCE SET. SET. MAIN & REPAIR MOVINGTIONI DENOL SH MAIN SLOGS. ACCESS. BLDGS. BUILD NO. OF BUI 7�T'9[1—f_.rl n_ .. , 1 nn•�eamn 7 VAR.# OATS .. e q •CCG/.\/mll EXTERIOR L GWALL COVERING N:OOd Shake By V1" DATE -y -� BUILDING AND WORK TO BE PERF TRMED l L-- ghborhood Shopping Center •L}i 1j , ,� . � f.Rcizr `bMG.H. I.DuY i- to • N O. FT. G ACKNOWLIDO! THAT I HAV! qFl O THIS APPLIGTION TN8 AMOUNT SHOWN UNDER VALUATION IB FOR THE z TE THAT THE ABOVE IB CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT PER ONLY. O ALL CITY OR ANCHH AND BTArB LAWS REGULATING m G CONRTR U ON.� VALUATION PERMITTEE 3.S U RE OP�L�1 ��L��/��y, /�/y _TEP /// O C OIZED AGENT _ u TOTAL FEE S 9.�i G7.5 :,. 93253 :,COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 317 COSTA MESA, CALIFORNIA For Applicant to Fill In Completely TYPE OR. PRINT \DDRESS / / jCC�OSTA MESA, CALIFORNIA � )WNER 27,AkC D '■ / OF 0 SETBACK DESCRIPTION OF EXTERIOR WALL COVERING USE OF BUILDIN IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COM- PLY WIYH ALL CITY ORDINANCES AND STAT/g LAWS REGULATING BUILDING CONSTRY"N.,�F_ /l,-%/ .• 0 AUTHORIZED AGENT FEE RECEIVED NOV 30 1964 FINANCE DEPT. IINANCEDEPT.. APpCbN'FbTAP" BUILDING For Office Use Only RECEIPT NO. I PERMIT No. _ REI NG ADSS FIRE ZONE TYPE GROUP APPROVED �f BY i DATE NING TANi NO. OP USEOFNBW /. PLANS "Y BUILDIND "GAL DESCRIP ION{' V' A. P. NO. 141 / —(, NOTE: NO CAVE OVERHANG SHALL BE LESS THAN YARDS VED YARDS APPROVED MAIN BUILDING _ I ACCESSORY BUILDING I DISTANCE BET. I BET. MAIN 8 MAIN BLDGS. ACCESS. SLOGS. VAR.# DATE _ N SD. FT. P THE AMOUNT SHOWN UNDER VALUATIONIS FOR THE 4 PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O VALUATION PERMITFEE $ 1� ` __ � a Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. - - 6"� - - l,I (• t T 1' GY OF COSTFI'MESA! CONs'TRUCTION PERMIT P IT NO 2 —' %. ,TRACT NO. LOT NO. :goJ. - BL i - i ... ' J J�ZtiL Applicant's Mailing Address - - TYPE OF CONSTRUCTION NEW ADD ALTERATION • REPAIR -_ ❑ ❑ Project AddressN CONVERSION'❑ DEMOLISH OTHER Owner's Name hon AuR—C I�IQOFVj(ORK - - - - ZONING REGULATIONS Ia.: A �n•- 3 I . . FK4 ,VO - - - - Address l ,. _ _ - MA 'TYPE PERMIT GRADING FOUNDATION STRUCTURAL '. A. P-. ;is. —4q ^/.' ZONE - Arch/Eng.. Lice Se Npa ;ENANTI ❑ ELECTRICAL' ❑IPLUMBING ❑ MECHANICAL - PLNG. REF. yIs- -. BUILDING - - Address % '' i A .mow , .❑,BOTHER I ,- , .- _ TO BUILDING , I _ Contractor's Nam hone -' PROJECT DESCRIPTION 5q. F=� i t' �OCCUPAN P P LINE q EA VP.RD (TO P/C) ' Address lmaifng) - ''CONSTRUCT.ION TYPE �' VALUATION$ LEFT SIDE VAFID IGHT V D' � , , ! License No: I,ZONE If-• GRAOINGCU.VDS. t PKG. SPACE'REO. IDED LICENSED• CONTRACTOR DECLARATION I Remarks: ' i •_f^�'• S6V ZZ - _STREET WIDTH i I PARK FEE,$ Iv. I-hereby,afflrirl that -Ilam licensed' under provisions of•Charter,9 (commencing - ` with section 7000) of Division 3 of the Business and Professions Code, and 2 t1 71 j ��—�& T S'eLL Wel-Fes TT ! T SPECIAL CONDITIONS: L my license as in full force and. effect. t i - l � - �7 License - ' i� cgPu N.+�/ I I 4 PLUMBING ° j , - 10 � uCl/p5z+ Data :�(_P SI9 toe Lam' 1 WORKE S' MPENSATION DEC TION Bar Sink ( Server Cap . ELECTRICAL :. • `eraby,aftirmihatl.have a iertifirate of,consent', o self -Insure of-a.cerlifiwte _ _ _ - ;-., _. -- backflow Preventar -• - - -Sewer Connection -- _..-..._ Automatic Washer , - - (Meter ❑over 100 amps - Workers' Compensation Insurance„ or a certified' copy thereof (Section. 00 Lab .f.L I 7�iO �mpanv N.S. CO: Of N•Ii. Backflow Irrigation .i Solar Collectors ( ' ! Construction Pole .- ,Sub Panel, t N0.�%G�Z t - -` y - I Certified PY Is hereby turnliheG. : f . Bathtubs Solar Pi ' ; 4 _ _ Ping I , Cooking Um[ ° I •�' Sub Pole;f ! ; 1 Certf p f awApIth theoity I I ., r f Clarifiers • Solar Tank; + t t I. ( Dishwasher - 1 )Motors 00.1 HP Date—Applicant— 1 -HXEM PTIO N;FROM WORKERS' COMPE f0 LARATI if is 1t 1 , > OfyefS -OGas -D Electric;••- `— �"'- - " IInC.Solar' ❑g-,15 HP 16d 5+ , ' Dish Washer l 4 , i Swimming Pool, w/Spa) : (This section need not De completed the permit or one hundred ($100) or less): 1 t t I l ( f - - - - I A Fan • .. 'f'•i, :Microwave ^„I I certify that In the performance of the work for w l h thl; permit is Issued I �j 9 , Drinking Fountains ( Uncal ',�•-, ( , _ -. : shall} not emplo any parson In any m o s to b ectYo the Worker •: o p (Laws of Call, nl .I - - , i Floor Drains I I I Water Cloxt� + F F.A.U. - r f + Pole Light }� Date' 19nalure !-NOT 1C : If, er-ma Ing -this declaratl u hould become Dledt to the — Floor-Sink6 - - -- + - Water Heeiei�' --� --� - _ ' , .1f Fixtures _� i jRange , i Workers' Com pehsation provisions of the Labor Code, -yo must forthwith comply with. Such provislonsr or ''this }permit Ishail betleemetl revoked.: - f . Gat $erJice ;Duct@ts i Water Service 4 1 S • Device Boxes r Sign; . CONSTRUCTION! NOING AGENCY +-� , ,I I I hereby affirm that there is abonstruction.lending agencyrfor the performance 'work - 1 ' _ Outlets ( ' ( I Standing Sections - ' 3 ZO Interceptare �` + -3 ! - r, I �„ j .. ' 1 - '- of the for( is , Is; permit' is Issued }(Section 3097 Civ, CJ 's, Name- - ' I - KRcheg5inkl ( - i : ,- l •.' I 0 .Switches' -I. �-„+' ; `Trost} Compactor t Z XLander X Lenders fidtlres• � .' + , i- OWNE R,BIIILDER DEC LA RAT ON ( Lavatories-. , ( r I ., Garbage Disposal O 1 herebyliffirin'thit I am -exempt -from the: Contractor's' License Law for Me 7031:5 Professional) L - P—Trap' ` - 1 Generator 00-5 KW 05-15'KW I following reason (Section Business and Code: Any city or , county which requires a permit to construct, alter, Improve; demolish or repair any structure, prior to Its; Issuance, alio requires the-applicanbfor such permit I - , - p I Roof Drains " J j ,• -• .' Trensformer 015-50 KIN I .. :Q , , I 1 to file a signed statement -that he/she Is licensed pursuant to the provisions of ( I the Contiactor'z'License Law (Chapter 9 (commencing' with Section 7000) of 1 ' 1 1 '+ l i 1 `- • • ; t 1 1 ❑50,'f KVA,", w 1� ,,'Reinepeption Foe � I yvislon 3'of the Business and Professions Code)'1or'that he/she'is•exempt ( efrom and the' basis for the alleged axe'mption.Any'vtola violation ofl5action Showers _ ; Reinspection;Fae _ ` I •, Meter �upa0 100 am_p5 rlssue Fee! ( $ 3 ' `P>"SES by any applicant foria: permit -subjects, thetapplicant to a-civll : Lir all of not more than five. hundred dollars ($500). ! A I , • a I I'_ � • Seivfte Sink Issue Fee i $ 3 1 - - v Zoning Approved BY ' . I — - Ddte 1 (J I,'as joivner of the'property or` my employees With wages as that r sale com ensation' will -do the work, and the structure is not Intended or offered sale ; I t t _ i - MECHANICAL 1 y , + , • i t 'Application Approved By - f hi ` .f - I 'Date I I I for I(Secfion 7044, Bust n ass, and; Professional Code. Tha Cont rector's I _ ' " 1 t License Law does not apply to,an owner of a property who builds or Improves thereon„and ,who'd oes. such' work himself/herself or through his or her own Boller ' Refrigeration System I y '• Application Issued By < ,� fj 1 + - Dete employees, provttla that such improvements are'not intended or offered for sale. If however, the bulld In or Improvement Is sold within one.yearof com- j Duct -Under Ground ❑0-,100,000 BTU ❑100,0068TU, , t ' U MARY OF FEES y elation, the owner:wlll have the burtlan of proving he/she did not build or Im- r ve for the urpose of sale'. _ , PPmmyy P ) r i ) Duct - Structural i System Re air/Alteration P - ' . - I .BUILDING PEflM1T $ r SMTP $ ' �• / 7 ; /\ 1, as ownei of the property, ain a 6iuslve ly contracting with; icensed con. tiattorsto construct I e' role t (Section 7044, Business. and Professions Code:. j _ Duct - Ventilating _, . + _ W _ M ^_� + 1 PLAN CHECK $ PERMIT i a Contractor's License Law does not apply to an owner of Property who-. buittls or Im roves thereon, and who contracts for such p projects with Icon- tractor(s) license purtuant to the Contractors License Law): I , Exhaust System ❑ Multiple ❑ • - - # , .PLUMBING $ ' �! �• .00 ISSUANCE ; ! .� _ $ t ' - ❑ ham exempt under Section B, & P. C. for this reason Firepl/Fact. Bit. ICBG ak { *PLAN CHECK' ,$ .00. GRADING - i $ i I ' j , - Heating System & Ducting , ,•i I ,. + ELECTRICAL .' $ LO a x'3' $ Date i Owner, ' ( 1 information certify- that'I?have-read to Is, application and state that the -above ❑6100,000'BTU 0100,000 . -- - ! ' ', 1PLAN CHECK} "� $ _ ' MICROFILM - I / $ 1 } information is correct. I agree tc comply with all city and county ordinances ; t 1 1 I •$, �O TOTAL FEE; 1 $ . and•stata ting b Ing cons uction,!and hereby authorize repro-' sentalives f ;this It t o the above-mentioned pro art for y Hood or Type I ❑�' i Reinspection Fee; ,•''MECHANICAL p - + i ''^ ;.� 1 1 Inspection p ose` ( 1 I : I �' Cano T e II ❑I i 1 - .LESS ,PLAN CHECK $t I '' ADVANCED,PC ' 1 $ l JK Signature 1 Date Ori vers' License or S ' j Registers f l l . Issue Fee $ 3 , ,• , i F,INAL FEE 1 / • $ { s� z - : CMF 0865- /� •rte - Building; Canary - Appllcant: Pink - Accounting; a6 rev. 12 82 wh Goldenrod - Assessor -• '^ -' - - ` 1 - .'CONSTRUCTION AND PLANNING ; ' ^• " - . . =-. -- ,- - POOL `A' - - APPROVALS-; Permit�h - -Dates ,:"Inspector ;VAPPROVALS ."PeimitylE - Date" Inspector 1. Temporary;bectrical Service or Pole ., „" : ; ( U. -Pool & Equipment Location ' 2.rSoil Pipe-Uridrgrnd` -53._ Steel Reinforcement - 3: Electrical Condiiit Utilitv-Undrgrnd. - •;r '� 54. Forms_ ,4 ! . Electri;;'FConduh-Undrgrnd. Y - ' - F • 55: Electrical Bonding - _ 5. Steel Reinforcement 56. Rough:Plumbing &Pressure Test & iElectrical UFER Grnd =* j- t• 57: APPROVAL`'TO COVER-GUNITE. 7. Footing's t `.: j ( q ..�° ' -- ..58'. •Electrical Conduit-Undramd: " 8., Foundation-- I ! ' - 59. Gas Pipe;�O.Undrgrnd., Test 9. ,Water PiperUntlrgrnd. „ - `; ` `60. Backwash Lines,:P-Trap, 0 Undrgrnd. 10. Structural F16orSystem 61. 'APPROVAL TO DECK 11. roperty Sewer -Line &'House Connection' - 62. Backwash &Receptor-Final ' 12. Sewer Cap; 63. Heater &Vent-Final - - 13..Roof Drains' - 64. Plumbing-Sy -Final 14. Rough Plumbing : - MAO,-? ' 65. Electrical-Final `75. Rough Electrical=Conduit- ---- -"-- "---' - ",66: So!,A System-Final - - - - - - - 16. Rough-Elect is Wiring wAcL•3 eNc C� 67: Fencing &,Access Approval -17. Rough Wiririg;Sign; ;r M. APPROVED FOR PLASTERING - 18.1 Rough El Beiling' ,I i ectric1.alzTar C ,g3 � � 69. POOL/SPA SYSTEMS FINAL 19.-Rough ;Heating & Air.Conditioning : I I" I FIRE DEPT. REQUIREMENT, APPROVALS Permit �k . . 201 RbugWFactory Fireplace - •i , i.. 21. Ducts,lin Structure. 70. Underground Hydro " 22: Ducts„Ventilating .�) a i,' ' i j 71. Product Piping ElGas 0Oil ' .23. Gas:PiperRough & Test �•" '•-+ ' r ' 72: Underground Flush 24! Roof Framing, `' i . . •j'='k- - - 73.E Undergrnd.Storage Tank ❑Gas 0Oil.• 25. Roof Sheathing , }': 74. Overhead Hydro -26_.T-Bar Ceiling (Structural), &'Monocoat' 4%14-63 , B,'✓� 75. Dry Chemical , :27: Frame and Flashing 1 ,I ' - - 76. r Dy Standpipe 1 2$. Cathing & Siding ; = 77. FIXED SYSTEM FINAL 29. Insulation it q' �` 78. FIRE PREV. FINAL - ' 30. Drywall Nailing f "� •! �J�.�3 ., ,Notes: 31. Plaster Brown Coati.,' 32.*ElectricaI,Power Meter-Final �' "• • �:;' �' 33. Final Electric ' ' ( � • � N 34. Final Heating & Air Conditioning _ 35. Final Gas Pipe-Test - - - 36. Hood or Canopy'ejWe ' - 37. Final Factory Fireplace.` '' 'f,,. l 1 I - • •' 38. Final Plumbing'' - 44�2,p-,P-i' 10A;e� 0,642- 39. Water Seyyioe-Final'OALO 40. Gas Service-Final-•.' i. - ZP 41. Solar Dome;tic=Final ` it ; ••� "; 42. Backflow Preventer, - I '• '_ ` t _ 43. Backflow Irrigation' - j lf%" rAfro 44. Landscape ftrigation System - 45. Sound 'Attenuation 46. Handicap Regulations , •!',� I, ' 47. FINAL STRUCTURE•&BUILDI.NGr /1 o? 48. Special Requirements Completed 49. Electric Release to Edisonl 50. Gas Release to Southern California Gas Co- .�. 51. CERTIFICATE OF OCCUPANCY No. Date - - a r. 53 APPLICATION FOR STRUCTURAL PERMIT 7 For Applicant to Fill in Completely —Use Ink Only REDtIyGD Mil N° 50549 BUILDING' C ( O ADDRESS A.P. NO. Pyi I —^ OWNER N OR i ADDRESS/ D� C(l�Yf UNIT OR SPACE NO. MAILING ADDRESS �j31 L ' ,a TR.NO.4 T /��/� BLK. Z lZ �f// ::90 NEW ADD ALTER REPAIR MOVING DEMOLISH ��+--� TEL G CITY o-� /� N0.,�7f(/IZ CONSTRUCTION y LENDER !r .� BRANCH O OWNER ADDRESS T VALUE USE -4;(/ / •��, E ARCHITECT TEL. OR ENGINEER ZONE TVP N GROUP Z ADDRESS CONTRACTOR D APPROVED o By DATE —Zz7—p ADDRESS TEL. CITY NO. STATE CITY LIC. NO. LIC. NO. APPROVED SETBACKS SIZENO. Of LOT OF BLDGS. NOW ON LOT (FROM C/L STREET) ONT Fou I USE OF EXISTING BLDG. 12 Separate permits are required for electric, plumbing and heating work: L SIDE F REAR USE OF BUILDING AND TO BE PERFORMED PLANNING ACTION /WORK TE APPROVED APPROVED art — v^� 1 hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of the State of California. 1 hereby certify that I am properly licensed as a contractor under the State of California Business and Profe one Code, Division 3, Chapter 9, and at such licenses are In ful force antl effect, or 1 am exempt fro the p ovisions of the tet of California Business and Professions ode, ' islon 3, Cha ter Signature of e� Permittee SQ. FT. 30o . — THE AMOUNT SHOWN UNDER VALUATION IS FOR THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: VALUATION S is DO, PERMIT FEE S SOQ PLAN CHECK E TAX $ or ` AuthorizetlA e Date TOTAL PAID E 50 50 ,PPLICATION FOR A BUILDING PEt_.IIT Tract BIOCk LO[ BUILDING PERMIT NO. 1 p Electrical Permit No. BuI1tlIn9 Address b Plumin9 Permit No. / r1// Cross Ar ea�.s S� Street r1%l vs' /Il Mechanical Permit No. OwnerV- b / �//}I Type of Project: El Now Alter ❑ Addition Address s��-j�� ❑ Repair ❑ Convert ❑ Domo ❑ Occupancy Pmt. City Zip Phone A.P. Sup. Dist./ Insp. Area Architect/ G /� Designer t/ (- License NO. Zone SPI. Pmt. No. Setbacks P/L F ont C/L St. Street Width Address Yards Le Right ear CIIY ZIP Phone ave _M_0T. e g Engineer License No. _ffar ng Raoul ad Provide oversir- Atltlr¢Ss Struct o. of No. of City Zip Phone Height for jos Family LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm that I am licensed under provisions of Chapter 9 Park Fees YesFee Required No C T. Receipt Zoning Approved BY: Date (commencing with Section 7000 of Division 3 of the Business and Professions Code, and my license is in full force and effect). License Clas License Number Data Contractor Misc. Address Proposed Use of Structure City and Zip Phone 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, Civ. C.). Otc. Class Type Cons[. Cotle Year USE/OCCUPA Y SIZE SO. FT. Lender's Name Lender's Address 1. OWNER -BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law to the following reason: I, as owner of the property, or my employees with wages as their 2. sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ A, as Owner of the pro arty, am exclusive contracting with 3 4' Iitansed contractors to eon ruct t a proje t. ❑ I em exempt�y nder Sec. B&P for this eason Total Valuation Dern ��-O'Ti00wner WORKERS' COI DECLARATION Encroachment Permit Required Yes ❑ No JENSATION I hereby affirm that I haw./e a certificate of consent to self -insure, or acertificate of Workers'Componsation Insurance, or a certified copy thereof, Policy No Company Grading Pmt. Required ❑ Yes ❑ No Grading Pmt. No. ❑ Certified copy is hereby furnished. ❑ certified copy is filed with Orange County, EMA. Data Applicant Rough Grading Approved by: s Date CERTIFICATE OF EXEMPTION \ FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if permit is for $100 or less). \ I certify that in the performance of the work for which this permit is PERMIT FEES , issued, I shell not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Data Applicant NOTICE TO APPLICANT: If, after making this Certificate of Structural S Plan Check $ Exemption, you should become subject to the Workers' Compensation ElettllWl $ Invest. $ provisions of the Labor Code, you must forthwith comply with suchSpecial provisions or this permit shell be tleomotl revoked. Plumbing $ 1 CERTIFY THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INF,QRMATION IS CORRECT. I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REL ATI TO BUILDI CONSTRUCTION, AND HEREBY AUTH- OR ZE R PRESEN AT VES OF THIS COUNTY TO ENTER UPON Mechanical $ TH AB VE ME 1 ED PROPERTY FOR INSPECTION PUP. PO ES.1 1, 0 Pre-Gratle Inspection $ S net a of A ppsi an ' r Agent Dae Pre -Grade Ret. No. $ Permit Issue $ ' nt�� Print Applica's Age S's Name All spaces within this box must be completed to process Plan Check By: Approve Approved: GMF 0335.46 (BU -28) rev. 6/80 PPFP/ Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. ATY,0F ONSTA MESATRACT NO. L NO. BLDG. - \ /COIVSTRUCTION PERMIT p IT'N0I X Project Address TYPE OF CONSTRUCTION LJ NEW ADD. ALTERATION REPAIR ar age Applicant's Mailin Ad �� ,♦♦'' 1:1 CONVERSION El DEMOLISH rJ LJ OTHER A.P. # 177_77I -- ressa Reinspection Fee - $ Owner's Name hone ' T DESCRIPTION OF WORK S Main Building: c I Address M TVPE PERMIT��/ GRADING VENANT FOUNDATIfO--N� STRUCTURAL - T — Front Zoning Approved By��l.: Arch/Eng. License NO.' L4'J ELECTRICAL PLUMBING LYJ MECHANIOAL B Rear Address ❑ BOTHER - A f ! System Repair/Alteration - C Right Contractor's Nam hone PROJECT DESCRIPTION SO. FT. OCCUPANCv - — Address(malling) CON STRUCTION TYPE VALUATION$ S Left --- ZONE - GRADING CU.YDS. _T ACRES Ping. Ref. # City License No. _ LICENSED CONTRACTOR DECLARATION Remarks: ' Parking Req./Provided 1 hereby affirm that I am licensed undir provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and Use of Building: �e�_frG� my license is in full force and,effect. PLAN CHECK $ License Class - - License No. PLUMBING - FEES Planning Notes: r �- Date i • Signature Bar Sink Showers - , WORKERS' COMPENSATION DECLARATION '' 1 hereby affirm that I have a certificate of consent to self -insure or a certificate Backflow Preventer - Service Sink I of. Workers' Compensatlon .Insurance, or z certified. copy thereof •(Section . � - - 3800, Lab. C.) , Backflow Irrigation Sewer Cap - - E Policy No. Company Certified copy is hereby furnished. H Bathtubs Sewer Connection. I AutOmBtic Washer Certified copy is filed with the city Building Division. - -r r _ Date Applicant ' Clarifiers Solar Collectors' Construction Pole Sub. EXEMPTION FROM.WORKERS"COMPENSATION DECLARATION Dish Washer $Dior Piping - - - Cookie Unit (This section need not be completed if the permit is for one hundred ($100) or g . less) 1 certify that in the performance of the work for which this permit Is Issued I Drinking Fountains Solar Tank F�, _ Dishwasher ' shall not employ any person in any manner so as tome subject to the Work . om ensati ws of Calilew+la.l C-( A ! Floor Drains' Swimming Pool'liv/Spa Dryers ❑Gas ❑Electric Oate Ignature r>>r�"`l'F�tir NOTICE: f, aft¢ making this tleclaratio ,you should become subject to the Floor Sinks Urinal �srl , Fan , Workers' Compensation provisions -of the -Labor Code, -you must forthwith - comply with such provisions or this, permit . Shall be ltleemed revo ketl. Gas Service S[Outlets, Water Closet F.A: U. CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the performance Ihterceptors Water Heater, Fixtures of the work for welch this persnit is, issued .(Section 3097 Civ. C.) - - j Lender's Name /i7CTB. Kiichen Sink , - Water Service Device Boxes Lender's'Atltlrefs r OWNER BUILDER DECLARATION - - Lavatories Outlets I hereby' affirm that 1 am exempt from the Contrac[or's.License Law for the following reason (Section -7031.5 Business and'Professlonal Code: Any city or p—TTa - p_ - Z Switches county which requires a permit to construct, alter. Improve, demolish or repair 'anv structure. orlor to Its Issuance. also requires the aoolicant for such nermil Rnnf'Drains' _ G b Di I 7031.5 by. any -applicant for a permit subjects the' applicant to a civil mer ity of not more than five hundred dollars ($500). L11. as owner of the! property or my employees with wages' as their sole 'compensation, will do the work, and the structure is not intended or offered for sale (Section ,7044, Business and Professional Code: The' Contractor's License Law does not apply to an owner of a property Who builds or Improves thereon, and who does such work himself/herself or through his or her own employees, provided that such,lmprovements are not Intended or offered for , sale. If, however, the building or Improvement Is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or im- rove for the purpose of sale). 1, as owner of the property, am exclusively contracting with licensed con- tractorsto construct the project (Section 7044, Business and Professions Code. The Contractor's License Law ddoes not apply to.an owner. of property who builds or improves thereon, and who contracts for such projects with a con. tractor(s) license pursuant to the Cnn Uaptor's License Law). , En am exe)Apt under $gctiotl r Y''// B.A P. G• for this reason that I have read the above ,Reinspection Fee ; .$25 Boiler - - Duct - Under, Ground 1 Duct - Structural Duct - Ventilating xhausi System ❑ Multiple ❑ Firepl/Fact, Bit. ICBOi'k Heating System & Ducting 00-100,000 BTU ❑ 100,000 BT 8 I Signature s DateE/'C I7� O Drivers' License o,SS Reinspection Fee $25 ICMF 0865-46 rev, 7/83 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor .' Di ar age SMIP $ Generator 00.5 KW ❑5-15 Issue Fee $ 3 Reinspection Fee - $ MECHANICALFEES $ Hood or Type 1 9z GRADING $ PUBLIC SERVICES R U �i EE'll Canopy Type 11 C1J ` 4 Zoning Approved By��l.: , $ OO Application Approved By — Application Issued By Refrigeration System 130-100,000 BTU ❑100,000 BTU 2 f BUILDING PERMIT $ PLAN CHECK -$ System Repair/Alteration - PLUMBING . $ ' PLAN CHECK $ _ ELECTRICAL $ PLAN CHECK j $ ' MECHANICAL $ Issue Fee $ 3 PLAN CHECK $ 6893 10/06/83 -Zone ('- ( - Park -Fees , t TICAL FEES Transformer ❑ 15;50 KW ❑ 50+ KW J Meter ❑up to -100 amps - Meter ❑over 100 amps` Motors 00-1 HP &'V% - B Inc.Solar 09-15 HP 016-15+ Pole Light Range Sign I Standing Sections Trash Compactor , Issue Fee' , $ 3 O N I N G R E 0 U I' R E M E FEES SMIP $ PERMIT ISSUANCE $ ENERGY P.C. $ GRADING $ - MICROFILM $ TOTALFEE , $ OO CONSTRUCTION AND PLANNING r' APPROVALS Permit # Date Inspector POOL & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe'Undrgrnd. 53. Steel Reinforcement 3. Electrical Condurt Utility-Undrgrnd. - - 54. Forms ` 4. Electrical Conduit-Undrgrnd. - 55. Electrical Bonding ' 5. Steel Reinforcement - 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings .` . 58. Electrical Conduit-Undrgrnd. 8. Foundation �- 59. Gas Pipe, 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 17.6. Rough Electric Wiring 67. Fencing &.Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 8. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL . 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT -APPROVALS Permit # -26. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 1.. 71. Product Piping OGas 0Oil 23, Gas Pipe -Rough &-Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27'. Frame and Flashing 76. Dry Standpipe 28. Lathing,& Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing i : HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat£' 79. FINAL INSPECTION 32. Electrical Power Meter -Final ,80. FOOD CERTIFICATE ISSUED ' 33. Final Electric tNotes: ''� 1- 34. Final Heating & Air Conditioning , 35. Final Gas Pipe -Test . 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final - 42. Backflow Preventer - - 43. Backflow Irrigation 44. ,Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison - - 50. Gas Release to Southern California Gas Co - 51. CERTIFICATE OF OCCUPANCY No. Date Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. 9260 1 1/ 17/ 9'] CITY OF COSTA MESA CONSTRUCTION PERMIT. Project Address —/' / 4 F L.• Gfq i'vlf y,/ U Applicant's Mailing Address _ Owner's Name LC1 t A PptS �RTtRfrl Phone Addressloll r-.'. G i0rr /rJ U Arch/Eng. License No. Address Contractor's Nam¢ c,&A6t U"t^J.,y r'zis ptPhone 534�SOV7 Address (mailing) 11 AS YL r=^ _ i I AZ _ City License No. LICENSED CONTRACTOR DECLARATION I hereby,aflirm that I' am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is In full forpe and effect. I 4 License Class (-'- Licen a No. 6�0 Date 0 -(Q-V'% Signaturel WORKERS' COMPENSATION DECLARATI N I hereby affirm that I have a certificate of consent to self -Insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section - 3800, Lab. C.) Policy No. Company try'I. Certified Copy is hereby furnishc d. g Certifieci co�7 Is filed with the city Bu Ing Division. 1s Date I t-fU'�yS' Applicant >_ y v EXEMPTION FROM WORKERS' COMPERSAT N ECLARATION (This section need not be completed If the permit is for one hundred ($100) or less).. I certify'[hat in the performance to the work for which this per is Issued. I ll shanot employ any person in any manner so as to become subject to the Workers' CompensationLawsCalifornia. Date —Signature NOTICE: If, 'mafter making this ions f the you mould became subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with. Such Or this ,permit,shall be tle¢metl revoked.. CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction agency for the performance of the work for which this. permit iss Issued (Section• 3097 Civ. C.): Lender's Name. Lender's Add—re's _ OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section ,7031.5 Business and Professional Code: Any city or county which requires a permit to construct, alter Improve, demolish or repair any structure, prior to Its Issuance, also requires tke applicant for such permit' to 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 Divi Sion 3 of the Business and Professions Code) or that he She IS exempt therefrom and the basis for the alleged exemption. Any,vlolation of Section 7031.5 by any applicant for a per mlt subjects the applicant to a civil enalty of not more than five hundred dollars ($500). 1. as owner of the orooertv or my emolovees ,with wanes as their sole sale tt,ecrion iv44, business anu rroresslonal Cope: Ine contractors :nse Law does not apply t0 an Owner Of a property Who builds or Improves ,eon, and who does such work hlmself/herself or through his or her own )levees, provided that such improvements are not Intended Or offered for If, however, the building or Improvement is sold within one year of com- .ion, the owner will have the burden of proving he/she did not build or Im- ve for the purpose of sale). 1, as owner of the property, am exclusively contracting with licensed con- dors to construct the project (Section 7044, Business and Professions Code: r Contractor's License Law does not apply to an owner of property who - Ids or Improves thereon, and who contracts for such projects with a con- .tor(s) license pursuant to the Contractor's License taw). Lam exempt under Section B. & P. C. for this reason Date Owner _ I hereby certify that 1 have read thi informal Ion is correct. "1 agree to com and slate laws relating to building co sentatives of this city; to enter up( inspection purpose t r. Signature �1+� Drivers' License 0 S YA that the above mty ordinances iuthorlie repre- I property for tk-0-1 TYPE OF CONSTRUCTION LJ NEW LJ ADD LJ ALTERATION, IJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER q•p•#/ —� DESCRIPTION OF WORK S Main Building: E ISSUANCE TYPE OF PERMIT GRADING 17 FOUNDATION 11 STRUCTURAL T Front ❑ TENANTi ❑ ELECTRICAL ❑ PLUMBING '❑ MECHANICAL $ GRADING 1-1OTHER A Rear $ C Right PROJECT DESCRIPTION SD. FT. occuPArvcY 'CONSTRUCTION TYPE VALUATIONS 41 .� $ Left' ZONE GRADI NGCU.YDS. ACRES Ping. Ref.+ Remarks: 6a,1 cit -L C ✓h ILA L_ � Ile l S5 Tz W\ Parking Req./Provided Use of Building: ' PLUMBING FEES I Planning Notes: Bar Sink Backflow Preventer Backflow Irrigation Bathtubs ' Clarifiers loor Drains Outlets Kitchen Sink Lavatories P .Trap ' Roof -Drains 'Reinspection Fee . I $25 Boiler Duct- Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Bit. ICBG + Heating System & Ducting ❑0.100,000 BTU 0100,0008T' Reinspection Fee CMF 0865-46 rev. 7/83- White-Building;Canary-Applicant;Pink- Accounting; Goldenrod - Assessor Service Sink Sewer Cap Sewer Connection Soler Collectors Solar Piping Solar Tank Swimming Pool w Urinal Water Closet Water Heater Water Service - Issue Fee 1ANICAL Hood or Type ❑ Canopy Type 11 ❑ Refrigeration System ❑O.100,000BTU ❑100,000 System RRI'P41Alteration Y r 1�,Issue Fee Automatic Washer Zone L (' Accessory Building: Park. ELECTRICAL Transformer 0 15=50 KW ❑ 50+KW Cooking Unit - - •Meter ❑up to 100 amps - Dishwasher Meter Dover 100 amps Dryers ❑Gas ❑Electric I,Sub P. Fan F.A.U. ' Fixtures Device Boxes Outlets Switches Garbage Disposal Generator 00.5 KW 05-15 KW O N 1 N G R E Q U ' 1 R E M E N T S FEES Motors 00-1 HP C31 X.-8 _ Inc. Solar 09-15 HP 016-15+ Microwave I Pole Light Range Sign r Standing Sections •. ,Trash Compactor $ 3 Reinspection Fee $25 Issue Fee FEES PUBLIC SERVICES REQUIREMENTS: Zoning Approved By Application Approved By •% / BUILDING PERMIT PLAN CHECK PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK MECHANICAL $ 3 PLAN CHECK $ 3 SUMMARY OF FEES $ D. s-0 SMIP $ $ / 3 3 7- PERMIT $ ISSUANCE $ ' $ ENERGY P.C. $ $ GRADING $ ' $ ' MICROFILM $ $ TOTALFEE $ 3�•3� CONSTRUCTION AND PLANNING APPROVALS Permit# F91�42 Date Inspector POOL & SPA APPROVALS Permit Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE ' 7. Footings. 58. Electrical Conduit-Undrgrnd. ' 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection - 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign _ 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit# 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping OGas OOil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O Gas O Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical -,.�• 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final•Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing, 39. Water Service -Final - 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer 43. Backflow Irrigation 44. -Landscape Irrigation System ' 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison - - 50. Gas Release to Southern California Gas Co 51. CERTIFIC ATEOFOCCUPANCY' No. Date